There’s a good chance some readers are going to find this post a bit too much on the TMI scale. I’m giving you fair warning. Turn back now. There’s balls. Or, well there were… balls voyage.
Honestly, never know how this kind of stuff might be misused in modern society. Someone will try and make money on it in some fucked up way. Someone else will shame it into something it’s not. But, the reality is men don’t talk nearly enough about health and well-being and just like everything else on this blog, it’s just another part of who I am and what’s on my mind.
In the United State’s the process of sex, pregnancy and birth is a glorious cluster-fuck of widespread cultural and scientific ignorance primarily driven by traditional puritanical Religious beliefs, a patriarchal and occasionally misogynistic capitalistic framework and misguided conservative social idealism clad as a poorly phrased marketing like “family values” and “pro-life.” This approach, at best, points people toward so-called solutions that only work by accident, but at worst carries costs on individuals and society that are beyond calculation. And, it’s not offset in any clear and thoughtful way at the moment either. Rather, a mish-mosh of compromises often comes together watering down actual medical community science, liberal and progressive social ideas and moderate voter preferences in such a way to tippy-toe around real conversations, never mind real solutions.
One way in which this occurs is specifically around the male contribution the status of procreation. The honest truth is women bear the undeniable burden of overseeing the procreative process. Not because they are the vessel of life once DNA is mixed, but because society has chosen then, to this point, to also have to figure out how to limit the DNA mixing in the first place.
Not that Men cannot participate. They can.
They can communicate with women about when a women might be fertile and make decisions about intimacy based on this. But, they often don’t. Things like periods tend to make some men squeamish, for example, so the rest of the conversation gets shut down. If they even realize that it’s their responsibility to ask in the first place – heck, even in so-called religious households that promote the “Rhythm Method,” for example, it’s not an equal task.
They can wear a condom. But, many try and come up with any excuse not to wear one. God forbid it’s not as “pleasurable” for them along the way that they might have to try harder by focusing on the woman to stay hard in the process. There’s some shitbag assumption than women are already taking some precaution despite the fact that sponges, diaphragms and other manual barriers are exceptionally more difficult to come by than OTC men’s condoms.
They could take hormones of their own. But, the side effects in the trials have continued to make men believe that it’s not worth the inconvenience even if the side effects for women’s hormones are as bad, if not worse, so there really aren’t many viable options on the market for men like there are in the wide variety of pills, vulva rings, IUDs, etc that exist leveraging a variety of, potentially toxic levels of, hormones.
They could get a vasectomy. But, neutering men isn’t exactly the kind of turn of phrase that would inspire it’s use. And even beyond the euphemism, the procedure is not well promoted or understood by men in general. It is so poorly positioned that the most recent social meme was actually to position it as an anti-abortion solution – as if that is going to appeal to a bunch of dudes pumped up on Viagra, Androgel and Muscle Milk while driving IROCs and open carrying AR-15s while thumping their Bibles to Porn Hub are really going to respond to that line of thinking anyhow. They’ve ll been told women can get their “tubes tied.”
This last option though is why we are here. This is my story…
When I first looked into a Vasectomy online I quickly found out getting snipped is 10-minute out-patient procedure that can take weeks, if not months, to even get approval for. The early research though provided me with three very important pieces of information which made my journey much easier
- I knew who to talk to in what order. Here’s what I ended up doing…
Therapy: I went to my therapist first and discussed family planning with them. I often joke that I go to therapy not because I am crazy but because the rest of the world is and I just want to stay sane in the face of society’s crazy. My therapist is awesome and every step of my relationship with my partner has gone through them at some point so when this started to surface as a possibility it went through them from the initial inclination through till now and will continue for the months, and probably years, to come. This is why I’ve been in therapy for more than a quarter century and why I have no inclination to cease it. You see a GP/PCP for physical health on an ongoing basis, a good relationship with a psycho-emotional one exists for the same reason.
Believe it or not, talking to a therapist is, in some cases, a prerequisite to the procedure and can be mandated by the insurance company, and/or the doctor performing the procedure, and/or local regulations, and/or cultural construct. The reasoning is that it’s semi-permanent and those involved want to make sure you really want to do it. It wasn’t necessary for me, but it might be fore you.
Significant Other: I went to my partner and we discussed family planning as a partnership. We’d briefly touched on the options in passing before but a full-on, frank conversation about the impact of where we were in our lives, what we expected of one another and our changing family and that of what to do next was a big assistance in the process.
Did you know that depending on who’s insurance is covering the procedure you might need an SO’s sign off…or, that regardless of how it’s covered you might be required by local regulation to disclose it to your SO, or that doctors might request it, or there could be other fiduciary responsibility for disclosure for cultural reasons?
General Practitioner, or Primary Care Physician: I already had a physical scheduled so I took the opportunity to bring it up with them as a part of my general health and well being. It’s a best practice, in general, to keep them appraised of this kind of stuff anyhow. Although I used to hate and fear going to the appointments, I have been fortunate enough to have a couple of good GPs lately which helped cast going in a different light.
As you may know, some insurance companies require PCP referrals and sign off on procedures. But, what you might not remember is in most cases the physician doing the procedure will probably also require the GP to sign off on your health before snipping, including having you get a wide range of blood tests and related info that they’ll need pre-procedure to make sure you could handle it in the first place. And, for your own piece of mind it’s not a bad thing to have either.
The Insurance Company: Always good to double check what’s covered. This includes the general coverage for the procedure. The Urologist. The Anesthesiologist if you’re using one. Any pre-procedure tests. The facility it is being done at. Any after care including medicines prescribed, possible follow ups at Emergency Care Facilities, and so on. The post-procedure tests such as final sperm count. Seriously, talk to them about the procedure if you’re not sure, don’t just read their gibberish, because there’s lots of ways to accrue unexpected bills and the costs can add up very, very quick if you’re not diligent.
Urologist: Generally speaking this is the physician who will do the procedure. It’s usually a good idea to get the sign off on a procedure for the operating doctor, no?
I did not interview multiple doctors or get multiple opinions for several reasons including the first impression of them and their staff was very good, my GP highly recommended them, when I researched them they had no outstanding legal issues or history or suits or fines, they were highly accredited with multiple awards, their online reviews were good, and I was able to speak with a couple of patients who all had kind words and, oh, yeah, my insurance covered them. However, when in doubt, for any reason, as with any medical treatment, seek a second or even third opinion.
The Anesthesiologist: If you’re using one (and honestly, this is not a high threshold of pain thing, get one if you can, it’s worth it) you’ll need to have a pre-procedure conversation with them as well.
Sperm Freezing Facility: I didn’t do this because I saw no need for it. Nor did my SO show interest in it. But, I’ll be honest, as a last form of due diligence I did look into it. It’s expensive as fuck. It’s not secure (don’t believe me, look into how much fraud there is in the industry).
- I knew what questions were coming and how to answer them.
For me, I went with my Significant Other to all the appointments, where my age as a forty-something is in all of my records, as is the revelation I have two toddler Padawan for whom I have had to come to appointments for/because of.
You’ll notice I’ve phrased this very thoughtfully. This is because every step of the way each of these is a key piece of information in order to proceed to the next step. There are a number of reasons why this is and here’s what I’ve learned:
Single dudes have the most difficult time getting snipped. Those in short(er) term relationships are only slightly better off. Those in documented long term relationships such as domestic partnerships and common law marriages get a little more leeway and maybe in some circumstances duration might even help. Married couples get even more still but duration is a key here also, since things like the three year, five year, seven year and decade itch are supposedly real — no joke, I actually did come across an example of a story where three years of marriage wasn’t enough for one practitioner.
Younger dudes have the most difficult time getting snipped. Retirement age usually is enough although, I wouldn’t hold my breath because at least one person would mention Charlie Chaplin. Generally, however, the closer a man’s age is to being older than the average age of menopause for women the easier is such that as you hit mid-life, somewhere between early 40s and late 50s, the easier it should get. During the thirties it’s a challenge. The twenties is, well, that’s a whole different conversation.
Fatherlessness has the most difficult for getting snipped. And, the key here is biological offspring, preferably more than one, too, mind you. No joke. You can have adopted and still run into questions about having your own. You can have more than one biological but if they are not of the same mother, or if they are not of different birth genders, or, believe it or not, if any of them have any kind of known “human defects” (sorry not even sure the all encompassing terms here) you might even face questions about if you want, need or desire another.
Dudes who don’t are poor have the most difficult for getting snipped. Basically, if you have enough money you can freeze sperm and in extreme cases can undo the procedure but for everyone else it’s fairly to very permanent and because of that the entirety of the industry doesn’t want to take chances you might change your mind … which leads us to the next part.
Straight Cis Males have the easiest time. This probably comes as a surprise to a lot of people by I am neither binary cis or binary straight. 25 years and counting of trying to figure this shit out and all I can tell you is going through the sterilization process I was super aware of the presumption of being traditional a “presenting” “cis male”. This should seem like it is a given since the cultural idea is if you’re “homo” rather than “hetero” and/or that if you’re “trans” rather than “cis” you don’t want to procreate anyhow but that’s not true at all. In my case both have the physical ability and emotional reasons from a purely external perception “to want to procreate” meant I was treated in a way that reflected those things, but, I was asked along the way if I was both cis and straight and, in being frank with practitioners and myself over the years the answers weren’t along the typical binary. I was ok because despite my so-called “deviance” I lead a typical “cis straight” life, thus, no problem. But if you vary and want the procedure, be forewarned.
Yeah, if you’re starting to think this though and go, woah, wait this is fucked up… realize, as I alluded to before, there’s some reasons why this though process occurs
Physical Reasons — The procedure isn’t fully reversible despite what the memes tell you. They bisect the Vas deferens in the scrotal sac. Then remove a portion of it. Cauterizing each end of the remaining aspects. And, in some cases also creating a tie-off on the ductorus deferans side of the bisection. This is by design to eliminate all known ways sperm can potentially circumvent the procedure.
The thoroughness of the modern procedure means it’s not easy to undo. You can get part of one sewn into the other, giving you one good ball to globe trod with. Or you can try and reconnect either or both along the original line but being “short.” Or, in some cases you you can try and use some other viable tube from another unrelated part of your body and hope it performs admirably. Or, you can get a transplant of a tube from someone else’s body, or in some cases some animals, and hope it works too. Or, you can try one of the synthetics that are available and hope it works. Oh, and by the way, most of these aren’t covered anyhow, that’s part of the push back, it’s not easy in any way shape or form.
Social Reasons — Men are expected to be dads. To spread their seed. Snipping too young, or too early in a relationship, or before they’ve otherwise spread it enough is not good, for whatever reason. Cum, lots, everywhere is the message, all else be damned.
Physician Reasons — Honestly, there is a bit of dichotomy of “do no harm” in the Hippocratic Oath that’s never been quite worked out. Read the above and tell me why some doctors might look at vasectomy as an intentional maiming under some of those circumstances.
Regulatory, Legislative and Legalistic Reasons — Honestly, there is a bit of dichotomy of “will of the people” in the Constitutional Oath that’s never been quite worked out. Read the above and tell me why some politicians might look at vasectomy as an intentional maiming under some of those circumstances.
Insurance reasons — US Health Care is totally for profit. So, yeah, it’s for profit insurance and it is afraid of, well everything. Lawsuits. Regulation. Social change.
- I knew what to expect
Knowing all aspects of what’s above I knew what was expected from me from the local regulations to the health care providers involved to the insurance companies to my own out-of-pocket responsibilities and that of society around me, including my significant other to get to the day of surgery… and yes, it is surgery even if you do the most simple version of it at this point.
Pain – I mean, what is your pain tolerance? I have several pieces of ink that clear the six square inches of high volume shading, I’ve been stung by bees in my ear canal, eye lid and between my toes, I’ve broken the coccyx in my lower spine, xiphoid process below my sternum, and badly fragged my third metacarpal among others in my hand and wrist among other strains and sprains. I have advanced, youth onset, Psoriatic Arthritis. I have additional problems that I don’t need or want to document here.
I know pain. This was tolerable both immediate and in the mid term. Personally, I didn’t use the short term prescription pain killers and anti-inflams, but I understand why someone might. I barely used OTC pain killers and no anti-inflams but again I understand why someone might. All I really relied on was the pills and antibacterial topicals for their perscribed time frames. That and a lot of clean jock straps…
Support: Because jock straps can be sexy. No really. Wear that shit before you get snipped and get used to how it feels and how it’s perceived. There are a lot of nice ones out there these days that aren’t beige dude or bleached white as if they came from the hospital or your 5th grade PE teacher nightmares (assuming your at least late Gen-X/Xenial/early former Gen-Y and know what I’m referring to)