The Subtle Art and Exploration of the Vasectomy

I am going to open up in a rare moment of vulnerability here and speak on a process that I just went through. Most likely will be a long read, but for me this is important. I have flipped back and forth all weekend trying to decide if I should share or not, and I have landed on the understanding that I should; as a man, as a sex therapist, and as an ally for the rights of women and their choice in their reproduction.

I had a vasectomy this past week, which has ended up being one of the most profound, deeply emotional experiences I have had. One of the reasons why I am exploring this here is that as a culture, we rarely hear of the male perspective of the process, what it entails, and what are the internal processes like. Much of what you read out there on the internet washes over it like it is a dentist appointment and tooth cleaning. In and out, over your lunch break. Conceptually, yes, it is that easy. Local numbing, a few cuts, and you are in and out in 30 minutes. What is not spoken on is the emotions that can/do come with self-selecting out of the gene pool of the human race. I am a single guy, no children, and almost 50, so not really planning the kid route at this point. My path towards my decision for self-selection into sterilization was mainly around the willingness to take responsibility for my choice not to have kids, and not burden any possible partner I will have for having to hold that choice for me. It is both freeing and constricting at the same time. Hard to define, yet very visceral in its emotional connection to who I am, as a biological animal who has a genetic drive to pass down my genes to offspring, like anyone else. A deep part of me did NOT want this process, the part of my being that resisted any way of cutting myself away from society in that way. Even the doctor doing the surgery commented on my body's will to stay intact was unlike anything he had witnessed before (it was a struggle to finish the surgery he said and had to fight my body at times). It has been something I have been holding space with for the past two days, doing a deep dive into new ways of knowing about myself, about the culture I have the privilege of making this choice where many women (and men at times) are no longer given that freedom to make a decision as I have. The decision to make an informed choice around one’s sexual/reproductive needs. This experience blew me wide open in the truths that yes, a choice like this is not a flippant thing, that what/when/how these choices are made should be the individual’s choice and informed by their medical professional to help them make sound decisions based on continued health.

The process was quick. Without going into extreme detail, you undress, they cover you up except the portion they will work on, the do a simple quick injection into the testicular skin to numb you up, and the incision is only about ½” long. As a whole, I laid there, staring into the ceiling tiles and they played music to help calm my nerves (happened to be Guardians of the Galaxy mix tape of 70’s rock). As a whole, I did not feel anything except for the deep tugging as they worked their way to get to the vas deferens. As a whole, this part was the most intense, as the nerves that run along that go into the abdomen, and straight into the CNS. The overwhelming intensity of the feeling there was hard to describe. It was pain, but a whole bodied, animalistic pain of survival, deep into my being. They cut the first one and while I did not feel it, my body understood. I felt a huge emotional wave come over me, almost bringing me to tears, which was quickly shifted to extreme nausea and a bit of dry heaving (no breakfast so nothing came up). It felt like someone had quickly tugged all of my internal organs out while kicking me in the groin. I broke out in sweat and did everything I could to hold that together. They paused, let me collect myself, cauterized one side, and did the same on the other. 30 minutes later, they stitch me up, I get dressed, and drive home to contemplate this.

Why am I sharing this? Perhaps it is to reflect on the fact that much of what we know of the process is glossed over. Even in my process, they knew I was military and treated me like I should be able to handle it. The vulnerability, the loss, the grief, the sorrow of now not being able to father, and even more the sadness of not having that capacity in my past became all too real. My present “me” felt sorrow for my past “me” and acknowledged with my future “me” that we will be alone in that regard now. This is what I chose, and yet, a part of me understands that there is something deeper in that choice. I will be reflecting on that for a while, but I acknowledge that I, as a man in our culture, get to have that choice without question. Almost that choice is celebrated in some ways. It was easy for the system to make it alongside me, rushing me towards this without a whole lot of second guessing and talking through it. I desperately wanted the doctor, the nurse, anyone to say “hey, are you sure? Do you honestly want this?” so I can reflect on the decision, but it felt rushed, like I was on an oiled slide headed into the process without a second glance. It took three months from the appointment setting to the actual appointment, and I wonder if that is ultimately long enough to sit with the decision. I don’t know. All I know is that this was my experience, and I am positive that others may have different ones.

What I also know is that we as men are not talking about this for some reason, we are not sharing honestly about our reproductive understanding, rights, and needs. Everything I learned out there about this process was about 50% of the story. That breaks my heart. It also breaks my heart to know my sisters out there are suffering in a system that destroys these choices for them as well, and silences them in the process. While I will never fully understand a women’s reproductive decisions that she will have to make, I do fully understand that it is her right to make those choices, much like it was my right to make mine, and share here. Do I regret the experience? No, but like I said, there is parts of my being that hold space for mourning the loss and capacity to be a father now. Maybe that ship sailed long ago, and I am now just catching up to the physical place in that reality. What are the aftereffects of the surgery like? Soreness, a bit of swelling, some bruising, not much in the way of physical issues, but the inner reflection of who I am now, what I have to offer, and what my role in our society is now is huge. As a sex therapist I now can speak from an informed place around decision making, or not, and how I have been able to hold it and process it for myself and perhaps that will give me some greater insight into the choices my clients make for themselves. At the very least my capacity to ally with these needs, both men and women, has become much deeper.

Thank you for reading this. It took a lot of courage to write these words down. Many of you don’t even really know me, so being able to say this and perhaps reach someone who may be asking the same thing of themselves or a partner is worth the exposure. I hope this reaches those that need to hear it.