The Fi­nal Cut

Get­ting a va­sec­tomy strikes at the core of what it means to be a man. Here, one MH writer who ag­o­nised over get­ting ‘The Snip’ for years takes you through what it’s re­ally like to put your balls on the block

Men's Health (Australia) - - CONTENTS - BY STEPHEN CORBY PHO­TOG­RA­PHY BY PHILIP LE MASURIER

Con­sid­er­ing a va­sec­tomy? First, read our writer’s ball-tear­ing story.

This is what walk­ing, wob­bly kneed, to the guil­lo­tine must have felt like. And those poor French suck­ers prob­a­bly weren’t wear­ing un­der­wear ei­ther.

A sharp im­ple­ment is about to cut off my life force, ef­fec­tively, and yet I’m not scream­ing for mercy or re­pent­ing. And when the nice nurse asks me, for the third time, whether I’d like to change my mind, I meekly shake my head and sub­mit my­self to the va­sec­tomy I’ve been avoid­ing, and dread­ing, for years.

And then I see the gi­ant pad of gauze taped to the op­er­at­ing ta­ble – the size of a Mo­nop­oly board – and try to make a joke with my smil­ing sur­geon about how much he’s ex­pect­ing my beloved balls to bleed. But the words won’t come out be­cause I’m too damn scared.

All I can think is, thank God I’m be­ing se­dated for this.

TO SLEEP, PERCHANCE TO SCREAM

Go­ing for the lo­cal, as a stag­ger­ing 60 per cent of Aus­tralian blokes do when it comes to va­sec­tomies – ly­ing there, awake, while their hairy purse is pil­fered – was never go­ing to be an op­tion for me. Largely, but not en­tirely, be­cause I’m a wuss.

I also blame a former col­league, Nathan, who came into the of­fice two days af­ter his pro­ce­dure, walk­ing like a man who’d spent a week rid­ing a stegosaurus, and ru­ing his de­ci­sion to choose lo­cal anaes­thetic for his snip.

“I was ly­ing there, feel­ing noth­ing, and all of a sud­den there was this wave of pain, like I’d been kicked in the balls re­ally hard by some­one, who then slashed me down there with a knife at the same time. It was both a dull pain and a stab­bing one all at once,” Nathan told our of­fice, as we bent over dou­ble in em­pa­thy.

“And I just tried to sit straight up, so the nurse jumped on to hold me down and she’s shouting at the doc­tor, ‘I think he can feel that!’ And I’m scream­ing, ‘Do you THINK?’

“It was the most ex­cru­ci­at­ing pain I’ve ever felt in my life, and the doc­tor’s say­ing, ‘Oh, don’t worry, this hap­pens some­times’.”

Al­most a decade later, as I was toy­ing, for the umpteenth time, with spay­ing my­self, I called him to see how he felt about this hor­ror show now, and his an­swer sur­prised me. “It’s the best thing I’ve ever done – you should do it,” chirped Nathan, now 44. “Care­free sex, and I’ll never have to use a con­dom again. Ever. It’s great.”

All this from the guy I’d blamed for putting me off do­ing the deed for years. God knows, I’d tried, at least men­tally, to get around to it. Some­times I’d even looked at my phone and thought about di­alling the num­ber to book my­self in. But some­thing, per­haps ev­ery­thing, held me back.

I was wor­ried about the pain, mostly, if I were forced to jus­tify my re­luc­tance. But there was also some­thing deeper, in­tan­gi­ble, a fear I couldn’t put my fin­ger on, but cer­tainly one I could wrap my hand around.

So why did I want to do it at all? Be­cause my wife, who can eas­ily re­mem­ber all of my many faults, and list them, prob­a­bly in al­pha­bet­i­cal order, some­times strug­gled to re­mem­ber to take a sin­gle pill each day, which was al­most ter­ri­fy­ing enough for me. But then she de­cided it was time to stop tak­ing it al­to­gether – now that we had two chil­dren – and pointed out there was an­other way.

This may also have been around the first time I heard it ar­gued that hav­ing a va­sec­tomy is the least a man can do, af­ter all his part­ner has been through to pro­duce his chil­dren. It’s some­thing that came up a lot, af­ter I fi­nally talked my­self into hav­ing one (partly be­cause I wanted to write about it – jour­nal­ists are weird peo­ple).

Be­tween you and me, though, the largest and most selfish driver was that I just hate con­doms. For me, the dif­fer­ence be­tween them and un­pro­tected sex is like the con­trast be­tween watch­ing your team win the World Cup on TV and be­ing there in the sta­dium.

Mind you, I didn’t hate them quite enough to stop me from chang­ing my mind, re­peat­edly, and walk­ing back­wards, fig­u­ra­tively, away from that guil­lo­tine.

THE RUN­NING MEN

Chang­ing your mind, even at the last minute, is not un­com­mon, ac­cord­ing to Dr Justin Low – one of Aus­tralia’s most pro­lific snip­pers and the na­tional

“THERE WAS THIS PAIN, LIKE I’D BEEN KICKED IN THE BALLS RE­ALLY HARD ”

lead va­sec­tomist at Marie Stopes Aus­tralia – a man known to his friends as “the ball whis­perer”.

“We’ve had guys come in af­ter 10 years of not quite get­ting around to it, they’ve had three more kids than they wanted to in that time, but they kept putting it off,” he chuck­les.

“And some­times we’ll have run­ners; guys who make it to the front desk and then the nurse will turn away to get their pa­per­work and they’ll van­ish. You call them up and they pre­tend they were sud­denly called to a meet­ing.

“We had one guy, a big fel­low, a plumber, looked like a tough guy, and he got up off the ta­ble, wear­ing noth­ing but his sur­gi­cal gown, and ran off down the street. Two years later, he came back. I recog­nised his name and once we had him on the ta­ble I grabbed him by the balls and said, ‘Okay, you’re not go­ing any­where this time’.”

So, what is it we’re so afraid of? So ter­ri­fied, in fact, that when I asked one mate, Sam, 48, who has two young boys and doesn’t want any more why he wouldn’t even con­sider a va­sec­tomy, he couldn’t even squeak an an­swer. He just gave me this par­tic­u­lar pained ex­pres­sion that you get a lot when you men­tion The Snip to men.

His wife, how­ever, was keen to point out that he is sim­ply too scared of the idea of any­thing sharp go­ing near that part of his anatomy, and blankly re­fuses to budge on the is­sue, de­spite her con­tra­cep­tion re­cently hav­ing failed, leav­ing them with an un­wanted preg­nancy.

“I think there are two bar­ri­ers, and the first is the whole ‘pro­tect-your­balls’ thing,” Low pos­tu­lates. “It’s just a nat­u­ral thing for men to want to pro­tect that area, so they have this fear about the pain.”

For other guys, he says, there’s the mas­culin­ity bar­rier – if I’m ster­ile, that’s my seed, that’s my mas­culin­ity, that’s who I am, I won’t be a man any more. “But I think that’s chang­ing, be­cause it is to­tally un­founded,” Low adds. “Plus, there are stud­ies show­ing sex­ual fre­quency and the ex­pe­ri­ence of sex are bet­ter af­ter va­sec­tomy.”

In­ter­est­ingly, though, I did have one fe­male friend tell me she’d never ask her hus­band to get the cut be­cause she hates the idea and would see him as less of a man if he did. Then she gave me a look of great pity, shook her head and walked away.

There is one more strange, and typ­i­cally male, rea­son why some blokes just won’t coun­te­nance the idea, as ex­plained to me by a col­league, James, 44.

“It’s not the pain, for me, and it’s not that I’d feel like less of a man. It’s more the psy­cho­log­i­cal thing,” he says.

“The big thing is that, like all men, I like to keep my op­tions open. You look at Richard Gere (hav­ing an­other baby at age 68 with this 35-year-old wife) and you think, Yeah, maybe, one day, you never know, if I had some much younger woman who I’d shacked up with, and she wanted one, and I was rich, so some­one else could look af­ter the kid. Just maybe. And that’s the thing about men: we’re hope­lessly op­ti­mistic. So I just don’t think I could do some­thing so . . . fi­nal. I worry about whether my new hair­cut is go­ing to suit me in a week’s time. And I find the idea of a tat­too far too per­ma­nent, so a va­sec­tomy? There’s just no way.”

My wife pointed out that she tried to tell me the same, and warned that, if I’m fool­ish enough to leave her for a younger woman years from now, I should not blame her when said sylph is an­gry that I can’t pro­duce chil­dren.

In all hon­esty, this was not some­thing I spent a minute wor­ry­ing about in the weeks lead­ing up to my pro­ce­dure. And then, on the last morn­ing, as I des­per­ately tried to ex­plain to my 11-year-old son and seven-year-old daugh­ter why on Earth I was do­ing this, it hit me, hard. If I love th­ese two chil­dren of my own so much, what the hell was I think­ing, stop­ping my­self from hav­ing any more?

It was a deeply emo­tional and un­ex­pected punch in the lower cock­les, and it lasted all of a minute, un­til I re­called the stench of nap­pies, the sting of sleep­less nights, and the fact that two kids re­ally is enough.

WHOSE TURN IS IT?

I have a mate who started hav­ing kids much ear­lier than me, in a dif­fer­ent age, and when he and his part­ner re­alised he’d had enough he had no hes­i­ta­tion in pres­sur­ing her into hav­ing her tubes tied. When

I sug­gested he might con­sider a va­sec­tomy he looked at me as if I’d sug­gested he have his butt sewn shut.

One thing I’m fas­ci­nated by is that, in the 20-plus years since I was young, the per­cep­tion of va­sec­tomies has shifted so vastly. When I was a teen, the idea of any man hav­ing The Snip was some­thing to joke about, be­cause if cou­ples wanted to stop hav­ing chil­dren it was usu­ally a case of the mother be­ing ster­ilised.

When I ap­proached my GP for a re­fer­ral, he as­sured me that men get­ting va­sec­tomies was ac­tu­ally far more com­mon, partly be­cause it is a cheaper and far less se­ri­ous and in­va­sive pro­ce­dure than tubal lig­a­tion, but also largely be­cause of so­ci­etal change and the gen­eral em­pow­er­ment of women in re­la­tion­ships.

“It’s re­ally a case of women say­ing, ‘No, why don’t YOU go and do it?’ And it re­ally is much safer. It just makes more sense for men to do this,” one med­i­cal pro­fes­sional put it to me.

Un­for­tu­nately, the num­bers, par­tic­u­larly glob­ally, do not re­flect that so­ci­etal shift (in some coun­tries, the idea that a man would take any re­spon­si­bil­ity for con­tra­cep­tion is laugh­able). Low says that de­spite the ef­forts of or­gan­i­sa­tions like Marie Stopes In­ter­na­tional – a not-for­profit provider of fam­ily plan­ning ser­vices, in­clud­ing free va­sec­tomies, in 40 coun­tries around the world – tubal lig­a­tions still far out­num­ber va­sec­tomies world­wide.

“It’s a mas­sive pub­lic health is­sue, and Bill Gates sup­ports Marie Stopes’ work in the third world through his foun­da­tion. We talk about cli­mate change, but be­hind that it’s pop­u­la­tion change that’s the prob­lem. There are just too many peo­ple. And va­sec­tomy is the cheap­est and safest way to con­trol pop­u­la­tion growth,” says Low, who does 1300 va­sec­tomies in NSW each year.

“In Aus­tralia what we’ve no­ticed is this sen­ti­ment of, ‘I’m tak­ing one for the team, it’s my turn, she’s done ev­ery­thing else’, and it’s good to see men step­ping up and con­tribut­ing.”

The num­ber of men get­ting va­sec­tomies in Aus­tralia ac­tu­ally peaked, at nearly 29,000, in 1997, and then dropped dra­mat­i­cally over the next decade. But Low says they have been on the rise again in the past four years, with the fig­ure for 2017 hit­ting 24,380, ac­cord­ing to Medi­care data.

Part of that rise has been a sur­pris­ing in­crease in the num­ber of blokes in their 20s and early 30s – who don’t want kids now and don’t think they ever will – opt­ing for the pro­ce­dure.

“In the past there was no way they would get it, be­cause a urol­o­gist would sim­ply refuse to give you a va­sec­tomy if you were un­der the age of 30. But that’s changed. And now we’re see­ing more men in their 20s and early 30s, with no kids, who just don’t want them, some­times be­cause they say there are enough chil­dren in the world.”

IS THIS GO­ING TO HURT?

As the date of my much-feared pro­ce­dure looms, I ask Low to ex­plain his ad­ver­tised “open-ended, scalpel-free” tech­nique in de­tail (see break­out), and ad­mit to him that as I am choos­ing to be se­dated rather than have the oper­a­tion un­der lo­cal anaes­thetic, what re­ally wor­ries me is the re­cov­ery process.

Surely the pain, and the swelling, once the drugs have worn off, must be aw­ful?

I’d asked a few blokes about this and re­ceived wildly dif­fer­ing re­ports. One mate, Alex, 49, told me he’d had no pain what­so­ever, but that his bol­locks had swollen to the size of egg­plants and gone an equally pur­plish-black.

An­other friend, a hugely tough and frightening man, Ivan, 52, ad­mit­ted that, “I only got it done be­cause my wife promised me lim­it­less sex, but she lied. I got my re­venge by pre­tend­ing it hurt for longer than it did, and stayed on the couch de­mand­ing nurs­ing.”

Other, pos­si­bly more hon­est, men merely gave pained, far­away looks and mut­tered about the im­por­tance of frozen peas when asked to re­call their con­va­les­cent ex­pe­ri­ence.

Low has, of course, had a va­sec­tomy him­self. In­deed, he says it’s such a sim­ple pro­ce­dure that some of his Amer­i­can col­leagues have done their own, us­ing a mir­ror, and videoed it.

“What you feel af­ter­wards is just a dull ache. It’s ex­actly like in footy, if you ever got a knock down there. It’s what it feels like one or two days af­ter that – it’s not like the ini­tial smash in the balls. It’s just a lit­tle bit of aware­ness, and Panadol does the job,” he claims, cheer­ily.

When the dark day fi­nally ar­rives – af­ter an even darker night be­fore, spent try­ing to shave ev­ery hair from my scro­tum and pe­nis, a job that’s even less fun than it sounds – my wife is only too happy to take me in.

Her face falls some­what in the pre-op brief­ing, how­ever, when Low ex­plains that the sperm com­po­nent of each ejac­u­la­tion makes up just 2-3 per cent of the to­tal fluid; the rest of the stuff is just there to keep it alive. And it will con­tinue not do­ing that job, hope­fully, for as long as I live.

Low of­fers to write a med­i­cal cer­tifi­cate for her, in­sist­ing I’d need to pro­duce 25 ejac­u­la­tions over the next three months to “clear the re­main­ing bul­lets from the cham­ber”. She gives him a with­er­ing yet quizzi­cal look that says he is a fool if he thinks she doesn’t know there is more than one way to do that.

One of the more dif­fi­cult parts of the va­sec­tomy process is the de­layed de­liv­ery on what you’re pay­ing for. It takes a full three months be­fore you’re al­lowed to have your­self tested and find out if all your sperm are gone.

And if you fail that test you have to wait an­other month for retest­ing. This is like buy­ing a car and be­ing told it’s yours, but you have to keep catch­ing the bus for an­other three months.

The good news is I can re­port that the pro­ce­dure it­self is, er, a snip. No pain, no mem­o­ries, in and out in less than an hour. And the bloke next to me when I wake up, who’d only had the lo­cal, seems even more re­lieved and happy af­ter­wards than me.

The re­cov­ery, how­ever, is not, for me at least, a dod­dle. Low tells me that, for about 90 per cent of men, there’s a bit of dull aching for a day or two, and that’s it. I fear I might have fallen into the other 10 per cent.

While the swelling down there is ex­pected – and makes me look like an un­der­wear model, al­beit a sour-faced, gri­mac­ing one – what comes as a shock is the bruis­ing. I was pre­pared for it to look like my balls were pre­par­ing for a game of squash, but the fact that my

pe­nis also turns black, and pur­ple, is more than mildly alarm­ing. The good doc­tor tells me it is slightly un­usual, but not un­heard of, and that it would go away . . . in a cou­ple of weeks.

While I hate not be­ing able to ex­er­cise for a fort­night af­ter­wards, the gen­eral level of dis­com­fort (com­bat­ted by ice packs and Panadol) is more both­er­some than bru­tal for the first few days. But then I make an un­for­tu­nate slip when a ke­bab falls off a plate and I duck down to catch it and put my­self in the kind of pain that makes me think of poor Nathan’s hor­ror story. Frankly, it would have hurt less if I’d shoved the ke­bab stick straight into my tes­ti­cle.it took the full two weeks for that par­tic­u­lar ball to stop mak­ing its ex­is­tence known via ev­ery sin­gle step. THE BRAIN GAME Sex is, quite sen­si­bly, for­bid­den for the first week af­ter­wards, but that re­ally isn’t an is­sue. For me, the most dif­fi­cult part of this whole process is the psy­cho­log­i­cal pain of that first seven days, dur­ing which, for the first time in liv­ing me­mory, my pe­nis does not move, nor even feels like it might stir mean­ing­fully, in any way.

In short, it looks, and feels, so bat­tered and bro­ken that I fear it might never work again. Nor am I brave enough to en­cour­age it to arise.

Hap­pily, ev­ery­thing did even­tu­ally re­turn to nor­mal ser­vice. I’m now see­ing out what will hope­fully be my fi­nal months of us­ing con­tra­cep­tion. For­ever. I, too, may well look back on all this as one of the best things I’ve ever done.

What I do know is that, like many men, I wish I hadn’t scared my­self out of do­ing it for so long be­cause, par­tic­u­larly when com­pared to child birth, hav­ing The Snip isn’t that tough at all.

Low, in case you’re won­der­ing, was hor­ri­fied by the story about Nathan and his failed anaes­the­sia and says it’s not com­mon at all. So, don’t worry. (But go for the se­da­tion, trust me.)

“THE SWELLING MAKES ME LOOK LIKE AN UN­DER­WEAR MODEL, AL­BEIT A SOUR-FACED ONE”

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