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
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”