Would you consider getting a surgery so your partner does not have to take birth control? E&M Author Nelli Naukkarinen busts common misconceptions about vasectomies, and dives into the persisting inequalities between men and women in heterosexual relationships when it comes to who is responsible for contraception.

For International Women’s day 2022, the contraception pill was recognized as one of the most significant inventions of the 20th century.

The creation of the pill in 1950 completely changed the history of women’s liberation. For the first time in human history, women had control over their own fertility and body. Since the creation of the pill and its widespread availability, eleven other forms of contraception have been created for people with uteruses, ranging from hormonal to non-hormonal options. For people with male reproductive organs, there are only three, vasectomies, condoms and the new male contraception pill.

While it is fantastic to see that contraception for people with uteruses is so widely researched and available, it also shows the responsibility for contraception is placed disproportionately on women And with the backlash following the reversal of Roe vs. Wade, the inequality and objectification women face when it comes to contraception is even more evident. If we want this to change we must take a closer look at the contraception options out there, especially for men. For example, vasectomies are commonly disregarded as a long-term contraception option and have faced disproportionate societal backlash despite the fact that it is a very minimal and no invasive procedure.

Contraception for people with uteruses

Currently there are eleven options for people with uteruses to take in the short-term to prevent pregnancy, ranging from medication and hormone treatments like the pill, capsule and mini pill, to non-hormonal options like female condoms and cervical cap. However, most of these options as mentioned are short-term or require regular action on the part of the person responsible for the contraception, such as taking the pill everyday. Long-term options such as the capsule and IUD, still do not guarantee that the person on the contraception will not get pregnant, and come with a long list of medical and psychological side effects such as bleeding, mood swings, or moving of the implant.

Vasectomies – Facts and misconceptions

For men currently on the market there are three options available, the new male contraception pill, condoms and vasectomies. The vasectomy has become one of the most highly debated ways of contraception. A vasectomy is a reversible operation where the tubes in the scrotum are either blocked or cut off to stop their ability to carry sperm. It is one of the safest and easiest ways to completely prevent pregnancies. Moreover, as it is reversible it does not bar someone from becoming a parent in the future. The operation can be done quickly and usually only requires local anaesthesia that is inserted directly into the scrotum. Very rarely does the procedure lead to any complications or the patient needing to be admitted to the hospital.

Regardless of how medically safe and easily reversible the procedure is many men oppose vasectomies as a form of contraception. They compare getting vasectomies to being neutered like a dog, referring to it as loosing part of their masculinity or holding on to the myth that vasectomies remove sexual pleasure or reduces the skill level pertaining to sex. Now, while it should be clear without saying that whether you are “good” at sex is not influenced by a vasectomy and is instead about listening to the the wants and needs of the other person, beliefs like this one appear to affect the rate of vasectomies. 

Tubal Ligation and Hysterectomies – Facts and figures

This becomes very clear when you compare it to the rate of women turning to surgical contraception, i.e. tubal ligation or hysterectomies. Tubal ligation is an operation done under general anaesthesia where the fallopian tubes are tied off and cut apart. A hysterectomy refers to the complete removal of the uterus. The rate of tubal ligations and hysterectomies is considerably higher than the rate of vasectomies in the US. 700.000 women seek sterilisation every year with the contraception method being more common than the usage of the pill while the yearly rate of vasectomies is around 500.000. And while there has been a significant increase in the rate of men getting vasectomies since the 90s, still women carry an unequal burden of contraception compared to the male population.

Furthermore, access to sterilisation is often much harder for women. Due to their permanent nature, doctors are often quite hesitant to perform the procedures. Depending on the country, hysterectomies and tubal ligation often need the consent of multiple doctors as well as the consent of the husband. Sometimes doctors just generally refuse to carry out the operation, not trusting that the woman’s decision is final.

Financial Burden of Contraception

Women do not only disproportionately face health consequences and societal responsibilities, they are also often the ones who have to foot the bill when it comes to contraception. Fertile Women spend 68% more on birth control than men, with most women paying between 20 and 800 dollars on contraception per year. Therefore, contraception can also be a huge financial burden for them. It is important to mention that most insurances do not cover the cost of birth control.

What needs to happen

Studies show that while most men actually recognize that the responsibility of contraception needs to be divided equally between women and men in heterosexual partnerships, this belief has not been implemented in reality. And that needs to change. It is time for men to step up, inform themselves and take responsibility to end the cycle of unequal physiological, mental and financial burden women face when it comes to contraception. 


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    Originally from Finland, Nelli thinks sex and consent are topics we can never talk about too much. She studied International Relations in Leiden and is now doing a Masters in Public Policy, Economics and Development at the Erasmus University in Rotterdam

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