I lay supine on an operating table in a dispiriting room. A failing ballast buzzed incessantly. Jaundice-colored paint besmeared the walls. Cutaway diagrams of idealized male genitalia sagged in their frames. Suddenly I felt an odd tugging deep in my abdomen, like somebody pulling a string anchored somewhere between my groin and navel. Unnerving but not painful.
Although I wanted to know what caused this tugging sensation, I had long given up trying to converse with the dour and rather tedious physician who had cut open my scrotum and was, I hoped, severing my vas deferens. Instead of asking him, I raised my head so I could look down and watch his bloodied fingers work between my open legs.
I was finally getting a vasectomy. Not a “SNIP!” or a “Snippety, snip, snip…..” or “The snip” or any of the other popular euphemisms. A vasectomy. Not as birth control — although birth control is an added benefit it trivializes the procedure by layering on a family-planning veneer. Not for the Mother — although I had consulted her and had considered her thoughts and opinions, I was not offering up my vas deferens as some sort of reproductive reciprocity. No, this vasectomy was for me. It was about taking control of my body. It was about anatomical and philosophical autonomy.
Arriving at this operating table had taken too long. Initially, cultural pressure and the medical establishment’s hurdles (which, in this case, are themselves merely institutionalized expressions of those cultural pressures) had dissuaded me. Later, conjugal considerations had deferred my actions. Even now as I slid down the far side of my procreative arc, I found myself struggling against both culture and medicine, mostly medicine.
Two weeks before my operation I had endured the mandatory pre-op consultation. Although it is marketed as an information session, a sort of medical PSA complete with full-color laminated brochures, the pre-op felt more like a psychological evaluation where a physician with no expertise in mental health assumed I was most likely non compos mentis or, at a minimum, benighted and irrational.
The physician promised to describe the procedure in order to help me make the “right choice.” But first, he wanted to know a little about my family history. In a carefully modulated voice, intending no doubt to convey the gravity of the situation, he asked: How old was I? Was I married? Did I have children? How many? Did I want more children? Was I sure that I didn’t want more? Had I considered other forms of contraception, e.g., the pill, IUD, “or even condoms”? Did I understand that a vasectomy is irreversible? Had I discussed this with my wife? Did she want more children? Had she encouraged me to get a vasectomy? Was she comfortable with the decision? Did she understand that a vasectomy is irreversible? What if I remarried and wanted children with my new wife? What if I lost a child?
By point this physician’s real purpose for conducting the pre-op’s was clear: to convince me to make the “right choice,” that is, not to have a vasectomy.
The hetero-normative assumptions linking worth and fulfillment to breeding as well as the reductive subtext that linked “male” to “fertile” were as outdated as they were suffocating. Apparently only men suffering some sort of psychological hiccup would want a vasectomy. Or apparently men alone cannot make this decision but only do so when compelled by their wives.
Finally the physician handed me a brochure that resembled something from a middle-school sex-education class. He walked me through the anatomy. He told how he would perform the procedure, how long it would take, how long the recovery was, and what to avoid. He told me I would have to shave the morning of the procedure.
If, he stressed “if,” I was still interested, I could see the assistant on my way out to make an appointment for sometime the week after next. Take time, he encouraged me, to think over this decision and to discuss it with my wife. At any time, he assured me, I could cancel the appointment without incurring any charge.
I saw the assistant on my way out.
I felt the odd tugging sensation again. Looking at the anatomical diagram on the far wall, I decided that it must be the long side of the vas deferens that seemed to pass by the pubic bone and the bladder on its way to the urethra. I watched the physician pick up a pair of Metzenbaums. I heard them open and close a couple times. Felt some more tugging. When he reached for the cauterizer I knew that one side was done. One to go.
Ten minutes later, I pulled up my shorts, received care and cleaning instructions, and walked out of the office, content. For me this vasectomy was a profound act of self-determination.
The Mother had with some reservations agreed to support me in this process. ↩
Although the venerable American Urological Association does not mandate such consultations—merely encouraging physicians: “A preoperative interactive consultation should be conducted, preferably in person”—state and city laws often require such a consultation.
At first glance, the AUA’s guidelines appear sterile in the way that national medical association guidelines typically do: AUA’s vasectomy guidelines. Buried in the unabridged PDF version of these guidelines, however, are pervasive hetero-normative assumptions about the importance of male fertility, about who should be responsible for birth control, and, perhaps most disturbingly, about men’s inability to choose to have a vasectomy. On the one hand, near constant references to “partners” and “wives” indicate that only men in relationships should consider a vasectomy. On the other hand, frequent comments about the partner or wife having chosen a vasectomy for the man reinforce the view that normal men, even in relationships, would not elect to have a vasectomy. ↩
Surely, I thought, this is a lighthearted joke. I riposted with: “Is that a trick question?” No, he replied humorlessly. He assured me that patients sitting in my place, that is intending to have a vasectomy, do sometimes say that they might like to have more children. I was and remain incredulous. ↩
This seems as inane a question as the previous one. ↩
Although he was young physician, he clearly subscribed (and probably still subscribes) to the old-fashioned and problematic belief that birth control is a woman’s responsibility and burden. I wonder if a female urologist would use the same hierarchy. ↩
This is technically not true, as the physician made clear and any Google search will reveal. It is, however, difficult and costly and not guaranteed to work. ↩
I appreciate that marriage is a partnership. I have a moral responsibility to consult her about anything that will affect our relationship, and I have a responsibility to listen and take into consideration her opinion. But whatever the wife’s vested interest and with all due respect her opinion, when it comes to my body her opinion does not trump mine (just as my opinion does not trump hers when it comes to her body). ↩
This questions marked the consultation’s decline into the theater of the absurd. Unfortunately, this particular question was the least tenuous of the physician’s hypothetical scenarios. I explained that it would take an act of God to compel me to remarry, at which point I would ask God to heal me so I could consummate my new marriage. The physician seemed unamused. ↩
At this point the physician had clearly resorted to emotional blackmail. Not only does this reduce children to a numerical value—if you have two now and lose one, just have another to replace the lost child. WTF?!? Does this seem like a rational way to discuss an operation? Maybe, I suggested, I should find a second wife, just in case I lost the first one. Again, the physician seemed unamused. ↩