A new phenomenon: Young men choose vasectomy as safe form of contraception
Why do young men choose vasectomy?
Introduction
In the last 2 years, certainly since COVID we have seen a sharp increase in requests of young patients under 30 for vasectomies and some as young as 18-22 years of age. 10 years ago we used to see about 1 every 3 months. Now we get 1-3 enquiries a week. Our definition of a “young” man is anyone younger than 30 without children and anyone younger than 25, who already has children. This may be arbitrary, but “feels” right for our organisation.
Reasons for early vasectomy requests in young patients
The overwhelming reason for this request is climate change and the fact the “world is so full”. There seems to be a real change in attitude to this issue in the younger generation, a change that the older generation sometimes cannot understand.
Of course we also still get the requests of patients who had their children early and don’t want anymore, but the climate change reason is getting overwhelmingly the most common issue.
Other reasons are medical conditions, like autism, the feeling of inability to look after a young child. People make those decisions a lot more readily than my generation used to.
But is it the right decision?
We know that patients that are very young have a higher statistical likelihood of regret of their decision, also young unmarried patients or patients that are not currently in a relationship or in some cases never have been in a relationship. The usual rate of regret is 2-3% and the overwhelming reason for regret is meeting a partner, who wants children and therefore a changing attitude over time. Equally, there are also increasingly ladies out there, who do not want the risk of children and cannot tolerate hormonal contraception and on many occasions couples see us together.
Most young men have thought about this for quite some time, commonly years. They often start thinking about it in puberty and it often takes patients 5-10 years until they contact us.
In summary
There is no right decision over vasectomy. While it is to be seen as permanent it can be in many cases reversed successfully. But some cannot be reversed, so sperm freezing is an option. We do perform vasectomies for young patients, but due to the higher regret rate we require young patients to think about a few questions we ask them “What if…” etc. This is part of our young patient pathway and there is a special form for young patients to complete, which does a bit of soul searching and requires a bit of reflection to answer…