Hi Yana,

What can we do to build our case to hesitant doctors to perform vasectomies on young people (between 18-25 years old)? What would you recommend to someone interested in this procedure?

I have been trying to get my GP (general practitioner) on board since my early 20s and I know so many other young men aiming for the same procedure. When I ask for it, I’m chided for my decision, denied the procedure, or told to redirect my focus elsewhere by health professionals.

When a medical reason is not given, as in my case, it makes me curious how they’re reaching their professional opinion. (I don’t want to doubt my doctors and I will gladly trust someone who spent half her life in school just to help others’ live healthier).

But still, I’m clear that I do not wish to have children: What I am less clear about is why myself and so many other men my age are maligned as they try to schedule what I would say is arguably a standard health procedure.

— Def Don’t Want Kids

Dear Def,

I’ll be the first to say it: I know squat about vasectomies and I’m certainly no doctor, but here’s what I’ve found.

A vasectomy is a brief and relatively basic medical procedure used to sterilize penises by sealing off the vas deferens tubes, which act as the sperm superhighway during ejaculation. Sealed tubes = sperm-less ejaculate = deeply reduced chances of impregnating someone.

An estimated 500,000 Americans receive vasectomies each year. Fewer than 5 percent of people who get vasectomies experience complications. And around 10 percent of vasectomy-havers inquire about reversals post-vasectomy, according to the American Urological Association.

Though reversals are possible, they tend to be more costly, more invasive, and may not bring the person’s fertility back to the place it was pre-procedure, according to the Chicago Tribune article, “Young, Single Men Choosing Vasectomies.” Overall, it seems pretty common and safe.

In 2016, Lauren Oster wrote a piece for Redbook magazine, “The Parenting Choice My Doctors Won’t Let Me Make,” about her yet-to-be-fulfilled mission to get an elective medical sterilization procedure done — over the last 15 years. She is a childless-by-choice, 36-year-old woman who has had similar experiences you are reporting such as being redirected, shamed, questioned, and each time, rejected.

She quotes the American Urological Association’s advisory panel as stating that “… almost all men who request vasectomy have given the procedure serious thought for months or years, making a cool-down period superfluous in most cases.” Women, of course, (Are we surprised? No? Me neither.) tend to have a similarly low rate of regretting sterilization as men, but are given a harder time about it what with the serious Mommy issues we seem to love projecting onto women’s bodies.

So, here we are — the minute you can sexually reproduce, you are seemingly more socially and medically allowed to decide to have children than you are to decide not to have them (well, unless sterilization is being unethically used as a bargaining chip for reduced jail time as it is in a certain Tennessee prison getting media attention this July 2017).

From what I’ve read, doctors are required to give patients “extensive counseling” before performing vasectomies. You can help tip the scales by sticking to your still-reproductively-firing guns about your decision and proving that it’s a path you’ve committed to over time. Some doctors will say “No” the first time and then if the patient comes back a year or so later having stayed course, they’ll agree to it.

But by-and-large it seems as though you’re at the mercy of your doc’s opinions. I would encourage you to have a frank discussion with your doctor next time about what motivated and drove the decision to deny you a vasectomy. The answers may be illuminating. Or perhaps it’s time to shop for a doc who will help you reach your personal reproductive goals.

Yana Tallon-Hicks is a relationship therapist, sex educator, and writer living in the Pioneer Valley. You can find her work and professional contact information on her website, yanatallonhicks.com.