Meet the Vasectomists
The organizers of World Vasectomy Day want to educate the world about the values of voluntary male sterilization, one incision at a time.
o the founders of world vasectomy day, the benefits speak for themselves. The procedure is simple enough to do in a doctor's office or even a living room. It takes the burden of family planning off women. It’s inexpensive, has a short recovery period, and, so far as operations on genitals go, minimally invasive.
And yet in the United States nearly three times as many tubal ligations (the much costlier, invasive, and dangerous female equivalent to the vasectomy) are performed than vasectomies. The history of sterilization is a complicated and thorny terrain, marked by a heinous past. As recently as 2010, women of color were targeted for forced sterilizations in the California Institution for Women in Corona and the Valley State Prison for Women in Chowchilla. In 2014, California governor Jerry Brown passed a bill prohibiting forced or coerced sterilizations of inmates in California prisons and allowing felons behind bars easier access to DNA tests that could prove their innocence. But even as steps are being taken in an attempt to make up for this inhumane legacy, its repercussions are still being felt.
To its detractors, vasectomies can be an unholy alteration of God’s perfect work, to an unnecessarily drastic procedure, or virility sapping. Catholic bloggers disagree on permanent contraception to the extent of wondering if it is a venial or mortal sin, and many Christian denominations look askance at anything meddling with procreation. Even in the secular world, men generally view the procedure as somehow incompatible with the essence of masculinity. But for the founders of World Vasectomy Day, it's essential that they change this attitude—to empower women, to liberate men, and to lessen humanity's strain on the environment—even if they have to travel the world over.
The "aha" moment
I spoke to Jonathan Stack, co-founder of World Vasectomy Day, while he was in Bali making preparations for World Vasectomy Day 2015, part of a larger tour of south Asia that includes Bangladesh and India which he referred to as “a global scrotal adventure.” In New York, there was a World Vasectomy Day event that took place at a bar where vasectomies from Florida were live-streamed.
Before preaching the gospel of male sterilization, Stack made dozens of documentaries, most of which were about human rights abuses and how we respond to them. He’s interviewed child soldiers in Liberia during the ongoing civil war, and his documentary The Farm: Angola, USA followed the lives of multiple inmates in one of America’s grimmest maximum security prisons.
For all his time spent in prisons, war-torn countries, and impoverished communities, it not altogether unsurprising that Stack would move from filmmaking to organizing a global health campaign. “I had become a little frustrated with filmmaking” he said, thinking back to the origins of World Vasectomy Day, “it was so hard to measure the positive impact a film had.”
Around 2010, Stack’s mind began to focus on climate change and the future of humanity. “I was getting into this idea of the inconvenient truth of humanity, which is that [in climate change] we’re both the problem and the solution,” he reflected, “not that numbers determine our destiny, but that all our problems are exacerbated by having more people.”
His concern for the fate of our species and planet coincided with a smaller, personal struggle: Stack wanted to get a vasectomy. “My life was a bit of a mess back then,” he admits. After having three kids from different women, finding himself single and not in a good position to be a father to any more children, he resolved to take himself out of the gene pool. Being a filmmaker, he documented his steps towards getting a vasectomy and his curiosity grew. His research brought him to a doctor named Doug Stein in Florida. “When I found him, he was traveling around the state in his Vasectomy Mobile,” Stack recalled.
While following Dr. Stein, who was working with No-Scalpel Vasectomy International, to Kenya, Stack had his “aha moment.” Stein had a habit of bringing levity to the operation rooms by engaging in small talk during the procedures, and Stack noticed a consistently upbeat tenor to these exchanges. “All these of guys were really positive,” he noticed, “they said they were doing this so their wife didn’t have to get pregnant again, or they were doing it to be a better father to their kids, or they were doing it to lessen the strain on the environment. Taken together, it was like a communal declaration of love.” And so, informally, Stack declared it the first World Vasectomy Day.
The first official event took place in 2013 in Australia, coinciding with the release of his documentary The Vasectomist (which Stack eventually extricated himself from: “I don’t like seeing myself on camera”). Since then, the slogan has had several permutations, from “Lowering Carbon Footprints One Vasectomy at a Time” to “World Vasectomy Day: An Act of Love," but the core message has remained the same: vasectomies are something men can do that will make the world a better place because, as Stack would put it, after seeing wars and poverty and prisons, “men are fucking up.”
“We’re not here to judge how many kids a person can have,” says Stack, “so much as we’re about getting men into this discussion. It’s about consciousness: how you bring kids into this life.” The message has, unsurprisingly, been well received by countries which struggle to provide resources for a massively growing population. India, without being asked to or provoked, recently declared World Vasectomy Day an official state event. “That wasn’t even me,” Stack says in mild disbelief of this fact, “it was just social media doing its magic.”
World Vasectomy Day also resonates with various national family planning associations and international organizations like the UN Populations Fund and Partners in Population Development. As the project becomes more successful, the hope is for more governments to become involved in these efforts. “What I’d really like to do is spend a whole year in a country that invites us and just build a complete self-sustaining campaign,” Stack says, envisioning training doctors so they can pass on their knowledge to future medical personnel, having annual outreach events and, his slightly warped personal ambition, “I’d develop a soap opera series. We could build up to the last episode which is ‘[which] character gets the vasectomy?’”
And for those like Ketut Sukanata, the campaign is a breath of fresh air. At 53, he is happily married with three grown children and neither he nor his wife would like more. He is also the executive director at the Bali chapter of PKBI (the Indonesian Planned Parenthood Association), which makes him one of a small cadre of men whose livelihood is tied to family planning. Like many couples in their 40s and 50s, Sukanata and his wife were in a period of being old enough to know they didn’t want a newborn baby, but young enough to conceive.
“My organization’s mission is to advocate for family planning. I want to be a motivator, especially for men, to see the burden of planning the family is not solely the burden of women,” Sukanata tells Hopes&Fears. When the opportunity to participate in World Vasectomy Day 2015 in Indonesia arose, Sukanata eagerly signed up.
On November 13th, Sukanata drove from his home to the WVD venue and was given a vasectomy by Dr. Stein who, in turn, was demonstrating his no-scalpel technique to a team of doctors. The entire procedure took about ten minutes. Afterwards, Sukanata drove himself home and was feeling well enough the next day to make his appointment for jury duty. “Now I feel more confident in encouraging men to get the procedure, having done it myself."
The hands that drive the movement
No matter how effective the campaign, and how much money organizations provide for it, services are dependent on having medical professionals trained in the procedure. Along with Vasectomy Mobile driving Doug Stein, physicians like Dr. Sarah Miller are part of a global effort to educate both the public and other doctors about permanent male contraception.
Dr. Miller headed up the World Vasectomy Day activities in New York earlier this year. Year round she educates medical students on rotations in her clinic as well as in conferences on family medicine, but on the 13th she was preparing for an extra push of vasectomies. “But what’s really fun,” she tells me, “is we’re involved with a medical student run free-clinic in a site near Union Square, and we’ll be continuing to offer eligible patients free sterilization on an ongoing basis.”
She first heard about World Vasectomy Day in 2012, while working in the Philippines with No-Scalpel Vasectomy International where Doug Stein and Jonathan Stack were already working on the filming of The Vasectomist. After her training in general primary care and family medicine, Miller specializes in family planning. “I couldn’t in good conscience be a family planning specialist, which is normally geared towards women, without really focusing on care for men too,” she says.
To Dr. Miller, combating the outsized burden of birth control placed on women starts with changing small, day-to-day practices from the doctor's end. Most of the time, when men see a doctor about reproductive care, it’s about testicular exams or prostate cancer. Doctors don’t often think to inquire about their birth control plans, and men generally don’t think to ask. “When medical students rotate through with us,” Miller explains, “they see this model of full spectrum primary care which involves family planning fully integrated. They see that if anyone, man or woman, comes in and they’re of reproductive age we ask them 'Hey, what’s up with your family? How many kids do you want? What are you doing for birth control?'”
When I asked if she found men reluctant to engage in family planning she told me, “I think most guys are open to talking about birth control once you ask them. They’re usually really curious about these things and don’t get a lot of chances to ask questions and talk about it.”
Miller sees general practice doctors as being on the front lines of a battle to better educate people: they’re the only doctor many Americans see on a regular basis. And knowing that dozens of states are actively working to defund family planning clinics like Planned Parenthood, while hospitals with religious affiliations are increasingly strict with what can be offered, it’s hard to see another point of contact to talk to people about how they plan on starting a family.
Fear and anxiety about the scrotal area looms large in the day to day activities of both Miller and Stack. In his travels to Kenya, Stack found that the word for vasectomy was the same word for castration. In America, the fears are less liberal: “I think clearly one of the biggest fears is that vasectomies are on par with castration or a fear that somehow virility is going to be affected by the operation,” explains Miller, “but that’s a pretty easy one to dispel just by explaining the procedure to them.” Miller enjoys citing statistics, like the fact that if there is a change in sexual affairs it is most likely to be positive, to disabuse men of latent castration anxiety. “Another fun historical fact,” she adds “is a lot of famous figures, including Sigmund Freud, had vasectomies.”
Before performing a vasectomy, Dr. Miller likes to make the attitude as positive as possible. “We have a good time. If people want to watch, I let them watch. I let the guys chose music if they want, invite their partners into the room, we make jokes. It’s actually fun.” I probed for an example of vasectomy humor, surely a rich vein of comedy, but Miller has no set schtick, “You gotta tailor it to the person. But when you think about it, there’s not a lot of opportunities where two people who barely notice each other are talking about balls and scrotums.”
When Brandon Perry, a DJ and record-store owner living in Bed-Stuy with an expressive, deep voice, met Dr. Miller on World Vasectomy Day, he didn’t come with music. “It’s the worst thing for a DJ to say,” Perry told me several days after his operation, “but I didn’t really have a playlist for that set up.” Instead, Perry’s girlfriend of two and a half years held his hand while, for about half an hour, he underwent the admittedly “weird” sensation of having someone operate on his anesthetized scrotum. With a slight soreness in his crotch, Perry returned to work the next day with the freedom of knowing he could never be a father.
Unlike Ketut Sukanata, Jonathan Stack, or most vasectomy recipients, Brandon Perry is neither married nor a father. He simply doesn’t want kids. “I’ve known I didn’t want kids for just about fifteen years,” he says. For a while, he planned on traveling to India for a procedure (not yet legal in the US) where a sperm-neutralizing gel is injected into the vas deferens, “but even that seemed like putting off something I knew I wanted.”
Perry didn’t freeze sperm (another contingency option for weary men) and, although he feels confident he’ll never want kids, if he did later feel a swell of paternal longing he would adopt. “There’s already plenty of kids out there who need families,” he says, before adding, “but I’m down to be a cool uncle.” His mother, understandably, was a bit sad to know she wouldn’t be a grandmother but, according to Perry, “we’ve got a cousin who converted to Mormonism and has eight kids, so I think she’ll be occupied with that.”
While saving the planet and mitigating the strain on our society are actions Perry, like most of us, agree are worthy, the greatest benefit felt after a vasectomy turns out to be something simpler and more personal. Getting a vasectomy proved a benefit for Perry’s girlfriend who reacted poorly to birth control pills and was reluctant to get an IUD. When he made the final decision to get a vasectomy “she was so excited” he recalls. “We signed a lease together, she got a raise, and the vasectomy people got back to us all on the same day. She was like ‘This is the best day ever.’”