Jeremy Youngman, a 32-year-old tattoo artist in Downers Grove, Ill., likes his birth control the way he likes his body art: permanent.
At 27, Youngman got a vasectomy. Unlike the vast majority of the 500,000 men in the United States who get sterilized every year, Youngman was single and had no children.
To Youngman, the thought of getting a woman pregnant was “the scariest thing in the world.” He said he's long known he doesn't want to be a father, and he didn't want to take any chances.
“It's hard enough to take care of myself, let alone a kid,” Youngman said, adding that he still uses condoms to protect against sexually transmitted diseases.
Half of all pregnancies in the United States are unwanted or mistimed, according to the Centers for Disease Control and Prevention. For some young men, relying on condoms or a woman's promise that she's on the Pill isn't enough to protect against unwanted progeny, so they're opting for vasectomies.
Though such cases are uncommon, the relative ease and affordability of vasectomies, plus the possibility of reversal, make them an attractive option for some men.
Doctors tread carefully in such cases. While any man older than 18 can legally get a vasectomy, doctors can turn men down if they don't believe them to be mature or sure enough of their future plans.
“I received a call from an 18-year-old high schooler, and that was a no-no,” said Dr. Arif Agha, owner of the Vasectomy and Reversal Center of Chicago, in Oak Brook, Ill.
Dr. Kiu Mostowfi, owner of Vasectomy Clinics of Chicago, said that when a 24-year-old man approached him about a vasectomy, he told him he was too young and suggested he come back in a year after he'd thought about it. When the man returned a year later and was still committed, Mostowfi agreed to perform the vasectomy.
Another of Mostowfi's patients, Justin Holt, 27, said the doctor grilled him with “what-if” questions for 40 minutes before agreeing to perform his vasectomy last month. Holt, who lives in Chicago's Logan Square, said he's sure he never wants children.
“It's the only way to be responsible for myself and my behavior,” said Holt, who works as a data specialist for a financial firm.
While Holt said he has no regrets, the finality of the decision has been surprisingly emotional.
“Every once in a while you get this weird thought of, ‘I'm never going to be a father,'.” Holt said. “It's equal parts terrifying because you're not like everyone else, and also because you made this extreme decision at 27.”
Doctors must give “extensive counseling” on the benefits and risks of vasectomy to ensure men know what they're getting into, said Dr. Chris Gonzalez, a urologist at Northwestern Memorial Hospital.
Among the benefits: The no-scalpel procedure, introduced in the United States in the 1980s, typically takes about 15 minutes under local anesthesia, and requires little recovery time. Its $1,000 cost is typically covered by insurance.
Among the risks: There's the possibility of chronic pain, which occurs in one of every 500 men. And while vasectomies can be reversed, men shouldn't count on it, doctors say. Vasectomy reversal is a complex procedure that takes three to four hours, and the $10,000 to $25,000 cost is typically not covered by insurance. Plus, men don't always get their fertility back, especially if more than 10 years pass between the vasectomy and the reversal.
“We want men to look at vasectomy as a permanent solution,” Gonzalez said.
Don Anderson, a mechanical engineer who lives in Oak Park, said he thought carefully before deciding to get a vasectomy at 34, a year after he got married. He and his wife agreed they didn't want any children, and they were tired of combining condoms and the birth control pill to ensure they didn't get pregnant. Vasectomy was cheaper and less risky than a tubal ligation, the surgical procedure to sterilize women. Instead of buying an engagement ring, they decided to use that money to buy a red Mazda Miata (for her) and a vasectomy (for him).
Anderson said that while his doctor didn't give him trouble, he's disappointed to hear of other young men who consistently get turned down for vasectomies simply because they don't already have children.
“Somebody who's in their 20s can easily decide to have children,” Anderson, now 42, said. “It's ridiculous that they can't make the decision to not have children.”
Men should realize being sterile could affect future relationships, said Dr. Laurence Levine, a urologist at Rush University Medical Center. Most vasectomy reversals are for men who get remarried and find that their new wives want to start a family.
Mark Witt of Park Ridge, Ill., got a vasectomy because he and his wife didn't want children. But when they divorced a year later, he discovered that was a deal breaker for some women on the dating scene, said Witt, 48, who works in healthcare administration.
“I've had some regret because I've lost some good women because of it,” Witt said.
© 2008, Chicago Tribune.
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PHOTO (from MCT Photo Service, 202-383-6099): vasectomies AMX-2008-08-28T08:31:00-04:00