Permanent contraception: more and more men are choosing vasectomy
No matter how much he searches, Thimothée no longer remembers exactly the date of his vasectomy. “That means it had an impact on me,” jokes this 38-year-old father of four. After careful consideration, the operation had to take place in 2021. According to health insurance figures, that year, in France, just over 23,000 men made the same choice. There were less than 2,000 in 2010. Vasectomy? An intervention consisting of cutting and blocking the ducts carrying sperm. The operation is potentially reversible with more extensive surgery but, as Dr. Vincent Hupertan, urologist, points out, “what is not reversible is aging. Between the ages of 25 and 45, a man sees his fertility divided by five.” Authorized since 2001 in France, vasectomy can only be performed on an adult. It must result from a “free, motivated and deliberate will”. Finally, specifies the public health code, “a doctor is never required to perform this act for contraceptive purposes but he must inform the person concerned of his refusal from the first consultation”.
The desire for men to share the contraceptive burden with women
The men we interviewed motivated their choice by the desire to share the contraceptive burden. Marc-Alexandre, 38 years old and father of two children, even considers this decision as “a proof of love” towards his wife. Also the father of two children born from a previous union, Julien, 40, soon to have surgery, saw his partner – who does not want to have a baby – “have to manage the pill and take it daily, while the hormones are not not great for your health. She talked to me about it, it touched me. Why inflict this on him when there is no procreation issue between the two of us? »
Mireille Le Guen, researcher in demography at the Catholic University of Louvain, notes an increase in the use of vasectomy since 2016. “Chronologically, we can make a link with “the pill crisis” (in 2012, controversies arose related to the use of 3rd and 4th generation pills, Editor’s note) , but it is not scientifically supported,” she emphasizes cautiously. For Thimothée, it was about doing his part: “During childbirth, it is the woman’s body that suffers. I could easily pass on the billiards table in my turn…”
In his office, Dr. Hupertan discerns several types of patients. Those who, like our witnesses, after several children, wish to relieve their spouses of the question of contraception “in a logic of equal responsibility within the couple”. They make up three-quarters of his patient base, he estimates. But we also have to take into account a younger generation who are making the deliberate choice not to have children, for ecological or, quite simply, lifestyle reasons. According to the urologist, they represent approximately 15% of the requests he receives. Finally, 10% of vasectomy candidates belong to the category of those over 55 “who no longer want to go through Pampers”. Our witnesses do not regret no longer being fertile and do not wish to have their sperm frozen, as suggested in the protocol before vasectomy.
For Julien, the intervention will take place next January. Indeed, the law imposes a reflection period of four months. The forty-year-old does not say he is worried about the prospect of going to the operating room. In fact, the operation is benign. It may require a scalpel and general anesthesia, but also be performed without a scalpel and under local anesthesia. It seems good to remember this, because Dr. Hupertan remembers with a smile this “rugbyman, with cauliflower ears, with I don’t know how many broken ribs, who fainted at the mere sight of the needle. However, the procedure lasts on average twelve minutes! I have performed more than a thousand vasectomies, without ever the slightest infection. Just a few hematomas with pain for two weeks. Complications remain very rare.” Marc-Alexandre speaks of an operation that was “a little bit painful”. For Jonathan, it caused “slight discomfort” for a few days.
An attack on virility?
Does vasectomy affect libido? The question arises regularly in consultation. “Men need to hear from me that this will have no impact on manhood. They need this moral guarantee on the absence of side effects, because there is always a fear of symbolic damage,” says Dr Hupertan. In fact, vasectomy is often perceived as an attack on virility. Jonathan still remembers discussions with friends. “Some people thought my testicles were going to be removed. Others that I was no longer going to be able to ejaculate…” Julien also notes how the operation can appear, for some, like a symbolic castration. “I’ve heard speeches like: ‘No one touches my testicles!’ As if it were a jewel, a treasure.” It must be said that, unlike other countries such as the United Kingdom or Quebec, communication around vasectomy remains very discreet in France.
“Few doctors practice it,” recalls Mireille Le Guen. The researcher also explains that in the United Kingdom, health professionals providing contraception are not gynecologists: “Everyone – men and women – therefore goes to see them and they are required to talk about all the existing methods . » Studies are lacking on the profile of men who choose vasectomy in France. But one thing seems clear to Mireille Le Guen: “Using it for a man amounts to questioning the norm, calling it into question. » As much as a personal decision, the increase in popularity of vasectomy is symptomatic of changes in society and new relationships within couples.
