The Weekly Dose: To my future partner, on my future vasectomy
Someday, like all couples, we will have a conversation about children: to have or not have them, when to have them and for how long to not have them, and how many to have, if we do. Eventually, we will, or we won’t. Then what?
Dear Woman Who Will Say Yes,
When I first thought of writing to you, a number of subjects that will be important to us both, crossed my mind: love, friendship, companionship, money, dreams – even retirement. I don’t suppose either one of us imagined that my first letter – nay, my first ever communication in any form to you, would be about my sperm. Even less likely was the possibility of me making public my private thoughts about my private parts.
But today is World Population Day, and there are enough of us in this country. And enough is enough.
Someday, like all couples, we will have a conversation about children: to have or not have them, when to have them and for how long to not have them, and how many to have if we do. Eventually, we will, or we won’t. Then what?
That’s what this letter is about.
Will we become a wham-bam-baby-in-pram-no-sex-fam? Or will the birth of our child(ren) be only a watershed in our sex lives, dividing the latter into years BC (Before Child) and AD (After Delivery)?
By this time, we will already be practising some form of contraception; if we’re anything like our compatriots, it’s likely that we’ll be using a method which, in effect, only you will have to use. The world over, and particularly in India, intrauterine devices (IUDs), diaphragms, and hormonal contraceptives – all of which require insertion into, or consumption by a woman’s body – are the most frequent choices of reproductive-age couples. Year after year, Indian men definitively respond to surveys by stressing exactly how much they detest wearing condoms.
I usually wouldn’t recommend Google to glean medical information, but enter ‘side effects of (name of female contraceptive)’ in the search bar; the interminable list is enough to make us hope that abstinence is a reliable contraceptive method (it is NOT). Incidentally, do you know who invented the IUD? A man. The diaphragm? Also a man. The hormone in oral contraceptive pills which inhibits ovulation was discovered by, and first artificially synthesised by men. Even the earliest undisputed description of condom use is by a 16thcentury physician who devised it not to protect the sexual partners of his male test subjects from becoming mothers, but so that the men wouldn’t contract sexually transmitted diseases.
Do you see the pattern here?
Each of these methods also has a failure rate. And there is no such thing as a partial failure of birth control; every failure results in a whole new conception. If we follow the trend, this is what we will have to live with.
And then, there is vasectomy. A term that conjures up horror stories from the Emergency in the minds of one generation, and produces giggles in the next. A good technique sullied by a bad name, because of its mass forceful application on a hapless public by a maniacal politician, forty years ago.
Simply put, a vasectomy involves cutting, and closing the cut ends of both the ducts that carry sperm out of the testes (where they are produced), thus cutting off any chance of their fertilising a potentially welcoming egg. Its equivalent in women is a tubectomy, in which the tubes which bringing eggs from the ovary to the uterus for fertilisation, are blocked.
Unlike tubectomies, which require diagnostic investigations, surgery, and hospitalisation, a vasectomy demands none of the above. The sperm-bearing duct is right there at the top-back of each testicle, and is immediately palpable by the man himself, leave alone his doctor. Again, unlike tubectomies, performing a vasectomy requires no scalpel, no stitches and almost no time. We could go out for an evening coffee, get the procedure done, and watch a 6 pm show at the local multiplex (albeit in comfortably padded seats!).
Nothing is left to chance. A vasectomy is literally the tying up of (cut) loose ends.
My medical university considered it so elementary that its syllabus mandates every medical student observe, assist or perform a vasectomy by the end of his course. I and most of my batch-mates have never even witnessed one. I cannot recollect it being taught in lectures, and my knowledge of it was certainly never tested in exams. On the other hand, if I had neglected to study female contraceptive methods, I would likely have failed my MBBS.
An effective vasectomy technique has been available for over a century, longer than most female contraceptives. In 1970 – before the Emergency – almost three-fourths of all permanent contraception in India was ascribed to vasectomies. In the early 90s, this had plummeted to a little over 4%. Over a quarter-century later, the figures still stand at just a little over 6%, despite the government offering men incentives such as compensation for a lost day of work, mobiles, TV sets, even gun licenses! This means Indian women bear 94% of the brunt of sterilisation.
Sterilisation, by the way, is a word we need to stop using. It reminds me of what veterinarians do to animals, against their consent. Contraception is, and should always be a choice, that leads to happiness.
I want us to remain happy, and free of side-effects. And I’m informed enough to know that my manliness won’t be affected by a vasectomy. Testosterone – the hormone responsible for it – is produced by the testes, but distributed throughout the body, not by the duct which is cut, but by blood vessels which are left untouched during the procedure.
Someday, we will have an actual conversation about this. If we disagree, here’s my winning argument in advance: These days, couples say things like ‘we are pregnant’ or ‘we are going to have a baby’. But men can’t get pregnant, nor fear the possibility of an unwanted pregnancy in their bodies. Nature has freed me of any culpability for the consequences of sex. This is my privilege; I must also bear my share of the responsibility of contraception.
When I do get a vasectomy done, I hope I will be candid enough to write another open letter like this one. Because there will be nothing to be embarrassed about; while other couples grope in the dark for condoms and women wait grey-faced in gynaecologists’ clinics or struggle to remember to take the damn pill, we will be living a stress-free life that actually requires long-term contraception.
That bodes well for our relationship, no?