How a Supreme Court ruling against women backfired

When America’s Supreme Court overturned the historic Roe vs Wade ruling that made abortion a federally protected right, it triggered a fierce debate over women’s freedom – and led to a total ban on the procedure in 13 states.

This ruling triggered a spike in Clinic vasectomies after the Supreme Court overturned Roe v Wade last year.

Campaigners on both sides had predicted precisely such an outcome, but there was another unexpected side effect. America is now undergoing what urologist Esgar Guarín, of the SimpleVas clinic in Iowa, dubs a “vasectomy revolution”.

Across the country, more and more men are choosing to have the operation because they no longer have a back up option.

“Within the first 48 hours of the overturning of Roe v Wade, our clinic saw a 300 p/c increase in the traffic to our website. Then we had a 100 pc increase in the number of vasectomies that we do in the clinic", Guarín says.

The full force of the boom lasted four months, but even today the clinic’s vasectomy procedure numbers are still up by 50 p/c on levels seen before the Supreme Court decision.

If maintained, this surge is likely to have long-term consequences – and not just for the men involved. It could further exacerbate a decline in the US birth rate that is already putting long-term growth at risk in the world's largest economy.

“The birth rate has fallen pretty dramatically since 2008", says Alison Gemmil, a demographer at Johns Hopkins University.

Women are having children at older ages.

“We expected this decline because of the great recession, because when the economy is bad, people don’t have children. But then the economy got better and the birth rate kept declining", says Gemmil.

“Since the pandemic, it just seems like there is something different that is changing people’s ideas about having children.

“It is not just linked to the traditional indicators of whether the economy is doing good or bad anymore".

Guarín also operates a mobile clinic, “a big box with sperm printed across itself and a big sign on the back that says ‘honk if you have had your vasectomy’'.

Each month, he drives 700 miles around the state of Iowa. In November, he drove to a series of Planned Parenthood centres between Iowa and Missouri – locations that previously carried out abortions – conducting 110 free vasectomies.

“They had been relying on the contraception that their partners were using. They came and said things like, ‘I am doing this because I cannot rely on the termination of a pregnancy, which was my last option’,” says Guarín.

As yet, there is no official data, but widespread anecdotal evidence shows that American men are racing to get vasectomies.

In the week in May 2022 that the decision to overturn Roe v Wade was leaked, Google Trends data shows searches for “vasectomy” in the US surged by 115 p/c. In the week when the decision was formally announced, searches were up by 285 p/c compared to the same point a year earlier.

It is clear that demand has been maintained. Searches in April this year were up 25 p/c from their pre-pandemic level.

For a research paper published in the International Journal of Impotence, a group of urologists at the Cleveland Clinic in Ohio tracked vasectomy procedural billing data from 2018 to this year at a large midwestern healthcare organization which encompassed 13 community hospitals across urban and rural settings.

The number of vasectomy procedures jumped when the Roe vs Wade decision was leaked, then rocketed after it was formally announced. By August 2022, the healthcare organisation was doing 218 procedures a month. This was more than double the monthly figure in 2018.

These figures incorporate patients who had initiated consultations before the ruling, but the decision likely pushed them to schedule the procedure, the report said. The trend is expected to continue. They noted a 35 p/c year-on-year increase in consultation requests and a 22 p c increase in consultations.

Crucially, the researchers reported a major demographic shift in the men who were seeking out the procedure.

Previously, men getting a vasectomy were older and already had children. Today, those getting the snip are younger and much more likely to be childless.

“Younger men, especially those under 30, as well as childless men were significantly more likely to seek consultation post-Dobbs compared to the prior reproductive legal climate", the report said.

“Findings indicate that men are invested in maintaining reproductive autonomy for themselves and their partners".

After Roe v Wade was overturned, the median age of a man getting a vasectomy fell from 38 to 35 years. Nearly a quarter were under 30, compared to just one in 10 in 2021. The 2022 cohort were also less likely to be married. The share who did not already have children doubled from one in 12 to one in six.

“The overturning of Roe v Wade in June 2022 has changed the landscape of family planning for male partners", the report said.

“The immediacy with which this change was seen indicates that the post-Dobbs generation has already been significantly affected by the legal climate and the population-based consequences of this decision will continue to be seen in multiple ways for decades to come".

The surge in vasectomies threatens to deepen the wider slump in America's birth rate.

In 2021, the number of births was the third lowest in 40 years. If the 2007 fertility rate had continued in the years after the financial crisis 8.6 million more children would have been born in America by 2021, says Kenneth Johnson, professor of sociology and senior demographer at the Carsey School.

There is also a secondary vasectomy revolution, which is separate to Roe v Wade. At his New York practice, consultations have doubled in the last six months, says Marc Goldstein, professor and director of male reproductive medicine at Weill Cornell Medicine in New York.

Here, abortion is legal. But men have a different motivation.

“What I’m seeing is very similar to what we saw during the great recession of 2008", he says.

“Back then, there was a marked increase in demand for these activities and a decrease in demand for reversals, and this was clearly related to economics, people felt they just couldn’t afford to have more children.

“The patients who are coming to me today are almost all couples who have decided that this is not a world into which they want to bring children into", says Goldstein. Half say they cannot afford to, he adds. Others cite climate change.

“I’m seeing men in their early 30s who have never had children but have decided that this isn’t the world they’d ever want to bring children into", says Goldstein.

Goldstein himself uses a method known as the “no scalpel” vasectomy. “I brought it back from China", says Goldstein.

It was a technique developed during the era of the One Child Policy – an era that created a demographic timebomb.

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Disclaimer:

A ‘vasectomy revolution’ threatens to plunge America into a population crisis. Story by Melissa Lawford-The Telegraph.