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The curious status of the vasectomy in the UK in 2023: ‘Young, none and done’
In the fallout from last year’s overturning of Roe v Wade, the legislation that secured abortion rights in the US, a great many young American men simultaneously did a quite radical thing. They took to social media to intimately document themselves getting a vasectomy, to prove it was a simple and painless act. One was vegan bodybuilder and influencer Brian Turner, who was certain from around the age of 22 that he’d never want children. He acted on his stance, aged 30, and made some genuinely great content in the process. “The reaction was positive,” he tells me. “A few people commented in disbelief, calling me crazy names or saying, ‘You’re no longer a man – you chopped your balls off.’ But they don’t bother me. I have a thick skin.” It started a global discussion on vasectomies, chiefly around how men can step up and take the burden of contraception away from their female partners forever. Adam, a 35-year-old father of two from Brighton, had the same desire around the same time: “I had a growing guilt about never really fully taking responsibility for contraception. Apart from condoms, all the solutions are for women, and they all seem to have pretty gnarly side effects. It seemed like the decent thing to do, to try to take on the responsibility.” But what of younger British men, who absolutely, definitely don’t want children, who know they want to be what I call “none and done”? For them, although the hurdles are curiously higher and their reasoning more diverse, the same desire to make an informed decision about their body exists. Britain has never had a big national conversation about the vasectomy, the way America – a place where some states even offered them for free in the wake of the Supreme Court’s historic verdict – clearly has in recent years. “The vasectomy was thought to be illegal here until around the Sixties, and only came on the NHS in the early Seventies,” explains Dr Georgia Grainger, a historian of vasectomy. Before this, the concept of men choosing to sterilise themselves was – in her words – “murky”, owing to many of the key doctors and campaigners evangelising the process also being supporters of eugenics. It was actually the beloved broadcaster Michael Parkinson who, in Grainger’s eyes, did the most to burst bubbles on the subject. “He was open about having a vasectomy back in 1972 when it was still very uncommon. He did an interview about it that was on the front page of the first issue of Cosmopolitan magazine. It definitely brought awareness and also dispelled some myths – that it would affect a man’s masculinity or even cause things like a higher-pitched voice”. While the procedure has undoubtedly become more common, I’m not sure that we as a society know a huge amount more about it than in the Seventies. The good news for men is that the procedure is more successful than ever. Doctors reported in March this year that, after surveying 94,000 patients, only 0.2 per cent of men get what’s known as “chronic scrotal pain”. It is generally seen as being more than 99 per cent effective as a form of birth control. The bad news is that there’s still a lot of misinformation around it – from daft macho ideas that it decreases your testosterone levels or sex drive (it doesn’t) to the more assimilated notion you hear a lot: that, similar to an intrauterine device (IUD) with women, it’s easy to undo (it isn’t sadly, not all reversals work, they get less successful over time plus they’re significantly more expensive too). In reality, a vasectomy is quick, carried out under local anaesthetic and takes around 15 minutes. Today, most are what’s known as “scalpel-free”, meaning the incision is so tiny (only 2-4mm) that it doesn’t require stitches. The two tubes that carry sperm from your testicles are severed (hence the colloquial term “the snip”) and closed. Post-surgery, men are encouraged to rest for a couple of days, to apply ice packs to their scrotum and – if possible – wear a jock strap that’s slightly too small to ease any swelling. And that’s it. “The most common question I get asked is, “Do you still cum?’”, says Gregory, who had a vasectomy in January. “It’s funny how so many people think you’ll never ejaculate again after a vasectomy. The truth is: the difference isn’t noticeable.” In fact, sperm is still produced, but it’s discharged internally and absorbed by the membrane around the epididymis (the coiled tube behind each testicle) in a totally natural process. The body still produces semen, which is ejaculated but it no longer contains sperm – although it’s said that a man needs to ejaculate on his own a good number of times before the presence of sperm totally vanishes. “I did hear rumours about ‘40 w***s’,” confirms Gregory, “but I just stuck with the doctor’s deadlines and the sperm test came back clear four months later.” Yet, while the procedure has some fringe areas of conjecture, one important aspect is dramatically less well known: men – especially young men – won’t automatically be granted a vasectomy if they choose to have one. There’s huge variation in the UK, based on regional NHS procedures and resources, plus, “a lot depends on the individual doctor, unfortunately” according to Grainger. Some areas don’t offer them, meaning having to go private and pay an often prohibitively expensive £600. But even simply having the autonomy to choose is also a grey area. “A lot of younger men, especially if they’re unmarried or don’t have children, really have to push to get a doctor to take them seriously,” says Grainger. “We often think of that kind of pushback as being something women get within their reproductive healthcare, but I’ve heard a lot of men share their experiences of having to go to multiple doctors to find one to agree to refer them for a vasectomy, just because they ‘might change their mind’.” This seems like quite a significant flashpoint, given that all the urologists we spoke to confirmed a definite movement of younger people wanting the snip. “Traditionally, the typical age of a man seeking a vasectomy would be 35-40 years old,” states Dr Peter Quinn who performs the procedure for Vasectomy NI. “However we are finding more and more younger men in their twenties are looking for a permanent method of contraception.” Luckily, I didn’t encounter a single man who had any regrets or who had “changed their mind”. What I found instead were more men making an informed choice around their own reproductive health, from a variety of backgrounds, viewpoints and life situations. Some for example, like Simon, are single and dating. He had his tubes snipped aged 28, while in a long-term relationship that subsequently ended. Does he have any regrets? “Absolutely not – I really want to make that clear.” Despite being from a big family with plenty of cousins whom he loves, he’s felt like he’s known he never wanted children himself “from as far back as my teens”. Now aged 30, he’s starting to date again. He doesn’t declare his snipped status on the dating app he uses, but does bring it up quickly, in case there’s any awkward confusion. “Not wanting to have kids is a pretty big part of who I am, I feel like I talk about it all the time anyway without needing to advertise it.” Ray, who is also young, single and snipped feels “it’s a flex” when it comes to being on the dating scene. Aside from being a talking point and a sign of emotional maturity, crucially it “finalises that aspect of ‘maybe he’ll change his mind’. which I have experienced in relationships in the past. I’ve been very clear I don’t want children previously, but nobody fully believes that when you tell them. They might put it to one side and say ‘let’s think about that later’.” Ray also has no regrets. Dr Nick Demediuk has performed more than 50,000 vasectomies in his career. The name of his clinic in Australia says it all: Dr Snip. His perspective over 34 years of performing a life-changing operation is thus pretty unique and his recommendation is unequivocal: “It’s the simplest and easiest form of permanent contraception that responsible men can use to contribute to their relationships and the planet.” For him, one of the key reasons behind the growth in younger men taking up vasectomies has been “issues related to climate change”, with a significant subgroup of “hard-line vegans”. There’s not enough resources for people alive on earth today – it feels almost a bit selfish for us to contribute to that scenario Nat and Charlie* This chimes with Nat and Charlie*, a male/female couple who moved from a big city to the English countryside this year, in part motivated by a desire to give their beloved trio of cats more space. Having been on the fringes of eco-activism since university, their decision – raised initially by Nat and enthusiastically supported by Charlie – to have the procedure when Nat was 29 was very much informed by the climate emergency. “We both feel like we’re loving people and capable of lots of love,” says Charlie “but we both felt inside of ourselves that we never wanted to have children, especially in the world as it is today.” Citing the extreme weather events all over Europe this summer as just one example, they fundamentally worry about the world being safe enough to bring kids into, as well as the feeling that “there are not enough resources for people alive on earth today – it feels almost a bit selfish for us to contribute to that scenario.” They stop short of endorsing the emerging philosophy of anti-natalism, a controversial belief first advanced by South African philosopher David Benatar that sees all human reproduction as immoral, in part due to the climate emergency but also because life is inevitably tinged with suffering and pain. But, in choosing not to have children out of concern for the environment, they find themselves at one end of an extreme and widening political spectrum. The same week I speak to them, Hungary’s leader Viktor Orban was holding the fourth of his biannual Demographic Summits, which – with Italy’s leader Georgia Meloni, religious leaders and right-wing thinkers in tow – aimed to solve what’s seen as a crisis in underpopulation in Europe. Encouraging more babies via defence of traditional family values feels a world away from the outlooks of Nat, Charlie and the many others taking up the vasectomy as a way of definitely not having kids on principle. As if we didn’t have enough 50-50 splits in society today, an increasing number of people believe we need fewer children while an equal number believe we need more. Britain in 2023 therefore seems conflicted between two worlds – the privatised freedom of America where a young, non-parent like Brian Turner is waved through (“I talked to my GP and she said, ‘All good’ and referred me straight away”) and a more prohibitive or simply untrusting mindset that looks at a young man and says, “Hmm, go away and think about it a while.” Perhaps if we want young men in society to play a more positive, active role, maybe they need to be trusted with their own bodily autonomy first? *Names have been changed Read More No music, no ball games, no fun: society is wiping out play ‘I was really struggling to get it up’: Why younger men are turning to Viagra I couldn’t climax, so I let ‘big testosterone’ take me for a ride Woman prepares hamper basket as her husband’s vasectomy gift Why taking a mental health day could be bad… for your mental health What the world’s happiest children tell us about where Britain is going wrong
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The dish that defines me: Frank Yeung’s prawn wontons
Defining Dishes is an IndyEats column that explores the significance of food at key moments in our lives. From recipes that have been passed down for generations, to flavours that hold a special place in our hearts, food shapes every part of our lives in ways we might not have ever imagined. There is a family scene I would love to engrave into my memory that involves my father, myself and my son, all making prawn wontons in one kitchen. Prawn wontons are so simple, like all good dishes, and they have a really special place in my heart. I have very fond memories of making them with my father, who is from Hong Kong, when I was growing up and it is my favourite dish. Now, it’s my five-year-old son’s favourite dish as well and he’s the same age I was when I first started making prawn wontons with my father, so it makes me excited to share the dish with him. When my son was younger, his Ye Ye (grandfather) would bring homemade wontons whenever he came over to my house in Peckham. But just recently, we were over at my parents’ home, and he made his first wonton. We were all very proud! It’s so nice because it’s a dish that has run right through my family, it was brought and championed here by my dad. He moved here in 1975 and has the classic first-generation immigrant story. He worked three jobs, moved around a lot, saved money and opened his first restaurant in 1985, 10 years after arriving in England. He finally retired in 2017, but he couldn’t get away from my restaurants. I opened my own establishment, Mr Bao in Peckham in 2016, and then Daddy Bao in my father’s honour. Even now when he comes around to visit, I make him talk more about restaurants. I think he enjoys it, though, and it reminds him of home. That’s really important now because ever since the 2019-2020 mass protests in Hong Kong, the country is a sad place at the moment if you’re from there. But it’s still an amazing place. My favourite part about making wontons from scratch was always the time spent with my dad. The chit chat between us, me kneeling on a stool and him standing at the counter. My hands were not as dextrous at that age and I certainly wasn’t practised, but he would be there to help show the right way to make the little parcels and finish them up for me. The bonding moment is what I cherish the most. Mum is English and she got involved too, she is actually amazing at it. Prawn wontons are also part of Christmas time for my family. Our big tradition is to have a massive steamboat on Boxing Day, which most people of Chinese descent will be familiar with. It usually involves a big, steaming pot of soup on a constant boil, and everyone sits around the table cooking fresh, raw ingredients in it and eating as they go. Prawn wontons are a big, big part of that meal for us, especially now that we have a couple of young kids running around at Christmas time, they really love it. The thing I remember most about making wontons with Dad is the filling. He has his own method for making the prawn mince that goes inside the parcels. He gets his prawns and chops them up, mixes them with any additional ingredients like garlic, and then he would make me pick up a handful of the mixture and throw it back down onto the chopping board, pick it up and throw it back down. It somehow aerates the mince and softens it, and makes it stickier so there aren’t big chunks of prawns floating around. I haven’t really adapted Dad’s recipe for myself, aside from the type of dipping sauce I like to have with them. We keep it very traditional. Oh, I suppose I do have a slight modification, actually. I like to mix gambas (white) prawns from the southwest coast of Spain with North Atlantic shrimps, which are tiny, tiny little crustaceans the size of your nail. They have got a really good flavour. I like to chop those up into the mince with the bigger prawns, add a bit of salt and white pepper, stir it through and then do the throwing method as my dad does. We usually make our own wonton skins. In a pinch, we’ll use shop-bought ones, but when we know we’ve got time we’ll make our own. At the moment, Dad makes handmade dumplings with my sister for her business so they have a dumpling skins machine – but we used to make them by hand, old-school style. He would roll them out because he could get the thickness of the skins right. It wasn’t possible when I was young as I had no idea and was clumsy! They have to be thin, but not so thin that they break or the wontons will open up in the water. It’s something I haven’t managed to master, but there’s still time. Some places don’t even use the regular wonton skins, and they are still amazing. One of my favourite restaurants ever was in Hong Kong – it has closed down now – but it was a hole-in-the-wall type of place that served two types of wontons: classic wontons or fish skin wontons. That was their entire menu. They used fish skins instead of pastry skins to wrap their wontons, and they were something like £1.20 for a bowl at the time. It was definitely the best meal I had with Mum, Dad and my sisters in Hong Kong. The wontons get boiled for two minutes. You can make a wonton soup with a base stock, using ginger, spring onions, salt, pork bones. Boil that down and skim off the top. Or, you can dip the wontons into a chili garlic sauce, which is how my dad likes – although another way I differ from Dad is that I like to add black vinegar to the sauce of soy sauce, garlic and chili, to add an extra layer of acid. You can also eat them as they are, they are completely delicious. My stomach is rumbling as I think about them. As my son gets older, it will be really nice to be able to make wontons altogether, the three generations of us at the kitchen island, chatting away. That’s what I’d like my son to take away from those sessions, the memory of doing it with his Ye Ye and me. I’d also like him to, in time, be able to link quality to food and what you’re putting in your body. I want him to understand that even though it’s so easy to go to the shop and buy something, everything starts out as a living thing. A prawn is an animal and a chive is a real plant grown in the soil. You don’t have to make it yourself and you should go to restaurants to support them, but when you do go, you’ll have a better appreciation for it. Frank Yeung is the chef-owner of Mr Bao and Daddy Bao in London. 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