Chapter 9: “I'll Take One for the Team”: Individual- and Couple-Level Decisions About Sterilization

Men’s participation in family planning has garnered increased attention since the 2022 Dobbs decision ruling that the Constitution did not confer a federal right to abortion. Yet among those who have reached their desired family size, female sterilization (tubal ligation) occurs far more often than male sterilizations (vasectomies). We utilize unique longitudinal qualitative data from a class-diverse sample of 61 couples who were cohabiting in the early years of the 21st century and were reinterviewed in 2020, to explore the process of making decisions about sterilization among those nearing the end of their reproductive life course. Vasectomies were more prevalent than tubal ligations in our sample, unlike findings from nationally representative data, reflecting the union status, class, and racial composition of our respondents. Many more men had contemplated getting vasectomies than had gone through with the procedure. Those still considering whether to obtain a vasectomy mentioned cost, dissuasion from doctors, and nervousness about the procedure to justify why they had not yet obtained one. Vasectomies were more common among men who had married, in part because fatherhood was still on the table for cohabitors partnered with younger women. A partner’s encouragement and a desire to “do their part” shaped men’s willingness to obtain a vasectomy – suggesting the need for additional focus on allyship and men’s roles in reproductive health in existing research. Our results shed light on how partnership shapes the ways that men think about their reproductive responsibilities.