I was recently watching Netflix’s “Explained” series on birth control and pregnancy, and I was shocked to learn that females ages 15-49 are far more likely to be sterilized than males.

While this imbalance greatly differs based on the region, female sterilizations outweigh male vasectomies in all regions except Oceania. Even then, it’s a close call.  

Women are responsible for the larger portion of contraception and are tasked with live birth — so, why aren’t there more vasectomies? What are we doing as a society to make sure that females and males can support each other appropriately?

In this article, I’ll take a deep dive into the data surrounding sterilization, and the factors that may affect it.

The Facts Around Contraception

Birth control as we know it has had a rich history that has changed drastically within the past century. While condoms were originally made out of materials like animal intestines dating back to 3000 B.C, female oral contraception, otherwise known as “the pill”, wasn’t developed until the 1950s. 

Soon after, IUDs, hormonal patches, vaginal rings, and implants emerged on the market, though only fairly recently. Here is what the contraceptive market looks like today on the world scale based on the 2019 report by the UN. 

Source: “World Contraception Use 2019”

Surprisingly, female sterilization outweighs even short-term birth control methods. While 24% of females ages 15-49 rely on sterilization to prevent pregnancy, 21% of males use condoms.

Granted, these statistics are a result of a number of factors. Contraception access in undeveloped countries is significantly less than that of developed nations, making contraception less about choice and more about practicality. 

Source: “Principles of Gender-Specific Medicine”

As seen in this figure by Science Direct, males in more developed countries are more likely to engage in sterilization and use condoms, while females are more likely to use less long-term forms of contraception, like the pill. 

However, female to male sterilizations are still largely imbalanced in most developed nations regardless. From an objective standpoint, vasectomies are less invasive, just as effective, and offer less potential complications than female sterilizations.

Vasectomies are cheaper on average when paid for out of pocket in comparison to female sterilization costs. Interestingly enough, female sterilization is largely covered under the Affordable Care Act under most U.S insurance plans while vasectomies are not. 

With not as many options for men, it appears sterilization rates could come down to which method is more financially feasible under insurance. 

In the same vein, condoms are not covered by most insurance plans in the United States, though they aren’t a drastic expense for most people. Even so, most men don’t use them. Unfortunately, it appears our healthcare system is set up to disproportionately place the burden of pregnancy prevention on women. 

There have been a number of efforts to produce an effective male oral contraception pill, but these studies have been largely unfruitful due to three main factors: 1) It’s difficult to effectively eradicate sperm on a regular basis (Think blocking out one egg versus the production of millions of daily sperm), 2) Certain side effects have prevented clinical trials from taking place, especially with modern legislation, and 3) There’s not a lot of funding to back these studies.

Putting a drug out on the market requires endless amounts of testing, and it appears we aren’t super close to having a viable method of short-term male contraception. 

Why I Think Guys Need To Step Up

Statistics aside, I think vasectomies should be much more common for a variety of reasons. I can totally understand why a couple may opt for female contraception/sterilization if they are financially bound. However, if a couple is well-off enough to have the luxury of that choice, guys need to rise to the occasion. 

Childbirth alone is enough reason for men to bear some more weight of contraception. Everyone knows pregnancy and live birth can be excruciating, so it only makes sense to me that a man would gladly step up to the plate for sterilization if given the opportunity.

This is assuming that two partners are in a monogamous, long-term relationship. I can see how men may feel less inclined to sterilize considering their ability to get pregnant usually lasts well into old age. 

While families covered by insurance are likely to have more financial access to female sterilization under the Affordable Care Act, vasectomies are still safer and less invasive at the end of the day.

Women are tasked with dealing with periods, childbirth, the pill, you name it — at the very least, sterilization shouldn’t be a part of that list.