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Thomas Figueroa always knew he didn't want children. Growing up in Central Florida, he remembers his classmates getting pregnant as early as middle school and had considered getting a vasectomy for the past few years.
But after the Supreme Court overturned Roe v. Wade on Friday, he rushed to schedule one. He registered Monday for a vasectomy with Doug Stein, a Florida urologist known as the "Vasectomy King" for his advocacy of the procedure.
"It is something I put on the backburner of my mind until very recently, when the Supreme Court decision happened," said Figueroa, 27, who lives in Tampa. "That was basically the triggering factor right there. It pushed my mind to say: 'OK, I really do not want children. I'm going to get this vasectomy now.'"
Figueroa is not alone. Urologists told The Washington Post that they have seen a spike in requests for the procedure in response to the Supreme Court's decision in Dobbs v. Jackson Women's Health Organization.
Stein said that before Friday, he received four or five vasectomy requests a day. Since the court's decision was announced, that number has spiked to 12 to 18 requests per day.
"It was very, very noticeable Friday, and then the number that came in over the weekend was huge and the number that is still coming in far exceeds what we have experienced in the past," Stein told The Post. "Many of the guys are saying that they have been thinking about a vasectomy for a while, and the Roe v. Wade decision was just that final factor that tipped them over the edge and made them submit the online registration."
Some physicians are facing confusion and fear in a post-Roe world. The American College of Obstetricians and Gynecologists (ACOG) joined several other professional organizations and medical journals in the past few days in warning that the ruling will affect health care beyond abortion, posing new risks for patients and possibly increasing maternal mortality. Doctors are concerned about the impact on situations including miscarriage and in vitro fertilization. The practice of medicine will be reshaped, the group said, or even contradicted "by laws not founded in science or based on evidence."
A vasectomy is a form of permanent sterilization that prevents sperm from flowing through the vas deferens and combining with semen. The National Center for Health Statistics reported that in 2002, the main reasons women provided as to why they were relying on a vasectomy as a form of birth control is that they or their partners already had all the children they wanted. But from 2011 to 2015, other reasons for relying on vasectomies, including medical reasons and problems with other types of birth control, became more common.
There has been a push for vasectomies in anticipation of Roe being overturned and antiabortion legislation taking effect in states across the country. Stein and other vasectomy proponents have taken to the streets and child support offices to encourage people to get the procedure.
Stein said his practice is booked through the end of August with vasectomy appointments, prompting him to open up more days in his schedule to accommodate patients who have recently registered. He and his associate, John Curington, said the decision overturning Roe has directly factored into their patients' requests for vasectomies. Men under the age of 30 who do not have children are requesting vasectomies in greater numbers than before, the physicians said.
"I'd say at least 60 or 70% are mentioning the Supreme Court decision," Curington said. "And a few of them have such sophistication as young men that they actually are thinking about Justice Thomas and his opinion that contraception may fall next. And that's shocking. That's something that doesn't enter into our conversations ever, until this week."
Amanda Omelian, 33, and her boyfriend, Eric Nisi, have also always known they didn't want children. Nisi, 29, had been considering getting a vasectomy for the past few years but said the Supreme Court decision is what prompted him to take the next step.
Omelian, who is from Homosassa, Fla., and is already on two forms of birth control, worries that Florida will soon restrict access to these contraceptives in addition to restricting abortion rights with its 15-week abortion ban that was recently passed. That led Nisi to register for a vasectomy Tuesday.
The sharp increase Stein's practice has reported is consistent with what other urologists say they've seen since the draft of the Dobbs opinion was leaked last month.
Philip Werthman, a Los Angeles urologist, also reported a "300 to 400%" increase in the number of vasectomy consultations he has performed. Esgar Guarín, an Iowa-based urologist who trained under Stein and specializes in vasectomies, said he has seen a "200 to 250%" increase in traffic on his website offering information specifically about vasectomies.
Marc Goldstein, a urologist and director of the Center for Male Reproductive Medicine and Microsurgery at Weill Cornell Medical Center in New York, said he usually sees twice as many patients per week for vasectomy reversals compared to vasectomies.
"Now it's the other way around," he said. "So it's been a dramatic shift. And this [decision] is only going to further impact that in terms of increasing requests."
It isn't the first time a significant news event has caused an uptick in vasectomies. Goldstein said vasectomy requests spiked after the Great Recession of 2008 as more men began to worry about raising additional children while under financial stress. When the coronavirus pandemic began in 2020, there was also an increase in requests with more men working from home, Guarín said.
"When something like that in the news happens, we get a bump," Guarín said, adding that he has seen a consistent increase in vasectomy requests per year. "The overall upward trend continues but the dramatic bumps don't."
The Affordable Care Act doesn't require all insurance companies to cover the deductible for vasectomies, unlike women's contraceptives, which are covered as "preventive services." Nisi, who is between jobs and doesn't have health insurance, said he is paying out-of-pocket for the procedure, which costs just under $600 at Stein and Curington's practice.
Figueroa, an IT professional, said he also decided to pay out-of-pocket despite having health insurance from his employer.
"That's no worry for me at all," he said, adding that the ease of the procedure motivated him to get it done. "Birth control for a woman doesn't really need to be necessary for something, in my opinion, that is as cheap and very quick."
Urologists attribute the general increase in vasectomies to an evolution in attitudes among men.
Werthman emphasized that the recent uptick in vasectomy requests in California has come despite the fact that the right to an abortion in the state will probably remain unaffected by the Supreme Court decision. "If there's any state in the country that is not going to allow abortion rights to be abrogated, I think it would be California," he said.
Werthman, who performed vasectomies for two decades at Planned Parenthood, said he believes there has been a "change in the psyche of men," and that they are more concerned about their role in family planning than they were previously.
Nisi said he doesn't want Omelian, his girlfriend, to "stress over getting pregnant" because of a potential lack of access to birth control in the future. "The world is a scary place and you don't know what's coming, because it seems like we're moving backward."
Figueroa echoed the sentiment, saying what has unfolded in the days since last week acted as the final push he needed to register for the vasectomy he had long been considering.
"This is probably one of the very, very rare things in politics that actually does affect me very personally and very hard," he said. "It really woke my eyes up."
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The Washington Post's Ariana Eunjung Cha contributed to this report.