Bracket-busting upsets, Cinderella stories, OT buzzer beaters – March Madness is here! Or, as some urologists think of it, vasectomy promotion season.
Since 2004, urologists have been promoting vasectomies every March, promising patients who elect the procedure an excellent excuse to relax on the couch and watch college basketball.
There’s evidence that these “Vas Madness” promotional tactics – sometimes paired with food giveaways and cheeky swag – may be effective. At least one study has noted an increase in vasectomy rates in the U.S. during the month of March.
This spike in vasectomies illustrates how communication about this procedure – and its perceived relation to manhood – can make a substantive shift in public acceptance of contraceptive sterilization for men.
I am a scholar of rhetoric and gender studies, and I have been studying the language around vasectomies for years. In my forthcoming book, “Stop Saying Snip! The Rhetoric of Vasectomy,” which will be published in April 2026, I show that communication plays a significant role in prompting people to welcome, seek or avoid vasectomies. In fact, I’ve found that language about fertility and communication about contraception greatly influence all decision-making around preventing pregnancy, particularly who should bear the burden of it.
Table of Contents
Gendered communication about contraception
For my book, I interviewed 17 people who rely on vasectomies to prevent pregnancies, and I asked them how they learned what a vasectomy was. Few knew for certain, and most did not remember at all.
This makes sense when you consider that information about this procedure is not routinely delivered to anyone. I have found that knowledge about vasectomies is not guaranteed to be covered through sex education in school, during annual doctor visits, through insurance coverage that encourages preventive health practices, or even in discussions with family and friends.
Rather, the rhetoric around preventing pregnancy places the onus of contraception on women. Throughout their lives, women receive messages from partners, parents, friends and medical providers that prompt them to think about their fertility and to take on the responsibility to manage that fertility. These messages subtly communicate that this is the most natural or normal way to prevent pregnancies.
In contrast, men do not often get this message that they should think about their fertility and take on the responsibility to manage that fertility. For example, men are rarely prompted to explain what they are doing to prevent pregnancies. One military father of two whom I interviewed for my book said that his primary care physician never discussed birth control with him at checkups. Yet each time his wife had a baby, her doctors would inquire whether she wanted to undergo tubal ligation, the sterilization procedure in which the fallopian tubes are cut.
Rhetoric, including questions providers do or don’t ask, plays a role in the unbalanced sterilization rates among men and women. According to a 2024 Kaiser Family Foundation survey, 25% of the women surveyed were sterilized, in contrast to just 11% of the men. And according to data from the National Survey of Family Growth, in 2022-2023, 6.8% of men age 18 to 49 had vasectomies, whereas during the same time period, 11.5% of women age 15 to 49 using contraception underwent sterilization.
In fact, female sterilization is the leading method of contraception used in the U.S., even though it is riskier and less cost-efficient than vasectomy.
Prostock Studio/iStock via Getty Images Plus
Manhood in the English language of fertility
The very language that English speakers use to refer to men’s fertility can conflate reproductive capacity with a positive vision of being a man. This makes acceptance of vasectomy quite tricky.
In medical articles, men’s reproductive capacity is discussed as “fertility.” But more colloquially, English speakers often use very different terms, such as “potency” and “virility.”
Potency comes from the Latin word potentia, meaning “power.” In English, potency refers to “power,” the “ability to affect something,” “authority” and “influence.” It also refers to the “ability to achieve erection or ejaculation in sexual intercourse,” to which the Oxford English Dictionary adds, “Also: fertility (of a male or female).” I have yet to encounter literature or messaging involving a potent woman — other than, perhaps, to refer to her scent.
Men who can reproduce may also be referred to as “virile,” from the Latin vir, meaning “man”. This inscribes a sense of “manhood” into language about men’s fertility: The Oxford English Dictionary defines virility as “mature or fully developed manhood or masculine force,” and “the power of procreation; capacity for sexual intercourse.”
The multiple meanings of these words help to explain the misconception that vasectomy, in curtailing fertility, threatens a man’s ability to influence others, access power and perform sexually. In this way, rhetoric around men’s fertility can interfere with broad acceptance of vasectomy.
After all, undergoing a vasectomy does require a willingness to be vulnerable. It involves talking to a medical expert about your sexual and reproductive desires, allowing medical staff to see and touch your otherwise private parts, and following another’s orders for what to do. This includes returning to the doctor’s office with semen to be analyzed in order to determine if the procedure was a success – a step many men skip.
And vasectomy is a surgical procedure, so it also means facing some risk of harm, albeit small.
Taken altogether, undergoing a vasectomy means behaving in a way that may feel in direct opposition to dominant cultural understandings of being “a man” – someone potent, virile and always in control.
Broadening communication about vasectomies
“Vas Madness” promotional tactics are one of the few public campaigns about the procedure. Yet even after the “madness” is all said and done, women still tend to do the brunt of pregnancy prevention work, consuming pills, implanting intrauterine devices, receiving injections and undergoing tubal ligation surgery, while managing all the doctor’s appointments and side effects those methods entail.
In conducting my research, I found that women’s efforts to give their partners information about vasectomies and to share the burdens they bear in managing fertility are an important driving force in many men’s decisions to have the procedure.
One 35-year-old man I spoke with had been relying on his partner to use birth control methods to prevent pregnancy, including an IUD placement that went wrong and then a contraceptive implant. After research and discussion, they decided on a vasectomy to prevent pregnancies moving forward. The man told me that his partner is “very informed about medical things.” He continued: “Any sort of trepidation I had about it, it was very easy to talk to her about it and be like, ‘OK, this really isn’t that big of a deal at all.’”
But communication from more sources, beyond seasonal urologist campaigns and the individual efforts of romantic partners, could help inspire more people to see vasectomies as a normal, needed and helpful procedure to prevent pregnancy.
In the meantime, reproductive labor continues to be, overwhelmingly, women’s work.
