On a Friday afternoon in August 2017, Marcos Cline and Rob Clyde meet up at AKA, a posh, extended-stay hotel in Los Angeles’s glamorous Golden Triangle, a few blocks from Rodeo Drive. When they enter their reserved suite, the two friends are greeted with white robes and slippers, Spago’s pizza, sparkling apple cider, and a flat-screen TV already tuned to ESPN. Soon, they get a phone call letting them know a stretch limo is waiting downstairs. A five-minute drive delivers them to the Beverly Hills clinic where Dr. Paul Turek is waiting, ready to sterilize them.
The idea of group vasectomies—getting snipped with one or more buddies by your side—isn’t new. Turek has been offering group vasectomies for the last five years, and many other urologists around the world offer a similar experience, but it wasn’t until July 2017 that Turek and his team began to refer to this procedure as a “brosectomy,” a term he trademarked in 2017. Later that month, on July 23, the Wall Street Journal weighed in on the “growing trend” of vasectomy parties and the story quickly spread across numerous news outlets, including ABC, which sent the Good Morning America correspondents to follow Marcos and Rob on their brosectomy journey.
I meet Marcos and Rob at the office they share on the 11th floor of a building in LA’s fashion district. Rob and his brother Ben run the creative production company Squint Direct; Marcos heads the content and commercial production company Altered.LA.
Rob offers me a cup of freshly brewed coffee, and the three of us sit around a table in a spacious conference room, as though we’re here to discuss a potential distribution deal. I’m suddenly aware that I’m here to ask a set of strangers some very personal questions. But Marcos and Rob are both easygoing, happy to share the details of their somewhat unorthodox experience.
When they enter their reserved suite, the two friends are greeted with white robes and slippers, Spago’s pizza, sparkling apple cider, and a flat-screen TV already tuned to ESPN.
Marcos, 41, has been married 11 years and has a nine-year-old son. Rob, 47, has been married to his wife 22 years, with two sons, ten and four years old. Neither of them had given much thought to vasectomies until fairly recently, when they began to consider the rising demands, sacrifices, and costs of expanding their families—not only financial considerations, but also professional and environmental ones. After talking it over with their wives, they agreed they had all the children they needed.
“My wife and I had originally thought we were going to have two kids and adopt a third,” Marcos told me. “And then when the reality of the cost of raising a child came into play, it changed our perspective entirely.”
Marcos explains that he had been depending on his wife to handle the couple’s birth control issues, placing the burden squarely on her shoulders. Nearly a decade after the birth of their son, and after agreeing they weren’t going to have more children, he and his wife decided he would now be the one to take on the responsibility.
“My wife was on an IUD for years and years, and that, to some extent, is a hormonal bomb inside of her,” he says. “And it only seemed fair that, after her doing that for ten years, the responsibility was now mine.”
Half a million vasectomies are performed in the United States every year. Nine percent of sexually active men, on average, get the procedure, compared with 27 percent of women who’ve gotten tubal ligation surgery (often called getting one’s “tubes tied”). The rate of men getting vasectomies is in decline in the US—possibly because couples are holding off on starting families until later in life, or because of the increased popularity of IUDs. The UK is seeing the same trend: there were 29,344 reported vasectomies in that country between 2005 and 2006; between 2015 and 2016 that number dropped to 10,880, according to the British National Health Service.
The reasons why a man might be apprehensive about having a vasectomy vary, from general squeamishness to concerns that it will affect his virility. Though the procedure does not usually affect one’s sex drive, a common concern men have is that it might somehow threaten their perceived manhood.
“I found that a lot of conversations I’d had with men—a lot of them were fearful,” Marcos says about the discussions he had after his surgery. “I had so many people ask me, ‘You don’t feel like a little bit less of a man?’”
“I think comments like ‘You are less of a man’ are more of a reflection on one’s own perspective of their own manhood,” Rob adds. “If being a 55-year-old man and knowing you can get somebody pregnant makes you more of a man, well, good for you. But that’s not me.”
“I had so many people ask me, ‘You don’t feel like a little bit less of a man?’”
The first recorded vasectomy was performed on a dog by British nobleman Sir Astley Cooper in 1823. With his study, “Observations on the Structure and Diseases of the Testis,” Cooper’s experiments demonstrated that the procedure did not affect the dog’s virility and was not a gentler form of castration. By the early 20th century, thousands of vasectomies were being performed on men in the United States and Europe—although they were usually prisoners and it was frequently done without their consent, as a means of eugenics or forced sterilization. In 1902, 42 inmates at the Indiana Reformatory were sterilized by the appropriately named Harry C. Sharp, who believed that it would stop future criminals from being born, while also curbing an inmate’s criminal tendencies.
Vasectomies took an entirely different turn in Europe in the 1920s and ’30s, when such distinguished thinkers as Sigmund Freud and William Butler Yeats went under the knife. The surgery was then being promoted for its rejuvenating effects; Freud, who suffered from jaw cancer, hoped it would prevent his cancer from recurring. But it was also pushed as a sort of permanent antecedent to Viagra. Yeats called his post-vasectomy period his “second puberty”: “It revived my creative power,” he said. “It revived also sexual desire; and that in all likelihood will last me until I die.”
In the US, it wasn’t until after the Second World War that vasectomies started to shake off their association with eugenics to become a more common form of voluntary birth control. Studies released in the 1950s showed that the procedure was not harmful to men’s health, and having one became more popular in the decades to follow, coinciding with the rise of the women’s rights movement and a wider discussion about contraception.
But even today, whether from a fear of sharp objects or fear of emasculation, vasectomies remain nerve-wracking for many men, as evidenced by the comparatively low numbers of American males who undergo the procedure. Nearly two centuries after Cooper’s experiment, men still aren’t convinced they’re not being neutered; a 2015 study by the United Nations found that only one in ten American men had had a vasectomy, a lower number than in other developed countries. An increase in public awareness, education, and improved access to health care might help. Or, like public speaking or whitewater rafting, sometimes it can just help to have a trusted buddy to talk you into it.
“Rob called me up and he was like, ‘Have you ever heard of a brosectomy?’” Marcos says. “And I was like, ‘What? I have no idea what you’re talking about.’”
“It’s a weird thing to bring up to a friend,” Rob admits.
Rob says he’d reached out to other friends and colleagues, but Marcos was the only one who said yes. Marcos had already been considering getting a vasectomy, but now, with Rob’s nudging—and, most importantly, with his camaraderie—he was ready to do it.
“By making it fun, and being among a bunch of guys, it relieved I think some of the potential stress that would come from being with my wife,” Marcos says. “Because your wife cares for you, and your wife is concerned about the pain you’re feeling. [When she asks you] ‘Is it hurting? Are you OK? I’m nervous,’ then you get nervous. But when you’re with a bunch of guys and you’re giving each other shit, it kind of minimizes the pain.”
“The psychology of that is pretty elementary,” Rob adds. “It’s pretty common sense that you’re probably going to hold up better, at least emotionally, with your guys, ’cause you’re not going to let yourself go there, which we didn’t. We joked the whole time. It was clear that I would much rather [have the vasectomy] with him, or any other guy, than have my wife there, for sure.”
William Butler Yeats called his post-vasectomy period his “second puberty”: “It revived my creative power,” he said. “It revived also sexual desire; and that in all likelihood will last me until I die.”
The vasectomy procedure hasn’t changed much over the years. It begins by making small incisions in the scrotum, then severing the vas deferens—the two, tubelike ducts that carry sperm from each testicle to the urethra. The vas deferens are then sealed or tied, to prevent fertilization of semen. The surgery is typically done under local anesthesia, takes no longer than 30 minutes, and the patient can go home the same day. With rest and light activity, recovery time is usually about a week. Although men can have sex a week or so after surgery, it takes about 6 to 12 weeks before semen is free and clear of sperm. It’s probably no coincidence that vasectomy appointments tend to spike every year in mid-March, just in time for the NCAA March Madness tournament. Vasectomies, barring any complications, are over 99 percent successful at preventing pregnancy, making it one of the most effective, permanent birth control methods available.
Rob went first, and Turek completed his procedure in less than ten minutes. While Rob was wheeled out on his gurney, Marcos was wheeled in on his, and within 12 minutes, Marcos was finished. Fifteen minutes later, the limo brought the two back to their suite, where they got back and shoulder massages.
Rob and Marcos joke that the experience, aside from fertility and family obligations, also bonded them closer together as friends.
“There are blood brothers, and there’s us,” Marcos says.
I meet Dr. Paul Turek at an office in Brentwood. Turek is a board-certified physician, urologist, writer, and lecturer, specializing in men’s reproductive health and male fertility. Based in Beverly Hills and San Francisco, the Turek Clinic offers personalized service, providing men with whatever amenities they request before, during, and after their vasectomies. With his short, silver-flecked hair, impeccable suit and tie, and designer eyeglasses, Turek doesn’t give the impression of one who has ever used “bro” in a non-ironic way, or ever spent an afternoon eating pizza and watching ESPN with his buddies. His job isn’t to be one of the boys, but to make vasectomies more attractive to the average guy, which often involves such age-old, tried-and-true techniques as peer pressure.
“Guys do things because someone challenges them to do it,” Turek explains.
Aside from apparently being incapable of turning down a challenge, men also require visual proof of success and will observe their recently snipped buddies for any potential complications or disfigurements.
“Usually, when the first guy comes out, the others are like, ‘Is he OK? Is he still human? Is he still walking?’” Turek says. “They’re checking him out, head to toe.”
Turek’s most recent brosectomy started as a group of ten men—colleagues from a marijuana company in Humboldt County. They requested top-shelf tequila in their San Francisco hotel room and brought their own cannabis with them. Turek explains that alcohol (or certain other substances) is fine in moderation; though, if used, the patient won’t be given painkillers or other medical sedatives during or after the procedure. When the moment finally came, eight of the Humboldt County group got cold feet. Turek says this is normal. The largest group he’s ever done was three, but typically it’s only two, as many men get last-minute jitters and drop out.
The minutes leading up to the surgery aren’t the only time men get anxious. Since Turek does his vasectomies under local anesthesia, his patients are awake and conscious for the entire procedure, and they can panic during the middle of the surgery. For that reason, Turek has learned to work quickly. He’s typically in and out in under ten minutes.
“Once they get concerned, you can’t stop it,” Turek says. “The guy’s on his back, and you tell him to relax, what’s he going to do? How do you respond to that? The brosectomy is a way to get the anxiety level way down from the beginning, and you’re much less likely to have them spiral out of control.”
Turek is a proponent of the no-scalpel technique—a method developed in China around 40 years ago that makes punctures in the scrotum rather than incisions. In addition to boasting a speedier recovery rate, no-scalpel vasectomies are also quicker to administer. With over 1,500 no-scalpel surgeries under his belt, Turek likens himself to an artist—the Vivaldi of vasectomies.
“It’s like a piano concerto,” he tells me. “There’s no wasted motion.”
The cost for the full brosectomy experience varies—a regular vasectomy costs between $300 and $1000—depending on the number of add-ons and other special requests. Though it isn’t cheap (tequila and limo rides likely won’t be covered by most insurance plans), Turek claims it’s more cost-effective in the long run, because patients “have fewer complications, take fewer pain pills, quality of life returns faster, and they’re more productive quicker.”
Though men might feel a sense of pride or gallantry for what they see as a noble sacrifice, their wives and partners tend to hold a more pragmatic view. “Typically, men do not get a lot of empathy or sympathy from their partners, because they’ve been through births,” Turek says. “Literally, it’s like, ‘Just do it. Don’t be a baby.’ Most times the partner’s not even there, and the men Uber home.”
To help give the men a sense of validation or accomplishment, Turek rewards every patient with a certificate after his vasectomy, framed and signed by participating staff. It reads: “Certificate of honor for uncommon bravery and meritorious performance.”
But should men really be rewarded for taking charge of their fertility, for undergoing a rather routine birth control procedure? Should they be celebrated for doing something women have been doing for years without fanfare? Women have inundated their bodies with pills, patches, shots, implants, and more, often accompanied by crippling pain or hormonal imbalances, and not once have they been rewarded with a certificate of honor.
Women, too, have accompanied each other on sexual-health procedures—legal or illegal; innocuous or dangerous—and have been publicly condemned for their actions. That men are entitled, and even encouraged, to be given a party for managing their own contraception—to relax in a luxury hotel suite and ride in a limo, all for a procedure that takes less than ten minutes—speaks to how far we still have to go when discussing equality in birth control and sexuality.
But should men really be rewarded for taking charge of their fertility, for undergoing a rather routine birth control procedure?
Not long after Marcos and Rob’s brosectomy, Marcos was in the kitchen with his wife and nine-year-old son. His son was aware he’d recently had surgery and wanted to know what happened.
“‘Well, Daddy got surgery so that your mom and I don’t have any more babies,’” Marcos says he told his son. “And he let out this belly laugh: ‘Dad! Mommy gets pregnant, not you!’”
For Marcos and Rob, having a vasectomy wasn’t a rejection of fatherhood or admission of regret. They don’t consider it a failure of the supposed “male duty” to spread their seed far and wide, or a dereliction of the Biblical command to be fruitful, multiply, and populate the earth. They certainly don’t consider themselves “less than men,” just as women don’t consider themselves “less than women” for their own contraceptive choices. While environmental and financial costs were a decisive factor for Marcos and Rob, the biggest benefit to having no more children is the ability to be better and more attentive fathers to the sons they have now.
“We’re all trying to be fathers of the year, on some level,” Rob says. “We do want to give our kids love and attention. I’m planning on being a hero to my kids, right? And I’m juggling a career, but I’m trying to be there for them. I was the oldest of five, and I look back and go, ‘Man, my dad really spread himself thin.’ That certainly didn’t make him a better father … My decision to have two is definitely so I can give each of them a significant amount of attention.”
After Marcos and Rob got their post-vasectomy massages, they returned home to convalesce. Unlike their earlier camaraderie, neither of them now needed or particularly wanted each other’s company, preferring instead care and pampering from their wives. The group aspect of the brosectomy experience ended when the clinic door shut behind them.
“I wouldn’t want to be with you that weekend,” Rob tells Marcos. “I wouldn’t want us to sit on the couch together watching ESPN with ice packs on our nuts.”