March Madness and the Sterilization of Basketball Fans

I was so surprised the first time I saw a commercial on television advertising sterilization. Yes, that’s right. Once a year, during March Madness, the annual NCAA college basketball tournament, urologists across the country encourage men to visit their offices to get vasectomies.

This is a good time to have the procedure done, the pitch goes, because guys will want to be sitting home for days anyway, watching game after game, and so they might as well be recuperating with an ice pack in their lap. In 2009 the Oregon Urology Institute sent recovering patients home with sports magazines, pizza, and a bag of frozen peas.

“Snip City” (a play on “Rip City,” a motto for the Portland Trail Blazers) is a clever marketing strategy, no doubt, but it obscures some important truths about the gender politics of sterilization. It’s easy for men to get sterilized; not so much for women. And I’m not just talking about the ease of the procedure itself.

Some physicians are reluctant to sterilize young women, justifying their aversion by a belief that such women might regret their decision years later. They don’t believe these women when they say they never want children, and so they refuse to perform tubal ligations, the primary method of female sterilization, encouraging the use of long acting birth control instead.

Even when physicians agree to the procedure, Medicaid requires a 30-day waiting period for women, though it demands no such enforced contemplation time for men. Is this prudent or sexist? Why should we think that men know their minds and can decide to spend a few days glued to the television watching basketball but that women need thirty days to think over this important decision?

[gpullquote]One consent form, for example, asks women to consider a vasectomy instead.[/gpullquote]

Both vasectomies for men and tubal ligations for women are extremely effective (though there is always a slight chance of failure) and irreversible for the most part. Vasectomies can sometimes be reversed with microsurgery, but it’s best not to count on that. And so patients, male and female, should understand thoroughly what they are in for if they elect to be permanently sterilized. Men can simply make an appointment, sign a consent form, save some sperm if they’re so inclined (egg freezing, on the other hand, is a much more invasive and expensive process), lie back, relax, and enjoy the games.

Even the consent forms for men and women betray the gendered assumptions about patients’ intimate relationships and their autonomy. The typical consent form for men is straightforward and focused on a single individual, the man undergoing the procedure, as it should be.

The consent form for women, by contrast, assumes that women who want to be sterilized will be in long-term relationships with men. This may or may not be the case, of course. Women may not want to bear children, regardless of their relationship status.

One consent form, for example, asks women to consider a vasectomy instead. What!? “Our recommendation is that all patients should consider vasectomy before considering bilateral tubal ligation as it is a much less risky procedure for the patient.” Since women don’t get vasectomies, clearly the form is implying something else — that an imagined (prescribed) couple should discuss their reproductive options and that perhaps the man should “take one for the team,” as it were.

Fair enough, for some couples. Suggesting that the male partner undergo a much less complicated procedure does make sense. But tubal ligation should be a woman’s own decision, one that she can make with or without a male partner in the picture. Reproductive autonomy means that people should be able to make their own decisions about their reproductive futures, independently.

Should we be at all concerned that the lighthearted, commercialized March Madness vasectomy campaign might lead to the kind of involuntary sterilization abuse that we’ve seen in the past? Throughout the 1900s, physicians sterilized thousands of (mostly) women without their consent in at least thirty states. PBS just aired a new documentary, No Más Bebés, about Mexican American women enduring such abuse in California hospitals. The film explains that even when they signed forms, they were not truly consenting since the forms were written in English, while they spoke only Spanish. In addition, some women misunderstood the euphemism, “tying the tubes.” If they can be tied, one woman supposed, presumably they could be untied later.

Is it “madness” to promote sterilization? Probably we can just recognize the vasectomy campaign as an entertaining marketing ploy. Not only that, it encourages men to recognize their responsibility for birth control, and the women in their lives might appreciate not having to worry about unwanted pregnancy anymore. But let’s also be aware that the game has been rigged against women in various ways for some time now. No one should be sterilized against their knowledge or will, and yet any woman who knows that she doesn’t ever want to bear children should have the right to make that decision on her own, without considering a vasectomy for her (perhaps nonexistent) man.

Elizabeth Reis

Elizabeth Reis is a professor of gender and bioethics at the Macaulay Honors College at the City University of New York. She is the author of Bodies in Doubt: An American History of Intersex, which was recently published in a 2nd edition, and Damned Women: Sinners and Witches in Puritan New England. She is also the editor of American Sexual Histories: A Social and Cultural History Reader.

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