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Why Are Female Sterilization Rates So High?

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by Kate Brunotts

As someone who is constantly paranoid about the effectiveness of her birth control, I can’t wait for the day that my partner has a vasectomy. I promise I’m not a sadist, but we both agree that the shared anxiety of having an unplanned pregnancy will only go away when it is 100% biologically impossible, and I suspect that we are not alone in our feelings as a couple. 

After doing a bit of research, I was pretty shocked to learn that female sterilization isn’t just more popular than vasectomies by a long shot, but that it’s the most common form of birth control worldwide (which takes condoms, the pill, and all other usual methods into consideration). 

So, what exactly is making female sterilization rates so popular? Most importantly, how can we better position ourselves as a society to have a more equal distribution of birth control methods across all sexes? 

Contraception Ranked

Before getting into the more complex reasoning behind the dominance of female sterilization, let’s take a look at the facts. Here is a graph depicting the estimated worldwide contraception methods used by couples ages 15-49 released in the 2019 report by the UN

(I realize that this graph is titled “numbers of women….using various contraception methods” over “sexually-active partners” or “couples”, which I suspect feeds into our underlying assumption that contraception is something for women exclusively to manage, rather than a partnered choice, but more on that later.)

For maximum clarity, the contraception methods ranked by popularity are as follows:

  1. Female Sterilization (24%)
  2. Male Condom (21%)
  3. IUD (17%)
  4. The Pill (16%)
  5. Injectable (8%)
  6. Rhythm (Similar to the pull-out method 3%) 
  7. Implant (2%)
  8. Other (2%)

I was pretty surprised to find that female sterilization outweighs more short term birth control methods like the pill or IUD, despite the age sample including a wide swath of young adults. 

However, it’s important to note that this sample is taking the entire world into account. As shown by regional graphs below from the same study, contraceptive method preference varies heavily from region to region. 

Interestingly enough, Oceania appears to be the only region where male sterilization outweighs that of females.

Source: “Principles of Gender-Specific Medicine”

Clearly, more developed nations are more likely to have equal rates of sterilization across sex. So, why is there such a large discrepancy from region to region? 

Why Aren’t There More Vasectomies?

While sterilization is more level in developed nations, female sterilization still comes out on top despite vasectomies being a less invasive and just as effective procedure. Here are a couple of the possible reasons why men aren’t jumping to get the snip. 

Insurance Coverage 

In terms of the United States’ contraception policies, we still default towards a greater degree of female responsibility despite being a more developed nation. While female sterilization is usually covered under the Affordable Care Act, vasectomies typically aren’t. 

However, vasectomies are typically cheaper on average when paid out of pocket. 

Overall Access

Unfortunately, undeveloped nations may simply not have access to more modern birth control methods like the vasectomy. Not surprisingly, vasectomies are more prevalent in nations that have large movements surrounding gender-equality, which typically end up being those with higher rates of socioeconomic status. 

Social Reasons

According to a couple of accounts recorded by this New York Times article and a bit of anecdotal evidence speaking to some of my male friends, some men have at strong adherence to the procedure for social or personal beliefs. 

Why The Market Needs To Be More Even

Outside of whatever numbers can prove, I deeply believe that in order to bring ourselves one step closer to achieving gender equity, we need to look at how we approach contraception. For too long, we’ve disproportionately leaned on women to prevent pregnancy when in reality, they are only half of the equation. 

While it’s true there are many more options for women available, I wonder how much of that is by design. Sure, it’s much easier preventing one egg versus thousands of sperm on a daily basis, but this still doesn’t explain our embrace of female sterilization despite vasectomies being a far less invasive procedure.

If women are tasked with childbirth, periods, and remembering to take a pill at the same time every single day, I think her partner (assuming a cis-heterosexual relationship) should be willing to step up when the couple no longer desires children. 

In order to promote true equality, we need to start looking at how we approach contraception. 

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