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With Roe overturned, Tampa Bay doctors see surge in tubal ligation, vasectomies

Here and across the country, more people are looking for vasectomies, or to get their tubes tied.
Dr. Doug Stein applies lidocaine before performing a vasectomy in his Tampa office. [Times (2009)]
Dr. Doug Stein applies lidocaine before performing a vasectomy in his Tampa office. [Times (2009)] [ RIAL | St. Petersburg Times ]
Published Jul. 5|Updated Jul. 6

The ruling came down and the phone kept ringing. After taking calls on his lunch break — his staff was so busy — the doctor typed out an email.

“JUST TODAY, 9 young (<30) men with fewer than 2 children registered and paid a deposit to have a vasectomy in the near future,” Doug Stein wrote on June 24, in the missive to a Google group of more than 600 other doctors across the country. “(We usually get 2-3 childfree young men per week.) All said they did not want to take any chances.”

Stein, who works out of an office in Lutz, is perhaps Florida’s most prominent vasectomy provider after four decades of prolific snipping. (“I’ve spent a lot of my time hovering over scrotums in windowless rooms on sunny Saturdays,” he said.) He lost count of the procedures he’s done after crossing the 45,000 mark. He’s seen tidal waves of demand — he once performed 71 vasectomies in one day during a trip to the Philippines.

But Stein said he’s never seen an influx of patients in response to “a legal or social change” like the one that’s hit his practice in the week since the U.S. Supreme Court overturned Roe v. Wade and threw a dark shroud over the future of reproductive rights and health care.

It’s not just Stein. Reproductive health care providers in Tampa Bay and around the U.S. are reporting spikes in interest in permanent birth control, driven in part by an unusual demographic: young, childless people. Per Google Trends, search terms like “vasectomy” and “tubal ligation” have shot up since the Supreme Court ruling; the same terms had a smaller surge in early May, when a draft version of the opinion was leaked.

Rachel Rapkin, a Tampa-based OB-GYN, said calls to her clinic about sterilization procedures — such as tubal ligation, popularly known as getting one’s tubes tied, or salpingectomy, a removal of tubes — have doubled since the ruling. She’s hearing similar stories from colleagues and watching the spread of a Reddit list of doctors open to performing sterilizations on those without children.

“I think the idea of having a tubal ligation or a salpingectomy is starting to explode,” she said.

After Stein’s email, he heard from an Atlanta vasectomist who reported getting five to 10 times the usual number of calls. Another in Iowa opined, Stein said, that doctors “should take the opportunity to remind everybody that men have a responsibility in reproductive decisions.” His new patients aren’t knee-jerk reactors, he said, but men who had already been considering a vasectomy and were pushed to action by the ruling.

In a vasectomy, a tube called the vas deferens is cut or blocked to prevent sperm from leaving the body. In tubal ligation, cutting or blocking parts of fallopian tubes keeps sperm from reaching an egg.

None of these procedures is rare: In the U.S., estimates are pegged at 500,000 vasectomies a year and 700,000 tubal ligations and salpingectomies. Of those 700,000, according to the journal Reviews in Obstetrics & Gynecology, half take place within two days after a patient gives birth. They’re usually covered by insurance.

Still, doctors say, people seeking sterilization often hit obstacles. Some doctors put arbitrary limits on sterilizations, Rapkin said: that patients must be at least 25 years old or have at least two children. Low-income people on Medicaid are covered for sterilization, but only if they’re at least 21 and go through a 30-day waiting period after signing a consent form.

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These challenges loom especially large for women seeking sterilization, Rapkin said.

“We have this crazy, paternalistic view toward people with uteruses,” she said. “For patients who know that they don’t ever want children, it’s a totally reasonable option.”

Not that it’s unimportant for doctors to understand why their patients want sterilization, understand the risk and know there may be other options for long-term but reversible birth control. The medical establishment considers sterilization procedures to be permanent, and though there are procedures to reverse vasectomies and tubal ligation, they’re complicated and don’t always work.

Regret is a real concern, one doctors discuss with their patients. Stein’s website has a page specifically for men under 30 with fewer than two children, and his office does an extra consultation with those patients that older ones aren’t required to go through. But he and Rapkin both said it’s simply their job to inform patients, not make the decision for them.

“We need to trust our patients that they know their bodies and can make whatever decisions are best for them and not impose our own beliefs on them,” Rapkin said.

Both doctors are looking toward a cloudy future. Rapkin expects the number of people seeking sterilization to keep growing, and she envisions a grim scenario in which some states outlaw elective sterilization, or at least make it harder for those on public insurance to get it.

Stein, meanwhile, was wondering if his influx of patients would be shorter-lived. After huge increases in calls on the day of the verdict and the following Monday, the next couple of days remained busier than average, but the numbers had leveled off.

“Society is somewhat reactionary, and pretty soon the Roe v. Wade decision is going to be old news,” he said. “There might be another surge when the Florida Republicans decide they’re going to tighten the restrictions in the state of Florida.”

Then, on Thursday morning, he came into work to find that 14 people had registered online for vasectomies after the office had closed the previous night — nearly triple the usual number.

“I thought activity would die down a few days after the Supreme Court ruling,” he said in a text message. “But the effect seems to be lingering.”

• • •

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