‘Vas Madness’ shows the power of messaging in men’s contraceptive decisions

Bracket-beating upsets, Cinderella stories, OT buzzer beaters – March Madness is here! Or, as some urologists think of it, vasectomy promotion season.

Since 2004urologists promote vasectomies every March, promising patients who choose the procedure an excellent excuse to relax on the couch and watch college basketball.

There is evidence that these “Vas Madness” promotional tactics – sometimes combined with food giveaways and cheeky swag – can be effective. At least one study has saw an increase in vasectomy rates in the US in March.

This rise in vasectomies shows how communication about this procedure—and its perceived connection to masculinity—can make a meaningful difference in public acceptance of male contraceptive sterilization.

I am a scholar of rhetoric and gender studiesand I’ve been studying the language around vasectomies for years. In my next book, “Stop saying Snip! The Rhetoric of Vasectomy,” to be published in April 2026, I show that communication plays an important role in motivating people to welcome, seek, or avoid vasectomies. In fact, I have found that language about fertility and communication about contraception greatly influences all decisions about pregnancy prevention, especially who should bear his burden.

Gender-based communication about contraception

For my book, I interviewed 17 people who rely on vasectomies to prevent pregnancies and asked them how they learned about vasectomies. Few knew for sure, and most did not remember at all.

This makes sense when you consider that information about this process is not usually given to anyone. I found that knowledge about vasectomies is not guaranteed to be covered sex education in schoolduring annual doctor visitsvia insurance coverage that encourages preventive health practicesor even inside conversations with family and friends.

Rather, the rhetoric surrounding pregnancy prevention places the burden of contraception on women. Throughout their lives, women receive messages from partners, parents, friends and doctors who push them to think about their fertility and take responsibility for managing that fertility. These messages subtly suggest that this is the most natural or normal way to prevent pregnancy.

Conversely, men don’t often get this message that they need to think about their fertility and take responsibility for managing that fertility. For example, men are rarely prompted to explain what they do to prevent pregnancies. A military father of two whom I interviewed for my book told me that his primary care doctor never discussed birth control with him in the exam. However, every time his wife had a baby, the doctors asked her if she wanted to undergo it tubal ligationthe sterilization process in which the fallopian tubes are cut.

Rhetoric, including what questions providers do or don’t askplays a role in unbalanced sterilization rates between men and women. According to a 2024 Kaiser Family Foundation survey, 25% of women surveyed were sterilized, as opposed to just 11% of men. And according to data from the National Survey on Family Development, in 2022-2023, 6.8% of men aged 18 to 49 had a vasectomywhile during the same time period, 11.5% of women aged 15 to 49 using contraception were sterilized.

In fact, female sterilization is the top method of contraception used in the US, even though it is riskier and less economical than a vasectomy.

Masculinity in the English language of fertility

The very language that English speakers use to refer to male fertility can conflate reproductive capacity with a positive vision of being a man. This makes accepting a vasectomy quite difficult.

In medical articles, male reproductive capacity is discussed as “fertility”. But more colloquially, English speakers often use very different terms, such as “power” and “masculinity.”

Potency comes from the Latin word potentialmeaning “power”. In English, Power refers to “strength“, the “ability to influence something”, “power” and “influence”. It also refers to “the ability to achieve an erection or ejaculation during sexual intercourse,” to which the Oxford English Dictionary adds, “Also: fertility (of male or female).” I have yet to come across literature or messages that refer to a strong woman – except, perhaps, to refer to her perfume.

Reproductive males may also be referred to as “masculine”. from Latin virmeaning “man”. This inscribes a sense of “masculinity” in language about male fertility: The Oxford English Dictionary defines masculinity as “mature or fully developed manhood or masculine power” and “the power of procreation; capacity for intercourse.”

The multiple meanings of these words help explain the misconception that vasectomy, by limiting fertility, threatens a man’s ability to influence others, access power, and perform sexually. In this way, the rhetoric surrounding male fertility can influence the widespread acceptance of vasectomy.

After all, getting a vasectomy requires a willingness to be vulnerable. It includes talking to a doctor about your sexual and reproductive desires, allowing medical personnel to see and touch your otherwise private parts, and following someone else’s orders about what to do. This involves returning to the clinic with semen for analysis to see if the procedure was successful – a step many men skip.

And vasectomy is a surgical procedure, so it also means faces some risk of harmalthough small.

All in all, getting a vasectomy means behaving in a way that can feel directly at odds with mainstream cultural notions of being a “man” – someone strong, masculine, and always in control.

Expanding communication about vasectomies

“Vas Madness” promotional tactics are one of the few public campaigns about the process. However, even after the “craze” is said and done, women still tend to do it it does the main work of preventing pregnancy, taking pills, implantation of intrauterine devices, receiving injections and undergo tubal ligation surgery while managing all the doctor appointments and side effects that come with these procedures.

In conducting my research, I found that women’s efforts to provide their partners with information about vasectomies and to share the burdens they bring to fertility management are a major driver of many men’s decisions to have the procedure.

A 35-year-old man I spoke to relied on his partner to use birth control methods to prevent pregnancy, including an IUD insertion that went wrong and then contraceptive implant. After research and discussion, they decided to have a vasectomy to prevent the pregnancy from developing. My husband told me that his partner is “very knowledgeable about medical stuff.” She continued: “Any kind of trepidation I had about it, it was very easy to talk to her about it and say, ‘OK, this really isn’t that big of a deal.'”

However, communication from more sources, beyond the seasonal campaigns of urologists and the individual efforts of romantic partners, could help more people see vasectomies as a normal, necessary and useful procedure to prevent pregnancy.

Meanwhile, reproductive work continues to be predominantly women’s work.

Jenna VinsonAssociate Professor of English, Umass Lowell

This article is republished from The Conversation with a Creative Commons license. Read it original article.