Ethan Scruples
2 min readSep 23, 2019


Thanks for your comment. It is true that vasectomy is worthwhile for a high majority of men, which makes the situation quite frustrating.

I can’t really say that men should not be getting this surgery, given poor available alternatives. But you go in and 49 times out of 50 you get a nice little surgery that heals quickly and makes your life better. But one out of every 50 end up with a bad outcome and no way to fix it.

The thing I *can* say is that doctors have an obligation to make men and their partners understand exactly what they are risking, and they are utterly failing at that. The overall message people get is “This is one of the safest surgeries you can get. There are no risks worth taking into consideration. You’ll be back to normal in a week. There is no reason at all that this could affect your sex life — other than to make it better.”

To look at the situation with fresh eyes, imagine if there were a roller coaster at some amusement park, which had a particular exciting bump in it. Now most people ride this roller coaster and have a great time. But about 1 out of every 50 people who ride this roller coaster end up with a compression injury which makes their lower back hurt for the rest of their life. They can’t walk, or ride a bike, or drive a car, or even sit in a chair without nagging pain from their injury. Their sex life is also negatively impacted by distracting pain.

And let’s say we have the amusement park owners, who are aware that people have been privately reporting this problem for decades, but the owners have only reacted by adding a clause in the disclaimer fine print, while loudly advertising that although obviously there is some tiny chance that something unforeseeable might go wrong, the roller coaster is safe. VERY safe in fact.

I can’t see any way in which this would not be a scandal. That would not be considered a safe ride at all. In fact, it would be quickly torn down, and the amusement park would likely be sued or even held criminally negligent.

Here is a timeline indexing 285 different stories about this complication which I have collected: