Le Monde: the number of male sterilization operations has increased sharply in France

These figures were published on Monday 12 February by the EPI-PHARE group led by Professor Mahmoud Zureik. The research team used health system data to conduct the necessary analyses. Alerted by urologists who had noticed an increase in demand for vasectomies, especially among young people, epidemiologists set out to understand what was happening with the practice. According to study leader Dr. Noémie Roland, this is “all the more important because men, unlike women, have very few contraception options.” There’s really only one thing: a condom.

“If we are talking about the distribution of responsibility for contraception, that is, who uses it [мужчина или женщина]condoms can be an important means of protection,” – notes Roland. As research director, she is also responsible for the Women’s Health Program at EPI-PHARE.

The scale of the results was surprising

“Such rapid changes are rare in epidemiology,” – Roland emphasized. Over 12 years, the number of vasectomies performed on men aged 20 to 70 increased from 9.8 procedures per hundred thousand people to 149.5. This is rapid and sustainable growth. From 2010 to 2022, the number of surgical procedures has increased steadily. Only in 2020 was a plateau recorded – then, during the COVID-19 pandemic, many non-vital operations were postponed.

If you look at the world situation with male sterilization, you can see that according to this criterion, France has long been behind and lagged behind the Anglo-Saxon countries, Northern Europe and South Korea. Although vasectomy prevalence seemed directly related to gender equality rates, Hexagon was an exception (The hexagon, “l’Hexagone”, is what the French often call their country). Without a doubt, this is a consequence of the policy of natalism (birth rate policy), poorly compatible with irreversible operations [по стерилизации]continues Noémie Roland.

Even if restoration of the vas deferens is theoretically possible, the prospects for their return to normal remain uncertain. As a result, health authorities did not carry out any relevant campaigns. Urologists themselves, apparently, are reluctant to perform this operation, especially on young people.

Change in situation

France, on the contrary, has always had a high level of female sterilization – through tubal ligation or implantation. But here, too, everything is changing: the number of such operations has fallen sharply, the curves [числа женских и мужских стерилизаций] got together for the first time in 2021. In 2022, for every two female sterilizations there were three male sterilizations, the study emphasizes. Thus, France joined a very small club of states (there are ten in total) in which the stronger sex is deprived of the ability to bear children more often than the weaker sex.

The EPI-PHARE team tried to create a profile of such men. “As a rule, these are representatives of privileged circles, says Noémie Roland. “They are mostly white heterosexual men. Very few of them benefit from universal health care (la couverture maladie universelle, a system that guarantees the provision of medical care within the framework of a health insurance plan; gives people with low incomes additional insurance and exempts them from upfront costs).

They are more likely to come from the western part of the country, with the Pays de la Loire and Brittany regions particularly notable, with rates of vasectomy at 331 and 271 per hundred thousand, respectively. Ile-de-France, on the contrary, lags behind (58 per hundred thousand).“We can’t explain where the latest numbers come from.”admits the epidemiologist.

The average age of men undergoing vasectomy has dropped from 44 years to 41 years. This difference – just three years – may not seem significant, but for the EPI-PHARE researchers it is important. Undoubtedly, it reflects changes in the context of the situation or even speaks of the emergence of a new one. Men over 40 who have already had children are being joined by young people who have consciously decided to remain childless.

The study found that 6.8% of French men who decided to have a vasectomy froze their sperm. The epidemiologist also mentions a very small number of complications, this is due to the emergence of new, less invasive surgical methods. She draws attention to one curious fact: the peak of such operations occurs in September.

At first glance, this is not surprising – after the summer pause, there is often a surge in medical procedures at the beginning of autumn. But with a vasectomy they give you four months to “think about it” – and only then get down to business. “This means that decisions about sterilization are made at the end of winter or in the spring,” explains the scientist. “Why is that? We don’t know.”

Will this trend continue? This is exactly what the first data for 2023 suggests – from January to June, 21 thousand surgical operations were recorded. In addition, the French Association of Urology last year published its first official recommendations, which should help dispel some doubts among doctors. In particular, they indicate that after a vasectomy it is better to do a spermogram to make sure that there are no sperm in the ejaculate. This is a necessity—there are also mistakes during surgery. However, according to the EPI-PHARE study, only two-thirds of men submitted a sperm sample for testing. Gentlemen, it would be nice to put in a little more effort.

PS In fact, this can be called in one word – collective suicide of the nation. Considering that the number of immigrants from Asia and Africa in France has long exceeded 25%, such a “departure” will only accelerate the change in the national composition of the country, bringing closer the time described in the book “Notre Dame Mosque”…