Figure. Vasectomy procedural volume from 2018-2022. Dobbs decision leak is noted in gray, and the final Dobbs decision is highlighted in red. The green line delineates the 2022 post-Dobbs cohort.

In June 2022 the United States Supreme Court issued a ruling in the case Dobbs v. Jackson Women’s Health Organization that overturned Roe v. Wade, the 1973 ruling establishing the federally protected right to abortion.¹ Despite wide support for female reproductive autonomy through decades of national polling, each state now had the ability to set its own abortion-related laws.² The ruling resulted in a profound and unanticipated impact on males seeking vasectomies. Following widespread media coverage of the phenomenon, Sellke et al found that Google searches for “vasectomy” spiked fourfold on the day after the ruling as compared to the past 5 years.³ Patel et al had similar findings based on an analysis of Google search trends, particularly in states with fewer urologists and abortion bans.⁴ The Cleveland Clinic Foundation was then the first to confirm an actual rise in vasectomy consultation and volume after the Dobbs ruling.⁵ A retrospective analysis of the 13-hospital network demonstrated a doubling of median monthly vasectomy volume immediately following Dobbs, from 104 to 218 vasectomies performed (P = .03; see Figure). Study authors also found a rise in childless men (16.9% vs 8.6%) and men under 30 years old (23.9% vs 10.3%) seeking vasectomy post Dobbs.

The influence of the Dobbs ruling on family planning cannot be understated. While women have historically borne the brunt of contraceptive decision-making, the current legal climate has galvanized men to take on this burden. The reversal in attitudes is particularly striking in a country which had declining rates of vasectomy over the prior decade.⁶ Increased conversation about reproductive rights may have prompted motivated men to seek control of their reproductive capabilities much earlier than their older counterparts.⁷

While we continue to learn the long-term effects of the Dobbs ruling on population demographics, physicians must keep advocating for and practicing the highest standards of medicine. In an increasingly fraught political landscape, the doctor-patient relationship may be one of the only places where patients retain autonomy in their own medical care.