(About men, fertility and privileged experiences with medical care.)
“You’ll have to make the appointment for him,” she said. That was not going to happen.
My spouse heard this several times from several other married women. When they and their husbands were done having kids, they had concluded that the most sensible long-term contraception was vasectomy. That’s an easy conclusion to reach. It’s not really a big deal at all. Yet for some reason that they could not or would not articulate, these men all dragged their heels. They had to be pushed, prodded and handheld through a medical decision that they reasoned to but about which they felt a nameless unease.
That was not how we were going to handle things. I made a medical decision about my fertility; carrying it out was my responsibility. I got recommendations for two surgeons, I called both. One had just moved to set up a small town practice, and I made arrangements with the other.
We sat down in his office. My spouse wasn’t there. I told her she could come if she wanted but she didn’t need to. She told me later that it was important to her that I did this alone without the slightest suggestion of prodding, because of that assumption that guys drag their heels until their wives make them do it. She missed all the fun.
I’m a litigator, so I make doctors nervous to start with. And it wouldn’t be true to say I don’t like doctors — some I like very much. But it would be true to say I’m tough on doctors. I don’t have any sense of deference to them. They are degreed professionals, I’m a degreed professional. They went to school, I went to school. They’re smart people, I’m smart people. My clients expect me to explain to them why they should do what I’m recommending and … some doctors still seem a little surprised that their clients want to probe behind the headlines. And I expect the same kind of equal-footing discussion with doctors as clients have with lawyers.
So this surgeon started to ask questions that, I got the sense, are so standard he doesn’t think about them. He wanted to make sure I had thought this through, make sure I knew that I should not count on reversal which is possible but not reliable. He wanted to know why I was doing this, not (it seemed clear) because he cared, but to make sure I had really made up my mind and was clear about my decision. I was. I told him I had all the children that I wanted, all that I thought I could raise, and that for various reasons having to do with their early years I was not emotionally capable of going through the baby phase with another one.
(I can’t look at my child in a plexiglass case in a NICU again. I can’t do it again. I don’t have it in me, and if I had to, I couldn’t be the spouse or parent that I need to be. And I know that.)
So far, so good. I’ve heard stories about doctors stonewalling women, particularly those with no children, who want a permanent fertility solution. This was not that. This was a responsible inquiry.
Then, with no apparent thought to the question, he asked me, “and your wife is on board with this?”
“I’m making a decision about my fertility. I’m done.”
It was a point about bodily autonomy. My body is not my spouse’s. It is neither her responsibility, nor her property. This is, of course, is the sort of thing privilege shields me from. Cis- het- men’s rights to control our own bodies, especially when we’re affluent and white, is something usually unchallenged. Something usually unquestioned. Something we can usually take for granted. So much so that this affluent white man sitting across from me didn’t think he was challenging it; much less that I’d call him out on it.
He pressed, and I said, “If I said no, would you refuse to do the procedure?”
He demurred. “I’d want to know more about what was going on.”
I had made my point, shaken his routine assumption, questioned the premise of the question. I told him it was my decision but my spouse was on board.
I had a few questions, ones I’m sure he hears all the time. He said I would probably have no sperm in my ejaculate after eight orgasms. I said, “so maybe two days, then?” He didn’t laugh. Either I had rattled him or he has no sense of humor. I’m still not sure which of those things is true.
I did have one question that I know wasn’t on the standard menu. “So my wife and I do a lot of BDSM, and squeezing and slapping testicles is a big part of our intimate conduct. How long until we can resume that activity?”
“BD …? I’m sorry, I don’t recognize the acronym you used …”
It was my turn to be surprised. This is New York — really, Doc? BDSM? Never heard of it? Okay. I explained.
I explained, because some day some other guy is going to be sitting in that chair. And he’s going to need to have a frank talk with this same surgeon about what he does with his penis and testicles. And he may not be as affluent or as educated, or straight or married or cis-sexual. He (or she or ze — lots of folks need to see a urologist) may be in a less privileged, more vulnerable position than I am in any number of ways. Or he may just not be as comfortable with what he does with his sex partners. Any way you slice it, I could just abstain from ball-smacking until I felt ready, but I’d rather have a straight answer from the doctor, and damnit, if he’s going to have to have an awkward conversation with some kinkster, let him do it the first time with me. I don’t bruise easily.
Credit where it’s due. He looked a little … nonplussed, but he gave me a direct answer. “I would say wait two weeks. After that the scrotum should be fully healed.” I’m sure he had a story to tell at lunch. And maybe some things to think about.
I sure did.