It’s difficult to understand why. Vasectomies are typically covered by insurance, so cost isn’t the primary factor. Neither is risk, given that vasectomies are overwhelmingly safe. Neither is time or even pain: vasectomies are simple outpatient procedures. The recovery so minimal that urologists have deemed the month of March to be “vasectomy season”: men schedule the procedures to coincide with March Madness, so they can sit on the couch with a bag of frozen peas on their crotch, watching basketball.

For men who have already had children or know they don’t want children, vasectomy is the safest, easiest and most effective method of contraception. It’s also safer and easier to reverse than tubal ligation. It allows men more control over their own fertility. And it gives men with female partners an opportunity to more equally share in the work of planning their families. But for too many men – and even in conversations about family planning and reproductive rights – vasectomy remains an afterthought. There is a built-in presumption that women will bear nearly all of the reproductive burdens, even though reproducing (at least the old-fashioned way) always takes two.