1. The assumption that men are not willing to get a vasectomy is an oversimplification.  Yes, there are places where there is no tradition of vasectomy, but in the US there are over 500,000 vasectomies done yearly and in Canada, NZ and Australia, there are more vasectomies done than tubal ligations.
  1. When building a movement, don’t try to change ‘everyone’, let alone the hardest to reach and most resistant to change.  Instead, connect with those who are already predisposed to join up and contribute, but have not known how or why…until now.
  1. The determination that your family is complete and a vasectomy is a viable option, can take years.  It is important that men know that on the far side of their ‘fertility’ this option exists, even if it’s a decade or more away.  Getting there requires:
    1. A consistent and sustained commitment to promote the procedure as an acceptable family planning option.
    2. High quality procedures done with modern techniques.
    3. Publicly acknowledge those who volunteer to get a vasectomy – positive affirmation is appealing.
  1. We know there are men who want a ‘football team’s worth of children’, but the fact is the vast majority prefer 1-3 children.
  1. Instead of asking a man if he wants to get a vasectomy, it is more productive to frame the conversation around the following three questions:
    1. How important is it to you that the quality of life you offer your children is better than what you experienced? 
    2. Do the number of children you have affect your ability to offer them a quality of life to which you aspire?
    3. Do you want to be part of the decision-making regarding family size or leave it up to your wife or partner? 

The answer to (a) is inevitably some variation of ‘Yes, and that’s why I work so hard’.

The answer to (b) is ‘Of course’.  It’s just math.

The answer to (c) is also inevitably yes – often accompanied by an assertion that if they don’t talk about family size, they’re likely to have more children than they would have otherwise wanted.

  1.  Although a vasectomy is physically simpler than a tubal ligation, many men fear that it will make them less strong, less ‘manly’ and less sexually ‘fit’.  Equating a vasectomy as an act of love (or just decency) transforms resistance into courage. Where there are obstacles to overcome, there are opportunities to increase one’s sense of self-worth.
  2. Getting men to participate in their own health outcomes, let alone their reproductive health needs, requires consistent communication.  At present in the US, women visit a doctors 3x more than men.
  3. The best advocates for a vasectomy are those who have already gotten one and had a positive experience.
  4. There are always individuals who are ready to do right by themselves, their family and their partner, but men are similar to  ‘pack animals’ and follow what is considered the ‘norm’. We choose to make WVD a public event to help redefine this norm so that the ‘first acceptors’ feel supported. It’s why we say,  “What one man fears, a thousand together will not hesitate”.
  5. WVD treats vasectomy providers, be they urologists or family doctors, as leaders in a public health movement, or as ‘shamans’ in a very ancient and powerful ritual of ‘in-fertilization’.
  1. Income replacement or any form of recompense is very complicated and comes with a spotted history of coercion and manipulation – usually of the poorest of the poor.  That said, facilitating and encouraging men to make a hard choice that benefits others and their family, might make sense in certain contexts, as long as it’s done transparently and does not impose on anyone’s human rights. 
  1. We need to make it eminently clear that vasectomy is a permanent form of birth control, even while acknowledging the possibility of a reversal.  Indeed, it’s potential reversibility was how we are able to secure permission in Indonesia. .
  1. In most countries, a vasectomy program cannot achieve ‘scale’ without national and local government support. Our goal is to work with Ministers of Health whenever it is possible.   
  1. Research has demonstrated a correlation between vasectomy acceptance and better gender relations. I.e. we believe that men who are willing to get a vasectomy, are more likely to treat their women with more kindness, more consciousness and greater respect.
  1. On the day men voluntarily choose a vasectomy, they are at their most vulnerable. Ask a man why he’s getting a vasectomy and regardless of culture, class or country, they almost inevitably speak of love for their children and their partners.  WVD aggregates individual acts of kindness into a collective movement for social good.
  1. In the coming years we want to build this into a truly powerful global movement that emphasizes important principles of positive human behavior.
  1. We don’t believe that numbers fully determine our planet’s destiny, but we do believe that every human problem we face is made more difficult to resolve with a growing population. We don’t need 1 billion more people today to achieve our potential – we need to take better care of the 7.8 billion already here.


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