Tim Burrows is absolutely right to highlight the importance of vasectomy, the anxiety many men feel about it, and the continuing imbalance in contraceptive responsibility between men and women (My first thought after having a vasectomy: why aren’t more British men having them?, 11 May). However, the commonly quoted decline in vasectomy numbers needs careful interpretation.

NHS Digital figures do not capture the full picture, because they largely exclude NHS vasectomies performed in community and primary care settings, where a substantial proportion of procedures now take place.

In 2022-23, NHS Digital recorded 10,710 vasectomies in England. In the same year, members of the Association of Surgeons in Primary Care (ASPC) reported a further 17,776 vasectomies in England, performed in community settings and not reflected in that national total. Despite repeated attempts by the ASPC to have these figures recognised within official national datasets, they remain excluded.

So the issue may not simply be that British men no longer want vasectomies. In many areas, the problem is that access has been capped, underfunded, restricted or even withdrawn.

This matters. If commissioners look at incomplete data and assume demand is falling, they may reduce services further. That creates a self-fulfilling cycle: fewer commissioned services, longer waits, reduced recorded activity, and then a mistaken belief that men are no longer interested.

The consequence is predictable. Men lose access to a safe, effective, permanent contraceptive option, couples lose reproductive choice, and the burden of contraception is pushed back on to women.

The question is therefore not only “why aren’t more British men having vasectomies?” It is also “why is the NHS making it so difficult for men to take responsibility for contraception?”
Dr Gareth James
President, Association of Surgeons in Primary Care