Why Are Young, Childless Men Seeking Vasectomies?

What a Study from Bolivia Reveals about Modern Uncertainty

by Dominick Shattuck & Alison Hoover (published May 15, 2026, on Substack)

For decades, vasectomy has largely been framed as a contraceptive method for older married men who have already had children and decided their families were complete. But a recent study from Bolivia challenges that assumption in surprising ways.

Our team’s analysis of a national vasectomy campaign found unexpectedly high demand for the permanent contraceptive procedure among younger men, including many who were unmarried and without children (Hoover et al., 2026). These findings complicate traditional assumptions about who seeks permanent contraception and the reasons behind the decision. They also raise a deeper question: What does it mean when younger adults begin making permanent reproductive decisions earlier in life and under increasingly uncertain social conditions?

The Bolivia study arrives at a moment of growing global concern about declining fertility rates, delayed family formation, and changing attitudes toward relationships and parenthood. Yet the findings may reveal less about a rejection of traditional family structures and more about how younger generations are navigating uncertainty, responsibility, and future planning in an increasingly unstable world.

Male-focused contraceptive methods are limited to condoms and vasectomy. Historically, vasectomy has been associated with a relatively narrow demographic profile. In the United States, vasectomy users have traditionally been more likely to be older, married, white, higher-income men with children already in the household (Anderson et al., 2012; Sharma et al., 2013). Fertility research has generally framed vasectomy as a “completed family” method, often positioned near the end of an individual’s reproductive timeline.

But the Bolivia findings suggest something may be changing.

Recent studies in the United States point in a similar direction. Huang and colleagues (2023) found that the largest relative increases in vasectomy rates between 2014 and 2021 occurred among men without children, single men, and men ages 18 to 24. Following the Dobbs decision in the United States, researchers also documented substantial increases in vasectomy consultations among younger and childless men (Bole et al., 2023). Other work during the COVID-19 period similarly identified increasing proportions of childless vasectomy recipients (Lawton, 2023).

Taken together, these findings suggest that reproductive decision-making among younger adults may be shifting in important ways.

It would be easy to interpret these trends through a culture-war lens or as evidence that younger generations no longer value parenthood or family life. But the broader evidence suggests a much more complicated picture.

A growing body of fertility research now argues that uncertainty itself has become a defining feature of reproductive decision-making. In a recent paper examining fertility goals in the United States, Badolato and colleagues (2025) found that declining fertility cannot be fully explained by declining desire for children alone. Instead, many individuals still express positive fertility intentions while simultaneously feeling uncertain about whether those goals are realistically achievable.

The authors distinguish between several forms of uncertainty, including “realization uncertainty,” or uncertainty about whether one will actually be able to achieve desired family goals. Their findings are striking: up to half of women who intended to have children were uncertain whether they would ultimately follow through with those intentions, and younger, childless individuals increasingly reported weaker attachment to fertility goals over time (Badolato et al., 2025).

This distinction matters.

The issue may not simply be whether younger adults want children. The issue may increasingly be whether they feel capable of building stable enough lives to support long-term commitments like parenthood.

Housing costs, inflation, unstable labor markets, delayed partnership formation, climate anxiety, political polarization, and declining trust in institutions all shape how younger adults imagine the future. Family formation increasingly occurs within what sociologists sometimes describe as the “shadow of the future,” where uncertainty about tomorrow reshapes decisions made today.

Recent polling reinforces this tension between aspiration and uncertainty.

A Gallup study, released in 2025, found that Americans still report an ideal family size averaging 2.7 children, even as the national fertility rate has fallen to historic lows (Brenan, 2025). Similarly, the Pew Research Center found that many younger adults without children still hope to become parents one day, particularly young men (Aragão, 2024). At the same time, younger adults (under 35) increasingly rank friendship, meaningful work, and financial stability above marriage and parenthood as markers of a fulfilling life (Parker & Minkin, 2023).

This contradiction may reveal less about declining desire for conception and more about changing perceptions of what feels realistically attainable.

Claire Cain Miller recently described this broader demographic shift as a “postponement transition,” where many adults delay parenthood rather than reject it entirely (Miller, 2026). Fertility rates among younger women have declined sharply since the Great Recession in 2008, while births among women in their 30s and 40s have increased. In other words, many people still appear to want children, but they are increasingly waiting until they feel economically, emotionally, and relationally secure enough to pursue parenthood.

But that security can feel increasingly difficult to achieve.

This is where the Bolivia findings become especially interesting.

Rather than viewing vasectomy simply as a medical procedure or a rejection of traditional family structures, it may be more useful to understand it as part of a broader negotiation around uncertainty, responsibility, and reproductive agency. Younger men seeking vasectomy may not necessarily be rejecting parenting or caregiving altogether. Some may instead be attempting to exercise greater control over when to have a child and assuming vasectomy is easily reversible or stepping into other parental roles like adoption and blended families.

This interpretation also connects to a broader cultural shift previously described on Relational Ground as “individualism under constraint.” Modern adults are increasingly asked to privately manage risks that were once buffered collectively through stronger communities, affordable housing, stable employment pathways, extended family networks, and more predictable institutional structures.

Today, many younger adults are expected to navigate fertility, partnership, caregiving, and economic insecurity largely on their own.

Within this environment, reproductive decisions can become less about abstract ideology and more about risk management.

Importantly, this does not mean younger generations are anti-family or anti-relationship. In fact, much of the evidence suggests the opposite. Many younger adults still want intimacy, caregiving, meaning, and connection. But they are increasingly uncertain about whether stable adulthood itself remains achievable.

That distinction matters for public health.

Historically, contraception has been heavily feminized, with relatively limited contraceptive options available to men. The Bolivia findings may signal broader unmet demand for male-controlled contraceptive methods, including future reversible male contraceptive technologies. Younger generations may increasingly want greater reproductive agency, flexibility, and shared responsibility within relationships, including through expanded contraceptive options.

At the same time, expanding male contraceptive options alone will not resolve the deeper structural conditions shaping fertility decisions. Contraceptive technology cannot solve housing insecurity, economic precarity, social isolation, or declining trust in institutions.

But it may help couples navigate those conditions together more collaboratively.

Ultimately, the Bolivia study may reveal less about a rejection of parenthood than about changing relationships between uncertainty, responsibility, and future planning. Reproductive decisions do not emerge in isolation from social conditions. They reflect how people experience stability, possibility, belonging, and whether the future itself feels safe enough to invest in.

References

Anderson, J. E., Jamieson, D. J., Warner, L., Kissin, D. M., Nangia, A. K., & Macaluso, M. (2012). Contraceptive sterilization among married adults: National data on who chooses vasectomy and tubal sterilization. Contraception, 85(6), 552–557. https://doi.org/10.1016/j.contraception.2011.10.009

Aragão, C. (2024). Among young adults without children, men are more likely than women to say they want to be parents someday. Pew Research Center. https://www.pewresearch.org/short-reads/2024/02/15/among-young-adults-without-children-men-are-more-likely-than-women-to-say-they-want-to-be-parents-someday/

Badolato, L., Hayford, S. R., & Guzzo, K. B. (2025). Multiple dimensions of uncertainty in fertility goals: Recent trends and patterns in the United States. Genus, 81(14). https://doi.org/10.1186/s41118-025-00251-6

Bole, R., Lundy, S. D., Pei, E., Bajic, P., Parekh, N., & Vij, S. C. (2023). Rising vasectomy volume following reversal of federal protections for abortion rights in the United States. International Journal of Impotence Research. https://doi.org/10.1038/s41443-023-00672-x

Brenan, M. (2025, September 4). Americans’ ideal family size remains above two children. Gallup. https://news.gallup.com/poll/694640/americans-ideal-family-size-remains-above-two-children.aspx

Hoover, A. T., Lawton, S., Velasco Parihuana, S., Lledo Weber, P., Labrecque, M., Shattuck, D., & Velasquez Rossi, A. C. (2026). Unexpected profiles in vasectomy demand during a national campaign in Bolivia: Cross-sectional study and associations in age, number of children, and motivations for seeking vasectomy. Contraception and Reproductive Medicine, 11(1), 30. https://doi.org/10.1186/s40834-026-00441-3

Huang, Z., Hyman, M. J., & Raheem, O. A. (2023). Trends in the vasectomy rate among privately insured men aged 18–64 in the United States between 2014 and 2021. Urology. https://doi.org/10.1016/j.urology.2023.06.013

Lawton, S. (2023). Characteristics of vasectomy recipients in the United States during the COVID-19 pandemic (Master’s thesis, Emory University Rollins School of Public Health).

Miller, C. C. (2026, April 9). Women in their 20s may not be having babies, but by 45 most probably will. The New York Times. https://www.nytimes.com/2026/04/09/upshot/births-decline-older-mothers.html

Parker, K., & Minkin, R. (2023). Public has mixed views on the modern American family. Pew Research Center. https://www.pewresearch.org/social-trends/2023/09/14/public-has-mixed-views-on-the-modern-american-family/

Sharma, V., Le, B. V., Sheth, K. R., Zargaroff, S., Dupree, J. M., Cashy, J., & Brannigan, R. E. (2013). Vasectomy demographics and postvasectomy desire for future children: Results from a contemporary national survey. Fertility and Sterility, 99(7), 1880–1885. https://doi.org/10.1016/j.fertnstert.2013.02.032