In a small clinic on the outskirts of Dhaka, a man in his late thirties signs a consent form, lowers his voice, and asks a final question that has nothing to do with medicine. “No one will know, right?” He is not asking about confidentiality in a legal sense. He is asking about লজ্জা (lojja)—shame—and about পুরুষত্ব (purushotto), the fragile social architecture of masculinity in Bangladesh. The procedure he is about to undergo is a no-scalpel vasectomy, one of the safest and most effective forms of permanent contraception. The secrecy around it is the most telling detail of all.
Bangladesh is often cited as a family-planning success story, with fertility falling dramatically over the past decades and contraceptive use widespread. Yet scratch beneath the surface and a stark gender imbalance appears. Women shoulder almost all responsibility for birth control—pills, injectables, implants—while men remain peripheral. Male sterilization exists, is legal, and is offered by the public system, but uptake is vanishingly low. Recent analyses of national survey data place male sterilization at around one percent of all methods, a statistical footnote in a system otherwise praised for efficiency. That tiny number matters because it explains why men who do choose vasectomy often do so quietly, out of sight, and sometimes far from home.
The fear is not the scalpel. It is the rumor mill. In Bangla, the slur নপুংসক (nopungshok)—impotent—carries a heavy cultural weight, conflating fertility with virility and sexual ability with social worth. Vasectomy, despite decades of medical reassurance, is still misheard as castration. Men worry that neighbors will whisper that they have lost strength, desire, or authority; that brothers will mock them; that co-workers will assume they can no longer perform physically demanding work. In a society where being a provider is central to masculine identity, even the suggestion of bodily “weakness” can feel existential.
There is a revealing anecdote in reporting on Bangladesh’s family-planning system: a man who underwent vasectomy after his fourth child kept it secret from his brothers, fearing they would think he had become sexually incapable. That fear is not abstract. In many families, male reproductive decisions are discussed among men—brothers, cousins, elders—long before wives are consulted. Disclosure, then, is not a private marital matter but a public masculine performance. Silence becomes self-protection.
Program design has not helped. Bangladesh’s celebrated model relies heavily on female outreach—door-to-door visits by female health workers, counseling aimed at mothers, clinics that women frequent. Men, by contrast, encounter family planning as something adjacent to them, mediated through their wives. When male services are available, they are often episodic—special “camps” or referral days—rather than normalized parts of routine care. For a man already anxious about being seen, the prospect of turning up at a clearly labeled sterilization event can be daunting. Some travel to distant facilities; others wait until they can plausibly explain an absence from work; a few ask providers to schedule procedures at odd hours. Secrecy becomes an informal coping strategy layered on top of a formal health system.
Religion is frequently blamed, but the picture is more nuanced. Islamic scholars in Bangladesh have long debated family planning, and many accept contraception within marriage. The barrier is less doctrine than gendered expectation. A “good husband” is expected to be fertile, potent, and decisive; contraception is feminized labor. When a man opts for a permanent method, he risks being read as controlled by his wife, another blow to purushotto. In some communities, jokes about men who “listen too much” to their wives circulate easily; vasectomy can be folded into that ridicule.
The economic angle sharpens the stigma. Men who do manual labor fear that surgery—even minor—will cost them wages or signal vulnerability to employers. Although no-scalpel vasectomy typically requires minimal recovery time, myths of prolonged weakness persist. In households where every day’s income matters, a rumor can be as damaging as a fact. Women’s methods, by contrast, are normalized as part of maternal health, absorbed into existing expectations of female endurance.
Yet when men speak candidly—often only after the procedure—the motivations are pragmatic and caring. Many cite concern for their wives’ health after years of hormonal side effects or difficult pregnancies. Others mention economic planning, a desire to educate fewer children better. A few talk about intimacy: the relief of sex without anxiety once childbearing is complete. These are not anti-masculine motives; they are quietly responsible ones. What turns them into secrets is not the decision itself but the social cost of naming it.
Local service providers such as Marie Stopes Bangladesh emphasize that vasectomy does not affect sexual performance or strength, and that the no-scalpel technique is quick and safe. Public campaigns occasionally echo this message, but they compete with generations of hearsay. In a context where men rarely hear other men say, “I did this and I’m fine,” silence reproduces itself. Low uptake feeds invisibility; invisibility feeds stigma; stigma feeds secrecy.
Breaking that loop requires more than posters. It demands male-friendly counseling spaces, routine integration of vasectomy into primary care, and—perhaps most importantly—visible male narratives. When respected figures, local leaders, or simply ordinary men speak openly, the meaning of vasectomy can shift from nopungshok to responsible adulthood. Until then, many Bangladeshi men will continue to choose a medically simple solution wrapped in social complexity, stepping quietly into clinics, signing forms in whispers, and carrying their decision like a private truth in a culture that still measures manhood by fertility.
I’m a great fan of vasectomy. There, I said it. Auntie has never understood why a twenty-minute snip that frees women from decades of hormonal roulette is treated like a moral collapse of manhood. In my book, vasectomy is not the end of masculinity; it’s one of its most elegant upgrades.
Let’s be honest about the double standard. For years—sometimes for life—women are expected to swallow pills that mess with mood, libido, blood pressure, and sanity; accept injections that turn calendars into chemistry experiments; endure implants that bruise and migrate; or submit to surgical procedures far more invasive than anything men are asked to consider. All this is normalized as “responsible womanhood.” Meanwhile, when men are invited to do one small, permanent thing, the room fills with panic about impotence, weakness, and becoming less of a man. Auntie rolls her eyes so hard she risks a muscle strain.
What really bothers me isn’t ignorance—it’s the secrecy born from shame. Men sneaking into clinics like they’re committing a crime, whispering to doctors, hiding from brothers, colleagues, neighbors. The procedure is quick; the fear is cultural. Somewhere along the way, fertility got welded to ego, and ejaculation was promoted to a public performance of virility. Lose the fear of accidental pregnancy, and suddenly some people think you lose your rank in the patriarchy. Ridiculous.
Here’s the thing Auntie loves most about vasectomy: it’s quiet feminism. No slogans, no marches, no lectures—just a man saying, “I’ve done my share.” It’s solidarity with your partner’s body. It’s acknowledging that equality doesn’t end at dinner-table decisions; it extends into clinics, bedrooms, and long-term health. A vasectomy says, “I don’t need endless proof of potency to know who I am.” That confidence? Very sexy.
And let’s talk pleasure, because everyone pretends this is a taboo subject while secretly worrying about it. Vasectomy does not steal desire, erections, or orgasms. What it steals is anxiety. It removes that tiny, constant hum of “what if?” that lives in so many couples’ sex lives. Sex without fear is better sex. Auntie has seen enough bedrooms—and enough bad decisions—to know this is true.
So yes, I’m a fan. Not because vasectomy is perfect, but because it’s honest. It exposes how fragile masculinity can be—and how strong it becomes when men stop performing and start participating. If more men talked openly, the whispers would die. Until then, Auntie will keep clapping for every quiet snip that shifts the burden where it belongs.