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The Big Snip: The Men Making Vasectomies Go Viral in China
SHANGHAI — In July 2023, Liu Luyang walked into a hospital and changed his life in 30 minutes. Two small incisions made him part of a statistic so rare it barely registers: 0.02%, joining the fraction of men in China who choose vasectomies.
That staggering figure was only the start. Liu turned the camera on himself, transforming a quiet act of rebellion into a public statement. Over six weeks, he posted six two-minute videos on his channel, “Sterilization Diaries,” documenting every step — from the operating room to his recovery at home.
Applause, scorn, and everything in between flooded in. Women praised him as brave and a rare ally, while men ridiculed him, questioning his masculinity and mocking his choice with barbs like, “Have you done a paternity test yet?”
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Liu held rock steady. And just kept posting.
“To me, masculinity means taking responsibility, protecting my family, and keeping it safe from outside interference, even from elders or relatives,” 26-year-old Liu tells Sixth Tone.
It’s a stand a small but growing number within that minuscule 0.02% are now taking in a country where reproductive responsibility has long been a woman’s burden, and vasectomies remain steeped in stigma.
Many are young, born only after 2000. Through social media, they hope to share their choices and open conversations rarely heard offline. With professional doctors chipping in — offering clear facts and addressing doubts — these posts have attracted millions of views, stirring a dialogue long kept quiet.
Sixth Tone spoke with three men who have shared their vasectomy experiences online through videos and posts on platforms like the lifestyle app Xiaohongshu and Douyin, China’s version of TikTok.
Some focused their posts on the practicalities: navigating hospital protocols, the cost of surgery, and the timeline for recovery. Others took a more defiant tone, confronting misconceptions head-on, like the persistent belief that vasectomy diminishes masculinity or vigor.
Now, they receive private messages from strangers seeking advice — questions about appointments, recovery, or the costs. And above all, how to start the conversation at home. Because for most, sharing stories with strangers online is the easy part. The real challenge is facing family, meeting partners’ expectations, and confronting their own fears.
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Quiet rebellion
Long before Liu told his family, he and his wife, Zhai, had done their homework. A 33-year-old kindergarten teacher, Zhai researched the procedure thoroughly and discussed it with Liu. But she stopped short of imposing the choice.
“I was worried he might make a hasty decision, so I advised him to think it through carefully,” Zhai, who requested to be identified only by her surname, tells Sixth Tone. “Now that he has gone through with it, we have no regrets.”
The choice was theirs, but the backlash fell squarely on her.
“How could you let him do this?” Zhai’s mother demanded, deeming it “serious negligence.” The couple already had a son, but she wanted a granddaughter too. “She insisted my wife get an intrauterine device instead,” Liu recalls.
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But Liu went through with the surgery in Shanghai, unfazed by whether his mother-in-law found out. “She wouldn’t dare ask me,” he says, adding, “In modern society, the responsibility of reproduction should not rest solely on one individual, but rather seek a more equitable sharing approach.”
In China, the numbers show that sterilization has always been a woman’s burden.
While specific family planning data after 2021 is unavailable, official records show that in 2020, a total of 14.7 million birth control surgeries were performed in China. Of these, 61% were abortions, 17% were IUD insertions, and 1.3% were tubal ligations. In stark contrast, just 2,626 — or 0.02% — were vasectomies.
But compared to the invasive, often painful procedures women face — most of which require abdominal surgery and involve greater risks and longer recovery times — vasectomies are relatively simple, minimally invasive, and carry far fewer complications.
Liao Xuefen, chief physician at the Liuzhou Hospital of the Guangzhou Women and Children’s Medical Center, emphasizes that male sterilization is simpler and less invasive than female sterilization, with no impact on sexual activity.
More and more doctors are echoing this message, advocating for male sterilization on social media. They highlight its safety, affordability, and minimal physical impact compared to female alternatives, aiming to shift both public perception and practice.
While vasectomy is a simple, cost-effective procedure, public perception often exaggerates its risks. “Pre-surgery explanations and post-surgery support are critical for mental and physical recovery,” Liao says, emphasizing the role of hospitals and social media in breaking misconceptions and normalizing the procedure.
In his videos, Liu repeatedly echoes the same: vasectomies are safe, effective, and minimally invasive. He walks viewers through the process, addressing common fears and misconceptions directly.
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In one video titled “At 25, I Finally Got the Vasectomy,” Liu details his day: arriving at the hospital at 8 a.m., changing into a gown by 9, and then going through the procedure by 1 p.m. As his wife hesitates, tears in her eyes, unsure if they should go through with it, Liu reassures her.
Half an hour later, the procedure is complete. Lying on the bed with his eyes closed, he comments, “It’s minimally invasive but still a bit painful.” The nurse assures him that there’s no need for painkillers or ointments. After a short observation, he is free to go home.
In another video, Liu takes viewers through the step-by-step process of his surgery and recovery. He explains the simplicity of the procedure: preoperative assessments including chest X-rays, electrocardiograms, blood tests, and sperm analyses. While the entire process takes approximately half an hour — reversal surgery, however, is far more complex, taking at least four hours.
The total cost for the surgery and preoperative exams was about 1,600 yuan ($219), all of which was covered by health insurance.
“Before the surgery, the doctor repeatedly stressed that as long as I hadn’t entered the operating room, I could change my mind at any time — even after signing the consent form,” Liu recalls.
Liu says he published his videos to share his personal experience and send a message: when both partners decide they no longer want more children, men have just as much right to choose sterilization as women do.
Since posting his videos, the topic of male vasectomy has gained significant traction on Xiaohongshu, amassing over 230 million views and 1.38 million discussions.
Liu continues to receive private messages from men seeking information on the procedure, with questions ranging from appointment scheduling to recovery times. “How much does it cost?” or “How long is the recovery period?” Some ask. “Which doctor do you recommend?” another inquires.
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A new equation
For 28-year-old Lin Sen, the turning point came in early 2024, when his wife’s unexpected pregnancy forced a difficult decision. The emotional toll of potentially having a second child weighed heavily on them, leading the couple to opt for an abortion.
The experience left a lasting emotional strain on both, particularly his wife, who struggled with the physical and psychological impact of the pregnancy.
“This matter was viewed as a personal decision, with both of us confident in our choice without external interference,” says Lin. “Sterilization shouldn’t be a hasty decision but a deliberate choice made within a committed partnership for a safer and more comfortable intimate experience.”
Having undergone the procedure in the southwestern Sichuan province, Lin’s recovery was smooth, and he quickly resumed normal activities. But his real impact came through social media.
Lin too documented his experience on Xiaohongshu, where more than 110,000 people followed his journey, intrigued by his candid discussions about the procedure and recovery. His posts detailed how, by the 15th day post-surgery, he had resumed normal sexual activity, and a check-up just under two months later confirmed the procedure had been a success.
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However, Joy Lin, the founder of the Shanghai-based gender-related initiative Wequality, cautions that while male sterilization could be a long-term solution for contraception, there are significant cultural and societal barriers to its widespread acceptance.
“From a Chinese perspective, due to the aging population crisis and young women’s reluctance or fear of childbirth, promoting male sterilization — or any long-term contraceptive method — may face substantial resistance,” she says.
China’s family planning policies have historically prioritized controlling population growth, often relying on female-centric methods like sterilization and IUDs, especially during the one-child policy era.
However, in recent years, as concerns over a rapidly aging population and declining birth rates have grown, the government has shifted its focus to promoting marriage and larger families. Since the introduction of the two- and three-child policies, the emphasis has moved away from limiting family sizes.
As a result, while vasectomies are available, they remain underutilized — offered passively at hospitals and overshadowed by long-standing cultural norms. According to Joy Lin, these norms often place the burden of contraception on women. “Because the child is not born from the man, he is seen as having less connection to the child and less responsibility compared to the mother,” she says.
Breaking with entrenched norms, Jiang Yijun, a 35-year-old medical professional from Sichuan, approached sterilization with confidence and clarity. With a 2-year-old daughter, he saw the procedure as a practical solution for his family’s needs, leaving no doubts about its safety or simplicity.
Yet, navigating the cultural expectations surrounding his choice wasn’t entirely straightforward.
Jiang discussed his decision with his parents only after the surgery. While initially surprised, they refrained from interfering, respecting his autonomy as an adult. “For many of them, as long as their children are healthy and happy, not dependent on them, whether they have children is no longer so important,” he says.
Jiang has noticed a shift among younger generations, particularly Gen Z, who are increasingly opting out of parenthood or choosing sterilization.
“For many young people with limited income, the high costs and pressures associated with raising children make the decision to remain childfree even more appealing,” he says. “They prefer to enjoy a lifestyle focused on personal satisfaction and living the life they desire, sometimes described as a petit-bourgeois lifestyle.”
Joy Lin sees this shift as emblematic of broader changes in attitudes toward traditional gender roles and contraception. “Gender equality is increasingly becoming a way for men to show their progress, acceptance of new things, education level, and class in spouse selection,” she says.
Jiang adds that while older generations might cling to the notion of “raising children for old age,” today’s youth are prioritizing their own happiness and independence. “This attitude of no longer caring about external opinions actually reflects progress in thinking and a clearer understanding of life, knowing what they want and being more firm in their choices,” he says.
After sharing his experiences on various platforms, including his video channel “Go, Pikachu,” Jiang has faced a mix of reactions but remains unfazed. Through his videos, he candidly documents his vasectomy journey, hoping to normalize the procedure and spark open discussions.
“I hope my story helps more people see male sterilization for what it is: safe, simple, and nothing to be ashamed of,” Jiang says.
Additional reporting: Guo Yishun and Wen Ming; editor: Apurva.
(Header image: Visuals from VCG, reedited by Sixth Tone)