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More men are considering vasectomies, doctors say.
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PHOTO: PAVEL DANILYUK, PEXELS
Men in Greater Cincinnati Are Lining Up for Vasectomies in the Wake of Roe v. Wade Men in Greater Cincinnati Are Lining Up for Vasectomies in the Wake of Roe v. Wade With the legality of birth control becoming more and more uncertain in Ohio and Kentucky, With the legality of birth control becoming more and more uncertain in Ohio and Kentucky, local urologists are seeing an uptick in appointments. local urologists are seeing an uptick in appointments. BY MADELINE FENING
BY MADELINE FENING
Josh Rammel and his wife Megan planned on Josh getting a vasectomy after the birth of their rst child.
“We discussed it even before our son was born,” Rammel tells CityBeat. “Here recently with stu changing, it’s like, OK, now’s the time to do it. ings aren’t looking good for how things could go from now into the future.”
Rammel, of Perrysburg, is referring to the U.S. Supreme Court’s June 24 overturn of Roe v. Wade, which has caused a wave of laws outlawing abortion care across the country. Immediately after the court’s decision, Ohio decreased legal abortion access to six weeks gestation, before many people even know they are pregnant. e Supreme Court decision, which was previewed in a leaked draft opinion in May, seems to have caused a spike in vasectomy appointments. In June, e Urology Group, a Cincinnati-based urology practice, performed an 18.8% increase of vasectomy procedures over that same month last year, according to data from the provider. July’s scheduled vasectomies will be a 59.6% increase over those performed in July 2021, the medical provider says.
Andrew, from Independence, Kentucky, is part of the wave of vasectomy appointments being scheduled. His wife had a rough time during her last pregnancy, and she has an intrauterine device (IUD), a form of birth control that he says carries an added risk for ectopic pregnancy (the Mayo Clinic says that becoming pregnant with an IUD in place can increase the chance of an ectopic pregnancy). In an ectopic pregnancy, a fertilized egg lands outside the uterus and becomes life-threatening for the pregnant person, Cleveland Clinic says.
“I feel like I have to make the right choice for my family,” says Andrew, who has requested that CityBeat withhold his last name.
Even though Andrew nds that his vasectomy could be a safer option for family planning, the IUD his wife currently uses may no longer be an option in the future.
Like Andrew, Rammel also is thinking ahead.
Josh Rammel and his wife Megan planned on Josh getting a vasectomy after the birth of their rst child. “We discussed it even before our son was born,” Rammel tells CityBeat. “Here recently with stu changing, it’s like, OK, now’s the time to do it. ings aren’t looking good for how things could go from now into the future.” Rammel, of Perrysburg, is referring to the U.S. Supreme Court’s June 24 overturn of Roe v. Wade, which has caused a wave of laws outlawing abortion care across the country. Immediately after the court’s decision, Ohio decreased “I went to law school, so I can look at this and kinda see the reasoning for the reversal for Roe v. Wade and see how it can impact other things,” Rammel says. “Certain forms of birth control are a possibility to not be around in the future.” An Ohio lawmaker recently introduced a bill that broadly de nes a fertilized egg as a person, raising questions about the future of certain forms of birth control that could prevent implantation of an embryo (the science and medical communities do not have consensus on when personhood begins). legal abortion access to six weeks gestation, before many people even know they are pregnant. e Supreme Court decision, which was previewed in a leaked draft opinion in May, seems to have caused a spike in vasectomy appointments. In June, e Urology Group, a Cincinnati-based urology practice, performed an 18.8% increase of vasectomy procedures over that same month last year, according to data from the provider. July’s scheduled vasectomies will be a 59.6% increase over those performed in July 2021, the medical provider says. Andrew, from Independence, Kentucky, is part of the wave of vasectomy appointments being scheduled. His wife had a rough time during her last pregnancy, and she has an intrauterine device (IUD), a form of birth control that he says carries an added risk for ectopic pregnancy (the Mayo Clinic says that becoming pregnant with an IUD in place can increase the chance of an ectopic pregnancy). In an ectopic pregnancy, a fertilized egg lands outside the uterus and becomes life-threatening for the pregnant person, Cleveland Clinic says. “I feel like I have to make the right choice for my family,” says Andrew, who has requested that CityBeat withhold his last name. Even though Andrew nds that his vasectomy could be a safer option for family planning, the IUD his wife currently uses may no longer be an option in the future. Like Andrew, Rammel also is thinking ahead. “I went to law school, so I can look at this and kinda see the reasoning for the reversal for Roe v. Wade and see how it can impact other things,” Rammel says. “Certain forms of birth control are a possibility to not be around in the future.” An Ohio lawmaker recently introduced a bill that broadly de nes a fertilized egg as a person, raising questions about the future of certain forms of birth control that could prevent implantation of an embryo (the science and medical communities do not have consensus on when personhood begins).
Vasectomy, reversal and Roe v. Wade
Vasectomies typically are quick procedures that allow the patient to stay awake and drive home after. In contrast, forms of sterilization for uteruses, such as tubal ligation, often are much more involved and require a longer healing period. Tubal ligation is also considered permanent; any attempt at a reversal is considered major surgery, according to the Mayo Clinic. Vasectomies, on the
other hand, have a greater chance of being reversed. With the right to full abortion care diminishing and the right to birth control coming into question since the fall of Roe, some urologists worry that patients may seek vasectomies hastily and attempt to reverse the procedure down the road. “What we tell everybody is this should be considered a form of permanent sterilization,” says Dr. Ryan Flynn with e Urology Group. “I had a young guy who came into my practice and Vasectomy, reversal and said, ‘I’ll just get my vasectomy now Roe v. Wade and when I’m ready to have kids I’ll just Vasectomies typically are quick procedures that allow the patient to stay awake and drive home after. In contrast, forms of sterilization for uteruses, such as tubal ligation, often are much more involved and require a longer healing period. Tubal ligation is also considered permanent; any attempt at a reversal is considered major surgery, according to the Mayo Clinic. Vasectomies, on the get it reversed,’ and I tell them that is not the way to go.” Flynn says a vasectomy, while technically reversible, is not designed to be temporary. “A vasectomy is a medical procedure in which we remove part of the vas deferens, which is the tube that connects the testicles to the outside world,” Flynn says. “Cutting out that segment and cauterizing, we want to make it as dif cult as possible for things to nd their
other hand, have a greater chance of being reversed.
With the right to full abortion care diminishing and the right to birth control coming into question since the fall of Roe, some urologists worry that patients may seek vasectomies hastily and attempt to reverse the procedure down the road.
“What we tell everybody is this should be considered a form of permanent sterilization,” says Dr. Ryan Flynn with e Urology Group. “I had a young guy who came into my practice and said, ‘I’ll just get my vasectomy now and when I’m ready to have kids I’ll just get it reversed,’ and I tell them that is not the way to go.”
Flynn says a vasectomy, while technically reversible, is not designed to be temporary.
“A vasectomy is a medical procedure in which we remove part of the vas deferens, which is the tube that connects the testicles to the outside world,” Flynn says. “Cutting out that segment and cauterizing, we want to make it as dif cult as possible for things to nd their
way back together, even with medical help.”
Dr. Shane Russell, who runs the Vasectomy Reversal Center of Ohio, says reversals can be successful.
“It is reversible in the majority of people successfully, but it’s never a guaranteed success,” Russell tells CityBeat. “It’s still recommended that people consider it a permanent form of birth control. But 5-8% of people do change their mind, historically. But that number might go up in the future when people have a di erent equation in their mind for wanting to get a vasectomy or their reasons for getting one.”
Russell, whose practice is the only reversal center in Ohio, says the odds of a successful reversal are partially dependent on how much time has passed since the vasectomy, but the training of the doctor performing the reversal is the biggest factor.
“All urologists learn how to do vasectomies. It’s a pretty straightforward procedure to do an actual vasectomy,” Russell says. “A vasectomy takes 15 or 20 minutes; a reversal takes two and a half to three hours and is just very meticulous microsurgery. You really only learn how to do that if you do advanced fellowship training after your urology residency. Only about one percent of urologists choose to do that.” e advanced fellowship training gives the urologist a chance to learn a vas-to-epididymis connection, a procedure Russell says is less e ective than a typical reversal but usually only o ered by reversal specialists.
“If you see the unfavorable uid when you’re doing a reversal and you don’t know how to do a vas-to-epididymis connection, well, that side is guaranteed not to work. So, there goes half your chance,” Russell says. e “unfavorable uid” Russell mentions is semen that doesn’t contain sperm. Russell says professionals don’t know if a patient will need a vas-toepididymis reversal until they’re doing the procedure.
“What we do is we open up that end that has been tied or clipped o in the vasectomy, and we look at the uid that comes out of that tube and examine it microscopically,” Russell explains. “If you see favoriable uid – like [that] contains sperm or sperm parts – awesome, you can do the more successful vas-to-vas. If you see the unfavorable uid – like thick, creamy uid with no sperm – that’s when you have to go to the epididymis and nd sperm there, and that’s where you make your connection.” e epididymis is the structure that wraps around the side of the testicle where sperm matures, and a vas-to-epididymis connection is a last-ditch e ort Russell can o er patients who want to try for a pregnancy. e more typical
way back together, even with medical help.” Dr. Shane Russell, who runs the Vasectomy Reversal Center of Ohio, says reversals can be successful. “It is reversible in the majority of people successfully, but it’s never a guaranteed success,” Russell tells CityBeat. “It’s still recommended that people consider it a permanent form of birth control. But 5-8% of people do change their mind, historically. But that number might go up in the future when people have a di erent equation in their mind for wanting to get a vasectomy or their reasons for getting one.” Russell, whose practice is the only reversal center in Ohio, says the odds of a successful reversal are partially dependent on how much time has passed since the vasectomy, but the training of the doctor performing the reversal is the biggest factor. “All urologists learn how to do vasectomies. It’s a pretty straightforward procedure to do an actual vasectomy,” Russell says. “A vasectomy takes 15 or 20 minutes; a reversal takes two and a half to three hours and is just very meticulous microsurgery. You really only learn how to do that if you do advanced fellowship training after your urology residency. Only about one percent of urologists choose to do that.” e advanced fellowship training gives the urologist a chance to learn a vas-to-epididymis connection, a procedure Russell says is less e ective than a typical reversal but usually only o ered by reversal specialists. “If you see the unfavorable uid when you’re doing a reversal and you don’t know how to do a vas-to-epididymis connection, well, that side is guaranteed not to work. So, there goes half your chance,” Russell says. e “unfavorable uid” Russell mentions is semen that doesn’t contain sperm. Russell says professionals don’t know if a patient will need a vas-toepididymis reversal until they’re doing the procedure. “What we do is we open up that end that has been tied or clipped o in the vasectomy, and we look at the uid that comes out of that tube and examine it microscopically,” Russell explains. “If you see favoriable uid – like [that] contains sperm or sperm parts – awesome, you can do the more successful vas-to-vas. If you see the unfavorable uid – like thick, creamy uid with no sperm – that’s when you have to go to the epididymis and nd sperm there, and that’s where you make your connection.” e epididymis is the structure that wraps around the side of the testicle where sperm matures, and a vas-to-epididymis connection is a last-ditch e ort Russell can o er patients who want to try for a pregnancy. e more typical vasectomy reversal, the vas-to-vas connection in which the severed tubes are reconnected, has a 90-95% success rate in Russell’s practice. Flynn cautions patients who believe in the promise of successful vasectomy reversals. “ ere are reversals out there but there’s no guarantee to them, it’s all cash-based so there’s not coverage for a reversal,” Flynn says. Insurance companies tend to fully or partially cover a vasectomy, Flynn says, but a reversal generally is not covered and will cost thousands of dollars out of pocket. A reversal at one of Russell’s o ces in Cincinnati, Dayton or Columbus costs about $6,300. “People do these really cheap reversals that you can nd on the internet, but it’s really scary because they’re not even urologists usually,” Russell says. Urologists like Flynn take their time counseling patients, especially when discussing the future with patients who are looking at a vasectomy as temporary birth control in light of Roe. “I think it might be possible that we start to see that,” Flynn says. “From our side it’s going to come down to more counseling. I’m a big proponent of people making their own decisions. I’ve done [vasectomies] on 25-year-olds who have no kids, but those are longer counseling sessions than 38-year-olds with two or three kids.” Flynn also addresses myths and misconceptions about vasectomies during these counseling sessions. “It doesn’t a ect your ejaculation at all. It doesn’t a ect your testosterone because it’s not a ecting the testicle or the blood supply to the testicle, which is where that testosterone comes from and doesn’t change anything as far as erections, orgasms or the like,” Flynn says. Rammel, the patient who is trying for a child with his wife, did his homework before scheduling a vasectomy appointment, and he’s not afraid to talk about his decision with friends or family. “People say this all the time when they don’t actually do it, but do your research with it,” Rammel says. “If you look at the right places and read the right stu , it’s nothing to be worried about. It’s not the loss of your manhood, which I know I remember hearing growing up.” In his early years, Andrew also was exposed to media that poked fun at the procedure. “I think even in the ‘90s, on [TV show] Home Improvement, there’s an episode where Tim was going to do it and people were ribbing him,” Andrew says. “Do you lose part of your manhood? As a dad, as a husband, doing the things that keep your family safe is what manhood should be about.”
vasectomy reversal, the vas-to-vas connection in which the severed tubes are reconnected, has a 90-95% success rate in Russell’s practice.
Flynn cautions patients who believe in the promise of successful vasectomy reversals.
“ ere are reversals out there but there’s no guarantee to them, it’s all cash-based so there’s not coverage for a reversal,” Flynn says.
Insurance companies tend to fully or partially cover a vasectomy, Flynn says, but a reversal generally is not covered and will cost thousands of dollars out of pocket. A reversal at one of Russell’s o ces in Cincinnati, Dayton or Columbus costs about $6,300.
“People do these really cheap reversals that you can nd on the internet, but it’s really scary because they’re not even urologists usually,” Russell says.
Urologists like Flynn take their time counseling patients, especially when discussing the future with patients who are looking at a vasectomy as temporary birth control in light of Roe.
“I think it might be possible that we start to see that,” Flynn says. “From our side it’s going to come down to more counseling. I’m a big proponent of people making their own decisions. I’ve done [vasectomies] on 25-year-olds who have no kids, but those are longer counseling sessions than 38-year-olds with two or three kids.”
Flynn also addresses myths and misconceptions about vasectomies during these counseling sessions.
“It doesn’t a ect your ejaculation at all. It doesn’t a ect your testosterone because it’s not a ecting the testicle or the blood supply to the testicle, which is where that testosterone comes from and doesn’t change anything as far as erections, orgasms or the like,” Flynn says.
Rammel, the patient who is trying for a child with his wife, did his homework before scheduling a vasectomy appointment, and he’s not afraid to talk about his decision with friends or family.
“People say this all the time when they don’t actually do it, but do your research with it,” Rammel says. “If you look at the right places and read the right stu , it’s nothing to be worried about. It’s not the loss of your manhood, which I know I remember hearing growing up.”
In his early years, Andrew also was exposed to media that poked fun at the procedure.
“I think even in the ‘90s, on [TV show] Home Improvement, there’s an episode where Tim was going to do it and people were ribbing him,” Andrew says.
“Do you lose part of your manhood? As a dad, as a husband, doing the things that keep your family safe is what manhood should be about.”
The Cincinnati Bengals have a new alternate helmet.
PHOTO: BENGALS.COM The Cincinnati Bengals have a new alternate helmet. PHOTO: BENGALS.COM Cincinnati Bengals Unveil New
BY ALLISON BABKA
The Cincinnati Bengals recently debuted a glimpse of the team’s highly anticipated white helmet that will be used in games for the rst time during the 2022-2023 season. e helmet is virtually identical to the Bengals’ current helmet of orange with black “tiger” stripes but instead uses white for the background. e white helmet is considered an alternate and will be used only occasionally, leaving the orange helmet as the team’s main headgear.
Earlier in July, the team had announced that white helmets would be coming this season but did not share a photo of the new protective gear. As of press time, the Bengals have not indicated which games will feature the new color.
On Twitter, the team promised a look at the white helmets if a photo of Bengals quarterback Joe Burrow at practice earned 10,000 likes. Once that milestone was surpassed, the Bengals followed up on July 22 with a 10-second gif of the striped white helmet resting atop a rotating black platform, saying, “A deal’s a deal.” e NFL responded, “ ey’re here and they’re perfect.” e Bengals also have posted videos highlighting the new helmet on the team’s website. One video features a person applying black stripe decals individually to a white helmet in a precise pattern according to a diagram. e white helmet arrives shortly
The Cincinnati Bengals recently debuted a glimpse of the team’s highly anticipated white helmet that will be used in games for the rst time during the 2022-2023 season. e helmet is virtually identical to the Bengals’ current helmet of orange with black “tiger” stripes but instead uses white for the background. e white helmet is considered an alternate and will be used only occasionally, leaving the orange helmet as the team’s main headgear. Earlier in July, the team had announced that white helmets would be coming this season but did not share a photo of the new protective gear. As of press time, the Bengals have not indicated which games will feature the new color. On Twitter, the team promised a look at the white helmets if a photo of Bengals quarterback Joe Burrow at practice earned 10,000 likes. Once that milestone was surpassed, the Bengals followed up on July 22 with a 10-second gif of the striped white helmet resting atop a rotating black platform, saying, “A deal’s a deal.” e NFL responded, “ ey’re here and they’re perfect.” e Bengals also have posted videos highlighting the new helmet on the team’s website. One video features a person applying black stripe decals individually to a white helmet in a precise pattern according to a diagram. e white helmet arrives shortly after the Bengals debuted new uniforms in the 2021-2022 season for the rst time in 17 years. e team did not change the iconic orange helmet at that time, however. In January 2021, the NFL announced that it would nally lift a long-held rule that prohibited secondary helmets. NFL.com writer Kevin Patra wrote at the time that the rule was in place for safety. e alternate helmets must be identical to primary helmets except for color and must be worn during practices before the game in which they’ll be used. e 2022 season will be the rst in which the secondary helmet ban is gone. Franchises had until July 31 of last year to inform the NFL of their intent to use the additional helmet option for this season. e Cincinnati Bengals went to Super Bowl LVI in February, falling 20-23 to the Los Angeles Rams in the Bengals’ rst shot at the Vince Lombardi trophy since 1989. e team earned a 10-7 regular-season record for 2021-2022, won the AFC North, and pulled out magical win after magical win in the post-season — including the AFC Championship. Shortly after the Super Bowl, the Bengals extended head coach Zac Taylor’s contract through 2026. e Bengals’ 2022-2023 season kicks o against the Pittsburgh Steelers on Sept. 11 at Paul Brown Stadium and will end on Jan. 7 or 8 in a battle with the Baltimore Ravens in Cincinnati. e full schedule is at bengals.com.
after the Bengals debuted new uniforms in the 2021-2022 season for the rst time in 17 years. e team did not change the iconic orange helmet at that time, however.
In January 2021, the NFL announced that it would nally lift a long-held rule that prohibited secondary helmets. NFL.com writer Kevin Patra wrote at the time that the rule was in place for safety. e alternate helmets must be identical to primary helmets except for color and must be worn during practices before the game in which they’ll be used. e 2022 season will be the rst in which the secondary helmet ban is gone. Franchises had until July 31 of last year to inform the NFL of their intent to use the additional helmet option for this season. e Cincinnati Bengals went to Super Bowl LVI in February, falling 20-23 to the Los Angeles Rams in the Bengals’ rst shot at the Vince Lombardi trophy since 1989. e team earned a 10-7 regular-season record for 2021-2022, won the AFC North, and pulled out magical win after magical win in the post-season — including the AFC Championship. Shortly after the Super Bowl, the Bengals extended head coach Zac Taylor’s contract through 2026. e Bengals’ 2022-2023 season kicks o against the Pittsburgh Steelers on Sept. 11 at Paul Brown Stadium and will end on Jan. 7 or 8 in a battle with the Baltimore Ravens in Cincinnati. e full schedule is at bengals.com.
By calling 988, people with urgent needs can reach help quickly.
PHOTO: PAUL HANAOKO, UNSPLASH
New 988 Hotline Connects Callers with Mental Health Professionals in Ohio and Kentucky
BY MADELINE FENING AND ALLISON BABKA
Ohio, Kentucky and the rest of the United States have a new option for accessing mental health resources. e country recently rolled out its long-developing 988 program, which directs callers to suicide prevention counselors, addiction specialists and other mental health resources. e National Suicide Prevention Hotline has been in operation since 2005 but recently shortened its phone number from a 10-digit 800 number to the present three-digit number. People in distress now can call or text 9-8-8.
National leaders expect 988 to become a hub for mental health resources the way 911 is for emergency resources, saying it’s easier to remember and is faster to receive care. 988 is federally mandated by the Federal Communications Commission, but each state is responsible for setting up its own system.
Like most states, Ohio and Kentucky transitioned to the 988 system on July 16. When a person calls 988, they are routed to mental health professionals at a local or state call center. National call centers will step in if local centers are not available. ere are more than 200 call centers throughout the United States, so callers will never encounter a busy signal, the U.S. Department of Health and Human Services says.
HHS adds that in 2020, one person died by suicide every 11 minutes.
In Hamilton County
Talbert House, a local nonpro t network that provides suicide prevention counseling, housing, addiction and other services, serves as the 988 call center for Hamilton County. It also accepts backup calls from other parts of the state and country when other centers’ lines are busy. During 988’s rst two days, Talbert House received 93 local calls and 108 national calls, according to data Talbert House provided to CityBeat.
“It’s so important for people to have quick access when they are in crisis,” Teri Nau, vice president of community and donor relations for Talbert House, tells CityBeat.
Cincinnati’s Emergency Communications Center also works with Talbert House to forward 911 calls to the 988 counselors when the situation calls for it. Counselors may be conferenced into police calls to help de-escalate heightened situations.
Currently, the Cincinnati 988 program is available 40 hours per week and will later expand to 60 hours per week.
In other parts of Ohio
e 988 program now is available throughout Ohio. A release from the Ohio Mental Health & Addiction Services department says that callers will be routed to local or regional counselors based on their area code. e department adds that it has funding in place for one year of 988 operation, but national news outlet Axios reports that Ohio is not one of the states that has enacted long-term funding for the project.
Currently, Ohio has allocated $20 million to 988 e orts at 19 state call centers. Kentuckians also have access to emergency mental health services by dialing 988.
“Backup coverage is essential to quickly responding to individuals in crisis, and we are positioned to handle these calls, even as they increase,” Angela Roberts, 988 program administrator, says in a release.
If one of the 13 call centers in Kentucky is unable to take a call, the call is automatically routed to a national backup center in Florida or New York, according to the Substance Abuse and Mental Health Services Administration.
O cials in Kentucky anticipate that the easier-to-remember number and text capabilities will lead calls to quadruple by June 2023. e switch in Kentucky was made possible by a two-year, $1.16 million grant sourced from American Rescue Plan dollars, that release also states. In addition, Kentucky’s upcoming budget includes $19.6 million over a two-year period to boost infrastructure for 988 and to fund mobile crisis services.
According to Axios, Kentucky is one of the states that has enacted long-term funding for 988.
A new number for the nation
e 988 lifeline is part of a nationwide departure from the 10-digit National Suicide Prevention Lifeline, which will remain available even after the transition to 988; callers to the original number will be routed to local or regional call centers as if they’d called 988 in the rst place. 988 is available 24/7 for counselors to respond to calls, chats or text messages directly. e service also is available to those who are concerned about a loved one who may need crisis support.
In 2020, former U.S. President Donald Trump signed bipartisan legislation allowing a three-digit number for mental health crises. e Federal Communications Commission later assigned 988 as the phone number for the National Suicide Prevention Lifeline. Current U.S. President Joe Biden’s administration since has provided $432 million in federal funding towards building call centers and adding other resources to the 988 e ort, the U.S. Department of Health and Human Services says. 988 is available in all U.S. states and ve major territories. e National Suicide Prevention Lifeline’s original number of 1-800-273-TALK remains in e ect.
To accommodate the 988 e ort, Greater Cincinnati phone carriers have begun requiring area codes when dialing numbers within the region.
