Authors: Patrick Coffin
The moral assessment of sterilization differs only in degree from other kinds of contraception. Given the element of mutilation involved,
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along with the intention of permanence, all reliable moral theologians teach that sterilization is more seriously wrong than the other methods. While all artificial birth control is on the level of mortal sin, the three conditions for mortal sin— grave matter, full knowledge, and deliberate consent—have not generally been met in the lives of most contracepting couples today, particularly because of a lack in the second condition.
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As we will see, this does not mean that the decision will have no ill effects on bodies or marriages.
There is a tendency in the sterilization “information literature” to downplay the possible complications, risks, and negative side effects that can surface down the road. One might object that all surgical procedures entail some element of risk. And that is true. Bad side effects do not always, in themselves, make bad acts. In this case, however, even if medical science one day produced a method of sterilization with absolutely no bad side effects, sterilization would still be gravely immoral. (This is also true of the Pill.)
The absorption of sperm cells following a vasectomy is tied to one of many negative side effects. The man’s body interprets the sudden presence of the sperm cells as foreign matter and, to protect itself against the antigens produced by degenerated sperms cells, manufactures antibodies to combat the foreign invaders.
Medical science has known about this phenomenon since the early 1970s, when antibodies generated against sperm antigens were found in fifty-five to seventy-five percent of vasectomized men two years following the procedure.
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The implications of autoimmune disorders arising from vasectomy are not yet fully known. But some side effects include:
Pain:
While post-surgery pain should theoretically stop after about a week, some men report irritation and discomfort in the groin years later when riding a bike or sliding across the front car seat.
Granulomas:
The leakage of sperm from the snipped vasa into the scrotal tissues can cause benign (non-cancerous) lumps resulting from an inflammatory reaction. These sperm granulomas may be tender to the touch and, more rarely, develop into an abscess.
Erectile dysfunction or decreased sexual desire:
This can occur in the form of impotence, premature ejaculation, or painful intercourse, which may be partly psychological in nature. The vasectomy can also exacerbate previous problems between sexual partners.
Link to early onset dementia:
Researchers at Northwestern University studied forty-seven men aged fifty-five to eighty with a language-based dementia known as Primary Progressive Aphasia (PPA), and found that forty percent had had vasectomies, compared to sixteen percent of the control group with no cognitive impairment.
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Cancer:
Studies from the early 1990s have progressively shown an association between vasectomy and an increased risk of various kinds of cancers, such as lung cancer, non-Hodgkin’s lymphoma, and multiple myeloma.
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For women, the procedure is similar and is called a tubal ligation, better known as “having your tubes tied.” This procedure also entails considerable risks, including:
Serious complications at the time of surgery:
Depending on which kind of ligation method chosen, between 800 and 2,000 women per 100,000 can expect a major complication at the time of the procedure, such as infection, injury to the bladder or bleeding from a major blood vessel, burning of the bowel or other neighboring tissues, and anesthesia complications.
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Increased risk of ectopic pregnancy:
Approximately one half of pregnancies resulting despite the ligation will result in an ectopic pregnancy, a painful and potentially lethal event in which the egg is fertilized and begins to attach and grow outside the uterus, usually in the Fallopian tube.
Other lesser known risks include
menstrual irregularities and prolonged bleeding, increased cramping, and post-tubal sterilization syndrome (a form of depression)
.
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It is not well known that both vasectomies and TLs (tubal ligations) can be reversed with varying success rates, reckoned as somewhere between fifty to seventy-five percent.
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Achieving a post-reversal pregnancy depends mainly on how much time has elapsed since the sterilization, how frequently the physician performs the procedure, and whether the physical structures of the vasa and the Fallopian tubes remain conducive to reattachment.
Although reversal surgeries are more costly and more complicated than sterilization itself, a growing number of people are choosing them. Even if they don’t bring another baby into the world, the testimonies of people who changed their minds make for moving and enriching reading. I highly recommend
Sterilization Reversal: A Generous Act of Love
, a unique collection of twenty couples’ stories edited by John Long, and a conference talk by David and Nina Morton titled “Testimony of Healing,” both available from One More Soul (see Appendix).
As we saw in Chapter Five, the natural law is inviolable in the sense that flouting its directives eventually brings consequences, and not all of them foreseen. Since man is a union of matter and spirit, some of the side effects associated with vasectomy and tubal ligation may, in fact, be psychosomatic. God doesn’t punish arbitrarily the way an office manager might punish a clerk who steals a stapler. Rather, every unnatural act carries with it some repercussion, sooner or later, in this life or the next.
Dr. Gregory Polito, a Southern California urologist who performs vasovasectomies (aka, vasectomy reversals), knows this firsthand. He notes that not nearly enough research has been done to track the long-term repercussions—personal, marital, and social—of sterilization.
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In his clinical experience, patients who change their minds and have their vasectomies reversed invariably felt that something was awry but couldn’t put their finger on it—at first. “You don’t need to bring in a lot of theology,” Dr. Polito notes. “They’ve already detected a problem in their marriage, something ‘off,’ even apart from the new desire for more kids.”
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Regardless of religious belief, most reasonable people admit that an operation that intentionally destroys the capacity for fatherhood or motherhood is not the same as operations such as a heart bypass or a kidney transplant. In sterilization, of all the myriad types of cells in the man’s body, the only one with a singular role in co-creating new human beings—the sperm cell—is treated as a threat to be (literally) cut out of the picture.
In trading fertility for sterility, each subsequent sex act therefore loses the objective quality of openness to new life required by sacramental marriage. It is “seriously stained,” as Kippley puts it.
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For Catholics, at least, the decision results in an ongoing, implicit violation of their wedding vows when they promised “to welcome children lovingly from God, and bring them up according to the law of Christ and the Church.”
As it happens, if one of the spouses comes to regret the decision, they can spend many years hiding their regret.
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There are no studies extant on how many people change their minds about the procedure, but even if it’s a large number, regret doesn’t necessarily translate into reversal. Only about one percent of vasectomies and TLs are reversed, but that doesn’t tell us how many more live with the daily anguish of knowing they made a serious mistake and for whatever reason are unable to correct it.
Everyone reading this book knows firsthand how stubborn human nature can be. As children of Adam, we are allergic to the phrase, “I was wrong.” The precinct inhabited by a sterilized person, however, makes this allergy worse. Feeling “locked in,” a pattern of self-justification and rationalization can, over time, squelch the voice of conscience that is “inscribed by God in the human heart,” in the words of the Second Vatican Council (
GS
16).
Having invested much time and emotion in the decision process, it’s easy for the sterilized person/couple to adopt a hardened stance against the Church’s teaching.
Many couples drift for years before acknowledging that something between them is no longer in sync. After the initial pregnancy fear subsides, and the vision of 1001 erotic nights turns out to be something of a scam, spouse may (subtly) turn against spouse while doing their best to ignore the silent, disturbing “presence” of the choice they made. Or, worse, one spouse got sterilized without the consent of the other, which is possible under federal law protecting patient confidentiality.
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They start to see the mystery of sexual love through the prism of stagnation. At some not-fully-conscious level, their lovemaking is no longer regarded as the great co-creative adventure God made it to be.
Archbishop Sheen called this fed-upness “black grace,” the disturbing sense that God is absent, which Sheen contrasted with the white grace of God’s consoling presence.
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God is not absent, of course, but from an emotional or sensible point of view, our sinfulness impairs our capacity to experience God’s consoling presence.
With the help of God’s grace, however, this inner affliction can give way to a new ability to hear the still small voice of conscience. The
Catechism
teaches that “Conversion is first of all a work of the grace of God who makes our hearts return to Him: ‘Restore us to thyself, O Lord, that we may be restored!’”
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According to Christ’s most famous parable, if anyone responds to the graces of repentance, the Father doesn’t merely listen like a remote king: He leaps off His heavenly porch and runs to us (cf. Lk. 15:11–32).
So repentance is not the end, but the beginning. And while it doesn’t magically make the sterilization go away, there are practical options available. Although the Catholic Church, wisely, does not require sterilization reversal as a condition of God’s pardon, there is an obligation to at least consider it. And many couples—in the face of long odds and financial “impossibilities,” and after hearing a good priest assure them that repentance suffices—feel the Lord asking them to seek out that option.
As the beautiful stories of post-reversal babies attest, repentance can sometimes bring spectacular blessings. Few babies are cherished more deeply than post-reversal babies.
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A wonderful organization exists to help couples financially to reverse their sterilization, called Blessed Arrows. (For more information, see Appendix.)
Whether the couple is able to have the reversal, whether they have the reversal but are unsuccessful at achieving another pregnancy—and whether or not God blesses them with another child—all of this is secondary to the momentous thing they have achieved: In one of the most delicate and profound dimensions of their lives, they have set things right with the One who made them and brought them together.
So what about men (and women) who confess the sin of sterilization, yet who truly cannot have the reversal? A unique and vexing problem arises. They may, over time, find themselves sorely tempted to delight in the very sex-withoutbabies mentality that led to the sterilization in the first place (otherwise known as having your cake and eating it, too).
The best pastoral advice combines common sense with mature Christian spirituality.
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It is this: that the couple chooses to model their sex life after the same cycle of enjoyment-then-abstinence that fertile couples adopt when using NFP. This monthly time of abstinence (several days per month) is embraced as a pledge to the Lord that their rejection of the contraceptive mentality is sincere and permanent.
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Since the tubal ligation normally does not affect menstruation, the biological signs of fertility can still be tracked as they would be in a fertile couple.
The bottom line is that deep and lasting repentance is possible after the sin of deliberate sterilization, even if no steps are taken toward a reversal. Bishop Robert Vasa of Baker, Oregon, makes this clear: “God’s infinite strength does change hearts and dispose persons to the truth who were once blind to the transcendent. Deliberate sterilization is surely a ‘forgivable’ sin.”
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