CHICAGO - Jeremy Youngman, a 32-year-old tattoo artist in Downers Grove, Ill., likes his birth control the way he likes his body art: permanent.
At 27, Youngman got a vasectomy. Unlike the vast majority of the 500,000 men in the United States who get sterilized every year, Youngman was single and had no children.
To Youngman, the thought of getting a woman pregnant was "the scariest thing in the world." He says he has long known he doesn't want to be a father, and he didn't want to take any chances.
"It's hard enough to take care of myself, let alone a kid," says Youngman, adding that he still uses condoms to protect against sexually transmitted diseases.
Half of all pregnancies in the United States are unwanted or mistimed, according to the Centers for Disease Control and Prevention. For some young men, relying on condoms or a woman's promise that she's on the pill isn't enough to protect against unwanted progeny, so they're opting for vasectomies.
Though such cases are uncommon, the relative ease and affordability of vasectomies, plus the possibility of reversal, make them an attractive option for some men.
Doctors tread carefully in such cases. Though any man 18 or older can legally get a vasectomy, doctors can turn men down if they don't believe them to be mature or sure enough of their future plans.
"I received a call from an 18-year-old high-schooler, and that was a no-no," says Dr. Arif Agha, owner of the Vasectomy and Reversal Center of Chicago, in Oak Brook, Ill.
Dr. Kiu Mostowfi, owner of Vasectomy Clinics of Chicago, says that when a 24-year-old man approached him about a vasectomy, he told him he was too young and suggested he come back in a year after he'd thought about it. When the man returned a year later and was still committed, Mostowfi agreed to perform the vasectomy.
Another of Mostowfi's patients, Justin Holt, 27, says the doctor grilled him with "what-if" questions for 40 minutes before agreeing to perform his vasectomy last month. Holt, who lives in Chicago's Logan Square, says he's sure he never wants children.
"It's the only way to be responsible for myself and my behavior," says Holt, who works as a data specialist for a financial firm.
Though Holt says he has no regrets, the finality of the decision has been surprisingly emotional.
"Every once in a while you get this weird thought of, 'I'm never going to be a father,' " Holt says. "It's equal parts terrifying because you're not like everyone else, and also because you made this extreme decision at 27."
Doctors must give "extensive counseling" on the benefits and risks of vasectomy to ensure men know what they're getting into, says Dr. Chris Gonzalez, a urologist at Northwestern Memorial Hospital.
Men should realize being sterile could affect future relationships, says Dr. Laurence Levine, a urologist at Rush University Medical Center. Most vasectomy reversals are for men who get remarried and find that their new wives want to start a family.
Mark Witt of Park Ridge, Ill., got a vasectomy because he and his wife didn't want children. But when they divorced a year later, he discovered that was a deal breaker for some women on the dating scene, says Witt, 48, who works in health-care administration.
"I've had some regret," he says, "because I've lost some good women because of it."