Vasectomy incidence in the Military Health System after the reversal of Roe v. Wade

Abstract Dobbs v. Jackson Women’s Health Organization has already had profound impact on reproductive health care in the United States. Some studies have reported increased incidence of vasectomy after the Dobbs decision. The Military Health System (MHS) provides a unique opportunity to evaluate this relationship in a universally insured, geographically representative population. We conducted a retrospective cross-sectional study of vasectomies among all male beneficiaries in the MHS, ages 18 to 64, from 2018 to 2022. Analyses included descriptive statistics on patient demographics, rate change, time analysis, logistic regressions for the odds of a vasectomy after the Dobbs decision, and state-level analysis. Our analysis indicated a 19.7% increase in vasectomy utilization in 2022 compared to the average from 2018–2021. Analysis by state showed that the relative increase in vasectomy after the Dobbs decision was greater in a state immediately implementing a restriction on abortion access (Texas, 29.3%) compared to a state with no such restriction (Virginia, 10.6%). Our findings highlight the impact of the Dobbs decision on reproductive health care utilization outside of abortion.