GW researchers found a spike in young adults seeking forms of permanent contraception after the 2022 overturning of federal abortion protections in a study published this month. 

The study, led by Julia Strasser — an assistant research professor and the director of the Jacobs Institute of Women’s Health at the GW Milken Institute School of Public Health — found a 70 percent increase in tubal sterilizations and a 95 percent increase in vasectomies from May 2022 to August 2022 nationally among 19- to 26- year-olds. Strasser said young adults and adolescents reported “fear” about the fate of their bodily autonomy after the Supreme Court’s Dobbs v. Jackson decision in open-ended surveys analyzed as part of the study.

“What we found is that the young people in this study described that their interest in permanent contraception was motivated by concerns about losing access to abortion or the ability to make decisions regarding pregnancy,” Strasser said in an email.

Tubal sterilization is a procedure that severs the fallopian tubes from the uterus so a person can no longer get pregnant. A vasectomy is a procedure that seals the vas deferens tubes that carry sperm.

In May 2022, Politico reported that an unknown party leaked the Dobbs v. Jackson opinion, indicating that Supreme Court justices were going to overturn the landmark Roe v. Wade decision that federally protected the right to abortion up to viability of the fetus, which is usually around 24 weeks. The official decision came out in June 2022, putting abortion regulations in the hands of states. 

Strasser said researchers used the IQVIA medical claims database, which shows bills from physicians across the United States covering approximately 191 million patients from the time period January 2021 to December 2022, to see the number of in tubal sterilizations and vasectomies provided to 19- to 26-year-olds nationwide. 

“We used the moment of the Dobbs decision leak in May 2022 and conducted a difference-in-difference analysis comparing increases in states that were deemed likely to ban abortion at the time of the leak vs not likely to ban abortion,” Strasser said in an email.

Since the decision, 28 states have enacted laws banning abortion before viability, with the procedure being illegal in 12 states. The study found that vasectomies and tubal sterilizations increased at a greater rate in states that seemed likely to place restrictions on abortion access after the decision like Arkansas and Kentucky, which had trigger bans meant to automatically go into effect once Roe v. Wade was overturned for abortion on the books before the Dobbs decision was released. 

Strasser said researchers also took qualitative data from the MyVoice national survey. According to the study, MyVoice surveyed 638 people aged 14 to 24 in 2022 and 2023 and asked young people open-ended questions on political issues, ranging from gun violence to climate change. Strasser said researchers used the survey to analyze attitudes toward contraception and found young people said the Dobbs v. Jackson decision played a factor in their decision to pursue permanent contraception.

Sara Luckenbill, a research assistant for Strasser and collaborator on the project, said she went through the quotes from survey respondents concerning contraception and reproductive health to include in the study. 

“As we had gone through the quotes from young people, I think some of the main themes that emerged were more people were scared and frustrated,” Luckenbill said. “And there are some very illustrative quotes that you can see in the paper themselves that this was something that young people were actively thinking about and engaging with and were worried about.” 

Luckenbill said the study decided to focus on people aged 19 to 26 because they face additional barriers to accessing reproductive health services like financial burdens due to lack of parental support. 

“It has made me want to be sterilized more,” a 24-year-old female surveyed said. “Because the pill isn’t 100% effective and I’m afraid of losing access to it, and I do not want children in the future and would much rather be sterilized. I’m afraid of getting pregnant and not being able to make decisions for myself.”

Luckenbill said she had heard anecdotal evidence of more men getting vasectomies, but most of them came from older married men who already had children, so it was “surprising” to see the degree to which vasectomies increased in young men.

“We know from prior research that young people are more vulnerable to these changes because they have other barriers to contraception at their own planning to begin with whether that’s logistical like ‘I can’t actually physically get to an appointment’ or ‘I can’t pay for this, my parents gonna know,’” Luckenbill said. 

Lauryn King, a part-time instructor at the Women’s, Gender, and Sexuality Studies program, worked with Luckenbill to sort through the qualitative data from the study, which she said added the voices of young people into the study to support the quantitative data. 

“One of the things that was really important for us with this paper, and especially with the qualitative element of this paper, was centering the voices of the young people who we were interested in learning about,” King said.