Tim Burrows is absolutely right to highlight the importance of vasectomy, the anxiety many men feel about it, and the continuing imbalance in contraceptive responsibility between men and women ( My first thought after having a vasectomy: why aren’t more British men having them?, 11 May ). However, the commonly quoted decline in vasectomy numbers needs careful interpretation. NHS Digital figures do not capture the full picture, because they largely exclude NHS vasectomies performed in community and primary care settings, where a substantial proportion of procedures now take place. In 2022-23, NHS Digital recorded 10,710 vasectomies in England. In the same year, members of the Association of Surgeons in Primary Care (ASPC) reported a further 17,776 vasectomies in England, performed in community settings and not reflected in that national total. Despite repeated attempts by the ASPC to have these figures recognised within official national datasets, they remain excluded.…