I have a friend* who is about to get a vasectomy, and it turns out, it's a ridiculously involved process, presumably because of Religionists.
First, you have to get not one but two "mental health" exams, because the assumption is that if you are under 40, single, don't have kids, and don't want to have kids, you must be crazy.
Then, you can either spend many thousands of dollars at a private practice (apparently when you add up all the fees that insurance doesn't cover it gets absurd), or do Planned Parenthood. It turns out that San Francisco is some kind of mecca for men's health -- you can get your prostate examined on any street corner, and sometimes they'll pay you -- but not men's reproductive health, go figure.
So Planned Parenthood says, "Well, we only do this once a month, so let's find the next available date... how about eight months from now?" I guess this means there's only the one guy in the country who knows how to properly use the tiny scissors on his Swiss Army Knife, and he spends all his time traveling from town to town snipping nuts, like it's the Old West, or a Toshiro Mifune movie or something. Wait, no, it sounds more like Eversmile, New Jersey, that Daniel Day-Lewis movie where he plays an itinerant dentist traveling through South America on a motorcycle, dealing out the rough justice of fillings and extractions. (It's a great movie.)
* Honestly, these are not my nuts that are on the table here.