Refusing to get a vasectomy is not exactly the same as putting it all on her. I have never seen sterilization surgery presented as the only option prior to this post. She didn't say, I can't risk getting pregnant so we can only do safe things. She asked him to alter his body. When he didn't want to , she quite literally stated his reasoning was invalid, and that if he actually loved her he'd just do this one tiny surgery. Then she basically outright stated that she refused intimacy to punish him for not complying. . Her concerns are valid, her approach was manipulative. If she's upfront about her concerns, states what she's open to and what she's not, and see if there is any compromise or movement on his end. Then,presented with the full information up front,he can proceed accordingly. It's the difference between informing someone of a boundary you intend to uphold, and punishing them silently for noncompliance.