Following the Dobbs decision in 2022, which overturned the constitutional right to abortion, 21 U.S. states have restricted or banned abortion care. This decision may have influenced contraceptive decision-making, particularly for permanent contraception. Research shows increased demand for permanent contraception, including tubal sterilization and vasectomy, in the months following Dobbs. However, no study has evaluated the differential impact of Dobbs on permanent contraception among men and women or younger adults. This study used data from the TriNetX platform to assess changes in tubal ligation and vasectomy rates among younger adults (18-30 years) before and after Dobbs. The study found an abrupt increase in permanent contraception procedures among adults aged 18-30 years following Dobbs. The increase in procedures for female patients was double that for male patients. These findings suggest gendered dynamics in permanent contraceptive use, reflecting the disproportionate health, social, and economic consequences of compulsory pregnancy on women. The study has limitations, including the inability to assess state abortion policies or account for changes in data sources. Additionally, the study does not provide insight into the experiences of marginalized groups in contraceptive decision-making. The abrupt increase in permanent contraception rates may indicate a policy-induced change in contraceptive preferences. Dobbs may have also increased a sense of urgency among individuals interested in permanent contraception. Changes in contraceptive decision-making must be considered to understand the short- and long-term implications of Dobbs on reproductive autonomy. The study was conducted using deidentified patient data and was deemed exempt from review. The findings were robust to sensitivity analyses. The study highlights the need for further research on the impact of Dobbs on reproductive autonomy and contraceptive decision-making.Following the Dobbs decision in 2022, which overturned the constitutional right to abortion, 21 U.S. states have restricted or banned abortion care. This decision may have influenced contraceptive decision-making, particularly for permanent contraception. Research shows increased demand for permanent contraception, including tubal sterilization and vasectomy, in the months following Dobbs. However, no study has evaluated the differential impact of Dobbs on permanent contraception among men and women or younger adults. This study used data from the TriNetX platform to assess changes in tubal ligation and vasectomy rates among younger adults (18-30 years) before and after Dobbs. The study found an abrupt increase in permanent contraception procedures among adults aged 18-30 years following Dobbs. The increase in procedures for female patients was double that for male patients. These findings suggest gendered dynamics in permanent contraceptive use, reflecting the disproportionate health, social, and economic consequences of compulsory pregnancy on women. The study has limitations, including the inability to assess state abortion policies or account for changes in data sources. Additionally, the study does not provide insight into the experiences of marginalized groups in contraceptive decision-making. The abrupt increase in permanent contraception rates may indicate a policy-induced change in contraceptive preferences. Dobbs may have also increased a sense of urgency among individuals interested in permanent contraception. Changes in contraceptive decision-making must be considered to understand the short- and long-term implications of Dobbs on reproductive autonomy. The study was conducted using deidentified patient data and was deemed exempt from review. The findings were robust to sensitivity analyses. The study highlights the need for further research on the impact of Dobbs on reproductive autonomy and contraceptive decision-making.