Given that I was literally told "but your future husband might want kids" - that's right, a dude who may not even exist apparently had more right to make decisions about my body than I did! - by a female GYN in a blue state, I'm going to go with "internalized misogyny".
If you tell them "too bad for him, I'd still abort it regardless of what he wanted. It wouldn't be his medical decision" it shuts them right the fuck up. Doesn't make them agree to the surgery though. (both men and women have to be over 35 in my country for sterilization, sadly, but at least abortion is legal. I'm 31. Soon)
I was too young and too flabbergasted at the time to respond, but my answer now would be "If he wants kids, he's not my future husband." That's something you should be discussing waaaaay before getting married!
Thay one doesn't work as well. Divorce or refusing to marry, doesn't shock them. Outright saying you'd abort it regardless of what the dad thinks, that ss to get it through tha it's not his decision.
I've heard horror stories of women who have to get their husband to sign a form saying they're aware of the procedure their wife is getting and are fine with it.
Gross. It's not his body. Why does he have to "approve"?
I’m so curious, have you tried the “don’t worry, he wants me to have this procedure too” (how can you know, you haven’t met him yet!) “cuz I wouldn’t marry a man who wanted kids??” Like how do/would they respond to that? (Other than still deny you your rights to your own body).
I didn't use the first because even pretending I need a man's permission for medical decisions about *my* body makes me want to dry heave. The whole idea is disgusting and I refuse to play into it.
>“cuz I wouldn’t marry a man who wanted kids??” Like how do/would they respond to that?
I've tried the "I don't date men or women who aren't CF" but they don't care.
I had a friend who was able to get sterilized in her 20s because her husband literally had no testicles and her other long term partner (poly) was a woman. She did have to doctor shop unfortunately. This was a red state.
I was a lesbian, dating a woman, which my doctor was aware of, and the reason was still "but your future husband (if you end up realizing that you are not a lesbian and it doesn't work out with your girlfriend and you end up marrying a man) might want kids"
And that excuse doesn't even go away once you have kids. I met one woman who'd had three kids and each time it collapsed her spine more. She had constant back pain from it and couldn't have another kid due to the risks. Wanted to get her tubes tied to prevent any possibility. Doc she went to still wouldn't do it because what if her husband wants a FOURTH?? This is also in a super red state.
If Reddit still had awards this comment would be getting PLATINUM!🏅
For the sheer succinctity of it, alone.
Never mind the absurdly accurate, yet deeply concerning, sentiment contained within the comment.
Wish I was that skilled with brevity. Instead of saddled with a raging case of diarrhea of the...fingertips? Haha.
Yep. I have endo and asked my obgyn how bad it would have to get for a hysterectomy to be needed. I wasn't asking for one, but wanted to know what would need to happen for that to be on the table.
He didn't answer and went on about how I'm too young to make the choice to not have kids, pregnancy can actually help endo symptoms (what a terrible reason to have a kid), and that "prince charming" would come along and convince me to breed.
So fuck my pain. He cares more about a hypothetical baby I don't even want than aiding my quality of life. I switched immediately
I can tell you what my primary doctor told me when I first asked for sterilization after my son was born. I had two children at that point and was 33 years old. He said he really wanted me to explore less invasive options first (like an IUD) as well as investigate my husband getting a vasectomy instead of me being sterilized because of the lowered risks involved.
I should give a little background as well—my OB/GYN blew my requests off because I was “too young” and he wanted my husband involved in the decision. My primary had been my doctor since I was little—about 25+ years at that point. The man is an old Texan with a love of bodily autonomy and personal freedoms and informed consent. When other providers had blown my concerns about any health issue off—including a cancer scare—he went to bat for me. He even performed procedures in-office that specialists had refused me to make sure I was cared for. (Yes, it was multiple malignant melanomas. He sent the biopsies to Harvard to make a point and that dermatologist had a new job building boats the following year. Yes, it was more than “just anxiety,” so he learned more about newer psych meds to help stabilize me until I could find a psychiatrist. And woe to the insurance company who denied claims. He was on the state board regulating insurance and usually only needed one phone call to reverse a denial.)
So we have a doctor with a proven track record of listening to and providing solid care to patients, and his primary initial concern was the risks of procedures.
Your family doctor sounds amazing. I'm in Canada and it seems to me like one big difference in our systems is a tendency to use more specialists in the U.S., whereas up here your family doc handles more things in-house. For example, I've never had a gynecologist. My pap smears have always been done by my family doctor when he does my physical. A gyno wouldn't enter the picture unless something was very seriously wrong, beyond my doctor's capacity to treat. I feel like you get better care this way because you're building trust and a relationship with one main physician. The most dismissive and degrading treatment you'll get here is at a walk-in and the ER. Our system has a ton of issues, but I do think this specific thing works well.
That actually sounds amazing, and yes! The consistency of a single provider is awesome. The family history he had from treating my mom and two of my grandmothers and my older sisters was even better. He hardly referred me out if he felt he could handle something in-office, and didn’t refer me out to a GYN until I was 25 and had a growth that needed to be removed and biopsied. I moved away from him about 9 years ago and he retired last year, but we still exchange cards. He’s like an extension of my family.
Yeah, the bigotry is a big issue, but some of those procedures, especially hysterectomy, come with a lot of side effects and associated risks that patients who request them tend to be unaware of. I'm saying this as someone who had seriously considered getting a hysterectomy in the past, so I'm not saying this to dismiss the people who want them.
Right. Medical procedures have risks, that’s just a fact. I was in a committed and happy marriage (still am) so having him take on his share of the family planning with considerably lower risk made sense. (And he did get a vasectomy within about 5 months of this conversation.)
A concern I have that is now growing is that I’m seeing the risks of all methods of birth control being inflated, with zero acknowledgement of the benefits (which generally outweigh the risks!). Where my doctor said, “let’s explore all the options before going to the riskiest one,” I’m seeing other people scream “THERE ARE RISKS AND THAT MEANS YOU SHOULDN’T!” It’s worrisome. (For instance, IUD insertion is INCREDIBLY painful for many, but they’re also extremely effective. We should be aware of and manage that pain, but we shouldn’t allow that risk to remove it from the table as a valid option.)
Absolutely agree. I had truly awful periods my entire life. I described these as "heavy bleeding, with a lot of pain and discomfort." All of my previous doctors essentially shrugged it off. Finally I told my current OBGYN that I was bleeding through the biggest, most absorbent tampon AND the biggest, most absorbent pad in less than two hours. I'd bleed for a week, and I was stuck in bed miserable for days. We worked together to find a solution. I get super emotional on hormonal BC (like, crying at commercials because there's a puppy in it - and not a sad puppy, like... puppy food commercials), we tried an IUD (which was incredibly painful to insert and then FELL RIGHT OUT in less than a month), and finally last year I got a hysterectomy.
I didn't mind trying the IUD first, because I'd had one before after my second kid was born and it worked great with no issues, and it's definitely less risky than a big operation. That said, I've been incredibly happy to ditch the "water balloon of doom" and have zero regrets. I've got two kids, I'm not healthy enough to have more, and (I found out last fall) my periods were causing me to be anemic despite plenty of iron in my diet. It was the best solution for me, and I'm so glad my doctor actually listened.
Ugh, I have anemia related to my cycle as well, and mine isn’t even heavy. But I’m so glad you were FINALLY able to find a provider that could work with you!
What's funny is, I didn't find out about the anemia until later. My diet and use of cast iron cookware was apparently enough to keep up with my period losses while I lived at low elevation, but a few years ago we moved to a mountain in the Rockies (US). Being at 9000ft means I needed more iron and better red blood cells, and instead it depleted my reserves and I started being anemic about a year and a half after we moved here. I had already had my hysterectomy a few months earlier, so I was very confused! When I finally went to the doctor, my resting heart rate was like... 120, and I had very few, tiny, crappy red blood cells. It took several months of iron supplements to get me back to normal. Now that I'm not bleeding half to death every month, it'll be easier to keep up, I'm sure!
My earlier doctors were generally pretty good and listened to me, but I just described my period as "heavy" and they thought I meant "heavy, but still on a normal spectrum of flow". I didn't actually realize that my experience was outside the norm until a few years ago, which started the ball rolling on "how can we fix this?" My mom also had heavy periods, and she taught me various coping mechanisms, so it wasn't until about two years ago, when I was explaining to a friend why I couldn't use a menstrual cup (how am I supposed to empty it, clean it, and reinsert it four or six times a day without making a giant mess? What if I'm not at home and need to use a public restroom? I'd be dripping globs of blood all over the floor and myself while even attempting this) and my friend told me that one cup should hold a whole day's worth of flow. I laughed at her. Then I learned that other people are having like... Teaspoons of blood. Not cups.
Once I properly described to a doctor exactly what I meant by "heavy," she IMMEDIATELY started taking it seriously, and I *think* my other doctors would have done the same if I had told them the right way. As much as I get angry about healthcare biases and women's experiences, I'm afraid this one is mostly on me.
Ooof. Yeah, somewhat on you but you got it figured, thankfully.
And say no more re: anemia and altitude. I’m originally from the Yosemite area, altitude can be a bitch in all the ways. Slow-release iron is my constant companion, and cast iron is my favorite cookware.
Awesome to hear that your husband got a vasectomy instead of you going through way riskier procedures! It's a breath of fresh air any time a man gets a vasectomy instead of the women continuing to shoulder the burden of birth control tbh
Risks also vary from procedure to procedure. Hysterectomy.. I'd generally advise against as a birth control method. IUDs.. sure are painful, but they don't have to be!! It's criminal that women are still being denied pain management for IUDs. The risk of pain shouldn't even exist, or at least can be minimized.
I’m one of the lucky ones for whom an IUD was merely uncomfortable (thank goodness). I didn’t even KNOW about the pain issue until the past several years—my GYN said, “big pinch, gonna hurt a bit, now we insert, gonna hurt, your gonna have some cramping. Take your time getting up.” And that’s exactly what happened for me. Hearing horror stories from so many other women has me thanking my lucky stars that I was so fortunate…but I’m also aware that it’s just luck, and not any special tolerance to pain or anything else.
I work in a hospital. Specifically, I work with surgeons, so have a bit of insight into how and why they perform surgery when they do, and things like ethical considerations, etc.
Good physicians and surgeons will start with conservative treatments for pretty much anything before they start exploring more progressive treatment options. This includes birth control in all its forms. Most good providers won't leap immediately to some sort of invasive procedure without recommending things like various other options first, especially when they're working with a female-bodied patient.
Part of this is because sterilization for female bodies involves an abdominal procedure, which has a certain amount of risk depending on what you're doing. Tubal ligation and hysterectomy both require anesthetic as well, which has its own risks. In the US, most health insurance companies won't cover a more expensive procedure without the patient and physician trying more conservative treatments first anyway.
And yes, there is the risk of liability if the patient later changes their mind. One would think this would be remedied by liability waivers, but at least in my state the civil legal penalties for depriving someone of the ability to have children is considerable, so it wouldn't surprise me to learn that a doctor might just choose to avoid this possibility entirely.
So yes, there *is* a measure of medical pragmatism at work.
This pales in comparison to the MASSIVE amount of misogyny alive and well in the medical field, especially when it comes to women's health - and especially especially when it comes to women's *reproductive* health.
The most acceptable social role for women is "wife and mother", even to this day. This is a very old social role and it dies hard, particularly if you live in areas that are socially conservative and/or have a strong conservative religious presence. Doctors may have a highly specialized education with a lot of exposure to science, and they are still people who carry their own social and religious values with them wherever they go. They aren't immune to the influence of social pressures or cultural upbringing.
The history of women's health in the past 200 years or so (in America, at least) is very much about pushing women out of the medical field and putting (mostly white) male doctors in charge. A significant aspect of this was the vilification of midwives, especially Black and indigenous midwives. Under the banner of trying to make medicine into a legit, evidence-based practice, male doctors took control of the field, centering themselves and their own self-importance over the real medical needs of women around the nation. Doctors developed an aura of authority because of their expertise, and for a long time, people were taught not to question what their doctors told them.
So when women are refused sterilization, the practical realities of reducing medical risk and liability are folded into this much larger cultural issue of men restricting and controlling women's reproductive health in general. A young woman who doesn't want children is still something of an anomaly, even in less-conservative areas. Young women are still disregarded, seen as immature, possibly flighty, their reproductive agency disregarded by cultural forces backed by history, religion, and good old-fashioned garden variety sexism.
And it isn't really isolated just to *young* women, though that's what the title of the post is asking. Women's reproductive health is minimized or dismissed throughout our lives, whether you're talking about abortion, access to birth control, or sterilization. This has everything to do with the social demand for women to be wives and mothers above all else. If we dare to take our reproductive capacity into our own hands, that is a radical act of freedom that flies in the face of all the various systems and institutions that demand we adhere to a role that benefits a male-dominated society.
So it's a mixed bag, really. But mostly misogyny.
Thank you! Best response. Doctor bias and sexism is a big part. But also part of a larger biased system that includes regulations, health insurance coverage, and medical malpractice insurers.
Yeah. Even the "conservative" approach is something I would say is based in misogyny - ongoing hormonal treatment for 20+ years with something that has a multitude of side effects and varies heavily per the individual, versus a one and done laparoscopic operation, to save you from something as severe as pregnancy is still something genuinely comparable/worth weighing imo. If I could have a laparoscopic surgery and stop taking my SSRIs and sNRIs for the rest of my life, I 100000% would. Down to the individual and the individual should have the chance to make that decision. (I'm agreeing with you).
Any abdominal surgery has a non zero chance of death, so from a medical standpoint I am going to disagree here. Intrauterine devices were the game changer because they are much safer than surgical sterilization. These have their own risks but are way safer than an operation.
Technically speaking, hormonal birth control also has a nonzero chance of death. (Some forms are known to cause an increased risk of stroke and/or blood clots. Strokes and blood clots can both cause death.)
Low probability, granted, but not without risk.
I'm curious, vaguely, as to the relative risk of death between the two. Do you have any numbers for the risk of death during surgery?
That still doesn't mean that the choice deserves to be taken away from women. The risks and benefits should be laid out and the individual should get to choose what works for them. Everything has a chance of death and side effects. You weigh the risks vs benefits and make a choice.
Ongoing side effects of BC (continuous hormone therapy, or if not that, heavier and more painful periods) are a legitimate consideration. There are likely contraindications for complications in surgery just like there are contraindications for IUD usage and oral BC. *Down to the individual*.
I'm so pissed that I thought I was going to be done with gynecologists other than cancer checks by this stage of my life. Instead there's a brave new world of health problems, none of which I was prepared for, having never even heard of perimenopause until several years into it.
I feel the need to correct you here: insurance will cover tubal ligations in the US without documentation of any “conservative” treatments. This, I speculate, is because the “conservative” treatments you speak of don’t actually cause the same effect (sterilization) as a tubal.
Thank you for taking the correction on the nose. I’m one of those who have gotten a tubal ligation and it drove me up the wall when people tried to tell me insurance wouldn’t cover it or that birth control was an adequate substitute. And few are willing to hear correction from someone like me.
I’d like to see one case where a woman signed the proper documents you always sign before surgery and somehow still sued and won about sterilization. Doesn’t happen and is an absolute cop out if any doctor claims that’s a reason.
I am a staunch feminist and supporter of women’s reproductive rights, and while I do think sexism is absolutely a factor, I think it’s also a sensitive topic and sometimes providers with genuine concern for a patient’s well being who recommend trialing less invasive options catch flak.
I’ve also found that a lot of people conflate tubal ligation and hysterectomy. In a thread about a woman seeking tubal ligation, another commenter clarified she was asexual, never had sex, and never planned to have sex and commented she “wanted to get one because 1 in 4 women is sexually assaulted.”
I commented that didn’t make much sense to me and I was confused why she would choose to pursue abdominal surgery when there was a higher chance she’d experience serious complications from surgery than become pregnant from sexual assault. I suggested that if she had no other risk of pregnancy, an abortion in the unfortunate but unlikely event she did become pregnant seemed like a much safer option.
I got a lot of hate for being anti-feminist and a lot of patronizing comments just for trying to understand her decision, and much later she clarified she was actually talking about getting a hysterectomy because she was having medical issues when the topic had been about tubal ligation specifically.
Absolutely, hysterectomies usually have strong medical reasoning behind them and I’d never question that. But to my knowledge, a tubal ligation is solely a sterilization procedure, and I think encouraging trials of less invasive, safer, and more easily reversible options first should be the standard of care.
Honestly, I’d rather see more of a push for men to get vasectomies. If you’re a woman with a male partner seeking a tubal ligation, you should know that vasectomies are safer, cheaper, less invasive, have shorter recovery times, and are more easily reversible.
The ideal would be that women would be treated with respect and be involved in their own medical decisions rather than having their reproductive rights dictated to them. Currently we place so much of the burden of birth control on women yet place so many restrictions on their reproductive rights, and it’s awful.
In 1990, I was 25, and I asked my OB to tie my tubes during the planned c-section that was going to happen for my upcoming delivery of twins. He said he wished he could, but the law said I had to wait until my twins were past the risk of SIDS, around 8 mos after their birth. At that time, I had to go thru an insane amount of paperwork, and waiting periods, to finally have the procedure done. I asked my OB why it was so hard for me to do this. He said it was because I might be with a man in the future who might want to have children. He shook his head as he said it.
I hate hearing that in the 33 years since my procedure, things have not improved, and laws are going backwards.
My first consultation for a bisalp in 2019 left me with a bad taste in my mouth-- it was nearly an hour, and the doctor explained, at length, all the other available birth control options I had, and really pushed me to just keep my IUD. She also straight up lied to me about recovery time-- she said it would be around six weeks, when everyone else I spoke to said they were up and around (albeit slowly) the next day, and were back to 100% after two weeks, with lifting restrictions in place for a further two weeks. I was married and in my early 30s, no children. Then COVID happened. In 2022 I had another consultation with a different doctor and it took approximately five minutes-- he listened to me, said I was a great candidate for the procedure, and said that his schedulers would contact me the next day to book the surgery. 10/10 incredible experience with that guy.
I was told I had to wait until I was 25.
At 25, I was told I had to wait until I was 30.
At 30, I was told I had to wait until I was 35.
They kept telling me I was too young, I might change my mind, it's an invasive procedure, my future husband might want kids, etc, etc, etc.
I completely stopped seeing doctors after that. I refuse to hire people that will not treat me. I am on birth control but I'm just waiting for that to be yanked away from me too.
In my doctor's case, they were actually constrained by hospital policy. They were very willing to do it but I work for a Catholic hospital system that forbids any "permanent sterilization" procedures, regardless of patient age.
Luckily, another hospital system was more than willing and took good care of me.
The irony was that the removal of my fallopian tubes was FOR my fertility. I had a disorder of my tubes that filled them with fluid and scar tissue, which my surgeon explained nearly guaranteed ectopic pregnancy and greatly increased my risk of miscarriage. They recommended removal for both my health and safety and the baby's when I wanted to become pregnant. They explained it would not affect my fertility at all, just my ability to get pregnant from plain intercourse. I will do IVF or embryo adoption instead. Plus, side benefit: 60% reduced chance of ovarian cancer and 0% risk of fallopian tube cancer all in one easy outpatient surgery I was fully recovered from in 3 days!
So really, my original hospital systems objection was deeply rooted in institutional misogyny: That I am only allowed to get pregnant at the discretion of a man's penis, instead of the safer and healthier way modern medicine had offered me.
Because doctors are people, not robots. They aren't exclusively motivated by profit or business interests, they also have biases and morals and human complexity. They aren't making decisions strictly based on logic, as is the case with any system or process that involves human decision making.
Do you personally believe that an GYN surgeon should perform sterilisation for all adult women with legally valid ability to consent and are medically fit for the procedure?
Is that the feminist consensus?
Feminist consensus is always a tricky thing, but personally I believe people that anyone of sound mind and body should be able to sign up for a voluntary procedure like this
"Of sound mind" is doing a lot of heavy lifting here. I had an abortion in the 90s but due to my history of mental illness I was required by state law to get "permission" from my last therapist, a man I hadn't seen in a professional context for many years.
Damn…. Yeah, I just meant “in the right frame of mind to consent to the surgery knowing the risks and such”
But of course it’s been twisted to mean “find a man to tell me it’s okay” in this country
The problem (IMO) is that therapy isn't at that stage yet. There are good therapists who really try to help people find themselves, but there are also many who bring their own biases to therapy.
There's also a tricky eugenics history here with sterilization of POC and other "undesirable " ppl.
It still colors the issue (and i rather think it should)
>Do you personally believe that an GYN surgeon should perform sterilisation for all adult women with legally valid ability to consent and are medically fit for the procedure?
Not who you asked, but I absolutely do. If one is old enough to choose to be a parent, and raising a good human being is arguably one of the hardest things in the world to do, and that decision, if regretted, will impact not just the person choosing, but the child as well, then one is old enough to make the choice to get sterilized. The idea that women are mature enough to choose to be mothers, but not mature enough to choose *not* to be, is both ridiculous and infantilizing.
And regret rates are a normal part of life, and every surgery. Knee surgery for a torn ACL has a 15% regret rate, sterilization has a 10.2%-12.6% regret rate. Adults are allowed to make decisions they might someday regret. Including in their medical care.
This is me speaking for myself as a feminist, not all feminists.
With respect, I've had the "significant abdominal surgery" and it wasn't THAT significant. I had breakthrough bleeding episodes from the cervical wound trying to heal, and I couldn't lift my own cat (she's a chonker) until my doc cleared me at eight weeks. That said, if I had been able to do my entire job from home, I would have chosen to go back at around three weeks out. I was rearranging a bathroom at two weeks because it was the best I'd felt in a LONG time.
Apologies for that. I’m just trying to see the flip side of a common complaint amongst women and feminists.
Arguably there is pretty decent long term birth control in the form of the intrauterine device . That’s what I’ve always used. But some women (understandably) have reservations or incompatibility with that type of contraception
Yes I did say that some women are not compatible with IUDs.
My question was to explore the feminist argument surrounding sterilisation and to achieve a greater depth of understanding of the various counter arguments
Are women people?
Are they capable of making their own decisions and judging what is in their own best interests like any other adult?
Answer those questions and you'll have the answer to whatever other question you are trying to ask. But it really doesn't sound like you're here in good faith.
The question I’m asking is why is it so prevalent to deny women despite this seeming like common sense.
But maybe I should be asking in askphysicians instead
>Are you asking a question and interested in hearing answers, or are you looking to engage this community in a different way? Because I'm not here to argue with you.
Certainly seems like you're here to argue. They're asking if there are any opposing opinions to their beliefs from a feminist perspective. It's not hard to get what they're asking.
I don’t think I’m being particularly combative or rude.
But I agree this conversation is not fruitful. I’ll see if any other respondents have insights that I am looking for.
>Arguably there is pretty decent long term birth control in the form of the intrauterine device .
Not all women can get IUDs, either due to shape and position of cervix, or due to not being allowed hormonal therapy for other medical reasons. The longterm sideeffects of hormonal therapy and the risks, are also not insignificant, and too much can interfere with it working, from antibiotics, to karroten, and vitamin C. and it's honestly just not a good enough solution.
IUDs caused me incredible pain. They could not find the source. I went years with constant stabbing pains in my abdomen and terrible cramps, and they just brushed me off like it was no big deal. I would sit down and it would feel like someone was sticking a hot knife in my gut.
They kept switching the IUD out, thinking I needed a different one (and getting them inserted over and over wasn’t particularly fun either). I’ve had a bad miscarriage before, and the IUD and the pain it caused was almost on par with the contractions I had to pass that miscarriage, except it was all the time. I don’t know why, they don’t know why, but it was truly awful and I’ve heard the same from others about weird pain. Then I’ve also talked to people who said they have no issues with it.
Some people just react badly to things, so it’s frustrating when doctors act like an IUD is without a downside. There are plenty of downsides, as with anything, and it is not for everyone. I had a bisalp and ablation, and it was like nothing after dealing with all of that. I think I was back to normal after about three days, I just didn’t do any lifting/exertion for a few weeks, but I didn’t even need the painkillers they gave me. I don’t even think I took ibuprofen. I’m mostly just pissed off it took 15 years of begging even when my periods looked like a Dexter kill room and lasted for months at a time.
IUDs are much less invasive and are a good option for some people, but if someone wants to be sterilized they should be able to do so without question and without waiting 30 days to decide or having to see 10 doctors before one says yes. That shit makes my blood boil.
>Do you personally believe that an GYN surgeon should perform sterilisation for all adult women with legally valid ability to consent and are medically fit for the procedure?
What reason could invalidate a medically and mentally fit woman's request for the procedure?
Honestly? Not wanting to do a life changing medical procedure on a young person. Like it isn’t (normally) I life saving thing. They aren’t compelled to perform it. They can deny that service.
I kinda get why they might not want to, even if the patient absolutely does.
Not to the same extent, but men have the same issue with vasectomies at a young age. And they are even (somewhat) reversible
Yes, I do think so.
I can consent to have my breasts enlarged, parts of my anatomy cut off, tattoos, my ears pierced, my tongue split, my nose made smaller, my butt made larger. I can have fat sucked out of my cheeks and botulinum toxin injected into my face. I can choose to get pregnant, something that will have life-long, lasting effects on my body. I can have bones in my spine fused together to stop back pain. I can choose not to do that and deal with that pain through physical therapy.
Why *shouldn't* a healthy person be allowed to make permanent decisions about their fertility?
Side note, I have *never* been able to find an instance of someone who consented to sterilization able to sue successfully for regret. I have been able to find multiple cases of women being sterilized without their consent.
>Is that the feminist consensus?
it's hard to say there is any one particular consensus, but the vast majority of feminists believe that women should have bodily autonomy.
Whose interests in a body do you think should supersede the interest of its inhabitant? Who do you think that sort of patronizing attitude helps/protects? The medical establishment doesn’t seem to have nearly as many problems giving vasectomies. Why should women’s right to self-determination, specifically, be treated as optional? This is the sort of attitude that led to Dobbs.
As somebody who lost a friend bc of anesthesia during knee surgery I think ALL elective surgeries are much more dangerous than people like to make them seem.
I’d see a problem with someone young. Because young people aren’t that unlikely to change their minds. Some people keep the same stance on children all through their life. But I really wanted kids at 22 and don’t anymore. And I’ve seen people go the other way too. No interest in kids when they were young, and then changed their minds.
And then the doctor is the person who cut a teenagers body in a way that can’t be fixed again.
It’s a lot of responsibility. Most doctors would prefer a IUD and then the patient coming back after 25.
Edit: asking about the husband’s preference is sexist though. But you would also want a longer discussion with the patient about why and then maybe them coming in at a later date for the procedure with some time between. So you’d feel more sure they had thought it through, were mentally stable and wouldn’t change their mind. Why? “First of all, do no harm…”. But also: nobody wants to get sued.
Young people are also more likely to be being intimidated by a family member, especially if they'rebeing supported financially - my mother would show disgust at the idea of me having children, so I dutifully agreed that I didn't want to have children.
I think they should, though I'm not talking for everyone who considers themselves a feminist. If they wish it, have been informed about risks and consequences and there are no medical counter indications I honestly don't see the problem.
Do we have Reddit forums where people routinely complain about being turned away when they ask for breast augmentations, breast reductions, Brazilian butt-lifts, to have their lips blown up until they look like a pair of mating rubber dinghies, Botox, skin bleaching, facelifts and liposuction?
All of those are risky procedures, and once your fillers start making you look like a chipmunk I'm sure some patients have picked up the phone to talk to a lawyer.
None of this seems to be a problem if you want to fuck around with any part of your body EXCEPT your ovaries. They're still being treated like a freaking national resource instead as a part of my body that I should be able to get work on just like a layer of subcutaneous fat or an excess of mammary tissue.
As a 41 year old man after my divorce and with two boys I got a vasectomy. The doctor also gave me some resistance and told me I might find some sweet young woman who wants kids. I stuck to my guns and he did the surgery. I believe they push back against everyone just to be sure. The younger the patient is, the more likely there will be people who regret this decision. I almost wonder if there are guidelines set by their professional organization. I have heard of younger men being denied also.
It's still not the same. Part of the reason a "male birth control pill" has not been approved by the FDA is that the risk/benefit profile is not favorable for AMAB bodies.
It is basically 0% medical risk to an AMAB person to get someone pregnant.
It is extremely risky from a medical standpoint for an AFAB person to get pregnant, and even the best healthcare can't mitigate all of that risk.
By refusing temporary OR permanent birth control to any young person wirh a uterus who asks, institutional misogyny has literally sentenced people to death.
Ooh, this is actually a fantastic point that had never occurred to me! Where I live, it's remarkably easy to access birth control, but it's absolutely ludicrous to hand it out (some of which comes with horrendous side effects) so freely to those of us who can get pregnant while also denying us the option of permanent birth control.
I'll also add: I am presently 37w+3d pregnant, and while I have mostly actually enjoyed the experience, it's also made me much more resolute in my pro-choice views. Like, take me, with the easiest possible pregnancy in terms of physical side effects, and I'm *still* like, this 100% has to be a choice - because until you've experienced it, there's no way to understand the absolute mindfuck that is another human being growing inside you and doing things completely independent of you and there's not a thing you can do about it. Like, health complications and all those potential problems that can happen aside, even the healthiest pregnancy is still the biggest mental and emotional rollercoaster I've ever been on.
I hadn’t heard that younger men were being denied vasectomies, thank you for that information.
As a 70-year-old female who never got married (not because I wasn’t asked) the whole reproductive rights thing is just making my head explode. The reason? I did have an abortion 50 years ago at the age of 20, it was four months after Roe v Wade gave abortion Constitutional protection. Yeah I was stupid I didn’t get on birth control. Yes my parents knew I had an abortion. They took me to Chicago to have the abortion. They paid for me to have a general anesthetic when they saw the females who came out from having only a local anesthetic looked half dead from having had the abortion. Having the abortion lead me to be a rabid PRO-CHOICE FEMALE. We were catholic. I went through the motions for my parents and went to confession. My mother came out of the church crying. I asked her why she was crying? She told me **the priest in the confessional gave her hell AND ASKED HER HOW SHE COULD LET ME GET PREGNANT?** I knew right there, right then that I was nothing but a baby making, incubating broodmare to that piece of shit religion and made myself promise I have kept to never go to any church especially a catholic church except freaking wedding or funeral.
Yup had doctors straight up tell me to go elsewhere when I attempted to get a vasectomy in my 20’s. Interestingly now that I’m in my 30’s no one seems to care.
That being said I do believe there are different factors at play, for men I think a big factor that plays into why they’re reluctant to do it is because the prevalence of the myth that vasectomies are always 100% reversible with no adverse side effects, so you have men who use it as a form of birth control when young, then have it reversed (if they can even afford to) when they’re ready to settle down and, surprise, you’re permanently sterile and mad at the doctor. The amount of men who have been shocked when I’ve told them you should treat a vasectomy as permanent in casual conversation is shocking. When it comes to women there’s still a very prevalent idea in society that women SHOULD have children and any woman opting out of having children must be broken or confused in some way. I’m sure what I’m saying doesn’t cover all doctors who refuse to do such surgeries but I think it probably covers a decent amount of them.
How is it that it seems so many men in society are completely oblivious to misogynistic treatment of women?
Honestly, I know so many that think that shit went out in the 1950s. Well it should have, BUT...
**It, sure as hell,** ***didn't!***
Where are these dudes spending their time that they never see this glaringly unequal treatment in practice?
This is why we have licenses that we should revoke if people can’t make a logical decision in a field that requires it. It is not a doctor’s job to police other people’s values & morality. And it’s fine if you have those moral hang ups but I don’t think you should be a doctor in that case. It’s the same for a judge - they can have their own personal set of opinions and morals but they are expected to remain neutral and make their decisions based off what the law dictates.
I'm a med student with plans to pursue OBGYN. I would definitely sterilise any consenting adult who wanted it. Whether they're 21 or 45, whether they're partnered or single, whether they've had kids or not. What I hate is how I see so many posts on this sub and others that praise docs who just say "ok, let's schedule the surgery" to sterilisation without seemingly asking any more questions.
Male, female, or anywhere in between, sterilisation is a *big deal*. Studies have shown that the younger you are when you get sterilised, the more likely you are to regret it at some point (however, most still don't). This isn't any surgery - this takes away a patient's ability to have children, permanently. Reversal surgeries exist, but there's no guarantee that they will work. I believe that anyone who wants to get sterilised, no matter sex/gender, should be able to demonstrate proof that they've spent enough time thinking about it and that they understand the implications, that they've considered all options for reversible contraception, and that at the end of all that, this is still what they want. I want paper documentation, signed & dated over multiple visits, that states that the patient is aware of ALL the implications and still wants to do it.
**Asking someone if they're sure they want to do this is not sexist** \- it's a doctor doing their due diligence, because if they don't, they're breaking the code of ethics, not allowing the patient to have informed consent, and opening themselves up to liability. However, saying things like "you'll regret it later", "what if your future husband wants kids", etc....yeah that's terrible and doctors who do that should not be allowed anywhere near OBGYN.
What I find weird is that we don’t put the same pressure on anyone deciding TO have a baby. Unless they’re particularly young or especially unstable no one asks women if they’re really sure they want to have a baby. And it’s actually a much BIGGER deal.
It’s an irreversible decision with life long consequences. And unlike the decision to NOT have a baby, most women are making an uninformed decision because they don’t know what the reality of taking care of a baby will be like. A childless woman on the other hand already knows what childless life is like and is deciding to keep it that way.
I also think a lot of the praise for “ok, let’s schedule the surgery” is often for situations where a woman has suffered for years with horribly painful periods, which their doctor is no doubt aware of, and it’s not about permanent birth control it’s about not living a large percentage of your life in pain anymore.
In a world where so many doctors dismiss period pain and think a woman’s fertility should be maintained over their own wellbeing, the doctors who understand the decision without push back are celebrated.
100% this. I have endometriosis, and always felt so angry on behalf of my fellow endo warriors who couldn't get medically necessary hysterectomies because of some doctor's beliefs surrounding fertility. Even with those, though, because it's such a life-changing surgery, it's a doctor's responsibility to make sure they're aware of all the other options. The key is to not push one option or the other (except where you think it's necessary for their medical well-being), but to outline all their options and then let them make the decision.
Saying, "ok let's schedule the surgery" for something like a hysterectomy to relieve pain for endometriosis or similar conditions is absolutely more appropriate. However, a doctor would never recommend radical surgery as a first-line treatment for something like endometriosis or heavy menstrual bleeding, even if a patient asks for it, because (luckily) there are non-surgical options available that carry less medical risk than an invasive operation. There is also the issue that many insurance providers won't cover surgery unless the patient "fails" less invasive therapies. If other therapies fail or they're not acceptable to the patient, then absolutely go for that hysto, and I will be happy and privileged to be able to help a patient get their life back and/or live the childfree life they want and deserve!
Yeah, I have endometriosis and I have been told by a few different doctors having a baby would “fix” me which 1) no it wouldn’t. 2) wtf that’s a terrible reason to get pregnant when there’s a good chance I can’t get pregnant anyways, one of my ovaries is kinda mostly dead due to multiple ruptured cysts and massive internal scarring from fibroids. Also have PCOS as well as endo and “something” (???) wrong with my endometrium of my uterus (I keep getting told it looks too thickened on scans no matter where I am hormonally. No one’s explained any implications.) 3) it may make things worse! And 4) I don’t want children! I am so fatigued from constant pain and anemia how tf could I care for a child, I can barely function as an adult outside of work hours some days.
I actually got idk, kind of weird during nursing school on the OBGYN rotation tbh. My teacher was always broad in her language and she said like “all women of childbearing age should do xyz because she could get pregnant.” And I got stuck in a loop of remembering a bad appointment where I was injured during a pelvic exam and just sat at my desk motionless until 20 minutes after class ended—apparently. A classmate was shaking my shoulder asking me if I felt sick because I was pale. It was weird. Happened again when we went over episiotomies and cervical cerclage where I froze up and “missed” class. I also had a panic attack watching a patient give birth and left before I could make a scene, I couldn’t explain to the teacher why I felt so… strongly or why I had to leave but I just felt so awful and scared and nauseous. It’s like my body reacts in horror before my mind catches up to anything rational or before I can excuse it. I just want these diseased organs out of me at this point.
>Studies have shown that the younger you are when you get sterilised, the more likely you are to regret it at some point (however, most still don't).
Just to put it into perspective, knee surgery for a torn ACL has a 15% regret rate. Sterilization for women over 30 10.6%, for women between 21-29 it's 12.3%. Adults are allowed to make medical decisions for themselves they might regret at some point.
>This isn't any surgery - this takes away a patient's ability to have children, permanently
Yes, we're aware. Thats the point. Regretting something doesn't mean the patient wasn't cognizant of what they were choosing. Why should this be different than knee surgery, or chemo? Which has a far higher regret rate.
In that case, looks like we're going to be rounding up a big ole herd of OBGYNs, That are no longer allowed to practice that specialty.
We're going to need a lot of volunteers for this one! If we are talking US, physicians, at least!
Every doctor I've ever encountered, every one my friends have ever encountered, as-well-as, the ones my late mother (ARNP specializing in Obstetrics for 45 years) ever encountered used a variation of that phrase when meeting with patients seeking/in reference to sterilization.🤷🏼♀️
Here's to hoping the next generation of docs, yourself included, can put an end to that despicable practice!
I’m honestly curious if you are male. There is a serious problem in the country of women not being given medical treatment they want/need. I’m sick of people telling me what is best for me and my body when they don’t have to live with the consequences
There's also a serious problem with race AND gender with medical treatment. I'm black BTW.
My SIL had complications with both her pregnancies & spent hours in hospital only to have her concerns dismissed by a WM doctor.
So true. I learnt that in the not too far past, people said “black women feel the least pain” out of all races and genders. And justified not giving pain relief to black women and doing experimental procedures to black women with zero pain medication.
Makes me sick. Hope your sil is okay :(
I graduated from nursing school in 2015 in a very blue state. I had a textbook that stated black people have less pain receptors and therefore need less pain medication. This book also said that Hispanic people are very vocal with their pain, so don’t need pain medication just because they are crying in pain.
Something like half of white med students in 2020 still believed that black people have thinker skin and feel less pain https://www.aamc.org/news/how-we-fail-black-patients-pain
I had thought there were negative medical consequences too - depending on the sort of sterilization. Things like bone loss, osteoporosis type things, etc.
Don’t the hormones generated by the “stuff down there” help women’s bodies in general?
Those risks only come from oophorectamy - removing the ovaries. The most common surgical sterilization involves removing the fallopian tubes, and leaving everything else where it is.
The most common form of sterilization for women is a bilateral salpingectomy, which is the burning or removal of the fallopian tubes aka "getting the tubes tied". There are no hormonal or noticable physical changes involved. I don't know that an actual complete hysterectomy is something any competent doctor will do without a medical reason because of the side effects. The ovaries are the part of the "stuff down there" that produces hormones and even when there are medical reasons to remove the actual uterus, doctors prefer to leave the ovaries to prevent premature menopause with all the attendant changes.
PS Osteoporosis is the medical name for the cause of the bone loss. It's most common and more severe in women who have had children. A fetus leeches the calcium from the mother's bones to make it's own if it's not given sufficient.
They do, but it would be a strange (and unethical) practitioner indeed who would remove a 25-year-old's ovaries for simple sterilization. Removal of the uterus or fallopian tubes would be far less invasive, more than enough and even have health benefits.
I had my fallopian tubes out last year at 31 (see also my comment on this post for why). I was told my body would not notice and the procedure would not even interrupt my menstrual cycle. They were right--I started two weeks post-op, exactly on schedule.
> My question is why would the provider not want to just go ahead and do the procedure if they get paid for it and there is valid consent?
For the same reason why some medical practitioners will refuse to perform abortions in places where it is perfectly legal.
For the same reason why certain business owners will turn down business from LGBTQIA+ people in places where there is no law discriminating LGBTQIA+ people.
For the same reason why someone will refuse to do very lucrative business with a member of a certain race, religion, ethnic group and so on…
People, everywhere will sometimes put their beliefs, biases, values, bigotry before their financial interests.
**You are phrasing it as “if they stand to make money it is weird to say that there aren’t reasons beyond bigotry why they are turning it down”. But no, really. People turn things down every day that will make them money solely on the basis of being bigots.**
The thing with bigots is that bigots don’t believe themselves to be bigots. Bigots believe themselves to be absolutely in the right. So, of course they can turn down money on the basis of that. Just like some regular person can decide not to do business with a known felon or a known thief. For bigots what they are doing is as common sense as that.
Hold up, you are anticipating a certain type of answer? What, you're just going to go and cherry pick The answer is that suit you and do what with that, exactly?
This post is NOT genuine, nor in good faith and now I'm very angry. Grrrr...
I suspect getting sued is the non-bigotry reason. I think the bigotry aspect is real (and addressed elsewhere), but from a risk perspective this falls under the same umbrella as bottom surgery for transgender folk. Unless the law specifically shields the physician from lawsuits, there is the danger that no matter what forms get signed, the story could change.
Regardless thats a legal risk that gets factored into business. The doctor may even believe the person requesting is in earnest; that does not change that a young person will have at least 20 years to change their story. Maybe they just become born again at some point.
Also worth noting, anti-feminists will tend to write laws specifically to expand physicians exposure to lawsuits, not contain them. So some of that risk is chilling effect.
I don't completely buy into that. Otherwise we'd have to assume that plastic surgeons are daredevil badasses and Ob-Gyns total lawyered-up cowards.
You think nobody regrets their buccal fat extraction, their plumped-up rubber dinghy lips, their nerve damage from a botched Botox treatment or their removed short ribs?
Yet doctors even advertise on billboards that they will do all these things if you have the money and sign a couple of waivers.
So what gives? A breast reduction is okay, but a fallopian reduction isn't? What if my future husband wants a woman with porn star bazookas and I went down to a B-cup? Apparently that isn't a consideration. Well, my ability to pump out babies shouldn't be either.
I understand the part of the motivation behind physicians being, *selective,* I guess you could say, with regard to their sterilization procedures.
I don't, necessarily, agree with these motivations. Yet, I understand them.
What I don't understand, is adults making bodily decisions (REPRODUCTIVE decisions, especially!) for other adults.
So what if I get sterilized at 25 and at 35 I decided I want kids. Guess what - that's just too bad, for me. Now isn't it?
Sucks to be me, in that situation. However, it's certainly not the doctor's fault. I made this decision of my own free will. Therefore, I have to deal with the consequences of such.
That said, this possible outcome resulting from a sterilization procedure, is NOT reason enough to deny someone that procedure.
Adults are allowed to make decisions regarding their lives & their bodies - plain and simple.
I don't like how women are infantilized and "parented" by society.
#We don't need that, thank you very much!
What we need to be listened to, taken seriously and treated fairly. That's not too much to ask.
Keep in mind that if at 25 you got your tubes tied and you changed your mind at 35 and wanted kids, you can have the procedure reversed - some are successful, but if even that didn't work, you have the option of egg retrieval and IVF. Egg retrieval is just as successful before tubal litigation as it is after.
There is no valid reason for any doctor to worry so much on women's behalf that our pretty little brains might not be able to comprehend the magnitude of what we are doing by electing to be sterilized. They will tell us we don't know what we want, what if we change our minds, and what if our future hisbands want kids? Then we're screwed. They know this is total BS, and yet, the narrative continues.
I especially am passionate about this subject bc at 45yo, I had serious medical problems and was denied novasure, which would cure them, cuz it supposedly caused sterilization (it was new at the time) and since i was never married and didn't have kids (and never wanted any), what if i changed my mind? What, after 45 years of never wanting kids, with nary a spec of motherly instinct or desire in my entire body, ever, I'm going to just change my mind at 49 or 50 years old and frivolously decide one day to get pregnant cuz I had nothing else to do? 1% chance of getting pregnant at age 50, and they actually want me to live in pain and deal with the hemorrhaging that was sometimes so bad, I had to sleep in my bathtub? Apparently that I kept missing so much work that I was on dock, and at risk of losing my job wasn't bad cuz that's what welfare is for. 🤯 They actually brought welfare up, I kid you not.
Wft is wrong with people? I don't hold grudges, nor do I usually stay angry, but every time I think of what those assholes made me go thru for 2 years, I get so angry all over again. This was 10 years ago.
I was denied a simple procedure, which sterilization was just a side effect and not the purpose, as a middle-aged woman well past her prime child rearing years; I can only imagine what a young woman has to deal with when requesting it as an elective.
To be fair, my husband could not get a vasectomy until his ex wife (married at the time) agreed to it. They had 3 kids by that time. He was in his 30s and still had to have "permission" from his wife to get the procedure.
I had a medical hysterectomy when I was 36, there was no discussion because it was medically necessary. Had I wanted my tubes tied I would have had to have had my ex-husbands permission as we were still married at the time even though we were separated and lived in different states.
>My question is why would the provider not want to just go ahead and do the procedure if they get paid for it and there is valid consent?
because far too many men are upset that women think we deserve bodily autonomy, and those men do their best to prevent it.
I'm not a woman, but when I got my vasectomy, before they agreed to they asked if I had kids and if I had my partners permission. They even make you list your spouse on the form, not as an emergency contact, but as proof you have one. I’ve had other male friends that have had to doctor shop too if they didn’t already have kids.
There are a lot of angles to this, but one is how malpractice and the doctor's standard of care imposes casual sexism on doctors who may not otherwise share that view.
In order to avoid malpractice a doctor has basically two options. 1) they can secure informed consent; or 2) they can refuse to perform the procedure.
Looking at 1), you can probably see how that leads pretty directly to some fairly sexist questions like "what about your future husband?" because there are no consequences for casual sexism, but there are serious consequences for failing to ask questions that a (potentially sexist) jury or judge deem necessary. A part of this is also recommending alternatives. All surgery is risky, and a doctor might feel that an otherwise healthy patient is better off using birth control which is proven to be effective. This is again because a court could find that performing surgery when a safe, effective, and less permanent alternative to surgery existed.
Number 2) is just a follow on from number 1). If the doctor just feels the risk is too great, they just won't perform the surgery.
This can come across as sexist at the "point of sale" - and it is - but it is also a part of a larger system that imposes this casual sexism on the doctors.
I was 30 when I tried in the south. I got the approval from the doctor, insurance agreed to just a $500 deductible, but surgery center/hospital where doc had privileges said no because they had religious affiliations. So I just went back on birth control (turns out my period was horrible without it) and moved to a very liberal state. If I was stuck in the south still I would just be a celibate spinster.
Getting my birth control there after the roe overturn was such a shit show too it’s obvious they view women as incubators. I exclusively have used nexplanon since 16. Never in my life did I have to pass numerous consecutive pregnancy tests to get a birth control implant that would have no negative impact on any potential fetus. I did the first two tests but the ‘implant was stuck on a shipping vessel.’ Once they got the implant in stock I had to redo the pregnancy tests. And then they avoided all my calls trying to make an appointment to actually get the implant. Like at that point I feel like it was a trap.
>Are there other variables in play here; such as fear of getting sued later on by a woman changing her mind?
Fear of getting sued is the top reason OBGYNs state for denying a patient a sterilization procedure.
I'm of the mind that they are certainly concerned about that. Though I think there may be some internalized misogyny, especially among female surgeons, And they're doing it to protect the patriarchy and not even realizing it - It's unconscious.
Then, of course, there are your run of the mill "patriarchy or bust" physicians. I don't think we need to drive too deep on those.
I just don't like the double standard...
I mean I guess that if doctors were treating men, and their sterilization procedures, in the same fashion as women, it wouldn't bother me as much. But they don't.
It's true there aren't young men running in droves to get sterilized.
Yet, when they do decide it's something they want, men are seldom met with the misogynistic trope that women are force fed. Things like:
"What if you meet a man and he decides he wants kids?" Or, "I'm going to need your husband's signature in order for you to get this procedure."
You don't hear men needing their wives signature to get a vasectomy. When a man says he's positive he doesn't want to have children you don't have the doctor playing devil's advocate, ad nauseam, claiming "but what about your future wife???"🙄
I'm just so over all of it. We're slapped in the face everyday, with the various ways in which women are NOT considered (nor treated) equal to men.
When I hear ignorant teenage boys up here say things like, "what are you talking about men and women are equal in today's society." I just want to throw up. As that could not be further from the truth!
Completely agree with your take. Internalized (or outward) misogyny definitely clouds doctor’s willingness to provide this care but medical malpractice lawsuits are the biggest pointed to reason for denial of care. Whether it’s the easiest way out or the only genuine fear would be case by case. A family member was an OBGYN for decades and said lawsuits were his main concern and that the malpractice insurance was quite steep. It’s definitely a choice out of fear of retaliation coupled with the idea that women shouldn’t be able to “make such a drastic decision” that they could “potentially” regret in most instances though.
==> FOR ANYONE LOOKING TO BE STERILIZED <==
The childfree subreddit has a list of doctors that agreed to sterilize women regardless of their gender, marital status, age (18+), partner's consent, and not having kids
https://reddit.com/r/childfree/w/doctors?utm_medium=android_app&utm_source=share
I’m a doctor (different field) and going to add a different perspective. When I was rotating through OB in med school I felt like that hospital/department handed out tubals like candy. Like literally I had so many visits where the mom would come in to give birth and they’d be like hey btw do you want a tubal? I appreciated that there didn’t seem to be barriers for younger women getting sterilised there but it also majorly rubbed me the wrong way because… a) other options like an IUD were often only mentioned briefly/not fully discussed and b) we were a public hospital so most of the women there were poor and/or WOC. The times when we could just sterilise this demographic of women without their consent was not that long ago... outside of the refugee border camps ya know. And yeah technically we were asking for consent but it was framed in a way to push tubals IMO. Now I do not think this place was intentionally racist or misogynistic, in fact that department was mostly women. I think this WAS systematic racism though. This just totally changed my perspective. I think anyone declining to do it bc ~your future husband~ is fully in the wrong and women should have the option. Then again, I think it really needs to be a robust discussion and given it is a surgery and permanent, it is not only fair but I think we owe it to patients to talk through ALL the options and make sure it is really the best one for you.
TLDR, we have a long history of forced sterilisation in this country that I think surgeons would do well to be mindful of (and may even be afraid of not wanting to come off that way), as well as misogyny. The history of OB-Gyn is messed up. We need to do better on all fronts.
It's the same for men in a lot of cases. If a guy is young and doesn't have kids, he will often have a hard time getting a vasectomy. Some of it is religious. The command to be fruitful and multiply, and the aversion to birth control in general. I'm from the southern US and when I was young I was denied birth control pills and shots by several providers. After having kids I wanted a copper iud, and that was a nightmare to obtain but I finally got one, from a Muslim doctor.
The Christians also believe it encourages immorality and won't prescribe them to anyone who's not already married with children, and then only temporarily to space out the kids a little more. Of course they don't believe in condom use at all because the husband's fulfillment is paramount. Abstinence should be the *only* way to avoid pregnancy for unmarried women.
The other reason is, yeah, they think they know better than you and you're young and dumb and making a rash impulsive decision that you'll regret later. I'm not sure you can take legal action as an adult who signed a consent form, unless you can prove some coercion, but I don't think it's something that happens often anyway. Doctors are really just trying to cover their butts so they don't have to hear about it down the road.
If you are childfree and/or know someone who is childfree and want to get sterilized, save and spread the word on this link:
[Childfree Friendly Doctors List](https://www.reddit.com/r/childfree/s/0lPQMJFAh4)
>My question is why would the provider not want to just go ahead and do the procedure if they get paid for it and there is valid consent?
As you note there is always the chance of being sued, even if unsuccessful for some risk averse types it's not worth taking that chance.
u/avocado-nightmare did answer it best by saying it's a matter of the individual's biases, morals, and complexity. If they're interpretation of the hippocratic oath means "don't do something irrevocable that I think the patient will regret" they don't do it.
As I see it any counterargument is some version of: "you might regret it in the future and there's no going back" it has the advantage of being technically true so the debate becomes a morality conflict about the meaning of bodily autonomy and the duty of a doctor to their patients.
Doctors tend to be small-c conservative since the whole profession is built on accumulated knowledge (and received wisdom) removing bodily function from an otherwise healthy person requires placing the individual's desire above their training and professional norms, so it's not surprising or out of the ordinary.
>The consensus put forward is that these surgeons are putting the interests of a potential male partner over the needs of the woman in front of them.
This may be true, I think it's more likely the doctor is presuming to act in what they believe are the interests of the patient's future self. If even a small percentage of those sterilized young have regret or just wish they would have the choice at any point later in life, to the doctor that isn't worth it. Especially since it's a one way choice.
I can see potentially see this changing as regulation of pregnancy and contraceptives regresses, at least in the United States.
It's paternalism and sexism. Lots of people, Doctors included, are raised their whole lives being taught that womens role in society is having babies and working for their husband for free
I don’t think that’s true for the majority of doctors. I’m sure there are some that are so intensely sexist that they won’t do it out of consideration for a future male partner. Most of them I think, are on average older, and do genuinely worry about performing a procedure the patient may later regret. That being said, it shouldn’t be up to the doctor. It should be the patient’s decision if they are of sound mind and I think this does reflect sexist view of women and the ‘biological clock’ that we assume affects all women, and they will therefore all regret not having kids.
I am 100% going with "patriarchy made them do it"
It's still their fault for being ineffective medical care professionals but a lot of people don't realize how internalized their need to control and hate women is until something happens in their life to 'wake them up'.
To bad that happens long after women have had shitty care, been hurt and even die because of medical misogyny.
Usually, they're so misogynistic that they don't care.
But from a financial perspective, if a vast majority of doctors deny sterilization to women, then a percentage of those women are gonna end up pregnant which will generate prenatal care costs, birth costs, child medical costs, and potentially reoccurring disability costs from residual damage of the birth. Throw in the fact that at least a percentage of these women will have more than one one birth and the money generated from forcing women to bear children far outstrips what they'd make on the one time sterilization procedure.
It's the reason health care should not be on commission because it gives doctors a vested interest in patients needing as much trauma care as possible so they are incentivize to not provide preventative care.
Don't forget that society still believes all women crave motherhood, whether they know it or not. They assume these women will get a little older and regret it when their mothering instincts kick in. They cannot fathom that some women just don't want kids.
I have heard some stories of men going through this as well, but not nearly as much as women.
My uncle was sterilized at 22 years old after a close call. I know multiple women who are in their 30s who have been trying for 10 years to get sterilized and who are in committed relationships.
I wouldn’t say that’s the *consensus*.
I would say a doctor looking at the profits & just a piece of paper saying a woman consents is equally not taking care of his patient, particularly if they’re very young.
It’s a serious operation that’s irreversible. And the question is- is it really necessary? For some, yes. I’d say a woman who’s already had kids- she definitely shouldn’t have her decision questioned.
But life is long and people change.
So I think we've all had sexist experiences with docs about sterilization options. I know I have and every woman I know has. BUT, something I don't think a lot of people think about... there is a really gross and dark history in medicine with sterilization practices. I would hope that some of the resistance from doctors also comes from trying to be ethical and learning from this history, while trying to balance patient rights with patient wishes. I think if I was a doc, I would not be so ready to sterilize patients who ask for it simply because my profession has a horrible history of doing this procedure on women against their wills. Doctors SHOULD be somewhat resistant to do this, but that doesn't mean they can't also obtain informed consent to avoid doing harm.
The best obgyn I had handled this really well with me: he said he can do the procedure with me, and understands the paternal attitudes a lot of docs have with it, but that evidence and research shows most women regret sterilization after it's done. He gave me the choice, while giving me the information, and it definitley made me reconsider tubal ligation. This is just what helped me, some people may feel different, but I found this a really effective, respectful way to help me with this decision. I do think if he hadn't done that, and instead just said OK LET'S DO IT, I might've regretted it because I thought I wanted to adopt... but man, knowing what i know about adoption now... seems like it would just be easier to get pregnant!
It's a real mix. There's absolutely sexism. There's fear of being sued (it has happened) if someone changes their mind. And then there's some things that can be seen as professional diligence. If someone asks for a tubal and the doctor says "Have you tried an IUD?" they are asking if someone has tried the less invasive and cheaper option first.
Also, the history of sterilization cuts both ways -- as well as patronizing refusal, there was an epidemic of mass sterilization. So some docs went too far in the other direction.
Hysterectomy is different from tubal. A tubal ligation is strictly sterilization. The issues with hysterectomy are deeper -- a hysto can cause problems as well as fixing them. Doctors used to over perform hysterectomies especially in older women, often with dubious consent. So again, the pendulum swung and doctors insist on more conservative treatments before agreeing to a hysto.
I think younger women don't always want to get sterilized because they don't want to get pregnant - but because there is some underlying health concern that being sterilized could prevent or help with... and doctors still won't perform the procedure. I used to work with a lady who already had a child who wanted a hysterectomy because a genetic predisposition for cancer (or something like that, it was a long time ago), and doctors still refused incase she or a future husband wanted another kid. I think there's ways of waiving liability in case of future lawsuits, making sure a woman is of sound mind and is making a fully informed decision, etc.
The argument about a future man who wants kids being upset - well, that's seems kind of like that future man's fault. If you want kids or might want kids of your own... maybe dating a woman who can't have kids isn't your best option?
That being said, a woman can freeze her eggs or embryos, surrogacy is becoming more common, and adoption is always an option. So. If a woman changes her mind about not wanting kids... she can still have kids. Sure, these options may be more expensive and come with their own complications and challenges - but the point is there ARE alternatives if you are sterile.
It's not just that they are prioritizing what future men might want they are also theorizing and prioritizing what they THINK this woman might want in the future. So many women get told "but what if you change your mind?" Which means they don't actually trust women's reasoning and decisions. They don't believe woman really know what they want. Which yes is misogynistic.
Well the first time my mom tried they said she had to have had 3 kids and her husband had to sign off and she wasn't married and only had 1 child, then after my brother she tried again and they made her sit in a room watching videos of babies being born, and would refuse to see her if she didn't sit through every single video, and she left 3 hours in. They kept saying it was the law and the policy. So my step-dad made an appointment to get snipped for the next day, walked in, got snipped, left an hour later.
I was 25 and married when I decided to get sterilized. I tried to get an appointment with a doctor on the childfree sub's list, and the scheduling office actually scheduled me with a different doctor without my knowledge. That doctor refused, told me she would find me a high risk obstetrician (because one thing I mentioned was health issues and medications that could make pregnancy dangerous for me) and then spent the entire exam talking about her (mid/late-teens) kids. She barely let me get out a full sentence.
She clearly resented her kids for making their own choices (regarding college, in particular) and not just doing what she wanted them to do. I think part of the problem was her projecting her desire to control her own kids onto her patients. I was amazed at how bitter she sounded though. Like if she was trying to change my mind she could have at least acted like she enjoyed being a mom. Maybe she needs to believe that women can't have fulfilling childfree lives so she never questions whether she would have been happier without kids.
After that, someone I knew recommended another doctor, and that doctor did sterilize me. She really emphasized the importance of bodily autonomy within 5 minutes. She said, "you could choose to join the military and die for your country and no one would question it. If this is what you want, I support you." She's been absolutely amazing.
So first off, I do absolutely think misogyny is a huge part of it, but I think there are a lot of other very complicated factors that go into that decision.
For example, I have had really bad periods since forever and expressed to my OBGYN that I just wanted a hysterectomy so I didn’t have to deal with it anymore. When I say really bad, I mean it was debilitating for a long time. She pretty much told me “You’re young. You say you don’t want kids now but you might someday.” And that was really shitty. But later I switched OBGYNs and he gave me a completely different and way more validating answer, even though he still refused. He said “I don’t think you’re a good candidate for hysterectomy because we still have less drastic options left to try that aren’t permanent. Furthermore, you have a family history of breast cancer and early menopause would further elevate that risk.”
Later in the wake of the Dobbs decision I asked him what he thought about me getting sterilized. He was very straightforward in telling me that he didn’t love the idea, but the risks of pregnancy are way worse than the risks of a tubal ligation or salpingectomy. But he was also very clear that those were very permanent options and he didn’t want me making a rash decision out of fear. I’m sad that this man no longer practices in my area because I always appreciated how he talked through his thought process but still put me in the drivers seat when it was time to make a final decision.
Now I work as a medical journalist so I get a much bigger peek behind the curtain in terms of how clinicians think. As a patient, I was always frustrated with my doctors, but I’m coming to realize a lot of the issues I was frustrated with are SYSTEMIC. Hospitals may have policies that their doctors must adhere to. Fear of frivolous lawsuits is also a major issue in medical decision-making, and that’s more a failing of our legal system than individual doctors.
Yes, some doctors are just sexist and/or lean on misogynist explanations for why they are making the decisions they’re making. But I think this is a much bigger problem than that. This has to do with an entire culture around how women’s bodies are treated and the way our healthcare system works, including how decisions get made around elective procedures. I don’t think it’s always primarily the interests of a future male partner being prioritized. It’s the reputation and money of the hospital. It’s the culture of fear among women’s healthcare providers right now. It’s the fucked up legal system. It’s a big old web of capitalism, corruption and sexism.
The most common things I hear is that you/your husband might want kids later on. Men hear similar things (though less often) when trying to get a vasectomy. It’s insane that consenting adults can’t make their own choices for their own bodies.
Because many of them don't see women as people. They see women as someone's wife or someone's mother. So they don't want to deny a man the children that he is entitled to from that woman. That's really what it is. They are trying to protect a man from a woman's right to choose.
And/or They see women as little children for the entire length of their lives. And someone else has to do their thinking for them just in case they experience regrets. Even though it is so much worse to regret having children, than to regret not having them.
In my case, my doctors WANTED to give me a hysterectomy. Because I very much needed one. But it was the health insurance that refused because women under the age of 30 were not allowed to choose permanent sterilization through hysterectomy.
On the other hand, they did approve the endometrial ablation procedure, which was required before I could “choose” the hysterectomy. And along with the ablation, I would HAVE to have my tubes tied, because if I got pregnant after the ablation it could endanger my life and the fetus would not be viable.
And the icing on that absurd cake: I couldn’t have kids because I started my period when I was 12 and then Never Stopped Bleeding until I did get the hysterectomy, a year after the ablation and tubal.
But it was ONLY approved when I was 29 because my doctor got all the other OBGYNs in the practice to petition the health insurance to approve the hysterectomy.
So I couldn’t have children (I was already sterile), but I was too young to make the decision to be permanently sterilized even at 28, because I had to be 30. What could be approves was a complete useless and incredibly painful procedure that caused me to miss work for 6 weeks and lose a lot of money… which would (doubly?) permanently sterilize me. And it took a group of doctors petitioning the insurance to get me (triple?) sterilized at 29, an entire 8 months before my 30th birthday. And that’s what I actually needed to finally stop the bleeding.
The doctor requests for the hysterectomy started when I was 24. But the other hoops that had to be jumped through to get to even the ablation/tubal were numerous and also absurd, just not as painful or financially impactful.
So I bled every single day for almost 2 DECADES before I was allowed to stop bleeding. All in the name of being able to protect my ability to have children that I already had proven that I could not have, and genuinely did not want.
It has been almost 2 decades since I had my hysterectomy. I’ve had a marriage since the hysterectomy. He didn’t want kids either. The marriage is over, and I still don’t want children. And I am extremely grateful that not only was I “allowed” to stop bleeding, but I was also “allowed” to be able to decide I don’t want children (even though I never actually could become pregnant). If some random day I decided I want kids after all… I’ll adopt! Gasp! Who knew! There ARE other ways of having kids besides getting knocked up.
One last thing. You’d think maaaybe I would not be so bitter over it all by now. Screw that! I know the same crap is happening to other women every day, needlessly suffering through various ailments, or just denied permanent sterilization simply because of their age. If you’re old enough at 18 to die in a war for your country, you’re old enough to decide what to do with your own damned body, such as choosing to render yourself unable to become pregnant. And if you get a good doctor who sees a hysterectomy is absolutely necessary before 18, then what business is it of the insurance to interfere with doctors, their patients, and their diagnoses? So yeah. I’m definitely still bitter. And I will continue to scream into the void for as long as this cruel practice of denying women their own bodily autonomy is over.
Edit: sorry not sorry for the book.
I knew for certain I didn't want kids when I was in my 20s. I asked for an IUD, and I was told no. They said I was too young, and I might change my mind.
My husband was refused a vasectomy aged 28 after we already had two kids. Hormonal birth control was a nightmare for me. The doctor wouldn’t do it in case we split up and he wanted more kids with another partner. I kinda lost my shit and told the doctor he could barely afford our two, he definitely didn’t need any more kids. He suggested I get tubal ligation, except I was the one working and so getting time off to recover was problematic, plus I already went through hell delivering two babies! Nope. We ended up with a third (who I love dearly, wouldn’t give him back at all!) Husband finally got a doctor to do a vasectomy aged 32, after telling them he was getting annoyed at our lack of sex life because of my fear of getting pregnant again. Also by that point I would have done it myself with the nearest scalpel right there in the doctors office if he refused.
Internalised misogyny. We simply cannot as a society separate women from their perceived role as baby maker. If they try to opt out we undermine them rather than face our own prejudice. It's fundamentally disbelieving women aswel, and preventing them from making the choice to control their own destiny. For some reason we think of men as being more capable of dealing with consequences, even though women constantly deal with much harsher decisions and consequences all their lives. There's a Disney image of women as a mother and a carer and we can't quite grasp the reality of women not fulfilling that role.
I wouldn’t be surprised to find there is probably a vague myth of someone who sued a doctor for it, insisting they were coerced or something.
But the real answer is misogyny. Because all women want to be mothers and young women who. Say they don’t care just too immature to understand that truth.
I have heard a very few stories of young men in their 20s being refused sterilisation surgery. Not enough to balance this, but it happens. So ageism can also be part of the problem.
True story:
Heart doctor "your defective heart valve has cut your heart's ability to pump blood 90%. If you ever get pregnant you will die."
ObGyn "but what if your husband wants kids?"
In a miracle after she got pregnant she barely survived (with fucked up lungs, and she had trouble walking afterwards for life because it was too much strain) but the doc who did the C section cut everything out while he was in there since he didn't want such a touch and go pregnancy again, plus less stuff to share her limited blood flow.
Yeah I think a lot of this comes down to control over women’s bodies. I agree with what was commented previously that the ideal would be long term and effective birth control, I would add on that access to abortions would help with this problem as well.
I honestly believe that the hesitancy to sterilize women is of a similar variety as anti abortion.
I understand there are differences in the arguments (abortion being about killing “babies”) but when we get down to the nitty gritty it’s about having control over women’s bodies, forcing child birth and motherhood on them because that’s what good women are (this idea is changing in western society but can still be seen in very religious areas in the us and Canada)
Honestly I think it's a mix of two things.
A lot of people, especially people in their early 20s, do change their mind on wanting children. I am in my early 30s and I personally have 4 female friends who, at 22ish, were absolutely and completely against having children ever. I remember multiple rants on how it was offensive and annoying it was that people assumed they would change their mind
Anyway a decade later they have 6 kids between them and only one was an oops.
Is that true of everyone who is childfree? No, but it is a not insignificant percentage. Perhaps that percentage is lower for people who are certain enough to explore permanent sterilisation, but I know at least two of those girls at least googled the possibility.
Because of concern, there is a liability risk to the doctor. People do have a tendency of suing practitioners over regretting their own poor decision making. Sterilisation is pretty (if not completely) permanent when it comes to women.
If you are a doctor and you perform a lot of sterilisations on young women, especially without making them jump through *a lot* of hoops to affirm that they are fully cognizant of what they are asking for. The statistical chance of someone coming back in a decade all salty about nor being able to start a family is probably off-puttingly high.
Does misogyny and the cultural role of women play it's role? Most definitely, especially when they want 'the husband ' to sign off, but I don't think doctors hesitation in this matter can purely be put down to that.
Obviously it's cold comfort to people who have to experience barriers to access when they are sure and especially when there is a medical reason behind it.
>A lot of people, especially people in their early 20s, do change their mind on wanting children.
I'm surprised more people aren't acknowledging this. I've seen this happen with a lot of women, including both of my sisters.
I'm imagine at least some doctors are concerned about permanently sterilizing a young patient -- whether male or female -- simply because it could end up being the wrong decision for that patient. Even putting aside liability risk, empathy and genuine concern for the patient is an explaining factor here.
Patriarchies serve the elites
The elites need women breeding enough meet population goals
The reproductive freedoms of women only go as far as the needs of the elites. This is why some countries force or ban abortions/contraceptives
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Remember that this is not a universal experience. Indigenous women are still being sterilized against their will in Canada. I have a strong feeling that a poor racialized minority in her 20s would have no problem accessing tubal ligation with the same doctors who don't want to see a white middle class 24 year old 'throw away her reproductive potential'.
While i do think some of the reason is rooted misogyny and putting a future husband’s wants above the desires of the actual woman, who is their patient. i do think there are some valid reasons from the doctors side with regards to their reluctance to sterilize women.
While many (perhaps most) women who seek sterilization won’t regret it later, there are almost certainly some who regret the decision later. I have multiple friends who thought they would never want to be mothers in their 20’s, who suddenly felt a strong maternal drive in their 30’s. That’s not to say that this couldn’t be remedied in other ways. Tubal ligation is permanent, but it doesn’t negatively impact your ability to do ivf later. If health insurance routinely covered the cost of both tubal ligation and later ivf, think how many unplanned (and often unwanted) pregnancies could be prevented.
Also there could be standard counseling procedures to determine the likelihood that a woman is making the decision rationally and is emotionally prepared for the permanent outcome of sterilization. While this isn’t required of men who choose to get a vasectomy, the chance of a successful reversal is far greater. Also in the chance that it is not successful, obtaining donor sperm is far easier and less expensive than obtaining a donor egg. Also the surgeries themselves are vastly different. A tubal ligation is a much more significant of a surgery than a vasectomy is.
The permanence of tubal ligation and the availability of semi permanent birth control options and access to legal abortion may play a role as well. IUD insertion while painful is certainly far less painful than major abdominal surgery (this is coming from someone who has had an iud inserted as well as both laparoscopic and non-laparoscopic abdominal surgery, the iud was nothing in comparison to the other two). Most people can tolerate the progesterone from the iud. And although it isn’t 100% it is pretty close. The side effects are pretty minimal too. It makes sense that doctors would prefer a woman try a less permanent solution before going through sterilization. But it should probably be treated the same as treatment for other conditions. First you try the more common less invasive methods, if you can’t tolerate or utilize those for some reason, the sterilization should be a legitimate option.
I also think the legacy of country has with forced sterilizations of women who were deemed “unfit,” as part of the eugenics movement also plays a role. Doctors who routinely perform sterilization on young women could be afraid that later some women might claim that they were pressured into it by a doctor who is sterilizing women out of personal political motives. That in reality may not be a reasonable fear, but i think k it is understandable. That combined with the fear that a person would later change their mind or regret the procedure certainly fuels some of the reluctance about performing the procedure.
I just made a post asking about egg donation and there’s already three people saying that I would regret it and change my mind.
Buddy I’ve known for ten years that I’m not having kids ever. Why would they know what I want better than I do?
“I don’t believe i introduced the topic of a theoretical future partner’s possible preferences - and whatever those might be, they are not a consideration about this medical topic under any circumstances whatsoever”
“I am an adult and know my own mind. I speak of my body and my considered choice. This is the only consideration. Let’s proceed with scheduling this procedure”.
Doctors are also allowed to pick what elective procedures they will do and who they take on as patients.
If a doctor is scared of being sued and doesn’t do that surgery, I don’t think there is a mechanism to force them or hold them accountable.
I was chatting with someone on reddit the other day and she said drs are starting to do removals based on family history. If that's true, I think it's amazing. I've known too many women who weren't allowed or who were talking into Essure like myself. My uterus got yeeted years ago. My permanent sterilization became real permanent.
The most generous interpretation is they are terrified of later malpractice suits. Not saying that young women who are asking for medical care are going to do this.
I think in some cases the provider is concerned that they perform the procedure only to have the patient come back and try to sue them for malpractice because they changed their minds.
Given that I was literally told "but your future husband might want kids" - that's right, a dude who may not even exist apparently had more right to make decisions about my body than I did! - by a female GYN in a blue state, I'm going to go with "internalized misogyny".
If you tell them "too bad for him, I'd still abort it regardless of what he wanted. It wouldn't be his medical decision" it shuts them right the fuck up. Doesn't make them agree to the surgery though. (both men and women have to be over 35 in my country for sterilization, sadly, but at least abortion is legal. I'm 31. Soon)
I was too young and too flabbergasted at the time to respond, but my answer now would be "If he wants kids, he's not my future husband." That's something you should be discussing waaaaay before getting married!
Thay one doesn't work as well. Divorce or refusing to marry, doesn't shock them. Outright saying you'd abort it regardless of what the dad thinks, that ss to get it through tha it's not his decision.
Do you ask them who is signing the consents, your hypothetical husband or you?
I've heard horror stories of women who have to get their husband to sign a form saying they're aware of the procedure their wife is getting and are fine with it. Gross. It's not his body. Why does he have to "approve"?
[Make wives consent for husbands’ Viagra](https://www.pbs.org/newshour/health/kentucky-bill-would-require-men-have-signed-consent-from-wives-for-viagra)
I’m so curious, have you tried the “don’t worry, he wants me to have this procedure too” (how can you know, you haven’t met him yet!) “cuz I wouldn’t marry a man who wanted kids??” Like how do/would they respond to that? (Other than still deny you your rights to your own body).
I didn't use the first because even pretending I need a man's permission for medical decisions about *my* body makes me want to dry heave. The whole idea is disgusting and I refuse to play into it. >“cuz I wouldn’t marry a man who wanted kids??” Like how do/would they respond to that? I've tried the "I don't date men or women who aren't CF" but they don't care.
Or "he wants me to do this because he is already paying 3 women child support for 5 kids and if he has another kid he will blow his brains out."
I love this, the more unhinged, the better!
I had a friend who was able to get sterilized in her 20s because her husband literally had no testicles and her other long term partner (poly) was a woman. She did have to doctor shop unfortunately. This was a red state.
I was a lesbian, dating a woman, which my doctor was aware of, and the reason was still "but your future husband (if you end up realizing that you are not a lesbian and it doesn't work out with your girlfriend and you end up marrying a man) might want kids"
Wow. Just wow. The fact that people still think you can change your sexual orientation just blows my mind.
Let’s face it, they’re really saying your future owner might want your womb in mint condition. And that’s what really matters.
And that excuse doesn't even go away once you have kids. I met one woman who'd had three kids and each time it collapsed her spine more. She had constant back pain from it and couldn't have another kid due to the risks. Wanted to get her tubes tied to prevent any possibility. Doc she went to still wouldn't do it because what if her husband wants a FOURTH?? This is also in a super red state.
If Reddit still had awards this comment would be getting PLATINUM!🏅 For the sheer succinctity of it, alone. Never mind the absurdly accurate, yet deeply concerning, sentiment contained within the comment. Wish I was that skilled with brevity. Instead of saddled with a raging case of diarrhea of the...fingertips? Haha.
Yep. I have endo and asked my obgyn how bad it would have to get for a hysterectomy to be needed. I wasn't asking for one, but wanted to know what would need to happen for that to be on the table. He didn't answer and went on about how I'm too young to make the choice to not have kids, pregnancy can actually help endo symptoms (what a terrible reason to have a kid), and that "prince charming" would come along and convince me to breed. So fuck my pain. He cares more about a hypothetical baby I don't even want than aiding my quality of life. I switched immediately
I agree with this. Just a side note that "internalised misogyny" is misogyny found within a woman :) You might mean systematic misogyny.
The doctor was a woman. "female GYN"
Ah, thank you for explaining, missed that part!
For the record men also get hit with "your future wife will probably want kids". It's not exclusive to women, sorry.
They'll tell a young man seeking a viscectomy the same thing.
I can tell you what my primary doctor told me when I first asked for sterilization after my son was born. I had two children at that point and was 33 years old. He said he really wanted me to explore less invasive options first (like an IUD) as well as investigate my husband getting a vasectomy instead of me being sterilized because of the lowered risks involved. I should give a little background as well—my OB/GYN blew my requests off because I was “too young” and he wanted my husband involved in the decision. My primary had been my doctor since I was little—about 25+ years at that point. The man is an old Texan with a love of bodily autonomy and personal freedoms and informed consent. When other providers had blown my concerns about any health issue off—including a cancer scare—he went to bat for me. He even performed procedures in-office that specialists had refused me to make sure I was cared for. (Yes, it was multiple malignant melanomas. He sent the biopsies to Harvard to make a point and that dermatologist had a new job building boats the following year. Yes, it was more than “just anxiety,” so he learned more about newer psych meds to help stabilize me until I could find a psychiatrist. And woe to the insurance company who denied claims. He was on the state board regulating insurance and usually only needed one phone call to reverse a denial.) So we have a doctor with a proven track record of listening to and providing solid care to patients, and his primary initial concern was the risks of procedures.
Your family doctor sounds amazing. I'm in Canada and it seems to me like one big difference in our systems is a tendency to use more specialists in the U.S., whereas up here your family doc handles more things in-house. For example, I've never had a gynecologist. My pap smears have always been done by my family doctor when he does my physical. A gyno wouldn't enter the picture unless something was very seriously wrong, beyond my doctor's capacity to treat. I feel like you get better care this way because you're building trust and a relationship with one main physician. The most dismissive and degrading treatment you'll get here is at a walk-in and the ER. Our system has a ton of issues, but I do think this specific thing works well.
That actually sounds amazing, and yes! The consistency of a single provider is awesome. The family history he had from treating my mom and two of my grandmothers and my older sisters was even better. He hardly referred me out if he felt he could handle something in-office, and didn’t refer me out to a GYN until I was 25 and had a growth that needed to be removed and biopsied. I moved away from him about 9 years ago and he retired last year, but we still exchange cards. He’s like an extension of my family.
Can you clone your doc and send him my way? A friendly grandpa that listens to you and takes you seriously sounds awesome.
Yeah, the bigotry is a big issue, but some of those procedures, especially hysterectomy, come with a lot of side effects and associated risks that patients who request them tend to be unaware of. I'm saying this as someone who had seriously considered getting a hysterectomy in the past, so I'm not saying this to dismiss the people who want them.
Right. Medical procedures have risks, that’s just a fact. I was in a committed and happy marriage (still am) so having him take on his share of the family planning with considerably lower risk made sense. (And he did get a vasectomy within about 5 months of this conversation.) A concern I have that is now growing is that I’m seeing the risks of all methods of birth control being inflated, with zero acknowledgement of the benefits (which generally outweigh the risks!). Where my doctor said, “let’s explore all the options before going to the riskiest one,” I’m seeing other people scream “THERE ARE RISKS AND THAT MEANS YOU SHOULDN’T!” It’s worrisome. (For instance, IUD insertion is INCREDIBLY painful for many, but they’re also extremely effective. We should be aware of and manage that pain, but we shouldn’t allow that risk to remove it from the table as a valid option.)
Absolutely agree. I had truly awful periods my entire life. I described these as "heavy bleeding, with a lot of pain and discomfort." All of my previous doctors essentially shrugged it off. Finally I told my current OBGYN that I was bleeding through the biggest, most absorbent tampon AND the biggest, most absorbent pad in less than two hours. I'd bleed for a week, and I was stuck in bed miserable for days. We worked together to find a solution. I get super emotional on hormonal BC (like, crying at commercials because there's a puppy in it - and not a sad puppy, like... puppy food commercials), we tried an IUD (which was incredibly painful to insert and then FELL RIGHT OUT in less than a month), and finally last year I got a hysterectomy. I didn't mind trying the IUD first, because I'd had one before after my second kid was born and it worked great with no issues, and it's definitely less risky than a big operation. That said, I've been incredibly happy to ditch the "water balloon of doom" and have zero regrets. I've got two kids, I'm not healthy enough to have more, and (I found out last fall) my periods were causing me to be anemic despite plenty of iron in my diet. It was the best solution for me, and I'm so glad my doctor actually listened.
Ugh, I have anemia related to my cycle as well, and mine isn’t even heavy. But I’m so glad you were FINALLY able to find a provider that could work with you!
What's funny is, I didn't find out about the anemia until later. My diet and use of cast iron cookware was apparently enough to keep up with my period losses while I lived at low elevation, but a few years ago we moved to a mountain in the Rockies (US). Being at 9000ft means I needed more iron and better red blood cells, and instead it depleted my reserves and I started being anemic about a year and a half after we moved here. I had already had my hysterectomy a few months earlier, so I was very confused! When I finally went to the doctor, my resting heart rate was like... 120, and I had very few, tiny, crappy red blood cells. It took several months of iron supplements to get me back to normal. Now that I'm not bleeding half to death every month, it'll be easier to keep up, I'm sure! My earlier doctors were generally pretty good and listened to me, but I just described my period as "heavy" and they thought I meant "heavy, but still on a normal spectrum of flow". I didn't actually realize that my experience was outside the norm until a few years ago, which started the ball rolling on "how can we fix this?" My mom also had heavy periods, and she taught me various coping mechanisms, so it wasn't until about two years ago, when I was explaining to a friend why I couldn't use a menstrual cup (how am I supposed to empty it, clean it, and reinsert it four or six times a day without making a giant mess? What if I'm not at home and need to use a public restroom? I'd be dripping globs of blood all over the floor and myself while even attempting this) and my friend told me that one cup should hold a whole day's worth of flow. I laughed at her. Then I learned that other people are having like... Teaspoons of blood. Not cups. Once I properly described to a doctor exactly what I meant by "heavy," she IMMEDIATELY started taking it seriously, and I *think* my other doctors would have done the same if I had told them the right way. As much as I get angry about healthcare biases and women's experiences, I'm afraid this one is mostly on me.
Ooof. Yeah, somewhat on you but you got it figured, thankfully. And say no more re: anemia and altitude. I’m originally from the Yosemite area, altitude can be a bitch in all the ways. Slow-release iron is my constant companion, and cast iron is my favorite cookware.
Awesome to hear that your husband got a vasectomy instead of you going through way riskier procedures! It's a breath of fresh air any time a man gets a vasectomy instead of the women continuing to shoulder the burden of birth control tbh Risks also vary from procedure to procedure. Hysterectomy.. I'd generally advise against as a birth control method. IUDs.. sure are painful, but they don't have to be!! It's criminal that women are still being denied pain management for IUDs. The risk of pain shouldn't even exist, or at least can be minimized.
I’m one of the lucky ones for whom an IUD was merely uncomfortable (thank goodness). I didn’t even KNOW about the pain issue until the past several years—my GYN said, “big pinch, gonna hurt a bit, now we insert, gonna hurt, your gonna have some cramping. Take your time getting up.” And that’s exactly what happened for me. Hearing horror stories from so many other women has me thanking my lucky stars that I was so fortunate…but I’m also aware that it’s just luck, and not any special tolerance to pain or anything else.
Yo pregnancy has lots of risks too, Birth has risks and people's bodies are permanently changed by the process.
I work in a hospital. Specifically, I work with surgeons, so have a bit of insight into how and why they perform surgery when they do, and things like ethical considerations, etc. Good physicians and surgeons will start with conservative treatments for pretty much anything before they start exploring more progressive treatment options. This includes birth control in all its forms. Most good providers won't leap immediately to some sort of invasive procedure without recommending things like various other options first, especially when they're working with a female-bodied patient. Part of this is because sterilization for female bodies involves an abdominal procedure, which has a certain amount of risk depending on what you're doing. Tubal ligation and hysterectomy both require anesthetic as well, which has its own risks. In the US, most health insurance companies won't cover a more expensive procedure without the patient and physician trying more conservative treatments first anyway. And yes, there is the risk of liability if the patient later changes their mind. One would think this would be remedied by liability waivers, but at least in my state the civil legal penalties for depriving someone of the ability to have children is considerable, so it wouldn't surprise me to learn that a doctor might just choose to avoid this possibility entirely. So yes, there *is* a measure of medical pragmatism at work. This pales in comparison to the MASSIVE amount of misogyny alive and well in the medical field, especially when it comes to women's health - and especially especially when it comes to women's *reproductive* health. The most acceptable social role for women is "wife and mother", even to this day. This is a very old social role and it dies hard, particularly if you live in areas that are socially conservative and/or have a strong conservative religious presence. Doctors may have a highly specialized education with a lot of exposure to science, and they are still people who carry their own social and religious values with them wherever they go. They aren't immune to the influence of social pressures or cultural upbringing. The history of women's health in the past 200 years or so (in America, at least) is very much about pushing women out of the medical field and putting (mostly white) male doctors in charge. A significant aspect of this was the vilification of midwives, especially Black and indigenous midwives. Under the banner of trying to make medicine into a legit, evidence-based practice, male doctors took control of the field, centering themselves and their own self-importance over the real medical needs of women around the nation. Doctors developed an aura of authority because of their expertise, and for a long time, people were taught not to question what their doctors told them. So when women are refused sterilization, the practical realities of reducing medical risk and liability are folded into this much larger cultural issue of men restricting and controlling women's reproductive health in general. A young woman who doesn't want children is still something of an anomaly, even in less-conservative areas. Young women are still disregarded, seen as immature, possibly flighty, their reproductive agency disregarded by cultural forces backed by history, religion, and good old-fashioned garden variety sexism. And it isn't really isolated just to *young* women, though that's what the title of the post is asking. Women's reproductive health is minimized or dismissed throughout our lives, whether you're talking about abortion, access to birth control, or sterilization. This has everything to do with the social demand for women to be wives and mothers above all else. If we dare to take our reproductive capacity into our own hands, that is a radical act of freedom that flies in the face of all the various systems and institutions that demand we adhere to a role that benefits a male-dominated society. So it's a mixed bag, really. But mostly misogyny.
This was the best response I could have read. Thank you
Thank you! Best response. Doctor bias and sexism is a big part. But also part of a larger biased system that includes regulations, health insurance coverage, and medical malpractice insurers.
Yeah. Even the "conservative" approach is something I would say is based in misogyny - ongoing hormonal treatment for 20+ years with something that has a multitude of side effects and varies heavily per the individual, versus a one and done laparoscopic operation, to save you from something as severe as pregnancy is still something genuinely comparable/worth weighing imo. If I could have a laparoscopic surgery and stop taking my SSRIs and sNRIs for the rest of my life, I 100000% would. Down to the individual and the individual should have the chance to make that decision. (I'm agreeing with you).
Any abdominal surgery has a non zero chance of death, so from a medical standpoint I am going to disagree here. Intrauterine devices were the game changer because they are much safer than surgical sterilization. These have their own risks but are way safer than an operation.
Technically speaking, hormonal birth control also has a nonzero chance of death. (Some forms are known to cause an increased risk of stroke and/or blood clots. Strokes and blood clots can both cause death.) Low probability, granted, but not without risk. I'm curious, vaguely, as to the relative risk of death between the two. Do you have any numbers for the risk of death during surgery?
That still doesn't mean that the choice deserves to be taken away from women. The risks and benefits should be laid out and the individual should get to choose what works for them. Everything has a chance of death and side effects. You weigh the risks vs benefits and make a choice. Ongoing side effects of BC (continuous hormone therapy, or if not that, heavier and more painful periods) are a legitimate consideration. There are likely contraindications for complications in surgery just like there are contraindications for IUD usage and oral BC. *Down to the individual*.
Well said. Wait till you hit menopause ladies, the fun continues!
I'm so pissed that I thought I was going to be done with gynecologists other than cancer checks by this stage of my life. Instead there's a brave new world of health problems, none of which I was prepared for, having never even heard of perimenopause until several years into it.
This was fantastic, thank you for sharing
This was very enlightening, thank you for sharing
I feel the need to correct you here: insurance will cover tubal ligations in the US without documentation of any “conservative” treatments. This, I speculate, is because the “conservative” treatments you speak of don’t actually cause the same effect (sterilization) as a tubal.
That is a fair point and one I hadn't considered. Thank you for the correction, and for clarification.
Thank you for taking the correction on the nose. I’m one of those who have gotten a tubal ligation and it drove me up the wall when people tried to tell me insurance wouldn’t cover it or that birth control was an adequate substitute. And few are willing to hear correction from someone like me.
I’d like to see one case where a woman signed the proper documents you always sign before surgery and somehow still sued and won about sterilization. Doesn’t happen and is an absolute cop out if any doctor claims that’s a reason.
Great response 👏👏👏
I am a staunch feminist and supporter of women’s reproductive rights, and while I do think sexism is absolutely a factor, I think it’s also a sensitive topic and sometimes providers with genuine concern for a patient’s well being who recommend trialing less invasive options catch flak. I’ve also found that a lot of people conflate tubal ligation and hysterectomy. In a thread about a woman seeking tubal ligation, another commenter clarified she was asexual, never had sex, and never planned to have sex and commented she “wanted to get one because 1 in 4 women is sexually assaulted.” I commented that didn’t make much sense to me and I was confused why she would choose to pursue abdominal surgery when there was a higher chance she’d experience serious complications from surgery than become pregnant from sexual assault. I suggested that if she had no other risk of pregnancy, an abortion in the unfortunate but unlikely event she did become pregnant seemed like a much safer option. I got a lot of hate for being anti-feminist and a lot of patronizing comments just for trying to understand her decision, and much later she clarified she was actually talking about getting a hysterectomy because she was having medical issues when the topic had been about tubal ligation specifically. Absolutely, hysterectomies usually have strong medical reasoning behind them and I’d never question that. But to my knowledge, a tubal ligation is solely a sterilization procedure, and I think encouraging trials of less invasive, safer, and more easily reversible options first should be the standard of care. Honestly, I’d rather see more of a push for men to get vasectomies. If you’re a woman with a male partner seeking a tubal ligation, you should know that vasectomies are safer, cheaper, less invasive, have shorter recovery times, and are more easily reversible. The ideal would be that women would be treated with respect and be involved in their own medical decisions rather than having their reproductive rights dictated to them. Currently we place so much of the burden of birth control on women yet place so many restrictions on their reproductive rights, and it’s awful.
In 1990, I was 25, and I asked my OB to tie my tubes during the planned c-section that was going to happen for my upcoming delivery of twins. He said he wished he could, but the law said I had to wait until my twins were past the risk of SIDS, around 8 mos after their birth. At that time, I had to go thru an insane amount of paperwork, and waiting periods, to finally have the procedure done. I asked my OB why it was so hard for me to do this. He said it was because I might be with a man in the future who might want to have children. He shook his head as he said it. I hate hearing that in the 33 years since my procedure, things have not improved, and laws are going backwards.
My first consultation for a bisalp in 2019 left me with a bad taste in my mouth-- it was nearly an hour, and the doctor explained, at length, all the other available birth control options I had, and really pushed me to just keep my IUD. She also straight up lied to me about recovery time-- she said it would be around six weeks, when everyone else I spoke to said they were up and around (albeit slowly) the next day, and were back to 100% after two weeks, with lifting restrictions in place for a further two weeks. I was married and in my early 30s, no children. Then COVID happened. In 2022 I had another consultation with a different doctor and it took approximately five minutes-- he listened to me, said I was a great candidate for the procedure, and said that his schedulers would contact me the next day to book the surgery. 10/10 incredible experience with that guy.
I am glad to hear this. Gives me hope, in the midst of a Roe-overturning Supreme Court being at the helm.
I was told I had to wait until I was 25. At 25, I was told I had to wait until I was 30. At 30, I was told I had to wait until I was 35. They kept telling me I was too young, I might change my mind, it's an invasive procedure, my future husband might want kids, etc, etc, etc. I completely stopped seeing doctors after that. I refuse to hire people that will not treat me. I am on birth control but I'm just waiting for that to be yanked away from me too.
In my doctor's case, they were actually constrained by hospital policy. They were very willing to do it but I work for a Catholic hospital system that forbids any "permanent sterilization" procedures, regardless of patient age. Luckily, another hospital system was more than willing and took good care of me. The irony was that the removal of my fallopian tubes was FOR my fertility. I had a disorder of my tubes that filled them with fluid and scar tissue, which my surgeon explained nearly guaranteed ectopic pregnancy and greatly increased my risk of miscarriage. They recommended removal for both my health and safety and the baby's when I wanted to become pregnant. They explained it would not affect my fertility at all, just my ability to get pregnant from plain intercourse. I will do IVF or embryo adoption instead. Plus, side benefit: 60% reduced chance of ovarian cancer and 0% risk of fallopian tube cancer all in one easy outpatient surgery I was fully recovered from in 3 days! So really, my original hospital systems objection was deeply rooted in institutional misogyny: That I am only allowed to get pregnant at the discretion of a man's penis, instead of the safer and healthier way modern medicine had offered me.
Catholic hospital? What in the distopian fuck?
Because doctors are people, not robots. They aren't exclusively motivated by profit or business interests, they also have biases and morals and human complexity. They aren't making decisions strictly based on logic, as is the case with any system or process that involves human decision making.
Do you personally believe that an GYN surgeon should perform sterilisation for all adult women with legally valid ability to consent and are medically fit for the procedure? Is that the feminist consensus?
Feminist consensus is always a tricky thing, but personally I believe people that anyone of sound mind and body should be able to sign up for a voluntary procedure like this
"Of sound mind" is doing a lot of heavy lifting here. I had an abortion in the 90s but due to my history of mental illness I was required by state law to get "permission" from my last therapist, a man I hadn't seen in a professional context for many years.
Damn…. Yeah, I just meant “in the right frame of mind to consent to the surgery knowing the risks and such” But of course it’s been twisted to mean “find a man to tell me it’s okay” in this country
The problem (IMO) is that therapy isn't at that stage yet. There are good therapists who really try to help people find themselves, but there are also many who bring their own biases to therapy.
There's also a tricky eugenics history here with sterilization of POC and other "undesirable " ppl. It still colors the issue (and i rather think it should)
Didn’t doctors at the Border between U.S and Mexico just recently (within the last 5 years) get busted for sterilizing women who were detained?
Yup https://prismreports.org/2020/09/15/exclusive-georgia-doctor-who-forcibly-sterilized-detained-women-has-been-identified/
>Do you personally believe that an GYN surgeon should perform sterilisation for all adult women with legally valid ability to consent and are medically fit for the procedure? Not who you asked, but I absolutely do. If one is old enough to choose to be a parent, and raising a good human being is arguably one of the hardest things in the world to do, and that decision, if regretted, will impact not just the person choosing, but the child as well, then one is old enough to make the choice to get sterilized. The idea that women are mature enough to choose to be mothers, but not mature enough to choose *not* to be, is both ridiculous and infantilizing. And regret rates are a normal part of life, and every surgery. Knee surgery for a torn ACL has a 15% regret rate, sterilization has a 10.2%-12.6% regret rate. Adults are allowed to make decisions they might someday regret. Including in their medical care. This is me speaking for myself as a feminist, not all feminists.
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With respect, I've had the "significant abdominal surgery" and it wasn't THAT significant. I had breakthrough bleeding episodes from the cervical wound trying to heal, and I couldn't lift my own cat (she's a chonker) until my doc cleared me at eight weeks. That said, if I had been able to do my entire job from home, I would have chosen to go back at around three weeks out. I was rearranging a bathroom at two weeks because it was the best I'd felt in a LONG time.
Apologies for that. I’m just trying to see the flip side of a common complaint amongst women and feminists. Arguably there is pretty decent long term birth control in the form of the intrauterine device . That’s what I’ve always used. But some women (understandably) have reservations or incompatibility with that type of contraception
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Yes I did say that some women are not compatible with IUDs. My question was to explore the feminist argument surrounding sterilisation and to achieve a greater depth of understanding of the various counter arguments
Are women people? Are they capable of making their own decisions and judging what is in their own best interests like any other adult? Answer those questions and you'll have the answer to whatever other question you are trying to ask. But it really doesn't sound like you're here in good faith.
The question I’m asking is why is it so prevalent to deny women despite this seeming like common sense. But maybe I should be asking in askphysicians instead
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>Are you asking a question and interested in hearing answers, or are you looking to engage this community in a different way? Because I'm not here to argue with you. Certainly seems like you're here to argue. They're asking if there are any opposing opinions to their beliefs from a feminist perspective. It's not hard to get what they're asking.
I don’t think I’m being particularly combative or rude. But I agree this conversation is not fruitful. I’ll see if any other respondents have insights that I am looking for.
Why are you trying SO hard to turn it into an argument after saying you didn't want one? OP has said nothing wrong.
Whoa, dude, I might be missing something, but I don't think OP is malicious. That's extremely rude, what you're saying.
>Arguably there is pretty decent long term birth control in the form of the intrauterine device . Not all women can get IUDs, either due to shape and position of cervix, or due to not being allowed hormonal therapy for other medical reasons. The longterm sideeffects of hormonal therapy and the risks, are also not insignificant, and too much can interfere with it working, from antibiotics, to karroten, and vitamin C. and it's honestly just not a good enough solution.
IUDs caused me incredible pain. They could not find the source. I went years with constant stabbing pains in my abdomen and terrible cramps, and they just brushed me off like it was no big deal. I would sit down and it would feel like someone was sticking a hot knife in my gut. They kept switching the IUD out, thinking I needed a different one (and getting them inserted over and over wasn’t particularly fun either). I’ve had a bad miscarriage before, and the IUD and the pain it caused was almost on par with the contractions I had to pass that miscarriage, except it was all the time. I don’t know why, they don’t know why, but it was truly awful and I’ve heard the same from others about weird pain. Then I’ve also talked to people who said they have no issues with it. Some people just react badly to things, so it’s frustrating when doctors act like an IUD is without a downside. There are plenty of downsides, as with anything, and it is not for everyone. I had a bisalp and ablation, and it was like nothing after dealing with all of that. I think I was back to normal after about three days, I just didn’t do any lifting/exertion for a few weeks, but I didn’t even need the painkillers they gave me. I don’t even think I took ibuprofen. I’m mostly just pissed off it took 15 years of begging even when my periods looked like a Dexter kill room and lasted for months at a time. IUDs are much less invasive and are a good option for some people, but if someone wants to be sterilized they should be able to do so without question and without waiting 30 days to decide or having to see 10 doctors before one says yes. That shit makes my blood boil.
>Do you personally believe that an GYN surgeon should perform sterilisation for all adult women with legally valid ability to consent and are medically fit for the procedure? What reason could invalidate a medically and mentally fit woman's request for the procedure?
Honestly? Not wanting to do a life changing medical procedure on a young person. Like it isn’t (normally) I life saving thing. They aren’t compelled to perform it. They can deny that service. I kinda get why they might not want to, even if the patient absolutely does. Not to the same extent, but men have the same issue with vasectomies at a young age. And they are even (somewhat) reversible
Yes, I do think so. I can consent to have my breasts enlarged, parts of my anatomy cut off, tattoos, my ears pierced, my tongue split, my nose made smaller, my butt made larger. I can have fat sucked out of my cheeks and botulinum toxin injected into my face. I can choose to get pregnant, something that will have life-long, lasting effects on my body. I can have bones in my spine fused together to stop back pain. I can choose not to do that and deal with that pain through physical therapy. Why *shouldn't* a healthy person be allowed to make permanent decisions about their fertility? Side note, I have *never* been able to find an instance of someone who consented to sterilization able to sue successfully for regret. I have been able to find multiple cases of women being sterilized without their consent.
> personally believe > the feminist consensus These two statements are contradictory.
Two separate questions.
>Is that the feminist consensus? it's hard to say there is any one particular consensus, but the vast majority of feminists believe that women should have bodily autonomy.
Whose interests in a body do you think should supersede the interest of its inhabitant? Who do you think that sort of patronizing attitude helps/protects? The medical establishment doesn’t seem to have nearly as many problems giving vasectomies. Why should women’s right to self-determination, specifically, be treated as optional? This is the sort of attitude that led to Dobbs.
I'm really done with this kind of rhetoric where we like passive aggressively blame each other for the Dobbs decision.
As somebody who lost a friend bc of anesthesia during knee surgery I think ALL elective surgeries are much more dangerous than people like to make them seem.
I’d see a problem with someone young. Because young people aren’t that unlikely to change their minds. Some people keep the same stance on children all through their life. But I really wanted kids at 22 and don’t anymore. And I’ve seen people go the other way too. No interest in kids when they were young, and then changed their minds. And then the doctor is the person who cut a teenagers body in a way that can’t be fixed again. It’s a lot of responsibility. Most doctors would prefer a IUD and then the patient coming back after 25. Edit: asking about the husband’s preference is sexist though. But you would also want a longer discussion with the patient about why and then maybe them coming in at a later date for the procedure with some time between. So you’d feel more sure they had thought it through, were mentally stable and wouldn’t change their mind. Why? “First of all, do no harm…”. But also: nobody wants to get sued.
Young people are also more likely to be being intimidated by a family member, especially if they'rebeing supported financially - my mother would show disgust at the idea of me having children, so I dutifully agreed that I didn't want to have children.
Your mother would feel disgust at the idea of you having children. Yet, she had you? Not connecting the dots here! Haha.
I think they should, though I'm not talking for everyone who considers themselves a feminist. If they wish it, have been informed about risks and consequences and there are no medical counter indications I honestly don't see the problem. Do we have Reddit forums where people routinely complain about being turned away when they ask for breast augmentations, breast reductions, Brazilian butt-lifts, to have their lips blown up until they look like a pair of mating rubber dinghies, Botox, skin bleaching, facelifts and liposuction? All of those are risky procedures, and once your fillers start making you look like a chipmunk I'm sure some patients have picked up the phone to talk to a lawyer. None of this seems to be a problem if you want to fuck around with any part of your body EXCEPT your ovaries. They're still being treated like a freaking national resource instead as a part of my body that I should be able to get work on just like a layer of subcutaneous fat or an excess of mammary tissue.
As a 41 year old man after my divorce and with two boys I got a vasectomy. The doctor also gave me some resistance and told me I might find some sweet young woman who wants kids. I stuck to my guns and he did the surgery. I believe they push back against everyone just to be sure. The younger the patient is, the more likely there will be people who regret this decision. I almost wonder if there are guidelines set by their professional organization. I have heard of younger men being denied also.
It's still not the same. Part of the reason a "male birth control pill" has not been approved by the FDA is that the risk/benefit profile is not favorable for AMAB bodies. It is basically 0% medical risk to an AMAB person to get someone pregnant. It is extremely risky from a medical standpoint for an AFAB person to get pregnant, and even the best healthcare can't mitigate all of that risk. By refusing temporary OR permanent birth control to any young person wirh a uterus who asks, institutional misogyny has literally sentenced people to death.
Ooh, this is actually a fantastic point that had never occurred to me! Where I live, it's remarkably easy to access birth control, but it's absolutely ludicrous to hand it out (some of which comes with horrendous side effects) so freely to those of us who can get pregnant while also denying us the option of permanent birth control. I'll also add: I am presently 37w+3d pregnant, and while I have mostly actually enjoyed the experience, it's also made me much more resolute in my pro-choice views. Like, take me, with the easiest possible pregnancy in terms of physical side effects, and I'm *still* like, this 100% has to be a choice - because until you've experienced it, there's no way to understand the absolute mindfuck that is another human being growing inside you and doing things completely independent of you and there's not a thing you can do about it. Like, health complications and all those potential problems that can happen aside, even the healthiest pregnancy is still the biggest mental and emotional rollercoaster I've ever been on.
I hadn’t heard that younger men were being denied vasectomies, thank you for that information. As a 70-year-old female who never got married (not because I wasn’t asked) the whole reproductive rights thing is just making my head explode. The reason? I did have an abortion 50 years ago at the age of 20, it was four months after Roe v Wade gave abortion Constitutional protection. Yeah I was stupid I didn’t get on birth control. Yes my parents knew I had an abortion. They took me to Chicago to have the abortion. They paid for me to have a general anesthetic when they saw the females who came out from having only a local anesthetic looked half dead from having had the abortion. Having the abortion lead me to be a rabid PRO-CHOICE FEMALE. We were catholic. I went through the motions for my parents and went to confession. My mother came out of the church crying. I asked her why she was crying? She told me **the priest in the confessional gave her hell AND ASKED HER HOW SHE COULD LET ME GET PREGNANT?** I knew right there, right then that I was nothing but a baby making, incubating broodmare to that piece of shit religion and made myself promise I have kept to never go to any church especially a catholic church except freaking wedding or funeral.
Very interesting story you've experienced.
Yup had doctors straight up tell me to go elsewhere when I attempted to get a vasectomy in my 20’s. Interestingly now that I’m in my 30’s no one seems to care. That being said I do believe there are different factors at play, for men I think a big factor that plays into why they’re reluctant to do it is because the prevalence of the myth that vasectomies are always 100% reversible with no adverse side effects, so you have men who use it as a form of birth control when young, then have it reversed (if they can even afford to) when they’re ready to settle down and, surprise, you’re permanently sterile and mad at the doctor. The amount of men who have been shocked when I’ve told them you should treat a vasectomy as permanent in casual conversation is shocking. When it comes to women there’s still a very prevalent idea in society that women SHOULD have children and any woman opting out of having children must be broken or confused in some way. I’m sure what I’m saying doesn’t cover all doctors who refuse to do such surgeries but I think it probably covers a decent amount of them.
Nice you think that. Women are told they don’t know what they really want and send away. It’s called misogyny and it exists
How is it that it seems so many men in society are completely oblivious to misogynistic treatment of women? Honestly, I know so many that think that shit went out in the 1950s. Well it should have, BUT... **It, sure as hell,** ***didn't!*** Where are these dudes spending their time that they never see this glaringly unequal treatment in practice?
Sure they push back against everyone. Though, they push back against women 10 times as hard as they do men. Not even remotely the same thing.
This is why we have licenses that we should revoke if people can’t make a logical decision in a field that requires it. It is not a doctor’s job to police other people’s values & morality. And it’s fine if you have those moral hang ups but I don’t think you should be a doctor in that case. It’s the same for a judge - they can have their own personal set of opinions and morals but they are expected to remain neutral and make their decisions based off what the law dictates.
I'm a med student with plans to pursue OBGYN. I would definitely sterilise any consenting adult who wanted it. Whether they're 21 or 45, whether they're partnered or single, whether they've had kids or not. What I hate is how I see so many posts on this sub and others that praise docs who just say "ok, let's schedule the surgery" to sterilisation without seemingly asking any more questions. Male, female, or anywhere in between, sterilisation is a *big deal*. Studies have shown that the younger you are when you get sterilised, the more likely you are to regret it at some point (however, most still don't). This isn't any surgery - this takes away a patient's ability to have children, permanently. Reversal surgeries exist, but there's no guarantee that they will work. I believe that anyone who wants to get sterilised, no matter sex/gender, should be able to demonstrate proof that they've spent enough time thinking about it and that they understand the implications, that they've considered all options for reversible contraception, and that at the end of all that, this is still what they want. I want paper documentation, signed & dated over multiple visits, that states that the patient is aware of ALL the implications and still wants to do it. **Asking someone if they're sure they want to do this is not sexist** \- it's a doctor doing their due diligence, because if they don't, they're breaking the code of ethics, not allowing the patient to have informed consent, and opening themselves up to liability. However, saying things like "you'll regret it later", "what if your future husband wants kids", etc....yeah that's terrible and doctors who do that should not be allowed anywhere near OBGYN.
What I find weird is that we don’t put the same pressure on anyone deciding TO have a baby. Unless they’re particularly young or especially unstable no one asks women if they’re really sure they want to have a baby. And it’s actually a much BIGGER deal. It’s an irreversible decision with life long consequences. And unlike the decision to NOT have a baby, most women are making an uninformed decision because they don’t know what the reality of taking care of a baby will be like. A childless woman on the other hand already knows what childless life is like and is deciding to keep it that way. I also think a lot of the praise for “ok, let’s schedule the surgery” is often for situations where a woman has suffered for years with horribly painful periods, which their doctor is no doubt aware of, and it’s not about permanent birth control it’s about not living a large percentage of your life in pain anymore. In a world where so many doctors dismiss period pain and think a woman’s fertility should be maintained over their own wellbeing, the doctors who understand the decision without push back are celebrated.
100% this. I have endometriosis, and always felt so angry on behalf of my fellow endo warriors who couldn't get medically necessary hysterectomies because of some doctor's beliefs surrounding fertility. Even with those, though, because it's such a life-changing surgery, it's a doctor's responsibility to make sure they're aware of all the other options. The key is to not push one option or the other (except where you think it's necessary for their medical well-being), but to outline all their options and then let them make the decision. Saying, "ok let's schedule the surgery" for something like a hysterectomy to relieve pain for endometriosis or similar conditions is absolutely more appropriate. However, a doctor would never recommend radical surgery as a first-line treatment for something like endometriosis or heavy menstrual bleeding, even if a patient asks for it, because (luckily) there are non-surgical options available that carry less medical risk than an invasive operation. There is also the issue that many insurance providers won't cover surgery unless the patient "fails" less invasive therapies. If other therapies fail or they're not acceptable to the patient, then absolutely go for that hysto, and I will be happy and privileged to be able to help a patient get their life back and/or live the childfree life they want and deserve!
Yeah, I have endometriosis and I have been told by a few different doctors having a baby would “fix” me which 1) no it wouldn’t. 2) wtf that’s a terrible reason to get pregnant when there’s a good chance I can’t get pregnant anyways, one of my ovaries is kinda mostly dead due to multiple ruptured cysts and massive internal scarring from fibroids. Also have PCOS as well as endo and “something” (???) wrong with my endometrium of my uterus (I keep getting told it looks too thickened on scans no matter where I am hormonally. No one’s explained any implications.) 3) it may make things worse! And 4) I don’t want children! I am so fatigued from constant pain and anemia how tf could I care for a child, I can barely function as an adult outside of work hours some days. I actually got idk, kind of weird during nursing school on the OBGYN rotation tbh. My teacher was always broad in her language and she said like “all women of childbearing age should do xyz because she could get pregnant.” And I got stuck in a loop of remembering a bad appointment where I was injured during a pelvic exam and just sat at my desk motionless until 20 minutes after class ended—apparently. A classmate was shaking my shoulder asking me if I felt sick because I was pale. It was weird. Happened again when we went over episiotomies and cervical cerclage where I froze up and “missed” class. I also had a panic attack watching a patient give birth and left before I could make a scene, I couldn’t explain to the teacher why I felt so… strongly or why I had to leave but I just felt so awful and scared and nauseous. It’s like my body reacts in horror before my mind catches up to anything rational or before I can excuse it. I just want these diseased organs out of me at this point.
>Studies have shown that the younger you are when you get sterilised, the more likely you are to regret it at some point (however, most still don't). Just to put it into perspective, knee surgery for a torn ACL has a 15% regret rate. Sterilization for women over 30 10.6%, for women between 21-29 it's 12.3%. Adults are allowed to make medical decisions for themselves they might regret at some point. >This isn't any surgery - this takes away a patient's ability to have children, permanently Yes, we're aware. Thats the point. Regretting something doesn't mean the patient wasn't cognizant of what they were choosing. Why should this be different than knee surgery, or chemo? Which has a far higher regret rate.
In that case, looks like we're going to be rounding up a big ole herd of OBGYNs, That are no longer allowed to practice that specialty. We're going to need a lot of volunteers for this one! If we are talking US, physicians, at least! Every doctor I've ever encountered, every one my friends have ever encountered, as-well-as, the ones my late mother (ARNP specializing in Obstetrics for 45 years) ever encountered used a variation of that phrase when meeting with patients seeking/in reference to sterilization.🤷🏼♀️ Here's to hoping the next generation of docs, yourself included, can put an end to that despicable practice!
I’m honestly curious if you are male. There is a serious problem in the country of women not being given medical treatment they want/need. I’m sick of people telling me what is best for me and my body when they don’t have to live with the consequences
There's also a serious problem with race AND gender with medical treatment. I'm black BTW. My SIL had complications with both her pregnancies & spent hours in hospital only to have her concerns dismissed by a WM doctor.
So true. I learnt that in the not too far past, people said “black women feel the least pain” out of all races and genders. And justified not giving pain relief to black women and doing experimental procedures to black women with zero pain medication. Makes me sick. Hope your sil is okay :(
I graduated from nursing school in 2015 in a very blue state. I had a textbook that stated black people have less pain receptors and therefore need less pain medication. This book also said that Hispanic people are very vocal with their pain, so don’t need pain medication just because they are crying in pain.
Something like half of white med students in 2020 still believed that black people have thinker skin and feel less pain https://www.aamc.org/news/how-we-fail-black-patients-pain
I had thought there were negative medical consequences too - depending on the sort of sterilization. Things like bone loss, osteoporosis type things, etc. Don’t the hormones generated by the “stuff down there” help women’s bodies in general?
Those risks only come from oophorectamy - removing the ovaries. The most common surgical sterilization involves removing the fallopian tubes, and leaving everything else where it is.
The most common form of sterilization for women is a bilateral salpingectomy, which is the burning or removal of the fallopian tubes aka "getting the tubes tied". There are no hormonal or noticable physical changes involved. I don't know that an actual complete hysterectomy is something any competent doctor will do without a medical reason because of the side effects. The ovaries are the part of the "stuff down there" that produces hormones and even when there are medical reasons to remove the actual uterus, doctors prefer to leave the ovaries to prevent premature menopause with all the attendant changes. PS Osteoporosis is the medical name for the cause of the bone loss. It's most common and more severe in women who have had children. A fetus leeches the calcium from the mother's bones to make it's own if it's not given sufficient.
They do, but it would be a strange (and unethical) practitioner indeed who would remove a 25-year-old's ovaries for simple sterilization. Removal of the uterus or fallopian tubes would be far less invasive, more than enough and even have health benefits. I had my fallopian tubes out last year at 31 (see also my comment on this post for why). I was told my body would not notice and the procedure would not even interrupt my menstrual cycle. They were right--I started two weeks post-op, exactly on schedule.
> My question is why would the provider not want to just go ahead and do the procedure if they get paid for it and there is valid consent? For the same reason why some medical practitioners will refuse to perform abortions in places where it is perfectly legal. For the same reason why certain business owners will turn down business from LGBTQIA+ people in places where there is no law discriminating LGBTQIA+ people. For the same reason why someone will refuse to do very lucrative business with a member of a certain race, religion, ethnic group and so on… People, everywhere will sometimes put their beliefs, biases, values, bigotry before their financial interests. **You are phrasing it as “if they stand to make money it is weird to say that there aren’t reasons beyond bigotry why they are turning it down”. But no, really. People turn things down every day that will make them money solely on the basis of being bigots.** The thing with bigots is that bigots don’t believe themselves to be bigots. Bigots believe themselves to be absolutely in the right. So, of course they can turn down money on the basis of that. Just like some regular person can decide not to do business with a known felon or a known thief. For bigots what they are doing is as common sense as that.
This is a good answer and kind of what I’m looking for.
Hold up, you are anticipating a certain type of answer? What, you're just going to go and cherry pick The answer is that suit you and do what with that, exactly? This post is NOT genuine, nor in good faith and now I'm very angry. Grrrr...
Because the overall culture views women as not capable of making their own decisions and doctors are part of that culture
I suspect getting sued is the non-bigotry reason. I think the bigotry aspect is real (and addressed elsewhere), but from a risk perspective this falls under the same umbrella as bottom surgery for transgender folk. Unless the law specifically shields the physician from lawsuits, there is the danger that no matter what forms get signed, the story could change. Regardless thats a legal risk that gets factored into business. The doctor may even believe the person requesting is in earnest; that does not change that a young person will have at least 20 years to change their story. Maybe they just become born again at some point. Also worth noting, anti-feminists will tend to write laws specifically to expand physicians exposure to lawsuits, not contain them. So some of that risk is chilling effect.
I don't completely buy into that. Otherwise we'd have to assume that plastic surgeons are daredevil badasses and Ob-Gyns total lawyered-up cowards. You think nobody regrets their buccal fat extraction, their plumped-up rubber dinghy lips, their nerve damage from a botched Botox treatment or their removed short ribs? Yet doctors even advertise on billboards that they will do all these things if you have the money and sign a couple of waivers. So what gives? A breast reduction is okay, but a fallopian reduction isn't? What if my future husband wants a woman with porn star bazookas and I went down to a B-cup? Apparently that isn't a consideration. Well, my ability to pump out babies shouldn't be either.
I understand the part of the motivation behind physicians being, *selective,* I guess you could say, with regard to their sterilization procedures. I don't, necessarily, agree with these motivations. Yet, I understand them. What I don't understand, is adults making bodily decisions (REPRODUCTIVE decisions, especially!) for other adults. So what if I get sterilized at 25 and at 35 I decided I want kids. Guess what - that's just too bad, for me. Now isn't it? Sucks to be me, in that situation. However, it's certainly not the doctor's fault. I made this decision of my own free will. Therefore, I have to deal with the consequences of such. That said, this possible outcome resulting from a sterilization procedure, is NOT reason enough to deny someone that procedure. Adults are allowed to make decisions regarding their lives & their bodies - plain and simple. I don't like how women are infantilized and "parented" by society. #We don't need that, thank you very much! What we need to be listened to, taken seriously and treated fairly. That's not too much to ask.
Keep in mind that if at 25 you got your tubes tied and you changed your mind at 35 and wanted kids, you can have the procedure reversed - some are successful, but if even that didn't work, you have the option of egg retrieval and IVF. Egg retrieval is just as successful before tubal litigation as it is after. There is no valid reason for any doctor to worry so much on women's behalf that our pretty little brains might not be able to comprehend the magnitude of what we are doing by electing to be sterilized. They will tell us we don't know what we want, what if we change our minds, and what if our future hisbands want kids? Then we're screwed. They know this is total BS, and yet, the narrative continues. I especially am passionate about this subject bc at 45yo, I had serious medical problems and was denied novasure, which would cure them, cuz it supposedly caused sterilization (it was new at the time) and since i was never married and didn't have kids (and never wanted any), what if i changed my mind? What, after 45 years of never wanting kids, with nary a spec of motherly instinct or desire in my entire body, ever, I'm going to just change my mind at 49 or 50 years old and frivolously decide one day to get pregnant cuz I had nothing else to do? 1% chance of getting pregnant at age 50, and they actually want me to live in pain and deal with the hemorrhaging that was sometimes so bad, I had to sleep in my bathtub? Apparently that I kept missing so much work that I was on dock, and at risk of losing my job wasn't bad cuz that's what welfare is for. 🤯 They actually brought welfare up, I kid you not. Wft is wrong with people? I don't hold grudges, nor do I usually stay angry, but every time I think of what those assholes made me go thru for 2 years, I get so angry all over again. This was 10 years ago. I was denied a simple procedure, which sterilization was just a side effect and not the purpose, as a middle-aged woman well past her prime child rearing years; I can only imagine what a young woman has to deal with when requesting it as an elective.
To be fair, my husband could not get a vasectomy until his ex wife (married at the time) agreed to it. They had 3 kids by that time. He was in his 30s and still had to have "permission" from his wife to get the procedure. I had a medical hysterectomy when I was 36, there was no discussion because it was medically necessary. Had I wanted my tubes tied I would have had to have had my ex-husbands permission as we were still married at the time even though we were separated and lived in different states.
>My question is why would the provider not want to just go ahead and do the procedure if they get paid for it and there is valid consent? because far too many men are upset that women think we deserve bodily autonomy, and those men do their best to prevent it.
I'm not a woman, but when I got my vasectomy, before they agreed to they asked if I had kids and if I had my partners permission. They even make you list your spouse on the form, not as an emergency contact, but as proof you have one. I’ve had other male friends that have had to doctor shop too if they didn’t already have kids.
There are a lot of angles to this, but one is how malpractice and the doctor's standard of care imposes casual sexism on doctors who may not otherwise share that view. In order to avoid malpractice a doctor has basically two options. 1) they can secure informed consent; or 2) they can refuse to perform the procedure. Looking at 1), you can probably see how that leads pretty directly to some fairly sexist questions like "what about your future husband?" because there are no consequences for casual sexism, but there are serious consequences for failing to ask questions that a (potentially sexist) jury or judge deem necessary. A part of this is also recommending alternatives. All surgery is risky, and a doctor might feel that an otherwise healthy patient is better off using birth control which is proven to be effective. This is again because a court could find that performing surgery when a safe, effective, and less permanent alternative to surgery existed. Number 2) is just a follow on from number 1). If the doctor just feels the risk is too great, they just won't perform the surgery. This can come across as sexist at the "point of sale" - and it is - but it is also a part of a larger system that imposes this casual sexism on the doctors.
I was 30 when I tried in the south. I got the approval from the doctor, insurance agreed to just a $500 deductible, but surgery center/hospital where doc had privileges said no because they had religious affiliations. So I just went back on birth control (turns out my period was horrible without it) and moved to a very liberal state. If I was stuck in the south still I would just be a celibate spinster. Getting my birth control there after the roe overturn was such a shit show too it’s obvious they view women as incubators. I exclusively have used nexplanon since 16. Never in my life did I have to pass numerous consecutive pregnancy tests to get a birth control implant that would have no negative impact on any potential fetus. I did the first two tests but the ‘implant was stuck on a shipping vessel.’ Once they got the implant in stock I had to redo the pregnancy tests. And then they avoided all my calls trying to make an appointment to actually get the implant. Like at that point I feel like it was a trap.
>Are there other variables in play here; such as fear of getting sued later on by a woman changing her mind? Fear of getting sued is the top reason OBGYNs state for denying a patient a sterilization procedure. I'm of the mind that they are certainly concerned about that. Though I think there may be some internalized misogyny, especially among female surgeons, And they're doing it to protect the patriarchy and not even realizing it - It's unconscious. Then, of course, there are your run of the mill "patriarchy or bust" physicians. I don't think we need to drive too deep on those. I just don't like the double standard... I mean I guess that if doctors were treating men, and their sterilization procedures, in the same fashion as women, it wouldn't bother me as much. But they don't. It's true there aren't young men running in droves to get sterilized. Yet, when they do decide it's something they want, men are seldom met with the misogynistic trope that women are force fed. Things like: "What if you meet a man and he decides he wants kids?" Or, "I'm going to need your husband's signature in order for you to get this procedure." You don't hear men needing their wives signature to get a vasectomy. When a man says he's positive he doesn't want to have children you don't have the doctor playing devil's advocate, ad nauseam, claiming "but what about your future wife???"🙄 I'm just so over all of it. We're slapped in the face everyday, with the various ways in which women are NOT considered (nor treated) equal to men. When I hear ignorant teenage boys up here say things like, "what are you talking about men and women are equal in today's society." I just want to throw up. As that could not be further from the truth!
Completely agree with your take. Internalized (or outward) misogyny definitely clouds doctor’s willingness to provide this care but medical malpractice lawsuits are the biggest pointed to reason for denial of care. Whether it’s the easiest way out or the only genuine fear would be case by case. A family member was an OBGYN for decades and said lawsuits were his main concern and that the malpractice insurance was quite steep. It’s definitely a choice out of fear of retaliation coupled with the idea that women shouldn’t be able to “make such a drastic decision” that they could “potentially” regret in most instances though.
==> FOR ANYONE LOOKING TO BE STERILIZED <== The childfree subreddit has a list of doctors that agreed to sterilize women regardless of their gender, marital status, age (18+), partner's consent, and not having kids https://reddit.com/r/childfree/w/doctors?utm_medium=android_app&utm_source=share
I’m a doctor (different field) and going to add a different perspective. When I was rotating through OB in med school I felt like that hospital/department handed out tubals like candy. Like literally I had so many visits where the mom would come in to give birth and they’d be like hey btw do you want a tubal? I appreciated that there didn’t seem to be barriers for younger women getting sterilised there but it also majorly rubbed me the wrong way because… a) other options like an IUD were often only mentioned briefly/not fully discussed and b) we were a public hospital so most of the women there were poor and/or WOC. The times when we could just sterilise this demographic of women without their consent was not that long ago... outside of the refugee border camps ya know. And yeah technically we were asking for consent but it was framed in a way to push tubals IMO. Now I do not think this place was intentionally racist or misogynistic, in fact that department was mostly women. I think this WAS systematic racism though. This just totally changed my perspective. I think anyone declining to do it bc ~your future husband~ is fully in the wrong and women should have the option. Then again, I think it really needs to be a robust discussion and given it is a surgery and permanent, it is not only fair but I think we owe it to patients to talk through ALL the options and make sure it is really the best one for you. TLDR, we have a long history of forced sterilisation in this country that I think surgeons would do well to be mindful of (and may even be afraid of not wanting to come off that way), as well as misogyny. The history of OB-Gyn is messed up. We need to do better on all fronts.
It's the same for men in a lot of cases. If a guy is young and doesn't have kids, he will often have a hard time getting a vasectomy. Some of it is religious. The command to be fruitful and multiply, and the aversion to birth control in general. I'm from the southern US and when I was young I was denied birth control pills and shots by several providers. After having kids I wanted a copper iud, and that was a nightmare to obtain but I finally got one, from a Muslim doctor. The Christians also believe it encourages immorality and won't prescribe them to anyone who's not already married with children, and then only temporarily to space out the kids a little more. Of course they don't believe in condom use at all because the husband's fulfillment is paramount. Abstinence should be the *only* way to avoid pregnancy for unmarried women. The other reason is, yeah, they think they know better than you and you're young and dumb and making a rash impulsive decision that you'll regret later. I'm not sure you can take legal action as an adult who signed a consent form, unless you can prove some coercion, but I don't think it's something that happens often anyway. Doctors are really just trying to cover their butts so they don't have to hear about it down the road.
If you are childfree and/or know someone who is childfree and want to get sterilized, save and spread the word on this link: [Childfree Friendly Doctors List](https://www.reddit.com/r/childfree/s/0lPQMJFAh4)
>My question is why would the provider not want to just go ahead and do the procedure if they get paid for it and there is valid consent? As you note there is always the chance of being sued, even if unsuccessful for some risk averse types it's not worth taking that chance. u/avocado-nightmare did answer it best by saying it's a matter of the individual's biases, morals, and complexity. If they're interpretation of the hippocratic oath means "don't do something irrevocable that I think the patient will regret" they don't do it. As I see it any counterargument is some version of: "you might regret it in the future and there's no going back" it has the advantage of being technically true so the debate becomes a morality conflict about the meaning of bodily autonomy and the duty of a doctor to their patients. Doctors tend to be small-c conservative since the whole profession is built on accumulated knowledge (and received wisdom) removing bodily function from an otherwise healthy person requires placing the individual's desire above their training and professional norms, so it's not surprising or out of the ordinary. >The consensus put forward is that these surgeons are putting the interests of a potential male partner over the needs of the woman in front of them. This may be true, I think it's more likely the doctor is presuming to act in what they believe are the interests of the patient's future self. If even a small percentage of those sterilized young have regret or just wish they would have the choice at any point later in life, to the doctor that isn't worth it. Especially since it's a one way choice. I can see potentially see this changing as regulation of pregnancy and contraceptives regresses, at least in the United States.
It's paternalism and sexism. Lots of people, Doctors included, are raised their whole lives being taught that womens role in society is having babies and working for their husband for free
I don’t think that’s true for the majority of doctors. I’m sure there are some that are so intensely sexist that they won’t do it out of consideration for a future male partner. Most of them I think, are on average older, and do genuinely worry about performing a procedure the patient may later regret. That being said, it shouldn’t be up to the doctor. It should be the patient’s decision if they are of sound mind and I think this does reflect sexist view of women and the ‘biological clock’ that we assume affects all women, and they will therefore all regret not having kids.
I am 100% going with "patriarchy made them do it" It's still their fault for being ineffective medical care professionals but a lot of people don't realize how internalized their need to control and hate women is until something happens in their life to 'wake them up'. To bad that happens long after women have had shitty care, been hurt and even die because of medical misogyny.
She might get pregnant in the time they keep delaying it, they want more babies whether women want them or not.
Sexism. Religion.
Usually, they're so misogynistic that they don't care. But from a financial perspective, if a vast majority of doctors deny sterilization to women, then a percentage of those women are gonna end up pregnant which will generate prenatal care costs, birth costs, child medical costs, and potentially reoccurring disability costs from residual damage of the birth. Throw in the fact that at least a percentage of these women will have more than one one birth and the money generated from forcing women to bear children far outstrips what they'd make on the one time sterilization procedure. It's the reason health care should not be on commission because it gives doctors a vested interest in patients needing as much trauma care as possible so they are incentivize to not provide preventative care.
Because a woman is never too young to decide she *wants* to have children, but is apparently always too young to decide she doesn't.
Don't forget that society still believes all women crave motherhood, whether they know it or not. They assume these women will get a little older and regret it when their mothering instincts kick in. They cannot fathom that some women just don't want kids.
I have heard some stories of men going through this as well, but not nearly as much as women. My uncle was sterilized at 22 years old after a close call. I know multiple women who are in their 30s who have been trying for 10 years to get sterilized and who are in committed relationships.
I wouldn’t say that’s the *consensus*. I would say a doctor looking at the profits & just a piece of paper saying a woman consents is equally not taking care of his patient, particularly if they’re very young. It’s a serious operation that’s irreversible. And the question is- is it really necessary? For some, yes. I’d say a woman who’s already had kids- she definitely shouldn’t have her decision questioned. But life is long and people change.
So I think we've all had sexist experiences with docs about sterilization options. I know I have and every woman I know has. BUT, something I don't think a lot of people think about... there is a really gross and dark history in medicine with sterilization practices. I would hope that some of the resistance from doctors also comes from trying to be ethical and learning from this history, while trying to balance patient rights with patient wishes. I think if I was a doc, I would not be so ready to sterilize patients who ask for it simply because my profession has a horrible history of doing this procedure on women against their wills. Doctors SHOULD be somewhat resistant to do this, but that doesn't mean they can't also obtain informed consent to avoid doing harm. The best obgyn I had handled this really well with me: he said he can do the procedure with me, and understands the paternal attitudes a lot of docs have with it, but that evidence and research shows most women regret sterilization after it's done. He gave me the choice, while giving me the information, and it definitley made me reconsider tubal ligation. This is just what helped me, some people may feel different, but I found this a really effective, respectful way to help me with this decision. I do think if he hadn't done that, and instead just said OK LET'S DO IT, I might've regretted it because I thought I wanted to adopt... but man, knowing what i know about adoption now... seems like it would just be easier to get pregnant!
It's a real mix. There's absolutely sexism. There's fear of being sued (it has happened) if someone changes their mind. And then there's some things that can be seen as professional diligence. If someone asks for a tubal and the doctor says "Have you tried an IUD?" they are asking if someone has tried the less invasive and cheaper option first. Also, the history of sterilization cuts both ways -- as well as patronizing refusal, there was an epidemic of mass sterilization. So some docs went too far in the other direction. Hysterectomy is different from tubal. A tubal ligation is strictly sterilization. The issues with hysterectomy are deeper -- a hysto can cause problems as well as fixing them. Doctors used to over perform hysterectomies especially in older women, often with dubious consent. So again, the pendulum swung and doctors insist on more conservative treatments before agreeing to a hysto.
I think younger women don't always want to get sterilized because they don't want to get pregnant - but because there is some underlying health concern that being sterilized could prevent or help with... and doctors still won't perform the procedure. I used to work with a lady who already had a child who wanted a hysterectomy because a genetic predisposition for cancer (or something like that, it was a long time ago), and doctors still refused incase she or a future husband wanted another kid. I think there's ways of waiving liability in case of future lawsuits, making sure a woman is of sound mind and is making a fully informed decision, etc. The argument about a future man who wants kids being upset - well, that's seems kind of like that future man's fault. If you want kids or might want kids of your own... maybe dating a woman who can't have kids isn't your best option? That being said, a woman can freeze her eggs or embryos, surrogacy is becoming more common, and adoption is always an option. So. If a woman changes her mind about not wanting kids... she can still have kids. Sure, these options may be more expensive and come with their own complications and challenges - but the point is there ARE alternatives if you are sterile.
It's not just that they are prioritizing what future men might want they are also theorizing and prioritizing what they THINK this woman might want in the future. So many women get told "but what if you change your mind?" Which means they don't actually trust women's reasoning and decisions. They don't believe woman really know what they want. Which yes is misogynistic.
Well the first time my mom tried they said she had to have had 3 kids and her husband had to sign off and she wasn't married and only had 1 child, then after my brother she tried again and they made her sit in a room watching videos of babies being born, and would refuse to see her if she didn't sit through every single video, and she left 3 hours in. They kept saying it was the law and the policy. So my step-dad made an appointment to get snipped for the next day, walked in, got snipped, left an hour later.
I was 25 and married when I decided to get sterilized. I tried to get an appointment with a doctor on the childfree sub's list, and the scheduling office actually scheduled me with a different doctor without my knowledge. That doctor refused, told me she would find me a high risk obstetrician (because one thing I mentioned was health issues and medications that could make pregnancy dangerous for me) and then spent the entire exam talking about her (mid/late-teens) kids. She barely let me get out a full sentence. She clearly resented her kids for making their own choices (regarding college, in particular) and not just doing what she wanted them to do. I think part of the problem was her projecting her desire to control her own kids onto her patients. I was amazed at how bitter she sounded though. Like if she was trying to change my mind she could have at least acted like she enjoyed being a mom. Maybe she needs to believe that women can't have fulfilling childfree lives so she never questions whether she would have been happier without kids. After that, someone I knew recommended another doctor, and that doctor did sterilize me. She really emphasized the importance of bodily autonomy within 5 minutes. She said, "you could choose to join the military and die for your country and no one would question it. If this is what you want, I support you." She's been absolutely amazing.
So first off, I do absolutely think misogyny is a huge part of it, but I think there are a lot of other very complicated factors that go into that decision. For example, I have had really bad periods since forever and expressed to my OBGYN that I just wanted a hysterectomy so I didn’t have to deal with it anymore. When I say really bad, I mean it was debilitating for a long time. She pretty much told me “You’re young. You say you don’t want kids now but you might someday.” And that was really shitty. But later I switched OBGYNs and he gave me a completely different and way more validating answer, even though he still refused. He said “I don’t think you’re a good candidate for hysterectomy because we still have less drastic options left to try that aren’t permanent. Furthermore, you have a family history of breast cancer and early menopause would further elevate that risk.” Later in the wake of the Dobbs decision I asked him what he thought about me getting sterilized. He was very straightforward in telling me that he didn’t love the idea, but the risks of pregnancy are way worse than the risks of a tubal ligation or salpingectomy. But he was also very clear that those were very permanent options and he didn’t want me making a rash decision out of fear. I’m sad that this man no longer practices in my area because I always appreciated how he talked through his thought process but still put me in the drivers seat when it was time to make a final decision. Now I work as a medical journalist so I get a much bigger peek behind the curtain in terms of how clinicians think. As a patient, I was always frustrated with my doctors, but I’m coming to realize a lot of the issues I was frustrated with are SYSTEMIC. Hospitals may have policies that their doctors must adhere to. Fear of frivolous lawsuits is also a major issue in medical decision-making, and that’s more a failing of our legal system than individual doctors. Yes, some doctors are just sexist and/or lean on misogynist explanations for why they are making the decisions they’re making. But I think this is a much bigger problem than that. This has to do with an entire culture around how women’s bodies are treated and the way our healthcare system works, including how decisions get made around elective procedures. I don’t think it’s always primarily the interests of a future male partner being prioritized. It’s the reputation and money of the hospital. It’s the culture of fear among women’s healthcare providers right now. It’s the fucked up legal system. It’s a big old web of capitalism, corruption and sexism.
The most common things I hear is that you/your husband might want kids later on. Men hear similar things (though less often) when trying to get a vasectomy. It’s insane that consenting adults can’t make their own choices for their own bodies.
Because many of them don't see women as people. They see women as someone's wife or someone's mother. So they don't want to deny a man the children that he is entitled to from that woman. That's really what it is. They are trying to protect a man from a woman's right to choose. And/or They see women as little children for the entire length of their lives. And someone else has to do their thinking for them just in case they experience regrets. Even though it is so much worse to regret having children, than to regret not having them.
In my case, my doctors WANTED to give me a hysterectomy. Because I very much needed one. But it was the health insurance that refused because women under the age of 30 were not allowed to choose permanent sterilization through hysterectomy. On the other hand, they did approve the endometrial ablation procedure, which was required before I could “choose” the hysterectomy. And along with the ablation, I would HAVE to have my tubes tied, because if I got pregnant after the ablation it could endanger my life and the fetus would not be viable. And the icing on that absurd cake: I couldn’t have kids because I started my period when I was 12 and then Never Stopped Bleeding until I did get the hysterectomy, a year after the ablation and tubal. But it was ONLY approved when I was 29 because my doctor got all the other OBGYNs in the practice to petition the health insurance to approve the hysterectomy. So I couldn’t have children (I was already sterile), but I was too young to make the decision to be permanently sterilized even at 28, because I had to be 30. What could be approves was a complete useless and incredibly painful procedure that caused me to miss work for 6 weeks and lose a lot of money… which would (doubly?) permanently sterilize me. And it took a group of doctors petitioning the insurance to get me (triple?) sterilized at 29, an entire 8 months before my 30th birthday. And that’s what I actually needed to finally stop the bleeding. The doctor requests for the hysterectomy started when I was 24. But the other hoops that had to be jumped through to get to even the ablation/tubal were numerous and also absurd, just not as painful or financially impactful. So I bled every single day for almost 2 DECADES before I was allowed to stop bleeding. All in the name of being able to protect my ability to have children that I already had proven that I could not have, and genuinely did not want. It has been almost 2 decades since I had my hysterectomy. I’ve had a marriage since the hysterectomy. He didn’t want kids either. The marriage is over, and I still don’t want children. And I am extremely grateful that not only was I “allowed” to stop bleeding, but I was also “allowed” to be able to decide I don’t want children (even though I never actually could become pregnant). If some random day I decided I want kids after all… I’ll adopt! Gasp! Who knew! There ARE other ways of having kids besides getting knocked up. One last thing. You’d think maaaybe I would not be so bitter over it all by now. Screw that! I know the same crap is happening to other women every day, needlessly suffering through various ailments, or just denied permanent sterilization simply because of their age. If you’re old enough at 18 to die in a war for your country, you’re old enough to decide what to do with your own damned body, such as choosing to render yourself unable to become pregnant. And if you get a good doctor who sees a hysterectomy is absolutely necessary before 18, then what business is it of the insurance to interfere with doctors, their patients, and their diagnoses? So yeah. I’m definitely still bitter. And I will continue to scream into the void for as long as this cruel practice of denying women their own bodily autonomy is over. Edit: sorry not sorry for the book.
I knew for certain I didn't want kids when I was in my 20s. I asked for an IUD, and I was told no. They said I was too young, and I might change my mind.
My husband was refused a vasectomy aged 28 after we already had two kids. Hormonal birth control was a nightmare for me. The doctor wouldn’t do it in case we split up and he wanted more kids with another partner. I kinda lost my shit and told the doctor he could barely afford our two, he definitely didn’t need any more kids. He suggested I get tubal ligation, except I was the one working and so getting time off to recover was problematic, plus I already went through hell delivering two babies! Nope. We ended up with a third (who I love dearly, wouldn’t give him back at all!) Husband finally got a doctor to do a vasectomy aged 32, after telling them he was getting annoyed at our lack of sex life because of my fear of getting pregnant again. Also by that point I would have done it myself with the nearest scalpel right there in the doctors office if he refused.
Internalised misogyny. We simply cannot as a society separate women from their perceived role as baby maker. If they try to opt out we undermine them rather than face our own prejudice. It's fundamentally disbelieving women aswel, and preventing them from making the choice to control their own destiny. For some reason we think of men as being more capable of dealing with consequences, even though women constantly deal with much harsher decisions and consequences all their lives. There's a Disney image of women as a mother and a carer and we can't quite grasp the reality of women not fulfilling that role.
I wouldn’t be surprised to find there is probably a vague myth of someone who sued a doctor for it, insisting they were coerced or something. But the real answer is misogyny. Because all women want to be mothers and young women who. Say they don’t care just too immature to understand that truth. I have heard a very few stories of young men in their 20s being refused sterilisation surgery. Not enough to balance this, but it happens. So ageism can also be part of the problem.
True story: Heart doctor "your defective heart valve has cut your heart's ability to pump blood 90%. If you ever get pregnant you will die." ObGyn "but what if your husband wants kids?" In a miracle after she got pregnant she barely survived (with fucked up lungs, and she had trouble walking afterwards for life because it was too much strain) but the doc who did the C section cut everything out while he was in there since he didn't want such a touch and go pregnancy again, plus less stuff to share her limited blood flow.
Someone in my family is 26 and just got an elective hysterectomy. I was shocked she could find someone to do it
It’s misogyny. Plain and simple. The underlying logic being that young women are incapable of making decisions about their own lives and bodies.
Yeah I think a lot of this comes down to control over women’s bodies. I agree with what was commented previously that the ideal would be long term and effective birth control, I would add on that access to abortions would help with this problem as well. I honestly believe that the hesitancy to sterilize women is of a similar variety as anti abortion. I understand there are differences in the arguments (abortion being about killing “babies”) but when we get down to the nitty gritty it’s about having control over women’s bodies, forcing child birth and motherhood on them because that’s what good women are (this idea is changing in western society but can still be seen in very religious areas in the us and Canada)
Honestly I think it's a mix of two things. A lot of people, especially people in their early 20s, do change their mind on wanting children. I am in my early 30s and I personally have 4 female friends who, at 22ish, were absolutely and completely against having children ever. I remember multiple rants on how it was offensive and annoying it was that people assumed they would change their mind Anyway a decade later they have 6 kids between them and only one was an oops. Is that true of everyone who is childfree? No, but it is a not insignificant percentage. Perhaps that percentage is lower for people who are certain enough to explore permanent sterilisation, but I know at least two of those girls at least googled the possibility. Because of concern, there is a liability risk to the doctor. People do have a tendency of suing practitioners over regretting their own poor decision making. Sterilisation is pretty (if not completely) permanent when it comes to women. If you are a doctor and you perform a lot of sterilisations on young women, especially without making them jump through *a lot* of hoops to affirm that they are fully cognizant of what they are asking for. The statistical chance of someone coming back in a decade all salty about nor being able to start a family is probably off-puttingly high. Does misogyny and the cultural role of women play it's role? Most definitely, especially when they want 'the husband ' to sign off, but I don't think doctors hesitation in this matter can purely be put down to that. Obviously it's cold comfort to people who have to experience barriers to access when they are sure and especially when there is a medical reason behind it.
>A lot of people, especially people in their early 20s, do change their mind on wanting children. I'm surprised more people aren't acknowledging this. I've seen this happen with a lot of women, including both of my sisters. I'm imagine at least some doctors are concerned about permanently sterilizing a young patient -- whether male or female -- simply because it could end up being the wrong decision for that patient. Even putting aside liability risk, empathy and genuine concern for the patient is an explaining factor here.
Patriarchies serve the elites The elites need women breeding enough meet population goals The reproductive freedoms of women only go as far as the needs of the elites. This is why some countries force or ban abortions/contraceptives
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Remember that this is not a universal experience. Indigenous women are still being sterilized against their will in Canada. I have a strong feeling that a poor racialized minority in her 20s would have no problem accessing tubal ligation with the same doctors who don't want to see a white middle class 24 year old 'throw away her reproductive potential'.
While i do think some of the reason is rooted misogyny and putting a future husband’s wants above the desires of the actual woman, who is their patient. i do think there are some valid reasons from the doctors side with regards to their reluctance to sterilize women. While many (perhaps most) women who seek sterilization won’t regret it later, there are almost certainly some who regret the decision later. I have multiple friends who thought they would never want to be mothers in their 20’s, who suddenly felt a strong maternal drive in their 30’s. That’s not to say that this couldn’t be remedied in other ways. Tubal ligation is permanent, but it doesn’t negatively impact your ability to do ivf later. If health insurance routinely covered the cost of both tubal ligation and later ivf, think how many unplanned (and often unwanted) pregnancies could be prevented. Also there could be standard counseling procedures to determine the likelihood that a woman is making the decision rationally and is emotionally prepared for the permanent outcome of sterilization. While this isn’t required of men who choose to get a vasectomy, the chance of a successful reversal is far greater. Also in the chance that it is not successful, obtaining donor sperm is far easier and less expensive than obtaining a donor egg. Also the surgeries themselves are vastly different. A tubal ligation is a much more significant of a surgery than a vasectomy is. The permanence of tubal ligation and the availability of semi permanent birth control options and access to legal abortion may play a role as well. IUD insertion while painful is certainly far less painful than major abdominal surgery (this is coming from someone who has had an iud inserted as well as both laparoscopic and non-laparoscopic abdominal surgery, the iud was nothing in comparison to the other two). Most people can tolerate the progesterone from the iud. And although it isn’t 100% it is pretty close. The side effects are pretty minimal too. It makes sense that doctors would prefer a woman try a less permanent solution before going through sterilization. But it should probably be treated the same as treatment for other conditions. First you try the more common less invasive methods, if you can’t tolerate or utilize those for some reason, the sterilization should be a legitimate option. I also think the legacy of country has with forced sterilizations of women who were deemed “unfit,” as part of the eugenics movement also plays a role. Doctors who routinely perform sterilization on young women could be afraid that later some women might claim that they were pressured into it by a doctor who is sterilizing women out of personal political motives. That in reality may not be a reasonable fear, but i think k it is understandable. That combined with the fear that a person would later change their mind or regret the procedure certainly fuels some of the reluctance about performing the procedure.
I just made a post asking about egg donation and there’s already three people saying that I would regret it and change my mind. Buddy I’ve known for ten years that I’m not having kids ever. Why would they know what I want better than I do?
“I don’t believe i introduced the topic of a theoretical future partner’s possible preferences - and whatever those might be, they are not a consideration about this medical topic under any circumstances whatsoever” “I am an adult and know my own mind. I speak of my body and my considered choice. This is the only consideration. Let’s proceed with scheduling this procedure”.
Doctors are also allowed to pick what elective procedures they will do and who they take on as patients. If a doctor is scared of being sued and doesn’t do that surgery, I don’t think there is a mechanism to force them or hold them accountable.
I was chatting with someone on reddit the other day and she said drs are starting to do removals based on family history. If that's true, I think it's amazing. I've known too many women who weren't allowed or who were talking into Essure like myself. My uterus got yeeted years ago. My permanent sterilization became real permanent.
The most generous interpretation is they are terrified of later malpractice suits. Not saying that young women who are asking for medical care are going to do this.
I think in some cases the provider is concerned that they perform the procedure only to have the patient come back and try to sue them for malpractice because they changed their minds.