A good friend of mine has a host of learning disorders and abnormal body chemistry issues, and is positive that even if she wanted to have kids (she hates them), a pregnancy would either kill her or make her literally insane, not to mention the damage her body would do to the fetus. But she still can't get her tubes tied. Because she might "change her mind."

I have an idea. Let women get the bleeding operation (no pun intended), and /if/ they change their minds later (not outside the realm of possibility), there are thousands of kids in the system who need parents to adopt them. It's a win/win.

i bet if she told them she didn't want to have her own children but adopt instead, they would do it. as long as she's wants to be involved somewhere in the furthering the species then the doctor will 'know' she's mature enough to make her own reproductive choices.

It's particularly ironic to hear the decision to refuse to allow adult women (I feel the need to emphasise this because it seems vaguely important) to undergo the short-term risks of tubal ligation while leaving them no real option but to be subject to the long-term risks of hormonal contraception.

This is a profession that performs equally (or even more) risky elective procedures like rhinoplasty all the time, with no concern for anything but the patient's solvency, and yet when it comes to things like tubal ligation (and sex reassignment surgery, as the article mentions), suddenly they have scruples. Could it be that cosmetic surgery is often about meeting society's expectations, while tubal ligation, SRS, and the like contravene those expectations?

Yeah, this is one thing that really gets to me. I'm only 21 and am absolutely sure that I don't want kids, and I've always known this wouldn't be an option for me. Assuming I could even find a doctor who would be willing to let me have this simple surgery, there's no way an insurance company would cover it unless I were older or had a bunch of kids already.

It's incredibly frustrating, but this is the prevailing attitude of the medical community. And come to think of it, it's the prevailing attitude of everybody. I can't count the number of times I've been told, "Oh, just wait until you're older!" after telling someone that I don't want to have children.

At what point am I old enough to make decisions for myself and be trusted not to change my mind?

But to be fair, I think a man my age who wanted a vasectomy would face exactly the same problem.

The balance of harms is NOT equal. If you mistakenly get your tubes tied, you can adopt, use a surrogate, get IVF, or hope that, in 10 years, there will be technology to reverse it.

If you don't and you get pregnant, congrats - your life is forever changed.

I wish they would discuss the risks of abortion and/or pregnancy when talking about the risks of tubal ligations.

Only 7% of women regret their tubal ligations, yet some 40% of women will abort during their lives. (I'm using that as an absolute baseline of women who experience unwanted pregnancies.)

But making medical and ethical judgments like whether to tie a woman's tubes (or whether someone is prepared for a sex change) is a doctor's right and, arguably, an essential part of the job description."

Doctors are not robots. It is part of their job to analyse the health effects of anything they may do - you know, "first, do no harm."

Nevertheless, the appropriate method for dealing with a patient who wants her tubes tied is not to patronise her. Explore other options - including the potential health hazards of those, examining her reasons, and, if you still disagree, referring her to someone else who will do it.

It should not be easier to get plastic surgery than a tubal ligation.

IMHO, what we should really aim for is for this procedure to be treated exactly like any other.

Assuming I could even find a doctor who would be willing to let me have this simple surgery, there's no way an insurance company would cover it unless I were older or had a bunch of kids already.

A friend of mine, who had every severe reproductive disorder known to science and was a female-to-male transsexual on top of that, ran into this bullshit recently in Utah when asking for a hysterectomy. The doctor, a fundamentalist, said he wouldn't perform the procedure (which was medically necessary on multiple levels) because my friend hadn't given birth "yet".

That's the whole fucking point!

(Not to mention that, even had my friend not been FTM and had he actually wanted to get pregnant one day, the pregnancy probably would kill him, if the severe pain and haemorrhaging didn't do it first.)

Am I retarded, or can't you reverse a tubal ligation? Yeah, it's expensive and there's some risk (as there always is going under general anesthesia), but my understanding is that getting your tubes tied does not mean you will never, ever, with absolute certainty, ever, be able to change your mind. I think only hysterectomies are *really* permanent.

And anyway, regardless, even if it were permanent and you did change your mind -- adoption is an AWESOME option (and one I'm a huge fan of -- I myself intend to adopt at least two if and when I ever meet a suitable partner in crime).

But, yeah -- um, doctors perform breast enhancement surgeries every fucking day. Those have the potential to be just as damaging to aspects of motherhood as a tubal ligation, yet you never hear doctors objecting to those because "well, she might change her mind. You know, when she screws her head on straight and wakes up to the fact that she's a person and not boobs on legs." Because, well, MEN would not be happy about THAT!

Green’s experience is not that unusual. Though no actual laws have ever been put into place, most OBGYNs refuse to provide women under thirty with permanent forms of contraception. Dr. Daniel Wiener, assistant professor of obstetrics and gynecology at McGill University in Montreal, is one such doctor.

Incidentally, that's when fertility declines. "You can't get this done when you're as fertile as a bunny rabbit, sorry; just wait until it's harder to have kids even if you want them."

Count me among those who cannot get MDs to understand that I don't want kids.

Re: vascetomies. Not in agreement. Men can lie - they can say that they have three kids already. It's pretty obvious when a woman has never had kids.

"I can't count the number of times I've been told, "Oh, just wait until you're older!" after telling someone that I don't want to have children."

When people/parents tell me, "Oh, you'll change your mind!", I like to ask them (with a serene smile): "Did you change your mind about wanting kids?"

I've had people telling me I would change my mind since I was in high school. I'm nearing menopause, and I never did. I agree with Oenophile: it should be treated like other elective surgery. Elise is on the money as well.

Controlling women's reproductive health choices is part of the tradeoff that allows the AMA to remain the strongest union in the world.

Am I retarded, or can't you reverse a tubal ligation? Yeah, it's expensive and there's some risk (as there always is going under general anesthesia), but my understanding is that getting your tubes tied does not mean you will never, ever, with absolute certainty, ever, be able to change your mind. I think only hysterectomies are *really* permanent.

No, you're not retarded. There are two types of ligations: those in which the tubes are twisted and tied, and those in which they are also cut. I believe that the former are reversible.

When people/parents tell me, "Oh, you'll change your mind!"

Is it interesting how so many people think nothing of talking to grown women as if they were 10 year old girls wanting to dye their hair purple?

No, you're not retarded. There are two types of ligations: those in which the tubes are twisted and tied, and those in which they are also cut. I believe that the former are reversible.

And vasectomies, of course, are even more easily and cheaply reversed.

I am 21 years old as well and face similar issues when it comes to making decisions regarding my reproductive future.

I have come to the realization that I will not be able to get a tubal litigation any time in the near future, and so must run the risks of hormonal birth control until then. I definitely do not think it is fair or even makes a lick of sense in terms of economics, overpopulation, and strain on resources.

If I could afford the surgery, and could find a doctor who would perform it I would do it tomorrow. I understand that someday in the future I might change my mind (highly unlikely) but I also understand the women who won't and are quite sure of it.

The way I see it is, even if I had the operation and changed my mind, I would still be able to raise children through adoption or mentoring which would be a more selfless beneficial to the world than having one myself.

The argument I frequently hear is "what if your husband wants to have biological children" as if the hypothetical desires of someone else outweigh personal lifestyle decisions. I just know that if I get married, it is going to be with someone who shares my values and if we decide to raise children we can do so through adoption. If my "husband" would leave me for a more open minded uterus, we clearly were not meant to be together. Of course, if he wants to pop one out, I would be supportive XD

My husband got a vasectomy at 23. It took us over a year to get it. He dragged me to all sorts of different doctors so I could show them my engagement ring and talk about how I'm adopted and how I'd like to adopt one of the many kids in foster care someday and I'm really not keen on the idea of being pregnant, and almost all of them still denied us. One of them even scheduled him for the vasectomy, and then when he came in they told him they don't do those anymore! Finally we got one to do it. It's worth it, if you want it keep fighting for it.

I think that you will find that for women of color, low income women, or immigrant women, this issue is completely different. Rather than having trouble getting sterilization surgeries, they are being FORCIBLY sterilized.

There is a long history of this in the United States. In the 1970s, it was discovered that hundreds of Mexican-origin women were being unknowingly sterilized at an LA hospital. They were being told the operation was reversible and given forms they couldn't read (because they were in english) to sign.

These abuses promoted a campaign by a group called CESA (committee to end sterilization abuse) that was able to pass federal guidelines regarding sterilization--requiring forms in the person's native language, and a waiting period to give consent. Many times these women were being asked if they wanted the procedure while in labor.

This created an outrage among white feminists, for exactly the reasons Ann mentions above--they felt it was an infringement on a woman's right to choose sterilization and was a barrier to her access.

It's a great example of when the feminist movement gets divided along racial lines--white women and women of color are experiencing this issue in opposite ways.

Just to add to this discussion.

psst, it's not a question of surgical sterilization v. hormonal contraception: behold, the humble barrier method! the diaphragm and cervical cap! Or, lo, the non-chemical IUD!

If you've been denied a surgical sterilization, you needn't put chemicals into your body if you don't want to!

(me, I'm happy with my chemical-ridden body-helloooo NuvaRing!--but I know others don't want to go that route)

I feel torn about this. OTOH, the theoretical hand, it's a no-brainer that this should be up to the patient. OTOH, the practical hand, I have lost track of the number of friends I have who have sworn up and down, over a period of many years, that they never wanted to breed, only to completely reverse their decision in their late twenties or early thirties. They far outnumber the people I know who have remained blissfully without kids (and they also outnumber those I know who have always wanted to have kids--I think it's very common to change one's mind on this issue).

Normally we want doctors to take the long view--not prescribing drugs or treatments that will cure short-term problems by creating long-term ones. Even if the surgeries are reversable, that puts the patient under the knife twice instead of zero times--and surgeries, even routine ones, carry serious risks. Based on my own anecdotal observation, and without any data to the contrary, I would feel very uncomfortable performing this procedure on younger women based purely on a desire not to have kids (as opposed to a medical condition that would make pregnancy dangerous). Not because I want them to have kids--gestating, birthing, nd parenting are too much damn work to be foisted on anyone who doesn't want to do it--but because there are nonsurgical, nonchemical ways of achieving the same end, and a current doctor has a responsibility to both the current and future patient.

The reasonable, thing, though, would be to go out and do some solid research on how stable individual decisions re: childbearing are over time, because if I'm wrong, then hey, tubal ligations for everyone.

Long-time reader, first-time commenter (usually no need as there are always much more articulate people saying what I would have tried to).

But I just wanted to briefly step in and say that it really sucks to see otherwise progressive, sensitive, politically attuned people throwing around the word 'retarded' like this. Oppression and marginalization take many forms, as we all know, and the mentally ill and developmentally disabled are certainly among those we need to resist marginalizing. Using 'retarded' to mean 'stupid' is not helpful...

Sorry. Genuinely not snarking, just upset to see this.

and thanks, quickening, for that. I got too caught up in my typing and neglected it. It bothers me, too, to see that word used here.

quickening, my last comment isn't showing up for some reason, but thanks for that.

radicaldoula, you beat me to it!

just think, some women can't get sterilized if they beg for it, but for low income women, woc, or drug users--orgs are willing to PAY you to get sterilized or use long term bc.

remember CRACK (now known as the much more innocuous sounding Project Prevention)?

My husband and I are friends with a couple. Both he and his wife knew they didn't want kids. After about ten years of marriage, they decided the vasectomy route was the way to go because it was an easier procedure (compared to tubal ligation) and it was permanent. Cut to 8 doctors later and a one finally agrees. Nine years later, they very happy with the permanent results. And at least one doctor came right out with why he wouldn’t do it…(paraphrasing) “You might want to leave your wife and find one that wants to have kids.�
These people had been married for ten years and they were both in their mid-thirties at the time! I know where I’m from, it’s difficult for anyone who is childless and under 40 to get elective tubal ligations and vasectomies. Someone brought up that a man could just lie, and that is true if he is private paying, but I’m not sure he could get away with it if insurance was paying for it (in this man’s case, his did). I further agree with the above posters, adults should be able to make their own reproductive choices, that includes whether or not to be sterilized.

kmg…who cares if your friends changed their minds? So did I. That’s not a rationale for denying Kate21 or lilaeden or marle’s husband or anyone else that option.

Based on my own anecdotal observation, and without any data to the contrary, I would feel very uncomfortable performing this procedure on younger women based purely on a desire not to have kids (as opposed to a medical condition that would make pregnancy dangerous).

That's only because, to you, an unwanted pregnancy isn't a harm of not performing this procedure.

I don't want kids; I don't even find them to be cute. I cannot take the Pill. I find IUDs to be morally problematic (and, by the way, I like my light, cramp-free periods and refuse to give that up). Nevertheless, under your theory, I wouldn't get a TL until my 30s (when it doesn't matter much anymore). Why?

There are risks associated with every surgery imaginable. When I had a non-cancerous breast tumour, my doctor removed it - despite the fact that the surgery was risky and painful, despite the fact that it posed NO short-term harm, and despite the fact that yearly biopsies could monitor it. There were other, non-surgical solutions, but none of them worked as well. The risks of NOT having surgery were really high - turns out the tumour doubled in size before they could get it out.

The risks of NOT having TL when you don't want kids are really, really high. If you are morally against abortion, or just don't want to make that decision, or don't want to give your kid up for adoption, why shouldn't you be able to get a TL? If you are a med student yourself and will be in school until you're 35 and can't afford to get pregnant, why risk it?

There are medical and psychological risks associated with NOT having this procedure. It is completely disingenuous to talk only about the risks of any surgery - a standard under which no surgery would ever be performed - a standard under which my lumpectomy would never have been performed.

"psst, it's not a question of surgical sterilization v. hormonal contraception: behold, the humble barrier method! the diaphragm and cervical cap! Or, lo, the non-chemical IUD!"

OTOH, what if new IUDs are unavailable when and where you need to have your current IUD removed and a new one put in? I'm reminded of how abortions and birth control pills are becoming less available in some areas...

One advantage of sterilization is that it can't expire or be taken away from you once you get it.

kmg…who cares if your friends changed their minds? So did I. That’s not a rationale for denying Kate21 or lilaeden or marle’s husband or anyone else that option.

Shelby - good point. After all, the fact that many women opt out of practicing law shouldn't be a rationale to deny us all admission to law school, right?

(Add me among the "never wants kids" category.)

I know a woman who gave a child up for adoption at 17, had another child at 20, twins at 21, another at 23, and was pregnant with her sixth child at 25. She did actually use birth control after the first unplanned pregnancy but she's one of those super fertile types who gets pregnant from looking at her. Before her fifth pregnancy (sixth child), she had been begging for TL and was denied because of her age. Despite the number of children she'd already had, they told her she might want more and they wouldn't do it. The sixth child was actually the product of a marital rape and she has moral issues with abortion. Too bad she couldn't be trusted with her own body so when someone else decided he had the right to it, she got stuck holding the ball.

I've had this same experience. I've been seeking a tubal ligation for a *decade* (Christ I'm getting old). I gave up when the last place I went insisted on receiving my husband's *permission.* PERMISSION. P.E.R.M.I.S.S.I.O.N.

OTOH, the practical hand, I have lost track of the number of friends I have who have sworn up and down, over a period of many years, that they never wanted to breed, only to completely reverse their decision in their late twenties or early thirties.

Did they try to get sterilized? Because I feel like the groups "don't want kids" and "are so certain they don't want kids that they actively seek a tubal ligation" might not be the same group.

Oeneophile, can I ask why you find IUDs morally problematic? (I've never heard anyone say they felt this way and I'm curious).

Here's what sickens me about this kind of stuff:

There are more doctors willing and ready to do breast implants, liposuction, C-sections, and episiotomies on young women than tubal ligations.

And which operations are more dangerous or harmful for the women?

According to every doctor I've ever talked to (and that's quite a few lately), they don't like to to IUDs on young, childless women, either. Part of the rationale for that is that apparently a uterus that has never contained a fetus (and a cervix that has never pushed one out) might be smaller and therefore have more issues and more risk of infection with an IUD, but it also goes back to the whole "you might change your mind" thing.

"And at least one doctor came right out with why he wouldn’t do it… (paraphrasing) 'You might want to leave your wife and find one that wants to have kids.'"

Interestingly enough that was my Mother's worry when my father got his vasectomy. She had complications with her IUD, and not wanting to have any more children, my father opted for the procedure. Her major worry was that for whatever reason they may part and he might want more kids.

Please note that it was my PARENTS that had this worry and this conversation in PRIVATE. Not with the freakin' doctor. It shocks and disgusts me that any doctor would assume that much knowledge about a relationship or presume he knows better than the partnership.

Oeneophile, can I ask why you find IUDs morally problematic? (I've never heard anyone say they felt this way and I'm curious).

Sure. Some of them work by preventing fertilisation (via hormones, but that wouldn't be an option if you're trying to avoid the hormones in the Pill), which is fine, but many of them work by preventing implantation. Even if implantation is successful, the presence of the IUD will result in a spontaneous abortion.

The idea of conceiving every month bothers me. I mean, I really understand that the Pill, or nature, or whatever, will occasionally cause conception but not implantation, or a very early spontaneous abortion, but I really dislike the idea of bringing that about every single month.

There are doctors out there who are willing to sterilize women who are in their 20s and have no children. I found one myself and had the Essure procedure done at 24. I'm surprised no one else has mentioned this procedure yet in this posting thread, but it is worth considering for any woman wanting to get sterilized. It is a fairly new alternative to tubal ligations that involves metal implants being put into the fallopian tubes to block sperm. It's as effective or even better than tubal ligations. It also doesn't involve any surgical incisions into the body since the implants are put in by going through the cervix.

As I've learned in the past and am reading here, many young childfree women have trouble getting this procedure approved, but if you really have made up your mind and want it done you should keep pursuing it and not give up. The first doctor I approached was willing to do this, and I may have gotten lucky, but I'd like to offer some advice for how I picked the doctor that I did:

1)I looked for a facility/doctor who I thought would be pro-choice. Sometimes you can't tell, but if the facility performs abortions then you know they're pro-choice right there. NARAL may also have a list of doctors/practices in your state that are pro-choice. Pro-choice facilities are much more likely to respect any decisions you've made about your own body.

2)I picked a female doctor. I'm sure there are male doctors willing to perform this procedure, but I felt more comfortable having a woman doing it and also I felt I had a better chance of finding a woman willing to do this than a man.

Good luck and don't give up!

Cassandra, I cannot speak for Oeneophile, but I also have moral issues with the IUD-some prevent implantation, after the egg has been fertilized and conception has occured. This is a problem for me, so I choose the pill or condoms.

In reference to the original posting-I take a cyncial view and wonder how much this is about money. OBGYNs are having such a hard time now with malpractice insurance, I wouldn't be surprised if they were worried about future lawsuits.
Why do some many *men* feel the need to deny women's healthcare needs-from the pill, to EC, to this? Why does it always have to be about having babies? Why can't we view these from the perspective of women having 'medical needs' that require the pill, or TL?

Mathari,

You're pretty much right about my issues with IUDs. It's not anything I would ever want outlawed, but that idea makes me really uncomfortable.

I'm in the "young and want to be child free" situation. Nobody accepts it and i mean _nobody_.

I'm suffering a lot of pressure from both family and friends to be a mom. Being the only daughter isn't helping nor is my family's culture.

Any help/advice would be appreciated.

There actually is a good reason to delay tubal ligations -- the 10 year failure rate for tubal ligation when performed on someone under 30 is MUCH higher than if you wait till after 30. It's something like 7 or 10 percent I wanna say. Too high for my liking. That's why my OBGYN told me I'd be better off with an IUD and then getting a tubal after 30. More effective.

Of course, this is not the reason most women are denied tubals, just wanted to put that out there.

"Is it interesting how so many people think nothing of talking to grown women as if they were 10 year old girls wanting to dye their hair purple?"

You said it. Living in a Nanny State is bad enough.

Julianne - I mentioned earlier that I've known that I didn't want children since high school. It's never changed. Just be brave and know your own mind. People just cannot believe that young women are smart and confident enough to do other things. I trust you to know your mind, and I don't even know you. Maybe you should tell them you might do something more important than produce a child. Write a brilliant book or find some important scientific breakthrough. It's really up to you.

JustAnotherJane,

Why is the failure rate higher? Is it because doctors are performing more reversible, but less effectual tubal ligations?

http://www.babycenter.com/refcap/preconception/fertilityproblems/6155.html

Or, is it that your chances of becoming pregnant in a given year in your 20s are well above 80%, while your chances of becoming pregnant at age 35 are 50%?

Reduced fertility alone would account for a large part of that discrepancy.

The failure rate for tubal ligations is 0.5%. Over 10 years, that amounts to 4.88%.

----

I'm in the "young and want to be child free" situation. Nobody accepts it and i mean _nobody_.

I'm suffering a lot of pressure from both family and friends to be a mom. Being the only daughter isn't helping nor is my family's culture.

Any help/advice would be appreciated.

Julianne,

I've spent my entire life hearing that. As I've gotten older (now sliding towards my late 20s), with no signs of changing, it's gotten better. I don't know how old you are, but it does improve.

Some of it is that I also just ignore it. When people say, "When you have kids..." I just smile and let it slide.

I was harassed a LOT when I was a kid and a teenager. Some of it is age, now - I haven't changed my mind yet. Some of it is that I'm very clear that I'm looking for a man who doesn't want kids, or who is on his second time around and has older kids (elementary-school aged).

Sometimes, people get obnoxious. My favourite (ha!) was when someone smugly said, "Oh, you can't always plan for them! They come anyway." I really wanted to say, "I'm freakin ABSTINENT, and if I get knocked up, it's because the Second Coming of Christ is imminent, and you're going to have a lot more to worry about than my desire to avoid miniature humans that resemble extras from the X-Files."

(Really - are these the same numbnuts who think that I should have sex anyway, because birth control never ever fails?)

When all else fails, try sarcasm: "You mean that I should have a baby RIGHT NOW? My hormones are raging. Screw college; I want to sit at home and nurse and sing lullabies...." (Would go on, but making self nauseous.)

oenophile

Mom would do things like buy me baby dolls etc when i was little - i also got pushed into babysitting which i didnt really want to do - my heart doesn't melt if there's a tiny baby in my arms etc.

both her and my grandmother and aunts are none too subtle about how they see my future - mother and wife of course.

I just feel terribly alone and not sure what to do.

Julianne M, if it seems like no one in the world agrees with what you're doing, it's a sign you're on the right track. Your friends and family want what they *think* is best for you, which is not always what is *actually* best for you.

I personally don't plan on having children. If later I want to raise children, I'll adopt a child from Africa or China.

What is the crux of the issue is one of who decides. Who decides whether or not you can make an informed decision for your own life, based on what you want, what is best for you? We are in a society that holds womens choices as suspect, open to questioning and judgement at every turn. This isn't news. How do we subvert it? What action do we take to make our observations about the oppression of women more than just belly aching and instead a path to change the way we view our own choices and the way others view the right of women to make those choices.

by the by, I heart my IUD, its the best thing ever - for me. Because I'd never had a child, it took me two years and 8 doctors before I was able to get it. Preventing implantation is it's M.O. FYI, my period is super light with it (Mirena, if anyone wants to ask their doc) - it's a great option, just incredibly difficult to get if you've never had a kid. There are slightly higher risks associated with women who get them without having given birth, but I accepted those risks. My doc talked to me about what the risks were, gave me some literature and explained they don't typically like to give them to women at increased risk, but in my situation (I can't take hormonal birth control) it just made sense. It was an incredible feeling to finally have validataion -this is what I'd been saying for two years.

It's crazy that this is such a common experience for women. So what action can we take to change the way doctors treat women's health decisions?

There are even those who would try to pressure seven year old in to haing kids!!

I'm sorry for crying at the computer - i just feel so alone.

I'm in the "definitely don't want kids" category. I think the first time my doctor ever offered me the opportunity to have a tubal ligation, I was in my early 20s. I'm Canadian, which may make a difference. At the time, I'd just recently had surgery and I said I wasn't interested in going under the knife again soon.

I've actually now come to the conclusion that having a TL would be a waste of time, since my hormones are so messed up I pretty much have to be on hormonal birth control (hellooooo patch!!) just to keep from being miserable. Having a period that goes AWOL for a few months with an attendant six weeks of PMS is just an unhappy thing. Why go under the knife yet again (it would be my fifth surgery) for basically nothing?

Should 18 yr olds be allowed to opt out of 'Social(ist) (In)Security' and/or 'Medi(S)care'?

Probably not... they 'might' regret it later in life.

I'm 23, and I've been on a waiting list for a tubal ligation for the past two years. In Canada, doctors technically cannot discriminate regarding tubals on the basis of patient age. That said, they can condescend and give the run-around as much as possible, it seems. I've gotten the "what if you met a man who wanted kids?" (said to me knowing full well I'm in a relationship) as well as innumerable "but you'll change your mind!" refrains.

The "oh, there's always condoms and HBC!" is often trotted out. I use both now, and though the former is always a plus, I fail to see why I should have to deal with the latter for no apparent reason, when I could get sterilized now, and not have to worry about decades of hormones or fundamentalist pharmacists trying to keep me from being able to take care of myself.

And to Julianne M: You're not alone at all. I promise. There's a lot of people who don't want kids ever.

Thanks Becca. I want to talk about it all but am not sure where to start. I hope you all can help me with what to do.

Do not to listen to other people (who, if they weren't your friends/family, I might call "dumbasses") who think they have some kind of inside line on what you really want. You have the inside line on what you really want, and they're just trying to generalize from their own experiences (at best, that is; otherwise, they're just trying to pressure you into a certain life because they themselves never considered an alternative). Look, I desparately want children and have wanted them for years--that has to do with my character and desires.

My local news just ran a several-minute-long segment on a shocking story. Apparently, there are some people who don't have children, and don't want them, and enjoy their lives without them. But at the same time there are actual other people who have children, and are enjoy their lives with them. Go figure.

Apparently, this somehow counts as news. The follow-up will no doubt be a piece about how some people enjoy roller-skating, while others enjoy reading military histories. I guess it's a good thing that roller skates don't require a doctor's permission.

Julianne-- you're not alone. The numbers of childfree individuals are rising, and most of us have experienced the kind of judgment you're facing.

I know it's difficult to be the "one voice" that is different in your circle of friends and family, but stay strong. Only you know what is best for you. Personally, I was very angry after I realized I had a choice-- that I could opt NOT to have children-- and I too felt very alone, and very ostracized by everything and everyone around me. It was like I was walking in a different direction than the crowd, and people kept hollering at me to "stay in line".

It will get easier. It helps if you are confident in your decision, and if you're able to research the reasons why people do and don't have children. Also, it's useful to develop a number of catch phrases or practiced responses:

Like oenophile, I usually just smile and let it slide when strangers say "When you have kids...". Sometimes I say, "We aren't having children," and leave it at that. If they push it further and say "You'll change your mind", I ask if they changed their mind about wanting kids ("No..." "Well, then why do you think I will?"). When people tell me I *should* have kids, I ask: "Don't you think children should have parents who won't resent them?"

My close friends and family all know where my husband and I stand on the matter, and don't press the issue because: a) they know we can defend our choice (although we shouldn't have to) b) they agree with it (our two best friends are also childfree), or c) they simply respect the fact that it's our decision to make.

I'd recommend trying to find some Childfree communities online. Trust me-- though it may not feel like it, you have plenty of people who agree with and support your decision.

Julianne, don't let it get to you. No one knows you better than yourself-just keep that in mind and ignore the rest. Hell, I'm 38, never married, don't date, and honestly find nothing appealing about children-and I still get the occasional 'You'll change your mind! One day you'll want a husband and children!'.

Well, no, I won't. It probably helps that I don't like people that much, either. :)

I was wondering if, in regards to the denials of TLs, there wasn't another reason doctors and clinics might refuse to perform them-sexual freedom. I'm not saying that I believe a woman will get a TL and then go to town, but considering some of the nonsense 'moral' doctors spout with regards to birth control, does it make sense that some might oppose a TL because they believe a woman will start sleeping around?

Anywho, it comes down to this: it's my damn body, and I should have the freedom to do what I want with it. I'm tired of being a second-class citizen.

cest.la.vie and Wolf

where are some good online places to go?

It's especially hard with a family like mine - and being the only daughter.

I'm bitter that my brothers get none of the pressure, lectures and remarks that i have to face.

Again I'd like to talk about it but am not sure where to start. G*d I'm sorry for crying - i feel soo stupid :(

You said it. Living in a Nanny State is bad enough.

It's a "nanny state" if you're rich, white, and (preferably) male. Then the state takes good care of you. For the rest of us, it's a bit more of a bully state.

The argument I frequently hear is "what if your husband wants to have biological children"

Then he can get his own ass pregnant.

The thing that often gets lost in discussions in this topic (and the topic of pharmacists imposing their religious tastes on those who require their services) is that health care professionals simply neither have the ethical duty, nor the ethical right, to impose their personal taste (as opposed to a rational medical judgment that a particular medication or procedure presents a substantial danger to the patient) on a mentally competent adult patient. If they want to deprive an adult patient of her autonomy, they can make an application to have her declared mentally incompetent. If there's no basis for believing the patient is mentally incompetent, then the patient's right to autonomy prevails.

Julianne, a quick Google search I just did turned up a site, www.child-free.com, that seems to be a good place to start. And don't think you have to apologize for your feelings, there's nothing wrong with them or with you for feeling them. I know it's hard, particularly if the people around you aren't supportive, but it is your life and your choice period.

Personally, I've always wanted children, biological and/or adopted, and I know my brother does too. But my youngest sister is 11 and says she doesn't want kids ever. I've never said to her "you'll change your mind" or "when you're older, you'll feel differently" I just say "Fine, you'll make a great Aunt for the kids L and I will have" and then tease her about all the free babysitting she'll do (she never even wants to babysit). If she wanted a tubal ligation in her early 20's I can't think of any reason why she shouldn't get one. It's disgusting to think that she could be denied that autonomy over her own body because other people might think they know better then she does what she wants. If I went out and asked for a set of D-cup implants, no one would take me aside to point out that having a 30D after being a 30A naturally might cause shoulder pain or chronic back problems, they'd just say "Great!" and take my money. Gross.

Julianne-- there are quite a few childfree communities online, although they pop up in different places. I know there are a few on livejournal.com. There's also a childfree community on sparkpeople.com (a site geared towards nutrition, healthy eating and weight loss). And on Indiebride, there are many childfree members who I know would be more than happy to talk to you (though the site is geared towards people getting married, or who are already married). These are just a few of the places I've found. The sparkpeople.com one was the most supportive, in my opinion.

Honestly, I think if you started searching for "ChildFree forums" on google, you'll find some that match your interests.

Genny is there anyway to contact you off-blog?

Thank you for caring.

Julianne-- there are quite a few childfree communities online, although they pop up in different places. I know there are a few on livejournal.com. There's also a childfree community on sparkpeople.com (a site geared towards nutrition, healthy eating and weight loss). And on Indiebride.com, there are many childfree members who would be happy to talk to you (though the site is geared towards people getting married, or who are already married). These are just a few of the places I've found. The sparkpeople.com one was the most supportive, in my opinion.

Honestly, I think if you started searching for "ChildFree forums" on google, you'll find some that match your interests.

Julianne,

I am a new reader, haven't posted anything until now, but just know that you aren't alone. I knew at a young age that I didn't want children, and that didn't sit well with some people. Once, when I met someone very special, I tried to convince myself that I could have a child and I'd be happy. But I was lying to myself. I was a big crying, nauseated mess, because deep down I knew it would be the worst choice I could make. After that episode, I decided that I would never allow others to dictate what I would do with my body.
You'll always have people who think they can force you into fitting their ideals, but listen to what your heart says, and always follow. Good luck.
PS sorry to "post and run," but it's midnite and I can barely keep my eyes open. But I will check back on this thread.

Thank you both.

What should i say to my family and friends - nothing's worked so far and the problems from my family really hurt. They are a lot more traditional (and conservative) than me which probably hasn't helped.

i had a friend in michigan who wanted a tubal ligation after having her first child. it was unplanned, and she hadn't wanted children in the first place. she and her boyfriend decided that they would embrace it. she asked to have a TL following delivery, since it would be a good time to do it. her doctor said no because she was too young. he told her in no uncertain terms, that he would not do any such thing until she had three children or was 35.

she gave birth to twins less than a year later. (she doesn't believe in abortion) she had been using HBC.

when i was stationed in monterey, california, my primary care manager (the doctor military people are assigned to for their care) recommended an non hormonal IUD to me, as HBC would complicate some other medical issues i was being treated for. the ob/gyn on board there refused me b/c i was unmarried, and b/c she said it went against her moral beliefs, even though it WAS RECOMMENDED BY MY DOCTOR! i was outraged. i had to wait until i pcs'ed to another location to get it done. (btw, i had cramps for two months, and since then, for the last year and a half, i have been fine! i LOVE my IUD.) all of this, and i already have a child, am in a mutually monogomous relationship, and we want to wait until one of us is out of the military to have more children, if we decide to do it at all. it was unheard of that i would want to have sex and not procreate. (oh the shame!) being a parent in the military is tough, i couldn't bear doing it w/ two.

the point to all my babble is that it is ridiculous to be denied health care, told what to do w/ our bodies, and looked down upon for our reproductive choices. personally it enrages me. the people who make these policies and laws have no regard for our health. even when i was told that HBC would be bad for my health, i was refused. my friend, turned away b/c she was too young w/ not enough children to decide. (apparently just b/c you are old enough to be a parent doesn't mean you are old enought to decide what to do w/ your own reproductive system) it is an outrage. what do we do to fight for our repro rights?
how do we convince them that our bodies are our own?

I've been thinking about this issue, and though this is kind of a joke answer, what about saying to the doctor "I am sick and don't trust myself with children". Wouldn't they then feel obligated to? Might work better for males though.

Also I'd like to know how well bribery works.

A couple of notes on IUDs:

My local PP changed their protocol for IUD insertion within the last six months. Previously, to be a candidate for an IUD, you had to have had at least one pregnancy carried to at least 20 weeks. It was the issue of the size of the uterus that formed that protocol. The new protocol states that the candidate simply has to understand that the IUD lasts X number of years and that your risk of contracting PID from an STD is higher with one in place. The only absolute qualifier is that your uterus be at least six centimeters deep, to fit the IUD.

If anybody's interested in placement, I would recommend contacting the Planned Parenthoods in your area. Protocols vary from clinic group to clinic group.

Also, for Oenophile: I can't find the citation at the moment, but I remember quite clearly reading new research from Europe about the mechanism of IUDs. Several studies found that women with either type of IUD in place (hormonal or copper) had no ova in their tubes (they used a lavage process to find this out, which is skeevy in itself). Further, the simple fact that you have something in your uterus seems to redirect your immune system locally so that it destroys sperm. The monthly fertilization-and-failure to implant scenario has lost ground as a hypothesis for IUD action.

I'm childfree by choice and in my late 30's. For a number of reasons, I didn't feel comfortable getting a tubal ligation or occlusion. I *love* my IUD, hard. Now that it's again available to nulliparous women in the US (as it has been in Europe and Canada for some time), I think we'll see a lot more women trying it out.

The good news is though evolution wants us for more than just reproduction.

Is there any legal action that can be taken on this? On one hand, it seems pretty clear-cut that a physician/surgeon saying that he or she just doesn't want to do the procedure has no legal standing and is discrimination. But then there also isn't any ground for patients simply being able to demand any procedure at all (I'm thinking of the disorder where people want to have limbs removed).

Also a fan of the Mirena IUD here. I looked into it a lot, and as Jo just wrote found that it really prevents conception rather than implantation based on the available studies.

It's not necessarily any easier for you after you've had kids if you haven't hit the magical 30. After my second, which included a lovely episode of PPS, I wanted my tubes tied/cut promptly.

The FEMALE doctor who was taking over the practice of my OB/GYN refused to do a tubal on anyone under 30, regardless of circumstance. I've never felt so betrayed. I was referred to another MALE doctor with no qualms about doing it.

Apparently wanting to kill your children just isn't enough of a reason to prevent childbearing for some people.

Julianne - there's a great community of supportive childfree folks (men and women) hanging out at http://www.wekidyounot.org. I've been a member of that community for several years and they're a great bunch - and extremely supportive and helpful.

Thank you Emma!

OK, I am probably going to get flamed for this but hear me out. Let me clarify up front that if a woman wants her tubes tied, she should have the right to have it done.

That said (here comes the possible flames), I spent about a year trying to find a Dr. to give me a tubal ligation when I was in my mid-20s. I was in a long-term relationship and we planned to get married. We were both perfectly content to be childless and were very focused on our future careers – I was starting law school the fall after graduation. I felt very sure that I was going to be a hard charging public defender with no time or desire for a fussy child and I was furious that none of my Drs would do the surgery.

1 year later the guy cheated on me and our relationship fell apart. I spent a few years traveling and decided I didn’t want to go back to law school, began working on my PhD in anthropology and indigenous human rights. Traveling and seeing the world made me reevaluate what I personally wanted out of life and I decided that, if I met the right man, I might actually want kids. Fast forward 6 more years, I’ve finished my degree, have a successful career doing what I love, and met the man I actually want to reproduce with and I am glad I didn’t have my tubes tied.

Obviously there are many, many women who never want kids. Most of my friends fall in that category and they are perfectly content to never reproduce. All I am saying is that it isn’t outside the realm of possibility that life will change you. I guess I’m just saying that I don’t think it is entirely unethical for a Dr to have a serious, challenging conversation with a young woman about getting her tubes tied.

That said, of course if she is sure, then she should have the right to control her own body. Just putting my story out there because I think it actually illustrates what some of these people are concerned about.

JulianneM---LiveJournal (http://www.livejournal.com) has interest-based communities, and several of them are childfree in nature---you can type "childfree" into the interest-search feature and you'll get a list of communities and users who also have that in their interests.

I am aware of one at http://community.livejournal.com/childfree and as I recall there are others.

What should i say to my family and friends - nothing's worked so far and the problems from my family really hurt.

Julianne, it breaks my heart to read this. I'm going to offer some advice, with the caveat that it may not be the right advice for you.

I think the first, and most important thing, to accept is that you can't change your family's and friends' minds. You've already told them that you don't want to have children, and for some reason, they won't accept that. You can't argue them into respecting your decisions. What you can do is refuse to entertain any more of those discussions. If the topic comes up, and you make some reference to your future life without kids, and they say something like "But you'll change your mind! How can you not want kids blah blah blah," what you can do is to say calmly "I've made up my mind about this, and it's not up for debate. Let's talk about something else." If they persist, give them one more warning, something like "I've said I don't want to talk about this with you," and if they don't stop, put an end to the conversation. Whatever you have to do--hang up the phone, leave the room, pull out a book and start reading--end the conversation. Part of what keeps these people going is that they get a reaction from you, and stopping that may be the only way to curtail their rude behavior.

It's hard to do, because it feels rude, and because family and friends can be so important, but they're the ones being rude, which you can point out to them if they get snitty ("How could you hang up on me like that! That was so rude!" (calmly) "I told you twice that I didn't want to debate my personal decisions, and you ignored me--that seems very rude to me.").

Family is one thing, but friends should be supporting your decisions. Better friends may be in order as well.

You know what really bothers me about this? Since I was 18, I knew I didn't want children. I'm in my early 30s and it hasn't changed for a moment. Yet otherwise perfectly liberal, logical, reasonable friends and family insist on telling me that my body will *make* me want children one of these days, it's just "biology," I won't be able to help it, and so I had better not be too hasty. In other words, it's not about changing our minds as if we are capable of rational decisions, it's about being a victim of our hormones and therefore unable to *make* rational decisions.

Sound familiar?

The argument I frequently hear is "what if your husband wants to have biological children"

My response would be "Do you think it's acceptable for him to force me to have children for him against my will?! What the hell is wrong with you?!"

"What if you met a man who wanted kids?"

Me: "Then having the tubal would help make him take me seriously about not wanting kids; it'd make sure he didn't assume that what I want will be discarded whenever it inconveniently conflicts with what he wants. There's a huge problem with people discarding women's desires to not have children" (hint hint) "and a man might mistakenly think I'm the right woman for him and will give him kids despite what I say, and assumptions like that will cause him a huge disappointment when it becomes apparent that I won't. A tubal he'd have to take seriously even if he wouldn't take me seriously." (Never mind, for the moment, that a man who doesn't take me seriously is automatically disqualified on that basis alone.)

http://community.livejournal.com/childfree_zone/

That one's even better. Just discovered it.

"We were both perfectly content to be childless..."

There is a huge difference with "being content to be childless" and being adamantly, seriously, and unwaveringly childfree.

That may be true, but her point was that she sought a TL, was denied, and then later in life changed her mind. The language she uses to identify herself doesn't actually affect her point.

The fact that she changed her mind, of course, should not be used to deny other women TLs.

Just wanted to add to the comments here...I am almost 23 and I get my birth control through the health department. I can't complain because I don't pay for it, but I was told they would refuse me an IUD because I haven't had a kid. They would give me one, for free, if I did have a baby. I can also get medical assistance if I have a baby. I am being penalized for being responsible. The POINT of an IUD is that I don't have a kid. I know the risks are slightly greater with women who haven't had children, but IUDs CAN be used even if you haven't given birth yet (the cervix just isn't as open). Planned Parenthood will give me one, for $300, which I cannot afford so for now I am a slave to hormone birth control, which I am not a fan of.
Why are we (as a country, as a world) still treating birth control, which is a health issue, as a luxury or something "extra" that women get if they have "benefits"? This should be a basic human right.

This is a comment on Clark-Flory claim about medical ethics.
It's absolutely true that physicians have to exercise ethical judgment in deciding what procedures to perform. Some procedures, for example, are so risky and their benefits so obscure that performing them would amount to bad medical practice. Also there are "treatments" that have no medical value whatsoever (such as giving antibiotics for a cold). And sometimes health professionals need to engage in medical decision-making about resource allocation: when there's 1 kidney available for transplant and 2 patients who need one, someone has to make a decision about who gets it. So, lots of opportunity for ethical decision-making.
But the age of medical paternalism is over. It's no longer supposed to be up to doctors to tell patients what's best for them, in terms of outcomes. (It happens, but it's not supposed to; there's no justification for it.) Adults are supposed to be allowed to choose: they're even allowed to make choices they end up regretting. Its up to doctors to make sure their patients are fully informed about risks (including psycho-social risks) and then to let patients choose from among the range of medically-responsible treatment options.

I'm 25 and a year ago my husband & I both got sterilized (he's a few months younger than I). I regret a surgery I had years ago (because I felt I was ill-informed about options) and so probably over-informed myself about this procedure. I went to a (new) OB-GYN (I'd been shopping around for one I liked) & said: This is what I want, I've looked at the options & I'm prepared to convince you that you need to do what I want. His response was basically, "you seem informed, sign here" (I'm white). My insurance paid for it.

I was prepared for the kinds of resistance noted above, but there are some doctors who respect their patient's right to be in charge of their own health care.

OTOH, the practical hand, I have lost track of the number of friends I have who have sworn up and down, over a period of many years, that they never wanted to breed, only to completely reverse their decision in their late twenties or early thirties.

But there's a difference between swearing you don't want kids (which I do) and saying you're SO sure you want a tubal (which I don't). I really believe that women who are confident enough in their feelings to request a tubal are probably far less likely to change their minds down the road than those who simply say they don't want kids.

Julianne, I second what EG said. In fact, I don't think you need to give them reasons at all. That is the approach that I took to my own family's pressure and they finally stopped when they realized that I would ignore the question, or get very hostile or walk away if they tried to talk to me about it.

If that doesn't work for you, though, and you're not averse to kids in general, another option that you might want to look into is getting involved with a kid that's already been born to someone else. For instance, you could become a Big Sister, or befriend a child in your neighborhood/at your church that could use a role model. Then, when your family brings up you having kids, you can tell them that you already have a kid in your life who you're like a parent to. This has worked pretty well for me with the more conservative members of my family. AND you'll be helping out a kid who needs you. :)

sunspots--

"...it's about being a victim of our hormones and therefore unable to *make* rational decisions.

Sound familiar?"

Absolutely. I've been hearing this argument for many things recently-- including making the excuse that "men can't help objectifying women", or in some cases, "men can't help groping women". The 'it's biology! I have no control!' excuse has never sat well with me, and it irritates me enormously when people attribute societally-trained behavior to "instinct", or when people think 'instincts' are incontrovertable.

sunspots--

"...it's about being a victim of our hormones and therefore unable to *make* rational decisions.

Sound familiar?"

Absolutely. I've been hearing this argument for many things recently-- including making the excuse that "men can't help objectifying women", or in some cases, "men can't help groping women". The 'it's biology! I have no control!' excuse never sat well with me, and it irritates me enormously when people attribute societally-trained behavior to "instinct", or when people think 'instincts' are incontrovertable.

I recently went through the process of trying to get sterilized via Essure (a non-surgical sterilization). I am 25 years old without children and for a while it was one of the biggest battles! I had several male doctors who told me that I would regret my decision and simply wouldn't listen to the reasons that I had behind wanting the procedure. These doctors didn't think I understood that the procedure was *permanent* which was hardly the case. They tried pushing IUDs on me which I had already tried and failed. Finally, I met with a female physician who *listened* to me and performed the procedure with no problems. I am now almost three weeks post the procedure and I am quite happy that I had it done. There are several studies that I brought to my consultations that state that the women with the least regret after sterilization are those *with* children. It is definitely a problem and for anyone trying to go through with a female sterilization procedure I definitely wish you luck, as it can, for the most part, be a difficult battle.

glad for you, lwbenner!

It seems a lot of doctors do not take women or their health issues seriously.

On the IUD issue (I have one, Mirena, love it) there are some legitimate reasons (other than higher risk of infection or doctor's inhibitions against it) that some women who haven't had children can't have it. The reason being is that the uterus has to be a certain minimum size to hold the IUD without the 'T' top of the IUD puncturing the uterus and about half of women who have not had children do not have a uterus large enough to hold it.

Before I got mine (I was 22 at the time, am 25 now), they had to measure my uterus. If you haven't had this done, it is one of the most awful things that can ever happen. Nothing like having your cervix pinched and clamped open and then having a mini-expanding ruler shoved into your uterus. Ouch. I can't remember the minimum size it needed to be, but I was *just* big enough.

Despite how awful it was to get it put in, I haven't regretted it for a minute.

As far as the tubal ligation thing, whether or not someone would change their mind or whatknot, I agree with a comment above (sorry, I can't find it now to quote it) but how those who say they dont want kids but never really seek out permanent methods and then end up wanting kids and those actively seeking out permanent methods, there is a big difference. I know I say I don't want kids of my own (I just don't want to be pregnant), there is enough of a 'what if' nag in the back of my head that keeps me from seeking out more permanent methods of birth control. One of those, actions speak louder than words. Doing, versus just talking about it.

"Dr. Wiener finds no good reason for putting otherwise healthy patients in surgery: for one, there are anesthetic risks involved. Plus, tubal ligations are considered elective surgeries"

And yet young woman requesting breast enhancement surgery are rarely turned away.

I'm reading this discussion, and I have to wonder: How much of these doctors' resistance comes from a genuine (albeit fucked up and paternalistic) concern for their patients, and how much of it is simply that they're afraid of getting sued?

Not that this would make their attitude justified. But when I hear a litany of "We don't want to do this procedure because you might change your mind and regret it," I have to wonder if that translates to, ""You might change your mind and take me to court over it." (I'm not sure that fear would be justified, but doctor's fear of getting sued can be irrational to the point of hysteria.)

And I think Deborah's analogy is dead-on. How many people (women and men) who get cosmetic surgery regret it?

radicaldoula's point about women of color reminds me of a documentary about forced sterilization in Puerto Rico called "La Operacion." What's striking about it is how the doctors in both cases of sterilization (forced and denied) held women in contempt by not giving them the information to make their own decisions. This is no surprise to feminists. Forced/denied sterilization really is the perfect example of racism, classism, and sexism all rolled in to one.

This also involves a bit of heterosexism! If a doctor told me "you might want to have kids some day with your husband," I would say "Ok, then, well my GIRLFRIEND could have the kid. She's all kinds of fertile. Just not me. So give me the damn surgery." Some would say that lesbians don't need BC anyway, but that's not the point. The point is: doctors shouldn't assume to know what's best for me. Plus, if I want to know what my future self will say about my fertility, I'll go to a goddamn psychic, not a patronizing doctor.

At 25, I'm extremely ambivalent about having children. My partner is 100% sure that children would fuck up our relationship and our careers.

This choice is viewed skeptically by the parent people. My best friend, while pregnant with her first child, got very angry about our reluctance to have children. When I mentioned that I could see myself adopting, she took it as an insult to all the labor she was going through to carry the child. Then she called me selfish and vain because adoption means that "you don't want to get fat." Really! But this is how women have been taught to criticize one another's choices. It's dangerous when women can't respect one another. Thus, we get caught up in this hypercompetitive drive to live out the shit that's been fed to us from the day we got our first babydoll: women who don't carry babies in their uteruses and push them out through their vaginas ARE NOT REAL WOMEN.

The honest to god truth is that my partner and I agree that we are both scared of caring for something that can't go to the bathroom on its own. Let me ask the group: Is it weird to prefer children that are at a certain age? I think I would hate a baby but would love a five year old. I'm scared of the idea of carrying and feeding something that can't talk to me.

For Meg, above; No, I don't think there's anything weird at all about preferring kids of one age to kids at another. I do *great* with newborns, especially preemies...but past the age when they're immobile, I don't do so well until they're rational, say age 8 or so. For me it's an issue of control: I made a fantastic pregnant woman (aside from the feeling that I'd chew my leg off rather than continue to be pregnant) and I'm endlessly patient with people who can't feed or toilet themselves.

It's no shock I'm working primarily with people who have brain injuries now. Heh.

In reference to a comment above, I have a real problem with discriminating between Childfree women who choose permanent methods and Childfree women who are committed to being CF, but who don't want sterilization.

Years ago, on Turtle's page, there was a commenter who accused any woman who hadn't had a tubal of being a "breeder in disguise" or a "breeder apologist". I find serious problems with drawing that sort of line; it's a lot like saying "If you don't like X or Y, then you're not a *real* feminist".

I *still* don't have a permanent method of contraception (IUDs are considered reversible), and yet, given my family history, it would take a donkey and a stable in Bethlehem for me to get pregnant at 38. I don't consider myself any less Childfree because I've eschewed permanent methods up to this point; the fact is that non-permanent methods, combined with the reasonable certainty of finding an abortion provider (even if the procedure became illegal) worked fine for me for twenty years.

My point here is that setting benchmarks for Childfree people is just as damaging as setting benchmarks for those who are feminist, or African-American, or Gay, or Lesbian. Every benchmark we set denies somebody's life experience and denies that person the ability to speak their truth without fear of judgement. There are as many different experiences of Childfree as there are people who are CF; I don't like culling the herd by saying "There's a big difference between those who say they don't want kids but never seek out permanent methods, and those who get sterilized."

Mom would do things like buy me baby dolls etc when i was little - i also got pushed into babysitting which i didnt really want to do - my heart doesn't melt if there's a tiny baby in my arms etc.

both her and my grandmother and aunts are none too subtle about how they see my future - mother and wife of course.

I just feel terribly alone and not sure what to do.

You're not really alone - thanks to the wonders of the internet, there are dozens of women who are telling you that they feel the same way. :)

Hug?

I'm traditional and conservative. I believe that part and parcel of personal responsibility is raising children only when you are prepared to do so. Far as I'm concerned, women who don't want kids aren't prepared to raise them - not through some deficiency.

I'm also all about huge extended families. Point out that you'll be a good sister, aunt, and godmother, and your nieces and nephews will benefit from the extra attention.

When in doubt, try some sarcasm: "Good thing you think I'll change my mind, because [insert loser's name here] and I had sex, and my period is three weeks late. We are SOOO excited."

It's dehumanising when people pretend to know your own mind better than you know it yourself. Consider how insecure they must be to go off on you like that. People who are secure in their desire to have children - who just want it - recognise when other people feel differently. They also recognise that someone who doesn't want kids is going to be a crappy mom, and having kids out of social pressure is plain selfish. If your family is pushing you to be selfish, recognise it for what it is and tell them to shove off.

oenophile why are we treated as abnormal for wanting to be child-free.

The craziest thing I've been told is how I'm "destined" to be a mother because my body is biologically created for motherhood - how my breasts are designed for nursing and 1 person talked about my " perfect child bearing hips".

I'm crying and i wish someone could hug me that's for sure.

Julianne, that is one of the most obnoxious fucking things I have ever heard--no wonder you feel horrible. I suppose those same people would look at me and decide that I shouldn't be a mother because I have small breasts and slim hips. Language like that reduces us to the level of animals, and can make a person feel betrayed by her own body.

But your body is you, and it is yours, and it is designed to do that which makes you happy. Having children or not isn't about measuring your hips--it's about the desire of your heart, and if the desire of your heart is to live your life without becoming a mother, that is a lovely desire, with much to recommend it.

Do you know what Miss Manners's advice is for dealing with unwanted/intrusive/rude questions or comments? She says that one should remain calm, look the offending person in the eye and say "Why would you say that to me?" or "Why does this matter to you?" or "Why do you want to know?" (if they're asking you a question) The technique is elaborated on the bottom of this page.

That doesn't help with how hurtful these comments can be coming from someone you care about, but practicing it might be a way to discourage the commenters.

Man this kind of shit makes me angry. I decided I wanted an IUD, booked it, changed my mind at the time and went with depo. At no time was I pressured either way, just given time and information from a professional

EG is there is any way to contact you off-blog - i would really like to keep talking to you. Sorry, just so alone.

Julianne, I'd be happy to talk more. The only real problem is that I stay anonymous on feministing for professional reasons...on the one hand, I don't really think that my employers and my students are scouring random blogs to track me down; on the other, I don't want to be wrong about that, either! My email address contains my real name, so I'd rather not post it. Is there perhaps a way I could email you?

julianne.rose.mcnamara (at) hotmail.com

Julianne M, basta, ça suffit. This is a blog where we talk about matters of general interest, not about ourselves as individuals in need of help. Several people have directed you to online communities where you can connect with the childfree, and all you do is keep whimpering about how alone you are. I feel sorry for you, but you're hijacking the thread and you need to stop.

I realize this isn't the popular opinion, but the doctor isn't just a service person. They have rights too, one of which is to choose not to do a risky procedure--risky in that there's a good chance the patient might change her mind later, and may decide to sue the doctor. It happens. More than you might think. Also, it's not as if the doctors are condemning these young women to a lifetime of babymaking. Although it's getting more and more problematical, this is still a country where, if you don't want to be a mother, you don't have to be. Don't want to be a mother? OK, don't be. That doesn't mean a doctor must perform a tubal litigation on you if you ask. You may know your own mind that you never have and will never want children, but the doctor can't read your mind. He or she doesn't know if you're going to change your mind in five years or not. The choice is do the operations, or...let you live like pretty much everyone else. Not a difficult choice, for the doctor. And as someone who is 40, not 22, I've seen so many of my friends change their minds, their lives, turn into completely different people than they were when we graduated from college. I've changed my own life path several times. It does happen, is the point. I'm not saying that everyone will change their minds and want babies someday even if they vow they don't at 22--but some will, and no one can tell who they are. So, you're stuck using contraceptives. Big deal. If you can't use them for various reasons, or have medical reasons why you don't want to be pregnant, ever, and want a tubal ligation, that's a different issue than the average woman who can use BC. No woman should be denied sterilization for paternalistic reasons, but some posters seem to think that there aren't any other possible reasons. And I don't think that's true.

Julianne, mental hugs to you. There's been lots of great advice here on the thread that I hope will help you find solace.

To all the great people here @ Feministing: Thanks for the info and POVs provided in this thread and all the others. Sometimes I feel like the only CF in my area, so I'm thrilled to have come across this post. I'm a noob here but I am totally digging this site!

I realize this isn't the popular opinion, but the doctor isn't just a service person. They have rights too, one of which is to choose not to do a risky procedure--risky in that there's a good chance the patient might change her mind later, and may decide to sue the doctor. It happens. More than you might think.

Outside of the huge blitz of "litigation explosion" propaganda coming from the insurance industry and their lawyers, this simply isn't true. Injury suits of any kind — malpractise or otherwise — are actually quite rare, especially compared to the incidence of actual malpractise. Most people simply don't file claims because the system is slow, expensive, and uncertain.

As for a woman changing her mind and suing a doctor for malpractise, this is simply unrealistic. Assuming that a lawyer on contingency (the usual case of the plaintiff's lawyer) would be willing to go out of pocket on a case like this, unless the doctor failed to provide full and accurate disclosure of the risks, benefits, and possible complications of the procedure before obtaining the patient's consent for the procedure(informed consent) and an independent physician were willing to sign an affidavit saying that the treatment provided was below the standard of care applicable to the profession (a requirement for filing now in many jurisdictions). Of course, the complications the surgeon failed to inform the patient of would have to actually occur.

Barring that — or a simply incompetent job of performing the procedure — there would be no case and the matter would be quickly dismissed, assuming that a lawyer was willing to go out of pocket on it and able to find a local physician willing to go on the record against a colleague.

You simply can't get in court by saying that you had a procedure done that had the desired effect, and now you just don't want it anymore. That's what Rule 11 is for.

On the other hand, there is the possibility (admittedly remote, given conventional attitudes) that a physician could be sued for refusing to perform a procedure on a patient for ideological reasons and without a valid medical justification. There is no justification in medical ethics for substituting one's own judgment for that of a mentally competent, adult patient.

You simply can't get in court by saying that you had a procedure done that had the desired effect, and now you just don't want it anymore. That's what Rule 11 is for.

Agree, with a few caveats.

The patient could claim that she was unaware of the fact that it could not be surgically reversed. She could claim that the side effects from it (I read something about post-tubal ligation syndrome - apparently, if done improperly, it can cause severe cramping and bleedidng) were unnecessary.

The question is not whether an objective judge and/or jury would rule for the doctor; the question is whether or not it is worth it to be in front of a judge or a jury.

It is rational to recognise that people (both potential litigants and fact-finders) are irrational, and that their irrationality has a cost.

Quite a few commenters have mentioned practitioners' fear of lawsuits as a reason why they might refuse women sterilization. Does anyone know the legal relevance of this fear, and why it should bear so much more weight in this situation rather than in all the other 'elective' surgical procedures other doctors perform? Do other doctors get constantly hit by all these lawsuits too? And if so, how do any of them stay in business? Methinks there's (pretty obviously)some extra focus given to female sterilization simply due to sexist, heteronormative bigotry in the world.

I don't understand how a person that proves to be competent and well-informed about the procedure can turn around later and sue simply because they 'changed their mind', unless a)they truly believed they were misled or mistreated in some relevant medical way, which would nix the "competent, informed" part...or b)they believed that doctors should never be allowed to perform permanent procedures upon patients that might EVER change their mind later down the road(which is everyone, really). The latter would require either for the doctors to have mind-reading and future-foretelling powers, or for them to never operate on anyone, ever.

I'm childfree myself and am looking into getting the procedure done(if I can find someone willing to perform it), but despite the fact that I am as sure about this as I am about anything in the world, I still accept the quantum possibility that I could hypothetically have a change of heart later (mind you, this is about as likely as pink unicorns materializing out of nowhere and electing me their Mighty Overlord). Even so, that's not enough to deter my insistence upon sterlization being the best fit for me.

If I suddently wanted to act all nurturing to a kid, there are a thousand and one different ways to get those needs met without resorting to birthing a child of my own.

And if, even after all that...I was still for some reason devastated about my inability to conceive, I'd hopefully still have the sanity left to realize that said devastation was the result of my own free will.

I don't see how any of these hypothetical situations should be blamed upon the doctor performing the procedure.

I also don't understand why women don't get the third degree regarding the choice to *have* children just as equally hard, since having children is no less permanent, life-changing and irreversible as sterilization. Even if they give the child up for adoption...they've still been pregnant, gestated the fetus and given birth. Not to mention the negative stigma given to women that do 'give up' their children.

Elise, you obviously read my mind and simultaneously answered my question as I was typing it. Thanks!

The question is not whether an objective judge and/or jury would rule for the doctor; the question is whether or not it is worth it to be in front of a judge or a jury.

The real question is whether a physician would be willing to go on the record and swear out an affidavit asserting that a colleague from the same area acted unprofessionally. Doctors are generally quite reluctant to side with patients against colleagues. And without that signed, sworn statement, no judge or jury ever has to make a decision on the merits of the case in many jurisdictions. Malpractise cases are notoriously hard to win.

"Malpractise cases are notoriously hard to win."

It's true, but when you win a malpractice case, you can win big, sometimes millions of dollars. Many physicians prefer to just do an out of court settlement just to avoid the prospect of paying some ridiculously huge sum. It doesn't matter how hard it is to win a malpractice case when you can force an out of court settlement.

I don't know everything there is to know about this issue so I might be wrong (or Time might be wrong, where I read about this a few years ago).

I don't know everything there is to know about this issue so I might be wrong (or Time might be wrong, where I read about this a few years ago).

I wouldn't be all that surprised if Time was wrong about it. A few years ago, when this topic was really hot, there was a lot of disinformation floating around about the supposed "explosion of frivolous litigation", mostly propagated by lobbying groups for the insurance industry. One of the most popular ones was the notion that something like 18 million "lawsuits" were filed every year. This was based on a misrepresentation of Bureau of Justice Statistics figures for all court activity, including criminal matters, divorce and domestic relations matters, traffic tickets, and all sorts of things completely unrelated to the sort of litigation (tort suits) that was being attacked. Doctors in particular have been subjected to a propaganda campaign that equals (or perhaps dwarfs) the attempts to get us shaking in our boots over the Iraqi Menace.

The fact is that these suits are rare, and when they are brought, it's a really clear case. Lawyers taking a contingency have no incentive to take on cases that aren't likely to win, since they end up out of pocket on the substantial expenses involved in getting the initial affidavit, securing expert witnesses willing to testify (who usually are on an exorbitant hourly fee), and the number of hours involved in dealing with all of the delaying tactics used by malpractise insurers.

Ralph Nader and Wesley Smith wrote an excellent book a few years ago, called No Contest, debunking the oft-creative myths of the "tort reform" movement. I'd recommend it to anyone who is interested in the realities of the situation (there is an excellent chapter dedicated specifically to malpractise suits).

Thanks for posting Elise, looks like you are right. Here's a link you might find interesting: http://www.slate.com/id/2145400/

Seems like there is no huge malpractice crisis.

I don't think this is a sexist thing. Doctors are pretty hesitant to give vasectomies to men under 30 years old for the same reasons.

Part of this makes sense to me. It's not hard to imagine an occasional case of someone sterilizing themselves and later regretting it. I would simply hope that doctors would have the ability to listen to a patient's reasoning and desire and being open to accepting that some 22 year-olds have sufficiently thought about the issue and are in a good place to make this decision.

"Part of this makes sense to me. It's not hard to imagine an occasional case of someone sterilizing themselves and later regretting it."

Ok, but if someone ends regretting it, that is what they have to live with. Yeah, that may sound harsh, but if the doctor made sure that the man or woman requesting sterilization had all of the information about risks and the possibility of regretting it, then that is a decision that they will have to live with.

I have given this a lot of thought since reading it. . .and I think that maybe one of the reasons Doctors refuse to perform the surgery before a patient is 30 or has other kids, is because they are trying to cover their butts in case someone who was young and got the surgery decides 10 years later that they do want kids and then sue the doctor for doing the surgery so young. I know that there are those that do not want children and are sure of that...but we live in such a law suit-crazy world that everyone is just trying to cover their butts.

Elise is absolutely right--there's never been a successful lawsuit against a doc by a competent young woman who got sterilized at her behest and later regretted it. People have mentioned cosmetic surgery as something a person might regret: I'd also mention teens and young women giving up their babies for adoption. That's a permanent loss, and there is a HUGE amount of evidence that this relinquishment is likely to cause distress and other bad effects, but I've never heard of anyone saying that a teenager should not be allowed to surrender her baby because she might regret her choice later and it's irrevocable.

OK, a question for you rare folks (YouCanToo,I'm looking at you!) who managed to find a doctor willing to offer permanent birth control with less haggling than usual...

Who are they, and where do they practice?

I'm sure many women would like to do business with a doctor who would actually treat them as something other than a toddler with a growth hormone problem.

I'm really torn on this. I agree in principal that it shouldn't be denied to someone who wants it. I've been toying with the idea myself as I definitely do not want biological children (I'm 25). However the one thing that's put me off is the experience of a family friend. Due to abuse she was adamant she didn't want kids and had her tubes tied in her early 20's (I'm in the UK so she only had a bit of difficulty finding a dr). However by her mid 30s had decided she wanted a child after all, she went through the reversal and eventually managed to have a baby. However since then in attempting to have another one she's had a number of ectopic pregnancies and has nearly died. In the end she's lost her fallopian tubes due to the scarring. The think to remember is that it's major surgery and I totally understand why people want it, I am terrifed of getting pregnant but after seeing everything that happened to my friend I've decided to stick with chemicals and make it more permanent in my 30s, just incase.

Answering Genetic_Mishap's query, The Hampton Roads VA Planned Parenthood has a great group of OB/GYNs, and I've had nothing but respectful, informative visits with them for all sorts of issues,including my own sterilization(Essure) at 26.

I realize I'm in the minority here, but I'm actually not sure this is a terrible thing.

I would not trust a 21 or 22 yr old to make such a huge decision regarding the rest of his/her life. Each of us remembers things we held to be so important and self-evident at that age that we now laugh at. Biologically speaking, the decision-making part of your brain doesn't even fully develop until age 25.

And, like some others I've seen on here, the one woman I've known who swore she'd never had kinds, later got pregnant by accident and now LOVES being a mom and is frustrated that she can't find a husband to have more children with (she also does not have the means to adopt on her own).

I know there are women who don't want children, and who will never change their minds. But tubal ligation is not the only option. As someone else mentioned, there's options like the IUD that you don't even have to think about once it's inserted. I think a better solution to this debate is to make birth control more available and less expensive so that it's not such a drag and inconvenience for these women who use it continually for years.

I would not trust a 21 or 22 yr old to make such a huge decision regarding the rest of his/her life.

Then, as others have pointed out before, how come it's perfectly ok for allegedly "immature" 21-year-olds to decide to have elective breast augmentation surgery, rhinoplasty, etc? The consequences can be equally devastating, yet plenty of cosmetic surgeons seem perfectly happy slicing up 20 or even 18-year-olds. (Actually, I think I've even seen younger girls undergoing plastic surgery in documentaries, but I don't have any data about that...).
Making birth control more readily available is a great idea anyway, but don't forget that there are plenty of women who have a hard time finding a birth control method that's ok for them. So why should they go through all that trouble if they're quite sure they don't even want kids at all.
I know I'm repeating some of the points already made earlier, but if a 20-year-old shows up pregnant at an OB-GYN's practice, I don't think she's going to get a lecture on how much it's going to change her life, even though childbirth is a more irreversible decision than sterilization (which CAN be reversed - besides, if you really change your mind, you can still adopt, which so many people seem to forget).

I would not trust a 21 or 22 yr old to make such a huge decision regarding the rest of his/her life.

Then, as others have pointed out before, how come it's perfectly ok for allegedly "immature" 21-year-olds to decide to have elective breast augmentation surgery, rhinoplasty, etc? The consequences can be equally devastating, yet plenty of cosmetic surgeons seem perfectly happy slicing up 20 or even 18-year-olds. (Actually, I think I've even seen younger girls undergoing plastic surgery in documentaries, but I don't have any data about that...).
Making birth control more readily available is a great idea anyway, but don't forget that there are plenty of women who have a hard time finding a birth control method that's ok for them. So why should they go through all that trouble if they're quite sure they don't even want kids at all.
I know I'm repeating some of the points already made earlier, but if a 20-year-old shows up pregnant at an OB-GYN's practice, I don't think she's going to get a lecture on how much it's going to change her life, even though childbirth is a more irreversible decision than sterilization (which CAN be reversed - besides, if you really change your mind, you can still adopt, which so many people seem to forget).
We make mistakes all the time, does it mean that we should be forbidden to take ANY life-altering decision before, say, the age of 30? Sounds a lot like dictatorship to me...

I know there are women who don't want children, and who will never change their minds.

Like myself. I'm 33, have been in a great relationship for over 10 years and I don't see why I'd change my mind. Yet, I was already absolutely adamant I'd never have kids from the age of 9 onwards and I got my fair share of "oh you'll change your mind later". I don't care if "some women" change their minds, I hate patronizing attitudes. Most marriages end up in divorces, does it mean no-one should ever marry before turning 30 because "you'll probably change your mind later"?
Of course not. The problem here is not about preventing people to make mistakes (however patronizing it is), it's about women refusing their "natural roles" as mothers.

Little late to the party on this one, aren't I?

Marcy, don't be so patronizing. Young doesn't necessarily mean stupid (although the two can certainly coincide). Some women change their minds. Some don't. But the fact of the matter is that a woman in her early twenties is still a competant, rational adult. She should be, in fact must be allowed to make her own decisions. If she makes mistakes, so be it. But it is not up to doctors and our society to "protect us from ourselves." We need to be treated like the fully autonomous adults we are.

I started asking for a tubal when I was twenty. I finally got one when I was twenty-seven. Seven straight years of yearly (sometimes twice or thrice yearly, if I happened to be in for something else) conversations about my lack of desire to have children.

My doctor had told me to keep asking him over time, so he'd know I was really serious.

Finally, I brought my mother in (she's a smashing negotiator and can be kind of scary when she wants to be). She and I tag-teamed him with reminders about my ectopic pregnancy (more likely to have another), my biologically-based medical issues, my distaste for children and the very idea of pregnancy, and my general unsuitability for motherhood. We asked him if he would rather I were in asking about an abortion than a tubal ligation.

Finally, after about fifteen minutes of this, he broke down and agreed. Two weeks later it was done. Easiest thing in the world, and I'm so very glad.

On the other hand, my ex-husband went in when he was twenty-five, asked for a vascectomy, and received one a month later (they were heavily booked on appointments). No hassle, no fuss, no problem. *sigh*

My best friend had to wait until she was thirty + before they would 'allow' her to get a tubal. She has a genetic disease that is 100% passed on and didn't want to bring a child into the world with the burden she already faced.

It took her having a heart attack at 30 before her doctors agreed she shouldn't have children.

I find myself in the rather uncomfortable situation of discovering, after years of horror at the idea of children, that I may at some point want some myself. I'm 33, and have said for years that I didn't want kids, while older women said to me 'Oh, you'll change your mind...oh, you'd be such a great mom...you'll feel differently about kids when they are your own' etc. I've gone off on a few of them, using some of the arguments above.

Now, my sister has a baby, and I'm thinking...'hey, that's kind of awesome' and worse 'I can totally see why some moms want to stay at home-it may not be intellectually fulfilling, but damn, it's fun to watch babies grow!'

So, it turns out the other women were right when they said 'you'll feel differently when it's your own' even if 'my own' in this case means 'my own family' and not 'my own child'. I'm not saying I'm going to have kids, but if I were in a stable relationship, I would consider it.

My point is that while many of the doctor stories above are dreadful, 'what if you change your mind?' is a perfectly reasonable question. So is 'what if your future spouse wants kids?': not because you should bow to their wishes, but because it could be a factor in you changing your mind. It's your doctor's job to go through all these 'what-ifs' with you.

That said, it unconscionable for a doctor to substitute his or her judgement for yours, unless you are actually mentally incompetent.

I wonder, since these doctors seem to equate being female with mental incompetence, if women become competent after hysterectemies? Since being female is all about reproducing, obviously, does the inability to reproduce mean you're not really a woman anymore, and therefor can be considered mentally competent? (for the irony impaired-the above is intended ironically)

Been there and did that. At age 21, back in the 1970s, it took a little while to find a clinic willing to give me a vasectomy and even at the women's clinic that finally said yes it took a little talking to before they were sure I was making an informed decision.

Fast forward 20-some years and, as I had prepared for at 21, I met someone and we decided we might like to have children after all. And so, again as I decided back at age 21, we explored a vasectomy reversal with adoption (which costs about the same) as a backup. The reversal worked like a charm and, days after our second child was born, another 15-minute stitchless vasectomy undid all the previous surgeon's hard work.

But if the reversal hadn't worked adoption would have been acceptable to both of us.

Bottom line: if there was no such thing as medical progress in vasectomy or tubal-ligation reversal and egg extraction and IVF, if there was no such thing as adoption, if there was such a thing as 100% cold evidence that virtually all who with their eyes open are sterilized at an early age regretted it (I don't know any who have though I'm sure *some* do somewhere) then yeah, maybe it would be ok to decline to perform voluntary sterilization on young people. But I just don't think that's the case.

Oh yeah, one more thing if it hasn't been mentioned yet. Tubal ligation really is a far more intrusive procedure than men's vasectomies but that's not the standard of comparison. Instead how does it compare to, say, breast or cheek implants, nose jobs, labiaplasty, and other voluntary procedures cheerfully undertaken by surgeons. (I really don't know, even relatively minor abdominal surgery really could be that much riskier than "superficial" plastic surgery. But if not then these guys really don't have a leg to stand on.)

figleaf

I think a better solution to this debate is to make birth control more available and less expensive so that it's not such a drag and inconvenience for these women who use it continually for years.

Riiiight. Again, what if you find IUDs to be morally questionable? What if the Pill makes you depressed? What if you are prone to blood clots? What if you just plain don't want those hormones running around your body for your ENTIRE LIFE?

What if, like me, you are opposed to abortion? I would prefer to regret sterlisation than to have an unplanned pregnancy. THAT is the standard we should be using: comparing the relative harms from each course of action.

My point is that while many of the doctor stories above are dreadful, 'what if you change your mind?' is a perfectly reasonable question. So is 'what if your future spouse wants kids?': not because you should bow to their wishes, but because it could be a factor in you changing your mind. It's your doctor's job to go through all these 'what-ifs' with you.

Nobody said they couldn't or shouldn't ASK these questions. The problem is that even after painstakingly replying to all these questions, most young women are STILL denied this procedure. Once again, what's the big difference between sterilization and any other elective surgery? MY body, MY choice. And if my choice turns out to be the bad one, it's MY problem. We all make mistakes in our lives and we have to deal with the consequences. What's so particularly horrendous about that particular mistake? It's much more reversible than deciding to have a child and then realizing it wasn't such a good idea after all once it's born. And I'm really offended by people who assume that because so-and-so changed her mind, it means that all the "well-meaning" people who say you MUST want to have kids some day are not really wrong or not really intrusive. I don't give a damn how many women do it without being 100% sure or weighing in all the pros and cons, I know my mind well enough, thank you very much.

Again, what if you find IUDs to be morally questionable? What if the Pill makes you depressed? What if you are prone to blood clots? What if you just plain don't want those hormones running around your body for your ENTIRE LIFE?

Not to mention the fact that some doctors will refuse to fit a woman who has never had a child with an IUD. Their cervixes are often too narrow, which makes it more painful/harder to insert it.

Also -- the decision making portion of your brain isn't fully developed until you're 25? I'm a bit late coming into this, but whoever said that should really cite their sources. Cause I'm not buying it.

I can't take hormonal birth control because I am prone to blood clots. That stuff already landed me in the hospital once during college. I would also be quite likely to develop a blood clot during any pregnancy. Definitely not a risk I'm willing to take for a child my husband and I do not want. I don't want a tubal -- it's wise for me to avoid unecessary surgery with my clotting issues. But Essure would be great, if only I could find a doctor who would perform it.

Even with my medical issues, doctors still treat me is if one day I will throw caution to the wind in order to breed. I really don't understand that mindset. :(

the decision making portion of your brain isn't fully developed until you're 25?

And yet we allow 22-year-old women can join the army, vote, get married, and have children. Amazingly, the world has not imploded. Yet.

While it is always frustrating to have to prove or convince a health care provider that you want or need a given procedure or type of car, I honestly, and I say this as a logical human being, don't believe this is a sexist issue. The surgery is permanent, and there are women who for various reasons attempt later to have it reversed with varying, but disappointing levels of success. A conscientious doctor will always want to be certain that his patient knows and understands what he or she is doing, and I don't think they're being paternalistic or sexist.

It's a decision which can't be made lightly, and a given doctor is not going to have the psychic powers necessary to know whether his or her patient understands the gravity of their choice. They can only act according to habit and conscience.

However, I find the racial argument infinitely more convincing. If there were ever an abuse of medical authority, this would one of the worst. The whole point of this issue is to reinforce a woman's physical and personal sovereignty, and I can't help but admit that it seems that it appears to be neglected for reasons I wish I didn't understand.

So what should the age of consent be for sterilization? The same as the age for getting an abortion without parental consent?

I've got my doubts about whether that should be the case.

With regard to the subject of IUDs being abortifacient; recent research quoted by the World Health Organisation and Family Health International - http://www.fhi.org/en/RH/Pubs/factsheets/mechact.htm - are agreed that IUDs are not primarily abortifacient. In studies in which ova were retrieved from the fallopian tubes and uterus of women with various IUD types, and a control group without, only a very small number of the IUD group's ova showed any signs of fertilisation. Studies measuring levels of HCG in the blood repeated the finding that fertilisation does not occur, due to the effect of the IUD's copper wire on both sperm and egg. Sorry to post on just this one issue, but it does bother me to see the supposed morality of IUDs questioned, when recent reputable studies are agreed that their action is not primarily abortifacient, a outdated claim which removes yet another contraceptive option for many women.

Thank you so much for bringing attention to this issue. I'm 24, and I've known with absolute certainty for over a decade that I absolutely do not want children ever. There are very few other things I can I have *consistently* known throughout that time; my love for my brother and my faith in God (though not a particular religion) are literally the ONLY other things that come to mind.

And yet, no doctor will perform surgery on me. Adding to my irritation, when I've mentioned my intentions to other friends, boyfriends, my family, etc., they belittle the strength of my conviction: I'm too young, I'll change my mind, too immature, don't know what I really want yet, I'll regret it.

I have a resume full of honors, a salary and job to envy, involvement in sports and my community -- and yet, apparently my life will remain unfulfilled until I have kids.

I don't judge other people's choices, but I don't see why I should have to wait another 6 years until permanently fixing this is an option for me. It has frustrated both my committed relationships and the more casual sexual adventures that I'd like to have. Frankly, it's not fair.

I casually stumbled across the post, and I feel compelled to add my own thoughts to emphasize that there *are* women out there, even at a young age, who know that their life goals do not include kids. This IS a feminist issue. And it should be a pro-life issue... you want to stop unwanted pregancies, how about allowing me to prevent it from happening in the first place?

To other young women who feel the same: please, speak up about your feelings! I have made no secret about my position on this issue, despite the inevitable condescending, disappointed, or critical reactions from the listener. The more vocal we are, the less isolated we'll feel.

Thank you so much for bringing attention to this issue. I'm 24, and I've known with absolute certainty for over a decade that I absolutely do not want children ever. There are very few other things I can I have *consistently* known throughout that time; my love for my brother and my faith in God (though not a particular religion) are literally the ONLY other things that come to mind.

And yet, no doctor will perform surgery on me. Adding to my irritation, when I've mentioned my intentions to other friends, boyfriends, my family, etc., they belittle the strength of my conviction: I'm too young, I'll change my mind, too immature, don't know what I really want yet, I'll regret it.

I have a resume full of honors, a salary and job to envy, involvement in sports and my community -- and yet, apparently my life will remain unfulfilled until I have kids.

I don't judge other people's choices, but I don't see why I should have to wait another 6 years until permanently fixing this is an option for me. It has frustrated both my committed relationships and the more casual sexual adventures that I'd like to have. Frankly, it's not fair.

I casually stumbled across the post, and I feel compelled to add my own thoughts to emphasize that there *are* women out there, even at a young age, who know that their life goals do not include kids. This IS a feminist issue. And it should be a pro-life issue... you want to stop unwanted pregancies, how about allowing me to prevent it from happening in the first place?

To other young women who feel the same: please, speak up about your feelings! I have made no secret about my position on this issue, despite the inevitable condescending, disappointed, or critical reactions from the listener. The more vocal we are, the less isolated we'll feel.

Thank you so much for bringing attention to this issue. I'm 24, and I've known with absolute certainty for over a decade that I absolutely do not want children ever. There are very few other things I can I have *consistently* known throughout that time; my love for my brother and my faith in God (though not a particular religion) are literally the ONLY other things that come to mind.

And yet, no doctor will perform surgery on me. Adding to my irritation, when I've mentioned my intentions to other friends, boyfriends, my family, etc., they belittle the strength of my conviction: I'm too young, I'll change my mind, too immature, don't know what I really want yet, I'll regret it.

I have a resume full of honors, a salary and job to envy, involvement in sports and my community -- and yet, apparently my life will remain unfulfilled until I have kids.

I don't judge other people's choices, but I don't see why I should have to wait another 6 years until permanently fixing this is an option for me. It has frustrated both my committed relationships and the more casual sexual adventures that I'd like to have. Frankly, it's not fair.

I casually stumbled across the post, and I feel compelled to add my own thoughts to emphasize that there *are* women out there, even at a young age, who know that their life goals do not include kids. This IS a feminist issue. And it should be a pro-life issue... you want to stop unwanted pregancies, how about allowing me to prevent it from happening in the first place?

To other young women who feel the same: please, speak up about your feelings! I have made no secret about my position on this issue, despite the inevitable condescending, disappointed, or critical reactions from the listener. The more vocal we are, the less isolated we'll feel.

I have to weigh in from a different perspective. Some women who choose to have their tubes will change their minds. And that procedure is expensive. And they will sue their doctor who did the initial procedure, and now the doctor is out several thousand dollars and a few days of work, at best.

Doctors have a right to turn down risky procedures, risky being both danger to the doctor and danger to the patient. "No taksies-backsies" does not exist in any legal and medical contract.

And if a woman decides she no longer wants to be sterilized, but can't pay for the procedure to reverse, and you, as a feminist were on that jury, would you tell her tough luck? That she "deserves" to be sterile because of a choice she made when she wasn't even legal to drink?

I'm not saying that woman don't have a right to request this procedure and get it done. I'm saying doctors aren't always sexist pigs when they try to cover their ass.