Meet The 20-Somethings Who Want To Be Sterilized
October 24, 2014 9:51 AM Subscribe
They're young and childfree by choice, but can 20- and 30-something women get sterilized? [...] Ultimately, ACOG's official stance is that if a woman is well-informed and seeks sterilization, it doesn't matter how old she is or whether she's already had a child. Patients should be informed of the factors that have been shown to increase the risk of subsequent regret, but in the end, the decision is their own.
This post was deleted for the following reason: Poster's Request -- frimble
Kinda don't get why this is so controversial - there's nothing like the same sort of outrage over guys getting their tubes tied, even if they do it young.
(I joke, of course I know that endemic sexism is why.)
posted by Dysk at 9:55 AM on October 24, 2014 [13 favorites]
(I joke, of course I know that endemic sexism is why.)
posted by Dysk at 9:55 AM on October 24, 2014 [13 favorites]
I would have gladly gotten my tubes tied at twenty. At twenty-three I felt quite differently.
This is not as cut and dried as it seems.
It is not automatically paternalistic to question that serious of a decision. Sure, sometimes it is-I had to sign papers before my husband got his vasectomy, and that was AFTER we had three children-but you know what? I have no problem with them wanting us to make sure that is what we wanted to do.
posted by St. Alia of the Bunnies at 10:00 AM on October 24, 2014 [8 favorites]
This is not as cut and dried as it seems.
It is not automatically paternalistic to question that serious of a decision. Sure, sometimes it is-I had to sign papers before my husband got his vasectomy, and that was AFTER we had three children-but you know what? I have no problem with them wanting us to make sure that is what we wanted to do.
posted by St. Alia of the Bunnies at 10:00 AM on October 24, 2014 [8 favorites]
I was just confused why it's called "sterilization". Apparently, it's the common nomenclature. For me, it's confusing because I associate sterilization with cleaning stuff.
I guess the term kind of fits, since from the perspective of women getting sterilized, "pregnancy" would be like a bad growth or infection of the uterus.
posted by FJT at 10:00 AM on October 24, 2014
I guess the term kind of fits, since from the perspective of women getting sterilized, "pregnancy" would be like a bad growth or infection of the uterus.
posted by FJT at 10:00 AM on October 24, 2014
But the naturopath whom Seeley saw for her annual exam told her that because of her age, she was not a good candidate for permanent sterilization.
Since when can a naturopath sterilize anyone?
posted by asperity at 10:01 AM on October 24, 2014 [22 favorites]
Since when can a naturopath sterilize anyone?
posted by asperity at 10:01 AM on October 24, 2014 [22 favorites]
Someone I was very close to was desperate for a tubal ligation in her 20's. After being turned down a few times (I am pretty sure I remember that one doctor outright laughed at the request), she finally found someone who would do it through a recommendation by Planned Parenthood.
I am a big fan of Planned Parenthood.
posted by kyrademon at 10:03 AM on October 24, 2014 [23 favorites]
I am a big fan of Planned Parenthood.
posted by kyrademon at 10:03 AM on October 24, 2014 [23 favorites]
I tried to get an Essure at 28. Could not find any doctor in NYC who would agree to it, even though I stated that I am childfree. My husband is 30 years older than I am, and the risks of mental illness or other complications for any potential child are pretty big. I suffered for two years with debilitating cramps from a Paragard, which was the only thing my then-gyn would give me. I finally switched to a doctor who put in a Mirena, and told me to come back when I turn 35 (which will finally be next spring). Ugh.
posted by roomthreeseventeen at 10:08 AM on October 24, 2014 [2 favorites]
posted by roomthreeseventeen at 10:08 AM on October 24, 2014 [2 favorites]
So, are we going to start making young people answer a survey to make *sure sure sure* they really want that kid? Because the ramifications of having kids you don't want later are a lot worse than the ramifications of not having kids you decide you want later.
posted by holborne at 10:11 AM on October 24, 2014 [73 favorites]
posted by holborne at 10:11 AM on October 24, 2014 [73 favorites]
I had my tubes tied at 32. Best decision of my life. I'm almost 47 and have no regrets.
Factors in my case: 1. I was (am) married and my spouse was a bad candidate for vasectomy for medical reasons; 2. My long-time family doctor referred me to a woman gynecologist for the procedure; 3. I have a chronic illness that means childbearing and rearing would have a huge negative effect on my life; 4. I couldn't take my meds with hormonal BC; 5. My illness has a genetic marker and is presumably inherited.
I have consistently found in conversation that the one reason people understand and accept for my refusal to have kids is the last one, even above and beyond the third.
posted by immlass at 10:13 AM on October 24, 2014 [9 favorites]
Factors in my case: 1. I was (am) married and my spouse was a bad candidate for vasectomy for medical reasons; 2. My long-time family doctor referred me to a woman gynecologist for the procedure; 3. I have a chronic illness that means childbearing and rearing would have a huge negative effect on my life; 4. I couldn't take my meds with hormonal BC; 5. My illness has a genetic marker and is presumably inherited.
I have consistently found in conversation that the one reason people understand and accept for my refusal to have kids is the last one, even above and beyond the third.
posted by immlass at 10:13 AM on October 24, 2014 [9 favorites]
Since when can a naturopath sterilize anyone?
Don't underestimate the terrible sorcerous power of wielders of nature magic.
posted by Sangermaine at 10:15 AM on October 24, 2014 [10 favorites]
Don't underestimate the terrible sorcerous power of wielders of nature magic.
posted by Sangermaine at 10:15 AM on October 24, 2014 [10 favorites]
An ex of mine went to three different doctors before she found one who agreed that a hysterectomy was a thing to consider, given the terrible fibroids (the size of grapefruit!) she had and the unending bleeding they caused, and the acknowledgement that even if she had the fibroids removed, they'd probably come back - or the scarring would be so bad she wouldn't be able to carry a pregnancy to term. "You're too young to make this decision now!" said the no-saying doctors. She was 28.
She and her husband now have two delightful kids. They adopted.
posted by rtha at 10:15 AM on October 24, 2014 [13 favorites]
She and her husband now have two delightful kids. They adopted.
posted by rtha at 10:15 AM on October 24, 2014 [13 favorites]
I think sexism has something to do with it, but I also think doctors are really really scared of being sued for all sorts of reasons, and someone changing their mind after a tubal ligation and trying to blame their doctor for taking away their fertility is not outside the realm of possibility.
I'm 37 and have never wanted kids, but when I was 23 and didn't want kids, almost all of my friends also said they didn't want kids. I'm the only one left who is childless. They all have children now, by choice.
It's easy for this to become a hot button issue and I get that the implicit sexism is real and impossible to ignore, but it's also true that very few human beings end up having the lives we thought we wanted when we were in our early 20s. Although I have remained consistent on the childlessness issue, my life is all sorts of different than I thought it would be. I understand why there are doctors out there who don't want to participate in irrevocable decisions being made by someone that young.
posted by something something at 10:17 AM on October 24, 2014 [29 favorites]
I'm 37 and have never wanted kids, but when I was 23 and didn't want kids, almost all of my friends also said they didn't want kids. I'm the only one left who is childless. They all have children now, by choice.
It's easy for this to become a hot button issue and I get that the implicit sexism is real and impossible to ignore, but it's also true that very few human beings end up having the lives we thought we wanted when we were in our early 20s. Although I have remained consistent on the childlessness issue, my life is all sorts of different than I thought it would be. I understand why there are doctors out there who don't want to participate in irrevocable decisions being made by someone that young.
posted by something something at 10:17 AM on October 24, 2014 [29 favorites]
Can we please please not have "just adopt" as the easy alternative in this thread? Adoption is wonderful and terrible (often simultaneously!) and has all sorts of ethical and social complications that make it so not the magic solution to infertility as on TV.
posted by viggorlijah at 10:19 AM on October 24, 2014 [41 favorites]
posted by viggorlijah at 10:19 AM on October 24, 2014 [41 favorites]
A urologist patronizingly told me I didn't want to make a decision about a vasectomy when I was 24-ish. My thoughts on the subject hadn't wavered an iota over the next dozen years before I actually got to it.
An ex of mine went to three different doctors before she found one who agreed that a hysterectomy was a thing to consider, given the terrible fibroids (the size of grapefruit!) she had and the unending bleeding they caused, and the acknowledgement that even if she had the fibroids removed, they'd probably come back - or the scarring would be so bad she wouldn't be able to carry a pregnancy to term. "You're too young to make this decision now!" said the no-saying doctors. She was 28.
Ugh. Now that should be malpractice.
posted by Zed at 10:20 AM on October 24, 2014 [5 favorites]
An ex of mine went to three different doctors before she found one who agreed that a hysterectomy was a thing to consider, given the terrible fibroids (the size of grapefruit!) she had and the unending bleeding they caused, and the acknowledgement that even if she had the fibroids removed, they'd probably come back - or the scarring would be so bad she wouldn't be able to carry a pregnancy to term. "You're too young to make this decision now!" said the no-saying doctors. She was 28.
Ugh. Now that should be malpractice.
posted by Zed at 10:20 AM on October 24, 2014 [5 favorites]
the patriarchy values women primarily on the basis of their ability to rear children and provide sexual pleasure to men. A young woman wanting her tubes tied is explicitly refusing to cooperate with her assigned role, and that is not looked kindly upon by the men who take it upon themselves to regulate women's bodies.
I never really believed this until I saw how fast Viagra was pushed through the legislatures for insurance approval, back when it was invented.
posted by Melismata at 10:29 AM on October 24, 2014 [31 favorites]
I never really believed this until I saw how fast Viagra was pushed through the legislatures for insurance approval, back when it was invented.
posted by Melismata at 10:29 AM on October 24, 2014 [31 favorites]
I think sexism has something to do with it, but I also think doctors are really really scared of being sued for all sorts of reasons, and someone changing their mind after a tubal ligation and trying to blame their doctor for taking away their fertility is not outside the realm of possibility.
This doesn't explain why the reluctance is disproportionately with regard to women getting sterilised, and not men.
posted by Dysk at 10:29 AM on October 24, 2014 [7 favorites]
This doesn't explain why the reluctance is disproportionately with regard to women getting sterilised, and not men.
posted by Dysk at 10:29 AM on October 24, 2014 [7 favorites]
Amen.
For my 30th birthday in a few months I've decided to gift myself a tubal ligation.
I have never had interest in children and all other forms of birth control I've tried have had negative side effects. I've waited this long because I don't like experiencing rejection and medical procedures are anxiety inducing. I think at my age now (and the fact I live in liberal Seattle) I won't have to argue too hard for it.
posted by E3 at 10:30 AM on October 24, 2014 [3 favorites]
For my 30th birthday in a few months I've decided to gift myself a tubal ligation.
I have never had interest in children and all other forms of birth control I've tried have had negative side effects. I've waited this long because I don't like experiencing rejection and medical procedures are anxiety inducing. I think at my age now (and the fact I live in liberal Seattle) I won't have to argue too hard for it.
posted by E3 at 10:30 AM on October 24, 2014 [3 favorites]
I'd like to see some sort of "super-ultra-no-take-backsies" waiver created legislatively, such that once you sign it, there is absolutely, positively, no way in hell that you can sue the physician who does whatever elective procedure you're signing up for.
No so much because I believe in the "lawsuits are out of control!!1" angle—if that was a real problem, Planned Parenthood and other feminist clinics who perform sterilizations on younger patients wouldn't do them, either—but because it would eliminate the liability figleaf that so many cowardly, judgemental doctors are hiding behind when they refuse to perform procedures on patients for reasons that lie completely outside the realm of medicine.
Female sterilizations and IUD insertions seem to be the most common procedures to attract the Morality Police, but I have friends who have run into it in other areas. Almost always having something to do with a woman's sexuality or body integrity.
(Strangely, breast augmentation is not one of those things, despite the long-term effects it can have. It's worth thinking about why that is...)
posted by Kadin2048 at 10:30 AM on October 24, 2014 [34 favorites]
No so much because I believe in the "lawsuits are out of control!!1" angle—if that was a real problem, Planned Parenthood and other feminist clinics who perform sterilizations on younger patients wouldn't do them, either—but because it would eliminate the liability figleaf that so many cowardly, judgemental doctors are hiding behind when they refuse to perform procedures on patients for reasons that lie completely outside the realm of medicine.
Female sterilizations and IUD insertions seem to be the most common procedures to attract the Morality Police, but I have friends who have run into it in other areas. Almost always having something to do with a woman's sexuality or body integrity.
(Strangely, breast augmentation is not one of those things, despite the long-term effects it can have. It's worth thinking about why that is...)
posted by Kadin2048 at 10:30 AM on October 24, 2014 [34 favorites]
I would have gladly gotten my tubes tied at twenty. At twenty-three I felt quite differently.
I had my tubes tied at 32. Best decision of my life. I'm almost 47 and have no regrets.
Yeah, the older I get, the more resolved I become that we need to re-set the age of maturity to no younger than twenty-five. It's a thought that first occurred to me when I was maybe twenty-eight and reflecting on all the very dumb, weird, confused stuff I'd fumbled through as I passed from my teens through my early twenties. I just utterly lacked balance ... and yet, on the surface anyway, I seemed to handle those years better than very many of my friends etc.
posted by philip-random at 10:35 AM on October 24, 2014 [3 favorites]
I had my tubes tied at 32. Best decision of my life. I'm almost 47 and have no regrets.
Yeah, the older I get, the more resolved I become that we need to re-set the age of maturity to no younger than twenty-five. It's a thought that first occurred to me when I was maybe twenty-eight and reflecting on all the very dumb, weird, confused stuff I'd fumbled through as I passed from my teens through my early twenties. I just utterly lacked balance ... and yet, on the surface anyway, I seemed to handle those years better than very many of my friends etc.
posted by philip-random at 10:35 AM on October 24, 2014 [3 favorites]
I have consistently found in conversation that the one reason people understand and accept for my refusal to have kids is the last one, even above and beyond the third.
It drives me completely bugfuck that we even need to have these conversations, though. I'm in my late 40s with no kids, and I've had those conversations, too, more times than I can count. But in fact, there's no reason I should have to give anyone an "acceptable" biological or physiological reason that I don't have children. Not wanting them is the reason I don't have them, and that's sufficient.
It seriously chaps me that I eventually got so worn down by the zillionth "You don't have children?!?! How can you even consider yourself human?!?!" discussions that I started simply telling people I couldn't have children (most likely true, but entirely beside the point, as I also didn't want them). After couple decades of trying to figure it out, I still haven't come up with any valid reason that people who are more or less strangers to me should care one iota that I don't have children. But they do. Sexism explains a lot of it, but not all of it, since I do have male friends who have had similar conversations, although not quite as many times as I have.
posted by holborne at 10:37 AM on October 24, 2014 [15 favorites]
It drives me completely bugfuck that we even need to have these conversations, though. I'm in my late 40s with no kids, and I've had those conversations, too, more times than I can count. But in fact, there's no reason I should have to give anyone an "acceptable" biological or physiological reason that I don't have children. Not wanting them is the reason I don't have them, and that's sufficient.
It seriously chaps me that I eventually got so worn down by the zillionth "You don't have children?!?! How can you even consider yourself human?!?!" discussions that I started simply telling people I couldn't have children (most likely true, but entirely beside the point, as I also didn't want them). After couple decades of trying to figure it out, I still haven't come up with any valid reason that people who are more or less strangers to me should care one iota that I don't have children. But they do. Sexism explains a lot of it, but not all of it, since I do have male friends who have had similar conversations, although not quite as many times as I have.
posted by holborne at 10:37 AM on October 24, 2014 [15 favorites]
Well I'm in the camp that thinks sterilization is a pretty big deal because 1) it has a pretty unpleasant history and 2) because the procedure is really, really hard to reverse. Sure, some people do it and are happy with that decision for a long time. But not everyone is and doctors would rather be safe than sorry. I don't really blame them.
posted by GuyZero at 10:41 AM on October 24, 2014 [4 favorites]
posted by GuyZero at 10:41 AM on October 24, 2014 [4 favorites]
2) because the procedure is really, really hard to reverse
This is a feature, not a bug
posted by asockpuppet at 10:42 AM on October 24, 2014 [10 favorites]
This is a feature, not a bug
posted by asockpuppet at 10:42 AM on October 24, 2014 [10 favorites]
it has a pretty unpleasant history
When it's done involuntarily for eugenics purposes, sure. Not sure what that has to do with what we're discussing here, though.
posted by holborne at 10:44 AM on October 24, 2014 [18 favorites]
When it's done involuntarily for eugenics purposes, sure. Not sure what that has to do with what we're discussing here, though.
posted by holborne at 10:44 AM on October 24, 2014 [18 favorites]
Isn't there increasing biological pressure as one gets older to having kids? And if so, wouldn't denying someone of majority age be putting their earlier reason under siege by biology? Just waiting for the first to give out under unceasing pressure from the second?
posted by Slackermagee at 10:44 AM on October 24, 2014
posted by Slackermagee at 10:44 AM on October 24, 2014
It really disgusts me that the main argument in favor of the current status quo appears to be "adult women are genuinely too stupid to make permanent decisions about their own bodies until they are around 35".
posted by kyrademon at 10:48 AM on October 24, 2014 [39 favorites]
posted by kyrademon at 10:48 AM on October 24, 2014 [39 favorites]
If we let young women get sterilized, how will we grind them down with social pressure, guilt, and emotional blackmail from partners until they relent and spawn kids they vaguely resent forever?
It'd be the end of everything, I tells ya!
posted by like_a_friend at 10:49 AM on October 24, 2014 [10 favorites]
It'd be the end of everything, I tells ya!
posted by like_a_friend at 10:49 AM on October 24, 2014 [10 favorites]
I am 23 years old… my attempts to get a vasectomy done in the US have all failed.
posted by mbrubeck at 10:50 AM on October 24, 2014 [7 favorites]
posted by mbrubeck at 10:50 AM on October 24, 2014 [7 favorites]
Kinda don't get why this is so controversial - there's nothing like the same sort of outrage over guys getting their tubes tied, even if they do it young.
(I joke, of course I know that endemic sexism is why.)
I wanted a vasectomy in my early twenties. After the stories I'd heard about men getting turned down for vasectomies at that age, and lawsuit/liability concerns I decided to do a boatload of research & marshal my arguments ahead of time. I prepped like I was going to my most important job interview. Sailed through the mandatory counseling, but at the last minute when I came back for the procedure the woman who interviewed me tried to talk me out of it (still seems weird). Still, it's a thing, men get a lot of pushback on vasectomies including strange peer pressure from friends/acquaintances and FUD reasons not to do it. Not that that can't also be about patriarchy & misogyny at root. Also, I'm sure young women get much more pushback over tubal ligation, even beyond what the additional surgical risks would warrant.
posted by BrotherCaine at 10:52 AM on October 24, 2014 [2 favorites]
(I joke, of course I know that endemic sexism is why.)
I wanted a vasectomy in my early twenties. After the stories I'd heard about men getting turned down for vasectomies at that age, and lawsuit/liability concerns I decided to do a boatload of research & marshal my arguments ahead of time. I prepped like I was going to my most important job interview. Sailed through the mandatory counseling, but at the last minute when I came back for the procedure the woman who interviewed me tried to talk me out of it (still seems weird). Still, it's a thing, men get a lot of pushback on vasectomies including strange peer pressure from friends/acquaintances and FUD reasons not to do it. Not that that can't also be about patriarchy & misogyny at root. Also, I'm sure young women get much more pushback over tubal ligation, even beyond what the additional surgical risks would warrant.
posted by BrotherCaine at 10:52 AM on October 24, 2014 [2 favorites]
In seriousness though, the statement at the end of the article, about how finally being sterilized allowed her to relax and actually enjoy children really hit home. I have friends and relatives who I swear are scanning my every move for any indication, however slight, that I'm weakening in my no-kids resolve. So if I have a good time hanging out with my friend's kids, if I "like" someone's baby pictures on Facebook, if I tell a funny story about some kid I saw at Starbucks...all of a sudden people pounce on it, like SEE WE KNEW YOU WERE NOT A MONSTER NOW BIRTH.
I would love, just LOVE, for the question to be 100% off the table, forever and ever.
posted by like_a_friend at 10:58 AM on October 24, 2014 [39 favorites]
I would love, just LOVE, for the question to be 100% off the table, forever and ever.
posted by like_a_friend at 10:58 AM on October 24, 2014 [39 favorites]
When it's done involuntarily for eugenics purposes, sure. Not sure what that has to do with what we're discussing here, though.
Because if someone ends up regretting their sterilization then the doctor is going to be accused of having pushed it on the person.
Basically my thesis is that people can be pretty irrational about sterilizations and the default reaction to that is to avoid them.
posted by GuyZero at 11:04 AM on October 24, 2014 [3 favorites]
Because if someone ends up regretting their sterilization then the doctor is going to be accused of having pushed it on the person.
Basically my thesis is that people can be pretty irrational about sterilizations and the default reaction to that is to avoid them.
posted by GuyZero at 11:04 AM on October 24, 2014 [3 favorites]
I had my tubal at 21. I went to six doctors to find one willing. Two laughed in my face and even the one who performed the procedure told me I would regret it. I was in a long term relationship at the time, but I wasn't convinced he would be the last. I calmly explained to the doctor that I never wanted to have to worry about changing my mind or having someone talk me into a baby. I then told him that the alternative would be to leave a string of men behind with vasectomies.
I can honestly say that at one or two points in my thirties, if I had not taken the nuclear option in birth control I would have probably given in to pressure from previous boyfriends to try for a baby.
Adopting takes deliberate action and planning. Going off birth control, not so much. Honestly I wish fertility was more of a default off than a default on switch because I think men and women need to be more deliberate and thoughtful when they make these decisions.
Some days I almost wish I could have been okay with leaving pregnancy up to chance, but I still believe after all these years it would have been the end of me. Maybe it was chance and good luck that I found a doctor who was willing to help me stack the deck. Regardless, I made the best choice for me at 21 and it has remained a choice that I am proud of for 19 years.
posted by teleri025 at 11:11 AM on October 24, 2014 [20 favorites]
I can honestly say that at one or two points in my thirties, if I had not taken the nuclear option in birth control I would have probably given in to pressure from previous boyfriends to try for a baby.
Adopting takes deliberate action and planning. Going off birth control, not so much. Honestly I wish fertility was more of a default off than a default on switch because I think men and women need to be more deliberate and thoughtful when they make these decisions.
Some days I almost wish I could have been okay with leaving pregnancy up to chance, but I still believe after all these years it would have been the end of me. Maybe it was chance and good luck that I found a doctor who was willing to help me stack the deck. Regardless, I made the best choice for me at 21 and it has remained a choice that I am proud of for 19 years.
posted by teleri025 at 11:11 AM on October 24, 2014 [20 favorites]
Basically my thesis is that people can be pretty irrational about sterilizations
Oh, please do defend this thesis. I'll wait.
posted by asockpuppet at 11:16 AM on October 24, 2014 [6 favorites]
Oh, please do defend this thesis. I'll wait.
posted by asockpuppet at 11:16 AM on October 24, 2014 [6 favorites]
It is incredibly difficult for a woman to get a sterilization procedure. I've heard hundreds of stories of rejection for this.
posted by agregoli at 11:24 AM on October 24, 2014
posted by agregoli at 11:24 AM on October 24, 2014
This whole thing about "well you'll change your mind!" And... so? If you get pregnant at 21 and then wish you hadn't at age 35? (which isn't uncommon and I know too many moms who are happy to announce it loudly and frequently, in front of their children), too bad for you!
The risk that someone 10 years later might regret their children should outweigh the risk of someone regretting NOT having (biological) children.
posted by small_ruminant at 11:28 AM on October 24, 2014 [21 favorites]
The risk that someone 10 years later might regret their children should outweigh the risk of someone regretting NOT having (biological) children.
posted by small_ruminant at 11:28 AM on October 24, 2014 [21 favorites]
It's always the case that voluntary sterilization provokes questions about decision-making capacity, far beyond any other major life decision. Personally, I wouldn't mind if there were a legal lower age limit (barring medical necessity of course) for elective sterilization, let's say 25, as long as the same age limit applied to: having children; marriage; divorce; joining the military; cosmetic surgery; etc.
Is "regret" taken into account in any other professional situation of similar importance? If you try to get married to somebody you just met, is the justice going to ask a bunch of questions about how old you are and whether you'll regret it? Would they even ask how long you've been together or anything like that?
The only thing that comes to mind is face tattoos. They'll still give you your tat, but the artist will probably check that you've thought it through and are in a normal state of mind (if it's a reputable place, which most are not...).
posted by sharktopus at 11:30 AM on October 24, 2014 [3 favorites]
Is "regret" taken into account in any other professional situation of similar importance? If you try to get married to somebody you just met, is the justice going to ask a bunch of questions about how old you are and whether you'll regret it? Would they even ask how long you've been together or anything like that?
The only thing that comes to mind is face tattoos. They'll still give you your tat, but the artist will probably check that you've thought it through and are in a normal state of mind (if it's a reputable place, which most are not...).
posted by sharktopus at 11:30 AM on October 24, 2014 [3 favorites]
"Basically my thesis is that people can be pretty irrational about sterilizations"
"Oh, please do defend this thesis. I'll wait."
I have heard absurd things claimed about male sterilization. That it would lower testosterone, reduce libido, cause ejaculation-free orgasm.
This stuff pokes at deep fears / hangups about sex and gender, and this leads to bizarre and irrational beliefs and behaviors.
posted by idiopath at 11:32 AM on October 24, 2014 [2 favorites]
"Oh, please do defend this thesis. I'll wait."
I have heard absurd things claimed about male sterilization. That it would lower testosterone, reduce libido, cause ejaculation-free orgasm.
This stuff pokes at deep fears / hangups about sex and gender, and this leads to bizarre and irrational beliefs and behaviors.
posted by idiopath at 11:32 AM on October 24, 2014 [2 favorites]
I wish MORE people would get their tubes tied. I know most physicians will not do this, but I think it's inredibly brave to KNOW that you do not want children and cannot provide or do not want to provide for a child and get it taken care of.
However, there should be some kind of therapist evaluation before.
Also, lots of women who have had their tubes tied and changed their minds have still been able to hand children in their future with medical intervention.
As a believer in a womens right to choose, I definitely believe in this as well. Very interesting article!
posted by Sara_NOT_Sarah at 11:34 AM on October 24, 2014 [2 favorites]
However, there should be some kind of therapist evaluation before.
Also, lots of women who have had their tubes tied and changed their minds have still been able to hand children in their future with medical intervention.
As a believer in a womens right to choose, I definitely believe in this as well. Very interesting article!
posted by Sara_NOT_Sarah at 11:34 AM on October 24, 2014 [2 favorites]
But the naturopath whom Seeley saw for her annual exam
Well there's your problem.
posted by supercres at 11:35 AM on October 24, 2014 [1 favorite]
Well there's your problem.
posted by supercres at 11:35 AM on October 24, 2014 [1 favorite]
In terms of actual numbers, the number of women who regret getting a procedure such as tubal ligation appears to be about 4%
If malpractice is a concern, tubal ligation is indeed the third most common gynaecological procedure to provoke litigation, involving 15% of cases ... however, of those claims, 43% are lawsuits over the procedure FAILING, whereas only 14% are over regret and similar issues (the remainder are for things such as medical mistakes leading to injury.) That means regret over tubal ligation accounts for about 2% of all gynaecological malpractice lawsuits. These statistics are from the Canadian Medical Protective Association and are reported here.
(As a note, that link also mentions that rates of regret and procedure reversal are higher for younger patients, but the cohort they consider "younger patients" is so broad -- 15 to 29 years of age! -- that it is difficult to unpack ... if the rate were significantly higher for those 15 to 18 than for those 26 to 29, for example, there would be no way to tell from those statistics.)
posted by kyrademon at 11:39 AM on October 24, 2014 [12 favorites]
If malpractice is a concern, tubal ligation is indeed the third most common gynaecological procedure to provoke litigation, involving 15% of cases ... however, of those claims, 43% are lawsuits over the procedure FAILING, whereas only 14% are over regret and similar issues (the remainder are for things such as medical mistakes leading to injury.) That means regret over tubal ligation accounts for about 2% of all gynaecological malpractice lawsuits. These statistics are from the Canadian Medical Protective Association and are reported here.
(As a note, that link also mentions that rates of regret and procedure reversal are higher for younger patients, but the cohort they consider "younger patients" is so broad -- 15 to 29 years of age! -- that it is difficult to unpack ... if the rate were significantly higher for those 15 to 18 than for those 26 to 29, for example, there would be no way to tell from those statistics.)
posted by kyrademon at 11:39 AM on October 24, 2014 [12 favorites]
I turned 40 the year I had my second Mirena put in. Despite age, and never wanting children, I was still steered towards another Mirena instead of something more permanent. I'm honestly hoping that at 45 they'll finally take me seriously and I'll be able to sterilize. (Keeping in mind that it took me until 35 to finally find a practice that believed me when I said I didn't want children and to give me an IUD.) So I can say that with more women pushing off having kids until later years, the age for this is going to creep up as well.
posted by librarianamy at 11:42 AM on October 24, 2014
posted by librarianamy at 11:42 AM on October 24, 2014
I'll take the contrary position here.
I'm in my late 40's and so I see people in their 20's as still being children themselves, and the good Lord knows that I myself was a pretty immature little prick at that age. And I'm still suffering today from some of the boneheaded decisions that my younger self made for me back in the 1980's, and some of those decisions, while not irreversible, certainly did take years if not decades to recover from.
So if some doctor were to say to early-20's-me, "look, you need to really think about this because it's a permanent decision that will change your life," then late-40's-me would be shouting, "HELL YES YOU BETTER LISTEN THIS TIME, YOU DOPE."
posted by math at 11:45 AM on October 24, 2014 [5 favorites]
I'm in my late 40's and so I see people in their 20's as still being children themselves, and the good Lord knows that I myself was a pretty immature little prick at that age. And I'm still suffering today from some of the boneheaded decisions that my younger self made for me back in the 1980's, and some of those decisions, while not irreversible, certainly did take years if not decades to recover from.
So if some doctor were to say to early-20's-me, "look, you need to really think about this because it's a permanent decision that will change your life," then late-40's-me would be shouting, "HELL YES YOU BETTER LISTEN THIS TIME, YOU DOPE."
posted by math at 11:45 AM on October 24, 2014 [5 favorites]
If you try to get married to somebody you just met, is the justice going to ask a bunch of questions about how old you are and whether you'll regret it? Would they even ask how long you've been together or anything like that?
Quite a few nations and US states have waiting times for marriages (which is what makes "quickie" marriages in Las Vegas or Gretna Green a thing). Quite a few religious traditions will require you to go through some kind of counseling before you can be married by one of their officiants.
From TFA:
Personally I am a fan of my IUD for changing my fertility from "default on" to "default off," and if everyone tolerated IUDs as well as I do, I'd be in favor of telling any 23 year old who wanted to get sterilized to "Nope. Take an IUD and call me in ten years."
But of course not everyone tolerates an IUD well, and some people have other medical reasons (like the fibroids mentioned above) for wanting sterilizing procedures.
So actually I'm favor of doctors educating patients about all their other birth control options in as much detail as possible (like required pre-marriage counseling!) then offering the super ultra no-take-backies waiver mentioned above ("I hereby swear that I was not pressured into this for any reason by anybody ESPECIALLY MY DOCTOR") and going ahead.
But seriously, if you're young and thinking about doing this -- look into IUDs first. They're a great option.
posted by OnceUponATime at 11:45 AM on October 24, 2014 [6 favorites]
Quite a few nations and US states have waiting times for marriages (which is what makes "quickie" marriages in Las Vegas or Gretna Green a thing). Quite a few religious traditions will require you to go through some kind of counseling before you can be married by one of their officiants.
From TFA:
A comprehensive 2008 review looking at sterilization in the United States found that patient regret is the most common lasting complication of sterilization, and one that disproportionately affects women: Up to 26 percent of female patients say later that they regret the procedure, according to statistics cited in the study, compared to less than 5 percent of men who have a vasectomy. And age, the researchers concluded, is the top predictor of regret. Women who were under 30 when they were sterilized were twice as likely as their older counterparts to say they had later misgivings.I would say some kind of counseling and/or (short) waiting period is indeed indicated, based on those numbers.
Personally I am a fan of my IUD for changing my fertility from "default on" to "default off," and if everyone tolerated IUDs as well as I do, I'd be in favor of telling any 23 year old who wanted to get sterilized to "Nope. Take an IUD and call me in ten years."
But of course not everyone tolerates an IUD well, and some people have other medical reasons (like the fibroids mentioned above) for wanting sterilizing procedures.
So actually I'm favor of doctors educating patients about all their other birth control options in as much detail as possible (like required pre-marriage counseling!) then offering the super ultra no-take-backies waiver mentioned above ("I hereby swear that I was not pressured into this for any reason by anybody ESPECIALLY MY DOCTOR") and going ahead.
But seriously, if you're young and thinking about doing this -- look into IUDs first. They're a great option.
posted by OnceUponATime at 11:45 AM on October 24, 2014 [6 favorites]
... and I guess the problem is that early-20's-me would say what he always says, "YOU CAN'T TELL ME WHAT TO DO SO F%#! OFF".
posted by math at 11:46 AM on October 24, 2014 [2 favorites]
posted by math at 11:46 AM on October 24, 2014 [2 favorites]
There's a difference between "you need to really think about this" and "You can't have it because you aren't capable of making this decision."
The first one is about the individual's well-being, the second one is about the patient's agency. The second one is problematic.
posted by sharktopus at 11:49 AM on October 24, 2014 [13 favorites]
The first one is about the individual's well-being, the second one is about the patient's agency. The second one is problematic.
posted by sharktopus at 11:49 AM on October 24, 2014 [13 favorites]
Making any essentially irreversible decision in your twenties, or any age, should be moderately difficult and is properly challenged when asking another individual (professional or lay) to be a partner in making that decision possible. I think in most cases the individual has no more right to demand it of others, if it requires the others consent/participation, than the State or others have the right to deny it or demand it of the individual. I do not think professionals have the right to withhold a legal professional service within their scope of competence because of personal values/biases--but I also think no consumer/patient/client has a right to expect unquestioned agreement with their request. BTW--being sued for a failed procedure is no more problematic than being sued for regret. Don't casually blow off the implied liability a physician or other health professional has for elective procedures that have significant consequences.
posted by rmhsinc at 11:52 AM on October 24, 2014 [2 favorites]
posted by rmhsinc at 11:52 AM on October 24, 2014 [2 favorites]
Because if someone ends up regretting their sterilization then the doctor is going to be accused of having pushed it on the person.
This is a red herring; the chances of this actually happening are so small as to be zero, for all intents and purposes. First of all, patients undergoing any sort of surgical procedure sign about a zillion consent forms, creating a presumption that they gave informed consent to the procedure. There are certainly lawsuits regarding informed consent, but I don't think I've ever once seen one asserting that a physician "pushed" a procedure on a person. Informed consent lawsuits usually accuse doctors of failing to reveal all the possible risks of a procedure, not of forcing people to have procedures they didn't really want to have. Occasionally there will be one saying that a doctor used procedure B during the surgery even though she said she was going to use procedure A, but "pushing" a procedure on someone? Nuh-uh. I mean, I suppose any given doctor could be a test case, but believe me, doctors are pretty well aware of what might and might not subject them to a malpractice suit.
Second, even putting all that aside, given the fact that most doctors are extremely and demonstrably reluctant to perform these sorts of procedures on young people, such an accusation wouldn't exactly be plausible.
posted by holborne at 11:53 AM on October 24, 2014 [1 favorite]
This is a red herring; the chances of this actually happening are so small as to be zero, for all intents and purposes. First of all, patients undergoing any sort of surgical procedure sign about a zillion consent forms, creating a presumption that they gave informed consent to the procedure. There are certainly lawsuits regarding informed consent, but I don't think I've ever once seen one asserting that a physician "pushed" a procedure on a person. Informed consent lawsuits usually accuse doctors of failing to reveal all the possible risks of a procedure, not of forcing people to have procedures they didn't really want to have. Occasionally there will be one saying that a doctor used procedure B during the surgery even though she said she was going to use procedure A, but "pushing" a procedure on someone? Nuh-uh. I mean, I suppose any given doctor could be a test case, but believe me, doctors are pretty well aware of what might and might not subject them to a malpractice suit.
Second, even putting all that aside, given the fact that most doctors are extremely and demonstrably reluctant to perform these sorts of procedures on young people, such an accusation wouldn't exactly be plausible.
posted by holborne at 11:53 AM on October 24, 2014 [1 favorite]
Making any essentially irreversible decision in your twenties, or any age, should be moderately difficult
Like having kids?
posted by small_ruminant at 11:55 AM on October 24, 2014 [40 favorites]
Like having kids?
posted by small_ruminant at 11:55 AM on October 24, 2014 [40 favorites]
> "Up to 26 percent of female patients ..."
"Up to" 26 percent?
*reads the study from where they got that statistic*
"Patient regret following the procedure ... reported anywhere from 0.9% to 26% for female sterilization ..."
Uh-huh.
posted by kyrademon at 11:56 AM on October 24, 2014 [13 favorites]
"Up to" 26 percent?
*reads the study from where they got that statistic*
"Patient regret following the procedure ... reported anywhere from 0.9% to 26% for female sterilization ..."
Uh-huh.
posted by kyrademon at 11:56 AM on October 24, 2014 [13 favorites]
Basically my thesis is that people can be pretty irrational about sterilizations and the default reaction to that is to avoid them.
Hysterical, one might say, right?
posted by holybagel at 12:03 PM on October 24, 2014 [9 favorites]
Hysterical, one might say, right?
posted by holybagel at 12:03 PM on October 24, 2014 [9 favorites]
I just hit 45. In my cohort of close friends this age or older (60 and up) I have seen the intimate emotions of:
Women who have never had kids and are very happy with it
Women who though they would never have kids and then got pummeled with regret when it was too late
Women who had to persist to get tubes tied
Women who got pregnant accidentally and it was a tragedy
Women who got pregnant accidentally and it was the best thing that ever happened to them
Men who had to persist when getting vasectomy young
Men who had no problem getting vasectomy
Men who had vasectomy reversed
Men who got a woman pregnant accidentally and it was a tragedy
Men who got a woman pregnant accidentally and it was the best thing that ever happened to them
In short, I think trying to construct arguments and policies from first principles is crazy. There is just no way to know. In the age of IVF a woman could theoretically still bear her own child after tubal ligation. If the only consequence of coming to regret that decision at a later date is that it will be much more costly to conceive, well, there are far worse unintended outcomes.
posted by Sublimity at 12:04 PM on October 24, 2014 [6 favorites]
Women who have never had kids and are very happy with it
Women who though they would never have kids and then got pummeled with regret when it was too late
Women who had to persist to get tubes tied
Women who got pregnant accidentally and it was a tragedy
Women who got pregnant accidentally and it was the best thing that ever happened to them
Men who had to persist when getting vasectomy young
Men who had no problem getting vasectomy
Men who had vasectomy reversed
Men who got a woman pregnant accidentally and it was a tragedy
Men who got a woman pregnant accidentally and it was the best thing that ever happened to them
In short, I think trying to construct arguments and policies from first principles is crazy. There is just no way to know. In the age of IVF a woman could theoretically still bear her own child after tubal ligation. If the only consequence of coming to regret that decision at a later date is that it will be much more costly to conceive, well, there are far worse unintended outcomes.
posted by Sublimity at 12:04 PM on October 24, 2014 [6 favorites]
"like having kids"--fine with me if it was a bit more difficult. However, getting pregnant is not an irreversible decision and the State can reverse parenthood and divorce/custody can radically alter it. Are you making a point just to make a point or do you think that it should be easy to have children. I would point out that having children, at least in most cases, does involve the active participation of others and should be the result of an active discussion between the consenting parties. Do you think a person has a right to demand/expect parenthood without the active support of the other person/inseminating agent.
posted by rmhsinc at 12:06 PM on October 24, 2014
posted by rmhsinc at 12:06 PM on October 24, 2014
I tried to get sterilization done by a newish in-office procedure when I was 32. The doc chastised me for not getting my tubes tied at the same time that I'd birthed my eventually-decided-to-be-final child. WTF? Like I was going to make the decision in the third or fourth trimester? Hells no.
The doc said I didn't need to actually do the in office sterilization procedure and pay for it (several thousand dollars even with health insurance).
The doc said if I did something else for 'medical reasons', I could do an end run around the sterilization cost issue and save money. I certainly was open to the procedure because it would have made my life quite a bit less painful.
If that alternative procedure is done 'well' and the body takes to it well, an off label side effect is permanent sterilization. My doctor even mentioned that I might be completely sterile several times before we finally settled on the procedure date.
So eventually I'm lying there, getting dopey, about to be wheeled in, and the doc leans in and tells me, quietly, "By the way, this procedure is not sterilization, nor a guarantee of sterilization, and you must use other forms of birth control post-op."
I wanted to get up and walk out but declined to do so. I was just so damn tired of intense intense pain.
I got lucky, though. It did actually nicely render me sterile. I had it proved several times at my own expense. Between that and a decade or so of otherwise unprotected coitus with no consequence I'm finally comfortable with not watching my calendar and panic buying pregnancy tests every once in a while.
Still want them to yank the uterus out but that's another battle. I can do some drugs or something on the days of the year continuing to have one makes me weep in pain, because a couple double handfuls of days of soul-crushing pain is much better than months of days of soul-crushing pain.
posted by Buttons Bellbottom at 12:06 PM on October 24, 2014
The doc said I didn't need to actually do the in office sterilization procedure and pay for it (several thousand dollars even with health insurance).
The doc said if I did something else for 'medical reasons', I could do an end run around the sterilization cost issue and save money. I certainly was open to the procedure because it would have made my life quite a bit less painful.
If that alternative procedure is done 'well' and the body takes to it well, an off label side effect is permanent sterilization. My doctor even mentioned that I might be completely sterile several times before we finally settled on the procedure date.
So eventually I'm lying there, getting dopey, about to be wheeled in, and the doc leans in and tells me, quietly, "By the way, this procedure is not sterilization, nor a guarantee of sterilization, and you must use other forms of birth control post-op."
I wanted to get up and walk out but declined to do so. I was just so damn tired of intense intense pain.
I got lucky, though. It did actually nicely render me sterile. I had it proved several times at my own expense. Between that and a decade or so of otherwise unprotected coitus with no consequence I'm finally comfortable with not watching my calendar and panic buying pregnancy tests every once in a while.
Still want them to yank the uterus out but that's another battle. I can do some drugs or something on the days of the year continuing to have one makes me weep in pain, because a couple double handfuls of days of soul-crushing pain is much better than months of days of soul-crushing pain.
posted by Buttons Bellbottom at 12:06 PM on October 24, 2014
Quite a few nations and US states have waiting times for marriages
That's interesting, I didn't know that. A quick google provided a couple of lists. It looks like about half of states have no wait time, and the other half have wait times of 1-6 days, with 3-5 being typical. The lower age limit appears to be 18-21, or lower with parental and judicial consent.
Divorces also apparently have time restrictions such as requiring the process to take 6 months.
I guess my point is that if the state can recognize the potential for regret and account for it, then what is the legal basis for refusing voluntary sterilization? In other words, if the state thinks that 18 years and 3 days is maturity enough for permanent decisions, then why are doctors denying the decision making capacity of women in their thirties?
posted by sharktopus at 12:14 PM on October 24, 2014 [1 favorite]
That's interesting, I didn't know that. A quick google provided a couple of lists. It looks like about half of states have no wait time, and the other half have wait times of 1-6 days, with 3-5 being typical. The lower age limit appears to be 18-21, or lower with parental and judicial consent.
Divorces also apparently have time restrictions such as requiring the process to take 6 months.
I guess my point is that if the state can recognize the potential for regret and account for it, then what is the legal basis for refusing voluntary sterilization? In other words, if the state thinks that 18 years and 3 days is maturity enough for permanent decisions, then why are doctors denying the decision making capacity of women in their thirties?
posted by sharktopus at 12:14 PM on October 24, 2014 [1 favorite]
I am 42, no kids, pretty much never wanted them, and if some sort of procedure had been within my reach (in many ways) in my early 20s I might have pursued it. And I still don't think anyone should have given it to me without some kind of fairly serious discussion or a worksheet or something. Like, I would time-travel back and have a talk with myself, but I understand that doesn't mean I need to be pro-roadblock for anyone else.
I guess the solution is to just include a strongly-worded liability waiver and step back and let the first generation shake out the kinks in the process. If you are devastated at 34 by a decision you made at 22...well, you just have to figure out something else.
Eventually, women will know enough older women on various ends of the decision process to take most of the right things into consideration.
I worry about coercion. How much cash or power will be wielded under the table to get or force young women to fake the requisite enthusiasm? How many doctors who can be paid to turn a blind eye to a woman who is clearly reluctant? Young women who are profit centers for other people - athletes, celebrities, sex workers, breadwinner/caretaker - are going to be at risk, and I do think that's a good reason for there to be hoops to jump. I don't know what the solution to that is, aside from sweeping social changes.
I would argue that when you quit a job, it doesn't mean you can never have a job again. When you move states, you are allowed back in.
posted by Lyn Never at 12:15 PM on October 24, 2014 [3 favorites]
I guess the solution is to just include a strongly-worded liability waiver and step back and let the first generation shake out the kinks in the process. If you are devastated at 34 by a decision you made at 22...well, you just have to figure out something else.
Eventually, women will know enough older women on various ends of the decision process to take most of the right things into consideration.
I worry about coercion. How much cash or power will be wielded under the table to get or force young women to fake the requisite enthusiasm? How many doctors who can be paid to turn a blind eye to a woman who is clearly reluctant? Young women who are profit centers for other people - athletes, celebrities, sex workers, breadwinner/caretaker - are going to be at risk, and I do think that's a good reason for there to be hoops to jump. I don't know what the solution to that is, aside from sweeping social changes.
I would argue that when you quit a job, it doesn't mean you can never have a job again. When you move states, you are allowed back in.
posted by Lyn Never at 12:15 PM on October 24, 2014 [3 favorites]
However, getting pregnant is not an irreversible decision
The hell you say. Tell that to a kid in foster care.
All this hand wavy bullshit about regret and age of decision making is a window dressing for the real statement. Women really only have value via childbirth. Until that changes, it's never going to be a real discussion.
I am enraged that the idea of making a human life can even vaguely be considered more "reversible" than a decision to not create life.
posted by teleri025 at 12:16 PM on October 24, 2014 [9 favorites]
The hell you say. Tell that to a kid in foster care.
All this hand wavy bullshit about regret and age of decision making is a window dressing for the real statement. Women really only have value via childbirth. Until that changes, it's never going to be a real discussion.
I am enraged that the idea of making a human life can even vaguely be considered more "reversible" than a decision to not create life.
posted by teleri025 at 12:16 PM on October 24, 2014 [9 favorites]
I knew when I was 6 years old that I never wanted kids and I finally got rid of my horrible monstrous bleeding agony hellpit of a uterus back in May. I wish I'd been given it in a plastic bag afterwards to take around to all the people who smugly told me "oh, you'll change your mind, sweetie, just you wait!" and slap them across the face with it. The two times I was pregnant (once from just being stupidly careless and once accidentally from a BC failure) I didn't have to consider for more than .02 seconds about how fast I was gonna shut that shit down. I made the doctor's appointments right then and there with the pissed-on stick in my hand.
If I'd been given the chance to get my tubes tied when I was 18, I wouldn't have had to deal with that second abortion which subsequently caused all the painful grotesque problems that led to my hysterectomy in the first place. Instead, I was treated like a stupid child by a bunch of smug condescending assholes who had the nerve to think they knew me better than I ever could.
posted by poffin boffin at 12:16 PM on October 24, 2014 [42 favorites]
If I'd been given the chance to get my tubes tied when I was 18, I wouldn't have had to deal with that second abortion which subsequently caused all the painful grotesque problems that led to my hysterectomy in the first place. Instead, I was treated like a stupid child by a bunch of smug condescending assholes who had the nerve to think they knew me better than I ever could.
posted by poffin boffin at 12:16 PM on October 24, 2014 [42 favorites]
Sublimity -- is IVF after tubal ligation an established and reliable procedure? If so (and I had no idea) it would seem to evacuate any argument against allowing younger women to have tubal ligations.
posted by MattD at 12:16 PM on October 24, 2014
posted by MattD at 12:16 PM on October 24, 2014
getting pregnant is not an irreversible decision
Pregnancy can be aborted, actually having children - not so much. If you're arguing that a parent can put her children up for adoption, well then, I guess "regret" isn't such a big problem after all.
posted by sharktopus at 12:17 PM on October 24, 2014 [3 favorites]
Pregnancy can be aborted, actually having children - not so much. If you're arguing that a parent can put her children up for adoption, well then, I guess "regret" isn't such a big problem after all.
posted by sharktopus at 12:17 PM on October 24, 2014 [3 favorites]
I wish that doctors who denied the procedure could be sued for the cost of raising a child (and sending it to college).
That might change their stance on the subject.
posted by el io at 12:18 PM on October 24, 2014 [3 favorites]
That might change their stance on the subject.
posted by el io at 12:18 PM on October 24, 2014 [3 favorites]
However, getting pregnant is not an irreversible decision and the State can reverse parenthood and divorce/custody can radically alter it. Are you making a point just to make a point or do you think that it should be easy to have children. I would point out that having children, at least in most cases, does involve the active participation of others and should be the result of an active discussion between the consenting parties.
This comment is so far away from practicality that I don't know what it's doing here. Pregnancy is not irreversible but getting an abortion gets you right back to the same crap you get about being sterilized. You will regret it in 10 years! I guarantee it! (Oy vey.)
Carrying a pregnancy to term IS very permanent, whether the state takes your kid away after or not. (I mean, what?) That's a terrible definition of "reversible."
Having children involves the active participation of two people for at least 60 seconds, yet. That's about the extent of it. Yes, it's nice when there's more participation than that (in some cases) but setting policy based on "should be's" has worked out poorly for women, historically speaking.
I don't completely understand this aversion to regrets. There ARE going to be regrets in life. Aiming for a life in which you have zero regrets and all your options are perpetually kept open seems to me to be a modern ideal, and possibly a distinctly American one. I'm not sure.
posted by small_ruminant at 12:20 PM on October 24, 2014 [15 favorites]
This comment is so far away from practicality that I don't know what it's doing here. Pregnancy is not irreversible but getting an abortion gets you right back to the same crap you get about being sterilized. You will regret it in 10 years! I guarantee it! (Oy vey.)
Carrying a pregnancy to term IS very permanent, whether the state takes your kid away after or not. (I mean, what?) That's a terrible definition of "reversible."
Having children involves the active participation of two people for at least 60 seconds, yet. That's about the extent of it. Yes, it's nice when there's more participation than that (in some cases) but setting policy based on "should be's" has worked out poorly for women, historically speaking.
I don't completely understand this aversion to regrets. There ARE going to be regrets in life. Aiming for a life in which you have zero regrets and all your options are perpetually kept open seems to me to be a modern ideal, and possibly a distinctly American one. I'm not sure.
posted by small_ruminant at 12:20 PM on October 24, 2014 [15 favorites]
I still don't understand why it only took me ten minutes of powerpoint and one signature once to take out the loans for grad school, but I'm thirty and I still can't get my damn tubes tied.
You would think that if it only takes a year of therapy and an informed consent to get hormones for transition (did that too, still wondering why $60k in loans were so easy) that there would be a similar process for people seeking sterilization, if taking a person's word for it isn't enough. You can get a full-face tattoo more easily.
posted by blnkfrnk at 12:21 PM on October 24, 2014 [16 favorites]
You would think that if it only takes a year of therapy and an informed consent to get hormones for transition (did that too, still wondering why $60k in loans were so easy) that there would be a similar process for people seeking sterilization, if taking a person's word for it isn't enough. You can get a full-face tattoo more easily.
posted by blnkfrnk at 12:21 PM on October 24, 2014 [16 favorites]
(And pregnancy IS often irreversible if you consider the damage it so often does to women's bodies.)
posted by small_ruminant at 12:22 PM on October 24, 2014 [4 favorites]
posted by small_ruminant at 12:22 PM on October 24, 2014 [4 favorites]
Making any essentially irreversible decision in your twenties, or any age, should be moderately difficult and is properly challenged
Choosing to incur lifelong debt for your college and grad school education is an irreversible decision, one that you will literally be paying for for the rest of your life, and no one ever, ever says "I think you should reconsider this idea and revisit when you're about 35, and if it's still something you want then, we can discuss it again," or in any way presumes to smugly state that you are too immature to make this kind of decision.
posted by poffin boffin at 12:22 PM on October 24, 2014 [32 favorites]
Choosing to incur lifelong debt for your college and grad school education is an irreversible decision, one that you will literally be paying for for the rest of your life, and no one ever, ever says "I think you should reconsider this idea and revisit when you're about 35, and if it's still something you want then, we can discuss it again," or in any way presumes to smugly state that you are too immature to make this kind of decision.
posted by poffin boffin at 12:22 PM on October 24, 2014 [32 favorites]
Pregnancy can be aborted
Sometimes. If you can get an appointment. If you can get time off for the sometimes multiple appointments required because of waiting times. If you can get the money together in time. If you're not a teenager. If there's even a clinic near you.
posted by jeather at 12:22 PM on October 24, 2014 [8 favorites]
Sometimes. If you can get an appointment. If you can get time off for the sometimes multiple appointments required because of waiting times. If you can get the money together in time. If you're not a teenager. If there's even a clinic near you.
posted by jeather at 12:22 PM on October 24, 2014 [8 favorites]
If you live in an ever shrinking number of US states.
posted by poffin boffin at 12:23 PM on October 24, 2014 [15 favorites]
posted by poffin boffin at 12:23 PM on October 24, 2014 [15 favorites]
As I have mentioned before, I was friends with someone who got her tubes tied in her early 20s. In her late 30s she was in a relationship and wanted kids with that guy. So she adopted, but still spoke with great joy of how awesome it was to be able to have all that sex without worrying about pregnancy and wished more people could get the same procedure.
Changing your mind about wanting children doesn't necessarily mean you made the wrong decision earlier.
posted by jeather at 12:27 PM on October 24, 2014 [16 favorites]
Changing your mind about wanting children doesn't necessarily mean you made the wrong decision earlier.
posted by jeather at 12:27 PM on October 24, 2014 [16 favorites]
Good lord what the hell year is this and we are STILL having the tubes-tied-young discussion!?! I should not be reading the same type of article now that I could have read in Sassy way back when.
posted by kimberussell at 12:30 PM on October 24, 2014 [10 favorites]
posted by kimberussell at 12:30 PM on October 24, 2014 [10 favorites]
Sometimes.
If you live in an ever shrinking number of US states.
Sorry, the point I was making is that I wouldn't compare sterilization to abortion. I would compare sterilization to actually having a child. If a person is mature enough to have a child (and put it up for adoption, in case of regret), then a person is mature enough to get sterilized (or adopt, in case of regret).
posted by sharktopus at 12:33 PM on October 24, 2014 [2 favorites]
If you live in an ever shrinking number of US states.
Sorry, the point I was making is that I wouldn't compare sterilization to abortion. I would compare sterilization to actually having a child. If a person is mature enough to have a child (and put it up for adoption, in case of regret), then a person is mature enough to get sterilized (or adopt, in case of regret).
posted by sharktopus at 12:33 PM on October 24, 2014 [2 favorites]
Being pro choice...isn't this a choice? Why would this patient choice be denied?
posted by Chuffy at 12:54 PM on October 24, 2014 [1 favorite]
posted by Chuffy at 12:54 PM on October 24, 2014 [1 favorite]
Some people approach this like some stupid young kid getting a tattoo. I know plenty of women who never want kids, many who made that decision in their 20's and who still don't. It's a lifestyle choice, and anyone who wants to make this decision should be able to carry it out. Why does anyone else care about their decision?
posted by Chuffy at 12:58 PM on October 24, 2014
posted by Chuffy at 12:58 PM on October 24, 2014
I had to sign papers before my husband got his vasectomy
Wait, wait, WHAT? Really? Is this standard, to require a spouse's signature before the husband can have a vasectomy, or was that the doctor being an asshole?
posted by ThatFuzzyBastard at 1:09 PM on October 24, 2014
Wait, wait, WHAT? Really? Is this standard, to require a spouse's signature before the husband can have a vasectomy, or was that the doctor being an asshole?
posted by ThatFuzzyBastard at 1:09 PM on October 24, 2014
Totally agree that all the supposed worry about people having regrets is just a way to rationalize people's horror at the thought that a woman might not want to fulfill her biological destiny and instead decline to bear children. Same thing goes for the supposed fear of lawsuits. Doctors do far more risky elective procedures every day, and they don't seem to be paralyzed with the same fear that a woman is going to change her mind about, say, having radical plastic surgery to make herself look like a cat.
posted by holborne at 1:14 PM on October 24, 2014 [8 favorites]
posted by holborne at 1:14 PM on October 24, 2014 [8 favorites]
according to Janet Crepps, a lawyer at the Center for Reproductive Rights, while there’s absolutely no law requiring men to obtain their partner’s consent, it can be imposed on a case-by-case basis at a clinical level.
Doctors can impose requirements in a private setting in order to protect themselves legally. It’s their choice that they want to do that. While it would be pretty difficult for a wife to successfully sue a doctor for doing a vasectomy on her husband, it wouldn’t surprise me if their legal counsel insisted that they would be better off getting that consent. That said, nobody I know is imposing that kind of requirement.
In short, doctors are given license to decide on whom they perform surgery based on medical judgment and experience, but most of them seem to be conducting themselves reasonably and ethically.
This seems to be the consensus based on a cursory look on the web--my observation
posted by rmhsinc at 1:25 PM on October 24, 2014
Doctors can impose requirements in a private setting in order to protect themselves legally. It’s their choice that they want to do that. While it would be pretty difficult for a wife to successfully sue a doctor for doing a vasectomy on her husband, it wouldn’t surprise me if their legal counsel insisted that they would be better off getting that consent. That said, nobody I know is imposing that kind of requirement.
In short, doctors are given license to decide on whom they perform surgery based on medical judgment and experience, but most of them seem to be conducting themselves reasonably and ethically.
This seems to be the consensus based on a cursory look on the web--my observation
posted by rmhsinc at 1:25 PM on October 24, 2014
having radical plastic surgery to make herself look like a cat.
I would be surprised if every doctor would be willing to perform such a surgery, so I'm not sure that's the best example.
posted by small_ruminant at 1:28 PM on October 24, 2014 [3 favorites]
I would be surprised if every doctor would be willing to perform such a surgery, so I'm not sure that's the best example.
posted by small_ruminant at 1:28 PM on October 24, 2014 [3 favorites]
Doctors can decide on their own private requirements, but the rest of us can mention that a lot of those requirements are sexist as hell.
posted by jeather at 1:31 PM on October 24, 2014 [8 favorites]
posted by jeather at 1:31 PM on October 24, 2014 [8 favorites]
like_a_friend loved your comment but toooooo tempting
Metafilter: SEE WE KNEW YOU WERE NOT A MONSTER NOW BIRTH.
posted by lalochezia at 1:51 PM on October 24, 2014 [4 favorites]
Metafilter: SEE WE KNEW YOU WERE NOT A MONSTER NOW BIRTH.
posted by lalochezia at 1:51 PM on October 24, 2014 [4 favorites]
In my early 30s, I finally found a doctor willing to give me an IUD. I cling to the hope that by the time the IUD is ready to come out, someone will finally agree I am old enough to know my own mind, capabilities, and family history, and to tie my damn tubes. I get angrier about this by the year, so I may be capable of a truly spectacular rage fit by then, if I am denied.
posted by Stacey at 2:56 PM on October 24, 2014 [4 favorites]
posted by Stacey at 2:56 PM on October 24, 2014 [4 favorites]
I may be bias/cynical, but I can't help but nth what everyone else is saying: this is absolutely about controlling women's reproductive rights in some way. Can't have women not popping out babies. In fact, bonus points if they don't want children, end up with one anyway (because we're not sterilizing them) and have to admit they love their children/being a mom (because they probably will, of course) - therefore proving the "all women secretly want to have babies and will change their mind when older and/or need a push" justification they use to deny sterilization in the first place. Or maybe I'm over-thinking it.
What's surprising to me (ok, maybe not), is that this is still a thing.
I encountered enormous opposition to a hysterectomy about 10 years ago. Granted, my experience was exclusively with male military doctors (some older, some quite younger). Despite being of adult age, being transgendered (and yes, following the HBIGDA SOCs), suffering from endometriosis (diagnosed), armed with information, and seeing doctors over several years about the matter, I was still refused every single time I brought it up. There was no dialog. Conversations about it were instantly shut down with a variant of 'no' and a reason. Reasons given to me were:
"You're too young."
"You might change your mind."
"That's what you say now. SoandSo's sister said the same thing and now loves being a mom!"
"It's not medically necessary." (the diagnosis, pain and impact on my life suggested otherwise)
"You're a virgin." (I wasn't) - followed by - "You've never had vaginal sex." (Because oral/anal sex didn't count?)
"You say that now, but you'll feel differently when you meet the right boy."
"Family planning is a decision you and your future husband should make." (Yes, really.)
None of these reasons ever made me reconsider my position. They just made me distrustful of medical professionals and pretty resentful---after all, I'm old enough to sign my life over and possibly die for my country but not enough to make decisions about my own future/body? All because some guys insist I'll want babies if I give it enough time? Fuck that. Ultimately, I ended up finding a women's clinic who was absolutely wonderful and who performed a full hysto shortly after a couple visits and after reviewing all my medical records. That was over 10 years ago. I have not regretted the decision once. I still have absolutely NO desire for children.
The fact that this sort of boils down to 'regret' or not is horrifically patronizing. Lots of choices we make in our youth permanently affect our adult lives -- no one forces us to stave them off because we -might- regret one of them later. As long as someone is of sound mind (ie: capable of understanding the decision they are making and its permanent/lasting impacts), they shouldn't have to fight with medical professionals over decisions involving their own bodies.
posted by stubbehtail at 3:06 PM on October 24, 2014 [17 favorites]
What's surprising to me (ok, maybe not), is that this is still a thing.
I encountered enormous opposition to a hysterectomy about 10 years ago. Granted, my experience was exclusively with male military doctors (some older, some quite younger). Despite being of adult age, being transgendered (and yes, following the HBIGDA SOCs), suffering from endometriosis (diagnosed), armed with information, and seeing doctors over several years about the matter, I was still refused every single time I brought it up. There was no dialog. Conversations about it were instantly shut down with a variant of 'no' and a reason. Reasons given to me were:
"You're too young."
"You might change your mind."
"That's what you say now. SoandSo's sister said the same thing and now loves being a mom!"
"It's not medically necessary." (the diagnosis, pain and impact on my life suggested otherwise)
"You're a virgin." (I wasn't) - followed by - "You've never had vaginal sex." (Because oral/anal sex didn't count?)
"You say that now, but you'll feel differently when you meet the right boy."
"Family planning is a decision you and your future husband should make." (Yes, really.)
None of these reasons ever made me reconsider my position. They just made me distrustful of medical professionals and pretty resentful---after all, I'm old enough to sign my life over and possibly die for my country but not enough to make decisions about my own future/body? All because some guys insist I'll want babies if I give it enough time? Fuck that. Ultimately, I ended up finding a women's clinic who was absolutely wonderful and who performed a full hysto shortly after a couple visits and after reviewing all my medical records. That was over 10 years ago. I have not regretted the decision once. I still have absolutely NO desire for children.
The fact that this sort of boils down to 'regret' or not is horrifically patronizing. Lots of choices we make in our youth permanently affect our adult lives -- no one forces us to stave them off because we -might- regret one of them later. As long as someone is of sound mind (ie: capable of understanding the decision they are making and its permanent/lasting impacts), they shouldn't have to fight with medical professionals over decisions involving their own bodies.
posted by stubbehtail at 3:06 PM on October 24, 2014 [17 favorites]
Some enraging insult to injury:
If I had my way* step 4 would be 'strip doctor of his license to practice'.
*I won't have my way.
posted by el io at 4:12 PM on October 24, 2014
"[The naturopath] would say, 'You can go get a consultation, but you're going to pay for this consultation, and they're going to tell you no,'" Seeley said. "You're too young."So, step one, ask permission. Step two, pay for the privilege of asking permission. Step 3, be told no.
If I had my way* step 4 would be 'strip doctor of his license to practice'.
*I won't have my way.
posted by el io at 4:12 PM on October 24, 2014
roomthreeseventeen - I'm curious why your older husband didn't just have a vasectomy, given the difficulties you were having in finding a solution for yourself?
I had a vasectomy at 23, after the birth of our second child. Partly because of some difficulties my wife had with both pregnancies, but also because we both felt that two children was enough. Great doctor. At the time of the procedure he got my lying on the table, I was nervous of course, and then he brings out 2 house bricks and claps them together, saying "ok, are you ready?". Hilarious.
I can't remember how much it cost - maybe a couple of hundred, and I think it was partly subsidised by Medicare (i.e. Australia's public/free healthcare scheme).
posted by joz at 4:14 PM on October 24, 2014 [3 favorites]
I had a vasectomy at 23, after the birth of our second child. Partly because of some difficulties my wife had with both pregnancies, but also because we both felt that two children was enough. Great doctor. At the time of the procedure he got my lying on the table, I was nervous of course, and then he brings out 2 house bricks and claps them together, saying "ok, are you ready?". Hilarious.
I can't remember how much it cost - maybe a couple of hundred, and I think it was partly subsidised by Medicare (i.e. Australia's public/free healthcare scheme).
posted by joz at 4:14 PM on October 24, 2014 [3 favorites]
I had to sign papers before my husband got his vasectomyPretty standard in some states / practices. A friend was to have balloon ablation after her second child & her doc would not do in until her husband had had the test they do post-vasectomy to prove it had taken.
Wait, wait, WHAT? Really? Is this standard, to require a spouse's signature before the husband can have a vasectomy, or was that the doctor being an asshole?
Some folks wanted to give me a quote to replace parts of my house once.
They wouldn't book an appointment unless I could guarantee my spouse woold be at the appointment for a quote (they looked up my addy & saw him on the title after making said quote appointment). I told them to go away & never call me again.
Had damage to my house a year later - three companies have me a quote without a blink, just needed his sig or POA to do the actual work.
posted by Buttons Bellbottom at 4:17 PM on October 24, 2014
MattD, tubal ligation cuts the Fallopian tubes. There's no reason to remove ovaries and so they presumably remain functional in situ. IVF involves hyper stimulating the ovaries to produce multiple mature ova, which are I believe extracted by syringe and then fertilized in a Petri dish and subsequently implanted in the uterus... Suffice to say that IVF is expensive, complicated, invasive, and risky in many respects. To take that on after the expensive and invasive process of ligation seems like a strange sad choice, but you know, life is long and strange.
That said, vasectomies can be and are sometimes reversed, which is also incredibly invasive and not always successful. (Anecdotally the man I know who got his vasectomy reversed had the procedure done for free by a Christian urologist who felt like he was doing God's work by undoing processes that interfered with natural conception. His fertility ended up being severely diminished anyway which apparently was somewhat related to having been surgically sterile for 15 years.)
posted by Sublimity at 5:54 PM on October 24, 2014
That said, vasectomies can be and are sometimes reversed, which is also incredibly invasive and not always successful. (Anecdotally the man I know who got his vasectomy reversed had the procedure done for free by a Christian urologist who felt like he was doing God's work by undoing processes that interfered with natural conception. His fertility ended up being severely diminished anyway which apparently was somewhat related to having been surgically sterile for 15 years.)
posted by Sublimity at 5:54 PM on October 24, 2014
True story. At 34, I said to my GYN "I'd like to talk about sterilization." She said "Oh, no, honey, you're too young, you're going to change your mind." I otherwise love my GYN, and it's difficult to find a queer friendly fat positive friendly GYN, so I gritted my teeth and said okay. She was willing to put in an IUD, but I was squeamish about that, so it was the pill for another year.
The next year, at 35, I said "I'd like to talk about sterilization." She said "Let me call your insurance and see what they cover."
Maybe it was the two years running that I asked. Maybe it was my age. Who knows. It was frustrating, but I got what I wanted in the end and couldn't be more pleased.
(The punch line to this is I ended up marrying a woman, but we're poly, so... )
posted by joycehealy at 6:11 PM on October 24, 2014 [1 favorite]
The next year, at 35, I said "I'd like to talk about sterilization." She said "Let me call your insurance and see what they cover."
Maybe it was the two years running that I asked. Maybe it was my age. Who knows. It was frustrating, but I got what I wanted in the end and couldn't be more pleased.
(The punch line to this is I ended up marrying a woman, but we're poly, so... )
posted by joycehealy at 6:11 PM on October 24, 2014 [1 favorite]
I was pleased that when I discussed tubal ligation with the doc, following a failed attempt at placing an IUD, his reluctance was not because I was a 35-year-old woman, it was because "This is abdominal surgery under general anesthesia. It's a surgery we do a lot of and we're good at it, but it's still abdominal surgery under general anesthesia. Your husband is willing to get a vasectomy. For him it's not abdominal surgery under general anesthesia. Let him get snipped."
At this point, having had a successful placement verified by a transvaginal ultrasound (oh, so that's what my uterus looks like!) I am so strongly Team IUD it's mildly amusing. One more 10-year copper-T should (with luck) take me into menopause (fingers crossed).
posted by Lexica at 6:22 PM on October 24, 2014 [1 favorite]
At this point, having had a successful placement verified by a transvaginal ultrasound (oh, so that's what my uterus looks like!) I am so strongly Team IUD it's mildly amusing. One more 10-year copper-T should (with luck) take me into menopause (fingers crossed).
posted by Lexica at 6:22 PM on October 24, 2014 [1 favorite]
there's nothing like the same sort of outrage over guys getting their tubes tied, even if they do it young
I looked into doing this when I was in my mid 20s and there plenty of stories about how doctors aren't willing to do it for guys who are under 40 or who don't have multiple kids already. I also know a guy who did it at 20 and he had to look around for a doctor who was willing to do it. So yes, there is the same sort of outrage.
(Also, for a guy it's a much less invasive procedure, so it's a lot easier to do. That means it's a lot easier to shop around to find a doctor who is willing to do it.)
posted by aspo at 6:35 PM on October 24, 2014 [1 favorite]
I looked into doing this when I was in my mid 20s and there plenty of stories about how doctors aren't willing to do it for guys who are under 40 or who don't have multiple kids already. I also know a guy who did it at 20 and he had to look around for a doctor who was willing to do it. So yes, there is the same sort of outrage.
(Also, for a guy it's a much less invasive procedure, so it's a lot easier to do. That means it's a lot easier to shop around to find a doctor who is willing to do it.)
posted by aspo at 6:35 PM on October 24, 2014 [1 favorite]
I then told him that the alternative would be to leave a string of men behind with vasectomies.
And this is bad, because...?
OK, that was low. If you knew my ex SonIL, you'd think it was funny, but yes, it was low.
Off hand I can think of seven young men that have gotten vasectomies (and told me about it! And I'm old enough to be their grandma! What you hear working as a sub teacher....)
To one and all of them, I said, "BRAVO!" Unfortunately, for a couple of them it was too late, they had already reproduced (and were out of the relationship,) but at least they wised up enough to figure out where it was coming from and how to stop it. Those young men that were mature enough to get a vas after having had a child (or two) are at least trying their darndest to pay their child support and be active dads. Unlike my SIL, with five on the ground and ANOTHER on the way. He's a busy guy, thought. It's pretty tough working so hard to avoid working to pay your child support.
posted by BlueHorse at 7:39 PM on October 24, 2014 [1 favorite]
And this is bad, because...?
OK, that was low. If you knew my ex SonIL, you'd think it was funny, but yes, it was low.
Off hand I can think of seven young men that have gotten vasectomies (and told me about it! And I'm old enough to be their grandma! What you hear working as a sub teacher....)
To one and all of them, I said, "BRAVO!" Unfortunately, for a couple of them it was too late, they had already reproduced (and were out of the relationship,) but at least they wised up enough to figure out where it was coming from and how to stop it. Those young men that were mature enough to get a vas after having had a child (or two) are at least trying their darndest to pay their child support and be active dads. Unlike my SIL, with five on the ground and ANOTHER on the way. He's a busy guy, thought. It's pretty tough working so hard to avoid working to pay your child support.
posted by BlueHorse at 7:39 PM on October 24, 2014 [1 favorite]
http://www.ncbi.nlm.nih.gov/pubmed/10546707
These female physicians (ages 30-44 years) were more likely to use contraception than women in the general population (ages 15-44 years); this was true even when the physicians were compared with only other women of high socioeconomic status and when stratified by ethnicity, age, and number of children. Physicians were also more likely to use intrauterine devices, diaphragms, or condoms, and less likely to use female or male sterilization than were other women. Younger female physicians were especially unlikely to use permanent methods, particularly when compared with their age-matched counterparts in the general population. One fifth of contracepting physicians used more than one type of contraceptive; the most frequently used combination was spermicide with a barrier method.
posted by rmhsinc at 7:42 PM on October 24, 2014 [3 favorites]
These female physicians (ages 30-44 years) were more likely to use contraception than women in the general population (ages 15-44 years); this was true even when the physicians were compared with only other women of high socioeconomic status and when stratified by ethnicity, age, and number of children. Physicians were also more likely to use intrauterine devices, diaphragms, or condoms, and less likely to use female or male sterilization than were other women. Younger female physicians were especially unlikely to use permanent methods, particularly when compared with their age-matched counterparts in the general population. One fifth of contracepting physicians used more than one type of contraceptive; the most frequently used combination was spermicide with a barrier method.
posted by rmhsinc at 7:42 PM on October 24, 2014 [3 favorites]
I would be surprised if every doctor would be willing to perform such a surgery, so I'm not sure that's the best example.
The example was deliberately absurd. My point is that doctors don't seem to have much trouble performing other procedures that are irreversible or not easily reversible and that might well lead to regret, suggesting there's something else going on here other than being concerned with women's feelings.
posted by holborne at 8:10 PM on October 24, 2014
The example was deliberately absurd. My point is that doctors don't seem to have much trouble performing other procedures that are irreversible or not easily reversible and that might well lead to regret, suggesting there's something else going on here other than being concerned with women's feelings.
posted by holborne at 8:10 PM on October 24, 2014
I got curious about what the actual stats were about female vs male sterilization usage, so I googled around and found several articles. There's loads to ponder in them, but here are some of the things I found interesting:
1. "Male sterilization (vasectomy) is the most effective form and only long-acting form of contraception available to men in the United States. Compared to female sterilization, it is more efficacious, more cost-effective, and has lower rates of complications. Despite these advantages, in the United States, vasectomy is utilized at less than half the rate of female sterilization." [pdf] from the peer-reviewed journal Conception.
2. As one might expect, rates of tubal ligation go up with age. Of people who use contraception, the rates of tubal ligation in each age group are: 20-24: 2%; 25-29: 15%, 30-34: 29%, 35-39: 38%, 40+: 50% [page 10 in this very interesting pdf from the CDC]
3. I believe this is the study where the 0.9-26% statistic came from. (Actually, it cites this paper, but I can only find an abstract so that's not much use). From the first paper: "Patient regret following the procedure is the most common long-term complication of sterilization, with rates reported anywhere from 0.9% to 26% for female sterilization and less than 5% for male sterilization. According to the CREST study, the cumulative probability of expressing regret following tubal sterilization was 12.7% (95% CI, 11.2–14.3). Several patient characteristics have been determined to be predictors of regret. Young age at the time of sterilization is the strongest predictor of future regret. Women under the age of 30 at the time of the procedure were twice as likely as women older than 30 to report regretting having the procedure performed (Figure 5)." You can see Figure 5 at the first link, which does break it down into smaller age ranges, and it does indeed show a pattern where younger ages have higher regret.
4. The paper in #3 goes on to say: "Furthermore, CREST data demonstrate that women regretting their partners’ vasectomies (6.1%; 95% CI, 3.6–8.6) is similar to that of women regretting their own tubal sterilizations (7%; 95% CI, 5.8–8.1)."
5. And finally, still from the paper in #3, there is some evidence of unequal treatment under the law: "In all states, there are special consent forms for all women undergoing publicly funded sterilization. A few states have special consents for all women seeking sterilization. Medicaid-funded sterilizations require a 30-day waiting period between consent and the procedure (except in the special circumstances of premature delivery or emergency abdominal surgery in the setting of prior consent) and that the patient be at least 21 years old and mentally competent. There are no such restrictions for male sterilization. Arbitrary denial of patient sterilization by health care professionals has been ruled in US courts to violate a man’s or woman’s basic rights."
Anyway, I found it all interesting, thought others might as well.
posted by forza at 8:37 PM on October 24, 2014 [10 favorites]
1. "Male sterilization (vasectomy) is the most effective form and only long-acting form of contraception available to men in the United States. Compared to female sterilization, it is more efficacious, more cost-effective, and has lower rates of complications. Despite these advantages, in the United States, vasectomy is utilized at less than half the rate of female sterilization." [pdf] from the peer-reviewed journal Conception.
2. As one might expect, rates of tubal ligation go up with age. Of people who use contraception, the rates of tubal ligation in each age group are: 20-24: 2%; 25-29: 15%, 30-34: 29%, 35-39: 38%, 40+: 50% [page 10 in this very interesting pdf from the CDC]
3. I believe this is the study where the 0.9-26% statistic came from. (Actually, it cites this paper, but I can only find an abstract so that's not much use). From the first paper: "Patient regret following the procedure is the most common long-term complication of sterilization, with rates reported anywhere from 0.9% to 26% for female sterilization and less than 5% for male sterilization. According to the CREST study, the cumulative probability of expressing regret following tubal sterilization was 12.7% (95% CI, 11.2–14.3). Several patient characteristics have been determined to be predictors of regret. Young age at the time of sterilization is the strongest predictor of future regret. Women under the age of 30 at the time of the procedure were twice as likely as women older than 30 to report regretting having the procedure performed (Figure 5)." You can see Figure 5 at the first link, which does break it down into smaller age ranges, and it does indeed show a pattern where younger ages have higher regret.
4. The paper in #3 goes on to say: "Furthermore, CREST data demonstrate that women regretting their partners’ vasectomies (6.1%; 95% CI, 3.6–8.6) is similar to that of women regretting their own tubal sterilizations (7%; 95% CI, 5.8–8.1)."
5. And finally, still from the paper in #3, there is some evidence of unequal treatment under the law: "In all states, there are special consent forms for all women undergoing publicly funded sterilization. A few states have special consents for all women seeking sterilization. Medicaid-funded sterilizations require a 30-day waiting period between consent and the procedure (except in the special circumstances of premature delivery or emergency abdominal surgery in the setting of prior consent) and that the patient be at least 21 years old and mentally competent. There are no such restrictions for male sterilization. Arbitrary denial of patient sterilization by health care professionals has been ruled in US courts to violate a man’s or woman’s basic rights."
Anyway, I found it all interesting, thought others might as well.
posted by forza at 8:37 PM on October 24, 2014 [10 favorites]
Is "regret" taken into account in any other professional situation of similar importance?
The specter of regret is also commonly raised when pressuring trans people to delay or forgo transition.
posted by vibratory manner of working at 12:56 PM on October 25, 2014 [3 favorites]
The specter of regret is also commonly raised when pressuring trans people to delay or forgo transition.
posted by vibratory manner of working at 12:56 PM on October 25, 2014 [3 favorites]
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