Why Are Childfree People Still Struggling To Have Their Requests For Sterilisation Taken Seriously By Medical Professionals?

“If they are prepared to assist somebody of the same age in getting pregnant (an equally permanent decision) then refusing to sterilise is rooted in discrimination and misogyny.”

Selection of Contraceptives by Reproductive Health Supplies Coalition via Unsplash
Selection of contraceptives: emergency pill, contraceptive pills, vaginal ring, IUDs, female and male condoms, DMPA. By Reproductive Health Supplies Coalition via Unsplash.
https://glumshoe.tumblr.com/post/617982353726488576/im-absolutely-blaming-doctors-who-insist-that-i

 

While social media is not a peer-reviewed, science-based source for medical ethics, Tumblr user ‘glumshoe’ makes a great point about the requirements childfree people, particularly women, face in trying to get sterilisation. Why do medical professionals continue to make it extremely difficult, or flat out prevent their patients from achieving sterilisation?

A childfree person is someone who has made the decision to never become a parent (different from a childless person, who is simply someone without children currently), and these people could simply use temporary contraception, however there is a desire for sterilisation among these communities.

Part of the appeal of sterilisation for childfree people is having a more permanent and effective contraceptive method. For some, it’s a relief not needing to constantly worry about temporary contraception in their sexual relationships. For others, temporary contraception comes with its own set of issues: hormonal contraception can cause more problems than it solves, condoms can break, temporary options can get expensive, among others. Wanting a life without the risk of pregnancy should be much easier than this, yet medical professionals continue to place their personal opinions on their patients. Why is this the case?

Some possible answers are discussed in the Tumblr thread above, one being that a patient who does happen to change their mind about wanting children might sue the doctor for performing the surgery. A valid fear for a medical professional, perhaps, but should this possibility allow doctors to prevent people from seeking their desired elective surgery?

In a survey conducted in a childfree Facebook community, respondents said that doctors have refused them for sterilisation for anecdotal reasons, such as “you will change your mind”, “you just haven’t met the right guy yet”, and “you don’t have two children yet”.

One respondent shared this story:

  • “The last GYN I saw asked me what my husband would think if he knew I was attempting to seek sterilization, as if it was something I was doing behind my partner’s back. When I explained that I was engaged and not married, but that my partner knew and also didn’t want children, the doctor said I should not get sterilized because one day I might meet a nice man who wanted children and I would want to be able to give them to him because deep down we all want to be mothers. It was incredibly condescending and upsetting.

This kind of response, while unprofessional, is unfortunately all too common for the childfree community. In this story alone, a woman is accused of not communicating with her partner and seeking an important surgery behind his back (as though she might need his permission to do so), then condescendingly told that she does not know what she wants in life, with a nice dash of assumption that her current relationship might not work out, to round it out.

Another issue with the above story is the general society’s apparent obsession with parenthood, and the idea that if someone doesn’t want this life there must be something wrong with them. Parenthood is a choice, not a requirement, and one that should be very carefully considered.

Another responder to the survey said:

  • “Lots of “you’ll change your mind”, “what if your husband wants kids”, “what’s wrong with hormonal birth control?” “you’re too young to make a permanent decision” (I was 30). Just LOTS and LOTS of second guessing, undermining my decisions, and patronizing statements.”

Many other responders had similar experiences:

  • “I’m always told “I might change my mind” or “what if your future husband wants kids?” I won’t change my mind, or marry someone who wants kids.”
  • “Usual patronising ‘you’ll change your mind’ garbage. I haven’t changed my mind.”
  • “A doctor did tell me I was too young to have a hysterectomy. We were discussing it as I have dysmenorrhea.”
  • “Even gynaecology stated they’d expect me to have an IUD first before surgery.”
  • “She flat out told me that because I didn’t have two kids she wouldn’t sterilise me. She said my husband could get a vasectomy but she wouldn’t approve my sterilisation. I asked if I could have ten kids, on the national health service no questions asked, everything paid for and she said yes. But not sterilisation.”

These kinds of stories are common, not only in online social communities, but in the media. Holly Maitland, who, despite being 27 weeks pregnant with her third child, was still denied sterilisation by doctors, as she was 22 years old at the time. It took Alejandra Mattoni 13 years of pain and discomfort to find a doctor willing to sterilise her. Jessica Hill waited 12 years before a doctor agreed to sterilise her.

Why are women consistently made to feel as though they do not know what is best for their body and their life? Like they do not know what will make them happy?

According to the Government of Western Australia North Metropolitan Health Service, there are no legal or medically ethical reasons to deny a young woman sterilisation even if she has not given birth previously – it simply states that more care is needed in the lead-up to the procedure.

In a 2005 article from the British Medical Journal, Piers Benn, lecturer in medical ethics and law and Martin Lupton, consultant in obstetrics and gynaecology, discuss the ethics involved in performing sterilisation on young, competent, childless women. The summary states:

“Later regret should not be a factor in a doctor’s decision about whether sterilisation is in a patient’s best interest. Sterilisation of young, childless adults for non-medical reasons is ethical if they are properly informed of all the risks, including regret.”

Responders to the survey were asked for their opinions on doctors who refuse patients for sterilisation (assuming the procedure would not gravely and physically injure the patient). These are some of the responses:

  • “It’s not their choice.”
  • “I believe it is wrong to deny anyone a sterilisation procedure should this be their choice. I believe it’s a fundamental human right and denial is tantamount to abuse.”
  • “If they are prepared to assist somebody of the same age in getting pregnant (an equally permanent decision) then refusing to sterilise is rooted in discrimination and misogyny.”
  • “I don’t think it’s acceptable to deny sterilisation to any patient making that informed choice.”
  • “It’s unethical to determine whether or not someone should be allowed to have an elective surgery because they might think of them as “too young” or whatever reason it may be.”
  • “They need to put their patients before their own opinions.”
  • “It’s not their body so it’s not their choice. I would appreciate to know all side effects and risk just like with any procedure but at the end of the day it is my body.”
  • “Get your opinions out of my life. Same with pharmacists that won’t hand out plan b or birth control. It’s none of your damn business! You have no dog in the race and therefore no opinion. If I change my mind, that’s on me.

One of the key take-aways from these opinions is that the childfree community are not able to make an important decision regarding their own body. This is very frustrating to the respondents as, for the most part, the surgery only affects them as the patient, not anyone else. Yet, they are still denied.

Whether or not childfree people should have access to sterilisation is seemingly as controversial as whether women should have access to abortion (they should). Ironic, as access to sterilisation would prevent unwanted pregnancies and potential abortions. Unfortunately, a societal obsession with parenthood and the constant, incorrect belief that childfree people – especially young women – do not know what they want in life continues to prevent access to sterilisation.

Much like access to abortion, access to sterilisation is not something that warrants an opposing opinion.

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