Why, No—I'm Not an Idiot, But Thanks for Assuming

by Shaker Ali_K

When I was much younger, I didn't know that childless (by choice) women existed. I believed that every good girl had to get married and have children when she grew up. But even in the patriarchy-induced stupor, my girlish fantasies involved loopholes. I didn't daydream of mini-Ali's, but about convents or adoption.

I didn't want biological children then, and I don't want children at all now. Hey, I like kids; I just have no desire to have children of my own. And, well, being an atheist kind of knocked that whole nunnery thing right out of the picture. I don't want children, but—surprise, surprise—I do like sex (sorry, Catholic Republican parents!), so I decided to opt for a birth control that was a bit more permanent and didn't come with the negative reactions I've experienced with other temporary options. I thought about it, did the research, thought about it some more, did even more research, then decided on a permanent, nonreversible option that worked best for me and my concerns.

Unfortunately my OB didn't care about any of that. She didn't care how long I had thought about it or how much research I had done. She didn't even care about the serious reactions I was having to my current birth control method. She didn't care about any of that because she never heard it. All she heard was 25 and childless and her only response was along the lines of, "No, you might regret it. Lots of other women have."

After lots of tears and screaming into the phone (oh, I was classy, let me tell you), I decided to do some research on that one little thing that I kept being told: "Lots of women have regretted it." Something about it just didn't sit right, starting with never being told how many women "lots" is, and also not being told, despite asking numerous times, what this magical age was when I'd finally be able to determine my own reproductive future. I decided to find out for myself.

1. The most recent (2002) study I found said that only 7% off all women who were voluntarily sterilized experienced regret up to 5 years after their sterilization, comparable to the rate of women regretting their husband's vasectomy.* And the greatest risk factor for regret (according to the abstract) was when the women reported conflict with their partners at the time of sterilization. Even so, the reversal rate (not just regret) for women topped out at 2.2%.

2. In a Journal of Reproductive Medicine study that broke down the results among age groups, women under 27 years had only a 2% higher rate of regret than older women. And, the part that made me particularly happy, "single women were more certain than mothers of their decision to be sterilized."

3. A CDC study also found the same 2% difference between older and younger women, with the former having a regret rate of 2.4% and the latter having a regret rate of 4.3%.

4. The longest-running study I found (14 years versus 5 years) had the highest regret rates—20.3% for women under 30.

This last one is most likely the number (1 in 5! 1 in 5!!!! BOOGABOOGA!) that doctors will cite to young women like me, but even just looking at the abstract, 20% is not the end of the story:

For women aged 30 or younger at sterilization, the cumulative probability of regret decreased as time since the birth of the youngest child increased … and was lowest among women who had no previous births (6.3%).

Women who don't want children tend to continue to not want children. Who knew?

And what is this dreaded regret anyway? First off, regret does not necessarily mean desire for a reversal. I regret not applying to MIT for college. I wouldn't have gone there regardless, but it would be kind of neat to see if I would have been accepted. Regret can simply mean you didn't think out all the details as well you would have liked. And yes, young age is a stronger indicator of possible regret, but so is a change in marital status, having experienced marital problems at the time of the procedure, and being sterilized immediately after giving birth. And what is the best way to ensure satisfaction instead of regret? Presterilization counseling. Something I was never offered.

Yes, regret after a permanent procedure like sterilization is a horrible outcome, but looking at the numbers, and knowing how to counteract a lot of potential regret, it is ridiculous that an entire subset of the population is outright denied this procedure. Are there any other common procedures that are denied to huge swaths of people simply because of possible regret afterwards?

Liss made the point: "Millions of women have elective—and irreversible—cosmetic surgery procedures done every year, some of them high-risk, just to adhere more closely to the contemporary beauty standard, and yet doctors don't routinely discourage the practice by ominously quoting rates of regret or reconstructive surgery to 'fix' or make further adjustments to surgically-altered areas. Isn't it funny (where funny equals totally fucking infuriating) that women who want to alter their bodies to conform to patriarchal expectations aren't disabused of their desires, but women who want to alter their bodies in a way perceived (often rightly) as a rejection of those expectations are discouraged at every turn?"

Isn't it just?

This is a huge issue. Doctors (once again) are trying to protect women from themselves, when the evidence clearly shows that we do not. need. protecting. It took me 3 pages of doctors** and half a day of phone calls before I was finally able to find a doctor even willing to see me. What happens when a woman doesn't have the time that I did to make those phone calls? If she lives in a place that doesn't have 3 pages of doctors who do a certain procedure? If she gets discouraged by the constant nos and inability for anyone to listen? If she doesn't have insurance (or good enough insurance) to be able to cover the procedure when she finally does find a doctor, or if any doctor she finds will even be on her insurance plan?

This is just one more aspect of women being "less than" and it's fucking sickening. If you don't want children, you're outta luck. If you do want children, but society doesn't find you "acceptable," you could have your children forcibly taken away from you or you could be sterilized against your will or under false pretenses. You're outta luck. If you want children and you're fortunate enough that society does find you "acceptable," society will still do fuck-all for you the second you need any kind of help in caring for your children. You're outta luck. Even if you do the "right" thing by society, and give up unwanted children as opposed to aborting, you're still outta luck.

We need to fight for all of our reproductive rights, and for the rights of women who can't fight, because the people in charge sure won't do us any favors.

UPDATE: I don't know how I missed this article in all the rampant google research I did on sterilization. It describes just perfectly the frustration young women like myself go through when we are denied sterilization and the paternalism of doctors who refuse to provide us with treatment. There are 2 quotes I'd like to highlight, but definitely go check it out for yourself.

Why do we arbitrarily choose thirty? Because of the thirty years of practice in my life. Because of the number of years of experience that we, as physicians, have come to see that twenty-five, twenty-six, twenty-seven year old women have, historically, more often than not, told you they regretted their decision to get their tubes tied.

That was Dr. Daniel Wiener, assistant professor of obstetrics and gynecology at McGill University in Montreal, who obviously did not do the whopping half a day of research that I did.

I think there's definitely this idea where a woman's function is to have babies cause your body is made to do it. My body is made to do a lot of things. It's made to run. That doesn't mean I go running every day. Nor should I have to.

And that was Lauren Green (name changed), giving the best. quote. eva.

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* In all my mad googling, the only regret rates I could find for vasectomies studied the wives and not the men themselves. Does anyone know the rate of regret for male sterilization?

** Until I called up that last doctor, only one person even bothered to ask why I wanted permanent sterilization. At one point she asked me what I would do if 10 years from now I changed my mind. Evidently "adoption" is not a legitimate answer.

(Crossposted.)