If you’re old enough to have a child, you’re old enough to decide that you don’t want them. Each year, around 700,000 child-bearing people choose to be sterilized, and that number is only growing following the fall of Roe v. Wade. After the Supreme Court took away our constitutional right to abortion healthcare, the search volume for terms such as “tubes tied” and “tubal ligation,” the process by which the fallopian tubes are blocked or cut, nearly quadrupled.
These procedures have always been relevant and needed, even before this enormous blow to human rights — but they haven’t always been easy to get. Although around one in four Americans are able to complete the procedure, there are an overwhelming amount of anecdotes about people experiencing pushback, shame, and downright refusal from their doctors for seemingly random, inconsequential reasons.
It’s hard to ignore that the procedure has insidious roots. The U.S. has a long history of forced sterilization, and it has always been a ghastly tool used to enforce eugenics and racism — and we haven’t exactly escaped it. From the 1900s to the 1970s, thousands of Black and brown women were forcibly sterilized without their knowledge. In 2020, it was reported that ICE had been performing mass hysterectomies on migrants at one of its detention centers in Georgia. Puerto Rico is still reckoning with its legacy of mass sterilization.
Reproductive justice doesn’t just mean access to abortion, but the agency to reproduce — at all, or never — on one’s own terms. We spoke with four people about their experiences seeking sterilization, both successful and not.
Jenna Clark, 22, New York City
“I always knew that I didn't want children. When I went to seek sterilization last fall, I went to multiple gynecologists. The first doctor was very dismissive and said something along the lines of, ‘Oh, you're very young. Are you sure it's what you want?’ They kind of ignored the request completely and recommended birth control. For me, hormonal birth control was something I definitely didn't want because of the side effects.
I decided to try with a different doctor. This one was even more dismissive than the first. As soon as I mentioned it, she was like, ‘There's birth control for that.’ There was no conversation and that was when I started to get really angry about them dismissing me because of my age. I felt like their personal biases were being brought into the conversation. It wasn't a medical reasoning that they were giving me; it was more of their personal opinion.
I was kind of hoping that because I'm in New York City doctors would be more open to the idea, and I was very surprised that they were so averse to it. I haven’t given up yet. I've been researching doctors who may have more of a progressive view, and I’m trying to find sources online to see who else has had it done young and reach out to them. I’ve seen some posts of gynecologists who are willing to do it, but finding ones that are under my insurance in the area has been difficult. When I look at the list I’ve made, the closest one to me is in Pennsylvania.
Following the reversal of Roe v. Wade, I think getting the procedure is going to be even harder because everyone's trying to get it done. It’s very disheartening. I have spoken to my family and friends about it, and my friends are super supportive. They think that it's my decision, my body, and I should be able to do what I want, whereas the older people in my life say that I don't know what I’m talking about or that I’ll change my mind or my biological clock will tick or whatever.
It’s frustrating to be on the younger side and try to get this procedure. I feel like there shouldn't be this much of a pushback; I shouldn't have to potentially drive to Pennsylvania to get it done.”
Natalie Bartels, 31, San Diego
“I’ve always known from a very young age that I didn't want kids — it's never been something that’s a maybe for me. I went on birth control around 18, and in my mid-twenties I started to think it might be nice not to have to take this pill every day or put a bar in my arm just to avoid getting pregnant. So during one of my regular visits when I was 25, I asked my physician if I could get my tubes tied. It was almost like a joke to her that I was asking for it. She said that it was a no from the hospital she was affiliated with for anybody under the age of 30 to do that procedure. When you're 30, if that's still how you feel, you can come back and discuss it.
The doctor kept saying that when people get older they change their minds, and this is not reversible. I kept trying to tell her that I understand that some people change their minds, but that's not me, and at the end of the day if that is something that I change my mind on later, that's my decision to deal with repercussions. What really stood out to me was that 30 was this magical age then you’ll know what you're doing. I wasn’t really sure what the difference between 25 and 30 was going to make for me personally. I had a long-term partner then, and I told my doctor that my partner and I both decided that we weren't having children.
The next time I asked, I was 27 and living in California. I was separated from my long-term partner, but still very confident in my decision. The provider gave me the same answer. I remember feeling like, This is a male doctor telling me that I can't make this choice for myself because I need to wait and see what my future male partner wants. To me, that was so fucked up because I don't care what my future partners want, it's not up to them whether I'm having kids or not. It felt like it came down to, ‘We'll let the man decide when you get with him.’
As women, we see this in healthcare in general. We don't really know how to fight back and advocate for ourselves. I was definitely at an age and in a position in life where I didn't know that I could push back and say, No, this is my decision. I trusted my doctor. I wish that I had been more knowledgeable about the impacts of birth control, because if I'd gotten off of that sooner, I think I could have avoided other stressors in my life.
I got married in October 2020, and my partner and I are both very sure that we don’t want to have kids. Now that we’re in our thirties, people take it seriously. We had a conversation about whether or not he or I were going to get sterilized, and obviously it's easier for a man to get it done. We found a person here in San Diego and it was one of the easiest experiences. The co-pay was $50, it took 30 minutes, he recovered in three days.
We were in the consultation together and I remember that he didn’t experience the same questioning I had. It was, ‘Okay, we've got these dates available, let’s get you on our schedules, this is what pre- and post-op are like.’ The doctor was great and I appreciated that experience, but it was definitely a stark contrast.
While I am so appreciative that he got the procedure for us and it was something that he chose to do, it again put the decision in his hands. One of my fears now, in a post-Roe v. Wade world, is what happens if I get pregnant for some other reason? Whether his vasectomy fails, or if I'm attacked… There's a lot of things that are possible, and me not having been able to get that procedure before and now being off birth control could mean an unwanted pregnancy. Thankfully I'm privileged enough that I’m currently in California or could access a different state if needed, but it again causes that fear of not having control. I'm still counting on somebody else to do that for me.
I'm again considering trying to get my tubes tied. I haven't taken any steps towards it, but I have talked to some other friends who've done it. I think I need to educate myself more on the impact of it long-term and I just got my body into a good place after being off birth control for seven months.”
Kore Inman, 25, New York City
“It’s not that I don't enjoy children — I work with them. I like being around them. It’s really the idea of being pregnant that scares me and makes me uncomfortable. It seems like being a parent is a very selfless, all-in thing to want to do, and it’s just not me. I don’t have the desire to give up my life for someone else. Maybe that's selfish, but that's just how I feel.
When I was about 17 or 18, I told my mom that I don't think I'm going to have children, and she said the standard, 'You'll change your mind,' but I was like, no, I'm thinking about getting my tubes tied. All of a sudden she switched up and started screaming. My mother has her tubes tied, so I didn't understand why she was so mad at me for wanting my tubes tied. At the time, I was still seeing a family physician who was seeing my entire family. She was a Black woman and I was really hoping she’d be on my side, but because she was my mother's doctor, my mother had spoken to her about it, so of course she gave me the same speech.
I stopped seeing her after a couple of years and bounced around from doctor to doctor. The first thing I would tell them was, I don’t want to have children and I’m looking to get my tubes tied. All of them gave me the same speech: If that’s what you really want we can do that, but this isn’t reversible, and what if you get married in a couple of years? It was just so frustrating because first of all, I wasn't even dating anybody at that time, so not only are you telling me I can't get this thing done on my own body, but I needed permission from somebody I haven’t even met yet.
I really prefer seeing Black female gynecologists, but of course I would see anybody because I was looking to get the procedure done as soon as possible. I went to this one white male doctor at a clinic in the Upper West Side. I explained that I was looking for a new primary care physician, but what I was really looking for was someone who would agree to tie my tubes because I do not want to have children. He was the most condescending, saying, ‘Oh, you're so young, you're going to change your mind, you're so beautiful, why wouldn’t you want to have babies? Any man would be so lucky.’ I understood what he was trying to say, but I had been told no so many times and the way he was saying it made me upset and I started screaming at him. After that, I sort of just stopped looking for a couple of years.
When I turned 24, I started going out with someone and while I was with him, I happened to get pregnant. I immediately knew I wanted to terminate — it was awful. I ended up scheduling my abortion a couple of weeks later at a Planned Parenthood on Christmas Eve, and they were so amazing. They were absolutely wonderful to me there. I asked them if they could do anything for me in regards to getting my tubes tied, and they said they could give me an IUD that lasts 10 years. So, I now have an IUD. I would love to have it removed if possible, but right when I was thinking about getting it removed, they overturned Roe v. Wade. I decided to keep it in, because I never know where I will go or end up, and the last thing I need is to end up in a state where I would have no idea what to do if I got pregnant."
Shannyn McCauley, 31, Washington D.C.
“As soon as I turned 18, I started trying to either get the partial hysterectomy or my tubes tied — any kind of surgery to prevent me from having kids and hopefully eliminate some of the period pain I had been having. My doctors said that I was too young and that I didn't know what I was doing. It was just constant rejection.
I had just graduated high school and my classmates were getting pregnant and having babies, and everyone was saying that that's okay and normal and fine. But for me, to say the opposite, that suddenly I'm too young to make that decision — it just felt really hypocritical to me.
I’ve asked at least once a year since then. Since I moved fairly often, I asked a different doctor almost every time. There was one point in my early twenties where I was getting really frustrated with the whole thing. I'd asked so many people, I had done all this research, and I was trying to sound really educated to see if that would help, and it didn't. And I gave up.
There were two years that I didn't ask anyone about it because I felt like it was never going to happen. Then I got married and started trying to do it again and it was almost worse. It turned into doctors asking what my husband would think or would he give me permission to do that. I'm not his property. He doesn't have any control over me, and he doesn't want children either. It blew my mind. I never encountered something like that in my adult life before, where anyone tried to act like a man had a say in what I was doing with myself. One doctor said that I needed my husband to sign a permission slip, and I wasn’t going to entertain that.
I’m not actively seeking it out anymore as far as birth control goes because my husband got a vasectomy. I’d still like to do something about my uterus for my period pain."