Sterilization and Sexism

[Blalron]

I've heard it's virtually impossible for a woman who hasn't had any kids to get her tubes tied, whereas it's relatively easy for a man in a similar situation to get a vasectomy.

If this is indeed the case, shouldn't the law step in to address this inequality?

It always seemed like a bullshit argument to deny the procedure because later the person may regret it. It may very well be a permanent decision, but so is having a child. It is vastly better, in my not so humble opinion, to regret never having a child than to have a child whose existence you'll (secretly, because admitting it out loud would never be socially acceptable) regret.

[Jillyvn]

I have addressed this issue with my doctors and can speak to it from a personal standpoint.

I have wanted to be sterilized since I was about 19. At that age, I knew it was impractical, and I held off doing anything about it since I knew I would be laughed out of the office. My reasons, however, may somewhat complicate the debate since they are medical in nature - I would like to have a hysterectomy to help deal with my endometriosis.

When I was 22, and the pain was so intense I could barely function, I asked about a hysterectomy. I was told that I would need to have a child before they would consider it. I explained that I do not ever intend to have child, which was greeted with much scepticism. I was repeadetly told that I would change my mind when I "settled down". When I was 24, I asked again, and was given the same reason. At 27, I was told they would consider it if I was firmly committed to being childless after 30. All this when I had a sound medical reason for wanting the hysterectomy. I can't imagine what women go through trying to get their tubes tied at a younger age without children.

I wonder if the doctors refuse to do this is based on the numbers of women who later "regret" their decision. I'm not sure of the stats on this. I would be curious to know if a woman can sue a doctor for malpractice for performing a sterilzation at a young age and if this is a factor in the doctor's decision making process?

I fully agree with the OP, and I think this is firmly a women's rights issues. No one but me should be entitled to decide if I have children, and if I make the choice to deal with it permanently before becoming pregnant so much the better. Complications may arise if there are mental health issues, or rash decisions due to sudden life changing events... but on the whole, this one is clear cut for me.

[Blalron]

Originally Posted by Jillyvn

When I was 24, I asked again, and was given the same reason. At 27, I was told they would consider it if I was firmly committed to being childless after 30. All this when I had a sound medical reason for wanting the hysterectomy. I can't imagine what women go through trying to get their tubes tied at a younger age without children.
.

So apparently it takes 12 years or so of consistantly wanting to be childless for that decision to be "valid", but the decision to have a child can be had in a single night over a few glasses of wine.

[Der Trihs]

Originally Posted by Blalron

So apparently it takes 12 years or so of consistantly wanting to be childless for that decision to be "valid", but the decision to have a child can be had in a single night over a few glasses of wine.

Rather like the abortion debate, where an underage girl isn't "responsible enough" to choose abortion, but somehow IS responsible enough for pregnancy, childbirth and parenthood.

[Justin_Bailey]

Doesn't this really just come down to the fact that a vasectomy can be reserved and a tubal ligation or hysterectomy can't?

[WhyNot]

Originally Posted by Justin_Bailey

Doesn't this really just come down to the fact that a vasectomy can be reserved and a tubal ligation or hysterectomy can't?

Vasectomies can not be reliably reversed. If you're considering a vasectomy, consider it permanent. While a reversal can sometimes be done, you won't know before hand if your scar tissue will allow it.

As for the matter at hand, I think it's ridiculous, but I'm not sure legislation is the way to go here. Seems like what it would take is a change in standards of practice - probably by the The American Board of Obstetrics and Gynecology and/or the AMA.

And I do think it's a misogynistic holdover - from the idea that all women must want children from their own wombs and the fragile creatures will be devastated someday if they can't. And, of course, Doctor Knows Best. Otherwise, they'd suggest egg harvest and surrogacy or adoption as alternate ways to become a mother.

[Drain Bead]

I've also heard about successful tubal reversals--I've seen a few women get pregnant after a tubal reversal on a pregnancy message board I frequent.

[Kobal2]

Originally Posted by WhyNot

Vasectomies can not be reliably reversed. If you're considering a vasectomy, consider it permanent. While a reversal can sometimes be done, you won't know before hand if your scar tissue will allow it.

As for the matter at hand, I think it's ridiculous, but I'm not sure legislation is the way to go here. Seems like what it would take is a change in standards of practice - probably by the The American Board of Obstetrics and Gynecology and/or the AMA.

And I do think it's a misogynistic holdover - from the idea that all women must want children from their own wombs and the fragile creatures will be devastated someday if they can't. And, of course, Doctor Knows Best. Otherwise, they'd suggest egg harvest and surrogacy or adoption as alternate ways to become a mother.

Not sure it's misogynistic per se. I too don't ever want to have children, yet every time I mentionned the fact to siblings or doctors, I got the "you don't know yet, you'll change your mind, trust us, you'll settle down, you're young, blah blah blah" speech. Yet I'm a big (er...) strong (ERRRR...) man.

So either it's merely an age thing ("you're a dumb 18...22...30 year old kid, Father Knows Best") or it's a societal thing ("If you don't want kids, you're a freak, buddy.")

[Justin_Bailey]

Originally Posted by Kobal2

So either it's merely an age thing ("you're a dumb 18...22...30 year old kid, Father Knows Best") or it's a societal thing ("If you don't want kids, you're a freak, buddy.")

Couldn't it be super secret choice C: This is a fairly permanent operation (that can only be reversed with luck) and it it not medically beneficial to 99.9% of the world. Therefore, it would be irresponsible to do it to someone under X number of years old.

[catsix]

Justin_Bailey said:
Couldn't it be super secret choice C: This is a fairly permanent operation (that can only be reversed with luck) and it it not medically beneficial to 99.9% of the world. Therefore, it would be irresponsible to do it to someone under X number of years old.

The age at which I can have elective surgery under general anesthetic by providing informed consent is 18. I could go into an operating room for a tummy tuck, a breast augmentation, breast reduction, ACL repair, or any other procedure without anyone ever saying 'You are too young to make this decision.'

I've been trying to get sterilized for 12 years, since I was 18. Although most such procedures require going under general anesthesia, there is at least one that does not. Essure is permanent, non-hormonal birth control which can be put in place as an outpatient procedure with minimal risk and recovery time.

The fact of the matter is that I could decide, as has been mentioned, after a couple or ten drinks that I need to have a kid, right now, and nobody would dare ever question whether I am old enough (I'm 30) to make such a permanent decision. I have had doctors tell me that I'm not old enough, that I don't understand what it's like, that I will feel differently about my own kids, that I'm in denial, that I will later regret it, that my biological clock will start ticking when I'm 25 (28, 30, 35.. the age keeps changing) and that I should see a psychiatrist to learn to accept my natural role as a woman.

This has nothing whatsoever to do with any risk about it being an elective, unnecessary surgery and everything to do with the fact that doctors don't want to be sued later by women who regret their decision. They think a jury would hammer them for not protecting us poor, incapable women from making decisions we might regret.

Every time, I ask them, which is worse? If I never have kids and one day regret that, or if I do have a kid and one day regret that? They don't seem to understand, or care, about the consequences of that question. In my personal experience, women doctors have been the most hostile.

[WhyNot]

Originally Posted by Justin_Bailey

Couldn't it be super secret choice C: This is a fairly permanent operation (that can only be reversed with luck) and it it not medically beneficial to 99.9% of the world. Therefore, it would be irresponsible to do it to someone under X number of years old.

No, not when the procedure is being sought by someone with a medical problem that could be solved by it.

[Justin_Bailey]

Originally Posted by WhyNot

No, not when the procedure is being sought by someone with a medical problem that could be solved by it.

Thus, the 0.1% of people that are not covered by Super Secret Choice C

[jsgoddess]

Originally Posted by WhyNot

No, not when the procedure is being sought by someone with a medical problem that could be solved by it.

Everyone who seeks sterilization has a medical problem that could be solved by it: fertility

[catsix]

jsgoddess said:
Everyone who seeks sterilization has a medical problem that could be solved by it: fertility

And when you don't want kids, ever, fertility is a HUGE problem.

[Vox Imperatoris]

As far as I can tell, you're saying it's not illegal, but that the doctors refuse to do it. I think they're wrong, but it is their choice.

Valete,
Vox Imperatoris

[Blalron]

Originally Posted by Vox Imperatoris

As far as I can tell, you're saying it's not illegal, but that the doctors refuse to do it. I think they're wrong, but it is their choice.

So if there's a trend where most doctors decide that black folks aren't competent enough for surgery X, but white folks are, is that ok because it's "their choice"?

"We have the right to refuse service to anyone" isn't an absolute principle, especially if discimination is rampant.

[Jillyvn]

Originally Posted by Vox Imperatoris

As far as I can tell, you're saying it's not illegal, but that the doctors refuse to do it. I think they're wrong, but it is their choice.

Valete,
Vox Imperatoris

I don't think a doctor can refuse to provide a valid surgical option to a patient solely on the basis of their belief that a woman will be naturally inclined to pregnancy at some point in her future. Unless the surgeon is also a trained psychologist with insight into the mental well-being of this patient, this is a leap of logic they are not qualified to make. Furthermore, this is not a procedure that is dangerous or out of the norm. I can understand a doctor refusing to perform a breast augmentation surgery on a 16 year old with body issues. I cannot abide a doctor refusing to sterilize a woman on the patriarchic notion that she must be delusional or mistaken in her commitment to remain childless.

To Catsix - I, too, was denied the Essure, which indicates to me that the refusal to provide service is not at all linked to the invasive nature of the surgery.

[Jillyvn]

I missed my edit window, but wanted to add...

I have tried several approaches to convince the doctors I have seen that my desire to be sterilized is a well thought out decision. A hysterectomy seems the best approach because it solves a dual problem: my endometriosis and my desire to not have children. When that was taken off the table, I appealed for the essure. I told them that I didn't want children, but, in the highly unlikely event that I do decide to have a child, I would not, under any circumstances, bear my own child. I have serious medical history in my family that I've no wish to pass on to a child. The fact that I had medical justifications that were entirely rational for my decision and yet was still refused by three separate doctors is further justification for the argument that this decision is being passed on archaic notions of womanhood.

[even sven]

One factor is surely that there are a half-dozen very effective and fully reversible means of birth control.

[aruvqan]

Originally Posted by Justin_Bailey

Doesn't this really just come down to the fact that a vasectomy can be reserved and a tubal ligation or hysterectomy can't?

i had a tubal ligation that reversed itself ... the old style where they just sort of made a loop and tied it off.

When they fixed *that* little issue, they actually cut and removed tube.

And I had a seriously great obgyn, i got my tubal at 22 ... but i had almost died 2 times from pregnancies first.

[Lamia]

I know a woman who had her tubes tied at 30, AFTER having three kids, and even then she said she had a hard time convincing a doctor that she was really really sure she didn't want to have any more children and really really wanted to have the procedure.

This attitude is pretty obnoxious, but I don't know that this is a problem that can be legally addressed without interfering with the rights of doctors. I don't think a doctor can be required by law to perform an elective procedure. The patient is, in theory, free to find another doctor who is willing to perform the requested procedure.

The problem comes when the patient can't find another doctor who is willing to perform the procedure. In some areas this is also an issue when it comes to abortion. It may be perfectly legal for the woman to seek an abortion, but there might not be any local doctors who perform them. This is a bad situation to be sure, but I don't see an easy solution to it.

A simply discrimination lawsuit is unlikely to work, as a vasectomy is not actually the same procedure as a tubal ligation. The latter is more expensive, more invasive, and more dangerous. I doubt that the same doctor would normally be qualified to perform both procedures, so it would be unusual for a woman to be able to say "This doctor could sterilize me but won't, but is perfectly happy to sterilize a man."

[mswas]

Endometriosis is a strange condition and I feel sorry for any woman who has it. My sister wanted to get one when her endometriosis got really bad. She has since had a child and her endometriosis symptoms have gone away. I have heard a similar story from someone I went to school with when I did a paper on endometriosis. If you don't want kids then you should be allowed to get the procedure.

[QuercusMax]

One thing I would add is that it's a lot easier and more reliable for a man to freeze some sperm and use it later if he changes his mind.

Additionally, there is no permanent-ish male birth control system, unlike the Pill, IUDs, NuvaRing, Depo-Provera, etc. Basically, the only types of birth control that a man has any say in are the barrier methods (condoms, etc).

I wonder if there are any statistics related to how many men/women get vasectomies/tubal ligations regret their decision and try to have it reversed? If there is a large difference between these numbers, that might explain some of the reticence to perform these procedures.

Now, the issue that Jillvyn refers to is very different. Sounds like her doctors have been a bunch of jerks.

[mswas]

Originally Posted by catsix

And when you don't want kids, ever, fertility is a HUGE problem.

The menopause at a young age side-effect doesn't bother you?

[Der Trihs]

Originally Posted by mswas

The menopause at a young age side-effect doesn't bother you?

Not that I'm an expert, but having her tubes tied shouldn't do that to a woman since her ovaries are still there. It's the difference between a vasectomy and castration.

[mswas]

Originally Posted by Der Trihs

Not that I'm an expert, but having her tubes tied shouldn't do that to a woman since her ovaries are still there. It's the difference between a vasectomy and castration.

She talked about the possibility of the biological clock ticking early. I thought that meant early menopause.

[Der Trihs]

Originally Posted by mswas

She talked about the possibility of the biological clock ticking early. I thought that meant early menopause.

She was talking about what excuses the doctors were using to refuse her; "biological clock" clearly meaning that they think she'll suddenly want a baby.

[torie]

I don't know how reliable this number is, but the website for the IUD Mirena states that 25% of women who have tubal ligation later regret it.

[alphaboi867]

Originally Posted by QuercusMax

...Additionally, there is no permanent-ish male birth control system, unlike the Pill, IUDs, NuvaRing, Depo-Provera, etc. Basically, the only types of birth control that a man has any say in are the barrier methods (condoms, etc)...

Good point. The only male contraceptive is a condom and if it fails he has no control over results. Women have several methods of contraception and the option of terminating the pregnancy if they fail..

[Guinastasia]

I probably won't ever have kids biologically, because of medical issues-all the meds I'm on, the seizures, etc. Would that make a difference? (Apparently, lamictal can cause birth defects, and the recently when the doctor tried a new type of drug, I ended up having grand mals every other week). So if I ever want to have kids, I'll have to adopt.

[Chief Pedant]

Originally Posted by Blalron

I've heard it's virtually impossible for a woman who hasn't had any kids to get her tubes tied, whereas it's relatively easy for a man in a similar situation to get a vasectomy.

If this is indeed the case, shouldn't the law step in to address this inequality?

It always seemed like a bullshit argument to deny the procedure because later the person may regret it. It may very well be a permanent decision, but so is having a child. It is vastly better, in my not so humble opinion, to regret never having a child than to have a child whose existence you'll (secretly, because admitting it out loud would never be socially acceptable) regret.

I'd be curious to see a study reflecting how often such a request is refused. It would not surprise me (a physician) to find out that it is, in fact, commonly refused, particularly to nulliparous women.

Why?

Tradition is probably the simplest answer, annoying as it might be, especially if the woman is young. With respect to this reason, I suspect younger and (possibly) female Ob-Gyn surgeons might be better prospects to ask.

Other reasons that I suspect are advanced:

1. It is a more complicated to reverse if the woman does change her mind. Most Ob-Gyn surgeons are going to have at least some anecdotal experience with patients who decide to have a baby late in life.

2. It involves more risk than a vasectomy. It is not risky in absolute terms, although of course for a given individual factors such as obesity would come into play for increasing risk.

Having suggested those two weak reasons I wonder if there is third one: it's just not worth the bother of figuring out if it's really the right decision for a young and childless woman to undertake. I mean, to do it right you would have to make sure she's not a nut; that her psychologic state is good; that she's not gonna come back and haunt you...etc etc. Fair or not, I'd venture a guess that physicians don't think the chance a male patient would blame them for a too-hasty vasectomy is as high as the chance a female patient would. While it may be the political position du jour that modern women are as capable of standing behind their decisions as modern men, I don't think that's the perception. So it's easier to just not risk being the doctor who did it.

Here's a study for a little ammo. It's very small, and it's very old. But it's the sort of thing I might take into a physician's office if I were trying to persuade her.

http://www.ncbi.nlm.nih.gov/pubmed/7409229

There may be newer ones. And as always, there is usually a niche market for some guy willing to do what others pass up. So the trick is to ask "Who will?" if your doc happens to think procreation is some sort of sacrosant opportunity that no woman in her right mind would pass up.

Let me be the first to encourage all you women to remain childless. Despite my criticism of Anti-Natalists in another thread, I am closet member. Life would be so convenient without any children in the world. Until I need them to pay off our national debt, anyway.

One last thing: you can't really make a law ordering doctors to do a particular surgery. Damn prima donnas (Prime donne? Primi uomini?).

[SenorBeef]

Have we become such a ridiculous and litigous society that the idea that someone fully conseting to a certain procedure will have a doctor perform it without error and still get sued by malpractice because the victim changed their minds about it?

If so, nuke us from orbit, it's the only way to be sure.

[Chief Pedant]

At the bottom of this article are a number of additional studies looking at post-sterilization regret (First nineteen cites, I believe). I did not look through the cites themselves.

http://www.who.int/reproductive-heal...ec/13_ster.pdf

There is this comment on Page 2 of the article:


Clarification: Young women, like all women, should
be counselled about the permanency of sterilization
and the availability of alternative, long-term, highly
effective methods.
Evidence: Studies show that up to 20% of women
sterilized at a young age later regret this decision, and
that young age is one of the strongest predictors of
regret (including request for reversal information and
obtaining reversal) that can be identified before
sterilization. Cites 1-19

You might look through the articles cited to see if nulliparous women were parsed out from those who had children.

[Manda JO]

Originally Posted by QuercusMax

Additionally, there is no permanent-ish male birth control system, unlike the Pill, IUDs, NuvaRing, Depo-Provera, etc. Basically, the only types of birth control that a man has any say in are the barrier methods (condoms, etc).

Except that hormonal birth control has significant side effects for many women--and yes, you can always try a wide variety of types and find an option that works better for you, but that can literally take years -- that's years of significant weight gain and a cratered libido, and there's no promise that you will actually find anything that works in the end. If a woman is positive she won't ever want to have kids, why should she have to go through all that?

[Zoe]

I would contact Planned Parenthood for a referral to a doctor who treats women as if they are adults and does not believe in prolonged suffering until she's a big girl in her thirties or forties. Yes, she may regret it. She may regret cosmetic surgery too, but that doesn't slow surgeons down much in that field.

Women who choose hysterectomies should talk to other women who have had the work done to see how it has affected their sex lives. Doctors aren't as informative as they should be. Maybe it's because male surgeons don't realize what a change it can make.

[Green Cymbeline]

I came across this tidbit today in [url=http://www.time.com/time/magazine/article/0,9171,1865975,00.html]Time Magazine, which is about Essure: "a newer, cheaper, faster, scalpel-free alternative to tubal ligation"[url]

One general concern among doctors is that women who choose to get sterilized might later change their minds. In a study in Obstetrics & Gynecology of 11,232 women who had been voluntarily sterilized, 20% of those who were younger than 30 at the time of the operation felt regret later, compared with 6% of those who were older than 30.

But you know what? Who cares? The medical establishment should not discriminate against women based on the fact that some women regret it later on. How easy is it to just have the patient sign a form stating that they are aware of what they are doing and agree not to sue later on?? I think it's shameful that women have to go through this...

[Green Cymbeline]

Sorry, that should be:
I came across this tidbit today in Time Magazine, which is about Essure: "a newer, cheaper, faster, scalpel-free alternative to tubal ligation"...

[Markxxx]

Originally Posted by torie

I don't know how reliable this number is, but the website for the IUD Mirena states that 25% of women who have tubal ligation later regret it.

I don't doubt the figure, but how does one qualify this? Everyone has regrets. But since there is no real way to see if they really regret it enough to fix it, the question is not valid.

What I mean is, suppose I wanted to visit the World Trade Center. Well I can't it's gone. So I say "I regret not having visited it while I have the chance." Since there is no way in reality I can reverse this, the choice is meaningless.

If by magic I could make the Twin Towers reappear, does this mean I would immediately go into hock or whatever to get money to visit NYC and see them?

Would a woman who KNOWS she can't get pregnant and says she regrets it, still feel that way if she COULD get pregnant? It's easy to say something when you know it can't happen.

Did these women who say they regret it, try to adopt? Did they think of artifical means like surrogacy or whatever?

As Archie Bunker said "It's easy to be generous when it ain't costing you nothing."

To parapharase that, "It's easy to say something when you know you'll never be called on to prove your point."

[Kobal2]

Originally Posted by Zoe

I would contact Planned Parenthood for a referral to a doctor who treats women as if they are adults and does not believe in prolonged suffering until she's a big girl in her thirties or forties. Yes, she may regret it. She may regret cosmetic surgery too, but that doesn't slow surgeons down much in that field.

Damn you Zoe, elective plastic surgery that was the zinger I wanted to throw Justin_Bailey's way .

Plus, what kind of half-assed reason is "you may regret it" in the first place ? Would a sports medicine practician refuse me a certificate of good health on the grounds that Scuba diving is dangerous and trust me, you may regret that bill of clean health later when you get decompression sickness ?

Or, to put it in another context, would it be OK if your voting rights were suspended because you might regret voting for that guy later ? For that matter, think about all the decisions you've made that you later came to regret, would it have been OK at the time for a third party to deny you the option ? Of course not.

Bottomline is : it's her damn decision, good or bad. If she comes to regret it later, there's lots of kids need adoption.

[Grumman]

Originally Posted by nyctea scandiaca

How easy is it to just have the patient sign a form stating that they are aware of what they are doing and agree not to sue later on??

Has there been a precedent in the U.S. courts that would confirm that such an agreement would be binding?

[Jillyvn]

Living in Canada throws another wrench into the issue for women here. I'm given to understand that, in the US, patients have choice of doctor. Here, once you get referred to a specialist, and wait the requisite period of time to get in, the chances of changing to another specialist are very slim. For reasons that are TMI, I wanted to change gynes once. I was basically told by my family doctor to be very subtle about it because I did not want to get a repuatation as a "high maintenance" patient, but that he would help me out b/c the particular gyne I wanted to switch from had a bad rep.

So, unless things are radically different in other parts of Canada, women here don't have the option of asking "well, who will?"

Side tracking somewhat, I did contact planned parenthood in Calgary about this issue, before I ever got a reference to a gyne in that city. This was after three cities, three doctors, three different "no's" and I was at the point where I was ready to cut myself open. They gave me the name of a female doctor who had, in the past, consented to procedures that would sterilize young women. This doctor was wonderful. We agreed to try one last option before the big H, the Mirena. Luckily for me, this was a magic bullet that got rid of my pain, so I've been able to delay the surgery for five years. Unluckily for me, I've since moved, so I'll need to start this dance all over again if the Mirena stops working.

I would just say - all of this is unnecessary. There seems to be some sort of sanctity attributed to the ability to bear a child. I second the adoption comment - really, if you have the procedure and deeply regret it, it's not as though you have no other options. Everything comes with risks.

[jsgoddess]

Originally Posted by nyctea scandiaca

But you know what? Who cares? The medical establishment should not discriminate against women based on the fact that some women regret it later on.

And 80% don't regret it.

How many women regret having to wait so long?

[Vox Imperatoris]

But saying the medical establishment shouldn't discriminate against young women because they may regret their decisions later is like saying a car insurance company shouldn't be allowed to discriminate against 16-year-old boys because they are more likely to have a wreck. Most women may be perfectly committed in their decisions, but it only takes one crazy woman and a good lawyer to ruin a doctor's day. Again, I'm not saying that this is the correct decision (I don't pretend to be an expert on this issue), but that seems to be the situation from the doctor's point of view.

Valete,
Vox Imperatoris

[Der Trihs]

Originally Posted by Vox Imperatoris

But saying the medical establishment shouldn't discriminate against young women because they may regret their decisions later is like saying a car insurance company shouldn't be allowed to discriminate against 16-year-old boys because they are more likely to have a wreck. Most women may be perfectly committed in their decisions, but it only takes one crazy woman and a good lawyer to ruin a doctor's day. Again, I'm not saying that this is the correct decision (I don't pretend to be an expert on this issue), but that seems to be the situation from the doctor's point of view.

And do you have any evidence this has a thing to do with fear of lawsuits ?

And the other problem with your argument is that amounts to a claim that doctors shouldn't practice any kind of medicine at all, since anyone can sue. If lawsuits were the problem, such a massive problem that denying women their choice and condemning at least some to major suffering ( like Jillyvn ), they'd be a problem for all medical procedures. "Fear of lawsuits" sure doesn't seem to keep them from cosmetic surgery.

No. This is about sexism, not lawsuits.

[maggenpye]

Originally Posted by Der Trihs

Not that I'm an expert, but having her tubes tied shouldn't do that to a woman since her ovaries are still there. It's the difference between a vasectomy and castration.

Sorry to take so long to get to this point - hysterectomy may also leave the ovaries. My mother had hers during the 70's and menopause three years ago. A pedant could argue (and probably will, given our location) that menopause literally means the end of menstruation and that would have happened with the hysterectomy. The periods did stop then, but there were none of the other biological alterations associated with 'the change' until she had a normal hormonal shift as her ovaries finally ran out of eggs.

She'd asked for a hysterectomy after my birth (mid 60's) having completed the parental plan of 'one of each', but was told she should wait, in case she needed to 'replace' either myself or my sibling. Her personal doctor hit the roof, saying that a tubal ligation would only lead to a collapsed uterus later, given the medical history.

But, the GYN knew better.

So she had 10 years of birth control (which, back then, had to be changed every year or so - pills, cap, iud, lather rinse repeat), until her uterus collapsed.

She was married, had completed her family, had her husband's full support and a doctor on her side - but at 21 she couldn't get a medically indicated hysterectomy.

[Grumman]

Originally Posted by Der Trihs

"Fear of lawsuits" sure doesn't seem to keep them from cosmetic surgery.

Why do you trust plastic surgeons' judgement over that of other doctors? Couldn't you just as easily argue that cosmetic surgery should not be offered as readily, given that 20% of patients are not satisfied with the results of their surgery?

No. This is about sexism, not lawsuits.

You throw that accusation around too freely.

[Manda JO]

Originally Posted by Vox Imperatoris

But saying the medical establishment shouldn't discriminate against young women because they may regret their decisions later is like saying a car insurance company shouldn't be allowed to discriminate against 16-year-old boys because they are more likely to have a wreck. Most women may be perfectly committed in their decisions, but it only takes one crazy woman and a good lawyer to ruin a doctor's day. Again, I'm not saying that this is the correct decision (I don't pretend to be an expert on this issue), but that seems to be the situation from the doctor's point of view.

Valete,
Vox Imperatoris

But, by definition, an insurance company is liable for the accidents a teenager causes. This is not the case with elective surgery.

[Malacandra]

I could be wrong, but couldn't the difference between the sexes be explained by the fact that it is really easy for a man to take steps to ensure his future fertility despite vasectomy, and it's a darned sight harder (and seldom done) for a woman?

[Broomstick]

No, because I remember hearing about the same bias before saving sperm was as easy and as inexpensive as today.

I really think it's explainable as a cultural bias that the "proper role" or "natural role" of woman as childbearer. It not that different from when I go to a new doctor and say I have no children - I am immediately bombarded with questions about whether my fertility problems have been looked into (actually, it's my husband who sterile, not me) and bombarded with information on assisted fertility and/or psychological counseling and support groups - all before I have a chance to say I'm totally OK with not having kids, it was never a priority for me, and that's not what I came here to talk about.

I look forward to menopause when I am no longer fertile and don't have to listen to all that anymore. I can just say "I never had kids" and be done with it, although I suspect there will still be cultural baggage to contend with,

[catsix]

mswas said:
The menopause at a young age side-effect doesn't bother you?

Tubal ligation does not cause menopause. Removal of the ovaries would, but that's not what I asked for. With tubal ligation (or Essure), your ovaries are still there, cranking out the hormones and popping the follicles. They just can't get the eggs to the uterus. I would also be OK with a hysterectomy in which the ovaries were left in place because although periods would stop (who needs 'em if you never intend to get pregnant?) the ovaries would still be there regulating the hormones.

Der Trihs said:
She was talking about what excuses the doctors were using to refuse her; "biological clock" clearly meaning that they think she'll suddenly want a baby.

Yes, that's what it means. Doctors seem to think that there is some magical age at which I will suddenly hear that clock and think that I just have to have a baby, right now.

torie said:
I don't know how reliable this number is, but the website for the IUD Mirena states that 25% of women who have tubal ligation later regret it.

Part of being an adult means that you can make choices you one day might regret. From tattoos to breast implants, adults can alter their bodies in many permanent ways that they could later regret.

No one would dare say to a 30 year-old woman who is about to enter into the equally permanent scenario of getting pregnant and having a baby 'What if you later regret this?'

However, I am of the mind that it is far worse to reget having a kid than it is to regret not having one.

Kobal2 said:
Damn you Zoe, elective plastic surgery that was the zinger I wanted to throw Justin_Bailey's way

I already mentioned it way back up there in post #10

Vox Imperatoris said:
But saying the medical establishment shouldn't discriminate against young women because they may regret their decisions later is like saying a car insurance company shouldn't be allowed to discriminate against 16-year-old boys because they are more likely to have a wreck.

The standard for elective surgery is whether or not the patient is over the age of majority (which is 18 years where I live) and whether or not they can provide informed consent. We don't judge any other surgery based on whether the doctor thinks the patient will later regret it. That insulting and paternalistic bullshit is reserved solely for women who want control over their reproductive future.

Broomstick said:
'I really think it's explainable as a cultural bias that the "proper role" or "natural role" of woman as childbearer.

It's even more apparent when those actual words come out of a doctor's mouth. As one told me that I should 'see a psychiatrist to learn to accept my natural role as a woman'.