Sterilization and Sexism

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.

And 80% don’t regret it.

How many women regret having to wait so long?

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

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.

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.

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?

You throw that accusation around too freely.

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

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?

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,

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.

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.

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.

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

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.

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’.

It should also be mentioned that in a case like catsix’s, where she’s not requesting hysterectomy but fallopian tube blockage, that she’d be perfectly capable of carrying an in vitro fertilized embryo to term should she get hit by a brick, wake up with amnesia, undergo a complete personality rewrite and suddenly start craving sprog.

in some cases, maybe. However, with newer methods of non-invasive sterilization for women, such as Essure, this excuse is losing weight.

MY experiences parallel those just related by Catsix. I have had doctors encourage me to visit a psychiatrist to discuss my resistance to child bearing. I even had one lovely doctor ask me to consider what this will do when I “settle down” with a nice man and he decides he wants to have kids.

I think there is a larger issue in place here - one that I’m only just now starting to see the other side of. From 19 -29, being childless by choice was something I only had to justify to a doctor when asking for a sterilization. Now, this weird thing has started happening… When I meet new people, they ask if I have children. When I say no, I frequently get this strange, sometimes fleeting, pitying or confused look. On more than one occasion, I’ve had people I’ve just met say “well, that’s not too far down the road, so don’t worry” or, “bet you can’t wait!” I never take it personally, it doesn’t offend me, and I usually laugh it off. But, it is the first time I’ve come smack up against the societal expectation that I ought to reproduce. If the attitudes are this prevalent in well-meaning, intelligent and otherwise sensitive people in general society, it is little wonder they have a strong hold in our medical community, reflecting as it does societal norms.

It has nothing to do with trust. It has to do with the fact that if fear of lawsuits was the problem, then that fear would logically apply to ALL of medicine; I just picked cosmetic surgery at random. Why aren’t other specialities so “afraid of lawsuits” that they refuse to treat their patients ?

Have you been reading the same thread I have ? There’s no reason to consider it anything else. “Sexism” is being polite; a less polite way of saying it is that this is about treating women as subhumans and brood mares, as creatures who have no right to make their own decisions and whose overriding function is to breed. Regardless of their health or desires.

Or, doctors who have seen upset and lawsuit-happy patients come down on other physicians after they (the patients) did something they regretted want to cover their asses. Or, they’ve had many women come to them after requesting and being refused a sterlisation and thank them, since they did change their minds. Or, as you say, some hold sexist ideas about women’s fertility. I doubt that we can generalise any single reason to a given doctor, let alone the whole profession.

Except this isn’t a matter a sizable portion of doctors won’t perform sterilization procedures on women but will on men–this is a virtually uniform practice across the profession. And no one has presented any evidence whatsoever that patients are more likely to sue over this issue than they are to sue over any other elective procedure.

Hell, there is a protocol for a person in their early twenties to get a sex change–you have to jump through hoops, but at least the hoops are defined. Women who want to be sterilized–even when they have legitimate medical reasons–aren’t told to go off and think about it for a year or three and then come back. They aren’t even asked to consult with an expert to discuss the issue with a professional to make sure they are really sure. They are simply told “no”.

AGAIN, if that’s the problem, then why does it to apply to sterilization of women and that alone ?

Now that’s a really good effin’ point. See, catsix, you *can *get sterilized, you just have to accept a penis first. :rolleyes:

Der Trihs is right. This is very much an issue of sexism. If this wasn’t an issue of blatant and unchecked sexism, then doctors would have set up a formal and accepted medical route to the procedure, as Manda JO suggested.

For example, the doctor I saw who did agree that the hysterectomy would be an option for me was entirely rational. She advised me that she would not consent to perform any seriously life-changing procedure on any client, male or female, without being able to assure herself that the procedure was a) well-considered and consented to in the face of full evidence of consequences and risks and b) all other non-invasive options had been considered, and, if agreed to by the patient, tried. Her practice is to counsel a woman to see her for six months. By then, she will know the patient well enough, and have had time to ensure she has related all the necessary medical knowledge the patient needs to consent to the procedure. Is she determines that there is no deficit motivating the patient to make a decision (personal pressures, mental illness etc), she would happily move foward. In fact, it was her that told me about the Essure, just before I left town. My Mirena was working well, and I joked that this had derailed my option to kill two birds with one stone, since the hysterectomy was no longer “necessary”. She told me that she would consider the Essure if I wanted to do that instead.

Here’s my proposal. Doctors should be educated in med school that part of our societies protection of the right to chose includes the right of a woman to of sound mind and free will to decide not to get pregnant at all, not just to terminate a foetus should they become pregnant. Doctors should be advised that choosing sterilization instead of permanently medicating oneself with hormones is a valid medical choice. They should be taught how to assess for informed consent. With a little education, this could all switch. It’s an archaic holdover from the patriarchy, and one one we have long since outgrown.

Not to get into the rest of the thread, but wouldn’t that be something that changes by geography? I seem to remember reading than in some countries/areas (Puerto Rico, Mexico), female sterilization is one of the main forms of birth control. Now, by the time it is performed the woman already has one (or more) kids, but there is no question nor is it denied…

My cousin’s wife had her tubes tied immediately after having her second child (she was in the late 20’s-early 30’s, in Puerto Rico), and had no problem finding who would do the procedure, which is why I find it weird what happened to your friend.

Not only that, but I’ve known of friends’ and relatives’ mom who’ve had histerectomies performed (for medical reasons) before turning 30. Again, they already had a couple of kids, but unlike someone else’s relative experienced earlier in this thread, there was no question about doing the surgery.

I’m very curious about the whole “lawsuit” angle.

Can anyone cite even one case of a successful lawsuit from a woman who agreed to be sterilized, but later regreted it? Or a man, for that matter?