A threat vector for Mommy.

Is the NBA on the way out?

Long, interesting thread, started in the UK, about how difficult it can be for women who want to get sterilized - even women over 30.

https://old.reddit.com/r/childfree/comments/icigxz/so_i_cant_be_sterilised_but_i_can_have_a_dick/

At least one commentator pointed out that doctors are NOT necessarily helpful and sympathetic to people who want sex changes. But the original claim is certainly worth looking into.

(And, unless I missed something, one subject that didn't get mentioned was whether or not unmarried men - under 30, anyway - really have far less trouble than unmarried women when they want to get sterilized.)

“Long, interesting thread, started in the UK, about how difficult it can be for women who want to get sterilized - even women over 30.“

I suspect getting any kind of medical care from the NHS is a lifelong struggle.

Medicine has become so politicized, no surprise a sex change is easier.

no surprise a sex change is easier

Solution: I want a sex change operation. Tie my tubes. *done* Oh, I think I'll put off the rest of the change for a while. That operation was exhausting.

Darth - that's almost what GingerRabbits suggested, in the thread. If the comments are ranked according to Best, you only have to scroll about 1/3 down.

Quote:

"Honestly - finding the LGBTQ+ supportive doctors and clinics is the easiest route to getting sterilized. You don't have to be trans, but contact them and tell them how you can't find a doctor who will respect your bodily autonomy and they'll usually at least know who to recommend."

(It's worth reading the rest of that short exchange - it won't take long.)

Oh, and check what another person says immediately after that part - it's about the rules in Japan. If true, the rules sound awful.

(In a nutshell, it's OK for doctors to FORCE sterilization on you, but if you WANT the operation, you can't get it except for medical reasons!)

Oh, and check what another person says immediately after that part - it's about the rules in Japan. If true, the rules sound awful.

(In a nutshell, it's OK for doctors to FORCE sterilization on you, but if you WANT the operation, you can't get it except for medical reasons!)

Lenona at August 20, 2020 10:55 AM

Now do China.... :-)

Maybe the US is not the bastion of soul crushing totalitarianism you dems imagine it to be.

Also remember in socialized medicine, the doctor doesn’t work for you. He is like the guy down at the DMV. “Just following the rules ma’am.”

Doctors work for whomever is paying them. If you ain't paying, you're the product, not the customer.

Then why are there plenty of stories of doctors (in the US, at least) who are downright hostile to mentally healthy patients over 30 who want an operation for reasons that are hardly frivolous, unlike many plastic surgeries?

Whatever happened to "the customer is always right"?

"Doctors work for whomever is paying them. If you ain't paying, you're the product, not the customer."

Dingdingdingding! We have a winner! (Obviously!)

Thank you, IRADA!

Then why are there plenty of stories of doctors (in the US, at least) who are downright hostile to mentally healthy patients over 30 who want an operation for reasons that are hardly frivolous, unlike many plastic surgeries?

Whatever happened to "the customer is always right"?

Lenona at August 20, 2020 2:12 PM

There are always plenty of stories about everything Lenona. Most of them can’t be substantiated.

However, second point, most plastic surgeons operate on a cash basis. True free enterprise.

A lot of other surgeons are beholden to insurance companies, HOAs and the hospital they have surgical privileges in, so let’s get some specifics about what type of surgeries you are talking about; how we determined that it was *mentally healthy people* requesting them, and that they were willing and able to pay in full up front for it. (No third party payer or approval authority in the middle)

A lot of doctors I know, won’t ethically perform certain procedures. So let’s hear some concrete examples, instead of the usual anecdotal drivel.

Oh, and now do China.

Trump AND HIS TEAM really came through with that whole "wall" thing, didn't they? Excellent! Super.

And Trump certainly "isn’t in the pocket of China," right?

Right?

Sure.

"Do China."

The guy through whom China is 'done.'

Here you go Crid.

https://www.justsecurity.org/71615/chinas-forced-sterilization-of-uyghur-women-violates-clear-international-law/

MAYBE I can't prove a negative, but I have never heard of any doctors who claimed that most female patients over 30 who asked to be sterilized were mentally unstable, unable to pay, or even just as likely to change their minds as women under 30. So since that includes the doctors who won't do it, what ARE their excuses - other than religion, maybe? How can it be "unethical" for a woman to choose such an operation? How is it "ethical" to help put her at risk for unwanted pregnancies?

According to one female professor, Karen Lindsey (co-author of "Dr. Susan Love's Breast Book"), who was born in 1944 and managed to get the operation in 1972, the rule among doctors, at that time, was that a woman could not be allowed to have the operation unless her age times the number of children she already had was equal to...120. Obviously, that would be infuriating to any woman who didn't want any.

And I already knew that plenty of forced sterilizations happen in China. What's your point? I assume that if the following were true, you would have SAID that it's easier to get that particular operation in the US than in, say, the average European democracy.

And, according to one source, the last LEGAL forced sterilization in the US was in 1981. But illegal sterilizations still happen. From Fox News:

https://www.foxnews.com/entertainment/new-documentary-illuminates-the-forced-sterilization-of-women-in-california-prison

"In the depths of Central California Women’s maximum-security prison, hundreds of the incarcerated women have had to undergo forced sterilizations, according to a new documentary shown last week as the opener to the Human Rights Watch (HRW) Film Festival.

"Forced sterilization is defined as the involuntary medical 'process or act that renders as individual incapable of sexual reproduction' and a grave human rights violation still occurring in many pockets around the world.

"Erika Cohn's 'Belly of the Beast' documentary states it occurred in the United States up until at least 2013.

"The HRW film festival was a digital event this year due to the coronavirus pandemic..."

(snip)

Right. What's happening to the Uyghurs is a galactic horror. I've talked about this for awhile. There are said to be a million in camps over there. There's a beating: The prisoner is asked if god exists, and the only acceptable answer is "No," else the beating resumes. Etc.

Again, I can't imagine what point you're making… Trump hasn't done anything about it. He's a Xi fanboy. Trump's not mentioned in your link.

Does it even seem like the kind of thing he cares about, let alone knows about? Of course not.

> how difficult it can be for
> women who want to get
> sterilized - even women
> over 30.

Maybe it's flat sexism. But part of the problem might be their approach.

A healthy, persuasive and perhaps attractive young woman who asks a doctor to tie her tubes might stir romantic feelings in his soul about the resilience of passion, and a presumption that she just hasn't found the right man yet.

Or it might stir the fear that if he does it and she changes her mind in a few years, she can drag him into court and successfully sue him for every penny he's worth.

How exactly is she equipping him (or her) for that moment? Does she offer correspondence on the topic going back for some years? Testimonial letters from friends affirming her certainty on the matter?

After a single office visit to request the procedure at age 32, the urologist readily assented to my vasectomy.

I can be persuasive when speaking about such heartfelt matters. But it's at least possible he decided in some corner of his heart that I wasn't the type who should be leading young souls into our corporeal realm of suffering and strife in any case.

Okay by me! There's no room to be offended. Live your dream, right?

Do you think female doctors are more likely to say yes? They are less likely to have romantic feelings for their female patients...

Personally I am uncomfortable with male gynos and always seek out women when possible, I wonder if it really does make a difference.

FTR, I didn't mean 'romantic' in the sense of "I want to take her to take her out to dinner," but in the sense of "Sometimes pretty little ladies need an extra year or two to find that someone special, plus I don't want to lose my Lexus or the money for Conor's grad school."

I HAVE heard that the regret rate can be high - one out of three at the most - but it was not clear whether that only referred to women under 30 or not. At any rate, it seems to be pretty darn rare for an adult to choose the operation, without pressure from anyone, and then sue the doctor. Especially when the patient could simply spend all that money on trying to get the operation reversed!

Oh, and in the same vein of doctors' arrogance, it used to be common for parents, at least, to tell girls with severe cramps that they just had to "accept their womanhood" and that ten years later, maybe, when they married and gave birth, they wouldn't have that problem anymore. (As if it were somehow sinful or decadent to take the poor girl, Right Away, to a female doctor, who could provide her with some relief! For some girls, I've heard, the pain is so bad they can't even stand to get out of bed - and no, that doesn't just happen on school days, ha ha.)

Here's a good 2014 article that raises many points that don't get mentioned often:

https://www.chicagotribune.com/lifestyles/ct-xpm-2014-05-13-ct-met-sterilization-denied-20140513-story.html

Yes, insurance problems get mentioned. But the regret rate, even for women in their 20s, doesn't seem to be that high.

I was shocked to hear how many women apparently thought the Fallopian tubes would "grow back"!
___________________________________

Doctors reluctant to give young women permanent birth control

Julie Deardorff, Tribune reporter

When Lori Witt began pursuing a tubal ligation at age 27, she said physicians refused to even discuss it with her, telling her she was too young and might change her mind about having children.

For more than a year, Witt tried to get sterilized. Finally she went with her 28-year-old husband to a military medical clinic overseas, where Witt said he was given a vasectomy with few questions asked.

Decades after sterilization became broadly available to women in the U.S., some still have trouble obtaining one of the safest and most effective forms of birth control.

The American College of Obstetricians and Gynecologists says nobody who seeks sterilization should be denied. But some women say the reality can be much different, especially for younger women and those without children.

In interviews and on Internet forums, women report facing resistance and flat-out refusal from health care providers as they seek permanent contraception. Along the way, they encounter sexist and paternalistic attitudes, such as the assumption that all women desire children or that they'll come to regret their decision.

"I've yet to come across a story of a woman without children who was granted sterilization on her first request," said Cristina Richie, a Massachusetts professor whose report on voluntary sterilization among child-free women was published by the Hastings Center, a bioethics research institute.

Julie Palm of Colorado Springs, Colo., received a tubal ligation three years ago when she was 22, but not without a fight.

"When I met with my first OB-GYN, he seemed to struggle with the idea," Palm said. "He was uncomfortable with sterilizing someone so young ... but I refused to back down. He agreed with the point that it was my body."

In addition to the fear of regret, doctors who are reluctant to sterilize a young woman may have misgivings because of their own religious beliefs, concerns about insurance coverage or potential liability, and the fact that other effective forms of long-term birth control exist.

"I strongly discourage it under age 30 because I've seen so many people change their minds," said Dr. John Merling, a family medicine specialist in Wilmington, Ohio. "They come in and are absolutely sure they want it done."

About 13 percent of women who obtain a tubal ligation express regret within 14 years, according to the U.S. Collaborative Review of Sterilization, though the CREST study found rates to be higher among younger, poorer and less-educated women.

But for many women, the potential cost of an unplanned pregnancy — an unwanted child or an abortion — or side effects from other forms of birth control are risks that far outweigh the potential for regret.

"Regret is the competent woman's burden, not the doctor's," said Richie, an adjunct professor at the Massachusetts College of Pharmacy and Health Sciences. "Very few providers of other permanent elective treatments like plastic surgery refuse treatment over fear of regret. Why should sterilization be any different?"

Physicians may fear doing something the patient might later view as detrimental, said Katie Watson, an assistant professor in the medical humanities and bioethics program at Northwestern University's Feinberg School of Medicine. "That's upsetting. No physician wants to feel like they've harmed a patient."

But Watson said the physician's focus should be ensuring that the patient receives adequate counseling beforehand. Informed consent also protects doctors from lawsuits, she said.

"Patients get to make the decisions because they are the ones who have to live with them," she said.

Doctors are significantly more likely to discourage a patient from undergoing surgical sterilization if she is younger, has fewer children and is not in full agreement with her husband, according to a national survey of women's physicians in the U.S. that was published in 2011 in the journal Human Reproduction. Nevertheless, nearly all the physicians said they would help the patient obtain the procedure if she persisted.

In a traditional tubal ligation, the fallopian tubes, which carry the eggs from the ovary to the womb, are burned, clipped, cut or tied to prevent sperm and egg from meeting. Another method, called Essure, involves implanting tiny coils that create a blockage inside the fallopian tubes.

Some doctors say they find that women often aren't aware of long-lasting but reversible alternatives to sterilization, noting that intrauterine devices (IUDs) and contraceptive implants are equally effective at preventing pregnancy and may even be safer.

"Many women see the benefits of closing the door forever so they don't have to think about it," said Dr. Nancy Stanwood, an associate professor of obstetrics and gynecology at the Yale School of Medicine. "But we could do a better job of explaining alternatives. I've certainly had patients come, ready to convince me to do tubal. But when I tell them about alternatives they say, 'Wait, that sounds so much better!'"

In addition, some women hold mistaken beliefs about the permanency of tubal ligation. In one survey of women who had undergone the operation, 35 percent thought the fallopian tubes would grow back together or unblock themselves after five years.

Tubal ligations can be reversed, but the process requires major surgery and does not always restore fertility. Reversal is also expensive and often is not covered by insurance.

Before American contraceptive practices underwent a revolution in the 1960s, tubal sterilization was mainly used to prevent pregnancy in women with severe medical problems; some women also were sterilized without their consent as part of the eugenics movement.

In the 1950s, a woman who wanted to control her fertility with a tubal ligation had to meet arbitrary standards set by hospitals, said historian Rebecca Kluchin, an associate professor of history at California State University at Sacramento.

The "120 rule," for example, held that a woman was ineligible for sterilization unless her age, multiplied by her number of children, totaled at least 120. That meant a 30-year-old woman had to have four children before she could be sterilized, said Kluchin, the author of "Fit to Be Tied: Sterilization and Reproductive Rights in America 1950-1980."

Many states also had laws that prohibited the sale or use of birth control, even by married people. But after federal courts removed the last restrictions in 1972, sterilization quickly became one of the most popular forms of contraception.

Yet some women who seek it out still are told they might want to reconsider. Comments such as, "You'll change your mind," "What if your parents thought like you?" and "What if you meet the right person and he wants to have children?" are so common that the women derisively call them "bingos."

"Some physicians might not believe women in their 20s," Watson said. "It's a radical proposition for a woman to say, 'I never want to be a mother.' It challenges a foundational paradigm."

Anne Trate, 28, of Pittsburgh, said she's certain she never wants children, in part because she's been diagnosed with bipolar disorder. If she became pregnant she'd have to stop taking her medications, she said, and that might place her life in danger.

"I'm not even sure I could care for children if I had them. I have to stay balanced," said Trate, who so far hasn't been able to find a doctor willing to help.

Overall, satisfaction rates are high among women who are successfully sterilized. Even among women who are under 30 when they undergo the procedure, 80 percent do not regret their decision, according to the CREST data.

"Sterilization isn't the first thing you do," Richie said. "You've usually been on birth control for years and thought about this for a while."

It's difficult to find comparable data about how many men regret their vasectomies, Richie said, as research more often frames the issue in terms of the regret of the man's female partner.

But "information on the Internet indicates that child-free men have almost no trouble finding a doctor to perform a vasectomy," she wrote in the Hastings Center Report. "This fits with the view that men are less bound by cultural norms of parenthood and more competent to make decisions."

Watson said regret is a fair topic of discussion for any procedure because doctors need to know what the patient is thinking. "Does she want a tubal ligation because she's in an abusive relationship? You want a doctor who wants to do what's best for you. The question is what happens when you and your doctor disagree," Watson said.

In Witt's case, the one physician who would consider sterilizing her first required Witt to try an IUD for six months, she said. Witt refused, citing a problematic history with artificial hormones and other health conditions.

"The risks and side effects of an IUD were not acceptable to me," said Witt, who lives near Omaha, Neb. "But the risks and side effects of a tubal were not acceptable to him."

In the end, she was left feeling condescended to and angry. "I felt like I was only allowed to make reproductive decisions if they fell in line with the status quo," she said. "Basically my life could be anything I wanted it to be as long as it was motherhood."

And:

https://pubmed.ncbi.nlm.nih.gov/10362150/

"The cumulative probability of expressing regret during a follow-up interview within 14 years after tubal sterilization was 20.3% for women aged 30 or younger at the time of sterilization and 5.9% for women over age 30 at sterilization (adjusted relative risk [RR] 1.9; 95% confidence interval [CI] 1.6, 2.3)."

And THIS is interesting (from 2018):

https://tubalfacts.com/post/175416489047/sterilization-regret-tubal-salpingectomy-nulliparous

Lowest Among Nulliparous Women

The landmark CREST studies found that, among women aged 30 or younger at the time of sterilization, regret “was lowest among women who had no previous births” at 6.3%. Among women aged 30 or younger, nulliparous women are less likely to regret sterilization than those who have had children.

Compare to 5.9% for women over age 30 at sterilization (all parities), and 5.4% for nulliparous women aged over 30 at sterilization. The difference between age 30 is only 0.4-0.9%.

(All are cumulative probabilities at 14 years post-sterilization.)

This means that among those who haven’t had children, the risk of sterilization regret is not significantly reduced by waiting until after age 30 for sterilization...

(snip)