Sterilization Denial in Women’s Healthcare: The Hidden Medical Misogyny No One Talks About
At 21, I was in the military and at boot camp during my “Female Wellness Exam.” They walked us through different types of birth control and offered everything free of charge. I remember being so excited about the IUD because, in my mind, it was the gold standard for preventing pregnancy — something I’d always feared. I couldn’t have afforded it before then. I went in for the procedure and holy shit, it was the most painful experience I’d had up to that point. But once it was in, I felt relief. I wouldn’t have to worry about pregnancy for at least five years.
A few years later, I had it removed. I couldn’t take the hormonal side effects anymore. So I switched to condoms and cycle tracking. Looking back, I think I subconsciously avoided pregnancy even though I always said, “If it happens, it happens.” But honestly? I’m a meticulous planner. I did everything I could—timing, tracking, vigilance—to make sure it didn’t happen. It was a lot of work. Later I realized I wanted to be childfree. Once that truth landed, I knew I didn’t want to go back on hormonal birth control. It had always made me feel off. I hated it — just not as much as I hated the idea of getting pregnant.
At 28, newly divorced, I asked a doctor in Texas if he’d perform a bilateral salpingectomy — complete removal of my fallopian tubes. He said he could “eventually,” but wanted me to wait and think about it. He suggested I was just “emotional” after the divorce and that my next husband might want kids. So even without a husband, a hypothetical man’s hypothetical future desires still mattered more than my decision about my own body.
It wasn’t until I moved to the Pacific Northwest — to a blue state, far from Texas — that I finally found a provider who said yes the first time I asked. She was shocked it had taken me three tries and several years.
And that’s why I’m writing this: because what happened to me wasn’t rare, and it wasn’t “medical caution.”
It was medical misogyny, plain and simple.
What Sterilization Actually Is (and Why People Request It)
Sterilization refers to any surgical procedure intended to permanently prevent pregnancy. There are several types that someone with a uterus, fallopian tubes, and ovaries might undergo. The most common forms of intentional sterilization include tubal ligation and bilateral salpingectomy.
Bilateral Salpingectomy: Complete removal of both fallopian tubes.
Tubal Ligation: Often referred to as “getting your tubes tied,” this procedure involves permanently closing, cutting, or removing portions of the fallopian tubes to block fertilization.
After the U.S. Supreme Court struck down the constitutional right to abortion (Roe v. Wade and Planned Parenthood v. Casey) with Dobbs v. Jackson Women’s Health Organization, sterilization requests began to rise.
Researchers found a 3% increase in tubal sterilizations per month in the six months following the Dobbs decision (July–December 2022). Other studies have also noted a spike in vasectomy requests — and honestly, we love a man who takes responsibility for his own fertility.
For me, that ruling was the turning point. Living in Texas at the time, I used to think that if I ever had an unplanned pregnancy, I could just take a quick trip to visit a friend in a blue state, get a prescription for misoprostol, and handle it quietly.
But as abortion access crumbled across the country, the “what ifs” started keeping me up at night. What if my birth control failed? What if I didn’t have the time or money to travel? What if I lost control of my own body because lawmakers decided they knew better? What if I was raped?
I’ll admit — I’ve always been cautious to the point of paranoia about avoiding pregnancy. Thankfully, I’ve never had to face an abortion. But after that Supreme Court decision, even the possibility of being forced to carry a pregnancy to term terrified me. I needed to be absolutely sure I’d never get pregnant.
Turns out, unsurprisingly, that I am not the only woman who has had issues while seeking sterilization. So why are doctors denying the sterilization procedures?
Physician Attitudes and Bias
I’ve talked to so many people, including medical professionals, about the bias that childfree women face when trying to access sterilization. The pattern is clear: it often comes down to the physician’s own attitudes and internal biases. Factors like a patient’s age, marital status, or number of children can completely change whether a doctor says yes or no.
Honestly, I fully believe that if I already had two or more kids, I wouldn’t have faced any resistance at all. My decision would have been seen as “reasonable” because once you’ve fulfilled your supposed duty of motherhood, suddenly your autonomy matters again.
A Vice article shared the story of a woman who spent 15 years trying to find a doctor willing to sterilize her. The one who finally agreed only did so because she had a documented history of “mental illness” and, in his words, “probably shouldn’t have kids anyway.” That says it all. A woman’s right to control her own body shouldn’t depend on a doctor’s personal comfort level or moral judgment. Yet it often does.
In fact, a 2010 study published in Obstetrics & Gynecology found that doctors were significantly more likely to discourage sterilization requests from younger women, especially those without children or with partners who disagreed. The data confirmed what so many of us already know firsthand — the barrier isn’t medical, it’s ideological.
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“Regret” as Gatekeeping
Once again, doctors project their personal biases onto women claiming that we might “regret it” later, as if they’ve suddenly become psychic. Apparently, they can predict our future feelings better than we can.
This kind of thinking completely undermines women’s autonomy and assumes we’re incapable of knowing what we want for our own lives. It’s rooted in an outdated, post–World War II mindset where women were expected to follow some biological script: marry young, have babies, and BOOM! You’re fulfilled.
When a woman says she doesn’t want children, she’s treated like an anomaly, as if something must be psychologically wrong with her. Maybe she’s just “selfish,” or “immature,” or going through a phase she’ll eventually “outgrow.” And that’s exactly how many doctors still behave: as if a woman who doesn’t want kids is broken, confused, or in need of saving from herself.
Meanwhile, men aren’t asked any of these questions.
No one tells a 25-year-old man he might “regret” a vasectomy. It’s always softened with, “Oh, it’s reversible!” No one suggests he wait until he meets the right woman or has a few kids first. In fact, vasectomies are often as easy to schedule as getting a wart removed — quick, simple, and free of judgment.
It’s 2025, and it’s honestly infuriating that parts of the medical community still operate like this. They ignore decades of research, data, and lived experience proving that women do know what they want and have been saying it loud and clear.
Institutional and Religious Barriers
It’s not just individual doctors standing in the way… the system itself can block access to sterilization. In many parts of the U.S., faith-based hospitals flat-out refuse to perform sterilization procedures. In these areas, there’s often a geographical desert for OB/GYN care, meaning the only available hospital might be one that follows religious doctrine over patient autonomy.
These facilities often deny sterilization on the grounds that it “interferes with God’s plan” or violates their interpretation of religious ethics. So even when a woman makes an informed, confident decision about her own body, she can still be told no because her doctor’s employer answers to a “higher power.”
Then there are insurance barriers that quietly reinforce the same control. For instance, patients covered by Medicaid must wait a mandatory 30 days between signing their consent form and actually getting the procedure. This rule was originally meant to prevent coercion, but in practice, it often punishes low-income women by making the process slower, harder, and sometimes impossible to complete if scheduling or transportation fall through.
So Where Do We Go From Here?
Sterilization denial isn’t about medical caution, it’s once again about control or someone else’s opinions being more important than women’s choices. It’s a symptom of a system that still doesn’t trust women to make permanent choices about their own bodies.
A doctor’s job is to inform, not to impose. To trust that a woman’s “no” to motherhood is just as valid as her “yes.”
Every person whether they are 23 or 43, single or married, parent or not, deserves the same respect when it comes to their own reproductive autonomy. Yet women everyday are STILL being forced to justify, explain, and defend their choices like something is fundamentally wrong with them if they do not want any (or more) children.
If you’re childfree and considering sterilization, keep pushing. Ask the hard questions. Document everything. Find providers who actually listen.
I HIGHLY RECOMMEND THIS REDDIT PAGE TO START YOUR SEARCH
And when you finally find a doctor who says “yes” without hesitation, know that you earned that right, because it was yours all along. We shouldn’t have to fight this hard for autonomy, but until the system catches up, we’ll keep demanding it.
Say to yourself:
My body isn’t a debate.
My decision isn’t up for review.
And my future doesn’t need a second opinion.
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