This essay was published with permission from Gender-Focus.
My spouse and I are seeking permanent birth control, and the entire process has been difficult. At this point, we are sick to death of unsolicited advice on the subject (Pro-tip: If someone you don’t know says they’re not judging you, they are judging you.) Everyone’s heart is in the right place, I can only assume. People think they are telling us new information that will keep us from making what they perceive to be a mistake. I get that they’re trying to help. But we continually find ourselves defending this very personal decision to total strangers. So to keep myself from screaming, I’m going to outline why the condescension disguised as concern is totally unfounded. Trust us. We’ve thought it through.
Bullshit Assumption #1: But you’re so YOUNG! And it’s such a BIG decision!
We know we’re only 24. Thanks for telling us! No one says this to people in our situation who decide to have children, which is an equally big decision. It’s not the weight of the decision that makes people uncomfortable; it’s the fact that we decided against having children. If you’re going to offer unsolicited advice, at least be honest about why.
Bullshit Assumption #2: It’s permanent. You’ll regret it later and resent each other.
Why do they always pair those two? This “advice” intrigues me the most, because there are so many layers and implications. Firstly, it implies that we do not know what “permanent” means. The permanence of a thing is not inherently an effective reason to argue against it. That’s actually the most attractive feature of this birth control option. Thanks, but we’re set.
Furthermore, my husband and I don’t think we’ll ever want to be parents. But this isn’t a conversation about parenthood. This is a conversation about birth control. They’re related, but not the same. We like kids, and we might make kickass parents. And in the (very unlikely) event that we want to be parents at a later date, we still can. According to the US Department of Health and Human Services, in 2011 there were over 400,000 children in the foster care system, 25 percent of whom were seeking adoption. There are human beings behind that statistic, and they deserve love. We don’t feel the need to assemble a child from scratch when so many are looking for homes.
If we ever change our minds and decide parenthood actually is for us and our lives actually can’t be complete without it, we don’t have to bemoan our permanent decision and grow to hate each other — mostly because we’re adults who talk about our problems, but also because there are steps we can take to be parents if we so choose. As depressing as it is, our backup plan is that there will probably always be kids without homes. Once every single last orphan has a home, I will entertain this nonsense about needing to remain fertile just in case.
Bullshit Assumption #3: You have several other birth control options available.
We were in a urologist’s office when we heard this gem. He refused (on moral grounds!) to perform a vasectomy because of our age. In the meantime, he told us that we have many birth control options (as if we didn’t already know that).
We also already know that the Mirena IUD, our current method of birth control, can cause:
- Depressed mood
- Heavy or prolonged menstrual bleeding
- Vaginal discharge
- Breast pain or tenderness
- Inflammation of cervix, vulva or vagina
- Pelvic pain during your period
- Back pain
- Weight increase
- Decreased sex drive
- High blood pressure
- Pain during intercourse
- Unusual hair growth or loss
- Skin irritations (such as hives, rash, eczema or itching)
- Feeling bloated
- Swelling of hands and feet
And last but not least, my personal favorite:
- Although uncommon, pregnancy while using Mirena can be life threatening and may result in loss of pregnancy or fertility.
Life threatening, folks! Most methods of birth control (the super effective ones, at least) have a list of side effects like this. The doctor then went on to say that he would feel more comfortable performing the procedure on someone older, so we should just wait. But here’s the thing.
According to the National Institute on Aging, the average age for hitting menopause is 51. So. This doctor (and everyone who tries to talk us out of this) is “uncomfortable” with sterilization, but totally fine with me experiencing any or all of the previous symptoms for the next 27 or so years. I have at least five of those, and 27 years is too long to experience any of them. Even if we had children, I would still be on birth control for most of those years. Only someone really selfish would have such wack priorities.
Bullshit Assumption #4: Not having children is selfish.
People say this! But only people who take our extremely personal decision not to have children as an attack against their (equally personal) decision to have children. I donate to charities and do volunteer work (with children!) but even if I didn’t, and even if not having children actually was selfish, that still wouldn’t be a legitimate concern. If what we’re doing doesn’t hurt anyone else, why does it matter?
Bullshit Assumption #5: What if your spouse dies?
During my husband’s initial consult, his doctor tried to use this “divide and conquer” tactic to see if I was nagging him into having the procedure. I’ve also heard a similar excuse, “What if one of your kids dies?”, launched at parents looking to sterilize themselves. (Fun fact: If someone’s kid dies, having another one won’t change that. Don’t be a jerk.)
If I die before my husband, his new, less awesome wife will have to be cool with his vasectomy, because, as we adults understand, that is meant to be a permanent decision. If she wasn’t cool with it, I guess that would be a deal breaker, and she would have to pass on marrying such a handsome widower. Anyone who would object probably wouldn’t be a good fit for my husband anyway, because they would have very different opinions on a very important topic.
One more thing: flip it around. Would you ask a couple who says they are trying to have children what they would do if one of them dies based on whether a new partner would disapprove? What if your new partner doesn’t like kids? That sounds crass and insensitive because it is. I’m not dead yet. Keep this concern to yourself.
Bullshit Assumption #6: You’ll try to have it reversed later.
We’ve already established that this is permanent, and we’re on board. But one of the reasons my husband’s doctor refused to perform the procedure was that too many people change their minds and want to have the procedure reversed, and those that do are often unsatisfied with the results. How many is “too many” though? How often is “often”? Information on this topic was hard to find, mostly because searches including the words “vasectomy reversal” and “regret” brought me to message boards about just that. But according to this article in The Independent, “U.S. research suggested 6 per cent of men change their minds at some point after vasectomy and seek to restore their fertility.” Ohio State University tells us that “Approximately half a million vasectomies are performed in the United States each year.” But we had to listen to a doctor compare this choice to suicide (yes, really) because 6 percent change their minds. Cool.
No one is hurt by any ill-effects of this procedure but us. We would be willing to sign something to the effect of “We understand this is permanent.” That’s how it works with permanent decisions. Welcome to adulthood.
Bullshit Assumption #7: Why doesn’t your wife get the procedure?
This was another attempt to turn my husband against me, because obviously I must be trying to control him and nag him to death. But I’ll stop you right there. I volunteered to get a tubal ligation. I’m the one with the phobias and the aversion to being pregnant, but I was more than willing to go under the knife. However, after doing some research, we found that vasectomy is a less invasive procedure with less recovery time, fewer complications, and it’s less likely to fail. So he volunteered. His body, his choice. And, if I were the one getting sterilized, people would be asking me why he didn’t just get a vasectomy. And we would still be facing this con(cern)descension.
Planned Parenthood to the Rescue
I don’t ever want to be pregnant. That alone should make it a done deal and no one’s business. And, with the exception of the post you’re reading right now, I don’t feel like I should ever have to justify that to anyone. So whether or not people agree with our choice, we’re going to find a way to do this. Planned Parenthood agrees and is helping us find a doctor who thinks that our reproductive choices are ours to make and ours alone.
Happily Ever After? Problems with the birth control debate, myself included
My experience is by no means standard. I am a white, middle class, heterosexual, cis-gendered, able-bodied, married woman. While it is cathartic to talk about my struggles with reproductive choice, I hold several privileged positions in society that shape these experiences. For example, I have the luxury of framing this as a series of personal choices. And, while it gets irritating, it should be noted that there is a huge amount of privilege in the fact that society in general is obsessed with women like me reproducing as soon as possible, lest we run out of white babies.
With the way abortion and birth control debates are polarized, it can be easy to overlook the fact that not all women are pressured to have children, at least not equally. For people of color, people of marginalized social classes, individuals who are transgender or outside of the gender binary, and people with disabilities, there is a history (and in some cases an ongoing practice) of forced and coerced sterilization.* It is also important to note that much of the birth control many of us depend on to regulate our fertility was developed at great cost to women of color. And, once people other than married, straight, cis-gendered white ladies have children, their parenthood is usually open to far more scrutiny.
So while some of us are fighting to avoid parenthood, it bears repeating that others are fighting for the chance to have children and raise them as they see fit. I would love to see a day when no one has to justify their choices – reproductive or otherwise – to anyone. But we have some work ahead of us. I’m going to do my part by, among other things, being unapologetic about my choices. Hopefully I can make a little more room for others to do the same.
*(See: Sterilization of Puerto Rican Women, Mississippi Appendectomy, Forced Sterilization of Native Americans, Mandatory Transgender Sterilization, Sterilization of Women and Girls with Disabilities for just a few examples.)