How Young Is Too Young to Get Your Tubes Tied?

I knew from a young age I did not want to have children. Even before I got my first period, I knew that becoming a mother wasn’t for me. I may have still been a child myself, but the thought of being bogged down with something you can’t shake until they’re at least 18 didn’t sit well with me. I’d look at my parents—both supportive, loving, and affectionate—and watch how they constantly put my sister and me before themselves. Although I was too young at the time to truly understand my appreciation and gratitude for my mom and dad, I knew that being a parent was no whimsical, carefree walk in a cherry-blossom-lined park. It required work, lots of it, and patience—something I didn’t have much of then or now. 

All throughout high school and college and into my 20s, I remained steadfast in my child-free beliefs. Even when I fell in love for the first time, something I was told might change my thinking, I didn’t waver. I adored him deeply, and because he was my first, I thought we’d be together forever, as one often does when one experiences their first taste of love. But while I could see us growing old side by side on a porch swing somewhere with a view of the sea, I couldn’t envision having children with him. What maternal instinct I had was reserved for dogs, so much so that when my nephew was born, I gently pet his head as if he were a puppy. I probably would have asked if he wanted a treat or a belly rub too, if my sister hadn’t reminded me that he wasn’t a dog.

When I found myself pregnant at 27, the decision had already been made almost two decades before. I didn’t need to think about it, I didn’t have to weigh the pros and cons, nor did I have to struggle with making a choice. Without skipping a beat, I made an appointment to get an abortion, and to this day, I regard it as one of the best decisions of my life. 

At my follow-up visit, I inquired about getting my tubes tied. Because I’d gotten pregnant while on the pill, it seemed like the best option for me. I also had insurance at the time, something we freelancers don’t always have, so I thought I’d take advantage of the opportunity if there were possible coverage. 

The nurse practitioner immediately told me no, explaining that I was too young and, as I would hear dozens of times throughout my life, “you may change your mind.” She explained that no “respectable”—an adjective that still echoes in my ears—doctor would perform the procedure on me. But if I were 27 and already had kids, it would be a different story. 

I didn’t push the subject. I was still recovering from the physical side effects—the cramping and bleeding—of the abortion, and having only limited knowledge about tubal ligation, I shifted my eyes upward toward the ceiling. Instead, I asked her who decides on the ceiling murals you often see in gynecologist offices. She didn’t answer me.

When I turned 30, I decided to pursue my quest again. By then I had done my research. 

Tubal ligation is an outpatient procedure in which the fallopian tubes are cut and tied via a suture—hence the phrase getting your tubes tied. It prevents eggs from leaving the fallopian tubes, reaching the uterus, and possibly being fertilized, making pregnancy no longer a concern. The procedure takes roughly 30 minutes and is performed under either general or local anesthesia. Recovery time can take anywhere from one to three weeks, and abdominal and shoulder pain, as well as fatigue, are normal side effects. Tubal ligation is extremely safe, with serious issues occurring in fewer than one out of every 1,000 women.

Not only did I know what the procedure entailed, but I also knew that should I change my mind, tubal-ligation reversal was a procedure that could allow for pregnancy—albeit with lower success rates than if the fallopian tubes had never been closed. Three medical professionals—two in New York City and the family doctor I’d been seeing since I aged out of pediatrics—said it would be better if I waited. I was still too young, and the insinuation that I’d change my mind persisted.

I was forced to realize a harsh truth: As a person with a uterus, it was my obligation to get pregnant or, at the very least, change my mind about having kids, even if I never followed through on having them. I’d been allowed my abortion without any loopholes, thanks to where I lived, but that didn’t mean I had total bodily autonomy. “Women never do,” I remember my mother saying in response to my failed quest.

Men, on the other hand, don’t have as many obstacles, but they also don’t request sterilization nearly as often as women do. In the US, women are twice as likely to get sterilized than men. Between lack of education and a culture that has fostered toxic masculinity, some men believe they’re not real men if they don’t have viable sperm—whether they use it or not. In fact, the US has the lowest rate of vasectomies of all the wealthiest countries. Our culture has decided birth control is a woman’s responsibility but only if she’s granted permission to take on that responsibility. 

When Roe v. Wade was officially overturned last June, I did what many of us who advocate for reproductive rights did that day: I cried, I screamed, I threw around a lot of expletives regarding the SCOTUS justices. Then I thought about not just what the ban would mean for those with uteruses but the dire consequences that could come. How many more people would be turned away from procedures they deemed necessary? How many of those would be unable to access an abortion? The irony is that female sterilization would prevent unwanted pregnancy in the first place—no matter your stance on abortion, it should be seen as a viable option for women who desire it.

In the first few months following the Roe decision, multiple outlets reported an increase in women seeking tubal ligation. And like me, many were—and still are—being turned away because of their age. 

The American College of Obstetricians and Gynecologists states in their official opinion that if someone of childbearing age, who has all their faculties and is not being coerced, requests sterilization, they should not be turned away based on age. Their very first recommendation: “Respect for an individual woman’s reproductive autonomy should be the primary concern guiding sterilization provision and policy.” It can’t possibly get any clearer than that. And yet the stigma persists.

I still haven’t had my tubes tied. I moved forward after my rejections, using different methods of birth control over the years. But when I read about people being denied a simple procedure that could ultimately save their lives, I’m enraged and disgusted all over again—and somewhat saddened that I didn’t more forcefully confront the medical professionals with whom I interacted. Maybe I was afraid to face the reality of it: that there are many ways to take away a woman’s autonomy.