By Katrina Arellano
When it comes to the bodily autonomy of someone with a female reproductive system, there are certain hoops they have to go through in order to obtain certain medical procedures, such as sterilization. There are various reasons as to why a person would want to undergo the varying kinds such as a hysterectomy or tubal ligation, like not wanting children, being a transgender man, cancer and/or to escape a painful uterine condition. Regardless of why people want to have these procedures, it seems the journey is profoundly long. People under 35 do not typically have a hysterectomy, and while there is no strict minimum age for people to be in order to have the procedure, depending on the insurance and the opinion of medical professionals, people under 35 are not usually accepted. For example, people who utilize Medicaid and seek sterilization for non-medical reasons will not be covered. Since it is federally funded, people who do have serious medical conditions are inclined to wait 30 days between signing the consent form and having the procedure. While private insurance is more willing to help cover the cost of hysterectomies, I talked with a couple of people who said their private insurance will not help cover it despite immense suffering. Even for having private insurance, my dear friend Anai Bell, 23, insurance provider will not help cover the cost of a hysterectomy and despite have undergone alternate procedures, she said. “I’ve been fighting to get one due to my endo and adeno and I can’t until I have at least 3 children.”
My old friend Zade Coronado, 27, was rejected by a surgeon who said she was not comfortable performing the surgery because even though he is transgender he could still want children of his own later. Zade switched providers, went through a series of counseling, signed a waiver stating he does not want children, and then was approved for a hysterectomy. He said, “This surgery was one of the most important surgeries… I was at higher risk for ovarian cancer because of the hormone treatments I am on.” He even mentioned how the surgeon and staff of St. Luke’s took very good care of him and were all around professional of the whole situation. Hearing of Zade’s experience as a transman was very interesting because I think it reflects a progressive world of doctors accepting dysphoria. On the other hand, it makes me question the lack of opportunity for young women to go about doing something they also feel is the answer to their discomfort. Of course, it is a good idea to thoroughly think about the risks when it comes to any procedure, for there are always side effects no matter the severity, but I also believe it’s important to respect someone’s choice to do whatever they want with their body. If someone is physically suffering for years and keeps going through the pain of trying to have a child, then why make them go through that because of that small chance they may have a child later? I asked Anai if she thought this reflected an internal bias and she said, “Yes and no. Goes back to really understating the circumstances of having a hysterectomy. Many people think it’s due to the ability to have children, but it goes more in-depth like how it affects your body and your mental well being.” I think the backlash emanates from a patriarchal stand point as well as a lack of understanding the mental and physical pain people go through at the hands of their uterus.
Hysterectomies are considered a last resort for all people considering or seeking one because of how invasive these procedures are, as well as the potential mental or physical side effects that could develop afterwards. Because of the potential physical and mental risks of undergoing sterilization, doctors try to encourage patients to seek other avenues that may not be as invasive, especially if someone is under 35. People who want a hysterectomy or their tubes tied are denied for these risks, but I think it’s deeper than wanting patients to be safe. The main reason people with or without serious medical issues are denied appears to be because of the notion of regret that might come later, for that person may want children in the future. My dear friend Jean Kel, 24, explained how some of her female family members are sterile, but have become pregnant and end up miscarrying and she believes she is the same way. She said, “I miscarried twice in my life, both times at 2 months in. The second time caused me to have my first ever seizure from losing so much blood. It was so traumatizing and hormonally I was a mess.” Jean is not alone in her experience of excruciating mental and physical pain of trying to go through a pregnancy, miscarrying, and then having her doctors still deny her sterilization. The collective of stories make me think of how much weight is put on people to have children of their own. It’s as if people and doctors do not want to accept that people, let alone women, are confident in their decisions to not want to conceive.
“I don’t want to conceive, I’d rather adopt. My periods are painful and heavy, and I don’t understand why I should have to go through this when I’m not trying to be pregnant. They always say, “you’re so young, what if you change your mind?” That’s okay but I don’t think I will. I know I won’t, actually. And I hate that I can’t just request it. I don’t understand why the government and medical industry has say over me and my tubes!”
Jean has not been diagnosed due to her financial situation, but hearing her experience alone is enough for me to believe something is wrong and she knows she wants/needs medical attention.
The National Women’s Health Network believes all other options should be exhausted before someone undergoes a hysterectomy, which is understandable, but how long must we make people suffer because of what could or could not happen? Even for all the backlash people hear and may continue to go through for their choice to undergo a hysterectomy, what ultimately matters is doctors listen to their patients’ concerns, doing the best they can without bias, and that the person undergoing the procedure is happy. Everyone’s relationship to their uterus is different and Allie Niemiec of HuffPost was glad to go through a hysterectomy. She wrote a piece on her mental and physical strain before she made it to the surgery table and she shared some powerful words that may help others who are struggling with what may feel like loss, “I want everyone to know I had a hysterectomy, and I am still just as much of a woman as I was before.”