1. The Inequality of Sterilization
Sterling Mackert
Tubal ligation is the procedure of blocking or disconnecting the
fallopian tubes rendering a patient sterile without removing
reproductive organs. This allows the patient to continue producing
hormones and eggs without the fear of pregnancy, and is considered a
permanent form of contraception. However tubal ligation does not
mean a woman can no longer have children due to recent advances in
the surgical, biological, and genetic fields of study. (I will cover those
advances later.)
In the 20th century many states sanctioned the practice of
eugenics, a process of “bettering” the human race and the human gene
pool by preventing the reproduction of people with undesirable traits,
this meant that many people were not allowed to reproduce and in
order to prevent reproduction by these undesirables many states
enacted laws allowing state mandated sterilization of mental patients
and criminals, along with other groups. Unfortunately, Georgia was one
of the many states to propose laws enforcing eugenics. However, the
Georgia act allowing state enforced tubal ligations and vasectomies,
was vetoed by 1935. Many states did not veto these bills, and states
who enforced these acts sterilized tens of thousands of men and
women against their will.
Despite the decision of these states to forcefully sterilize these
men and women, Women still face prejudice when they request
voluntary sterilization.
In Georgia according to state code Title 31-Chapter 20-Section 2
"It shall be lawful for any physician to perform a sterilization
procedure upon a person 18 years of age or over, or less than 18 years
of age if legally married, provided that a request in writing is made by
such person and provided, further, that prior to or at the time of such
request a full and reasonable medical explanation is given by such
physician to such person as to the meaning and consequence of such
operation." Effective: Wednesday, September 11th, 2013

2. Not every state is as considerate though, Women all over the
United States are denied voluntary sterilization. Women like Victoria
Amrhein, a 23 year old of Jacksonville, Florida who reported her
experience: "Each doctor I went to had the same story-the new ones
straight out of medical school or the one's who'd been around the
block for 30 years. I discussed the fact that getting abortions is more
dangerous than being sterilized and the fact that every time I got
pregnant I could get one, but I am unable to get sterilized. It amazed
me that they were OK (well at least open) to the fact of having
abortions, but not of permanent sterilization which would prevent my
ever needing an abortion!”
Gynecologists like Yekaterina Rabkin who practices in Winchester,
Virginia claim they are not outright refusing to do a tubal ligation on a
qualifying patient but encouraging an alternative course of action. “My
personal opinion is that the only time a tubal is preferable to LARC’s
[Long Acting Reversible Contraception] for someone who is done with
childbearing is if it's done during a C-section, where it is a minor part
of an otherwise major surgery,” she explained. “Otherwise, you expose
someone to surgical risk without any improvement in efficacy, a higher
risk of ectopic pregnancy [due to procedural failure], and the issue of
regret... I genuinely believe that a tubal ligation is not the best option
for contraception for most people.”
Some doctors claim they consult with their patients about other
methods but patients often report feelings of discrimination. There is
still definite evidence of inequality between males and females
treatment while requesting and being consulted on voluntary
sterilization, when comparing the requirements or reasons for
voluntary sterilization. In a 2010 survey of American Gynecologists
70% were likely or very likely to disagree with a 26 year old woman
with one child requesting sterilization, with a disagreeing husband.
Predictably, the doctors became more agreeable as the age, number of
children, and the willingness of the husband increased. (91% said they
would comply if the patient insisted, 7% said they would refer her to

3. another doctor, but 2% stated they would refuse.) Interestingly the
result did not vary between the genders of the doctors, suggesting
sexism isn't a factor.
Women between the age of 18 and 30 often receive comments
such as "You'll change your mind," "You'll regret this later in life," "You
don't have children now," "Eventually women feel their biological clock
ticking," "What if you meet a wealthy man who wants kids?" "You're too
young to make this type of decision.” These questions are often used
by doctors to avoid a procedure they fear a patient may regret and
later decide to sue them for.
One answer is artificial insemination, eggs can be removed from
the ovaries, to be frozen or used immediately, and artificially
inseminated in the uterus, which means you may choose when having a
child is appropriate for you rather than worrying whether you need an
abortion because the condom might have broken, you forgot to take
the pill, or any other contraceptive failure. All of which are
unnecessary stress that often ruins sexual pleasure for women.
If artificial insemination isn't right for you and you do desire
children, reversal is another option; some doctors are now boasting a
25-87% success rate in tubal ligation reversal. Consider, 14% of women
who get tubal ligation request information on reversal, only 1.1% elect
to reverse their tubal ligation. 40% of the women who requested
information on tubal ligation reversal were 18-24 years old at the point
that they were sterilized.
Many times we hear that the statistics for vasectomies are
better than tubal ligations therefore making it more reasonable to let
the man get a vasectomy, but the rates are actually in favor of tubal
ligation. The failure rate of tubal ligation is 1.85% in a 10 year span
while 1.11% of men who receive vasectomies reported failure in the
first 5 years. 80% of vasectomy reversals result in success, but tubal
ligations reversal rate is as high as 87%. 2-6% of sterilized men
request vasectomy reversal, that’s 10-30 thousand a year, only 1% of
women request tubal ligation reversal. The cost for a vasectomy is

4. $750-850, for tubal ligation the cost is 25 hundred dollars. The risk of
a failed sterilization is the same whether a cesarean section is being
performed or not, and a tubal ligation is less invasive than a C-section,
which will leave a scar.
While a woman can be refused tubal ligation based on age, lack of
children, small family size, the attitude of their husband or because
they are single. Positive signs a vasectomy is for you include; being in a
stable marriage for 10 years and being in agreement with your spouse,
meaning married men as young as 28 can get a vasectomy, men may
choose to have vasectomies because they do not want to use temporary
methods... No man is too big for condoms. Family size is not considered
when a man requests a vasectomy. Women face a wait time of 30 days,
after written request is presented to their doctor, to receive tubal
ligation, yet there is no wait time for a vasectomy.
When we get to the statistics we see tubal ligation has good or
better results than vasectomies. You would expect equal treatment for
men and women who seek sterilization, but like many issues regarding
gender equality women are still treated with less respect to personal
beliefs, preference, or understanding. So why are doctors reluctant to
sterilize. Is it fear of litigation, or is it sexism?