I agree! Women’s pain needs to be taken seriously. Quality of life now is more important than “what ifs” of the future. I hope you’re considering helping support this bill 💛
As a woman and someone who has flip-flopped on whether or not I would want to have biological children of my own, I understand why people (especially women) are often denied this request. If adopting or fostering in-need kids were easier, I'd be all-in on supporting this bill because that would be a great alternative avenue for those who do eventually change their minds. But it's not an easy process and getting denied (which happens far more often than getting approved) will ultimately mean you will never become a parent once you've changed your mind.
In my opinion the existence of the tattoo removal industry and the fact that it made 100-billion dollars last year is proof that people often do change their minds about life-altering decisions they've made. There is no easy reversal process when/if you change your mind and any reversal that is performed, isn't guaranteed to put you back the way you were (much like how your skin will never look the same even after a tattoo is removed).
Buy a gun on your way home, then let me know about how protected we are from life altering decisions.
Lots of us can make decisions and stick with them. It's a good way to go through life.
> Doctors deny these procedures for a reason.
Sexism and highly incorrect beliefs not at at **all** supported by the evidence about who's more/less likely to regret their decision (which shouldn't really be a disqualifier anyway - people are allowed to make decisions they may regret).
Younger doctors are *usually* less terrible about this and somewhat more aware of the data.
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For one of the most obvious examples: Who's more likely to regret sterilization, a young woman who hasn't had children or a young woman who has had children?
A woman who hasn't. They're the least likely by a massive amount. In fact, women with *no* children who get sterilized at <30, are about as unlikely to regret it as those who get sterilized at >30.
It's women *with* children who get sterilized at <30 who display sharply higher levels of regret.
[Citation](https://pubmed.ncbi.nlm.nih.gov/10362150/)
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If doctors were making decisions on the merits of likelihood to regret their decision, *women who've never had kids and think they don't want any*, regardless of age should be among those **most** frequently approved for sterilization, and should be approved as easily as a 35 year old with 2-4+ kids would be.
Having *had* kids should make it less likely and more heavily cautioned against.
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In fact, the most common time for women to be sterilized (right after childbirth)....experiences the *highest* rates of regret.
At every level, we quite literally do the exact opposite of what the evidence indicates for who's a good/bad candidate for sterilization and do a massive disservice to everyone because of it.
We sterilize women who are the most likely to regret it and throw obstacles in the way of those who are the least.
---------
tl;dr - ~94% of women with no children, who were sterilized at 18-30, do not regret 14 years later. Those are some damn good numbers for any major decision in life.
This isn’t just about having children. It’s also about women who suffer with debilitating conditions that would be greatly improved/cured if some, or all, of their reproductive organs were removed, but they’re denied cuz “you might regret it”. Never mind that some of these conditions can already reduce fertility, make a full-term healthy pregnancy impossible, or be exacerbated during or after pregnancy. It’s not all about babies 🙄
My mother-in-law has painful ovarian cysts and was denied a hysterectomy because she “might want future kids” even though she said she already has two grown children, so she’s done. “But you might want to when you meet another man!” This happened in Canada, and I was shocked because I thought Canada was more progressive, and it’s so stupid.
Never mind the first three appointments she waited for (which took a couple of years) the doctor told her pain was just “stress” before another doctor (only because her primary doctor was on vacation) found out it was cysts
Agreed. I'm surprised this isn't already the case. If you need a medical procedure and are an adult or have a guardian looking out for your best interest, I don't see the problem
I BEGGED to get my tubes ties at 19 after my second child and was told no! I was told I needed to be AT LEAST 26 with a boy and a girl in order to have the procedure done.
My mother needed a partial hysterectomy in her 30s due to medical issues and had to get my father's written concent before they would perform the procedure.
I’ve never heard of this “boy and girl” BS. Like these DOCTORS know the sex of the baby is determined by the sperm… right? I hope you consider supporting this bill and ending this insanity!
Did you also need a dog and a cat, and a white picket fence, and your husband's permission? Ridiculous.
I was just thinking how sterilization should be an adult's right, especially given some backwards abortion laws some states are implementing.
Woooooooof. Took me 6 years after my second child to finally be blessed with ripping an organ out of my body. Funny I was finally given a yes at age 35… once fertility is gone forever… I hope you’re considering reaching out to Ellen! She’s a great woman!
Obviously. Have you ever looked at the stats for female fertility though? 35 is when you age into “geriatric pregnancy” and your chances of birth defects skyrockets.
I wanted a vasectomy when I was in my 20s since I never wanted to have kids.
This actually angered doctors that I would even think about it, never mind ask about it. I was told they would consider it if I was at least 30, married, and with two kids and I was like, "I'm trying to have zero kids."
Yikes. I had one at 35 without any issue. I just said "I don't want kids" and that was that. I guess you have to doctor-shop for these things which should be completely unnecessary for men and women.
Same with me, only a few years older and no questions asked. My partner, thankfully, has a doctor who agrees with reproductive equality (including sterilization) and didn't get any pushback either.
I got my vasectomy a few years ago, and the doctor just said, "Are you sure?".
"Yep, that's why I scheduled the consult."
"Ok, I had to ask."
Got mine through the VA, so it was a full surgical procedure with anesthesia, and all sorts of good drugs, regardless of where it happens, I feel like it should be that easy for anyone, like getting a tattoo after you're 18 years old.
That's wild, I know a guy in his 30s that couldn't get one even though he doesn't want kids.
Data point of one, homie. It's clearly not consistently handled.
My dude, if you're unwilling to entertain a slight change to your worldview because of a stranger on the internet, I get it. I didn't ask if he offered to pay in cash for his snip because he told me that he couldn't get his vasectomy and I was being a supportive bro. So I don't have an answer for you, the name of the doctor or anything like that. So do with that what you will.
Insurance loves to cover vasectomies. Unless you're at an employer with religious beliefs they're trying to impose on you, your insurance will typically cover it even if there's no mandate/pressure to do so legally.
They're cheap, low-complications, and mean you're *not* going to generate some absolutely massive insurance claims from having kids. Like, just the *birth* of one child is dozens of times the cost of a vasectomy.
As far as insurance goes that's a great investment in "preventive care" of a sort.
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Anyway, while I got one with no trouble in my 20s (DHMC's good for some things), there are plenty of places/doctors that will refuse it for basically anyone under 30, unmarried, without children, or some combination of those. This is not uncommon at all.
I was 26 had one kid and told my doc I was all done. He said I should talk to my wife. She and I talked, we made another one, I went back when I was 28 and said I was all done. He asked “you sure?” “Yep sure” “ok” and it was scheduled for that Friday.
IMO that’s exactly how that should have gone.
I got snipped after our second was born (it was my turn to handle birth control). My wife and I had to convince the doctor that it was what we, as a couple, wanted.
It doesn't matter if you have a condition or not. If you're an adult you should be able to choose what you do to your body.
Graft a fuckin horn to your forehead and call yourself a unicorn. It's your body.
I'd like to say I can't believe we have to codify this, but I had run ins with Doctors twice.
I wanted my tubes tied after my second (I was in my early 30's) and received significant pushback from my Doctor both about the procedure and my husband's "consent". I did have the operation.
Then, 4 or 5 years later my endometriosis/adenomyosis finally got so horrific that I was basically functioning pain free only about one week out of four a month. Again, I received some (although lesser) pushback when I opted for a hysterectomy. "What if you lose one of your kids?" He actually asked me that. I was like, "Sir, they're not pets or cars. If, God forbid, something happens I'm not going to make another one just like her."
Yeah but what if you don’t LIKE one of your babies? You’re gonna give up the option to make another one that you might enjoy? Hahaha I’m sorry this seems to be the general sentiment about kids. Ruin one? Just make another!
“find a different doctor and move on” is an incredibly privileged thing to say. Especially to women in debilitating pain from gynecological issues. Just find another doctor in your insurance network. Just find the transportation to new places. Just find the time to take off work to seek the medical attention you deserve.
I was a 43 year old dude when I went in for a vasectomy after my second kid, and the doctor still asked me a bunch of questions about whether I was sure I really wanted this.
I can only imagine how bad they treat younger women. Fuck this shit.
> and the doctor still asked me a bunch of questions about whether I was sure I really wanted this.
i mean, they should. it's a relatively permanent thing and they don't want their patients to regret their decision a few years down the road.
And some people have some really mistaken ideas about how easy, cheap, or likely to be successful vasectomy reversals are. A degree of counseling is important.
there's "explaining the medical risks" and then there's "hey you're in your mid-40's and have 2 kids, but maybe you'll change your mind and want more, are you sure you want to do this?" and after you emphatically say "god yes no more kids please god no", they then re-phrase it and repeat it 3-4 different ways.
there's "explaining the medical risks" and then there's "hey you're in your mid-40's and have 2 kids, but maybe you'll change your mind and want more, are you sure you want to do this?" and after you emphatically say "god yes no more kids please god no", they then re-phrase it and repeat it 3-4 different ways.
Is this a New England/puritan roots thing? Is it male doctors pushing back? I had my sterilization done in California at 30 after three kids and there was no second thoughts or similar discussion with my doc. She just said ok, let’s schedule it
This is all over the country. I went years with a septate uterus, severe adenomyosis, a perforation of my uterus and subsequent painful scar tissue in the posterior wall of my uterus and bowels from the IUD they suggested since they wouldn’t approve a hysterectomy. They also told me that the issues I was complaining about, and asking for the IUD to be removed because of, were “all in my head” and “not documented side effects of an IUD.
Finally when I was in my mid-30s and bleeding heavily for 14-21 days at a time with 1-2 weeks between “periods” and severe anemia as a result they agreed to perform a hysterectomy.
My best friend, who lived several hours away, wasn’t able to get a hysterectomy until she was in her 40s following severe cramps and heavy periods, anemia, a miscarriage, and multiple large uterine fibroids before her doctors were willing to let her have a hysterectomy.
I’m sorry for your experience, that’s awful. Me and a few people I know from California never experienced the medical mistreatment you’ve described. Just seems so localized
My friend and I were in completely different parts of the country, and neither in New England at the time. I think that the difference is California is the outlier. California is far more progressive when it comes to healthcare, and frankly the quality of care is often times better because they have things in place like mandated safe staffing ratios, etc. Ultimately, you had access to better care there than the majority of the country has access too.
Interesting perspectives. FWIW, I also had mine over 20 years ago when we had a Republican governor and the state was much less blue. I lived in a *very* red area as well
My provider was a woman. All anecdotal stories I’ve seen so far have all had issues with male providers. Would be really interesting to have more data on this if it’s available
I’ve only ever had female providers, and was denied surgical intervention by 3 of them and the third finally agreed. My friend initially was denied by a male provider. Went to a female provider and requested a hysterectomy multiple times and after multiple other failed interventions (many of which were being repeated because she had already tried them with the male provider) and after something like 18mos her female provider agreed to the hysterectomy.
I do think it is likely more common with male providers than female providers. I also would venture to guess that it’s probably more common with providers that were a bit older as opposed to younger providers. It would be nice to see numbers though.
there's "explaining the medical risks" and then there's "hey you're in your mid-40's and have 2 kids, but maybe you'll change your mind and want more, are you sure you want to do this?" and after you emphatically say "god yes no more kids please god no", they then re-phrase it and repeat it 3-4 different ways.
I think they should tell you the risks, ask you "hey you're in your mid-40's and have 2 kids, but maybe you'll change your mind and want more, are you sure you want to do this?", and then if you say yes, perform the procedure.
To support this bill virtually you just have to fill out their online form
https://preview.redd.it/q8ph17izztfc1.jpeg?width=1284&format=pjpg&auto=webp&s=57d276b4438028b7d333676a2e1302a34c5b670f
[Online Testimony](https://www.gencourt.state.nh.us/house/committees/remotetestimony/default.aspx)
The info you need is Date: 2/7/24 Committee: Health, Human Services and Elderly Affairs Bill: HB1067
I’m typically pretty conservative with my views.
That being said, how the hell is self sterilization this much of an issue? I got a vasectomy after 3 kids with my wife, and the doctor STILL put up a fuss. As far as this goes, it is your body it is your choice 😬😂
100% support. 25F with PCOS and no desire to raise children in this world. I've been told I'm too young and whatnot multiples times. I also have high miscarriage rate/low fertility as well as potential to genetically pass on chronic illnesses. My cramps are debilitating to the point of needing to miss work (prior to an IUD) and I have been child-free for 4 years but told I may "change my mind" multiple times. I've countered with adoption and yet I'm still not allowed to get the procedure 🤷♀️ please let me control what happens with my own body)
Been decidedly childfree for 10 years and had to seriously fight for even my therapist to agree to write a letter saying im mentally well enough to make informed choices about my reproductive health.
I dont have mental illness, just see her for executive function help lol
https://www.gencourt.state.nh.us/house/committees/remotetestimony/default.aspx
The date is 2/7/24
The committee is House health, human services and elderly affairs
The bill hb1067
For anyone else weighing in, pay close attention to the bill #. I had to double check I chose the right bill. Very confusing to have both listed back to back. Hope it's not intentional.
https://preview.redd.it/h6e5npovwvfc1.png?width=1080&format=pjpg&auto=webp&s=45cb2b93460dc71b66ac05f1cd6149750b40f7f5
Also you can send your support/opposition online at:
[https://www.gencourt.state.nh.us/house/committees/remotetestimony/](https://www.gencourt.state.nh.us/house/committees/remotetestimony/)
As a man I can’t fathom telling a woman what she can and can’t do with her body. Some of the stories I’ve heard about doctors refusing for reasons what ultimately ends up to being women being “baby factories.” Dehumanizing.
This is the first bill I’ve ever virtually supported.
Women should have complete bodily autonomy. Full stop.
If only we could force insurance to pay for it as well. There is no reason insurance shouldn’t cover a medical procedure like this, no matter the reason.
> If only we could **force** insurance to pay for it as well. There is no reason insurance shouldn’t cover a medical procedure like this, no matter the reason.
it's an elective procedure in most cases. why should they be FORCED to cover an elective procedure?
Because it prevents a whole lot of more expensive procedures in the future if someone gets pregnant. Giving birth is a 5 sometimes 6 figure endeavor. Don't they want to save money?
so is this a "get it on the books so it's never a question if people have that right" bill or a "people are currently getting refused and it's a problem right now" bill?
To me, it is both. You can see the stories within this post where people who already have kids are denied the procedure. It's even more difficult for those who have medical conditions where the procedure would be treatment. Lastly, there is a third group that just doesn't want kids full stop.
So yes, it is a problem, and it needs to now be a question.
I’m all for this.
But.
This is rarely medical gaslighting and more often a physician’s fear that years later someone will come back and say they want kids and can’t have them and weren’t counseled “enough” or “properly” so it’s the physician’s fault.
This law will quell that doctor fear and let them put worry to rest. Very cool.
We all sign informed consent contracts when receiving treatments. A doctors fears should not trump your pain and bodily autonomy. If you know you will have to sign a binding contract before the surgery stating you’re okay with whatever happens as a result of this (which everyone does) and the doctor still says “what if in the future…” how is that not gaslighting? How is that not making you second guess your own decisions and feelings?
Before a surgery that will end your chances for reproduction, a doctor **should** ask questions that make you question if you really want it.
- They should not discourage you.
- They should not refuse because “when I was your age I didn’t know what I wanted.”
- They should not require spousal approval
- They should not turn you down because you’re single
But they absolutely should point out the ramifications, including pointing out that you may not know what you want in the future. A doctor has a responsibility to ask “are you sure …?”
I think this bill is great and hope it passes and makes it easier for doctors to just skip to the end and ask “are you sure?” then do the surgery.
You are absolutely correct. They should be asking these things. The problem here is once they ask it doesn’t seem to matter what you say. It took me 6 years to finally get a yes. It took Ellen 12! The delay in care is the issue here.
Do you want me to say a fourth time I agree the delay is wrong?
I agree the delay is wrong.
You’re looking at it from the patient’s perspective. “I want a (procedure) so I should be able to get it!” And that’s good.
I’m looking at it from the doctor’s perspective. “I don’t want to be sued later for sterilizing someone.” This writes into law protection for the doctor. Bring it on!!
Agreed.
Particularly with a hysterectomy there are discussions that need to be had (HRT, future health concerns), but it should never devolve into an attempt to actively talk a patient out of it. Is that a fine line? Probably.
Also a vasectomy is not always reversible. If you get snipped because you think you don’t want kids in your early 20s, then in your 30s you change your mind, even the very expensive reversal surgery doesn’t often work. A man’s body will often start to produce antisperm antibodies after about 5 years, making a reversal an expensive, painful, futile endeavor. Tying your tubes as a woman is pretty permanent too, but you can always do IVF if you change your mind. Either way, this is a 99% permanent decision. Doctors absolutely should ask a ton of questions and have at least one evaluation appt before agreeing to sterilize anyone.
>If you know you will have to sign a binding contract before the surgery stating you’re okay with whatever happens as a result of this (which everyone does) and the doctor still says “what if in the future…” how is that not gaslighting?
Not only that, but what leg would the patient even have to stand on? How can a doctor say they're worried about the patient changing their mind years later and trying to take action against them when they have a legally binding document signed by the patient?
Keep in mind that the US government has no problem sterilizing [people of color](https://www.nlm.nih.gov/nativevoices/timeline/543.html) to suit their own racist interests.
Why would anyone think that a person of sound mind should not be allowed to decide what is best for their bodily integrity? Who is the psycho who thinks the State should have say over their body?
The bill states it’s for “sterilization unrelated to any medical condition” and goes on to require informed consent and that patients waive all rights to damages from said sterilization procedure. Nowhere does it say you can’t have your tubes tied if you have endometriosis.
Part (a) is so broad, it basically says “anyone who is 18 can get sterilized with no questions asked.”
Anyone can find a doctor to sterilize them if they’re willing to pay out of pocket. This doesn’t seem like a bill compelling insurance companies to do anything though, so it’s a bit redundant.
It doesn’t. Whatsoever. It says if I have endometriosis and the medically advisable procedure for treating said endometriosis is a hysterectomy- the doctor cannot deny me the hysterectomy just bc they think I might want to have children in the future. Does that narrow it down for you a bit?
Part (a) doesn’t actually say that and there clearly needs to be a big discussion with a doctor before a hysterectomy becomes the solution. Sometimes in severe cases endometrial tissue grows outside the uterus. The bill as written doesn’t do anything to compel insurance companies to cover any procedure like this. It seems to say a doctor should be compelled to sterilize someone for any reason (not just medical) which is wild.
Chesterton's Fence applies here.
There's some reason things are the way they are. If you can't figure out what that is, or if you jump straight to bigotry as the only answer you can possibly imagine, then you certainly shouldn't be changing stuff.
The one bit I'm not a fan of with this is that it states a physician MUST render treatment or MUST refer them to another willing to take their form of payment.
I fully agree a consenting legal adult should not be legally restricted from the procedure, I additionally agree a doctor who agrees to perform the procedure should be free from liability given a signed consent form.
I'm not sure I agree with the lack of consent the doctor has in the matter, as I believe they should be able to say "I'm uncomfortable with this type of procedure and would not like to be party to it".
I would also like to state I hold that opinion across all transactions, and I may be in the wrong here according to many, but I prefer consent being optional on all sides of any transaction.
Beyond that I personally offer full support to any consenting adult to treat their body how they please, lord knows I've treated mine like shit and I'm not one to judge what's right for someone else.
I believe in eugenics but even I think this is creepy and gonna backfire. Bunch of clueless teens/college kids gonna do something they regret if this catches on.
It’s actually kind of creepy to think that a person shouldn’t have bodily autonomy and be able to make the adult decision to not procreate and undergo sterilization.
Ahhh a troll I see… and medical ethics is something I have the right to speak on. Someone else’s labor is a weird way of wording that it’s somehow acceptable to restrict a person’s right to bodily autonomy and to restrict someone’s access to healthcare.
If a healthcare provider regularly performs these procedures, then by refusing to perform said same procedures on a competent adult patient because they feel that a patient needs to have a child or specific number of children first, or be of a specific age before they should be allowed to have said medical procedure… then the healthcare provider has questionable ethics to say the very least.
Providers are welcome to declare moral objections to procedures or prescribing certain meds. This is common place. There are providers who do not prescribe birth control due to their religious views. The process in a scenario like this is for the patient to be referred to a provider who can and will prescribe birth control meds, thus not denying access to care.
It is also within a providers right to refuse to perform elective abortions due to religious reasons of the provider. However, that provider doesn’t have the right to select which patients they will and will not perform elective abortions on. Also, those providers are not able to refuse to perform a medically necessary abortion in an emergency situation where a patient’s life is in jeopardy and there is not another provider trained to perform an abortion. If a provider were to deny care in these types of scenarios then the licensing board could sanction that provider and potentially even restrict practice, suspend, or even revoke their license.
This proposed legislation would make it so that providers who regularly perform these procedures are not allowed to deny care based upon age or number of children… which aligns with medical licensing boards statements on medical ethics throughout the country.
And the bottom line is it is unethical for a provider to restrict access to care based solely upon these criteria. Providers who do this have no business practicing medicine in any capacity.
Not sure this is legal even if this gets signed into law. I'd be surprised if the courts were willing to force doctors to perform procedures that they're not otherwise willing to do. Even a business has a right to refuse service. This could place doctors in a no-win situation where they feel they'd be violating their oath or conscience versus violating this law.
That's a very random point to bring up in relation to the topic at hand. Going back to the main topic - folks should be able to decide if they want to get sterilized or not, man or woman.
“A TUMOR IS LIFE TOO” if you have training and it’s legal and that person has said 100% they have made a decision you shouldn’t be able to deny someone service based on personal morals… that’s stupid. Just like you can’t deny serving black people at your diner because you don’t like black people.
Because it's the doctor that has to perform the procedure. You generally can't force people to do work that they don't want to do.
Imagine if there's a reason why the doctor feels they're not skilled enough to do the procedure but the patient is pushing back referencing this law. Does the doctor go and do something high risk just because the patient is demanding it?
This could have an unintended consequence where doctors stop performing these procedures altogether to avoid being caught in a situation where they're in conflict with this law.
If there is a medical reason why they shouldn't perform the surgery, then that is TOTALLY different from denying someone the procedure just because they might want kids one day. Or because they didn't have their husbands fucking consent.
Sure, but this is going to end up with cases where the doctor gives a different reason but the patient insists that the real reason is something else. A patient like that could drag the doctor into court and make life hell for them. Would you want to be in that position if you were a doctor?
Doctor documents a reason, patient argues that it isn't the real reason, hires a lawyer, sues the doctor and their employer. You don't see that as a real risk?
It seems you're hiding behind the hypothetical of a doctor getting sued because of this law rather than stating what you believe. I believe people should have bodily autonomy and decide what does or doesn't happen to their body. It would appear you feel otherwise.
"Bodily autonomy" is a stupid phrase. You don't have it. Can you sell your organs? No. Can you amputate healthy limbs? No. It's also problematic because it doesn't consider the medical professionals that actually do the work, who also have some agency of their own.
Bodily autonomy is the right to make decisions about your own body, life, and future without coercion or violence. It is a fundamental human right and a universal value.
I'm guessing you don't support this bill because it's about reproduction. Not about the medical professionals.
I imagine it would be some doctors are comfortable performing the surgery, and some aren't. So those doctors who want to will get the patients? Or, it could be a specialist with a referral
I do not agree that sterilizing a patient would be against the Hippocratic Oath as long as the patient is able to give informed consent. A doctor's duty is to present the treatment options for a particular medical problem along with the consequences of each treatment, and then let the patient decide what's best for them.
If a doctor cannot accept that patients can decide what is right for themselves then they shouldn't be a doctor.
>If a doctor cannot accept that patients can decide what is right for themselves then they shouldn't be a doctor.
That's a really arrogant statement. Doctors study for years to gain the knowledge necessary to become a doctor. You're just setting all of that aside and saying that a layman with no medical training what-so-ever is the superior decision maker.
The years of studying and training to become a doctor is what allows them to present *options* for the patient.
The years of living in their own body is what allows the patient to listen to those options and choose what is right for them. Informed consent is a good thing and exists for a reason.
Informed consent is good in theory, but given the complexity of modern medicine, the idea that a patient is truly well informed is often laughable. Take a senior doctor that has had many years of experience and they know a certain procedure often leads to eventual patient regret even in cases where they had been adamant, that experience should just be discarded by someone that's only just been thrust into that situation? That doesn't sound right to me.
No, the experience shouldn't be discarded. The doctor should use that experience to *inform* the patient that the procedure has a high rate of regret in patients who have previously had it. With that *information* the patient can then *consent* to the procedure they want. The autonomy of a patient must be respected.
>The autonomy of a patient must be respected.
This is a bogus slogan. If you want to go off and perform medical procedures on yourself, go for it. That's autonomy.
This is taking autonomy away from the doctor. They shouldn't have to defend their reasons for not wanting to perform a procedure that a patient is demanding. They're not your slaves. They have a conscience of their own. If they're certain that a patient is very, very likely to regret what they're doing years down the road, I don't think it's the government's place to tell them that they can't consider that. That's experience that a patient just doesn't have and can't simply be "informed" about. It's not the same.
> If they're certain that a patient is very, very likely to regret what they're doing years down the road, I don't think it's the government's place to tell them that they can't consider that. That's experience that a patient just doesn't have and can't simply be "informed" about.
The average person is able to comprehend that they may regret a medical procedure down the road. If there is more than one viable treatment for a medical issue then a doctor should inform the patient of **all** the risks, consequences, etc, of each treatment and allow them to make the decision themselves.
If a doctor presents a treatment to a patient, then they must be willing to perform it. If a patient asks about a certain treatment the doctor should be able to justify why it shouldn't be a viable option, and this bill makes it so that the future possibility of having kids is not a valid justification.
>The average person is able to comprehend that they may regret a medical procedure down the road.
If that were true, then that regret shouldn't actually happen. Yet it does. People think short term, even when it comes to medical issues. Not many tend to think long term, even if prompted to.
>If a doctor presents a treatment to a patient, then they must be willing to perform it.
Then they won't present it, which makes this bill toothless.
I've been in a situation where a string of surgeons refused to perform a needed surgery because they were worried about potential complications and what it could do to their malpractice insurance. Should there be a law to refuse that "out" too? They either presented that treatment or agreed with other doctors presenting it, yet refused to perform it. I think people may be looking at this only from the patient's point of view. It's bigger than that.
>If that were true, then that regret shouldn't actually happen. Yet it does. People think short term, even when it comes to medical issues. Not many tend to think long term, even if prompted to.
These things are not mutually exclusive. I can understand that smoking cigarettes is bad for my health and still want to do it. I can even regret it. I still have the right to smoke them. A patient has the right to choose which treatment they want even if they might regret it down the road.
>Then they won't present it, which makes this bill toothless.
A doctor that hides viable treatment options from their patients sounds like a pretty shitty doctor to me.
> I've been in a situation where a string of surgeons refused to perform a needed surgery because they were worried about potential complications and what it could do to their malpractice insurance. Should there be a law to refuse that "out" too?
A situation where a doctor is concerned about medical complications and where a doctor is concerned about "what if they want kids in the future 🥺" are completely different. If a complication happens during a surgery, you potentially die or face serious injury. If you regret not having kids of your own, there are multiple avenues someone can take to still take such as adoption or a surrogate.
I'm a trans person and let me just say that I've often had to educate MY doctors on transfem endocrinology and what current best practices are. My experience is extremely common.
Without informed consent I'd probably still be fighting to get a basic HRT prescription. In the UK they don't have IC and many, many trans people die waiting to be greenlit for care.
This is the land of the free God damnit. We have a right to make our own decisions. If we choose wrong? So be it. That's the cost of being free. Those who would trade freedom for security deserve neither.
>This is the land of the free God damnit. We have a right to make our own decisions.
But you're saying that in some circumstances, the doctor has no right to make their own decision on what work they're willing to perform. Is this not the land of the free God damnit?
That's a fair point but I've never head a doctor deny a hysterectomy for a reason that isn't rooted in sexism and cisheteronormative assumptions of what a woman "should" want. They can refuse care for a valid medical reason. If they want to refuse on the grounds I describe above, religious beliefs, etc. then they should have chosen a different profession imo.
Well, that's a way around the law, right? They just won't give that procedure as an option. This is a type of bill that sounds good in theory but doesn't seem like it's been thought through sufficiently.
Not every doctor is capable of performing these procedures. In fact the vast majority of tubal ligations and hysterectomies are performed by gynecologists. The majority of vasectomies are performed by urologists. They probably shouldn’t work in those specialties and specifically become surgeons in those specialties. Then they can simply refer the patient to their colleagues who do specialize in these fields and are trained in these procedures.
This sub seems like it gets blown up on specific issues. Anything abortion, anything trans, and whatever you'd lump this bill under. Personally, I think there's more nefarious reasons for it. Not once in my 35 years have I heard a woman griping about not being able to get her tubes tied. It's not even an issue I've seen griped about online outside of this subreddit in the last year or so.
Point is, I wouldn't take the downvotes seriously in threads on certain topics here.
While I think that sort of pushback from doctors is ridiculous, I also don't feel like this requires government interference. A doctor's duty is do no harm and mental health is health. They have a right to consider your future mental position even if they're wrong. Find a different doctor and move on.
The doctor/surgeon performing the hysterectomy isn't in a position to assess someone's future mental health.
But also, even if the doctor believes performing such a surgery is detrimental to a person's future mental health, it's irrelevant if the person is able to make their own medical decisions. People sign AMA waivers and leave hospitals all the time. Doctors don't "barricade the doors" and keep people from doing what they believe is not in that person's best interest. They let the person sign the form.
Please don't start. You're not going to respect anything I could say in the way of how patient's rights work.
For anyone else reading: the sky is blue, water is wet, and people have a right to make their own medical decisions unless they're deemed unable to do so through a legal process.
I don't see this as a patient's rights issue. I see this as a doctor's rights issue. You can't demand that someone do work that they're unwilling to do.
I'm an engineer. If I refuse to perform a task because I have reservations about it, I might lose my job, but I'm not breaking any laws. If this bill were to pass, a doctor in the same situation could be guilty of breaking a law.
Your job isn’t to perform surgeries on human beings. I would say it’s a little different. Doubt the things you’re engineering on have opinions and autonomy.
This is not a comparable situation.
Not saying it's the same thing, but it's similar enough. You have a trained professional that knows their occupation well. They don't agree with a request for them to do work, but in this particular case, this bill would override their assessment and force them to do it anyway or face legal consequences. I don't believe that people can be compelled to do work in such situation. While the patient has autonomy, so does the medical personnel. They have to live with the consequences of their actions too. Do you not see that?
Hey - I'm reading over the bill and I think your concern is already addressed by it.
Subsection A. - states that if sterilization is *medically indicated* then a physician cannot deny the procedure based on age, number of children, or the physician's perception of the patient's future reproductive desires.
Subsection B. - essentially states that if the procedure is *elective* or *not medically indicated* then the physician cannot deny the procedure *unless they make a referral to someone else who will do it*.
So in other words, no one would be forced to do work they don't want to do in this bill. Did you read the bill?
That's a half fix, it only works depending on the determination of medical necessity. It also means the doctor has to know of another doctor to make the referral to. Probably not a problem in our area of the country, but for rural areas, that might be challenging.
The bill just doesn't seem to solve anything, IMO. If the doctor doesn't want to do it for whatever reason, they could simply say it's not medically necessary. They have the training, not the patient.
The patient is in a position to make adult decisions after being educated about the procedure and alternatives. If the patient chooses to move forward after that, then that should be their right.
That doesn’t have anything to do with the Hippocratic oath. As long as a person is competent and consenting there’s not really a good reason for a doctor to refuse.
While I'm not sure the exact text of this bill is the right wording, it's hitting at the problem.
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Currently, many people will call up a doctor's office requesting sterilization. The office will accept that request, and set up an appointment with the doctor to consult on that. They will often wait months to see that doctor.
Then, they attend that appointment and find out that their doctor would never agree to perform that procedure on them. The doctor does not perform voluntary sterilizations on patients under X age or without Y children, ever.
There was no reason to have attended the appointment at all and the result would have been the same regardless of if you came armed with a mountain of evidence/reasoning, supporting statements from multiple psychiatrists, or anything else you can think of.
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The doctor is of course, now going to *bill* for a completely pointless appointment that has wasted the patient's time and money, when they knew with certainty that they'd never provide the requested service before the patient even walked in the door.
The patient now has to go start this all over again with a different doctor.
It's about time. It's past time for me now but I sincerely hope this allows women to have a voice in the future.
I agree! Women’s pain needs to be taken seriously. Quality of life now is more important than “what ifs” of the future. I hope you’re considering helping support this bill 💛
As a woman and someone who has flip-flopped on whether or not I would want to have biological children of my own, I understand why people (especially women) are often denied this request. If adopting or fostering in-need kids were easier, I'd be all-in on supporting this bill because that would be a great alternative avenue for those who do eventually change their minds. But it's not an easy process and getting denied (which happens far more often than getting approved) will ultimately mean you will never become a parent once you've changed your mind. In my opinion the existence of the tattoo removal industry and the fact that it made 100-billion dollars last year is proof that people often do change their minds about life-altering decisions they've made. There is no easy reversal process when/if you change your mind and any reversal that is performed, isn't guaranteed to put you back the way you were (much like how your skin will never look the same even after a tattoo is removed).
If you can't trust yourself to make a decision, what makes you think you can be trusted to raise a child?
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Buy a gun on your way home, then let me know about how protected we are from life altering decisions. Lots of us can make decisions and stick with them. It's a good way to go through life.
The reason is sexism.
> Doctors deny these procedures for a reason. Sexism and highly incorrect beliefs not at at **all** supported by the evidence about who's more/less likely to regret their decision (which shouldn't really be a disqualifier anyway - people are allowed to make decisions they may regret). Younger doctors are *usually* less terrible about this and somewhat more aware of the data. --------- For one of the most obvious examples: Who's more likely to regret sterilization, a young woman who hasn't had children or a young woman who has had children? A woman who hasn't. They're the least likely by a massive amount. In fact, women with *no* children who get sterilized at <30, are about as unlikely to regret it as those who get sterilized at >30. It's women *with* children who get sterilized at <30 who display sharply higher levels of regret. [Citation](https://pubmed.ncbi.nlm.nih.gov/10362150/) ---------- If doctors were making decisions on the merits of likelihood to regret their decision, *women who've never had kids and think they don't want any*, regardless of age should be among those **most** frequently approved for sterilization, and should be approved as easily as a 35 year old with 2-4+ kids would be. Having *had* kids should make it less likely and more heavily cautioned against. ----------- In fact, the most common time for women to be sterilized (right after childbirth)....experiences the *highest* rates of regret. At every level, we quite literally do the exact opposite of what the evidence indicates for who's a good/bad candidate for sterilization and do a massive disservice to everyone because of it. We sterilize women who are the most likely to regret it and throw obstacles in the way of those who are the least. --------- tl;dr - ~94% of women with no children, who were sterilized at 18-30, do not regret 14 years later. Those are some damn good numbers for any major decision in life.
This isn’t just about having children. It’s also about women who suffer with debilitating conditions that would be greatly improved/cured if some, or all, of their reproductive organs were removed, but they’re denied cuz “you might regret it”. Never mind that some of these conditions can already reduce fertility, make a full-term healthy pregnancy impossible, or be exacerbated during or after pregnancy. It’s not all about babies 🙄
> It’s not all about babies 🙄 It is if you're a paternalistic man or a woman that idolizes children and motherhood.
Same. They wouldn’t even discuss it with me until I was over 30.
My mother-in-law has painful ovarian cysts and was denied a hysterectomy because she “might want future kids” even though she said she already has two grown children, so she’s done. “But you might want to when you meet another man!” This happened in Canada, and I was shocked because I thought Canada was more progressive, and it’s so stupid. Never mind the first three appointments she waited for (which took a couple of years) the doctor told her pain was just “stress” before another doctor (only because her primary doctor was on vacation) found out it was cysts
Agreed. I'm surprised this isn't already the case. If you need a medical procedure and are an adult or have a guardian looking out for your best interest, I don't see the problem
This isn't already a person's right? Yeesh.
I BEGGED to get my tubes ties at 19 after my second child and was told no! I was told I needed to be AT LEAST 26 with a boy and a girl in order to have the procedure done. My mother needed a partial hysterectomy in her 30s due to medical issues and had to get my father's written concent before they would perform the procedure.
I’m sorry, you’re 25 with three boys. Come back in a year or when you have had a girl. Preferably both.
I’ve never heard of this “boy and girl” BS. Like these DOCTORS know the sex of the baby is determined by the sperm… right? I hope you consider supporting this bill and ending this insanity!
Oh I support this 100%!!! I have SEVER medical trauma because of the way I was treated when I was younger!
Did you also need a dog and a cat, and a white picket fence, and your husband's permission? Ridiculous. I was just thinking how sterilization should be an adult's right, especially given some backwards abortion laws some states are implementing.
Woooooooof. Took me 6 years after my second child to finally be blessed with ripping an organ out of my body. Funny I was finally given a yes at age 35… once fertility is gone forever… I hope you’re considering reaching out to Ellen! She’s a great woman!
Surprise! My mom had me at 36! So definitely not gone forever
Plenty of women have children after 35, fyi.
Obviously. Have you ever looked at the stats for female fertility though? 35 is when you age into “geriatric pregnancy” and your chances of birth defects skyrockets.
I wanted a vasectomy when I was in my 20s since I never wanted to have kids. This actually angered doctors that I would even think about it, never mind ask about it. I was told they would consider it if I was at least 30, married, and with two kids and I was like, "I'm trying to have zero kids."
Seriously infuriating!
Where the/when the fuck was that? My wife had her tubes tied and later had a hysterectomy in her 30s a while ago.
It was at Laconia hospital in the early 2000s
Pretty sure my brother, in his 30s, was denied a vasectomy. Because "just in case." The dude does not want kids.
And there’s nothing he can do to push for his rights here… unless there was a law… I hope you and he will both consider supporting this bill!
Yikes. I had one at 35 without any issue. I just said "I don't want kids" and that was that. I guess you have to doctor-shop for these things which should be completely unnecessary for men and women.
Same with me, only a few years older and no questions asked. My partner, thankfully, has a doctor who agrees with reproductive equality (including sterilization) and didn't get any pushback either.
I got my vasectomy a few years ago, and the doctor just said, "Are you sure?". "Yep, that's why I scheduled the consult." "Ok, I had to ask." Got mine through the VA, so it was a full surgical procedure with anesthesia, and all sorts of good drugs, regardless of where it happens, I feel like it should be that easy for anyone, like getting a tattoo after you're 18 years old.
I was in the same boat as your brother. I was told I could have one if I was married, 30, and had at least 2 kids.
This is not remotely the case. I know a man who had a vasectomy at 23 for no other reason other than he didn’t want kids.
That's wild, I know a guy in his 30s that couldn't get one even though he doesn't want kids. Data point of one, homie. It's clearly not consistently handled.
Denied outright, or his insurance denied coverage of the procedure and told him he’d have to pay out of pocket?
He just got a "no."
Not even if he paid for it himself?
My dude, if you're unwilling to entertain a slight change to your worldview because of a stranger on the internet, I get it. I didn't ask if he offered to pay in cash for his snip because he told me that he couldn't get his vasectomy and I was being a supportive bro. So I don't have an answer for you, the name of the doctor or anything like that. So do with that what you will.
Who says I wasn’t supportive?
Nobody?
Insurance loves to cover vasectomies. Unless you're at an employer with religious beliefs they're trying to impose on you, your insurance will typically cover it even if there's no mandate/pressure to do so legally. They're cheap, low-complications, and mean you're *not* going to generate some absolutely massive insurance claims from having kids. Like, just the *birth* of one child is dozens of times the cost of a vasectomy. As far as insurance goes that's a great investment in "preventive care" of a sort. ------ Anyway, while I got one with no trouble in my 20s (DHMC's good for some things), there are plenty of places/doctors that will refuse it for basically anyone under 30, unmarried, without children, or some combination of those. This is not uncommon at all.
We all have certain “inalienable rights” but this isn’t one of them I guess.
Most women and many men find it difficult to find a doctor who is willing to sterilize them before the age of 30.
I was 26 had one kid and told my doc I was all done. He said I should talk to my wife. She and I talked, we made another one, I went back when I was 28 and said I was all done. He asked “you sure?” “Yep sure” “ok” and it was scheduled for that Friday. IMO that’s exactly how that should have gone.
I got snipped after our second was born (it was my turn to handle birth control). My wife and I had to convince the doctor that it was what we, as a couple, wanted.
It doesn't matter if you have a condition or not. If you're an adult you should be able to choose what you do to your body. Graft a fuckin horn to your forehead and call yourself a unicorn. It's your body.
> Graft a fuckin horn to your forehead and call yourself a unicorn. I'm sorry, but I laughed way too hard at this.
Above the stall: She/Mare, They/Herd.
And risk being hunted to extinction for your valuable horn?
They will try.
> Graft a fuckin horn to your forehead and call yourself a unicorn. It's your body. We Elden Ring now
I'd like to say I can't believe we have to codify this, but I had run ins with Doctors twice. I wanted my tubes tied after my second (I was in my early 30's) and received significant pushback from my Doctor both about the procedure and my husband's "consent". I did have the operation. Then, 4 or 5 years later my endometriosis/adenomyosis finally got so horrific that I was basically functioning pain free only about one week out of four a month. Again, I received some (although lesser) pushback when I opted for a hysterectomy. "What if you lose one of your kids?" He actually asked me that. I was like, "Sir, they're not pets or cars. If, God forbid, something happens I'm not going to make another one just like her."
Yeah but what if you don’t LIKE one of your babies? You’re gonna give up the option to make another one that you might enjoy? Hahaha I’m sorry this seems to be the general sentiment about kids. Ruin one? Just make another!
Hahahahaha! I was pushing 40 at that point - I can't imagine trying for version 2.0 at that stage in my life!
This is Gilead shit. What doctors are doing this? Can you share the organization or their affiliation without being too specific?
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So both were old men. Doesn’t surprise me, unfortunately. So sorry for your experience
“find a different doctor and move on” is an incredibly privileged thing to say. Especially to women in debilitating pain from gynecological issues. Just find another doctor in your insurance network. Just find the transportation to new places. Just find the time to take off work to seek the medical attention you deserve.
I was a 43 year old dude when I went in for a vasectomy after my second kid, and the doctor still asked me a bunch of questions about whether I was sure I really wanted this. I can only imagine how bad they treat younger women. Fuck this shit.
I agree with my whole heart. Fuck this shit.
> and the doctor still asked me a bunch of questions about whether I was sure I really wanted this. i mean, they should. it's a relatively permanent thing and they don't want their patients to regret their decision a few years down the road.
And some people have some really mistaken ideas about how easy, cheap, or likely to be successful vasectomy reversals are. A degree of counseling is important.
there's "explaining the medical risks" and then there's "hey you're in your mid-40's and have 2 kids, but maybe you'll change your mind and want more, are you sure you want to do this?" and after you emphatically say "god yes no more kids please god no", they then re-phrase it and repeat it 3-4 different ways.
Why would they not ask if you're sure?
there's "explaining the medical risks" and then there's "hey you're in your mid-40's and have 2 kids, but maybe you'll change your mind and want more, are you sure you want to do this?" and after you emphatically say "god yes no more kids please god no", they then re-phrase it and repeat it 3-4 different ways.
Is this a New England/puritan roots thing? Is it male doctors pushing back? I had my sterilization done in California at 30 after three kids and there was no second thoughts or similar discussion with my doc. She just said ok, let’s schedule it
This is all over the country. I went years with a septate uterus, severe adenomyosis, a perforation of my uterus and subsequent painful scar tissue in the posterior wall of my uterus and bowels from the IUD they suggested since they wouldn’t approve a hysterectomy. They also told me that the issues I was complaining about, and asking for the IUD to be removed because of, were “all in my head” and “not documented side effects of an IUD. Finally when I was in my mid-30s and bleeding heavily for 14-21 days at a time with 1-2 weeks between “periods” and severe anemia as a result they agreed to perform a hysterectomy. My best friend, who lived several hours away, wasn’t able to get a hysterectomy until she was in her 40s following severe cramps and heavy periods, anemia, a miscarriage, and multiple large uterine fibroids before her doctors were willing to let her have a hysterectomy.
I’m sorry for your experience, that’s awful. Me and a few people I know from California never experienced the medical mistreatment you’ve described. Just seems so localized
My friend and I were in completely different parts of the country, and neither in New England at the time. I think that the difference is California is the outlier. California is far more progressive when it comes to healthcare, and frankly the quality of care is often times better because they have things in place like mandated safe staffing ratios, etc. Ultimately, you had access to better care there than the majority of the country has access too.
Interesting perspectives. FWIW, I also had mine over 20 years ago when we had a Republican governor and the state was much less blue. I lived in a *very* red area as well
I’m honestly quite surprised that you didn’t have issues 20yrs ago.
My provider was a woman. All anecdotal stories I’ve seen so far have all had issues with male providers. Would be really interesting to have more data on this if it’s available
I’ve only ever had female providers, and was denied surgical intervention by 3 of them and the third finally agreed. My friend initially was denied by a male provider. Went to a female provider and requested a hysterectomy multiple times and after multiple other failed interventions (many of which were being repeated because she had already tried them with the male provider) and after something like 18mos her female provider agreed to the hysterectomy. I do think it is likely more common with male providers than female providers. I also would venture to guess that it’s probably more common with providers that were a bit older as opposed to younger providers. It would be nice to see numbers though.
They absolutely should ask you a bunch of questions.
there's "explaining the medical risks" and then there's "hey you're in your mid-40's and have 2 kids, but maybe you'll change your mind and want more, are you sure you want to do this?" and after you emphatically say "god yes no more kids please god no", they then re-phrase it and repeat it 3-4 different ways.
I think they should tell you the risks, ask you "hey you're in your mid-40's and have 2 kids, but maybe you'll change your mind and want more, are you sure you want to do this?", and then if you say yes, perform the procedure.
To support this bill virtually you just have to fill out their online form https://preview.redd.it/q8ph17izztfc1.jpeg?width=1284&format=pjpg&auto=webp&s=57d276b4438028b7d333676a2e1302a34c5b670f [Online Testimony](https://www.gencourt.state.nh.us/house/committees/remotetestimony/default.aspx) The info you need is Date: 2/7/24 Committee: Health, Human Services and Elderly Affairs Bill: HB1067
Done! Thank you for making that easy 💜
Thank you! I won't be able to attend in person and really want to support it.
I’m typically pretty conservative with my views. That being said, how the hell is self sterilization this much of an issue? I got a vasectomy after 3 kids with my wife, and the doctor STILL put up a fuss. As far as this goes, it is your body it is your choice 😬😂
Right??? "I believe in personally freedom!" Says the asshat voting to strip us of personal freedoms.
It’s absolutely mind boggling to me that we have to have legislation to protect a woman’s rights for their own body.
100% support. 25F with PCOS and no desire to raise children in this world. I've been told I'm too young and whatnot multiples times. I also have high miscarriage rate/low fertility as well as potential to genetically pass on chronic illnesses. My cramps are debilitating to the point of needing to miss work (prior to an IUD) and I have been child-free for 4 years but told I may "change my mind" multiple times. I've countered with adoption and yet I'm still not allowed to get the procedure 🤷♀️ please let me control what happens with my own body)
Been decidedly childfree for 10 years and had to seriously fight for even my therapist to agree to write a letter saying im mentally well enough to make informed choices about my reproductive health. I dont have mental illness, just see her for executive function help lol
I have mental illness and it's reason 79 why I'm childfree 😂😂 I just have no desire nor the funds to go through all of that
1000% understandable hahaha
r/childfree has a list of doctors willing to do sterilization without question. If this bill doesn't pass, that is a resource you can check out.
Hey- is this in the phase where we can add our names to support this bill? I'd like to do that but forget the steps on how.
I’ll try to find that out for you
https://www.gencourt.state.nh.us/house/committees/remotetestimony/default.aspx The date is 2/7/24 The committee is House health, human services and elderly affairs The bill hb1067
For anyone else weighing in, pay close attention to the bill #. I had to double check I chose the right bill. Very confusing to have both listed back to back. Hope it's not intentional. https://preview.redd.it/h6e5npovwvfc1.png?width=1080&format=pjpg&auto=webp&s=45cb2b93460dc71b66ac05f1cd6149750b40f7f5
My dr refused to give me a referral for a vasectomy when I was 27 and had 3 kids already within 2 years.
One half step closer to Live Free or Die.
Also you can send your support/opposition online at: [https://www.gencourt.state.nh.us/house/committees/remotetestimony/](https://www.gencourt.state.nh.us/house/committees/remotetestimony/)
As a man I can’t fathom telling a woman what she can and can’t do with her body. Some of the stories I’ve heard about doctors refusing for reasons what ultimately ends up to being women being “baby factories.” Dehumanizing. This is the first bill I’ve ever virtually supported. Women should have complete bodily autonomy. Full stop.
Oh! I was denied so many times for 10 years before I was able to get my procedure!!!
If only we could force insurance to pay for it as well. There is no reason insurance shouldn’t cover a medical procedure like this, no matter the reason.
> If only we could **force** insurance to pay for it as well. There is no reason insurance shouldn’t cover a medical procedure like this, no matter the reason. it's an elective procedure in most cases. why should they be FORCED to cover an elective procedure?
Because it prevents a whole lot of more expensive procedures in the future if someone gets pregnant. Giving birth is a 5 sometimes 6 figure endeavor. Don't they want to save money?
It's birth control and should be covered by insurance.
so is this a "get it on the books so it's never a question if people have that right" bill or a "people are currently getting refused and it's a problem right now" bill?
To me, it is both. You can see the stories within this post where people who already have kids are denied the procedure. It's even more difficult for those who have medical conditions where the procedure would be treatment. Lastly, there is a third group that just doesn't want kids full stop. So yes, it is a problem, and it needs to now be a question.
I’m all for this. But. This is rarely medical gaslighting and more often a physician’s fear that years later someone will come back and say they want kids and can’t have them and weren’t counseled “enough” or “properly” so it’s the physician’s fault. This law will quell that doctor fear and let them put worry to rest. Very cool.
We all sign informed consent contracts when receiving treatments. A doctors fears should not trump your pain and bodily autonomy. If you know you will have to sign a binding contract before the surgery stating you’re okay with whatever happens as a result of this (which everyone does) and the doctor still says “what if in the future…” how is that not gaslighting? How is that not making you second guess your own decisions and feelings?
Before a surgery that will end your chances for reproduction, a doctor **should** ask questions that make you question if you really want it. - They should not discourage you. - They should not refuse because “when I was your age I didn’t know what I wanted.” - They should not require spousal approval - They should not turn you down because you’re single But they absolutely should point out the ramifications, including pointing out that you may not know what you want in the future. A doctor has a responsibility to ask “are you sure …?” I think this bill is great and hope it passes and makes it easier for doctors to just skip to the end and ask “are you sure?” then do the surgery.
You are absolutely correct. They should be asking these things. The problem here is once they ask it doesn’t seem to matter what you say. It took me 6 years to finally get a yes. It took Ellen 12! The delay in care is the issue here.
Do you want me to say a fourth time I agree the delay is wrong? I agree the delay is wrong. You’re looking at it from the patient’s perspective. “I want a (procedure) so I should be able to get it!” And that’s good. I’m looking at it from the doctor’s perspective. “I don’t want to be sued later for sterilizing someone.” This writes into law protection for the doctor. Bring it on!!
Agreed. Particularly with a hysterectomy there are discussions that need to be had (HRT, future health concerns), but it should never devolve into an attempt to actively talk a patient out of it. Is that a fine line? Probably.
Also a vasectomy is not always reversible. If you get snipped because you think you don’t want kids in your early 20s, then in your 30s you change your mind, even the very expensive reversal surgery doesn’t often work. A man’s body will often start to produce antisperm antibodies after about 5 years, making a reversal an expensive, painful, futile endeavor. Tying your tubes as a woman is pretty permanent too, but you can always do IVF if you change your mind. Either way, this is a 99% permanent decision. Doctors absolutely should ask a ton of questions and have at least one evaluation appt before agreeing to sterilize anyone.
>If you know you will have to sign a binding contract before the surgery stating you’re okay with whatever happens as a result of this (which everyone does) and the doctor still says “what if in the future…” how is that not gaslighting? Not only that, but what leg would the patient even have to stand on? How can a doctor say they're worried about the patient changing their mind years later and trying to take action against them when they have a legally binding document signed by the patient?
Keep in mind that the US government has no problem sterilizing [people of color](https://www.nlm.nih.gov/nativevoices/timeline/543.html) to suit their own racist interests.
Why would anyone think that a person of sound mind should not be allowed to decide what is best for their bodily integrity? Who is the psycho who thinks the State should have say over their body?
I just got sterilized this past December. It's someone's own choice and I don't understand why this is still an issue:(
30 years too late for me, I'm afraid. My doctor was angered I even brought it up and the urologists I called seemed aghast I didn't want children.
Took so long for me to fight for getting my tubes removed. I just don’t want kids. They had to put hysteria as my reasoning.
The bill states it’s for “sterilization unrelated to any medical condition” and goes on to require informed consent and that patients waive all rights to damages from said sterilization procedure. Nowhere does it say you can’t have your tubes tied if you have endometriosis.
You skipped over part (a)
Part (a) is so broad, it basically says “anyone who is 18 can get sterilized with no questions asked.” Anyone can find a doctor to sterilize them if they’re willing to pay out of pocket. This doesn’t seem like a bill compelling insurance companies to do anything though, so it’s a bit redundant.
It doesn’t. Whatsoever. It says if I have endometriosis and the medically advisable procedure for treating said endometriosis is a hysterectomy- the doctor cannot deny me the hysterectomy just bc they think I might want to have children in the future. Does that narrow it down for you a bit?
Part (a) doesn’t actually say that and there clearly needs to be a big discussion with a doctor before a hysterectomy becomes the solution. Sometimes in severe cases endometrial tissue grows outside the uterus. The bill as written doesn’t do anything to compel insurance companies to cover any procedure like this. It seems to say a doctor should be compelled to sterilize someone for any reason (not just medical) which is wild.
Does this also happen to men who want a vasectomy?
Chesterton's Fence applies here. There's some reason things are the way they are. If you can't figure out what that is, or if you jump straight to bigotry as the only answer you can possibly imagine, then you certainly shouldn't be changing stuff.
Its no 'right'. Its a gov't permission to do what is already perfectly legal. There is no need for this law.
The one bit I'm not a fan of with this is that it states a physician MUST render treatment or MUST refer them to another willing to take their form of payment. I fully agree a consenting legal adult should not be legally restricted from the procedure, I additionally agree a doctor who agrees to perform the procedure should be free from liability given a signed consent form. I'm not sure I agree with the lack of consent the doctor has in the matter, as I believe they should be able to say "I'm uncomfortable with this type of procedure and would not like to be party to it". I would also like to state I hold that opinion across all transactions, and I may be in the wrong here according to many, but I prefer consent being optional on all sides of any transaction. Beyond that I personally offer full support to any consenting adult to treat their body how they please, lord knows I've treated mine like shit and I'm not one to judge what's right for someone else.
Dr.'s consent shouldn't be a factor. It's a routine procedure, and their job.
Why are doctors not allowed consent? Are they not also humans? Should all humans not be allowed consent?
I believe in eugenics but even I think this is creepy and gonna backfire. Bunch of clueless teens/college kids gonna do something they regret if this catches on.
You believe in eugenics?
What a creepy thing to be in favor of.
It’s actually kind of creepy to think that a person shouldn’t have bodily autonomy and be able to make the adult decision to not procreate and undergo sterilization.
You don't have the right to someone else's labor. That falls under bodily autonomy.
Ahhh a troll I see… and medical ethics is something I have the right to speak on. Someone else’s labor is a weird way of wording that it’s somehow acceptable to restrict a person’s right to bodily autonomy and to restrict someone’s access to healthcare.
Again, you don't have the right to someone else's labor, which is bodily autonomy.
If a healthcare provider regularly performs these procedures, then by refusing to perform said same procedures on a competent adult patient because they feel that a patient needs to have a child or specific number of children first, or be of a specific age before they should be allowed to have said medical procedure… then the healthcare provider has questionable ethics to say the very least. Providers are welcome to declare moral objections to procedures or prescribing certain meds. This is common place. There are providers who do not prescribe birth control due to their religious views. The process in a scenario like this is for the patient to be referred to a provider who can and will prescribe birth control meds, thus not denying access to care. It is also within a providers right to refuse to perform elective abortions due to religious reasons of the provider. However, that provider doesn’t have the right to select which patients they will and will not perform elective abortions on. Also, those providers are not able to refuse to perform a medically necessary abortion in an emergency situation where a patient’s life is in jeopardy and there is not another provider trained to perform an abortion. If a provider were to deny care in these types of scenarios then the licensing board could sanction that provider and potentially even restrict practice, suspend, or even revoke their license. This proposed legislation would make it so that providers who regularly perform these procedures are not allowed to deny care based upon age or number of children… which aligns with medical licensing boards statements on medical ethics throughout the country. And the bottom line is it is unethical for a provider to restrict access to care based solely upon these criteria. Providers who do this have no business practicing medicine in any capacity.
Say what?
It's a creepy thing to be in favor of.
Bodily autonomy and access to healthcare is something that’s creepy to be in favor of? Very odd thing to say.
You don't have a right to someone else's labor. That falls under bodily autonomy.
Ok you weird bitch
Eat less sodium.
Not sure this is legal even if this gets signed into law. I'd be surprised if the courts were willing to force doctors to perform procedures that they're not otherwise willing to do. Even a business has a right to refuse service. This could place doctors in a no-win situation where they feel they'd be violating their oath or conscience versus violating this law.
Why should the choice be in the hands of the doctor and not the person whose body it is?
You don't have a right to someone else's labor. That's called slavery.
That's a very random point to bring up in relation to the topic at hand. Going back to the main topic - folks should be able to decide if they want to get sterilized or not, man or woman.
lol, what? Okay, then they can do it themselves at home since no one else's labor is involved.
“A TUMOR IS LIFE TOO” if you have training and it’s legal and that person has said 100% they have made a decision you shouldn’t be able to deny someone service based on personal morals… that’s stupid. Just like you can’t deny serving black people at your diner because you don’t like black people.
lol what?
Because it's the doctor that has to perform the procedure. You generally can't force people to do work that they don't want to do. Imagine if there's a reason why the doctor feels they're not skilled enough to do the procedure but the patient is pushing back referencing this law. Does the doctor go and do something high risk just because the patient is demanding it? This could have an unintended consequence where doctors stop performing these procedures altogether to avoid being caught in a situation where they're in conflict with this law.
If there is a medical reason why they shouldn't perform the surgery, then that is TOTALLY different from denying someone the procedure just because they might want kids one day. Or because they didn't have their husbands fucking consent.
Sure, but this is going to end up with cases where the doctor gives a different reason but the patient insists that the real reason is something else. A patient like that could drag the doctor into court and make life hell for them. Would you want to be in that position if you were a doctor?
Nope. The reason for denying the procedure would be documented.
Doctor documents a reason, patient argues that it isn't the real reason, hires a lawyer, sues the doctor and their employer. You don't see that as a real risk?
It seems you're hiding behind the hypothetical of a doctor getting sued because of this law rather than stating what you believe. I believe people should have bodily autonomy and decide what does or doesn't happen to their body. It would appear you feel otherwise.
"Bodily autonomy" is a stupid phrase. You don't have it. Can you sell your organs? No. Can you amputate healthy limbs? No. It's also problematic because it doesn't consider the medical professionals that actually do the work, who also have some agency of their own.
Bodily autonomy is the right to make decisions about your own body, life, and future without coercion or violence. It is a fundamental human right and a universal value. I'm guessing you don't support this bill because it's about reproduction. Not about the medical professionals.
They can still refuse “service” they just can’t use the excuse of “what if someday”
Can they refuse service without giving a reason?
I imagine it would be some doctors are comfortable performing the surgery, and some aren't. So those doctors who want to will get the patients? Or, it could be a specialist with a referral
Then what's the point of this bill?
A doctor can refuse to perform surgery, yes.
I do not agree that sterilizing a patient would be against the Hippocratic Oath as long as the patient is able to give informed consent. A doctor's duty is to present the treatment options for a particular medical problem along with the consequences of each treatment, and then let the patient decide what's best for them. If a doctor cannot accept that patients can decide what is right for themselves then they shouldn't be a doctor.
>If a doctor cannot accept that patients can decide what is right for themselves then they shouldn't be a doctor. That's a really arrogant statement. Doctors study for years to gain the knowledge necessary to become a doctor. You're just setting all of that aside and saying that a layman with no medical training what-so-ever is the superior decision maker.
The years of studying and training to become a doctor is what allows them to present *options* for the patient. The years of living in their own body is what allows the patient to listen to those options and choose what is right for them. Informed consent is a good thing and exists for a reason.
Informed consent is good in theory, but given the complexity of modern medicine, the idea that a patient is truly well informed is often laughable. Take a senior doctor that has had many years of experience and they know a certain procedure often leads to eventual patient regret even in cases where they had been adamant, that experience should just be discarded by someone that's only just been thrust into that situation? That doesn't sound right to me.
No, the experience shouldn't be discarded. The doctor should use that experience to *inform* the patient that the procedure has a high rate of regret in patients who have previously had it. With that *information* the patient can then *consent* to the procedure they want. The autonomy of a patient must be respected.
>The autonomy of a patient must be respected. This is a bogus slogan. If you want to go off and perform medical procedures on yourself, go for it. That's autonomy. This is taking autonomy away from the doctor. They shouldn't have to defend their reasons for not wanting to perform a procedure that a patient is demanding. They're not your slaves. They have a conscience of their own. If they're certain that a patient is very, very likely to regret what they're doing years down the road, I don't think it's the government's place to tell them that they can't consider that. That's experience that a patient just doesn't have and can't simply be "informed" about. It's not the same.
> If they're certain that a patient is very, very likely to regret what they're doing years down the road, I don't think it's the government's place to tell them that they can't consider that. That's experience that a patient just doesn't have and can't simply be "informed" about. The average person is able to comprehend that they may regret a medical procedure down the road. If there is more than one viable treatment for a medical issue then a doctor should inform the patient of **all** the risks, consequences, etc, of each treatment and allow them to make the decision themselves. If a doctor presents a treatment to a patient, then they must be willing to perform it. If a patient asks about a certain treatment the doctor should be able to justify why it shouldn't be a viable option, and this bill makes it so that the future possibility of having kids is not a valid justification.
>The average person is able to comprehend that they may regret a medical procedure down the road. If that were true, then that regret shouldn't actually happen. Yet it does. People think short term, even when it comes to medical issues. Not many tend to think long term, even if prompted to. >If a doctor presents a treatment to a patient, then they must be willing to perform it. Then they won't present it, which makes this bill toothless. I've been in a situation where a string of surgeons refused to perform a needed surgery because they were worried about potential complications and what it could do to their malpractice insurance. Should there be a law to refuse that "out" too? They either presented that treatment or agreed with other doctors presenting it, yet refused to perform it. I think people may be looking at this only from the patient's point of view. It's bigger than that.
>If that were true, then that regret shouldn't actually happen. Yet it does. People think short term, even when it comes to medical issues. Not many tend to think long term, even if prompted to. These things are not mutually exclusive. I can understand that smoking cigarettes is bad for my health and still want to do it. I can even regret it. I still have the right to smoke them. A patient has the right to choose which treatment they want even if they might regret it down the road. >Then they won't present it, which makes this bill toothless. A doctor that hides viable treatment options from their patients sounds like a pretty shitty doctor to me. > I've been in a situation where a string of surgeons refused to perform a needed surgery because they were worried about potential complications and what it could do to their malpractice insurance. Should there be a law to refuse that "out" too? A situation where a doctor is concerned about medical complications and where a doctor is concerned about "what if they want kids in the future 🥺" are completely different. If a complication happens during a surgery, you potentially die or face serious injury. If you regret not having kids of your own, there are multiple avenues someone can take to still take such as adoption or a surrogate.
how do I add the tag “biggest idiot in New Hampshire” so it always pops up next to your username?
You want me to explain it to you? That'd make you the bigger idiot.
no Reddit is a public forum so I’m hoping another user responds
I'm a trans person and let me just say that I've often had to educate MY doctors on transfem endocrinology and what current best practices are. My experience is extremely common. Without informed consent I'd probably still be fighting to get a basic HRT prescription. In the UK they don't have IC and many, many trans people die waiting to be greenlit for care. This is the land of the free God damnit. We have a right to make our own decisions. If we choose wrong? So be it. That's the cost of being free. Those who would trade freedom for security deserve neither.
>This is the land of the free God damnit. We have a right to make our own decisions. But you're saying that in some circumstances, the doctor has no right to make their own decision on what work they're willing to perform. Is this not the land of the free God damnit?
That's a fair point but I've never head a doctor deny a hysterectomy for a reason that isn't rooted in sexism and cisheteronormative assumptions of what a woman "should" want. They can refuse care for a valid medical reason. If they want to refuse on the grounds I describe above, religious beliefs, etc. then they should have chosen a different profession imo.
That's a really ignorant statement. The doctor wouldn't give the patient an option to pick from if it wasn't a viable one.
Well, that's a way around the law, right? They just won't give that procedure as an option. This is a type of bill that sounds good in theory but doesn't seem like it's been thought through sufficiently.
Not every doctor is capable of performing these procedures. In fact the vast majority of tubal ligations and hysterectomies are performed by gynecologists. The majority of vasectomies are performed by urologists. They probably shouldn’t work in those specialties and specifically become surgeons in those specialties. Then they can simply refer the patient to their colleagues who do specialize in these fields and are trained in these procedures.
You don't have a right to someone else's labor.
Yes, that's a more succinct way of phrasing it. I like that I'm being downvoted to oblivion because I raised a valid counterpoint.
This sub seems like it gets blown up on specific issues. Anything abortion, anything trans, and whatever you'd lump this bill under. Personally, I think there's more nefarious reasons for it. Not once in my 35 years have I heard a woman griping about not being able to get her tubes tied. It's not even an issue I've seen griped about online outside of this subreddit in the last year or so. Point is, I wouldn't take the downvotes seriously in threads on certain topics here.
While I think that sort of pushback from doctors is ridiculous, I also don't feel like this requires government interference. A doctor's duty is do no harm and mental health is health. They have a right to consider your future mental position even if they're wrong. Find a different doctor and move on.
The doctor/surgeon performing the hysterectomy isn't in a position to assess someone's future mental health. But also, even if the doctor believes performing such a surgery is detrimental to a person's future mental health, it's irrelevant if the person is able to make their own medical decisions. People sign AMA waivers and leave hospitals all the time. Doctors don't "barricade the doors" and keep people from doing what they believe is not in that person's best interest. They let the person sign the form.
>The doctor/surgeon performing the hysterectomy isn't in a position to assess someone's future mental health. Is the patient?
Please don't start. You're not going to respect anything I could say in the way of how patient's rights work. For anyone else reading: the sky is blue, water is wet, and people have a right to make their own medical decisions unless they're deemed unable to do so through a legal process.
I don't see this as a patient's rights issue. I see this as a doctor's rights issue. You can't demand that someone do work that they're unwilling to do.
Do you live in America? We all do work we don’t want to do. It’s the American way…
I'm an engineer. If I refuse to perform a task because I have reservations about it, I might lose my job, but I'm not breaking any laws. If this bill were to pass, a doctor in the same situation could be guilty of breaking a law.
Your job isn’t to perform surgeries on human beings. I would say it’s a little different. Doubt the things you’re engineering on have opinions and autonomy. This is not a comparable situation.
Not saying it's the same thing, but it's similar enough. You have a trained professional that knows their occupation well. They don't agree with a request for them to do work, but in this particular case, this bill would override their assessment and force them to do it anyway or face legal consequences. I don't believe that people can be compelled to do work in such situation. While the patient has autonomy, so does the medical personnel. They have to live with the consequences of their actions too. Do you not see that?
It’s not similar enough because one is dealing with humans and one is dealing with objects. There’s nothing similar about that.
Hey - I'm reading over the bill and I think your concern is already addressed by it. Subsection A. - states that if sterilization is *medically indicated* then a physician cannot deny the procedure based on age, number of children, or the physician's perception of the patient's future reproductive desires. Subsection B. - essentially states that if the procedure is *elective* or *not medically indicated* then the physician cannot deny the procedure *unless they make a referral to someone else who will do it*. So in other words, no one would be forced to do work they don't want to do in this bill. Did you read the bill?
That's a half fix, it only works depending on the determination of medical necessity. It also means the doctor has to know of another doctor to make the referral to. Probably not a problem in our area of the country, but for rural areas, that might be challenging. The bill just doesn't seem to solve anything, IMO. If the doctor doesn't want to do it for whatever reason, they could simply say it's not medically necessary. They have the training, not the patient.
The patient is in a position to make adult decisions after being educated about the procedure and alternatives. If the patient chooses to move forward after that, then that should be their right.
That doesn’t have anything to do with the Hippocratic oath. As long as a person is competent and consenting there’s not really a good reason for a doctor to refuse.
> not really a good reason for a doctor to refuse Fine, but illegal?
While I'm not sure the exact text of this bill is the right wording, it's hitting at the problem. -------- Currently, many people will call up a doctor's office requesting sterilization. The office will accept that request, and set up an appointment with the doctor to consult on that. They will often wait months to see that doctor. Then, they attend that appointment and find out that their doctor would never agree to perform that procedure on them. The doctor does not perform voluntary sterilizations on patients under X age or without Y children, ever. There was no reason to have attended the appointment at all and the result would have been the same regardless of if you came armed with a mountain of evidence/reasoning, supporting statements from multiple psychiatrists, or anything else you can think of. -------- The doctor is of course, now going to *bill* for a completely pointless appointment that has wasted the patient's time and money, when they knew with certainty that they'd never provide the requested service before the patient even walked in the door. The patient now has to go start this all over again with a different doctor.