Approved

Humans don’t like making permanent, life-altering decisions, even if they know what they want. Humans like having options, even if they know they cannot pursue most of them in a lifetime.

It is not as if I have never made a big decision before. Choosing where to go to college, my college major, what to study in graduate school, and where to go to graduate school were my biggest decisions. Even then, none of these were “permanent,” though in some cases it can be difficult to switch majors and virtually impossible to transfer to a different graduate program if I wanted. Still, I could give up and pursue something else if I truly wanted.

But this week I made what I feel is my first permanent life decision.

I never thought I would be approved. I thought I would have to fight tooth and nail despite how long I how much I researched this. After all, I am fairly young. I look even younger than I actually am. A couple weeks ago, a crossing guard supervisor who always asks me what book I am reading and tells me to have a nice day as I trudge to the metro on my way to work mistook me for a high-schooler. I am almost twenty-five years old.

It was much easier than expected.

On Monday, I was approved for a bilateral salpingectomy: I will not have biological children. The major risk of this procedure? Regret.

I already more or less mentally decided this for a couple years. The pandemic solidified this decision. Any adult I tell or perhaps anyone reading this might insist that I am so young and will probably change my mind. Biological clock, right? And what if the world somehow ends up not being a dumpster fire – the pandemic magically ends, climate change is a hoax, and men adopt an egalitarian approach to domestic care, among so many other concerns? I could imagine myself regretting my choice if that were the case. Why hinge such a permanent decision on speculation? A boomer could easily say I am depressed, should go to therapy, and then find a man whose children I want to bear. I am a woman, and it is my duty to perpetuate the human species. However, knowing that the world is a mess only adds fuel to my primary desires to not have kids.

First and foremost, I never want to be pregnant. Our pro-natalist society depicts pregnancy as something beautiful or at least something that should be at least tolerated. Not to mention the poor education on contraception and what motherhood entails; it is no coincidence that women opt to have fewer or no children after learning that everything is not sunshine and rainbows. We do not educate women on the risks of pregnancy and childbirth both as they occur and after-the-fact. Do I have tokophobia? Maybe, maybe not. Realistically, I am not sure my body could handle pregnancy anyway. Thankfully, there are enough women on this planet willing to endure its lifelong effects.

A bilateral salpingectomy, or bisalp, makes it virtually impossible to become pregnant. You would be the subject of a research article if that happened, as this procedure removes the fallopian tubes. This is the biggest advantage for me, as I never want to deal with hormonal birth control nor am I interested in an IUD. I will never be forced to carry a child, whether that be from shit luck from birth control failing or sexual assault. Yes, plan B and abortion are legally accessible – but for how long? Recent years indicate that many older male politicians want to control women. Texas is a great example. Missouri and several other states are already following in its footsteps. In fact, Roe v. Wade is at risk of being overturned as I write this. Who’s to say that politicians will not also target contraceptives? I’d rather not feel like a pawn living in the 1700s, thanks.

Theoretically, a sterilized woman can still carry a pregnancy via IVF, but the success rate is not compelling. Not to mention how expensive it is. If it were widely successful and not prohibitively expensive, I imagine more women who want biological children would take their chance on this method.

Okay, so no biological children for me. Someone will probably immediately point out that I can still adopt or foster. Well, of course I know that. I was adopted. Being an adoptee weighs on me every day.

And here is how I will respond to that: I am 99.9% sure I never want to be pregnant and 95% sure I never want to have kids regardless of the circumstances. Although I do not feel that adoption is a great option and would in some cases opt against it if society were different, I would still pursue this route if I did someday change my mind. That there are too many children out there waiting for a stable and patient caregiver will unfortunately probably never be the case. The world also does not need to be clogged up with more people. Almost no environmental warriors on the Internet want to admit the large environmental footprint that bringing a new child into the world entails. Don’t worry, Amazon, there will still be enough people to work in your warehouses for slave wages in future decades. Finally, I have lived my whole life without ever seeing a biological relative in person and don’t feel the selfish need to bring a Mini-Me into the world. I do enjoy helping young people, and adoption would be a big example of that. However, I feel that I can help young people in other ways without dealing with all the drawbacks of motherhood that for me are not worth the hassle. And I firmly believe that if something is not a “hell yes,” then it is a “hell no.” Parenting is no different.

All that aside, I have no interest in motherhood because I do not want to surrender my identity. I listened to an episode of the Childfree Girls podcast on my way to my consultation, and one of the hosts expressed this sentiment so elegantly: I have no desire to give up my dreams so that my child can live a life for which I was destined. This sounds like black-and-white thinking, especially as more women prove that it is possible to lead successful careers and raise children.

But motherhood is a full-time job, even if you are lucky enough to have a partner who equally contributes to domestic duties and or have enough money to pawn off children to a trusted caretaker. I would have to give up most if not all of my free time to care for a child. It is a 25/8 position. Going anywhere requires much more planning: can I take the child with me, or do I need to find a sitter? What if the child falls ill? What will the child want to eat later? And so on. This lifestyle is not for me. There are too many things I want to pursue. Raising kids drains time, money, and energy.

I applaud those women who genuinely want to be mothers – not because their family or society told them that is what they should do, but because they themselves chose this path. Someone has to do it, right?

I don’t hate children. As I said, I like helping young people. I can see myself extensively volunteering to help children in the future. Also, one reason that compels me to stay in academia is being able to guide young adults, especially first-generation students, through life. These things fulfill me – not coming home every day, exhausted, knowing I have to change a dirty diaper, cook something for a picky eater, or do laundry for the third time because my child threw up.

I do not fear responsibility, either. I look forward to having my own dog. Sure, having a pet is work, but I realize that it is nowhere near as demanding as parenting a child. That is why I will never call myself a “dog mom.”

I also think it is important for children, especially girls, to have women in their lives who are not mothers. I am not a walking incubator. I would be proud to be a positive, childfree role model in this sense.

Okay, back to my consultation. I came prepared for this: I brought a binder containing all the reasons why I want this procedure as well as several studies on regret because, after all, that is the biggest risk. What shocks many is that about 95% of sterilized women under thirty who have not given birth before do not regret their decision; the same cannot be said for those who already have biological children. I was and am still confident in my decision. I also chose to see a doctor who was already listed on the r/childfree list, a great resource for anyone seeking approval for sterilization, regardless of age or gender. Such homework is necessary to avoid rejection because they are supposed to change their mind when they meet the partner of their dreams, or they at least need their husband’s permission.

I was surprised by how much this doctor listened to me. It was refreshing. Of course, like any good medical professional, he first discussed non-permanent birth control options and their pros and cons. He asked about my previous experiences. He warned me about regret. But he also assured me that only I know what is best for my body. He understood me when I explained why I wanted a bisalp above all. He nodded and said that he had no problems performing this surgery on a soon-to-be 25 year-old, even though I have not been in a committed long-term relationship. I was also relieved to know that he understood my financial concerns, as most insurance policies will fully cover a tubal ligation – burning or clipping the fallopian tubes rather than removing them, which pose greater risks of pregnancy and especially an ectopic one – but not a bilateral salpingectomy, even if it is now the preferred standard of care. Medical billing codes and insurance policies are weird. My doctor said he knew how to work around that and even said that he has had no distressed patients afterwards dealing with unexpected costs. Excellent.

So, this week I scheduled my bisalp for January 26th. I also found out that my insurance will cover 80% of the procedure, and I happily paid for half the surgery upfront. My only concern is how antsy I will feel to get back to lifting after the procedure. The realness makes it feel weird even though I already decided on this in my head; it was a matter of when rather than if I would be sterilized. I think it is normal to feel this way about life-altering decisions; I am taking away a life that I could live, a life in which I parent my biological children. Yet there are so many other lives I will not be able to live, thanks to other decisions I make. It also feels like a more extreme example of not being able to read everything I want to read in this one life I have. I know I am young, but I know that I would rather regret not birthing a child than regret raising a child with whom I would be forever stuck. People call childfree people selfish, but I think that is an unselfish thing to admit.

Lastly, I look forward to this procedure decreasing my risk of ovarian cancer. Knowledge on my medical history is limited, but I do know one relative died from rectal cancer. Woo!