Ann Friedman of Feministing has a post up about an issue that’s very near and dear to my heart: young, often single people who seek vasectomies or tubal ligations in their late teens and early twenties.

For once, I’m not talking about the anti-choice movement. American Sexuality magazine has a piece describing one young woman’s travails in finding a doctor willing to perform a tubal ligation on her. She’s in her early 20s, and absolutely, positively, 100% certain she never wants children. Never.

“[Planned Parenthood of Boston**] said it was much too permanent and weren’t going to give it to me, plus my insurance wasn’t going to cover it,” recalls Green. What’s more, according to Green, “It was all and only about my age.” She was twenty-two at the time.

Green’s experience is not that unusual. Though no actual laws have ever been put into place, most OBGYNs refuse to provide women under thirty with permanent forms of contraception. Dr. Daniel Wiener, assistant professor of obstetrics and gynecology at McGill University in Montreal, is one such doctor.

With thirty plus years of medical practice, Dr. Wiener finds no good reason for putting otherwise healthy patients in surgery: for one, there are anesthetic risks involved. Plus, tubal ligations are considered elective surgeries (assuming the patient can use other, less invasive forms of birth control). More pressing, still, is the fear that a patient may one day change her mind. Sound familiar?

Read Friedman’s words in context here.

Went there and did that. At age 21, back in the 1970s, it took a little while to find a clinic willing to give me a vasectomy and even at the women’s clinic that finally said yes it took a little talking to before they were sure I was making an informed decision.

Fast forward 20-some years and, as I had prepared for at 21, I met someone and several years after marriage we decided we might like to have children after all. And so, again as I decided back at age 21, we explored a vasectomy reversal with adoption (which costs about the same) as a backup. The reversal worked like a charm and, days after our second child was born, another 15-minute stitchless vasectomy undid all the previous surgeon’s hard work.

But if the reversal hadn’t worked adoption would have been acceptable to both of us.

Bottom line: if there was no such thing as medical progress in vasectomy or tubal-ligation reversal and egg extraction and IVF, if there was no such thing as adoption, if there was such a thing as 100% cold evidence that virtually all who with their eyes open are sterilized at an early age regretted it (I don’t know any who have though I’m sure some do somewhere) then yeah, maybe it would be ok to decline to perform voluntary sterilization on young people. But I just don’t think that’s the case.

Oh yeah, one more thing. The tubal ligation sought in the article Ann references really is a far more intrusive and therefore risky procedure than men’s vasectomies. But that’s not the standard of comparison. Instead how does it compare to, say, breast or cheek implants, nose jobs, labiaplasty, and other voluntary procedures cheerfully undertaken by surgeons.

I really don’t know, even relatively minor abdominal surgery really could be that much riskier than “superficial” plastic surgery. But if not then these guys who decline to perform the surgery really don’t have a leg to stand on.

Update: Friedman adds a point raised by Radical Doula that, of course, poor, uneducated, disabled women and women of color, and southern Appalachian rural whites have historically had a harder time avoiding forcible sterilization than obtaining them voluntarily. For instance:

[Supreme Court justice Oliver Wendal] Holmes wrote for the majority, which upheld the constitutionality of a Virginia law proposing involuntary sterilization of persons believed to be mentally retarded—the “feebleminded,” in the jargon of the day. “The principle that sustains compulsory vaccination is broad enough to cover cutting the Fallopian tubes,” Holmes wrote in Buck v. Bell (1927). “Three generations of imbeciles,” Holmes volunteered, “is enough.”

Randomly Google’d quote located here.

Yikes! I can’t believe I forgot about that case! The cool thing about being pro choice, by the way, and something the ostinsible “pro-life” abortion opponents just don’t get, is that reproductive freedom means reproductive freedom! Not something to be forced on anyone, neither to be denied by cupidity either.

Update: Amanda Marcotte very nicely reinforces the point about choice and autonomy.