Latina & Child-Free: My Sterilization Journey

As I sat in yet another doctor’s office in February of this year, I flipped through my sterilization binder with my leg bouncing in anticipation. I was 21 years old when I decided to get sterilized and now it’s been just over two years of waiting. In that time I experienced two health insurance switches and met with several doctors who questioned my decision, mainly because of my age. However, it’s been far longer since I decided I would never want children.

Growing up in a large Latinx household, I was surrounded by children of various ages. Nieces, nephews, and cousins spread across Los Angeles that would converge during special occasions. I am half Honduran through my father’s side and half Salvadoran through my mother’s, though my father’s side was larger and tended to have more children. And like many Latinx households, there was an expectation, both overt and unspoken, that I would get married and then add to the family with children of my own when I was older. 

This was a common expectation among my other Latina friends I learned. We would grow up, marry, and start and dedicate our entire selves to our children and husbands. I had friends who talked about how they couldn’t wait to have their own children someday. However, I always found it difficult to see myself with one child let alone many. I could see myself falling in love and getting married, but I couldn’t see myself with any children. I thought something was wrong with me. After all, the rhetoric that a woman’s ultimate purpose in life was to have children was not just told to me by family but by all of society. 

However, as I grew and realized more and more of what having children entailed I became less certain. I could see through example the amount of sacrifice it took. How the Latinas in my life had to set aside most if not all of their goals and dreams to care for children practically alone since culturally it was a woman’s job to be the caretaker. I saw the physical toll pregnancy took on their body, sometimes dangerously so. I heard how expensive just delivering a baby, let alone raising them, was. I also saw that it seemed to be so strange that society should care so deeply about women becoming mothers but then villainize them for it at the same time. 

As a teenager, I began to more openly express that I may not want to have children in the future. Every single time I was met with ridicule or condescension by family members or sometimes even strangers. I was told I would change my mind. I was told that I was far too young to make that decision. I was told that not wanting children made me selfish. I was told that I would be alone forever because los hombres want someone to continue on their legacy. I could honestly fill a book with the amount of things people told me. 

Through all of this, the only thing these questions and statements did was solidify my decision. I knew I never wanted to get pregnant, so if I changed my mind I would rather adopt one of the hundreds of thousands of children without homes. If I was too young to decide I didn’t want kids then I was far too young to decide that I did. I felt it would be more selfish to have children when I knew I didn’t want them than to not have any. As for the last one, I have many thoughts on the idea of “legacy”, but I will leave it at this: I do not live my life based on what men want. 

So, in college, I started doing extensive research into my options to remain child-free. And my first decision was not sterilization. It was long-term birth control. Nexplanon to be specific, a very small rod that was implanted into my arm, that protected me for three years at a time. I say this because for some reason many people think I chose sterilization on a whim. That I woke up one day and thought tying my tubes sounded like a fun, trendy thing to do.

My decision came after two years of extensive research and talking to my doctor. Through that research, I learned that according to a 2021 Pew Research Center survey, 44 percent of nonparents younger than 50 say it’s unlikely they will have children, and of those, 56 percent say it’s simply because they don’t want them. I realized that I was not alone in my journey. My decision came after talking with people currently trying to get sterilized or who had already gotten the surgery. My decision came after realizing that although I did love my birth control, it didn’t make sense for me anymore when I knew that I would never want children, so why delay the inevitable?

So I began my active journey to sterilization. One of the first things I learned was what was covered by my insurance in California. In California, it is required by law that health insurance cover contraceptive methods, including sterilization, at little to no cost according to the Office of the California Surgeon General. The same isn’t true for more restrictive states, where although some of the costs may be covered, that is not guaranteed and the procedure can cost hundreds to even thousands of dollars. Despite that, I made sure to carefully read my benefits. My benefits stated that all sterilization is considered a form of birth control and therefore preventative care is covered at 100 percent.

After that, I scheduled an appointment with a doctor licensed to perform the surgeries in Los Angeles. I knew going into it that I was more than likely not going to receive a yes for a few reasons. I was under 30, I had no children, and because many doctors are allowed to say no to the procedure because of personal opinions. I was not prepared for how awful my first experience was.

The doctor spent forty minutes going into how my decision could affect him personally, how maybe I should lose weight first and then proceeded to schedule me an appointment for an intrauterine device (IUD) despite me explicitly stating that I did not want one. I decided then that I needed a different approach. 

Through my research, I found a community of people like me who wanted to be sterilized on Reddit through a forum called r/childfree. I was able to find resources as well as a user who had created a sterilization binder and she explained what each form was for. I created mine following her format and took it to my primary doctor for her to go over. She loved it and expressed how she had never seen something like this. From then on I took this binder with me to every appointment with every doctor.

While searching for another doctor to see me I discovered that my insurance had capped me to a single hospital in my city and I could only see doctors who were licensed to perform surgeries at that hospital. The second piece of news I uncovered was that for this procedure, there was only one doctor in Los Angeles covered by my insurance that could do that procedure. And that doctor was the very same doctor who had told me how this surgery could affect him personally. This news was shocking and dismaying. How could there only be one doctor and one hospital in all of Los Angeles that I could go to?

So I went under the long painstaking task of switching insurances. After that, I saw several more doctors who proceeded to tell me I was too young to decide this and they did not agree with my decision. Then on June 24, 2022, Roe v. Wade was overturned and fear spiked through me. Sure I lived in California, a protected state, but I didn’t know what the future held. More and more rights were being taken away from women all across the country and I wanted to make sure I had control of my own body and my own choices. So my search became that much more serious.

That was true for many, as new research from the JAMA Health Forum found. In this study, researchers looked at how many 18 to 30 year olds were getting sterilized before and after the ruling. The results show a sharp increase in both male and female sterilization. Tubal ligations doubled from June 2022 to September 2023, and vasectomies increased over three times during that same time. However, despite that increase, women are still getting sterilized much more often than men. Vasectomies have leveled off, while tubal ligations still appear to be increasing.

After having to switch insurances once again, I tried to schedule an appointment with a female doctor since I had only been seen — and turned away — by male doctors. I hoped for more understanding and respect, but unfortunately, the doctor I was assigned was male. During our appointment, I was once again faced with resistance as this doctor said he does not do this procedure on people under 30. However, he said he had never seen someone come to an appointment like this with a sterilization binder, so he knew I was serious and not taking no for an answer. So he referred me to another doctor, a woman this time. 

This leads me back to the beginning of the story. Sitting in an office, waiting to see if this doctor would finally be my last. And she was. After making sure I understood the risks with tubal ligation surgery and flipping through my binder, she proceeded to say “okay well, I’ll put you on the waitlist and we’ll contact you for a date,” so casually as if she didn’t just change my life. I asked how long the wait time would be, and she told me that since Roe v. Wade was overturned there was an uptick in women wanting a permanent solution so it would be within three months. After leaving the office, I couldn’t deny the drastic difference in how I was treated by male and female doctors. I had felt heard and respected after years of condescension and denial. 

Surprisingly, I didn’t have to even wait a month for my surgery date, which was scheduled for the next month. I was so incredibly excited and prepared as quickly as I could for the big day. During that time, I decided to tell only close friends and family. People who would be happy for me. I honestly just wanted some privacy and time to enjoy accomplishing my goal. The surgery went without a hitch and I was mostly healed after only a week of bed rest. 

After the surgery, I became more open about it and told my siblings who were all very understanding and knew of my decision to be childfree. As for the rest of my familia, I decided that if they asked again about “Cuando vas a tener hijos” I would be honest, but I was not going to volunteer information. It was a long and difficult road to get here, but I know I can stand my ground on my choice of being child-free.