Totally Tubal Adventures: The Initial Consult

“F*ck ovaries,” I was prepared to say, “and their stupid little eggs too. Let’s do this thing! Sterilisation now, ovulation never!”
Publish date:
April 30, 2012
birth control, pro-choice, surgery, tubal ligation, sterilization

“I’m aware the procedure is intended to be permanent,” I say.

“There is a chance of failure and subsequent very low risk of ectopic pregnancy. Additionally, there’s a slight decrease in the incidence of ovarian cancer among patients with tubal ligations.”

I’m punctuating each sentence with a grunt because I’m ripping out broccoli plants with a handheld scythe, and my friend starts laughing at me. I glare at her over the shreds of my victims. This is serious business: I’m practicing for my medical consult, the first step in the journey to sterility.

Tubal ligation, or tubal litigation as I called it when I was a small child and somewhat fuzzy on the details, has been pretty much a lifelong dream. This year I decided to make it a reality, plunging into the magical world of consults and presurgical consults and more consults in order to lie on an operating table sometime in June (hopefully) while a surgeon delves around in my abdomen, hunting down the elusive fallopian tubes and informing them it's closing time, so to speak.

As a fast young thing, I was warned repeatedly that I needed to prepare heavily for this initial consult, the first hurdle, in which a staid medical professional would attempt to dissaude me, and would withhold the referral for surgery. Almost everyone I talked to who’s had a tubal under 30 and doesn't have children has informed me that they encountered considerable resistance and had trouble getting a surgical referral, in addition to difficulty finding a surgeon.

“Go in strong and confident,” a friend advised. “Practice.”

Which is how I found myself talking about tubal ligations to a bed of broccoli in the drizzling rain.

I didn’t even really need to do my homework. I’ve been doing my homework for years.

For those just getting on the sterilisation bandwagon, tubal ligation is a form of permanent surgical sterilisation where the fallopian tubes are cut and sealed so eggs can’t travel into the warm, potentially babymaking environs of the uterus. While my risk of pregnancy is very low because I have sex with men extremely infrequently1, better safe than sorry; the idea of being fertile troubles me on a lot of levels, and consequently I’ve been wanting this procedure for a very long time.

I wanted to join the 27 club.

Fertility is so associated with being a woman that, as a genderqueer person, I experience a lot of dysphoria around the fact that, technically, I can bear children. It's not something I ever want to do for reasons beyond my gender, and not all genderqueer people experience this (some in fact have children and celebrate their fertility), but my gender definitely has played a role in my desire for sterilisation. Our potential fertility is a weapon people use against me and other transgender people to deny who we are, the most essential part of ourselves.

Fertility or lack thereof doesn't make or not make you a woman, of course, but many people seem to think it does. Sometimes I struggle with whether I am playing into gender essentialism by seeking sterilisation, but when it comes down to it, I need to make the choice that's most appropriate for me personally, not the one that's on-point with the movement.

Fertility is very much a personal matter; I support trans men and other nonbinary folks who want to bear children, just as I support infertile women of all stripes, from trans women to post-menopausal women to women with medical conditions that make pregnancy unsafe or impossible.

But, ultimately? My body, my choice.

I also just don't want children; I accept that I would make an absolutely terrible parent, and it's not in the best interests of me or any potential child to take on that responsibility.

Parenting is serious business and I have tremendous respect for parents. I just don't want to be one, and I've been self-aware enough about this for a very long time to know that sterilisation is 100% the right choice for me.

Gettin' ready to consent it up in the exam room.

So I made my appointment with Jenna, a reportedly supercool Certified Nurse-Midwife, at the local clinic, and prepared to do battle. I left no stone unturned in my quest to be the most educated, well-informed, focused, prepared patient ever. I arrived armed to the teeth with statistics and a ferocious commitment to sterility.

“Fuck ovaries,” I was prepared to say, “and their stupid little eggs too. Let’s do this thing! Sterilisation now, ovulation never!”

A medical assistant took down my details; she’s actually an acquaintance, and she shifted uncomfortably on her little spinny stool while taking my medical history.

“I’m all about this sterilisation thing,” I said, cheerfully, stretching my arms up until my elbows popped.

“Rad,” she replied. “Do you have sex with men, women, or both?”

She left me with some totally awesome pamphlets to peruse while I cooled my heels waiting for Jenna, thankful that for the first time in recorded history, I was in an ob/gyn office in my clothes with no prospect of having to take them off anywhere in the near future.

Jenna remembered me from a math class at the community college (life in a small town!) and we talked for a minute about how the teacher committed suicide and it was very sad before we got down to business.

“So you’re here to talk about tubal ligation,” she says.

“Yup,” I say.

I get ready to deliver my spiel, but she takes me off guard, asking me if I have kids. I say no, and fervently add that I never want them. She grins.

“Sounds like this would be the right choice for you,” she says, and just like that she signs the consent form.

So excited, I can ignore the gender essentialism in these pamphlets. And the fact that this picture turned out backwards.

After all my preparation, it seems almost like a letdown to have it happen so easily. My presurgical appointment is on 23 May, and I’ve been told the surgeon is a “very thorough dude.” I suspect that’s a warning to get my homework on, which means that I’ll be making the ultimate presurgical consult checklist before I go in (and I welcome tips from readers who've done the surgery dance!).

Two of us can play at this game, Dr. Thorough.

1. Being asexual doesn't necessarily mean you never have sex ever; it means you don't experience sexual attraction. This is an important distinction, and I know it's confusing, but it's important to keep in mind when interacting with members of the asexual community. Some of us don't have sex. Some of us do. Return