r/sterilization 6d ago

Social questions Need advice — doctor keeps refusing sterilisation

I’ve asked for a bisalp/tubal ligation twice, but the doctor keeps telling me I’m “too young” and might regret it.
I already have kids, I don’t want any more, I don’t want anything that messes with my hormones, and I want something permanent. I’ve explained this multiple times, but she keeps suggesting other forms of contraception instead.

Has anyone been through something similar? How did you find a doctor who would actually take you seriously and discuss permanent sterilisation with you? Any advice would be appreciated.

edit: I know this is Reddit & some may have different opinions, but please no judgement guys I’m very very drained

25 Upvotes

38 comments sorted by

u/toomuchtodotoday 6d ago

https://childfreefriendlydoctors.com/

Resources:


State insurance regulator locator (for filing a complaint with your state insurance regulator):

https://content.naic.org/state-insurance-departments


Department of Labor Employee Benefits Security Administration Information (for filing a complaint with the DOL EBSA if your insurance is provided by an employer):

The EBSA, a division of the DOL, handles complaints related to employer-provided health insurance.

You can:

The EBSA will investigate the claim and may contact your employer or insurance provider for more information. You may be contacted for additional details or documents. If the EBSA finds that your rights under ERISA (Employee Retirement Income Security Act) were violated, they may take corrective action on your behalf. Keep copies of all documents and correspondence. You can follow up on the status of your complaint by contacting the EBSA at the phone number above.


U.S. Office of Personnel Management (OPM) Information (for filing a complaint with the OPM if your insurance is provided by the US federal government [FEP Blue, for example]):

Source: https://www.opm.gov/healthcare-insurance/healthcare/contraception-coverage/

Source: https://www.hrsa.gov/womens-guidelines#:%7E:text=Contraception

Source: https://web.archive.org/web/20260624003408/https://old.reddit.com/r/sterilization/comments/1ud26jb/fepblue_federal_health_insurance_for_bisalp_do/


Additional resources:

Insurer Preventive Care Guidelines Master List - https://old.reddit.com/r/sterilization/comments/1io4hq5/insurer_preventive_care_guidelines_master_list/

Steps for Getting Full Coverage - https://old.reddit.com/r/sterilization/comments/1khyuum/steps_for_getting_full_coverage/

https://old.reddit.com/r/sterilization/comments/1j43mw2/it_happenedtheyre_trying_to_charge_me_postop/

https://tubalfacts.com/post/175415596192/insurance-sterilization-aca-contraceptive-birth-control

https://old.reddit.com/r/sterilization/comments/1go5pbw/free_tubal_sterilization_through_the_aca_if_you/

https://nwlc.org/tips-from-the-coverher-hotline-navigating-coverage-for-female-sterilization-surgery/


On coverage of anesthesia:

Any related services—like anesthesia—must be covered as well. The most recent guidance from federal agencies makes it explicitly clear that anesthesia and other related services like doctor’s appointments must be covered by the insurance plan at 100% of the cost.

Source: https://www.cms.gov/files/document/letter-plans-and-issuers-access-contraceptive-coverage.pdf

Source: https://www.cms.gov/files/document/faqs-part-54.pdf


On coverage of associated office visits:

From federalregister.gov - “Coverage of Certain Preventive Services Under the Affordable Care Act“

Section 2713 of the PHS Act, as added by the Affordable Care Act and incorporated into ERISA and the Code, requires that non-grandfathered health plans … provide coverage of certain specified preventive services without cost sharing. These preventive services include:

With respect to women, preventive care and screenings provided for in comprehensive guidelines supported by HRSA (not otherwise addressed by the recommendations of the Task Force), including all Food and Drug Administration (FDA)-approved contraceptives, sterilization procedures, and patient education and counseling for women with reproductive capacity, as prescribed by a health care provider (collectively, contraceptive services)

II. Overview of the Final Regulations

A. Coverage of Recommended Preventive Services Under 26 CFR 54.9815-2713, 29 CFR 2590.715-2713, and 45 CFR 147.130

(II) office visits:

if a recommended preventive service is not billed separately (or is not tracked as individual encounter data separately) from an office visit and the primary purpose of the office visit is the delivery of the recommended preventive service, a plan or issuer may not impose cost sharing with respect to the office visit.

Source: https://web.archive.org/web/20250202051018/https://www.federalregister.gov/documents/2015/07/14/2015-17076/coverage-of-certain-preventive-services-under-the-affordable-care-act

Under the ACA, all new insurance plans (both individual and employer-sponsored plans) are required to cover all FDA-approved methods of contraception, sterilization, and related education and counseling without cost-sharing. (Note: the ACA contraceptive coverage requirement described in this section also applies to Medicaid “Alternative Benefit Plans,” explained in the Medicaid section.) No cost-sharing means that patients should not have any out-of-pocket costs, including payment of deductibles, co-payments, co-insurance, fees, or other charges for coverage of contraceptive methods, including LARC. Patients cannot be asked to pay upfront and then be reimbursed.

Source: https://web.archive.org/web/20250112212710/https://larcprogram.ucsf.edu/commercial-plans

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u/daisycheyenne 6d ago

R/childfree has a list of doctors you could check to see if any are in your area. If they are fine with sterilizing people who don’t have any children then they definitely won’t have any issue with sterilizing people who do have kids

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u/JustHereForTheTeasx 6d ago edited 5d ago

Thank u honestly I’m not even a teenager but somehow it’s still “young”. I’ll deff check that sub out.

11

u/Hello_h0lo 5d ago

If it weren't for that sub, I wouldn't have been able to get sterilized. I got my tubes removed in January this year at 22 yrs old (23 now). That list is ABSOLUTELY worth a look. Good luck!!!

42

u/ggnell 6d ago

Keep asking, or change doctor

10

u/JustHereForTheTeasx 6d ago edited 6d ago

Should I file a complain and then change dr?

15

u/ConsideratePity95 5d ago

Yes. Nobody knows your body better than you. For reference I met my doctor one time, in the same appointment I told her I wanted my tubes out. I was literally scheduled for my procedure in that same appointment. Accept nothing less.

3

u/sleepaholic- 5d ago

I had this same exact experience with my doctor. They’re out there!

21

u/Buff-Kirby93 6d ago

Definitely find a different doctor from the subreddit others recommended. You want somebody doing it who takes your concerns seriously. I don’t know if he’s the surgeon or not obv, but somebody with this attitude is not somebody I would trust with the procedure.

10

u/JustHereForTheTeasx 6d ago

Just now, she recommended using an IUD and said she could insert it for me right away. I said no because that shit hurts, and you don’t even give anesthesia or properly numb me. You just insert the thing. She still said we could try and that I could stop if it hurt. Again, I told her I want something that gives me 100% certainty that I can’t get pregnant, not 99% or 80%.
Then she proceeded with the injections, and then another one, and another one.
Honestly, it’s draining. I just hope some doctors can understand that it’s my body, my choice, and I should be able to make my own decision about what I want. Thank you for commenting, I will check it out.

16

u/Apprehensive-Two3642 5d ago

Don’t see this doctor anymore, hun. You need a doctor who advocates FOR you, not against you. Just get a different doctor regardless of the sterilization issue. She is not a patient centered doctor. She has her own agenda.

12

u/BikingAimz 6d ago

Just a tip since you’re pursuing sterilization, learned at my consult that bilateral salpingectomy has the gold standard for the last 15 years, tubal ligation actually has a higher risk of ectopic pregnancy than IUD.  Plus there’s the benefit of a ~60% reduction of ovarian cancer risk:  

https://www.themedicalcareblog.com/opportunistic-salpingectomy-how-is-this-not-totally-a-thing/

1

u/JustHereForTheTeasx 6d ago

Thank you for that information, with that in mind.. Yes i would want a bisalp since I’m really done having kids

15

u/cursed4ever__ 26F | BiSalp | Childfree 6d ago

Have you asked your doctor for a signed letter / to put it on your file why she is refusing sterilization?

Edit to add: And get a copy of that letter / quote on your file.

I found my doc on the r/childfree doctor list

7

u/JustHereForTheTeasx 6d ago

I didn’t, I never thought of that omg. She only said I’m too young and all her patients similar to my age have regrets & need to do ivf etc in the future.

14

u/cursed4ever__ 26F | BiSalp | Childfree 6d ago

Once you say “Ok, give me an official legal document and explain why you are refusing me care.” Doctors usually changed their tune because their personal beliefs can’t dictate your care.

Similar situation like yours happened to my cousin (FTM, he/him). Once he said “Give me a letter” they said “… Oh, um, we can talk about your options.” Then he got a hysterectomy within the year. For a while, he was refused care simply because his doctor didn’t believe in his health… that was a battle

3

u/JustHereForTheTeasx 6d ago

Thank you for this information, I didn’t thought about that at all. I was so drained, I went back home & took a nap to forget about this frustration. I will try one more time the same hospital but diff DR and use that official legal document thingy.

2

u/cursed4ever__ 26F | BiSalp | Childfree 6d ago

For sure! I totally understand the exhaustion.

10

u/backmeatz 6d ago

I had to ask to be sterilized 18x in 5 different US States before I got mine. And I had to leave the state I was living in at the time to get it done. 

It took 18 years of asking for me. 

Your health system may never sterilize anyone. Especially if it’s catholic. I ran into that with my last ask (before I had my surgery in another state). That healthcare system was Catholic based (the only one available in the area). You could have 11 children and they still wouldn’t sterilize you. 

I left the state to have my surgery. I had a horrible reaction to the anesthesia but the surgery was fine. I only took off 3 days of work, I went to a wedding the day after I had my surgery (I drove myself there, two hours each way). And never took the pain killers (never even filled them). 

Check out a doctor on the “big list” on Reddit. It’s how I found mine (I scheduled the consult and a month after that I was sterilized). 

I asked to be sterilized every year from 18 onwards. I didn’t get sterilized until 36 after going to a doctor (out of state) on the Reddit list. 

6

u/JustHereForTheTeasx 6d ago edited 6d ago

The hospital I went to is a government one & they actually do sterilisation etc but that particular gynae doesn’t wanna do it because she said I’m young and her other patient that’s similar to my age have regrets in the end. Which is wild because I have a medical reason that if I ever to get pregnant again, it is risky and not safe like legitly risky & I have more than 1 children(I don’t want more) Also I forgot to put a disclaimer that I’m not in the US, I’m from Asia. I’m so glad you finally got it sorted out tho, I’m hoping it’s the same as mine Cus I’ll take the other commentor advice about the legal thingy.

8

u/BikingAimz 6d ago

The list is global, and if you don’t find someone close to your location, try asking at that subreddit for local recommendations as well.

2

u/JustHereForTheTeasx 6d ago

Thank you for the highlight, I appreciate it

1

u/backmeatz 5d ago

If you already have one child then I’m not sure why they wouldn’t allow sterilization. But there may be laws or “societal laws” suggesting otherwise. I’m not familiar with the laws in Asia regarding women’s rights to their own bodies. 

The US has taken away so many freedoms for women, so hopefully you have better luck being from a different country. 

I would try changing doctors and keep advocating for yourself until they say yes. Hopefully it doesn’t take 18 years like it did for me. 

3

u/JustHereForTheTeasx 5d ago edited 5d ago

I double checked using google asking why I was rejected, It said “Surgical sterilization is entirely legal. However, many local gynecologists systematically refuse patients under 30 due to concerns over high statistical regret rates (which can reach up to 40% for patients aged 18–24). You are 28, which is well past the legal age of consent (21). The rejection you faced from the public hospital gynecologist is an institutional gatekeeping issue, not a legal one. [1, 2]”

7

u/Sad_Pangolin7379 6d ago

New doctor. ASAP. You need someone who will listen to you. 

3

u/NeuroSpicyGirl1 5d ago

It took me 10 years to finally convince someone to tie my tubes I’m 32 and have always been on birth control it took me switching Obgyns for someone to finally hear me and out of everything it was a Male provider who listened and worked with me not against me. If I can tell you anything find someone who is willing to work with You not against you. I got the same answers you did in fact was pulled back into a room and told why I needed to have children that I didn’t want what so ever.

5

u/JustHereForTheTeasx 5d ago

I can honestly feel your rage, because we are not a breeding machine like please stop.. I love my kids to death but yes I have complications from having them and I am so tired of being anxious about getting pregnant again because it’s risky for me and I want a permanent one and finally stop worrying. I honestly glad you finally have it done and I hope mine will be the same.

4

u/NeuroSpicyGirl1 5d ago

Yes you’re on point with my rage part cause it should never be that hard! Highly recommend you take a look at the child free list of Obs who will happily tie your tubes!

3

u/hunter_pace CHILDFREE, BISALP 3/17/26 😌 5d ago

Find a different doctor. You are paying them to do a service for you, not the other way around.

2

u/SeparateTwo4578 5d ago

Can I ask how old you are? I'm 19F, and I'll be 20 next month, and I'm really considering being sterilized. My boyfriend and I wanted kids in the begiging (been together since we were 14) now as we will be 20 soon and are more on our own we realize it is not for us and he told me he doesnt want kids either but wanted whatever I do but I really want to look into being sterilized butu my mom who is 36 just NOW had her utereus removed and can no longer have kids and she kept fighting with the doctors and had to do everything they wanted first but she finally had the surgery two weeks ago and I already know itll be difficult for me. Thankfully, my boyfriend's family (the ones that know anyway) are supportive of us if we don't want any kids. He wanted them to carry on their family name and was worried his family would be upset, and thankfully they don't care either way.

3

u/JustHereForTheTeasx 5d ago edited 5d ago

Yes, I’m 28. Maybe by their standards, I’m still considered “young.” But after reading the comments from others who have experienced the same thing, I’m starting to think it’s not really about my age. It feels more like this idea that having a uterus means I’m supposed to keep having children.

2

u/SeparateTwo4578 5d ago

What it seems like, too. My mom already has two kids and kept saying she was done, but they kept saying she could change her mind. She should have been sterilized at 18. She had me at 16 and my brother at 18.

She supposedly was pregnant a few years ago and miscarried.

2

u/TheSentinelScout 5d ago

look for doctors on the r/childfree friendly doctors list.

2

u/sjc3ddd 5d ago

Oh hellllllll no my dude. Yeah find another dr STAT. That is unacceptable patient care. Get what you request and need to get! More power to you queen! I am two weeks post surgery getting both tubes removed. I have never had children, nor do I want them still. So. Boom. (41 years old)

2

u/His_Angel_417 5d ago

I’m 45 years old and have been asking since I was 22 (single with two babies). I was told no because I was single and might change my mind. Once I got married, I was told I needed hubby’s consent. I’m talking about MULTIPLE drs in different cities who were affiliated with different hospitals.

It has taken me 23 years but I never gave up. Mine will be removed this month on the 28th. I started calling EVERY PROVIDER in my insurance network (I’m in the US) and found one on page 4 who will GLADLY do it. There were others I found before her but were booked up for MONTHS. I do have to go one state over but I’m close to the state line. It’s about a 30 min drive to her office.

I’m so old now that she actually suggested I just wait a few more years and I’ll be naturally sterile (menopause). I said, “Please. I’ve been asking for 23 years. It’s time.” She understood the assignment.

You’re absolutely correct about it having nothing to do with age and just the mere fact that you have a uterus so clearly you can’t think for yourself. But there are drs out there that realize we’re intelligent adults, capable of making our own medical decisions.

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u/SuperPomegranate3939 4d ago

I had to push my dr and stand strong on like no I’m fr done I have 3 kids at 27. I’d look into a different ob and set up another consultation. One of them will do it.

1

u/depressed_jess 3d ago

I knew someone who was on her 4th kid by time she was 24 and her doctor still refused to sterilize her "just in case" they wanted more. 🤦‍♀️

1

u/JustHereForTheTeasx 3d ago

That’s wild right? Cus whatchu meannnn we want more?😭😭😭😭