After the US overturned Roe v Wade, permanent contraception surged among young adults living in states likely to ban abortion, new research found. Compared to May 2022, August 2022 saw 95% more vasectomies and 70% more tubal sterilizations performed on people between the ages of 19 and 26.

[u/mvea]

https://www.theguardian.com/us-news/2025/jan/06/permanent-contraception-abortion-roe-v-wade

[u/Doctor_Philgood]

My insurance covered my vasectomy for what it's worth.

[u/baes__theorem → u/Doctor_Philgood]

that’s great for sure, but probably not when you were 19-26, right?

also the case is different for people with uteruses – tubal ligations aren’t even allowed in lots of places if you’re under 30 and childless, let alone covered by insurance. it’s also a more complex and invasive procedure, and thus more expensive ¯_(ツ)_/¯

[u/Emotional-Cash5378 → u/baes__theorem]

It took me 3 months of calling various doctors & clinics until I found one that would perform my tubal. I even tried fibbing by telling them I had been pregnant twice when they asked if I’d had children but they either then asked if I had carried them to term (I hadn’t) or said their threshold for the procedure on someone younger than 30 was 3 living children. It was infuriating!

[u/Killbot_Wants_Hug → u/Emotional-Cash5378]

That really sucks. I told this story in this thread elsewhere, but you might think it's kind of funny.

A friend of mine growing up wanted to get her tubes tied. She was in her early 20's. The doctor told her no because she was too young and she might change her mind.

She told the doctor that if she got pregnant she'd put the baby in a blender and pour it through their mail slot.

The doctor decided she wasn't mother material after all and scheduled the operation.

To be fair to the doctor, I think a lot of people do change their mind. But I think it's also the patient's decision and as long as they're informed about the procedure and if it's reversible or not, than that's really all there should be to it.

[u/Pineapple_Herder → u/Killbot_Wants_Hug]

I don't know if enough people regret it to validate some of the insulting arguments made by doctors. My friend got her tubes tied and they asked her what her husband thought. She didn't have a husband. They asked about her future husband and she was like "Why would I marry him if we don't agree on something as fundamental as children?"

She ended up finding a different doctor, but oh boy do I remember the ranting phone call after that appointment. She was livid.

[u/neurodiverseotter → u/Pineapple_Herder]

Yeah, when a hypothetical mans opinion over a womans body is more important than her own choice. This must be the time where "White men are the most discriminated group of all"

[u/Pineapple_Herder → u/neurodiverseotter]

I understand why a doctor would ask, if the patient is married or in a long term relationship, have you discussed this with your partner? Because it does affect more than just the patient, and could be a reasonable line of questions that could unveil larger issues like domestic violence etc. Or uncover that the patient is making a permanent decision for temporary issues.

But to have a patient whose only risk is age be required to jump through so many hoops and grilled seems discriminatory not reasonable.

[u/KnownCar9524 → u/Emotional-Cash5378]

3 kids? That’s ridiculous

[u/LoosePhone1 → u/baes__theorem]

My SO just got a vasectomy within that age range. It was mostly covered by insurance but still expensive!

[u/Cautious-Progress876 → u/LoosePhone1]

Mine was $500 out of pocket without insurance. How much was your SO’s?

[u/LoosePhone1 → u/Cautious-Progress876]

It was around 1k but he had it done at a hospital under anesthesia so that probably made it cost more than usual

[u/Doctor_Philgood → u/Cautious-Progress876]

Mine covered 90 percent. All said and done, it was around 90 bucks. But this is some expensive insurance and should not be considered the norm.

But every penny is worth it.

[u/Cautious-Progress876 → u/Doctor_Philgood]

I view mine as worth it. I had a kid young due to being stupid and reckless, and wanted to make sure that never happened again. Plus my current SO doesn’t want children so me being fixed takes a lot of worry/risk away.

[u/Killbot_Wants_Hug → u/baes__theorem]

I would assume health insurance would happily pay for sterilization (especially if women).

Birthing is super expensive and a sterilization could save an insurance company from paying out multiple births.

I was on a high deductible plan when my wife got married. I wasn't expecting for her to get pregnant so fast (I sort of assumed/hoped I was sterile) so I didn't have time to change it after getting married.

I'm not sure how much the birthing procedure cost, but I know I had to pay my full $10,000 deductible, so it's pretty expensive.

A sterilization procedure is a drop in the bucket compared to that. So I would guess most insurance plans would cover it as it's just the best way to make money, which is their main goal. The exception probably being if the plan was paid for by a religious organization that specifically didn't want those services provided.

[u/Big-Goat-9026 → u/Doctor_Philgood]

Most insurances will also cover tubal ligations and hysterectomies for medical reasons including emotional/mental health reasons. 

[u/baes__theorem → u/Big-Goat-9026]

yes, for medical reasons – i.e. not elective. they also often cover it after one has had multiple children, but it’s not guaranteed.

that still makes it cost prohibitive and less accessible by people with low socioeconomic status

[u/Big-Goat-9026 → u/baes__theorem]

What I’m saying is that there are ways to get insurance to pay for it. Establishing a history of emotional problems is a way to do so. 

[u/baes__theorem → u/Big-Goat-9026]

how are low-income people meant to do that, practically? mental health often has horrible coverage.

I didn’t mean that it’s impossible. my point was about the many income-dependent barriers in place, which gives low-income people even less autonomy over their reproductive decisions.

[u/Big-Goat-9026 → u/baes__theorem]

I’m just trying to say that you can game the system. Many health plans offer yearly physicals at no cost. 

There are also free clinics that you can build a medical history with. 

You don’t have to go to a therapist to tell a doctor that you’re depressed. General practitioners, OBGYNs, and other specialties are able to diagnose and document mental health issues. They can even prescribe medications to treat mental illnesses. 

I’m aware that poverty sucks. I’m telling people that it’s possible to game the system it’s just 10x harder than it needs to be. Instead of naysaying everything, please offer your own advice. 

[u/baes__theorem → u/Big-Goat-9026]

I’m not “naysaying everything”, I’m highlighting the very real role of socioeconomic status in these statistics.

a depressive episode (MDD) is rarely – if ever – enough to get a doctor to say that a tubal ligation is medically necessary, since it is considered a temporary disorder. depression is only considered chronic if it persists 2 years post-diagnosis, at which point it becomes PDD. even then, it’s not a neurological disorder like ADHD or autism.

that being said, this is r/science, not really the place for giving medical advice as a non-medical doctor.

other commenters have said there’s a list of doctors aggregated on r/childfree’s wiki who will reportedly perform these operations on younger, childless people. that’s a much better solution than to get diagnosed with a mood disorder if you don’t have one

[u/Big-Goat-9026 → u/baes__theorem]

Of course the best solution is just to whine that everything is too expensive and give no work arounds. You’ve made me see the error of my ways. 

[u/n14shorecarcass → u/Doctor_Philgood]

My husband's was 100% covered, too.

[u/JimBeam823 → u/Doctor_Philgood]

Mine didn’t.