The trials and tribulation of tubal ligation
Reproductive health costs $15 billion more for those with a vagina in the U.S.
The number of health visits in the span of one year, amounted to more than one thousand dollars of medical bills under my belt. These included doctor visits, nutritional care, STI and vaginal check ups, a mammogram and of course, therapy. Women, trans folks or nonbinary people like myself who have a vagina, pay almost $15 billion more in healthcare costs each year than cis men.
Most of the additional cost comes from reproductive health.
This is a topic of interest to everyone in the U.S. and especially those wanting to control the scope of reproductive health to align with their values. And when the fate of Roe v Wade being overturned confirmed that I did not have a say in my body, it is only one weapon which has long existed to regulate access to reproductive care. What has nagged at my mind since early adolescence was cost.
While 20 states do not require contraceptives and birth control to be covered with insurance, even the ones that do, don’t always have expansive care for things like sterilization, long-term birth control, or gender-affirming surgery.
“Gender affirming,” sticks out here to me because, no I do not identify as trans or any gender, but I had longed dreamed of tubal ligation surgery. Tubal ligation is a permanent procedure where the ovarian tubes are ‘tied’ to prevent pregnancy.
The seed of wanting the surgery came from a very young girl raised in a traditional Mexican household where my value stemmed from what I could provide to my husband and children. As a teenager I would google the procedure, the requirements and the cost. At this time, some states required a husband or male figure to approve the surgery; and even then, most younger cases were denied. The procedure costs around six thousand dollars.
Just short of a decade later, my continuing desire for tubal ligation is not rooted in men. I’m a lesbian. But, there is a “gender (less) euphoria” I feel when thinking about the freedom of not having the paranoia of kids and forced pregnancy over my head.
Perhaps watching the show adaptation of Handmaid’s Tale at a young age is to blame for this fear. I still remember the lesbian couple separated at the airport because one was fertile and birthed their child. However, maybe the fear isn’t too far off from living in a country where there are states with hard stances, even prison, for getting an abortion.
In the state of California, tubal ligation is covered by MediCal, as in most states. Though you need to be 21 years of age, deemed mentally stable and have a wait period from signing off on the surgery till the actual date.
But can I afford the copay as a barely graduated student with looming debt? Would my mental health be weaponized, or my age? And, do I even want this surgery anymore?
As I enter my mid-twenties with more assurance as to who I am, the cost and additional barriers to accessing reproductive care continue to place limits on how I can be myself. In an ideal world, the last question would be the only one on my mind. But affordability and accessibility trumps desire.
Myriam-Fernanda (they/them/elle) is a producer fellow at KCRW. They graduated from USC in the spring with degrees in Journalism and English-Creative Writing. They focus on …
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