Does the average woman who doesn’t want children at the moment lives in constant and ever present fear that one day her luck might run out and she might get killed by a parasite that has infested her body? Probably no. As for me, I might not be a woman, but the patriarchal society has forced me to live with such a fear.
I have spent the last two years trying to obtain a hysterectomy. A transphobic surgeon kicks me out of their office, and I proceed to schedule another appointment with yet another doctor. Rinse and repeat. For the last two years I had been asking for “hysterectomy” to doctors in state owned hospitals. Here I wrote about how that didn’t work. In theory, European Union citizens have a right to gender reassignment surgery. In practice, it can be impossible for a patient to actually obtain it. And Latvian bureaucrats managed to successfully find a loophole how to get away with denying me the surgery I wanted.
Hysterectomy (surgical removal of the uterus) is the procedure I would have preferred. Given how I cannot get this procedure, I decided to settle for sterilization instead. That might not be my preference, but it would be better than nothing (a sterilization wouldn’t fix all my problems, but at least the risk of unwanted pregnancies would be greatly reduced). Anyway, in past I asked for a “hysterectomy” to doctors in state owned hospitals, this Friday I went to a private clinic instead and asked for “sterilization.” Here’s how the conversation started:
“Hello, how can I help you?”
“I want to sterilize myself.”
“How many children do you have?”
“Then I’m afraid I cannot help you. I cannot sterilize you unless you have had at least two children.”
Here is a quote from Latvia’s “Sexual and Reproductive Health Law”:
Section 24. Choice and Provision of Contraception
(1) The use of contraception is a person’s voluntary choice.
(2) Only a gynaecologist (childbirth specialist) or a general practitioner is permitted to prescribe any medicinal contraceptives or the use of contraceptive medical technologies (except for surgical contraception), and provide for the further medical observation of the patient.
(3) Surgical contraception is applicable in the following cases:
1) to a patient of more than 25 years of age – upon his or her written consent;
2) in the case of medical indications, to a patient (also less than 25 years of age) on the basis of an opinion of the council of doctors [the council consists of a gynaecologist (childbirth specialist) or a urologist, depending on the sex of the patient, and two doctors – specialists of the relevant field of medicine] and upon the written consent of the patient (if the patient is a person lacking a capacity to act – upon the written consent of a guardian) in cases prescribed by the Minister for Health.
(4) Surgical contraception may be administered to a patient by a gynaecologist (childbirth specialist), a urologist or a surgeon.
In my opinion, the law is very clearly written. I am 27 years old. Thus I have a right to sterilize myself. There can be no extra requirements except for “written consent,” and I’m more than happy to sign all the papers.
Here are my reasons for wanting a surgery (text copied from this article I wrote a while ago):
I have multiple reasons for wanting a hysterectomy. I got unlucky to be born with a female body, but I don’t feel as a woman. I don’t want to live as a woman, I don’t want to have children, I don’t want to live with a uterus.
In addition to gender dysphoria, I also have several more practical reasons for wanting a hysterectomy. Firstly, I feel severe pain during my periods. For the first two days of each cycle I feel a disgusting mix of pain and nausea in my stomach. Taking painkillers like Ibuprofen helps a little, but it’s still very unpleasant.
Due to the heavy bleeding I experience, I have had anemia. Back when I got the diagnosis, my family was experiencing financial difficulties, so I tried to spend on food as little money as possible. It turned out that I cannot afford to subsist on cheap food with little iron in it.
On top of that, being denied a hysterectomy messes up my ability to avoid unwanted pregnancy. I refuse to use hormonal contraceptives, because birth control pills would raise my estrogen levels. I already have too much female hormones in my body, I don’t need any more of them. Being unable to access safer birth control methods like sterilization or hormonal pills puts me at an increased risk of experiencing an unwanted pregnancy. With typical usage, male condoms are about 85% effective; that means about 15 out of 100 women who use condoms as their only birth control method will get pregnant each year. I’m a risk-averse person, I prefer to be cautious. A 15% probability that I will get pregnant within the next 12 months is way out of my comfort zone for what I would deem “safe enough” to have a peace of mind.
More importantly, I have a naturally elevated testosterone level due to having polycystic ovary syndrome. That means irregular periods. It’s perfectly normal for me not to have a period for up to 16 weeks at a time. Here’s the problem—in Latvia an abortion is legal only for the first 12 weeks of the pregnancy. I’m very scared to miss an unwanted pregnancy for a while only to realize that it’s already too late to get an abortion. Whenever I haven’t had a period for at least nine weeks, I have to get a pregnancy test. The cheap tests that are sold in pharmacies are unreliable. With those a false negative is possible. This means that each time I have to go to a clinic for a hCG blood test. In the year 2019 I have had two pregnancy tests already. In January the result was 7.04. An hCG level of less than 5 mIU/mL is considered negative for pregnancy, and anything above 25 mIU/mL is considered positive for pregnancy. An hCG level between 6 and 24 mIU/mL is considered a grey area. How do you think I felt for some days following that test result? Nervous obviously. This constant fear is messing with my mind.
If I got pregnant and realized it at a moment when it’s already too late for a legal abortion, I’d have to risk killing myself. DIY abortions are dangerous. And, yes, I’d take the risk. I’d prefer to die than to deliver a baby. I’m 27 years old already. So far I have been lucky. I have never gotten pregnant; I have never needed to get an abortion. But I know that I’m pushing my luck. Statistically, it’s quite likely that one day my luck will run out.
After the disastrous beginning, I decided to try to talk with the doctor anyway. She totally failed to understand why I don’t want hormonal contraceptive pills. In fact, she insisted that I need them. According to her, polycystic ovary syndrome is an illness that needs fixing. I, on the other hand, love having it. Since doctors have denied me access to testosterone injections, I’m happy that I at least have a naturally elevated testosterone level. That’s one thing I actually like about my body.
The doctor seemed surprisingly progressive and non-transphobic. At least that’s how her statements sounded. She didn’t tell me that “God wants me to have children” (yes, that’s an actual quote I have been told by another gynaecologist). Nor did she call me “a delusional lunatic” (that’s another quote from a surgeon who couldn’t accept my masculine-leaning gender identity).
Instead she talked about how she is worried that I might later change my mind about not wanting children and sue her for money. I tried to explain to her the current Latvian law and the fact that there exist consent forms. I’m not sure I managed to convince her. The doctor’s visit ended with her promising that she will check the law and corresponding consent forms and call me later.
Being a cynic, I expect that she won’t call me. Usually that’s just a polite way how people tend to get rid of me. Besides, half a year ago, another surgeon promised to learn about the necessary paperwork and call me. I patiently waited for his call for a month. Then I scheduled another appointment with this doctor, during which he said that he refuses to treat me.
Anyway, this Friday I just wasted 32 euros for another useless doctor’s appointment. Over the last two years I have had so many unpleasant doctors’ appointments, that I now dread seeing another doctor. In the morning, I felt like shit and I had butterflies in my stomach. In the afternoon, I felt like shit and I was emotionally drained and empty. As I type this blog post, there’s a bit of anger, some sadness, and this vast sense of dull emptiness. It’s not even a lack of energy, it’s just that I have no will or desire to do anything. Just an overwhelming sense of apathy and hopelessness. Nowadays I feel like this after every doctor’s appointment; usually I get better after a few days.
Oh well, at least now I have a blog, and I can vent online. Typing a blog post is more useful than just lying in bed doing nothing and feeling sorry for myself. This is a simple enough and relatively mindless task that I can manage even in my current state of apathy.
Being denied healthcare messes up a person’s mind. Sometimes medical problems are incurable, and there’s nothing anybody can do about it. But my medical problems would be easily solvable. I know that neither the state nor the insurance pay for sterilization or gender change procedures. Fine, I get this. I am willing to pay the full price from my own pocket. But no, doctors won’t let me have it. This intentional malice is so damn depressing. Doctors could easily fix my problems and make my life more convenient, but no, they won’t do it. The society shouldn’t abuse me like this. I feel angry, sad, and I keep on whispering to myself “not all doctors, not all doctors, not all doctors” in order to stop myself from starting to hate doctors as such. Why must they torture me like this?
Why does the world have to be so damn unfair? I was born with the wrong body, that’s nobody’s fault. No human could have done anything about this bit of unfairness. But most of my problems are caused by the society I live in. Being aware that other people could fix my problems but refuse to do so feels terrible, it is much worse than getting hurt by the laws of nature.
I hate all those monstrous doctors who patronize me, deny my bodily autonomy, and even claim that they are doing this for my own benefit, because I might regret my choices later in the future. It’s my body, it should be my choice. Since I have already written about patronizing attitudes before, this time I’ll abstain from further elaborating the topic.
It’s also unfair. Cis men don’t have to fear unwanted pregnancies. Cis people in general don’t have to prove to hostile doctors that they are crazy enough to need some body modifications but not too crazy so as to be total lunatics who must be locked up in white rooms. If some gender neutral pronoun was the norm, if I was allowed to use either a male name or some gender-neutral name, if unisex toilets and dressing rooms were the norm, then that alone would solve a significant portion of my problems. If doctors did the few procedures I want, then that would solve the rest of my problems. The emotional pain I have to experience is not caused by an unfortunate accident of birth. Instead I live in a society that could solve all my problems, yet this society so adamantly refuses to do so, instead doctors are making me suffer “for my own benefit,” because if I was allowed to have bodily autonomy, then “I would make a huge mistake I would later regret.”
Moreover, there’s the fear itself and all the resulting stress. I perceive pregnancy as an inherently feminine experience that would be incompatible with my gender identity. I know that there exist trans men who become fathers, but I absolutely don’t want that. There can be no biological children for me.
If my body became pregnant, I would perceive that as mutilating. I already dislike the fact that my body is too feminine for my own taste, but I can cope with my existing problems. Nonetheless, the thought of my body even potentially becoming any more feminine freaks me out. I keep my body thin, because the thought of having even more fat on my hips or in my breasts freaks me out. Thinking about a pregnant belly or breast milk simultaneously with thinking about my own body makes me highly uncomfortable. If you are cis, imagine an evil alien experimenter implanting in your body organs that are exclusive to the other sex. That’s about how the thought of pregnancy makes me feel.
My fear that my body might get pregnant against my will is seeping though and spreading also to other aspects of my life. There is no rational reason why I should feel uncomfortable while looking at other people’s babies or other people’s pregnant bellies. It’s not like a baby could “infect” me and make me pregnant. Nonetheless, the fear that is lingering at the back of my mind spikes every time I am reminded of childbirth per se.
For example, one of Freethoughblogs bloggers tends to regularly post photos of his grandchildren. Whenever the title of some blog post suggests that there might be baby photos in it, I won’t click on this link. But often baby photos appear on my computer screen unexpectedly. It’s not like “trigger warning: maternity or baby images” was a common thing. While browsing the Internet, I regularly run into photos of babies and pregnant bellies. Each time this happens, I experience a slight jolt of revulsion. And fear. That a parasite might mutilate or kill me.
The fear that I might accidentally get pregnant and fail to notice it until it is already the 13th week (making an abortion illegal in Latvia) is a constant worry lingering at the back of my mind. Of course, this messes up my brain.
Instead of getting the healthcare I need, I am feeling like shit and googling about DIY abortions after the 12th week in case someday the worst actually happens. By the way, here, on page 3, you can find the World Health Organization’s guidelines for how to use misoprostol and mifepristone in order to terminate a pregnancy between 12 and 24 weeks. The bad news is that at this point complications are much more likely compared to using the same pills earlier in the pregnancy, and the patient will probably need medical assistance. The good news is that these medications cannot be detected in blood tests, thus doctors working at the ambulance might assume that they are dealing with a naturally occurring spontaneous abortion, which means that the patient might not end up in the jail. And, of course, as long as you have money and know how to pay with Bitcoin, misoprostol and mifepristone can be shipped to anywhere in the world.
This Friday, I didn’t tell this doctor about my fears. If I want a surgery, I must pretend to be normal and sane. If an AFAB person tells, “I hate children,” then they will be perceived as a loveless monster who deserves to suffer. Amusingly, men don’t get the same treatment. I know a guy who has had a vasectomy. At first his doctor seemed hesitant. Once the guy said “I hate children,” the doctor immediately agreed to perform the procedure. Men who want a vasectomy don’t go through the same shit that has been going on with me for the last two years. Has a man ever been told, “You cannot have a vasectomy unless you already have at least two children”? I hate the sexist society we live in.
For the record: I have never hurt any child. I have arranged my life so as to be able to stay away from other people’s children. I absolutely condemn every form of child abuse and neglect. Each child deserves to grow up in a healthy environment, and I fully support state funded education, free healthcare for children, and so on. Even though being confronted with babies makes me uncomfortable, I do not want any of them to suffer for any reason.