Why should a person who isn’t a sadist even want to make decisions about what will happen with other people?

Sometimes people find themselves in situations where they are forced to make decisions about somebody else. For example, a parent of a 3 years old child must make decisions about their kid, because a person who is only 3 years old cannot decide for themselves. Alternatively, when a doctor who works at the ambulance gets an unconscious patient who is on the verge of dying, the doctor is forced to make decisions about how to treat this patient without being able to ask what the patient wants.

Contrast these examples with an entirely different situation. An adult person makes a statement: “I want to do X with my body or my life.” Then another person steps in and says: “No, I won’t allow you to do X.” Why would a person who isn’t sadistic even want to have such a responsibility? Why would they even want the legal right to be able to decide for somebody else?

Let’s say somebody states: “I want to steal your wallet.” At this point it would be reasonable for the would be victim to say: “No, I won’t allow you to steal my wallet, because that would hurt me.” But what if an adult person wants to do something that doesn’t influence or harm anybody else?

Let’s say that I go to a surgeon and say: “I want to surgically remove my reproductive organs, because I don’t want any children and I want to live as a man.” At this point, a surgeon who isn’t an authoritarian sadist with a desire to control other people ought to conclude that the patient is the one who should decide what they want to do with their body. Doctors should not try to forbid their patients from deciding how they want to live. In this scenario, the doctor should just perform the procedure that the patient has requested.

In this scenario, the patient is the one making the decision and the surgeon merely provides a service that has been requested from them. As some of you probably already know, I am an artist who makes tattoo designs. My attitude is that in exchange for money I will draw whatever some client requests. I do not make any decisions about what will happen with my client’s body. If a few years later my client regrets getting a tattoo, that’s not my fault—they (and not me) made a decision to get a tattoo, and they have to deal with the consequences. However, if I refused a specific client and started moralizing about how only some tattoos are pretty while others are ugly, then I would be making a decision about what happens with another person’s body. And I do not want this kind of responsibility.

A few days ago, I had a conversation with a surgeon who didn’t want to sterilize me. Her excuse—what if I later regret the procedure, then it will be her fault. I absolutely disagree with this attitude. When another person helps me carry out a decision I have made, then I am the one who is fully responsible for my choice. They didn’t decide for me, it was me who decided. If, on the other hand, a surgeon refuses my request, then that is their decision, and the negative consequences I may potentially face in the future are the result of their decision, their fault.

I have talked with several surgeons who seem to live with the attitude “if in doubt, refuse the procedure.” Meaning: Unless they personally are 100% sure that a sterilization is the right choice for the given patient, then refuse by default. Doctors don’t want to feel responsible for potential negative consequences that may happen after the surgery. Simultaneously, they live in a blissful denial about the fact that refusing some patient also can cause negative consequences.

As if a refusal couldn’t have any negative consequences for the patient! Let’s imagine a patient who absolutely refuses to have children. What if they get pregnant a few months after having been denied the sterilization? They will probably need an abortion, which is a serious problem. And what if the patient happens to be in a country where an abortion cannot be legally obtained? DIY abortions with illegally purchased misoprostol and mifepristone can harm the person’s health. And what if they are forced to deliver a baby against their will after all? Unwanted children tend to experience traumatizing childhoods that cause lifelong emotional problems. Moreover, even if the person gets lucky and never becomes pregnant, they are still spending years of their life living in constant fear and stress. If you categorically refuse to have biological children, a pregnancy risk can cause constant and ever present fear that one day your luck might run out and you might get killed by a parasite that has infested your body.

It’s odd how doctors think about the decisions they are making as if those were their decisions. A few days ago the doctor told me that “she has a right to decide whether she will perform a surgery on some patient.” Basically, she is the one who does surgeries, and thus each time deciding whether to perform or not to perform a surgery on some patient is her decision. This is a curious attitude.

The average surgeon has multiple surgeries per week. Choosing to accept or refuse me as a patient won’t influence her life almost at all. It will determine whether she spends two hours of her life providing a procedure for me or whether she spends those same hours doing something else. This decision slightly changes her daily schedule for a single day. Other then that, there will be absolutely no consequences for her one way or the other. Instead it is the patient who will have to live with the consequences of obtaining or having been refused said procedure. Thus the patient is the one who ought to be deciding about their own body. And keep in mind that doctors refusing to treat some patient can result in the patient’s life being ruined. And, yes, if I were forced to deliver a baby, then that would mutilate my body and ruin my life.

Trans people who want some medical procedures face the exact same problem as people who want to remain childfree by choice. Some doctor will try to act as a gatekeeper and decide whether some patient should be allowed to get the procedure they want. How can some psychiatrist even claim the right to decide what gender their patient actually is? Why do they even want the responsibility that allows them to decide whether their patient gets the healthcare they need or whether they will spend the rest of their life in misery instead? Are they just sadists who want to torture all the people whose lifestyle choices happen to differ from how the majority of the population chooses to lead their lives?

Of course, the same goes for TERFs. Are all the TERFs just sadists who want to make me suffer? Alternatively, why the hell are they trying to deny me access to surgeries that I want to have for myself? Of all the people, feminists ought to understand the principle of bodily autonomy. As feminists tend to say: “My body, my choice.” Unfortunately, according to TERFs, only cis women deserve the right to decide about their own bodies. As an AFAB person who prefers to live as a man, I no longer have the same right to choose what I want to do with my body.

Of course, all the authoritarian monsters who try to deny me bodily autonomy always have a handy excuse: “Some people don’t even know what’s good for them. They cannot be allowed to make decisions for themselves, or else they will regret their choices later in life.” Firstly, the fact that I want some procedure means that for me it constitutes healthcare, not mutilation. Secondly, I hate being patronized.

When a doctor patronizes their patient or a self-proclaimed feminist patronizes other AFAB people, then that’s a problematic attitude. Just who do they think they are? How can they be so incredibly arrogant? We are talking about people who imagine that “they are so smart that they know what’s best for every single person on the planet, while other people are so stupid that they cannot even know what’s best for themselves.”

I’m willing to believe that not all people who want to deny me bodily autonomy are sadists who want me to suffer. But what else can they be? Patronizers who are hardly any better? The patronizers don’t take my words seriously, they disrespect my choices. They talk to me in a way that seems friendly and kind on the surface, but is nonetheless disrespectful and insulting, and also betrays a feeling of moral and intellectual superiority. They question my intelligence; they assume me too foolish to decide for myself. “Look at the poor immature and foolish person!” thinks the patronizer, “They don’t even know what’s good for them. They cannot be allowed to make decisions for themselves, or else they will regret their choices later in life.” That’s a terrible attitude for a person to have.

Or maybe they are envious of my freedom? By making unusual lifestyle choices, I am not reaffirming that the normative choice is the only one a person can make. For example, why would a person who is happy to be a parent desire to force mandatory parenthood upon everybody else against their will? Only a person who is unhappy to be a parent and regrets their own fate would become upset after witnessing that other people seem to enjoy childfree life. Alternatively, there exist deeply religious people who have denied themselves the joy of casual sex for pleasure. Thus, due to their envy, they repeatedly tell themselves that everybody else who dares to enjoy sex is evil and will burn in hell.

Either way, there is something deeply wrong with people who want to police other people’s bodies and their lifestyle choices. A person who genuinely wants other people to be happy wouldn’t try to deny their autonomy “for their own benefit.”