I’m a physician, but not in a specialty that performs sterilizations. Here’s my take on it however. Overall, we want to do the best thing for the patient. Do not harm. We don’t want to contribute to a decision that will negatively affect them down the road.

I work in a hospital based setting so have the opportunity to work with A LOT of young people and see them grow over the years. I would say the overwhelming majority of people in their early 20s say they don’t want kids. By their early-mid 30s, they all have families or are trying for kids (many paying big $ for IVF).

On Reddit you get a lot of bias. The child-free crowd are going to continue to state how they were right, but nobody who changed their mind and had kids is going to keep posting about that stuff since they have moved on. Sterilization is such a huge, life-changing procedure, and when you look at the shear volume of people who change their feelings on this over the years, I can see why a lot of physicians are hesitant.

You could make arguments about patient autonomy, but it’s a tough spot. At the end of the day, a physicians job isn’t to do everything the patient asks, it’s to do the best thing for the patient. There are a lot of types of very effective birth control out there right now (yes, I understand that certain people have issues with certain products), that it isn’t really a necessity to make such a permanent decision at such a young age.