Since Dobbs, Some Are Considering Desperate Measures

When Roe v. Wade was overturned in 2022, Justice Samuel Alito asserted that the pro-choice arguments that had upheld Roe for nearly half a century were “damaging” and “wrong.” He wrote that “the contending sides … make impassioned and conflicting arguments about the effects of the abortion right on the lives of women,” but that he and the Supreme Court did not have the authority nor the expertise to settle those disputes. Now, three years later, women — and others who can become pregnant — who do have the authority and the lived experience are making informed decisions following the aftermath of the Court’s mistake, acting quickly and decisively before limits on reproductive healthcare go even further and their options disappear entirely.

On r/sterilization, a Reddit forum dedicated to discussing forms of permanent birth control, more than 17,000 users from across the country post daily to learn more about what options are available to them, who they can trust, and how to navigate medical systems that often disregard their autonomy. They also use the space to share their own healthcare experiences with a community of people facing similar fears and decisions, building solidarity in the face of institutional and cultural resistance.

“I’ve got medical anxiety [but] I want surgery because I’m afraid something terrible will happen to me against my will and I’ll be forced to carry a child, assuming I can’t get an abortion,” writes one anonymous user. “It’s not a far-fetched fear in my mind. The political state of the U.S. is very concerning.”

The surgery people are seeking is called a bilateral salpingectomy, in which both fallopian tubes are surgically removed. This is a minimally invasive procedure, often performed laparoscopically, with an internal recovery time that spans about six weeks. While many patients seek it out as a form of permanent birth control, it also offers additional health benefits, such as significantly reducing the risk of ovarian cancer and preventing ectopic pregnancies. Yet it remains difficult for individuals — especially those in their 20s or 30s — to find doctors willing to perform the surgery. Many providers cite concerns about future regret; medical practitioners have long imposed their paternalistic ideologies on patients seeking reproductive healthcare, which is intimidating and discouraging. But in many cases, it hasn’t diminished the desire nor demand for sterilization procedures, which has been sharply increasing according to new research published in JAMA Health Forum.

In addition to restricted abortion access, young people have cited specific fears of being sexually assaulted or raped. For some, preventative surgical procedures have become the only viable way of taking control over their autonomy — of making sure their bodies cannot be forced into an unwanted pregnancy by a rapist or their government.

“I first began considering it when Roe v. Wade was overturned,” 24-year-old Cody explains. “What really cemented my decision to get my tubes tied was when I saw that clip of Nick Fuentes (a white nationalist podcaster) right after the presidential election where he says directly into the camera, ‘Hey bitch, your body, our choice.’ That slogan was instantly everywhere. I was horrified.”

Cody, a transmasc Native and California resident, shares that he has received assault threats on social media and that two of his friends have experienced sexual assault, further reinforcing his fears and urgency.

“I try not to be overly paranoid, but I really do think that conservatives are rushing towards having full control over the bodily autonomy of AFAB (assigned female at birth) people,” says Cody. “The abortion laws in some states are already causing a dystopian level of control over our bodies, like the Black woman in Georgia who is brain-dead but being forced to host an unborn fetus all the same. Our bodies are seen as baby machines, and that’s not getting any better. It’s dehumanizing.”

The woman Cody references is Adrianna Smith, a 30-year-old nurse who was nine weeks pregnant when she died in February. Due to Georgia’s Living Infants Fairness and Equality (LIFE) Act, which bars abortion after a fetal heartbeat is identified, doctors have kept her organs functioning artificially for months in the hopes that the fetus survives. Smith’s case has caused widespread outrage, much of it expressed across social media platforms, cementing the argument that “pro-life” rhetoric often translates directly into “pro-forced birth” — at any cost.

Kat Tenbarge, an internet-culture journalist who primarily covers gender-based violence and online harassment, told DAME that soon after Donald Trump’s second election, the increasingly extreme language from white nationalists and conservative media moguls online like Matt Walsh, Ben Shapiro, and Fuentes became a chilling signal that the agenda behind their movement was not just anti-abortion, but deeply misogynistic and rooted in control and violence.

“Social media platforms have become such a cesspool of misogyny, which has just been more encouraged by platforms over recent years,” she explains. “It creates a platform that is so untenable to exist as a woman or someone who feels targeted by this type of rhetoric — and that’s very intentional.”

Tenbarge echoes a sentiment that is now painfully familiar for millions of women: that digital misogyny is not isolated. Cynthia Miller-Idriss, a professor at American University, voiced a similar concern.

“What we saw right around the election, leading up to the election with a candidate who was a woman, a woman of color, and then the reproductive rights that were also sort of at the heart of the election in many ways was a celebration in many ways by some young men who were viewed — whose posts were viewed many, many millions of times—of this reclaiming of power over women and power over women’s bodies,” Miller-Idriss told PBS White House correspondent Laura Barrón-López last December. “We know that the biggest predictor of support for political violence right now or of willingness to engage in it, or among the top three predictors … is misogyny or hostile sexism.”

For those targeted, the distinction between the online and the offline world is largely a myth. The emotional and psychological toll of digital abuse doesn’t disappear when the screen turns off. As Tenbarge explains, violence that originates in online platforms often spills into everyday life — and the cycle of radicalization continues to feed itself.

“It’s important to know that the violence is moving out of these social media platform contexts into ‘the real world’ where people are having physical interactions with each other where it’s a real relationship,” she explains. “You see the ideological leanings of the internet, which is like a distorted version of ‘real life,’ and you see that intensify some of this type of extremism in these online settings, which then … reverberates back into offline settings, and so the radicalization cycle becomes kind of like a loop or a circle in that sense.”

For people like Cody, none of this is easy. But in a country where rights are being chipped away and violent promises have become increasingly more abundant, preventative healthcare measures feel like the last defense against catastrophe. These individuals aren’t acting out of fear alone — they’re acting out of a rational assessment of worsening conditions.

“For quite a while, I wanted to be a parent. I wanted to have my child(ren) be raised with their culture and the experience of parenthood,” Cody concludes. “I was actually really excited at the prospect of being a transmasc dad, but I wanted kids on my terms. … Never having to fear unwanted pregnancies in the face of rising sexual assaults and birth-farming conservatives makes it worth it to me.”