A patient signing a form in a doctor’s office. Image by SHVETS production under Pexels license.

Reproductive rights are considered a hot-button topic by many, but different groups can face different pressures in exercising these rights. Moreover, rights around fertility-affecting operations like the removal of one’s uterus (hysterectomies), are often left out of the discussion. To shed light on these issues, recent research examines how gender and race affect those seeking a hysterectomy, usually seen as the most extreme birth control option. 

Andréa Becker, a postdoctoral researcher and instructor at the University of California San Francisco conducted 100 in-depth interviews with a diverse set of individuals who have undergone or are considering a hysterectomy. These operations were sought in many cases to remedy painful reproductive conditions like endometriosis, uterine tumors, or for gender-affirming care. 

She discovered that while white cisgender (cis) women are routinely blocked from accessing desired hysterectomies, cis women of color are pressured into having hysterectomies by medical professionals they are relying on for responsive treatment. Even in cases where a woman of color desires to preserve her fertility, she may experience unwanted pressure to have her uterus removed instead of seeking other treatments for painful reproductive conditions. For example, here’s how a Black woman named Kat described her struggle to preserve her fertility despite the medical establishment’s pressure.

“Every time I had a physical exam, every time I had a vaginal exam, every time I had a pelvic exam every time, it was like “hysterectomy, hysterectomy, hysterectomy,” it was it was definitely pushed.”

Women who did not have or intend to have a male partner or desire kids also experienced differential treatment when seeking a hysterectomy. One lesbian woman even described how medical practitioners did not consider her wishes on the matter at all and were more concerned with the fertility wishes of a fictitious future husband.

Perhaps surprisingly, trans men and non-binary patients reported having a comparatively easy experience getting a premenopausal hysterectomy if they wanted one and were readily offered the procedure or even directed to it as it reinforced societal gender norms.

The study clearly shows a systematic disregard for women’s agency by the medical community, especially that of women of color. The pressure exerted by practitioners to sterilize women of color, even when it contradicts their wishes and goals, has links to a much longer history of medical abuse of such patients. These findings reinforce the need for medical institutions and practitioners to understand and address how racial prejudice and other forms of discrimination affect their treatment of patients.