On becoming infertile – part 3 (final)

Becoming infertile creates a social minefield all its own. I thought I was used to strained awkwardness, given that I’m both a person with a disability and a person who spends a lot of time talking to philosophers. But I still wasn’t prepared for the interactive weirdness of being an infertile woman in a world obsessed with women’s fertility.

People who know about my infertility often assume that I will be upset at any interaction with ,or mention of, babies. When I visited my family shortly after my operation, my sister (my only sibling) tried – painfully, sweetly – to make as little reference as possible to the fact that she was about to have her first baby. If you want to see something hilarious, watch a petite, 5’2 woman try to be subtly eight months pregnant. It doesn’t really work.

The truth of the matter is that I feel about other people’s babies the same as I have always felt about other people’s babies: I like them very much, so long as I incur no diaper-changing or babysitting responsibilities. I do tend to dislike how child-centric our culture can sometimes be. But while infertility may have sharpened that dislike a little, it was something that I felt long before I became infertile. (This is worth emphasizing, because I’ve found that knowledge of my infertility often colors the way in which people interpret me. And this tinged perception is usually misleading. If I seem a little reluctant to look at a new set of pictures of your baby, it’s not because I can’t look at pictures of babies without risking emotional breakdown. It’s that you’ve already shown me 400 hundred other pictures of your baby, and I – like most everyone else – have my limits when it comes to admiring baby pictures.)

That’s not to say that my infertility doesn’t affect my social interactions. It does, just not in the way you might think. I often feel pressure to conceal my infertility – particularly from parents and even more particularly new parents – in order to avoid their concerned glances and sweet-but-needless attempts not to upset me. It’s hard enough, when you’re permanently childless, to keep friendships intact once babies enter the picture. (Not, I should add, because we childless ogres hate children and anything to do with them, but simply because children, naturally and inevitably, change things.) The added social discomfort that infertility can add to the mix just doesn’t seem worth it. But the pressured silence this creates is alienating. And being in the company of lots of parents and children can often, as a result, feel deeply saddening – not because I can’t see babies without crumbling into a pile of emotional wreckage, but because they reinforce a specific kind of social isolation.

And this brings me to the Scylla and Charybdis of social interaction when you’re infertile (at least as I experience it. Your mileage may vary.) If people know about it, they treat you differently – they creep around your precious infertile-feelings as though walking on eggshells. But if they don’t know about it, there are no eggshells – and they proceed to stomp all over your already-weary heart with gleeful abandon.

When I was growing up, we were always taught that you simply do not, by way of casual conversation, ask people – particularly people you don’t know very well – about their reproductive plans. Nor do you make any assumptions about what those plans might be. If the person you’re talking to brings it up, then fine. But you don’t ask and you don’t assume. My father is a therapist, so I suppose he had particularly vivid first-hand knowledge of how important this is. He would often remind us that you simply don’t know what you’re putting your foot in if you bring up baby-having by way of small talk. You could be talking to someone who desperately wants to get pregnant but can’t. You could be talking to a couple on the brink of divorce because one wants a child and the other does not. You could be talking to a survivor of childhood abuse who is terrified of bringing a child of their own into the world. You just don’t know. Whatever mild benefit you might gain from casually prying into other people’s reproductive plans is surely outweighed by the risks.

I grew up thinking this was a social (and moral) norm. But if it is a norm, there are certainly a lot of people who either don’t know about it or take pleasure in ignoring it. About two weeks after discovering that the operation I needed would lead to permanent infertility, I attended a conference. An interesting – and wonderful – thing about this conference was that you could scarcely move without tripping over either a pregnant woman or a baby. Having babies was thus, quite naturally, the hot conversation topic at this conference. But because of how people handle this topic, the conference remains in my memory as one of the most socially painful experiences of my life. By the end, I was reasonably certain that if one more person said something to the effect of “Wow – all these philosophers having kids! I guess you’re next!” my head would explode.

People had occasionally said these kind of things to me before, of course. But it had never bothered me all that much. It had always annoyed me. But I would generally just use that annoyance as an excuse to catapult onto my soapbox and rant to my partner or friends for a while; and if I’m honest I’m rarely happier than when I’ve got a good rant going. But the onset of infertility turned offhand remarks like these from a mild annoyance into salt on an open wound.

“No,” I wanted to say, “I am not going to be ‘next’. Regardless of my preferences, my body can’t grow babies anymore. Thanks very much for reminding me, and for reinforcing how abnormal this is.” But much as I might’ve wanted to, I never said anything like that. And I don’t really know why. Somehow it always seemed that the same social rules which allowed people to make me uncomfortable forbid me from making them uncomfortable in turn. Maybe it just comes back to this: having babies is something we talk about (regardless, it seems, of how much damage we may casually inflict), but infertility is not something we talk about.

Whatever the reason, I felt the onus was on me to endure people’s insensitivity, rather than to call them out (and in so doing, to transfer the burden of discomfort). And as a result, I spent a lot of my time at that conference – and several subsequent ones like it – hiding in my hotel room, not wanting to go out and talk to people. Not wanting to go out and talk to people, because I worried that if one more person asked me when I was going to have a baby I just couldn’t take it.

I’ve developed a thicker skin about this as I’ve become more accustomed both to other people’s comments and to my own infertility. When people make casual enquiries or assumptions, it still makes me uncomfortable, but it doesn’t evince the sort of raw pain that it used to. There is one kind of comment, though, that never fails to floor me, both for its insensitivity and its absurdity. “(When) are you guys thinking of starting a family?” is something that people have, on many occasions, had the gall to ask my partner and I.

My partner and I are a family. We are a childless family, but that doesn’t make our family any less real or legitimate. The implication that people who don’t have children don’t have families – don’t have parents and siblings, aunts and uncles, nieces and nephews, partners, friends, pets – is beyond insulting. People have sometimes clarified their comment by saying that they were talking about a “nuclear family” (whatever that means). But just as I have an extended family, I also have a nuclear family. We are simply a family of two, rather than some n greater than two. Likewise, people without children and without romantic partners have nuclear families just as much as I do – those families are simply composed a little differently than my own. Whatever child-bearing abilities infertile women may lack, they do not lack families.

And with that, I draw these little ramblings to a close. Thank you very much for reading.

Part 1

Part 2

On becoming infertile – part 2

[Moderator’s note – After the positive response to anonfemphil’s posts on breast cancer, we’ve invited a series of posts from another female philosopher on another taboo women’s health topic: infertility. Please note that we’re allowing comments on these posts, but we will be moderating them very strictly, given the sensitive nature of the topic.]

I never wanted children. And I spent a lot of effort convincing my doctors that infertility was something that wouldn’t have a drastic impact on my life. So I assumed – rather naively, perhaps – that actually becoming infertile wouldn’t be a big deal for me.

But it was a big deal, for reasons I still have difficulty articulating. It was also, and at the same time, both a massive relief and oddly liberating. My reactions to infertility have been complex, to say the least. But what seems clear enough is that, though actually having children wasn’t something I cared about, the ability to have to children was something I cared about much more than I would’ve expected.

The trouble wasn’t that I wanted my childlessness to be a matter of choice. My childlessness is a matter of choice. My disability makes me infertile, but it’s my preferences that make me childless. Childlessness and infertility are two very different things.

But whether or not you want children – and whether or not you want to have your own biological children – most everyone will grant that having babies is a truly amazing thing. And it’s an amazing thing that is intricately bound together (probably incorrectly, given what we know about trans men, but bound nonetheless) with our conception of womanhood and the female body. Whenever I’d been around babies, I’d never felt that “Oooooh, babies – I want one!” tug on my heartstrings that I guess is common to many women. But I had, subconsciously, thought: “Hey, those things are pretty awesome. I could totally make one of those, if I wanted to. I don’t want to, so I won’t. But I could.”

And now I can’t. And that’s hard in way I would never have expected it to be.

It isn’t simply a matter of losing an ability. I’ve lost plenty of those before, and while it can be inconvenient and at times upsetting, it’s never had the sort of effect on me that infertility has had. This seems odd, given that I’ve lost abilities – the ability to drive, for instance – that had far more impact on my everyday life than a non-utilized ability to have babies ever did. But somehow differences in ability always just seemed like a natural part of being disabled: there are things “normal” people can do that I can’t, because I ride the special bus to life. This has never bothered me all that much, and it’s certainly not something that makes me feel ashamed.

But infertility made me feel broken – made me feel somehow less than – in I way that I’m not used to, and in a way that I never would have predicted. What surprised me even more was how many of these feelings of inadequacy were tied to feelings about my relationship with my partner. We’re constantly bombarded with the thinly-veiled assumption that women should be able to give their men babies. When my partner and I had been merely uninterested in having children, we were making an alternative lifestyle choice. When I became infertile, I was suddenly the sort of woman that couldn’t give her man babies.

Let me hasten to add that my partner has never been anything other than kind, supportive, and generally wonderful. Like me, he has never wanted children. What he does want, in his charmingly overprotective way, is to keep me from harm as much has he can. He always had a lurking fear that I would get pregnant, matched with a sincere hope that I would get an abortion immediately if I ever did get pregnant. To him, my infertility has been a profound relief. (And quite a lot of the time, I’ve felt the same way.) So feeling inadequate in my relationship with him made pretty much no sense whatsoever. And I knew that. But I still felt bad.

I have no idea what roots these feelings of inadequacy and brokenness – and they are no doubt complex and multi-faceted, without a single source or impetus. Perhaps part of it is tied into innate biology. Perhaps some of it comes from a basic recognition that babies are amazing, as is the ability to grow them in your own body. Who knows, maybe some of it is just residual earth-mother-goddess stuff leftover from the Second Wave (I did, after all, read Mists of Avalon at a very impressionable age). But I suspect – though I don’t know – that quite a lot of it comes from how we treat infertile women, and infertility more generally.

What I am certain of is that social attitudes and assumptions about both fertility and infertility do not help. Baby-having is something that we celebrate publicly and openly. Infertility is something we, for the most part, simply do not talk about. I learned very quickly that infertility is not a topic for polite people in polite societies having polite conversations. (Heaven forbid, it could make people uncomfortable.) And so women who cannot get pregnant are left with a less-than-subtle message created from contrasting norms. Having babies is something we should shout about from the roof tops, something we should encourage, something we should expect from normal women. The inability to have babies is, in contrast, something uncomfortable, unnatural, something we should pretend doesn’t exist – at least once the hope of medical/technological/divine intervention has officially been extinguished.

No wonder people like me feel ashamed, inadequate, less than. I’m a well-educated feminist who never wanted children, partnered to a well-educated feminist who never wanted children, and I still, at times, feel embarrassed about and ashamed of my infertility. I cannot imagine what women who desperately wanted to be pregnant must feel.

Part 1

Part 3

On becoming infertile – part 1

[Moderator’s note – After the positive response to anonfemphil’s posts on breast cancer, we’ve invited a series of posts from another female philosopher on another taboo women’s health topic: infertility. Please note that we’re allowing comments on these posts, but we will be moderating them very strictly, given the sensitive nature of the topic.]

I have a disability which leads to a variety of medical “complications”, some of which require surgical intervention. Usually, there’s nothing terribly dramatic about the process. I go in for a battery of tests, a procedure is recommended, and then that’s that. But the most recent “complication” was different – it was different because it involved, among other things, my reproductive system. All my doctors agreed that I needed surgery. There was some debate about which procedure would be best, but the consensus was that something surgical had to be done.

But. All of the standard corrective procedures would prevent me from ever getting pregnant. I was 27, with no children and no history of previous pregnancies. And so I was told, rather vaguely, that any procedure which would end my fertility was “contraindicated”.

Not to worry, I assured the surgeons, my partner and I weren’t planning on having kids. Naively, I thought this extra bit of information would settle the matter. As it turned out, it had surprisingly little impact on the (male) surgeons. You think that now, they told me. But if you lose your ability to have children, it’s permanent – and you may regret it later. Sure, I thought, of course I may regret it. But then, having kids is also permanent – and I might regret that too. I couldn’t see how my potential regret should factor into this decision, especially given that people are statistically more likely to regret child-having than non-child-having. (Turns out I would also end up with very good reason to regret a surgery delayed by medical hand-wringing about my childlessness. But this was the sort of potential regret that didn’t matter in this context, as it was only indirectly connected to lack of babies.)

My case – which is medically unusual and complicated – ended up being taken for discussion to the surgical board of the medical school which runs the teaching hospital where I’m treated. The decision they handed down still shocks me, every time I can bear to think about it. The director of the surgical team advised tactics to delay the operation as long as possible, so that I could “try to complete my family”. That my family could already be complete was not, apparently, something they considered.

It was never obvious what exactly they wanted from me, when they advised that I “try to complete my family”. My condition – especially given what was happening at the time – made it unlikely that my body could sustain a pregnancy beyond the first trimester. And if I could manage to carry a pregnancy to term, it would be very dangerous for me, and would likely cause me permanent harm. It seemed that I was being told to undergo a series of frustrating miscarriages in pursuit of a dangerous pregnancy I didn’t want. When I asked my primary care physician why this was happening, she sighed, rolled her eyes, and said “They want to be able to say that they told you to try.”

The expectation throughout seemed to be that I should try, that I should pursue biological reproduction regardless of the harm or danger. That’s what the brave woman would do. If it worked, I would have the moral victory of motherhood against the odds. If it didn’t, I would have the moral reassurance that at least I’d tried. And if it ended up killing me – well, I would die in the noble pursuit of motherhood, surrounded by understanding women, like Julia Roberts in Steel Magnolias.

What followed were a series of increasingly frustrating conversations with (male) surgeons. One responded to my claim that I didn’t want children by patiently explaining: “You shouldn’t say that. You never know about these things. Children are a wonderful blessing.” I have a hard time imagining how a doctor could think that’s an appropriate thing to say to any adult woman. But that a doctor could think it’s an appropriate thing to say to an adult woman for whom pregnancy would be a serious risk defies belief.

Another surgeon, when faced with a similar declaration from me, reacted quite differently. He smiled, as though he suddenly understood something sad and profound, and then said: “Ah, I see. Is it that you’re afraid your child would have [your condition]?” This wasn’t the first time I’d heard something to this effect. In fact, it sometimes felt like the only way to avoid the doctors’ rampant paternalism was to embrace their equally rampant ableism. My condition is genetic – autosomal dominant – so my biological children would have a 50% chance of inheriting it. But this was never a part of my decision not to have children. Insofar as I wanted children, I would’ve been delighted to have children with my condition. It’s just that I didn’t want children, disabled or non-disabled.

Things finally changed when I saw that rarest of treasures – a female surgeon. She was as incensed and mystified as I was by the long delay, and promptly set about putting a stop to it. She also told me, with refreshing frankness: “A pregnancy would be completely disastrous for your body. It will be a very good thing if we end your fertility.” As I was leaving her office, one of the nurses pulled me aside. “That was good advice she gave you,” she said quietly, “very good advice. You won’t hear that from a male surgeon.”

And so I had my operation, and am now unable to get pregnant. Because of the delay, I ended up having to have a more invasive, riskier procedure than I would otherwise have needed. And, of course, I had the long months of lots of medicine, lots of pain, and nagging awareness of the list of “things you must go to the emergency room ASAP if you notice” that the surgeons’ stalling incurred.

But what I find most frustrating about the whole thing are the more intangible elements. The attitude of most of the doctors I dealt with made me feel like my preference for childlessness was somehow unnatural, and shouldn’t be given the same respect as most women’s preference for having children. And what upsets me most about this, on reflection, is not what happened to me specifically, but what must surely happen to many women like me. I’m fortunate – I’ve never wanted children, and so in this case the needs of my body didn’t conflict with my preferences. But there are so many women in similar situations who do want children very much. I suspect that these women feel a lot of pressure – sometimes subtle, sometimes not-so-subtle – to forge ahead fearlessly in their attempts to get pregnant, and to view adoption as a distant second-best.

Don’t get me wrong – I don’t doubt that there are women in my situation with an intense desire to have their biological children, and I respect their attempts to make this happen. But attitudes like those I encountered from doctors make facing infertility much more difficult, whether or not you have a strong desire for biological children. When I was facing permanent infertility, the expectation was that I would fight it with everything in my power, consequences be damned (cue Steel Magnolias music). Expectations like that create a tremendous amount of pressure, and a creeping sense that if you aren’t willing to make extreme sacrifices in order to have babies, there’s something odd about you.

Expectations like this must surely hurt adoptive families just as they hurt women facing infertility. Whenever I would point out to my doctors that I could have children without having my biological children, they would look at me like I’d just sprouted a second head. Adoption, surely, was the last resort – to be countenanced only once you’ve lost the battle for biological children. I never understood this – but then, I’m an unnatural childless woman so maybe I’m missing something. I guess it’s always seemed like adoption is something to consider, insofar as you’re considering having kids, whether or not infertility is part of the equation.

Expectations about what families should look like are harmful. They stigmatize families that fall outside the white-picket-fence idyll. And they make life harder for people in situations that are already perfectly hard enough.

Part 2

Part 3