Thoughts and Feelings on a Hysterectomy

I’m scheduled for a hysterectomy in December.

I’ve had endometriosis since I was a teenager. Endometriosis is a fairly common condition where, for reasons unknown, bits of tissue of the uterine lining find their way out of the uterus via the fallopian tubes, adhere to something else in the body cavity, and proceed to build up and shed with the menstrual cycle just like normal uterine lining does. The result is extremely painful, and the only non-surgical treatments are NSAIDS, hormonal birth control, and chemically inducing menopause for six months or so to try to do a hard reset on the lesions.

In 2020, having had no success with hormonal birth control (in any form), limited ability to handle my pain with OTC drugs, and not wanting to do a mini menopause in my late 20s, I opted for the one surgical treatment that isn’t a hysterectomy: laparoscopy where they locate the lesions inside my body and cauterize them with a laser, or something like that. I’m a little fuzzy on the details, because I don’t really care what they did, because it didn’t actually work to lessen my pain. When it became clear that surgery hadn’t helped, I attempted birth control one more time, to no success. After that I started telling myself I would get a hysterectomy as a 40th birthday present.

A fun little “hack” of evolution is that when your body is very stressed out, it puts fewer resources into reproduction. Babies can happen later, we are running from a tiger now. It meant that when I finished grad school (a slow but nonetheless very scary tiger) and my stress levels dropped to levels they hadn’t been at in six years, my endometriosis pain levels skyrocketed, and the amount I was bleeding in a day had me at “might go to urgent care if this keeps up” levels of concern. Right now I am losing 2-3 days a month to disabling levels of chronic pain. This year at my wellness visit I told the GYN I wanted to consult for a hysterectomy. A few weeks later I met with the surgeon, told her my whole sob story of failed treatments, and wham bam thank you ma’am I am scheduled for December.

I always liked the idea of having biological kids, but over the past few years I’ve come to believe that my assumption that I would purposely carry one or more pregnancies in my life was more of a default setting, placed quietly and persistently into my head by the prevailing culture. Of course you’ll get married and have babies, that’s what everyone does. And so I thought, of course I’ll get married and have babies, just like everyone does. I did get married, and I do recommend that experience. But the more my spouse and I pondered and discussed, the less I felt like I wanted to grow my own babies from scratch. Or even have babies at all.

But does that make me selfish? I wondered. Followed by: is being selfish even a bad thing in this scenario? As a society we aren’t doing much about climate change, a thing we’ve known about for decades, and the natural disasters are getting worse and more frequent by the year. Fascism is having its cyclical rise in this country and others, which is already killing people and threatening to kill many more. Bringing a child into the world is an act of hope, and while I have a grim, spite-filled optimism that things will eventually get better, I don’t know if I’m willing to stake another person’s whole life on it. Phrased this way, my stance doesn’t feel selfish to me.

I think the reason “selfish” keeps echoing in my mind around the prospect of not having babies is because of the small, gleeful thoughts I’ve had imagining about what the rest of my 30s and 40s could be like without babies. No multi-year interruption of my sleep cycle. No need to give up a room in our house that we could use as a home office. No stressful searches for reliable, affordable childcare. Travel will be easier! My career won’t be interrupted! I’ll have so much more disposable income! And I feel guilty for having these gleeful thoughts. I was raised Catholic, I’m a woman in the US, we are supposed to welcome suffering and trials. We are supposed to derive meaning from the suffering and trials. The suffering and trials are what make us who we are, or something. And who is a woman without a baby?

In my early 30s I am settling into what my “callings” are in life. I finally have the career I’ve wanted for a decade. I have a lot of wonderful people in my life who I know I can depend on when shit hits the fan. I see the value now in building a community, in taking care of people around you, in looking out for your neighbors. I’ve come to understand that the nuclear family is a scam and that real resilience is in building relationships, not bunkers. And in ruminating on my lack of any real “calling” to carry children, I realized my actual calling is in taking care of my people, my community. My neighbors, my coworkers, my fellow queers, my family, my friends. People who appreciate a quick conversation in the shared driveway, people who need a ride to the doctor’s office, people who will show up with food when there’s a tragedy. There are lots of people who are fully integrated into their communities and have babies, but the idea of helping friends with their babies appeals to me much more than having babies of my own. Isaac Fitzgerald nicely articulated some of how I feel in Esquire in 2022 with his piece “The World Needs Uncles, Too”. The world needs aunts, too. People with the extra bandwidth that comes from not having kids so they can use it to take care of kids whose parents need a break, or are falling short despite their best efforts. In my case (or so I hope), cool queer aunts who will take them to buy punk genderqueer outfits at the thrift store and go to weird obscure concerts that their parents have no interest in. Aunts who like learning about bugs as much as the six-year-old does. Aunts who will bring over pizza and old movies to watch when the parents need a night out. I don’t think it’s selfish of me to look forward to that future, as more of my friends and family have kids.

When I first scheduled the hysterectomy, I was 94% sure I wanted to go through with it. Then I had my period during a multi-day work conference and I became 99% sure I wanted to go through with it. Now I am 100% sure, sitting on the couch thoroughly miserable with what should be my second-to-last-ever period. Now I am allowing myself the gleeful thoughts, I am shedding my guilt about centering my own needs. I hope my 30s continue to go to this way.