Poppy Begum examines the growing number of young people in the UK who are opting to be sterilised, even though they don't have any children of their own.
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-It's really old.
-Andrea Macario de Oliviera.
It's so cute that your grandparents put your photo in the local paper,
and you still have it.
You're not going to have this any more, ever.
-What? A baby?
It doesn't bother me at all.
It's for the best.
One in five British women will end their child-bearing years
without having a child, twice the number 30 years ago.
I think we have to accept
-that some people just really don't want children.
We all know what a pain contraception is.
And it must be even more infuriating
when you really know you don't want to have children.
The UK doesn't collect statistics for men,
but figures from Europe suggest a similar decline in fatherhood.
Now a growing child-free movement online is allowing people
to share their advice and experiences with each other,
away from the prejudice of their child-bearing friends and family.
After spending time on the pages and forums,
I found a group of young people so sure they never want children,
they're getting permanently sterilised.
Why do you want to go to the extreme of being sterilised?
I think, essentially, because I'm so certain that I don't want kids
that I don't want the possibility of getting pregnant.
But with the potential for a lifetime of regret,
should young people be allowed to do this to their own bodies?
And should the NHS be supporting them?
-I mean, I don't want to be like...
I'm literally spinning around. I'm spinning around.
-Oh, my God, that was so stressful.
I'm so stressed out, I've got back pain.
'Last year, technology journalist Holly went public about her fight
'to get a sterilisation on the NHS,
'and her story became national news, sparking controversy.
'She was accused of using the taxpayer to subsidise
'what many thought was a lifestyle choice.'
-Can you show me some of the comments that you've got?
"Take responsibility for your own body.
"The NHS isn't responsible for your sex life, you are.
"There are other holes if you can't keep your legs shut."
That's one I hear a lot.
You know, hasn't she heard of the back door?
This happens all the time.
But this one was only particularly notable because she made a big point
of the fact that she works in the NHS.
"A&E is at breaking point, and this bird is bragging about this shit
"like some kind of wronged heroine.
"How about you take responsibility for your own sex life
"and contraception like the rest of us do,
"and stop acting like a stroppy, self-entitled teenager?"
I've heard that I should kill myself many times.
That I'm pointless as a human being, because I'm not going to reproduce.
That I have no heart, no soul.
And you must get this, but one of the first questions is,
-"It's so drastic, isn't it?"
-"You're destroying a healthy organ."
I have been thinking about this, researching it,
and fighting it for so long, you don't make an irreversible decision
unless you are 150% certain.
What if you change your mind?
Because you have to factor that that could potentially happen.
I don't think this is ever going to be something I need to worry about,
but in the event that that happens, there are other options.
And so the people who are terribly, terribly concerned on my behalf
that I'm going to die alone,
those people can rest easy that there are other ways,
if that comes to be.
But what about this indescribable feeling of being a mother?
Of having a child wrap its arm around you?
Something that you've created?
I mean, you're never going to feel that, ever.
That is true. I will never get to hold a baby that I've made,
I'll never feel what it's like to be a mother,
but equally, I will never get to be a space ballerina.
And I'm kind of OK with that, you know?
Life is about closing certain doors so that you can open other ones.
Have you ever been pregnant before?
I have been pregnant.
I don't think I've ever cried so much in my life.
I was just crying, and crying, and crying.
I didn't know what to do.
What did happen?
When I was pregnant last year...
I'm very, very much in favour of abortions being available,
but I personally don't think I would be able to have one.
So at the point where I was pregnant,
I was 100% sure that I was going to be carrying that baby to term,
and I was going to give it up for adoption.
It wasn't necessary in the end, you know, the baby didn't survive.
And I knew that people would say that somehow I had willed it away.
You know, that the baby had somehow felt unwanted and couldn't stay.
Because I didn't... It knew I didn't want to be its mother.
Holly had been sterile for six months.
Her story resonated with young, child-free people across the UK.
I wanted to meet some of them who had just started that journey.
-Hi, Paul, I'm Poppy.
-Nice to meet you.
-Hi, Poppy. If you want to come in.
'People such as Paul,
'a 29-year-old Warhammer enthusiast from Hampshire.'
Paul's wife didn't want to be in the film,
because she was concerned about the trolling and abuse she might receive
as a result of their decision to be child-free.
Paul is a type one diabetic, a condition which can be fatal
if not constantly monitored, and some studies indicate
that type one diabetes can double the risk of depression.
What does that say?
Ooh, 16.7. That's really quite high.
So all I'm going to do is dose up a little bit of extra insulin.
-You mentioned that you had depression.
Is that one of the reasons why you also don't want to have children?
Just because I've got depression,
it doesn't guarantee that any kids I would have would have it.
But it's an increased likelihood,
and I wouldn't want them to suffer that either, because it...
Mental health is so difficult for anyone to deal with,
let alone, like, people around you. Because everyone's different.
Why do you want a vasectomy?
I've never really found much in the way of a parental instinct.
If the worst should have occurred in the past and I had a child,
I would have, of course, stepped up to help look after it.
But I can't say I wouldn't resent the child.
You've seen a GP about getting a vasectomy before, haven't you?
When I was 18, I went in and tried to get one.
When I was 19, I tried to get one.
All the way through university and college.
And how were you treated?
It's the "you're too young, you definitely don't know what you want.
How far along are you in the whole process?
Well, I've got an appointment coming up,
but I'm not expecting them to give me that positive answer that I want.
So I'm looking that I'm probably going to have to fight for it.
As I spoke to more people online, I met Leah on a child-free forum.
Leah suffers from depression and ME,
also known as chronic fatigue, a debilitating condition
which leaves sufferers constantly exhausted.
Leah and her boyfriend, Phil, have both agreed not to have children.
'Leah is looking to get sterilised,
'and I wanted to know why a young couple would take
'what some may consider such a drastic step.'
Did kids come up on the first date?
Not the first date.
No, I certainly don't think it was anything like that.
Did that come up much, much later?
I don't think it was ever brought up.
How did you both know neither of you want children?
I think it's slightly more for Leah, in the fact that...
I can bear to be around them for a little bit longer.
-And, you know...
-He's very good with them, in comparison to me.
I blatantly look like I'm trying to interact with a foreign object.
And, you know, obviously, health-wise...
I couldn't physically handle one.
I'd have to come off my medication to have a pregnancy.
It would affect the health of a child,
should I come off my medication.
And that's the stuff that keeps me awake, keeps me pain free,
and helps me be a normal person.
And that is why I would opt out.
I don't think I could handle it, and it wouldn't be fair.
'Leah clearly had the full support of her boyfriend,
'but I wanted to know what her parents thought of her decision
'to get sterilised.'
You probably know about Leah, and what she wants to do.
-How do you feel about it?
-Totally her decision.
Yeah. Completely hers.
Should she accidentally become pregnant,
she could not cope with a baby.
The fact that she's got ME...
She hasn't got the energy.
Leah was a very, very active baby.
-Really, even very active is underselling it.
As she got older you'd hear the front door slam and she'd be out -
pogo stick, skates, bike, nonstop, running everywhere.
I think we've lost the person she used to be.
I don't know if it's hit Leah yet, but I think...
there's a sort of, I wouldn't say grieving process,
but you're really aware that you've lost the person
that they used to be, that you used to know,
and it's a different person who's taken their place.
The people I've met so far were in committed relationships
and had arrived at their decision
with the full consent of their partners.
I wanted to meet someone who was single when I heard from Vaughan.
He let me go with him to his vasectomy operation.
'Vaughan has Asperger's syndrome,
'and though he isn't in a relationship,
'he was extremely concerned about the prospect of becoming a parent.'
Can you tell me, why are you getting a vasectomy?
It's quite a drastic decision, isn't it?
It's because I am scared of the thought of having my own children,
and how much I would stand to lose.
-What you mean by that?
-Many people don't notice it in me,
but I am mildly on the autism spectrum.
I have seen a lot of parents
that can't cope with kids who are on the spectrum,
and I wouldn't want to risk it.
Do you worry about how you'll approach it when you, you know,
start dating, when you want to be in a long-term relationship?
I would find it difficult to break the news, and I mean,
I sadly will have to. But I mean, I have...
There have been situations where people have actually
tried to force me to have sex with them.
And I stopped myself.
I just said, "I don't want to get anyone pregnant,"
and I have had nightmares at night where people,
where I have got someone pregnant, and then I just wake up in a sweat,
and it is really scary.
But you could always wear a condom, though, couldn't you?
Well, it's because I know condoms can fail,
and it was really watching EastEnders in 2009
when Ronnie Mitchell secretly, desperately wanted children,
and I even saw her sticking a pin in her partner's condom beforehand,
to try and trick him into it.
And I know I would never want to chance that.
-So, Vaughan, good luck.
-See you the on other side.
Vaughan was so determined to get the operation
that he was paying for it himself, despite his concerns
about it affecting his chances of finding a partner.
With the growing community of people supporting sterilisation online,
there are some who are totally against it.
Leonora Butau is a bioethicist, a mother,
and specialist in the ethics of fertility and sex.
What do you think about those people who've made themselves
permanently infertile because they are worried they'll pass on
their mental health to their future offspring?
Sterilisation, basically, damages a perfectly healthy working organ.
It destroys it.
It's a really drastic procedure.
Medicine is a profession of healing, of health,
of restoring someone to health,
so the very philosophy of medicine is challenged by these procedures.
Would you go as far as to say that
sterilisation should be totally abolished?
I would say that sterilisation and vasectomy
is not good for the human person.
You know, our fertility is not a disease, it's a gift.
You know, something that's part of us as a human being,
and it has a huge stake on our overall health and wellbeing.
We're approaching these people in a way that we feel
that they're beyond redemption. They cannot be cured.
They cannot be helped. And I think that's a really, um...
That's a really harmful way of looking at people
who are dealing with all these issues.
Leonora seemed to believe that sterilisation
was a form of mutilation rather than a legitimate medical procedure.
Later that day,
Vaughan called me to say tell me how he'd got on at his operation.
Hi, Vaughan, how are you?
Unlike Vaughan, Paul's progress so far had been successful,
but perhaps the surgeon would eventually turn him away too,
telling him it was for his own good.
Now, you're coming in under your own steam?
You're not being forced into this? This is...
Yes, my own volition, yes.
You've thought through the implications,
and you're pretty happy, the both of you are happy about this?
And you're not sneaking in without your wife's consent?
Basically, she is fully in on this as well?
She knows. She's fully in on this.
OK. I'd like to examine you first, if that's all right.
-Just to make sure that everything
is structurally where we think it's going to be.
You don't usually have any chronic issues at all?
I've never had any issues other than catching it in a zip once.
-And the area we are basically trying to feel for is the vas.
If you rub your finger over it, it feels like, just undercooked pasta.
-So get yourself dressed, and come on through when you're ready.
The vas coming down is cut here, folded back on itself,
so that, basically, the sperm can't get back up.
The volume of ejaculate that you produce is a little bit less,
but it should still be the same intensity.
It shouldn't affect your erectile function,
it shouldn't affect your orgasm.
-There are side effects of this.
Potential risk of bleeding and infection, about 1% or 2% risk
for each of those, and there's a small risk of chronic pain.
It can be weeks to months, it can be much longer than that,
but very rarely, years or lifelong,
but it's not something to embark on lightly.
Do you get patients like Paul coming to you who don't have children?
Yeah, there are a few.
I can't say there's enough of them to be able to say, you know,
two last year, four this year.
There's not much of a trend. It's a smallish number, basically.
-Nice to see you.
-Indeed, thank you.
'How do you feel now?'
Quite elated that I can definitely get the procedure done.
Things have gone rather well so far.
'It was time to need the young person who got me looking
'into this subculture in the first place.'
'I first met Andie online.
'Andie chooses not to identify as a specific gender,
'so has asked to be referred to as they.
'I went to see Andie the night before the sterilisation.'
Ooh, hello, kitty cat. What's the cat's name?
-Hello, Pepe. PEPE MEOWS
Why are you doing this? What's motivated you?
I don't know. I just feel like I shouldn't be having children.
And I don't want to, you know...
Mental health problems, and things like that.
I just don't want to have to pass things on.
I don't know. And then, obviously the work that I do,
I just don't want to...
accidentally fall pregnant. That would be awful.
And what kind of work do you do?
I'm a sex worker. So, yeah, there's more...
I guess more risk of getting pregnant, in a way.
Because I'm having a lot of sex.
-Do you like my slippers?
-Yeah, I didn't notice those.
I do like them. It's not My Little Pony...
-Oh, it IS My Little Pony.
-Is that your dad?
-No, that's my uncle.
No, I never met my dad.
-You never met him?
-You've got, you know, My Pony.
-My Little Pony.
-My Little Pony.
You've got...Mr Squidgy there in the middle.
I mean, they're dolls and ponies, it's something that children have.
And yet, tomorrow, you're getting permanently sterilised.
Yeah. I'm like a five-year-old child in an adult body.
Yeah, I guess, like, I had a really difficult childhood.
And for most of it I wasn't able to be a child, so I kind of, like,
am, like, reliving my childhood, but, like, as an adult.
-Do you talk to your mum?
-No, no, no. My mum disowned me.
So, no, I don't have a mother.
Andie, do you think, you know,
the trauma that you experienced when you were younger
has anything to do with the fact that you don't want children?
Oh, yeah, definitely. 100%.
I wouldn't want to have kids and they go through the same experiences
that I've been through. 100%.
I'm sure I'd make a good mother, but...
I suppose that's not what you want.
-You don't want to be a mother.
-Yeah, I don't want to be a mother.
'I left Andie wondering whether their lifestyle was a result
'of a difficult upbringing and, if things had turned out differently,
'whether they would still deny themselves
'the chance of motherhood.'
The night before Paul's vasectomy, I went to meet his friends.
I wanted to know whether they supported his decision,
and if they did, was it due to friendship,
or a belief in his own fundamental rights?
Bonus points tonight if you have any cards referencing Paul's bollocks.
-Oh, I think I've got one.
-Go on, Poppy.
I bet it's going to be awful, isn't it?
"Before I kill you, Mr Bond, I must show you...
"Lance Armstrong's missing testicle."
I think it would actually be Lance Armstrong's missing testicle.
There we go, you get to keep the black one, that is your point.
So what do you guys think about Paul's operation tomorrow?
I think it's great, yeah. He's doing what he wants to do.
It's like, there's not a lot of people that you'll see,
cos everyone's like, "It's the dream - have kids, have a house,"
all that jazz. I want kids, but if you don't want kids,
then you don't want kids.
And also, Paul not being in the gene pool?
So none of you guys have tried to talk him out of it or...?
There wouldn't be much point anyway.
-He wouldn't listen.
-I find it really weird, cos, obviously,
we do the same thing. We both work for the same company,
we do exactly the same job. And if I didn't like kids,
I would find it really hard to do my job.
I've met people who are getting vasectomies,
who want to get sterilised,
who are in different parts of the process, and I've met people
who've got mental health problems who say that it runs in the family,
they don't want to pass that on. What do you guys think about that?
I think that's completely justified.
Obviously, if you bring a child into life,
then you have to witness part of yourself
suffer through that as well.
I can imagine that to be very emotionally hard.
And having been, sort of, "the cause of it," for want of a better word.
Yeah, cos I guess you could put yourself to blame.
Do you think there's a gene or an innate thing in you
that makes you not want to be a parent?
-If you're genetically deficient, yeah!
I just think Paul is taking that one extra step and saying,
"Well, I don't want kids. I'm a human being.
"I'm civilised enough to go..." It's just another step
in the civilisation process.
Eventually, I'd say, 100 years down the line,
one in five people will be doing it.
He's more civilised than the rest of us.
Don't tell him that! You can tell he's new to the group, can't you?
Andie had been posting live updates
throughout the sterilisation procedure online,
which had attracted a lot of attention.
I headed to the hospital to meet Andie,
where they were waiting with partner, Jo.
Hi. How are you feeling?
I read on your Facebook status that they had to put fluid,
and you're bleeding heavily and...
Yeah, my womb lining collapsed.
You didn't tell me on the phone! Oh, my God.
-So what does that mean? Is that...?
-Oh, no, it's fine.
'Andie seemed upset about something,
'and I soon found out it was because of a post
'a cousin had written online about the sterilisation.'
Why were you upset?
What did your cousin say to you on this Facebook thread?
"You're really going to regret it in the future," or something.
Something like that. And it put a dampener on how I was feeling.
Like, I was quite chirpy and stuff before,
and it did make me kind of feel really sad and upset.
It's easier to, like, put people in their place when it's, like,
friends and stuff, or people you don't know,
but it's a lot harder to have these conversations with family.
I think the thing that upset me the most
is that she then commented saying,
"I'm her cousin, so I can say whatever I want".
And it's kind of like, "Well, not really."
My friend, she's in her 30s, I think,
and she's been wanting to do this for ages and been struggling.
So I think she messaged you, being like,
"You've inspired me to try even harder now,"
because they won't let her do it.
I've got friends on there who are, like, nearing 40, and they...
Like, their GP and stuff is still saying no.
What's the reason for saying no?
I think it's more of a wider problem
in that the idea that particularly women,
or people who have uteruses,
having the control over their own body. Because even now,
we're still discussing abortion and the right to have an abortion,
and I think sterilisation kind of falls under that as well.
But there are so many people who should not be parents,
cos they're really unfit parents.
And they're having children, and it's fine.
And the state backs them up.
But if you know that you don't want children,
-and, you know, you're certain, it's so difficult.
Andie's sterilisation seemed to be
the culmination of a personal struggle
about taking control of one's own fertility.
Now it was time for Paul.
It was the morning of his vasectomy,
something he had wanted for 11 years.
-How are you feeling?
A little bit nervous, to be honest.
Yeah? Because of the actual procedure, or is it because
you're never going to have...?
It's honestly that there is going to be a knife stuck into my bollocks.
So, Paul, I'm going to go now.
I don't know why I feel nervous for you.
-I shouldn't say that. I'll see you later.
This is it. Do you feel a huge sense of relief now?
I do feel a sense of relief, yep,
because it means that there's no risk of children in the future.
And that makes you feel very happy?
Yeah. It means I can get on with my sexual misadventures
and not have to pay any prices for it.
And how would you summarise this entire experience?
Everyone has their own individual reason
for not wanting to have children.
And a lot of these people, like myself, have gone,
"OK, well I've got this medical condition,
"I don't want to risk that."
Some people just flat out hate children.
But is it like a growing movement here?
More and more people coming out here?
-In the UK?
-I think there are.
But at the same time, it's because we're so far-flung,
and everyone has their own individual reasons.
You can't really have a rallying banner and say,
"We're all child-free, rah, rah, rah".
Because we don't... We're not really oppressed or anything.
We're just unfortunately not taken as seriously as we'd like.
Sceptics might say the people I met
were too young to make a decision so final
with their lives still ahead of them.
But it struck me their conviction was much more
than just a choice of sexual convenience.
They've carefully considered
how serious their own mental and physical issues are,
and they don't want to pass these on to any children,
and, as such, have opted to remove themselves as potential parents.
A course of action which could, perhaps,
cost society and the taxpayer far less in the long run.
And for those who choose sterilisation,
it's not just contraception, but a means to fundamentally
take control of their own bodies and their lives.
A growing number of young people in the UK are opting to be sterilised, even though they don't have any children of their own.
Poppy Begum travels the country to meet some of these women and men fighting to take control over their bodies - despite some medical advice to the contrary - and discovers the reasons behind their choice to remain child-free for life.