I recognized the roles that were placed on me very early. One persistent concept that I observed -- existing in our language, in our media -- was that women are not only supposed to have children, they are supposed to want to. This existed everywhere. It existed in the ways that adults spoke to me when they posed questions in the context of "when." "When you get married ..." "When you have kids ..." And these future musings were always presented to me like part of this American dream, but it always felt to me like someone else's dream. You see, a value that I have always understood about myself was that I never wanted children. And as a kid, when I would try to explain this, this disconnect between their roles and my values, they often laughed in the way that adults do at the absurdities of children. And they would tell me knowingly, "You'll change your mind." And people have been saying things like that to me my whole life. Otherwise polite conversation can turn intrusive fast. "Does your husband know?" (Laughter) "Do your parents know?" (Laughter) "Don't you want a family?" "Don't you want to leave anything behind?" And the primary buzzword when discussing childlessness, "That's selfish." There are countless reasons a woman may have for choosing to abstain from motherhood, the majority of them not self-prioritizing. But it is still socially acceptable to publicly vilify women as such, because none of these reasons have made it into the social narrative. When I was little and learning about the inevitability of maternity, it was never explained to me the commonness of these factors that women consider, like the risk of passing on hereditary illness, the danger of having to stop life-saving medication for the duration of your pregnancy, concern about overpopulation, your access to resources, and the fact that there are 415,000 children in the foster-care system in the United States at any given time. Reasons like these, many more, and the fact that I don't like to leave things of this magnitude to chance, all informed my decision to become surgically sterilized. I began my research eagerly. I wanted to fully understand all that was going to come with undergoing a tubal ligation, which is just another word for getting your tubes tied. I wanted to know approval to aftermath, satisfaction rates, risks, statistics. And at first, I was empowered. You see, the way the narrative has always been taught to me, I would have thought that women who didn't want children were so rare, and then I learned one in five American women won't be having a biological child -- some by choice, some by chance. (Applause) But I was not alone. But the more I read, the more disheartened I became. I read women's stories, trying desperately to get this procedure. I learned how common it was for women to exhaust their finances appealing to dozens of ob-gyns over many years, only to be turned down so many times, often with such blatant disrespect that they just gave up. Women reported that medical practitioners were often condescending and dismissive of their motivations, being told things like, "Come back when you're married with a child." But women who did have children, who went to go get this procedure, were told they were too young, or they didn't have enough children, which is very interesting, because the legal requirements in my state for getting this kind of surgery were, "Be at least 21 years old," "appear of sound mind, acting of your own accord," and "have a 30-day waiting period." And I was perplexed that I could meet all of these legal requirements and still have to face a battle in the exam room for my bodily autonomy. And it was daunting, but I was determined. I remember I dressed so professionally to that first appointment. (Laughter) I sat up straight. I spoke clearly. I wanted to give that doctor every piece of evidence that I was not the date of birth in that file. And I made sure to mention things like, "I just got my bachelor's degree and I'm applying to these doctoral programs, I'm going to study these things." And "my long-term partner has this kind of business," and "I've done research on this for months. I understand everything about it, all the risks." Because I needed the doctor to know that this was not a whim, not reactionary, not your 20-something looking to go out and party without fear of getting knocked up ... (Laughter) that this supported something integral to who I was. And I understand informed consent, so I fully expected to be reeducated on how it all worked, but ... At one point, the information being given to me started to feel agenda'd, interlaced with bias and inflated statistics. The questions began to feel interrogative. At first they were asking me questions that seemed to understand my situation better, and then it seemed like they were asking questions to try to trip me up. I felt like I was on the witness stand, being cross-examined. The doctor asked me about my partner. "How does he or she feel about all of this?" "Well, I've been with the same man for five years, and he fully supports any decision I make for my body." And he said, "Well, what happens in the future, if you change partners? What happens when that person wants children?" And I didn't quite know how to react to that, because what I was hearing was this doctor tell me that I'm supposed to disregard everything I believe if a partner demands children. So I told him not to worry about that. My stance on childbearing has always been first date conversation. (Laughter) (Cheering) (Laughter) He then asks me to consider how "in 20 years, you could really come to regret this" ... as though I hadn't. I told him, "OK, if I wake up one day and realize, you know, I wish I'd made a different decision back then, the truth is, I'd only removed a single path to parenthood. I never needed biology to form family anyway." (Applause) And I would much rather deal with that any day than deal with one day waking up, realize I'd had a child that I didn't really want or was prepared to care for. Because one of these affects only me. The other affects a child, their development, their well-being -- (Applause) and human beings are not to be gambled with. He then tells me why no one was going to approve this procedure, certainly not he, because of a concept called medical paternalism, which allows him, as my well-informed provider, to make decisions for me ... based on his perception of my best interest, regardless of what I, as the patient, want or believe. He takes this opportunity to step out and discuss my case with my potential surgeon, and through the door, I hear him describe me as a little girl. I was so offended. I wanted to defend myself. I wanted to explicitly explain to each one of these providers how they were treating me, that it was belittling and sexist, and I didn't have to take it. But I did take it. I swallowed every sharp word in my throat, clenched my jaw, and instead answered each one of their condescending questions and statements. I had come here looking for objectivity and support and instead I felt dismissed and silenced, and I hated myself for it. I hated that I was letting people disrespect me repeatedly. But this was my one shot. That was one of multiple consultations that I had to go to. At one point, I had seen five or six medical professionals in the same hour. The door to the exam room felt more like the door to a clown car. There's my primary, there's his colleague, the director, OK. It felt like I was asking them to infect me with smallpox instead of, I don't know, obtain birth control. But I didn't waver, and I was persistent, and I eventually convinced one of them to allow the procedure. And even as I am in the room, signing the consent forms and getting the hormone shots and tying up loose ends ... my doctor is shaking his head in disapproval. "You'll change your mind." I never really understood how strongly this society clings to this role until I went through this. I experienced firsthand, repeatedly, how people, be it medical providers, colleagues, strangers, were literally unable to separate me being a woman from me being a mother. And I've always believed that having children was an extension of womanhood, not the definition. I believe that a woman's value should never be determined by whether or not she has a child, because that strips her of her entire identity as an adult unto herself. Women have this amazing ability to create life, but when we say that that is her purpose, that says that her entire existence is a means to an end. It's so easy to forget the roles that society places on us are so much more than mere titles. What about the weight that comes with them, the pressure to conform to these standards ... the fear associated with questioning them, and the desires that we cast aside to accept them? There are many paths to happiness and fulfillment. They all look very different, but I believe that every one is paved with the right to self-determination. I want women to know that your choice to embrace or forego motherhood is not in any way tied to your worthiness or identity as spouses, as adults, or as women ... and there absolutely is a choice behind maternity, and it is yours and yours alone. Thank you. (Applause)