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Unfortunately, it's often not easy to do. Women have a notoriously difficult time convincing fertility doctors to sterilize them because "well what if you change your mind some time in the future?" or "well what if you eventually meet a man who wants kids?". Yeah. Basically, your wants and desires take back-seat to some hypothetical future you, or some hypothetical future man's wants and desires. Unfortunately, even some of my blue state friends have faced major road blocks in this quest. It's a disease that's only going to get worse if the Republicans take over the executive. :(