Yeah I hear you, I live in the PNW and it still took me three obgyns before a doctor would finally approve. At the time I was a child free never pregnant 22 year old,. The doctor still required that I write a letter stating I understand it's irreversible. Still pretty condescending imo. You aren't wrong, it's hard and depending where you are in the us impossible to access humane women's healthcare.

But you are wrong to assume women seeking sterilizations all get hysterectomies. There are at least a handful of options, I got Essure but I think that it's no longer on the market. I walked out of my appointment, still more of an ordeal for ladies but not necessarily as dramatic as a hysterectomy.