[AnAmericanMother]

That is correct and my understanding as well.

The way my rector explained it to me is that medical reasons that require a tubal ligation, hysterectomy, or hormone treatment (endometriosis, dysmenorrhea, etc.) are o.k., so long as the couple doesn't *intend* to avoid conception. In other words, the infertility is a 'secondary effect'.

[Campion]

The way my rector explained it to me is that medical reasons that require a tubal ligation

There's no medical indication for a tubal ligation except to prevent pregnancy. It's never permitted.