Content Warning: This section of the guide includes discussion of forced sterilization and sexual trauma.

Lies are a motif throughout the novel illustrating challenges to Personal Agency and Autonomy. The title itself—Necessary Lies—hints at the novel’s central conflict. At the heart of this motif is the initial lie told to Mary Ella, who is falsely led to believe that she requires surgery for appendicitis when, in reality, she is being involuntarily sterilized. Because Mary Ella is not of legal age, this surgery is performed with her guardian’s permission. The welfare agency justifies this falsehood by claiming it was perpetrated in Mary Ella’s best interest: She will no longer be able to get pregnant, which could place a strain on the family’s already limited resources. By deeming the lie “necessary,” the act of sterilizing Mary Ella against her will is reframed not as an unethical act but as an honorable and wise choice.

Jane is the only social worker who feels that lying about sterilization is an ethical violation. She thus supports Ivy’s right to personal autonomy when the agency presses Jane to pursue sterilization for her. In Jane’s view, lying about sterilization implies that Ivy’s personal desires and freedoms are not valued and that the interests of the State should come first.