Young adults' access to contraception is shifting after the June 2022 United States Supreme Court Dobbs v. Jackson Women's Health Organization decision. This concurrent mixed-methods study measured young adults' use of and perceptions about tubal sterilization and vasectomy after the leaked Dobbs opinion in May 2022. Using national-level medical claims data from IQVIA, we conducted difference-in-differences analyses of tubal sterilizations and vasectomies by age and state policy; using open-text survey responses from national MyVoice surveys in 2022 and 2023, we thematically analyzed young adults' perspectives. Tubal sterilization and vasectomy visits increased after May 2022 among participants ages 19-26. Difference-in-differences analyses found significant increases in tubal sterilization and vasectomy visits in states deemed likely to ban abortion. Survey responses highlight fear of loss of bodily autonomy and changes to pregnancy plans after Dobbs. Young adults increasingly obtained permanent contraception post-Dobbs, especially in states deemed likely to ban abortion, and they continue to face challenges to their bodily autonomy, whether they feel pressured to seek permanent contraception because of abortion policy restrictions or whether they desire permanent contraception but experience barriers obtaining it.