Compulsory sterilization

Compulsory sterilization, also known as forced or coerced sterilization, programs are government policies which force people to undergo surgical or other sterilization. The reasons governments implement sterilization programs vary in purpose and intent.[1] In the first half of the 20th century, several such programs were instituted in countries around the world, usually as part of eugenics programs intended to prevent the reproduction of members of the population considered to be carriers of defective genetic traits.[2]

Other bases for compulsory sterilization have included general population growth management, sex discrimination, "sex-normalizing" surgeries of intersex persons, limiting the spread of HIV,[1] and reducing the population of ethnic groups. The last is counted as an act of genocide under the Statute of Rome. Some countries require transgender people to undergo sterilization before gaining legal recognition of their gender, a practice that Juan E. Méndez, the United Nations Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment cites as a violation of the Yogyakarta Principles.[3]

Affected populations

Governmental family planning programs emerged in the late nineteenth century and have continued to progress through the twenty-first century. During this time, feminists began advocating for reproductive choice, but eugenicists and hygienists were advocating for low income and disabled peoples to be sterilized or have their fertility tightly regulated in order to clean or perfect nations.[4][5] The second half of the twentieth century saw national governments uptake of neo-Malthusian ideology that directly linked population growth to increased (and uncontrollable) poverty, which during the embrace of capitalism, meant that countries were unable to economically develop due to this poverty. Any type of birth control can count as a method of population control if once administered women have no control over its use. These contraceptive methods include sterilization, Depo-Provera, Norplant, and IUDs. Much of these governmental population control programs were focused on using sterilization as the main avenue to reduce high birth rates, even though public acknowledgement that sterilization made an impact on the population levels of the developing world is still widely lacking.[6] Early population programs of the twentieth century were marked as part of the eugenics movement, with Nazi Germany providing the most well-known example of sterilization of disabled people, paired with encouraging white Germans who fit the “Aryan race” phenotype to rapidly reproduce.[7] In the 1970s, population control programs focused on the “third world” to help curtail over population of poverty areas that were beginning to “develop” (Duden 1992).

In May 2014, the World Health Organization, OHCHR, UN Women, UNAIDS, UNDP, UNFPA and UNICEF issued a joint statement on Eliminating forced, coercive and otherwise involuntary sterilization, An interagency statement. The report references the involuntary sterilization of a number of specific population groups. They include:

  • Women, especially in relation to coercive population control policies, and particularly including women living with HIV, indigenous and ethnic minority girls and women. Indigenous and ethnic minority women often face "wrongful stereotyping based on gender, race and ethnicity".
    • Funding of mothers on welfare by HEW (Health, Education, and Welfare) covers roughly 90% of cost and doctors are likely to concur with the compulsory sterilization of mothers on welfare.[8] Threats to cease welfare occur when women are hesitant to consent.[8]
  • Disabled people, often perceived as asexual. Women with intellectual disabilities are "often treated as if they have no control, or should have no control, over their sexual and reproductive choices". Other rationales include menstrual management for "women who have or are perceived to have difficulties coping with or managing menses, or whose health conditions (such as epilepsy) or behaviour are negatively affected by menses."
  • Intersex persons, who "are often subjected to cosmetic and other non-medically indicated surgeries performed on their reproductive organs, without their informed consent or that of their parents, and without taking into consideration the views of the children involved", often as a "sex-normalizing" treatment.
  • Transgender persons, "as a prerequisite to receiving gender-affirmative treatment and gender-marker changes".

The report recommends a range of guiding principles for medical treatment, including ensuring patient autonomy in decision-making, ensuring non-discrimination, accountability and access to remedies.[1]