Compulsory sterilization
Compulsory sterilization, also known as forced or coerced sterilization, is a government-mandated program to involuntarily sterilize a specific group of people. Sterilization removes a person's capacity to reproduce, and is usually done through surgical procedures. Several countries implemented sterilization programs in the early 20th century.[1] Although such programs have been made illegal in most countries of the world, instances of forced or coerced sterilizations persist.
Rationalizations for compulsory sterilization have included eugenics, population control, gender discrimination, limiting the spread of HIV,[2] "gender-normalizing" surgeries for intersex people, and ethnic genocide. In some countries, transgender individuals are required to undergo sterilization before gaining legal recognition of their gender, a practice that the United Nations Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment has described as a violation of the Yogyakarta Principles.[3]
Governmental family planning programs emerged in the late 19th century and have continued to progress through the 21st 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 20th 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.
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 20th century were marked as part of the eugenics movement, with Nazi Germany's programs providing the most well-known examples of sterilization of disabled people, paired with encouraging ethnic 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).
As of 2013, 24 countries in Europe required sterilization for legal gender recognition and 16 countries did not provide for any possibility to change legal gender at all, which meant that transgender people could have challenges applying for jobs, opening bank accounts, boarding planes, or may not be able to do these things at all.[8]
On 1 February 2013, "United Nations Special Rapporteur on Torture (SRT) issued a report on abusive practices in health care settings that has important implications for LGBT people and people with intersex conditions" and:[9] In section 88, the SRT says States should:
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". The report references the involuntary sterilization of a number of specific population groups. They include:
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.[2]
As a part of human population planning[edit]
Human population planning is the practice of artificially altering the rate of growth of a human population. Historically, human population planning has been implemented by limiting the population's birth rate, usually by government mandate, and has been undertaken as a response to factors including high or increasing levels of poverty, environmental concerns, religious reasons, and overpopulation. While population planning can involve measures that improve people's lives by giving them greater control of their reproduction, some programs have exposed them to exploitation.[12]
In the 1977 textbook Ecoscience: Population, Resources, Environment, authors Paul and Anne Ehrlich, and John Holdren discuss a variety of means to address human overpopulation, including the possibility of compulsory sterilization.[13] This book received renewed media attention with the appointment of Holdren as Assistant to the President for Science and Technology, Director of the White House Office of Science and Technology Policy, largely from conservative pundits who have published scans of the textbook online.[14] Several forms of compulsory sterilization are mentioned, including the proposal for vasectomies for men with three or more children in India in the 1960s,[15] sterilizing women after the birth of their second or third child, birth control implants as a form of removable, long-term sterilization, a licensing system allotting a certain number of children per woman,[16] economic and quota systems of having a certain number of children,[17] and adding a sterilant to drinking water or food sources, although the authors are clear that no such sterilant exists nor is one in development.[18] The authors state that most of these policies are not in practice, have not been tried, and most will likely "remain unacceptable to most societies."[18]
Holdren stated in his confirmation hearing that he no longer supports the creation of an optimum population by the U.S. government.[19] However, the population control policies suggested in the book are indicative of the concerns about overpopulation, also discussed in The Population Bomb a book written by Paul R. Ehrlich and Anne Ehrlich predicting major societal upheavals due to overpopulation. As this concern about overpopulation gained political, economic, and social currency, attempts to reduce fertility rates, often through compulsory sterilization, were results of this drive to reduce overpopulation.[20] These coercive and abusive population control policies impacted people around the world in different ways, and continue to have social, health, and political consequences, one of which is lasting mistrust in current family planning initiatives by populations who were subjected to coercive policies like forced sterilization.[21] Population control policies were widely critiqued by women's health movement in the 1980s and 1990s, with the International Conference on Population and Development in 1994 in Cairo initiating a shift from population control to reproductive rights and the contemporary reproductive justice movement.[22][23] However, new forms of population control policies, including coercive sterilization practices are a global issue and a reproductive rights and justice issue.[24]
By country[edit]
International law[edit]
The Istanbul Convention prohibits forced sterilization in most European countries (Article 39).[25] Widespread or systematic forced sterilization has been recognized as a Crime against Humanity by the Rome Statute of the International Criminal Court in the explanatory memorandum. This memorandum defines the jurisdiction of the International Criminal Court.[26][27] It does not have universal jurisdiction, with the United States, Russia and China among the countries to exclude themselves.[28] Rebecca Lee wrote in the Berkeley Journal of International Law that, as of 2015, twenty-one Council of Europe member states require proof of sterilization in order to change one's legal sex categorization. Lee wrote that requiring sterilization is a human rights violation and that LGBTQ-specific international treaties may need to be developed in order to protect LGBTQ human rights.[29]