International law The
Istanbul Convention prohibits forced sterilization in most European countries (Article 39). 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. It does not have universal jurisdiction, with the United States, Russia and China among the countries to exclude themselves. Rebecca Lee wrote in the
Berkeley Journal of International Law that, , twenty-one
Council of Europe member states require proof of sterilization 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 to protect LGBTQ human rights.
Bangladesh Poverty Bangladesh has the highest
population density among countries with a population of at least 10 million people. The capital Dhaka is the fourth
most densely populated city in the world, and ranked as the world's second most unlivable city in 2015 according to the annual "
Liveability Ranking" by the
Economist Intelligence Unit.
Bangladesh has a long-running government-operated civilian sterilization program as a part of its population control policy, which aims at women and men living in poverty. The government offers 2,000
Bangladeshi Taka (US$16) for women who are persuaded to undergo
tubal ligation and for men who are persuaded to undergo
vasectomy. Women are also offered a
sari, and men are offered a
kurta to wear for undergoing sterilization. The referrer, who persuades the woman or man to undergo sterilization gets 300 Bangladeshi Taka (US$2.70). In 1965, the targeted number of sterilizations per month was 600–1,000, in contrast to the insertion of 25,000
IUDs, which was increased in 1978 to about 50,000 sterilizations per month on average. A 50% rise in the amount paid to men coincided with a doubling of the number of vasectomies between 1980 and 1981. One study conducted in 1977, when incentives were only equivalent to US$1.10 (at that time), indicated that between 40% and 60% of the men chose vasectomy because of the payment, who otherwise did not have any serious urge to get sterilized. The "Bangladesh Association for Voluntary Sterilization" alone performed 67,000 tubal ligations and vasectomies in its 25 clinics in 1982. The sterilization rate increased 25 percent each year. On 16 December 1982, Bangladesh's military ruler
Lieutenant General Hussain Muhammad Ershad launched a two-year mass sterilization program for Bangladeshi women and men. About 3,000 women and men were planned to be sterilized on 16 December 1982 (the opening day). Ershad's government trained 1,200 doctors and 25,000 field workers who must conduct two tubal ligations and two vasectomies each month to earn their salaries. The government wanted to persuade 1.4 million people, both women and men, to undergo sterilization within two years. By January 1983, 40,000 government field workers were employed in Bangladesh's 65,000 villages to persuade women and men to undergo sterilization and to promote usage of birth-control across the country. There are reports that often when a woman had to undergo a
gastrointestinal surgery, doctors took this opportunity to sterilize her without her knowledge. According to Bangladesh governmental website "National Emergency Service", the 2000 Bangladeshi Taka (US$24) and the sari/lungi given to the persons undergoing sterilizations are their "
compensations". The Bangladesh government also assures the poor people that it will cover all medical expenses if complications arise after the sterilization. For women who are persuaded to have an IUD inserted into their
uterus, the government also offers 150 Bangladeshi Taka (US$1.80) after the procedure and 240 Bangladeshi Taka (US$2.88) in three follow-ups, where the referrer gets 50 Bangladeshi Taka (US$0.60). For the women who are persuaded to have an
etonogestrel birth control implant placed under the skin in their upper arm, the government offers 150 Bangladeshi Taka (US$1.80) after the procedure and 210 Bangladeshi Taka (US$2.52) in three follow-ups, where the referrer gets 60 Bangladeshi Taka (US$0.72). According to another study based on 20 sterilization-attributable deaths in
Dacca (now Dhaka) and
Rajshahi Divisions in Bangladesh, from 1 January 1979, to 31 March 1980, overall, the sterilization-attributable death-to-case rate was 21.3 deaths/100,000 sterilizations. The death rate for vasectomy was 1.6 times higher than that for tubal ligation.
Anesthesia overdosage was the leading cause of death following tubal ligation, along with
tetanus (24%), where intraperitoneal hemorrhage (14%), and infection other than tetanus (5%) were other leading causes of death. Two women (10%) died from
pulmonary embolism after tubal ligation; one (5%) died from each of the following:
anaphylaxis from anti-tetanus serum,
heat stroke,
small bowel obstruction, and aspiration of vomitus. All seven men died from scrotal infections after vasectomy. According to a second epidemiologic investigation of deaths attributable to sterilization in Bangladesh, where all deaths resulting from sterilizations performed nationwide between 16 September 1980 and 15 April 1981 were investigated and analyzed, nineteen deaths from tubal ligation were attributed to 153,032 sterilizations (both tubal ligation and vasectomy), for an overall death-to-case rate of 12.4 deaths per 100,000 sterilizations. This rate was lower than that (21.3) for sterilizations performed in Dacca (now Dhaka) and Rajshahi Divisions from 1 January 1979 to 31 March 1980, although this difference was not statistically significant. Anesthesia overdosage, tetanus, and
hemorrhage (bleeding) were the leading causes of death.
Rohingya Bangladesh is planning to introduce a sterilization program in its overcrowded
Rohingya refugee camps, where nearly a million refugees are fighting for space, after efforts to encourage birth control failed. Since 25 August 2017, more than 600,000 Rohingya Muslims have fled from
Rakhine state,
Myanmar to neighboring Bangladesh, which is a Muslim-majority country, following a military crackdown against Rohingya Muslims in Rakhine. Sabura, a Rohingya mother of seven, said her husband believed the couple could support a large family.
Brazil During the 1970s–80s, the U.S. government sponsored family planning campaigns in Brazil, although sterilization was illegal at the time there. While many women choose this form of contraception, many societal factors impact this decision, such as poor economic circumstances, low rates of employment, and Catholic religious mandates that stipulate sterilization as less harmful than abortion. An important case in the legal history of compulsory sterilization in Brazil is the 2018 São Paulo case. Prosecutors filed to have a mother of eight forcibly sterilized after she was arrested on charges of drug trafficking. This motion was justified by the mother's poverty, substance abuse disorder, and inability to care for her children, and the judge ruled in favor of sterilization. The surgery was carried out, reportedly against the woman's will. These laws uphold the basic tenets of what was previously put into practice, outlining the rights of the individuals and outlining what the Chinese government can and cannot do to enforce policy. However, accusations have been raised from groups such as
Amnesty International, who have claimed that practices of compulsory sterilization have been occurring for people who have already reached their one-child quota. The policy requires a "social compensation fee" for those who have more than the legal number of children. According to Forbes editor Heng Shao, critics claim this fee is a toll on the poor but not the rich. But after 2016, the country has allowed parents to give birth to
two children. In 2017, the government offered to surgically remove the IUDs that had been implanted in women to force them to adhere to the one-child policy if they qualified to have a second child. The removal of these long-used IUDs is a major surgery, and many women are not informed of the risks associated with the surgery, such as bleeding, infection, and removal of the uterus.
Xinjiang Beginning in 2019, reports of forced sterilization in
Xinjiang began to surface. In 2020, public reporting continued to indicate that large-scale compulsory sterilization was being carried out. While national sterilization rates have fallen since the passing of the two child policy in 2016, there has been a sharp increase in the amount of sterilizations in Xinjiang. Many of these surgeries have been forced according to reports, but this is difficult to confirm due to the closed off nature of the area. The dissidents of the
Charter 77 movement denounced these practices in 1977–78 as a
genocide. A 2005 report by the Czech government's independent ombudsman,
Otakar Motejl, identified dozens of cases of coercive sterilization between 1979 and 2001, and called for criminal investigations and possible prosecution against several healthcare workers and administrators. Beginning in 2012, undergoing sterilization is a requirement for a change of name and/or gender markers on official documents for all transgender people in Czechia. In May 2024, the constitutional court found the laws requiring sterilization to violate EU human rights laws. The court set June 2025 as the deadline for the current government to draft replacement laws.
Colombia The period 1964–1970 started Colombia's population policy development, including the founding of PROFAMILIA. Through the Ministry of Health, the family planning program promoted the use of IUDs, the Pill, and sterilization as the main avenues for contraception. By 2005, Colombia had one of the world's highest contraceptive usage rates at 76.9%, with female sterilization being the highest percentage of use at just over 30% (second highest is the IUD at around 12% and the pill around 10%) (Measham and Lopez-Escobar 2007). In Colombia during the 1980s, sterilization was the second most popular choice of pregnancy prevention (after the Pill), and public healthcare organizations and funders (USAID, AVSC, IPPF) supported sterilization as a way to decrease abortion rates. While not directly forced into sterilization, women of lower socio-economic standing had significantly fewer options to afford family planning care, as sterilizations were subsidized.
Denmark 11,000 people were sterilized in Denmark from 1929 to 1967, about half of them against their will. The forced sterilization program was "[mainly] directed at people who were mentally handicapped" because of the popularity of eugenics at the time in Denmark. Until 11 June 2014, sterilization was required for legal sex change in Denmark.
Finland Finland required forced sterilization for transgender adults to change their sex legally,
until 3 April 2023.
Germany One of the first acts by
Adolf Hitler after the
Reichstag Fire Decree and the
Enabling Act of 1933 gave him de facto legal dictatorship over the
German state was to pass the
Law for the Prevention of Hereditarily Diseased Offspring (
Gesetz zur Verhütung erbkranken Nachwuchses) in July 1933. The law was signed by Hitler himself, and over 200 eugenic courts were created specifically as a result of this law. Under it, all doctors in the
Third Reich were required to report any patients of theirs who were deemed
intellectually disabled, characterized
mentally ill (including
schizophrenia and
manic depression),
epileptic, blind, deaf, or physically deformed, and a steep monetary penalty was imposed for any patients who were not properly reported. Individuals with
alcoholism or
Huntington's disease could also be sterilized. The individual's case was then presented in front of a court of
Nazi officials and public health officers who would review their medical records, take testimony from friends and colleagues, and eventually decide whether or not to order a sterilization operation performed upon the individual, using force if necessary. Though not explicitly covered by the law, 400 mixed-race "
Rhineland Bastards" were also sterilized beginning in 1937. The sterilization program went on until the war started, with about 600,000 people sterilized. By the end of
World War II, over 400,000 individuals were sterilized under the German law and its revisions, most within its first four years of being enacted. When the issue of compulsory sterilization was brought up at the
Nuremberg trials after the war, many Nazis defended their actions on the matter by indicating that it was the United States itself from which they had taken inspiration. The Nazis had many other eugenics-inspired
racial policies, including their
T-4 euthanasia program, in which around 70,000 people who were institutionalized or had birth defects were killed.
Guatemala Guatemala is one country that resisted family planning programs, largely due to lack of governmental support, including
civil war strife, and strong opposition from both the Catholic Church and Evangelical Christians until 2000, and as such, has the lowest prevalence of contraceptive usage in Latin America. In the 1980s, the archbishop of the country accused USAID of mass sterilizations of women without consent, but President Reagan backed a commission that found the allegations to be false.
Iceland Since 2019, nonconsensual sterilization has been forbidden in Iceland unless deemed medically necessary. However, this law only addresses the procedures of tubal ligation and surgical blocking of the fallopian tubes, excluding hysterectomies from the ban. Iceland's laws surrounding the legalization of sterilization practices also do not address the consent of the disabled individuals undergoing these procedures. In March 2023, mother Hermina Hreidarsdottir authorized a hysterectomy for her severely cognitively impaired 20-year-old daughter due to her abnormal menstrual cycle. Ms. Hreidarsdottir took the liberty of making this decision for her daughter without consulting her because she believed that this sterilization procedure would improve her daughter's quality of life. On 6 August 1976, the state of
Maharashtra became the first governmental unit to enact legislation mandating compulsory sterilization of men and women after the birth of a third child, passing the Family (Restrictions on Size) Bill on its third reading and sending it to the President of India for the required assent. The President reacted favorably and sent the bill back to the Maharashtra government with suggested amendments necessary for an enactment. Before the measure could be passed, new elections were called, and the legislation was not passed. Another important case was
Uttawar forced sterilisations drive, leading to 800 sterilisations, which made international news. Stopping short of forced sterilization, the national government enacted an incentive program for a family planning initiative that began in 1976 in an attempt to lower the exponentially increasing population. This program focused on male citizens and used propaganda and monetary incentives to encourage impoverished citizens to get sterilized. People who agreed to get sterilized would receive land, housing, and money or loans. This program led millions of men to receive vasectomies, and an undetermined number of these were coerced. There were reports of officials blocking off villages and dragging men to surgical centers for vasectomies. However, after much protest and opposition, the country switched to targeting women through coercion, withholding welfare or ration card benefits, and bribing women with food and money. This switch was theorized to be based on the principle women are less likely to protest for their own rights. Sterilization policies are still enforced in India, targeting mostly indigenous and lower-class women who are herded into the sterilization camps. According to
Human Rights Law Network:Forced sterilization has been an issue that has also affected the disabled population of women in
India. In 2016, the Right to Persons with Disabilities Act (RPWD) was introduced to legally address the problems faced by the disabled community and ensure equitable access to justice for all members of society:"While the RPWD Act took a step towards recognizing the issue of forced abortions under Section 92(f)[1] which states that any medical procedure performed on a disabled woman without her express consent that leads to the termination of pregnancy is punishable with an imprisonment term, there is still no specific mention of forced sterilization as a problem."There is no clause in the RPWD that addresses the notion of "expressed consent." In 2009, feminist NGO
Haifa Women's Coalition published a first survey on the story, which was followed up by
Israeli Educational Television a few years later. Ethiopian-Jewish women said they were intimidated or tricked into taking the shot every three months. In 2013, the
Israeli Health Ministry instructed
HMOs to stop automatically renewing Depo-Provera prescriptions for Ethiopian-Israelis if there was any chance that the patients did not fully understand the implications of the treatment.
Japan In the first part of the reign of Emperor Hirohito, the Japanese government promoted increasing the number of healthy Japanese, while simultaneously decreasing the number of people who were afflicted with intellectual disability, disability, genetic disease, and other conditions that led to inferiority in the Japanese gene pool. The
Leprosy Prevention laws of 1907, 1931, and 1953 permitted the segregation of patients in sanitariums where forced abortions and sterilization were common, and authorized punishment of patients "disturbing peace". Under the colonial Korean
Leprosy prevention ordinance, Korean patients were also subjected to hard labor. The "National Eugenic Law" was promulgated in 1940 by the
Konoe government, after rejection of the original "Race Eugenic Protection Law" in 1938. From 1940 to 1945, sterilization was done to 454 Japanese persons under this law. Appx. 25,000 people, including 8,500 under (forced or spontaneous) consent, were surgically processed until 1995. According to the
Eugenic Protection Law (1948), sterilization could be enforced upon criminals "with genetic predisposition to commit crime", patients with genetic diseases, including mild ones such as total color-blindness,
hemophilia,
albinism,
ichthyosis, and mental affections such as schizophrenia, manic-depression possibly deemed occurrent in their opposition and epilepsy. The mental sicknesses were added in 1952. In early 2019, Japan's supreme court upheld a requirement that transgender people must have their reproductive organs removed. In March 2019, Japan's legal policy about transgender people was:The last stipulation of the GID Act concerning forced sterilization was recently overturned in October 2023. Japan's supreme court ruled that requiring transgender people to undergo sterilization so that they can legally change their gender identity is unconstitutional. The court stated that forcing the sterilization of the plaintiff, a transgender woman, as a requirement to change her gender on her Japanese family registry certificate was a restriction on "her freedom not to harm herself against her will". The court did not address the other requirement under the GID Act, which outlines that transgender people must undergo transition surgery to legally register as the gender with which they identify.
Kenya In Kenya, HIV was considered an ongoing issue, and the governor believed that compulsory sterilization of women infected with HIV could stop the spread of the virus. In 2012, a report titled "Robbed of Choice" sparked outrage. The report outlined the experiences of 40 women infected with HIV who had been sterilized against their will. 5 of the 40 women filed a lawsuit against the government of Kenya, claiming violations of their Health and Human Rights. The majority of the women who were sterilized knew nothing about the procedure or its consequences, which was one reason they did not push the issue. The President thought it would be good to keep a list of women who had been infected with HIV, but by naming these women, many of them did not want to receive medical treatment due to the shame associated with the virus. "The authors concluded that punitive and restrictive laws related to pregnancy have numerous adverse consequences—both health-related and socioeconomic—for women, and urged human rights groups to work with government institutions to protect and fulfill women's fundamental reproductive rights." In Nigeria, young girls with intellectual disabilities are susceptible to non-consensual sterilization. No current laws explicitly prevent involuntary sterilization. The laws that currently surround and may apply to the issue do not help prevent it. The African Commission on Human and Peoples' Rights declared that involuntary sterilization violates the right to “equality and non-discrimination, dignity, liberty and security of the person.” Involuntary sterilization in Nigeria is more common for girls with intellectual disabilities than for boys with intellectual disabilities, and more common for those with intellectual disabilities, specifically in comparison to other disabilities. Involuntary sterilization commonly occurs when relatives initiate it. In several studies involving parents of girls with disabilities who had initiated involuntary sterilization, respondents said that the primary reason for sterilization was to prevent pregnancy either for financial reasons or due to the risk of offspring with intellectual disabilities. However, similar motivations for sterilization were not common for girls without intellectual disabilities. There is also a gendered element of sterilization as the Nigerian law code penalizes emasculation, which makes it so that men cannot reproduce. There is no such penalization for the sterilization of women. A report made in El Salvador, Honduras, Mexico, and Nicaragua concluded that women living with HIV, and whose health providers knew about it at the time of pregnancy, were six times more likely to experience forced or coerced sterilization in those countries. In addition, most of these women reported that health providers told them that living with HIV cancelled their right to choose the number and spacing of the children they want to have as well as the right to choose the contraceptive method of their choice; provided misleading information about the consequences for their health and that of their children and denied them access to treatments that reduce mother-to-child HIV transmission to coerce them into sterilization. This happens even when the health norm NOM 005-SSA2-1993 states that family planning is "the right of everyone to decide freely, responsibly and in an informed way the number and spacing of their children and to obtain specialized information and proper services" and that "the exercise of this right is independent of gender, age, and social or legal status of persons". During his presidency, Fujimori put in place a program of forced sterilizations against
indigenous people (mainly the
Quechuas and the
Aymaras), in the name of a "
public health plan", presented on 28 July 1995. The plan was principally financed using funds from
USAID (36 million dollars), the
Nippon Foundation, and later, the
United Nations Population Fund (UNFPA). On 9 September 1995, Fujimori presented a Bill that would revise the "General Law of Population", to allow sterilization. Several contraceptive methods were also legalized, all measures that were strongly opposed by the
Roman Catholic Church, as well as the Catholic organization
Opus Dei. In February 1996, the World Health Organization (WHO) itself congratulated Fujimori on his success in controlling demographic growth. In September 2001, Minister of Health
Luis Solari launched a special commission into the activities of the voluntary surgical contraception, initiating a parliamentary commission tasked with inquiring into the "irregularities" of the program, and to put it on an acceptable footing. In July 2002, its final report ordered by the Minister of Health revealed that between 1995 and 2000, 331,600 women were sterilized, while 25,590 men submitted to vasectomies. It is unclear as to any progress in matter of the execution (debido ejecución sumaria) of the suspect in the course of any proof of their relevant accusations in the legal sphere of the constituted people in vindication of the rights of the people of South America. It may carry a parallel to any suspect cases for international investigation in any other continent, and be in the sphere of medical genocide. As of 12 December 2021:
Russia Since children cannot legally live in psychoneurologic internats in Russia (state-run residential institutions for adults with mental disabilities), and there are no institutions where internats' patients can live with their children, almost all pregnancies within PNIs are aborted. During abortions, PNI patients are also often subjected to forced sterilization - their
fallopian tubes are tied, motivated by allegedly detected "serious complications".
South Africa In
South Africa, there have been multiple reports of HIV-positive women sterilized without their informed consent and sometimes without their knowledge. The Commission for Gender Equality investigated 48 sterilizations that were performed in fifteen state hospitals without patient consent from 2002 to 2005. This investigation into these hospitals revealed that medical providers threatened not to assist women during birth if they did not sign consent forms to be sterilized. She went to the hospital were the surgery was performed and was told by a physician that it was done to save her life and consent was received from her mother. The bulk of these operations were performed to prevent women who are HIV-positive from having more children. Of those sterilized 93% were women. The reasons given for these sterilizations included mental slowness, racial differences, antisocial behavior, promiscuous behavior, and other behaviors deemed inappropriate. At the time, the government saw itself as a forward-thinking and enlightened welfare state. Until December 2012, Swedish law forced transgender individuals to be sterilized before having their legal documents updated. After the law was repealed, those who were forcibly sterilized under the law began to demand compensation.
Switzerland Compulsory sterilization in
Switzerland was practiced from the early 20th century until the 1970s, driven by
eugenics, psychiatric evaluations, and social welfare policies. Several thousand individuals, mostly women, were sterilized based on psychiatric assessments. Initially, castration was used for eugenic purposes, but by the 1910s, sterilization became the preferred method to prevent procreation among those deemed "hereditarily burdened" or socially dependent. From the mid-1920s, sterilizations were often linked to abortion approvals, involving de facto coercion despite formal consent, particularly in urban cantons like
Zürich,
Basel, and
Bern. Over 90% of sterilizations targeted women until the mid-20th century due to unwanted pregnancies and gendered behavioral norms. Men faced castration from the 1920s as a criminal policy measure to reduce sexual delinquency, affecting at least 500–800 men until the 1970s when chemical options emerged. Rural Catholic cantons like
Fribourg and
Valais had fewer sterilizations compared to urban Protestant areas. Since 2005, the
Sterilization Act permits sterilization only for adults capable of discernment with free, informed written consent. Sterilization of those incapable of discernment is generally prohibited, with rare exceptions for individuals over 16, requiring approval from adult protection authorities and expert assessments to confirm necessity and lack of alternatives.
United Kingdom In 1911, while he was serving as
Home Secretary,
Winston Churchill favored the sterilization of
feeble-minded persons.
Reginald McKenna, who succeeded Churchill as Home Secretary, introduced the
Feeble-Minded Control Bill, a bill that would enact forcible sterilization of such individuals; the bill gained the support of the
Anglican archbishops of
Canterbury and
York, that included forced sterilization. Despite support for the bill by the Anglican
primates, English writer
G. K. Chesterton and the
Catholic Church in the United Kingdom led a successful effort to defeat that clause's inclusion in what would eventually become the
1913 Mental Deficiency Act, though the final act did create a scheme for state-enforced
confinement of mentally disabled persons in specialized institutions. In 1934, the
Brock Report recommended sterilisation of people who were mentally and physically disabled, but its proposals did not gain enough support to be made law. In one specific case in 2015, the
Court of Protection of the
United Kingdom ruled that a woman with six children and an IQ of 70 should be sterilized for her own safety because another pregnancy would have been a "significantly life-threatening event" for her and the fetus and was not related to eugenics.
United States During the
Progressive Era ( to 1920), the United States was the first country to undertake compulsory sterilization programs concertedly for eugenics.
Thomas C. Leonard, professor at Princeton University, describes American eugenics and sterilization as ultimately rooted in economic arguments and further as a central element of Progressivism alongside minimum wage laws, restricted immigration, and the introduction of
pension programs. The heads of the programs were avid proponents of eugenics and frequently argued for their programs which achieved some success nationwide mainly in the first half of the 20th century.
Eugenics had two essential components. First, its advocates accepted as axiomatic that a range of mental and physical handicaps—blindness, deafness, and many forms of
mental illness—were largely, if not entirely, hereditary in cause. Second, they assumed that these scientific hypotheses could be used as the basis of social engineering across several policy areas, including family planning, education, and immigration. The most direct policy implications of eugenic thought were that "mental defectives" should not produce children, since they would only replicate these deficiencies, and that such individuals from other countries should be kept out of the polity. The principal targets of the American sterilization programs were intellectually disabled people and the mentally ill, but also targeted under many state laws were the deaf, the blind, people with epilepsy, and the physically deformed. The definition of who was "fit" and who was "unfit" was also heavily biased by racism, classism, and sexism. Someone could be declared "unfit" or "feeble-minded" for reasons such as race, immigration status, poverty, promiscuity/becoming pregnant out of wedlock, criminal behavior, and more. A relative minority of sterilizations targeting crime took place in
prisons and other penal institutions. In the end, over 65,000 individuals were sterilized in 33 states under state compulsory sterilization programs in the United States. The number of undocumented cases likely far exceeded this number. The first state to introduce a compulsory sterilization bill was
Michigan, in 1897, but the proposed law failed to pass. Eight years later,
Pennsylvania's state legislators passed a sterilization bill that was vetoed by the governor.
Indiana became the first state to enact sterilization legislation in 1907, followed closely by
California and
Washington in 1909. From 1912 to 1921, critics of eugenics challenged eight sterilization laws and had seven struck down across various states. Over the next four years, multiple states passed new compulsory sterilization laws that met the standards of the new rulings. Virginia's new law led to the landmark
Buck v. Bell case that upheld the Virginia compulsory sterilization law, with the infamous closing by Justice Oliver Wendell Holmes that "three generations of imbeciles are enough." In the 1920s, Eugenicists were particularly interested in black women in the South and Latina women in the Southwest to break the chain of welfare dependency and curb the population rise of non-white citizens. The 1973 involuntary sterilization of
Minnie Lee and Mary Alice Relf, aged 12 and 14, in Montgomery, Alabama resulted in the
Relf v. Weinberger lawsuit that brought national attention to thousands of Black, Latina, and Indigenous women who were coercively sterilized. The plaintiffs lost the case, but numerous changes to the consent process were made following the ruling, such as offering consent forms in the patient's native language, and a 72-hour waiting period between giving consent and undergoing the procedure. The
Oregon Board of Eugenics, later renamed the Board of Social Protection, existed until 1983, with the last forcible sterilization occurring in 1981. The U.S.
commonwealth of
Puerto Rico had a sterilization program as well. Some states continued to have sterilization laws on the books for much longer after that, though they were rarely, if ever, used. California sterilized more than any other state by a wide margin and was responsible for over a third of all sterilization operations. Information about the California sterilization program was produced into book form and widely disseminated by eugenicists
E. S. Gosney and
Paul Popenoe, which was said by the government of Adolf Hitler to be of key importance in proving that large-scale compulsory sterilization programs were feasible. In recent years, the governors of many states have made public apologies for their past programs, beginning with Virginia and followed by Oregon The 27 states where sterilization laws remained on the books (though not all were still in use) in 1956 were:
Arizona,
California,
Connecticut,
Delaware,
Georgia,
Idaho,
Indiana,
Iowa,
Kansas,
Maine,
Michigan,
Minnesota,
Mississippi,
Montana,
Nebraska,
New Hampshire,
North Carolina,
North Dakota,
Oklahoma,
Oregon,
South Carolina,
South Dakota,
Utah,
Vermont,
Virginia,
Washington,
West Virginia and
Wisconsin. Some states still have forced sterilization laws in effect, such as Washington state. In 2013 North Carolina announced that it would spend $10 million beginning in June 2015 to compensate men and women who were sterilized in the state's eugenics program; North Carolina sterilized 7,600 people from 1929 to 1974 who were deemed socially or mentally unfit. The inability to pay for the cost of raising children has been a reason courts have ordered coercive or compulsory sterilization. In June 2014, a Virginia judge ruled that a man on probation for child endangerment must be able to pay for his seven children before having more children; the man agreed to get a vasectomy as part of his plea deal. In 2013, an Ohio judge ordered a man owing nearly $100,000 in unpaid child support to "make all reasonable efforts to avoid impregnating a woman" as a condition of his probation. Kevin Maillard wrote that conditioning the right to reproduction on meeting child support obligations amounts to "constructive sterilization" for men unlikely to make the payments. As of 19 July 2021 it was reported that:
Georgia immigration detention center 2020 In 2020, four
non-profit organizations (which are listed below) joined Dawn Wooten to accuse a
privately owned U.S. immigration detention center in the U.S. state of
Georgia of forcibly sterilizing women. The reports claimed that a doctor conducted unauthorized medical procedures upon women who were detained by
Immigration and Customs Enforcement. Dawn Wooten was a nurse and former employee. She claims that a high rate of sterilizations was performed upon Spanish-speaking women and women who spoke various indigenous languages that are common in Latin America. Wooten said that the center did not obtain proper consent for these surgeries or lied to women about the medical procedures. More than 40 women submitted testimony in writing to document these abuses. In September 2020,
Mexico demanded more information from U.S. authorities about medical procedures that were performed upon illegal immigrants in detention centers, after allegations that six Mexican women were sterilized without their consent. The ministry said that consulate personnel had interviewed 18 Mexican women who were detained at the center, none of whom "claimed to have undergone a hysterectomy". Another woman said that she had undergone a gynecological operation, although there was nothing in her detention file to support that she had agreed to the procedure.
Effect on disabled persons As stated previously, eugenics in the United States spread to target mentally disabled persons. Sterilization rates across the country were relatively low, with the sole exception of California, until the 1927
U.S. Supreme Court decision in
Buck v. Bell, which upheld under the
U.S. Constitution the forced sterilization of patients at a
Virginia home for intellectually disabled people. In the wake of that decision, over 62,000 people in the United States, most of them women, were sterilized. The number of sterilizations performed per year increased until another Supreme Court case,
Skinner v. Oklahoma, 1942, complicated the legal situation by ruling against sterilization of criminals if the equal protection clause of the constitution was violated. That is, if sterilization was to be performed, then it could not exempt
white-collar criminals. This case, however, does not directly overturn the decision made in
Buck v. Bell. Instead, it invalidates the central argument of the decision, and has been used in several cases to deny guardians the right to sterilize the disabled person under their care. In 2003, Douglas Diekema wrote in Volume 9 of the journal Mental Retardation and Developmental Disabilities Research Reviews that "involuntary sterilization ought not be performed on mentally retarded persons who retain the capacity for reproductive decision-making, the ability to raise a child, or the capacity to provide valid consent to marriage." The
Journal of Medical Ethics claimed, in a 1999 article, that doctors are regularly confronted with requests to sterilize mentally limited people who cannot give consent for themselves. The article recommends that sterilization should only occur when there is a "situation of necessity" and the "benefits of sterilization outweigh the drawbacks." The
American Journal of Bioethics published an article in 2010, which concluded that the interventions used in the
Ashley treatment may benefit future patients. These interventions, at the request of the parents and guidance from the physicians, included a
hysterectomy and surgical removal of the
breast buds of the mentally and physically disabled child. Proponents of the treatments argue that it protects disabled persons from sexual assault, unwanted pregnancy, and difficulties of menstruation. The interventions are still legal in many states, despite the argument that it violates a person's constitutional right to avoid unwanted intrusions. California, the first state in the U.S. to enact compulsory sterilization based on eugenics, sterilized all prison inmates under the 1909 sterilization law. One of the most famous cases of this was
People v. Darlene Johnson, during which Johnson, a woman charged with child abuse sentenced to seven years in prison, was offered probation and a reduced prison sentence if she agreed to use
Norplant. In addition to child abuse cases, some politicians proposed bills mandating Norplant use among women on public assistance as a requirement to maintain welfare benefits. Some scholars argue that the extensive consent process and 30-day waiting period go beyond preventing instances of coercion and serve as a barrier to desired sterilization for women relying on public insurance. In September 2014, California enacted Bill SB 1135 that bans sterilization in correctional facilities, unless the procedure is required in a medical emergency to preserve an inmate's life.
Puerto Rico Puerto Rican physician Lanauze Rolón founded the League for Birth Control in
Ponce, Puerto Rico in 1925. The League was quickly squashed by opposition from the
Catholic church. A similar League was founded seven years later, in 1932, in
San Juan and continued in operation for two years before opposition and lack of support forced its closure. which went into effect on 13 May 1937. It was a
birth control and eugenic sterilization law that allowed the dissemination of information regarding birth control methods and legalized the practice of birth control. By 1965, approximately 34 percent of women of childbearing age had been sterilized, two thirds of whom were still in their early twenties. The law was repealed on 8 June 1960. Such rhetoric combined with eugenics ideology of reducing "population growth among a particular class or ethnic group because they are considered...a social burden," was the philosophical basis for the 1937 birth control legislation enacted in Puerto Rico. The legalization of sterilization was followed by a steady increase in the popularity of the procedure, both among the Puerto Rican population and among physicians working in Puerto Rico. Though sterilization could be performed on men and women, women were most likely to undergo the procedure. They cite the private and government funding of sterilization, coercive practices, and the eugenics ideology of Puerto Rican and American governments and physicians as evidence of a mass-sterilization campaign.
Effects When the United States took a census of Puerto Rico in 1899, the birth rate was 40 births per thousand people. She specifically analyzed data from the survey for women ages 20 to 49 who had at least one birth, resulting in an overall sample size of 1,071 women. In November 2007, a report by the
United Nations Committee Against Torture reported that "the large number of cases of forced sterilization and removal of reproductive organs of women at reproductive age after their first or second pregnancy indicate that the Uzbek government is trying to control the birth rate in the country" and noted that such actions were not against the national Criminal Code. In response to that, the Uzbek delegation to the associated conference was "puzzled by the suggestion of forced sterilization, and could not see how this could be enforced". Reports of forced sterilizations,
hysterectomies, and
IUD-insertions first emerged in 2005, although it is reported that the practice originated in the late 1990s, with reports of a secret decree dating from 2000. and which came into force in 2009. In 2005, Deputy Health Minister Assomidin Ismoilov confirmed that doctors in Uzbekistan were being held responsible for increased birth rates. In 2010, the Ministry of Health passed a decree stating all clinics in Uzbekistan should have sterilization equipment ready for use. The same report also states that sterilization is to be done voluntarily with the informed consent of the patient. Doctors also reported to Antelava that there are quotas they must reach every month on how many women they need to sterilize. These orders are passed on to them through their bosses and, allegedly, from the government. The Uzbek version of
RFE/RL reported that, with this statement, Karimov indirectly admitted that forced sterilization of women is indeed taking place in Uzbekistan.
Norway,
Estonia,
Switzerland,
Iceland, and some countries in
Latin America (including
Bolivia,
Chile, and the
Dominican Republic). In Europe, Roma and Traveler communities are at particular risk of sterilisation, whereas in Latin America, indigenous people and Afro-descendants are disproportionately affected. ==See also==