Involuntary Sterilisation of Marginalised Women

By Ronli Sifris

The (mis)use of power to perpetrate abuses or to entrench conditions of vulnerability is relevant in numerous contexts. One such context is the sterilisation of women without their full informed consent.

The use of the word “women”, rather than “people” is deliberate as it is predominately women, rather than men, who are targeted for involuntary sterilisation procedures.The reason for this is not immediately apparent given that a vasectomy is a much simpler operation, with fewer associated risks, as compared with any form of female sterilisation. One would therefore imagine that the scales of this practice would tip towards male sterilisation. And yet it is women who are disproportionately affected.

If we accept the fact that involuntary sterilisation disproportionately affects women, the next logical question is: why? It is interesting to consider not just the fact of the discriminatory application of involuntary sterilisation procedures but also the factors which influence such discrimination. The manner in which women have been targeted for involuntary sterilisation reflects existing power structures and the inferior position which women continue to occupy in society. Accordingly, Paula Abrams observes that “women are the target of most population programs because women have always been subject to extensive social control.”

Indeed, the power dynamics between the State and the individual are significantly magnified when gender is factored into the equation. Not only does the State exercise power over the individual in general, but the male State, the State where fundamental decisions are traditionally made by men within a male-centric framework which entrenches women’s inferior position, wields enormous power over the female citizen. Women’s bodies continue to be objectified and viewed as the property of society as a whole. As Johanna Bond comments:

Women’s bodies often serve as the site of bitter, violent struggles over national identity. In many patriarchal societies, men strive to protect and control women’s reproductive capacity, giving women’s reproduction the normative value of a male property right. Women’s reproduction is, therefore, not seen as a critical component of women’s human rights but, rather, as the prerogative of men.

In a society where women’s bodies are deemed the property of another, it is not surprising that sterilisation policies predominantly target women.

If a woman’s body belongs to the men in her life and the male paradigm of the State, then it is logical that involuntary sterilisation procedures should be carried out on women more than men, despite the simplicity of the medical procedure for men.

Thus when questioning the reason behind the discriminatory application of involuntary sterilisation procedures, it is necessary to view such procedures within the context of social norms which continue to place women in a subordinate position to men.

Further, within the category of “women”, certain women are placed above other women on the metaphorical social ladder. Certain types of women are more likely than others to be subjected to involuntary sterilisation procedures. Accordingly, in order to truly recognise the insidious nature of involuntary sterilisation and the power dynamics inherent in these procedures, one must appreciate that in general it is not only a form of discrimination against women but a form of intersectional discrimination.

In other words, involuntary sterilisation is generally a manifestation of multiple forms of discrimination, such as gender-based discrimination, race-based discrimination and class-based discrimination. As such, society’s power structures work together to render certain women vulnerable and then punish them for that vulnerability in the form of involuntary sterilisation.

Worldwide, there are numerous examples to demonstrate this point. For instance:

  • In the United States in the 1970s, the sterilisation movement disproportionately targeted African American, Hispanic and poor women.
  • In the 1990s during the authoritarian rule of Alberto Fujimori in Peru, over 200,000 mostly poor, uneducated, indigenous, rural women were subjected to involuntary sterilisation.
  • In recent years there has been growing recognition of the historic practice of forcibly sterilising Romani women, who are also subject to other forms of ethnic discrimination, in European countries including Slovakia, the Czech Republic and Hungary.
  • The targeting of HIV-positive women for involuntary sterilisation is a global issue, instances of which have been documented in countries including Chile, the Dominican Republic, Mexico, Venezuela, Namibia and South Africa.

“Involuntary sterilisation of women with

disabilities is a gendered practice that continues to

be carried out in Australia today.”

Sterilisation in the absence of full informed consent has also been an issue in Australia in the context of women and girls with disabilities. In fact, the prevalence of this practice globally is such that the United Nations Convention on the Rights of Persons with Disabilities, to which Australia is a party, directs itself specifically to the right of persons with disability to retain their fertility. The law in Australia relating to the sterilisation of children with disabilities was in part shaped by Marion’s case, the well-known 1990s High Court decision which held that court authorisation is required before a non-therapeutic sterilisation procedure may be performed on a child. It further held that authorisation may only be given where the procedure is in the child’s “best interests” and there is no feasible alternative.

Ongoing recent concerns about sterilisation of persons with disabilities in Australia led to the establishment of a Senate Committee to investigate the issue. In 2013, the Senate Committee released its report, in which it concluded that the involuntary sterilisation of women with disabilities is a gendered practice that continues to be carried out in Australia today.

As part of its recommendations, the Senate Committee suggested that the “best interests” approach be replaced with a “best protection of rights” approach. The Committee failed, however, to articulate what such an approach would look like. For example, in circumstances where a sterilisation procedure may promote a woman’s right to health but violate her right to reproductive autonomy, which right should prevail?

The involuntary sterilisation of women with disabilities is in part a manifestation of the systemic discrimination that people with disabilities suffer in many aspects of life and of the control which society at large, and the medical profession specifically, exercises over the lives of people with disabilities. It is an example of the continued devaluation of persons with disabilities in our society.

Women with disabilities have spoken out about the effect that sterilisation has had on their lives. According to one woman, ‘”It has resulted in loss of my identity as a woman, as a sexual being.” According to another, “I haven’t had the chance to grieve the loss of a part of me that should have been mine to choose whether I keep it or not.” And according to a third, “I was sterilised at the age of 18 without my consent. I still feel devastated by what happened because I will never be able to have children.”

The (mis)use of power to perpetrate abuses or to entrench conditions of vulnerability is relevant in numerous contexts. One such context is the sterilisation of vulnerable women without their full informed consent. Such procedures have been, and continue to be, carried out against marginalised women around the world, including in Australia.

Dr Ronli Sifris is a Lecturer in Law at Monash University and an Associate of the Castan Centre for Human Rights Law. She is the author of Reproductive Freedom, Torture and International Human Rights: Challenging the Masculinisation of Torture (Routledge, 2014).

Feature image: Rosino/Flickr.