User:Glandram/Compulsory sterilization

Brazil

During the 1970s–80s, the U.S. government sponsored family planning campaigns in Brazil, although sterilization was illegal at the time there. Dalsgaard examined sterilization practices in Brazil; analyzing the choices of women who opt for this type of reproductive healthcare in order to prevent future pregnancies and so they can accurately plan their families. While many women choose this form of contraception, there are many societal factors that 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 Sáo 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. Legal experts discussing the case have stated the sterilization of a woman in Brazil is legal when determined absolutely necessary, but it is not clear what qualifies as necessary.

Canada

Main article: Compulsory sterilization in Canada

Two Canadian provinces (Alberta and British Columbia) performed compulsory sterilization programs in the 20th century with eugenic aims. Canadian compulsory sterilization operated via the same overall mechanisms of institutionalization, judgment, and surgery as the American system. However, one notable difference is in the treatment of non-insane criminals. Canadian legislation never allowed for punitive sterilization of inmates.

The Sexual Sterilization Act of Alberta was enacted in 1928 and repealed in 1972. In 1995, Leilani Muir sued the Province of Alberta for forcing her to be sterilized against her will and without her permission in 1959. Since Muir's case, the Alberta government has apologized for the forced sterilization of over 2,800 people. Nearly 850 Albertans who were sterilized under the Sexual Sterilization Act were awarded C$142 million in damages.

In the 20th century, the eugenics movement grew in Canada, using forced sterilization as a method to control indigenous populations, alongside the Indian Act of 1876. Non-native physicians worked in the health system created for the native population and were encouraged to carry out sterilizations as a form of family planning. From the 1960s to the 1980s, aboriginal birth rate fell from 47% to 28%, and sterilization laws began to be repealed in the late 1970s. However, Indigenous women have come forward to report instances of coerced sterilization into 2018. Attorney Alisa Lombard has led several lawsuits on behalf of these Indigenous women with the support of the International Justice Resource Center (IJRC). The IJRC has noted the extent of the modern-day sterilization is unknown due to the lack of extensive investigation. After the Canadian government was publicly questioned by the UN regarding its involvement, it pledged to share any documentation of these events in its possession.

China

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 claims 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 that are 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 as part of the ongoing Uyghur genocide. 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.

According to researcher Adrian Zenz, 80% of all new IUD placements in China in 2018 were performed in Xinjiang, despite the region only constituting 1.8% of China's population. However, China's National Health Commission state that the figure is 8.7%. These IUD placements come alongside forced abortions for Uyghur women who have more children than the birth quota imposed by the government. It has been reported that these women have been threatened with or forced into the "re-education" camps if they do not comply with the coerced abortions or IUD placements. Within these camps, women have reported being tortured with electric sticks forced up their genital tracts. While this is not direct sterilization, it can affect the woman’s ability to conceive or safely give birth in the future. Reports from freed members of these camps detail being given shots, undisclosed cocktails of drugs, and surgeries that resulted in irreversible sterilization. The Chinese foreign ministry has stated that these allegations are “baseless,” and Chinese officials have repeatedly denied wrongdoing in the Uyghur “re-education” camps.

India

The Emergency in India from 1975 and 1977 resulted from internal and external conflict for the country, and resulted in misuse of power and human rights violations from the government. The state enacted 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 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 indeterminant amount 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 off the principle women are less likely to protest for their own rights. Many deaths occurred as a result of both the male and the female sterilization programs. These deaths were likely attributed to poor sanitation standards and quality standards in the Indian sterilization camps.

Sanjay Gandhi, the son of then-Prime Minister Indira Gandhi, was largely blamed for what turned out to be a failed program. A strong mistrust against family planning initiatives followed the highly controversial program, the effect of which continues into the 21st century. Sterilization policies are still enforced in India, targeting mostly indigenous and lower class women who are herded into the sterilization camps. The most recent abuse of family planning systems was highlighted by the death of 15 lower class women in a sterilization center in Chhattisgarh in 2014. Despite these deaths, sterilization is still the highest used method of birth control with 39% of women in India turning to sterilization in 2015.

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 legitimized the forced sterilization of patients at a Virginia home for the intellectually disabled. 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.

The Congress of Obstetricians and Gynecologists (ACOG) believes that mental disability is not a reason to deny sterilization. The opinion of ACOG is that "the physician must consult with the patient’s family, agents, and other caregivers" if sterilization is desired for a mentally limited patient. 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 request to sterilize mentally limited people who cannot give consent for themselves. The article recommend 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, that concluded 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. Discussion on the involuntary sterilization of disabled persons is now largely focused on the right of a guardian to request sterilization.

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 to not assist women during birth if they did sign consent forms to being sterilized. In most cases these forms were not explained to patients by medical personnel. However, the inquiry was hampered by hostile hospital staff and the sudden "disappearance" of patient files. An interview with one of these patients revealed that she did not learn that she had been sterilized during her C-section until a physician told her eleven years after that she had no uterus. 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 patient did not have HIV or any other life threatening condition, and her mother had not consented to the removal of her uterus. The report from the Commission for Gender Equality noted that some of the patients interviewed were given consent forms that they did not understand and were coerced to sign. The bulk of these operations were performed to prevent women who are HIV-positive from having more children. The HIV epidemic in South Africa has a prevalence of 13% and has largely affected the family structures in the country. Medical staff of these hospitals have justified their actions as an effort to stop the growing HIV numbers in the country that exhaust the healthcare systems. The Commission urged Health Minister Zweli Mkhize to take action against these state hospitals and to provide some form of redress to the many affected women.

Sweden

Main article: Compulsory sterilisation in Sweden

The eugenics program in Sweden was enacted in 1934 and was formally abolished in 1976. According to the 2000 governmental report, 21,000 were estimated to have been forcibly sterilized, 6,000 were coerced into a 'voluntary' sterilization while the nature of a further 4,000 cases could not be determined. 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. The Swedish state subsequently formed a commission of inquiry to determine victims that could claim compensation for trauma at the hands of the state. The sterilization program ended in the government paying over $22,000 in compensation to victims.

Until late 2012, Sweden implemented a law forcing transgender individuals to be sterilized before having their legal documents updated. This law was overturned relatively late, considering Sweden's status as a progressive country. After the law was declared unconstitutional, those who were forcibly sterilized under the law began to demand compensation. In 2017, the government announced that it will pay these compensations.