Sterilization is a permanent birth control method or fertility controlling method adopted by people across the globe to eliminate the chances of getting pregnant. It removes a person’s ability to conceive irreversibly. While sterilization is one of the most frequently opted contraceptive arrangements in the form of vasectomy for men and tubal ligation for women, it has a dark history of coercion by the government.
Several countries are known to adopt forced sterilization or compulsory sterilization upon its masses, particularly women, people belonging to social and ethnic minorities, HIV patients, transgender people, people with disabilities, etc. Most often, the surgery conducted happens without the knowledge of the person it’s operated on. UN considers the forceful nature of this treatment as “a violation of fundamental human rights, including the right to health, the right to information, the right to privacy, the right to decide on the number and spacing of children, the right to found a family and the right to be free from discrimination.” This regressive practice imposed upon people can be traced back to the early 1870s, during the heyday of the Eugenics Law.
What is the Eugenics Law?
Eugenics Law and involuntary or forced sterilization go hand in hand. The Eugenics Law or Eugenics, meaning well-born”, is a term coined by Francis Galton in the late 1860s. He concluded that “humanity could be improved by encouraging the fittest members of society to have more children.” He observed upper-class English families and formed the theory that their characteristics of intelligence and other abilities are hereditary and thus making it a desirable trait to pass down to future generations.
The law initially gained traction in the animal breeding industry but soon shifted it to human traits. The goal was “to improve the natural, physical, mental, and temperamental qualities of the human family.” Authorities who implemented Eugenics felt the need to eliminate “undesirable” traits from human society. These traits included pauperism, mental disability, dwarfism, promiscuity, criminality, epilepsy, bipolar disorder, alcoholism, and feeblemindedness. They also considered environmental factors such as poor housing, poor nutrition, and inadequate education to be some of the determinants of the aforementioned “undesirable” traits.
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Compulsory sterilization became a greater part of this policy. They aimed to prevent the reproduction of people with “undesirable” traits by imposing forced sterilization upon people who possess it. The movement was adopted in the United States with Indiana becoming the first state to enact it as a law in 1907. Soon enough, many countries across the world implemented sterilization, abortion, or embryo destruction based on the eugenic principle.
One of the recently recorded instances of coercive sterilization in India was exposed in 2014 in Chattisgarh, but the origin dates back to the 1970s.
Women, who underwent sterilization surgery at a government mass sterilisation camp, pose for pictures inside a hospital at Bilaspur district in the eastern Indian state of Chhattisgarh. ANINDITO MUKHERJEE / REUTERS
During the 1975 Emergency, India, backed by the World Bank, the Swedish International Development Authority, and the UN Population Fund, launched a rampant hunt to sterilize a targeted population. Sterilization camps set across the country operated on men and women. Although these camps were part of the Family Planning Policy launched to curb India’s burgeoning population, the dynamics of it altered based on the Eugenics law.
Under the guise of population control, hasty and targeted sterilization was conducted on socially challenged people. A journalist told the BBC, “India has a dark history of state-sponsored population control, often with eugenic aims – targeting the poor and underprivileged.” With fundamental rights suspended during the Emergency, Sanjay Gandhi (son of the then Prime Minister, Indira Gandhi) expedited the mass sterilization campaign, mainly on poor men.
Government servants and doctors were paid heftily to meet their targets, that is to quickly sterilize as many underprivileged people as they could. Witnesses and victims shared the gruesome stories of policemen chasing them down to get them sterilized. “Targets are set – like cricket scores – to impress the authorities or funding agencies. But care for the patient is inadequate. Sometimes surgeons are not even properly qualified, and there’s no proper post-surgical care,” reports BBC.
Reportedly, 6.2 million men were sterilized in one year during the inception of these campaigns. Many of which resulted in death. Lack of proper medical facility and botched treatment claimed the lives of around two thousand men.
The focus soon shifted from men to women, and it persists even today. Shoddy mass sterilization camps set in rural India still garners hundreds of women for tubectomy. Women are lured with monetary incentives and benefits to undergo the procedure at these state-organized camps. The surgery is conducted on uneducated and poor women without informed consent. “The women are told it’s a very simple procedure, you’ll go home in the evening, it’ll be just one stitch on your stomach,” reports BBC.
The manner of operations is quite negligent as well. In Chhattisgarh, a camp was set in a dilapidated charity hospital where a single doctor operated on 83 women in six hours, even though government rules state a doctor can only perform surgery on 35 patients in a day. The standard 25 minutes laparoscopic tubectomy gets done within 5 minutes at this camp. Unfortunately, more women in rural India continue to prefer sterilization due to the monetary perks as well as lack of understanding about other contraceptives.
In a benchmark victory, lawmakers of the Czech Republic approved a bill to compensate thousands of Roma women who were “unlawfully sterilized by the state between 1966 and 2012.”
There are no official records to prove exactly how many women were affected by the state’s coercive system. Women who were in hospitals for C-section delivery were deceived by their doctors, who removed their fallopian tubes without their approval. The doctors took advantage of such women’s level of literacy or lack of informed judgment amid surgery. It wasn’t until years later that the women realize that they had been sterilized.
Roma women who were sterilised aged 21, protesting at Ostrava hospital last year over the illegal sterilisations. Vladimir Prycek/CTK/Alamy
“I was still bleeding, and the doctors told me I had to have an operation, that I had already had too many babies. I can’t read, but I signed the document he gave me. Only later did they ask if I understood what had been done,” a Roma woman told The Guardian.
Involuntary sterilization was legalized in Czechoslovakia in 1971. The objective was “to control the highly unhealthy Roma population through family planning and contraception.” This allowed doctors to perform sterilization on women and people with disabilities without their consent.
Romani women were also promised monetary benefits to undergo sterilization as part of a campaign boost. Although the law was overruled in 1993, the practice prevailed well until 2007.
In 2020, the South African Commission on Gender Equality released a report that investigated 48 complaints of women who were coerced into sterilization in South Africa.
Based on the report, pregnant HIV-positive women were forced by hospital officials while giving birth. They recount the treatment as “cruel, torturous or inhumane and degrading”. Many times, doctors and nurses threatened these women to sterilize themselves to limit the transmission of HIV from mother to child. The misconceptions regarding HIV-positive pregnant women progressed the sterilizations by the healthcare workers.
One of the complainants discussed her exchange with a nurse who said, “You HIV people don’t ask questions when you make babies. Why are you asking questions now? You must be closed up because you HIV people like making babies and it just annoys us. Just sign the forms, so you can go to theater.” It took years before some of these women figured out that they were sterilized when their attempts to conceive failed repeatedly.
According to research, South Africa is the biggest HIV epidemic with a 20% prevalence rate. HIV-positive women are stigmatized in general and are also made skeptical by healthcare professionals due to mother-to-child transmission.
The United States of America headed the Eugenics principle. Reportedly, Nazi Germany adopted sterilization of the jews following America’s mass sterilization of its people.
Following the state of Indiana who mandated sterilizations for “criminals, idiots, rapists, and imbeciles in state custody”, 32 more states legalized eugenics sterilization laws soon after. Over 60,000 people were sterilized in those states during the 20th century. Post World War II, the rationality of the targets broadened to curb population, immigration, and other rising issues. Immigrants, people of color, socially backward people were burdened by the abuse of sterilization.
Between the 1930s and the 1970s, many Native American women, black women, Latinx women underwent the heinous procedure. Around 1400 female inmates were sterilized in California between 1997 and 2013 in lieu of a sentence reduction, despite the laws being repealed by the 1970s.
In 2020, amidst the COVID-19 pandemic, a nurse working at the ICE (Immigration and Customs Enforcement) revealed improper medical treatment of the immigrants incarcerated there, along with questionable hysterectomies of immigrant women. Speaking about this issue, an official from the Center for American Progress said, “These racist, eugenicist practices are often sanctioned by U.S. law, which to this day allows for the sterilization of anyone deemed ‘unfit.”
The Eugenics Sterilization law was made effective in Japan from 1948 to 1996 when the country suffered from acute food shortage while building a war-ravaged nation. Over 25,000 people were sterilized during this period, of which 16,000 were involuntary. Most of these victims were physically, mentally, or cognitively challenged. The country legalized abortion for the time and carried out at least a million abortions in a year.
In 2019, the Japanese government passed a law to compensate the victims with JPY 3.2 million (USD 28,080.16). Prime Minister Shinzo Abe issued an apology, and said, “During the period the law was in effect, many people were subjected to operations that made them unable to have children based on their having a disability or another chronic illness, causing them great suffering. As the government that carried out this law, after deep reflection, I would like to apologize from the bottom of my heart.”
Meanwhile, transgender people of Japan still suffer due to coercive sterilization. Based on a Japanese Act, transgender people must undergo sterilization to change their gender assigned at birth. They must be diagnosed with “gender identity disorder” after compulsory psychiatric analysis.
“Japan should uphold the rights of transgender people and stop forcing them to undergo surgery to be legally recognized. The law is based on an outdated premise that treats gender identity as a so-called ‘mental illness’ and should be urgently revised,” says the director at Human Rights Watch, Japan.