Compulsory sterilization, also known as forced or coerced sterilization, refers to any government-mandated program to involuntarily sterilize a specific group of people. Sterilization removes a person's capacity to reproduce and is usually done by surgical or chemical means. Purported justifications for compulsory sterilization have included population control, eugenics, limiting the spread of HIV, and ethnic genocide. Forced sterilization can also occur as a form of racial discrimination. While not always mandated by law (de jure), there are cases where forced sterilization has occurred in practice (de facto). This distinction highlights the difference between official policies and actual implementation, where coerced sterilization takes place even without explicit legal authorization. Several countries implemented sterilization programs in the early 20th century. Although such programs have been made illegal in much of the world, instances of forced or coerced sterilizations persist.
Affected populations Governmental family-planning programs emerged in the late 1800s and have continued to progress through the 21st century. During this time, as feminists began advocating for reproductive choice, eugenicists and hygienists were advocating for low-income and disabled people to be sterilized or have their fertility tightly regulated in order to "clean" or "perfect" nations. 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. Many 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. 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. In the 1970s, population control programs focused on the "third world" to help curtail overpopulation 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, boarding planes, or opening bank accounts. Disabled women in Europe are also common targets of forced sterilization. "'So many times, you hear it's in the best interest of the woman,' said Catalina Devandas Aguilar, a former United Nations special rapporteur for disability rights. 'But often, it's because it's more convenient for the family or the institution that takes care of them.'"
On 1 February 2013, the 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. In section 88, the SRT says states should:Repeal any law allowing intrusive and irreversible treatments, including forced genital-normalizing surgery, involuntary sterilization, unethical experimentation, medical display, "reparative therapies," or "conversion therapies," when enforced or administered without the free and informed consent of the person concerned. He also calls upon them to outlaw forced or coerced sterilization in all circumstances and provide special protection to individuals belonging to marginalized groups. 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 several specific population groups. They include:
Women, especially in relation to coercive population control policies, and particularly including women living with HIV and indigenous and ethnic minority girls and women. Indigenous and ethnic minority women often face "wrongful stereotyping based on gender, race, and ethnicity." In the United States, the funding of mothers on welfare by HEW (Health, Education, and Welfare) covers roughly 90% of the cost, and doctors are likely to concur with the compulsory sterilization of mothers on welfare. Threats to cease welfare occur when women are hesitant to consent. Disabled people, especially those with intellectual disabilities. Women with intellectual disabilities are often treated as if they have no control, or should have no control, over their sexual and reproductive choices. Other rationales include menstrual management for women who have or are perceived to have difficulties coping with or managing menses, or whose health conditions (such as epilepsy) or behaviour are negatively affected by menses. Men with intellectual disabilities are also sterilized, sometimes using the justification that it provides greater sexual freedom. Intersex persons, who are often subjected to cosmetic and other non-medically indicated surgeries performed on their reproductive organs, without their informed consent or that of their parents, and without taking into consideration the views of the children involved, often as a "sex-normalizing" treatment. Transgender persons, "as a prerequisite to receiving gender-affirmative treatment and gender marker changes." This being 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. The report recommends a range of guiding principles for medical treatment, including ensuring patient autonomy in decision-making, non-discrimination, accountability, and access to remedies. Scholars have also emphasized the importance of including the voices and stories of those who have been affected.
As a part of human population planning 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. 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. 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. Several forms of compulsory sterilization are mentioned, including the proposal for vasectomies for men with three or more children in India in the 1960s, 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, economic and quota systems of having a certain number of children, 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. 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." Holdren stated in his confirmation hearing that he no longer supports the creation of an optimum population by the U.S. government. 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 a result of this drive to reduce overpopulation. 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. Population control policies were widely critiqued by the 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. However, new forms of population control policies, including coercive sterilization practices, are a global issue and a reproductive rights and justice issue.
By country
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, as of 2015, 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 was 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. Food subsidies under the group feeding program (VGF) were given to only those women with certificates showing that they had undergone tubal ligation. 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's 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).
Complications In the 1977 study, a one-year follow-up of 585 men sterilized at vasectomy camps in Shibpur and Shalna in rural Bangladesh showed that almost half of the men were dissatisfied with their vasectomies. 58% of the men said their ability to work had decreased in the last year. 2–7% of the men said their sexual performance decreased. 30.6% of the Shibpur and 18.9% of the Shalna men experienced severe pain during the vasectomy. The men also said they had not received all of the incentives they had been promised. According to another study on 5,042 women and 264 men who underwent sterilization, complications such as painful urination, shaking chills, fever for at least two days, frequent urination, bleeding from the incision, sores with pus, stitches or skin breaking open, weakness, and dizziness arose after the sterilization. The person's sex, the sponsor and workload in the sterilization center, and the dose of sedatives administered to women were significantly associated with specific postoperative complaints. Five women died during the study, resulting in a death-to-case rate of 9.9/10,000 tubectomies (tubal ligations); four deaths were due to respiratory arrest caused by overuse of sedatives. The death-to-case rate of 9.9/10,000 tubectomies (tubal ligation) in this study is similar to the 10.0 deaths/10,000 cases estimated on the basis of a 1979 follow-up study in an Indian female sterilization camp. The presence of a complaint before the operation was generally a good predictor of postoperative complaints. Centers performing fewer than 200 procedures were associated with more complaints. According to another study based on 20 sterilization-attributable deaths in the 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%), whereas 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.
I spoke to my husband about birth control measures. But he is not convinced. He was given two condoms, but he did not use them. My husband said we need more children, as we have land and property (in Rakhine). We don't have to worry about feeding them. District family planning authorities have managed to distribute just 549 packets of condoms among the refugees, amid reports that they are reluctant to use them. They have asked the government to approve a plan to provide vasectomies for men and tubectomies (tubal ligation) for women in the camps. One volunteer, Farhana Sultana, said the women she spoke to believed birth control was a sin, and others saw it as against the tenets of Islam. Bangladeshi officials say about 20,000 Rohingya refugee women are pregnant and 600 have given birth since arriving in the country, but this may not be accurate, as many births take place without formal medical help. Every month, 250 Bangladeshis undergo sterilization routinely under the government's sterilization program in the border district of Cox's Bazar, where the Rohingya refugee Muslims have taken shelter.
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 to prevent future pregnancies and so they can accurately plan their families. 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. 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
China
In 1978, Chinese authorities became concerned with the possibility of a baby boom that the country could not handle, and they initiated the one-child policy. To effectively deal with the complex issues surrounding childbirth, the Chinese government placed great emphasis on family planning. Because this was such an important matter, the government thought it needed to be standardized, and so to this end, laws were introduced in 2002. These laws uphold the basic tenets of what was previously put into practice, outlining the rights of individuals and how policy can be enforced. 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. These practices run contrary to the stated principles of the law and seem to differ on a local level. The Chinese government appears to be aware of these discrepancies in policy implementation at the local level. For example, the National Population and Family Planning Commission stated that "some persons concerned in a few counties and townships of Linyi did commit practices that violated the law and infringed upon legitimate rights and interests of citizens while conducting family planning work." This statement comes in reference to some charges of forced sterilization and abortions in Linyi City of Shandong Province. 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 implanted IUDs if they were 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. These measures have sometimes been characterised as part of an ongoing Uyghur genocide in the province.
Czechoslovakia and the Czech Republic Czechoslovakia carried out a policy to sterilize Romani women, starting in 1973 and continuing through the Velvet Revolution of 1989. In some cases, the sterilization was in exchange for social welfare benefits, and the people who were affected were given written agreements that described what was to be done to them but which they were unable to read due to their illiteracy. 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% (the 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. During the 1960s and 1970s, thousands of Greenlandic Inuit women and girls had IUDs placed without their consent. The birth rate in Greenland was reduced by around 50%. In 2022, Denmark and Greenland agreed to hold a two-year investigation into the program, known as the spiral case. 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.
India The Emergency in India from 1975 to 1977 resulted from internal and external conflict for the country and resulted in the misuse of power and human rights violations by the government. On 6 August 1976, the state of Maharashtra became the first governmental unit to enact legislation that mandated the 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 enactment. Before the measure could be passed, new elections were called, and the legislation was not passed. Another important case was the 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. 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, son of the then-Prime Minister Indira Gandhi, was largely responsible for what turned out to be a failed program. A strong mistrust of 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. According to Human Rights Law Network:
In September 2016, the Supreme Court of India directed the union government to ensure the discontinuation of 'sterilization camps' within the following three years and to induce the state governments to follow suit. It also charged the government to ensure proper monitoring of the programme, investigate sterilization failures, complications, or deaths, and increase the compensation amount in these cases. It further ordered the implementation of established legal, medical, and technical standards for sterilization [...] Women were made to lay on bare mattresses for the surgeries, with no post-surgery recuperation facilities. Often the women were made to wait up to five hours after registering, and by the time they reached the operating table, their aesthetic would have worn off. In places like Bhubaneshwar, Odisha, and Ferozpur, Uttar Pradesh, the doctors conducting surgeries would use bicycle pumps instead of an insufflator to introduce air into the women's abdomens (as reported by Shreelatha Menon). The doctor in Bhubaneshwar stated that he had done over 60,000 tubectomies, and many of them with bicycle pumps. In Kaparfora, Bihar, a woman was operated upon, even though she was pregnant, and suffered a miscarriage as a result. [...] Today, while laws may not announce eugenic aims, a hidden agenda to dispose of "undesirables" in society can still be discovered by looking beyond the face of the law. While many population control policies may appear benign on their face, upon further investigation the stated medical reasons for sterilization and the identification of groups to which the law applies are revealed to be morally and legally suspect. For example, compulsory sterilization laws often target LGBT+ people, especially transgender people.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 India, the issue of consent in regard to reproductive rights for disabled individuals has been fiercely debated.
Israel In the late 2000s, reports in the Israeli media claimed that injections of long-acting contraceptive Depo-Provera had been forced on hundreds of Ethiopian-Jewish immigrants, both in transit camps in Ethiopia and after they arrived in Israel. 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." Korean patients were also subjected to hard labor under the colonial Korean Leprosy Prevention Ordinances. 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:
In Japan, transgender people who want to change their gender legally must appeal to a family court under the GID Act, which was introduced in 2004. The procedure is discriminatory, requiring applicants to be single and without children under age 20, to undergo a psychiatric evaluation to receive a diagnosis of "gender identity disorder," and to be sterilized. The requirements rest on an outdated and pejorative notion that a transgender identity is a mental health condition and compel transgender people to undergo lengthy, expensive, invasive, and irreversible medical procedures. 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. In July 2024, the Supreme Court of Japan ruled that the Eugenic Protection Law passed in 1948 was unconstitutional and eliminated the 20-year statute of limitations for those affected by the law.
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."
Nigeria Laws in Ghana, Nigeria, and Tanzania involve references to medical operations where the intended benefit for the patient is not tied to any legal consequences for medical professionals involved. Specifically, the criminal code of Nigeria States that "performing with good faith and with reasonable care and skill a surgical operation upon any person for his benefit, if the performance of the operation is reasonable, having regard to the patient's state and to all the circumstances of the case." 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