NEW YORK CITY — On June 18, multiple United Nations organizations released a statement on the ethics of sterilization.
The World Health Organization (WHO), OHCHR, UNAIDS, UNDP, UNFPA, UNICEF and U.N. Women published a report describing the injustices perpetrated against persons who are forcibly sterilized and methods to stop these injustices. The report advocates for sterilization as a means of contraception, but only when consciously chosen. These organizations call for “eliminating forced, coercive and otherwise involuntary sterilization.”
The report details the history of forced sterilization, which became institutionalized in the late 18th century and rose in popularity with eugenics. While most countries reformed their sterilization policies after World War II, many groups — such as women, ethnic minorities, persons with disabilities and transgender and intersex persons — are still being targeted by unethical sterilization laws.
The report then details these groups that continue to be sterilized and the stigmas responsible. Women are, by far, the sex most affected by involuntary sterilization. Women afflicted with HIV are a popular target. There is a belief that these women are incapable of caring for children. The reality is that with treatment, women can care for their children, and the risk of transmission can drop below 5 percent.
Ethnic minorities like the Roma in Europe are also targets for forced sterilization, as their alienation from general society has led to fear of their population.
Under the justification that it is “for their own good,” persons with disabilities are also forcibly sterilized. Sometimes this occurs just to alleviate the stress of managing the menstruation of a woman who lacks the mental capacity to take care of it herself, with no regard to her desire for children.
The last group specified by the report is comprised of transgender and intersex individuals. Intersex individuals are often given cosmetic surgery in infancy which leads to sterilization. Some countries also have laws requiring sterilization before a person can receive legal documents that indicate their desired sex.
This was the case in Denmark until a recent vote. The report prompted the Danish government to revoke a law requiring sterilization for transgender persons. Now all that is required is six “months of reflection” after the age of 18 to receive documents. The change in legislation will take effect on September 1.
Forced sterilization was declared unethical in 1992 under the European Court of Human Rights, but this latest report seems to finally be triggering the desired changes in Europe. Denmark will join the Netherlands and Sweden in banning sterilization for persons wanting to change their legal genders.
Sterilization often happens through coercion. Women undergoing pain, particularly during labor, are sometimes asked to sign forms they do not fully understand. Sometimes they believe the procedure they are agreeing to is a caesarian section, but they are unwittingly agreeing to sterilization. Family members who give consent are often under-informed as well.
The report ends by repeating that sterilization is a viable tool in family planning, and when performed under the informed consent of the individual, it is an effective contraceptive. The U.N. calls for safeguards for individuals who cannot give consent on their own, and it wants individuals to be able to access their own medical records. It also wants the process to be discrimination-free and for institutions performing the procedures to be accountable for their actions.
The hope is that Denmark is just the first of many countries to take the report to heart and that other governments will recognize these unethical policies.