TAKE ACTION to end sterilizations without consent

Canadian and international media are reporting on the ongoing practice of coerced of forced sterilizations of Indigenous women in Canada. Here’s what you need to know.

What is forced sterilization and coerced sterilization?

Forced sterilization is when a person is sterilized (via tubal ligation) without their knowledge or informed consent.

“Sterilization under coercion” is when people give their consent for the procedure, but on the basis of incorrect information (i.e. women being told the procedure is reversable) or other coercive tactics such as intimidation or that conditions are attached to sterilization, such as financial incentives or access to health services.

Forced and coerced sterilizations are a form of gender-based violence and torture.

History of coerced sterilization of Indigenous women in Canada

Forced or coerced sterilization of Indigenous women in Canada is the product of systemic discrimination and has been documented from the 1800s to the present.

In the 1970s, there were about 1,200 cases of coerced sterilization of Indigenous women, reportedly intended to reduce the numbers of Indigenous persons in Canada.

Although current numbers of forced and coerced sterilization are not known, there is compelling evidence that the practice has continued.

Indigenous women continue to be coercively or forcibly sterilized

In July 2017, the Saskatoon Regional Health Authority released the report of an external review commissioned after at least four Indigenous women reported in the media that they had been coercively sterilized in a Saskatoon hospital, mostly between 2008 and 2012. The report documented the experiences of 16 women, most of whom reported being coercively sterilized between 2005 and 2010, and noted that “pervasive structural discrimination and racism in the health care system in general (despite attempts to remedy these) remains unmistakable.” The pattern of systemic bias against Indigenous peoples in the provision of public services throughout Canada, from the criminal justice system to the healthcare system, is well known and acknowledged by government.

Since publication of the extension review in Saskatoon, more Indigenous women in Saskatchewan and at least three other provinces (Alberta, Manitoba, and Ontario) have come forward with allegations of forced or coerced sterilization. The number of women coming forward to disclose what happened to them increases as public awareness of this practice grows.

A class action law suit filed in Saskatchewan in October 2017 represents more than 60 Indigenous women in Saskatchewan, most of whom reported being sterilized in the last 10-15 years, and as recently as 2014. They have reported that their ‘consent’ to be sterilized was obtained during or immediately after the birthing process, through coercive means, and in some cases information about other methods of birth control was not provided and/or the permanency of tubal ligation was misrepresented.

Amnesty International has documented this pattern of rights violations in other countries

The pattern of coercive techniques used to obtain ‘consent’ is consistent with practices Amnesty International has documented in Chile, Mexico, and most notably, Peru, where thousands of Indigenous women were forcibly or coercively sterilized in the 1990s. In 2014, the Inter-American Commission on Human Rights held Bolivia accountable for forced sterilization of women, and agreed to hear the case of a woman living with HIV in Chile who was forcibly sterilized.

What rights are violated when a person is forcibly or coercively sterilized?  

Forced or coerced sterilization violates the rights to equality, non-discrimination, physical integrity, health, and security, and constitutes violence against women. In some cases, this could constitute torture and/or cruel, inhuman or degrading treatment or violation of the right to life.

International standards recognize the right of all women and girls to live free from violence and discrimination; to make decisions about reproduction free from discrimination, coercion or violence; to make free choices about the number, spacing and timing of their children; and to have access to sexual and reproductive health information and services.

Forced or coerced sterilization of Indigenous women is also an assault on the cultural integrity of societies that have already endured grave human rights violations including forced assimilation. Measures to prevent births within national, ethnic, racial, or religious groups are explicated prohibited by the Convention on the Prevention and Punishment of the Crime of Genocide.

What has government said about this issue?

In May 2018, when Canada’s human rights record was being reviewed by the United Nations during its Universal Periodic Review, the government of Argentina called on Canada to “take the necessary steps to investigate complaints lodged regarding forced sterilization of women from vulnerable groups and, where appropriate, punish those responsible and assist affected women” (Recommendation 212). In September 2018, the government of Canada accepted this recommendation.

In November 2018, Minister of Indigenous Services, the Honourable Jane Philpott acknowledged that coerced and forced sterilization of Indigenous women “is a very serious violation of human rights,” and noted that “Canada must ensure the practice stops through policies, education and awareness-raising.”

These are positive steps in the right direction, but much more must be done to truly understand the scope of coerced and forced sterilizations of Indigenous women, to ensure the practice is halted once and for all, and to ensure justice for all those impacted by this grave human rights violation.

What actions does Amnesty International call on governments in Canada to take to end coercive and forced sterilizations of Indigenous women?

Amnesty International calls on the government of Canada to:

• Investigate allegations of forced or coerced sterilizations in Canada, with particular attention to cases involving Indigenous women and girls, ensuring justice and reparations to survivors and their families.
• Appoint a special representative to meet with survivors and their families to hear their requests for justice and reparations.
• Apply existing criminal legislation on aggravated assault for cases of forced or coerced sterilization.
• Change government policies and practices to explicitly prohibit sterilization without free, full, and informed consent.
• Implement Truth and Reconciliation Commission Calls to Action 23 and 24 on increasing the number of Indigenous healthcare professionals and providing cultural competency training to all healthcare professionals.
• Develop a comprehensive National Action Plan to prevent and address gender-based violence involving the federal government, provinces, territories, municipalities, and First Nations.

Amnesty International calls on the government of Saskatchewan to:

• Implement the recommendations from Saskatoon Regional Health Authority external review.

Amnesty International calls on provincial and territorial colleges of physicians and surgeons to:

• Issue clear guidelines on free, full, and informed consent to all practicing healthcare professionals.
• Implement Truth and Reconciliation Commission Calls to Action 23 and 24 on increasing the number of Indigenous healthcare professionals and providing cultural competency training to all healthcare professionals.