The Dark Side of Protection: Forced Sterilization of Women with Disabilities

Women are sterilized without their knowledge or consent on various fallacious grounds. In some cases, proponents defend this practice as necessary to protect women. As our new briefing paper illustrates, nowhere is this argument invoked more than in the case of women with disabilities.

Sterilization, we are told, would protect women with disabilities, who cannot fend for themselves and are at a ten-fold risk of sexual violence, from unwanted pregnancies. It would release women, who rely on assistance from others for the most intimate activities, from the difficulty of managing their reproductive health. If they are not intending or able to become parents, so goes the logic, why not spare them and their caregivers from this burden as well as from the risks that pregnancy or parenthood may carry?

Caregivers, along with family members and oftentimes government workers, are tasked with making these reproductive decisions for women whom society deems are not capable of acting in their own “best interest.” Guardianship becomes the linchpin in the protective approach, providing a legal framework for substituting a woman’s consent to sterilization with the consent of another.

If we are to succeed in turning the tide against the practice of forced sterilization, the nature of this protective impulse must be revealed for what it is. Fortunately, we now have powerful tools to do so. The Convention on the Rights of Persons with Disabilities (CRPD) shifts the focus from the impairment of an individual to the obstacles in society: it becomes our collective responsibility to identify and remove environmental and attitudinal barriers that bring about pervasive isolation and segregation of persons with disabilities.

With this perspective in mind, it becomes clear that the over-exposure of women with disabilities to sexual abuse reflects society’s failure to prevent the worst forms of neglect and segregation. Women with disabilities would not be in situations of high risk if government leaders prioritized support that enables meaningful participation in family, work, and community life, instead of institutions or closed spaces (even within the community) that are a festering ground for abuse. Basing a policy of sterilization on the acknowledgment that we have failed to promote and respect the rights of women with disabilities is foolhardy. What message do we send when we suggest that sterilization is an appropriate response to sexual abuse, while it likely makes women even easier prey since the potential evidence of such abuse is removed?

The CRPD helps to show that arguments for the “protection” of women often have little to do with their rights, and more with covering up for gaps in support that can generate adequate caregiving, in measures to prevent sexual abuse, and in services to support women with disabilities in their decision to become parents. Society has yet to make sexual education and parenting programs available and accessible for persons with disabilities. Reproductive health services are virtually nonexistent for women with disabilities. Likewise, procedures that enable people with disabilities to report on abuse and testify against perpetrators are lacking. And rarely do we find self-defense training or assertiveness courses tailored for people with disabilities, which could help them ward off potential assaults.

Perhaps, most importantly, the CRPD requires that support be provided to women with disabilities to make their own informed decisions over the matter, rather than denying them that power and speaking for them even against their own will.

Despite significant challenges lying ahead, something is moving in this direction. The new International Federation of Gynecology and Obstetrics Guidelines on Female Contraceptive Sterilization, which rule out sterilization without the informed consent of a woman—all women, with no exception—and require that accommodations, time, and support be provided in decision-making, take an important step forward. The European Court of Human Rights will hopefully adopt a similar position, presented by disability rights and reproductive rights organizations in a pending case on this issue.

Policies on sterilization cannot be based on society’s glaring omission to ensure the inclusion of persons with disabilities in the most basic sense. On the contrary, we must promote policies and guidelines that firmly close the door on the notion that sterilization can cover up for such a failure. Instead of debating grounds for sterilization, our policymakers should instead be upgrading efforts that enable the full inclusion of persons with disabilities in society.

December 3 is the International Day of Persons with Disabilities–a day that marks the pursuit of full participation and inclusion of persons with disabilities in society. This post is part of a blog series that reflects on our work to advance the rights of persons with disabilities around the world.