The Other Side of Reproductive Justice: How Sterilization and Other Forms of Coercion Are Used Against "Unworthy" Parents

@RHRealityCheck

Earlier this fall, a committee of the Parliamentary Assembly for the Council of Europe held a hearing entitled “Putting an end to coercive sterilizations and castrations.” This debate continues today, November 21, 2011. What is remarkable about this is not the outcome or the discussion, but rather that it was necessary at all. After all, most parliamentary debates about contraception and childbearing these days seem to be about how to make women have more children than they want, not less.

However, if we scratch the surface a bit, it becomes clear that two seemingly contradictory political discourses happily coexist. On the one hand, policy-makers push for limits to contraceptive access for women, generally speaking. And on the other, they enforce policies that criminalize, condemn, or render impossible the reproduction of specific subgroups of women (and men), who for various reasons are seen as undesirable parents: Roma women, lesbians and gay men, transgender people, indigenous women,injection drug users, women living with HIV—the list goes on.

In this connection, coercive sterilizations and castration are at the extreme end of a spectrum that also includes criminal sanctions for drug use during pregnancy and barring LBGT individuals from in-vitro fertilization services and adoption, as well as a host of other policies geared at making pregnancy and parenting difficult for those deemed unworthy. In fact, the more “unworthy” the individual or group is considered by the general public, the more explicitly coercive the measure to limit their possibility for parenting. So much so that by considering the lengths to which a government will go to prevent certain individuals from procreating, we can gauge the extent of the stigma they face.

For example, it would probably no longer be politically viable to implement quotas for the sterilization of indigenous women, as the Peruvian government did in the 1990s, yet Roma women and even just poor women are still routinely sterilized without their consent in several countries. Lesbian women are rarely forcefully sterilized, yet they are often excluded from becoming adoptive parents or from benefiting from in-vitro fertilization processes. Many countries require transgender individuals to be sterilized before they can legally change their names or papers to reflect their preferred gender, and intersex individuals are often assigned a sex—and in the process rendered infertile—as infants and certainly before they can give meaningful consent. The most restrictive and invasive intervention, forced castration, is reserved for convicted sex offenders who, in turn, arguably are seen as the most unworthy and reviled of all.

As a human rights issue, coerced sterilization and castration are in many ways no different from other limitations on individual reproductive choice: they violate a number of fundamental rights, including the rights to health, privacy, and physical integrity. Additionally, they make discrimination and public contempt visible and as such can help target policy interventions to alleviate abuse.

But a more interesting aspect of the practice of coerced sterilization is that it crystallizes the hypocrisy of the limitations to reproductive rights. When I did research on access to abortion in Mexico in 2005, for example, I found that rape victims routinely were denied services they, by law, were entitled to, whereas sex workers and women living with HIV who were applying to the same hospitals for the same services were offered abortions they did not need and that would technically have been illegal.

When Parliamentary Assembly for the Council of Europe continues its debate on forced sterilizations on Monday, it would do well to think through in what other ways it can support individual choices on when, if, and with whom to become a parent. Only just a year ago, the Assembly refused to recommend adequate regulation of conscientious objection in the medical profession, a move that probably already has contributed to the denial of care to many women across the continent.

These are not separate issues. The Roma woman who is forcefully sterilized suffers as much as the one who is denied an abortion or other needed care. Everyone must be allowed to make individual and responsible decisions about parenting and procreation.