Forced sterilization is the practice of permanently removing a person’s ability to reproduce without their free and informed consent. It has been carried out by governments, medical institutions, and detention facilities across the world for over a century, targeting people on the basis of race, ethnicity, disability, HIV status, gender identity, or perceived social “unfitness.” Under the Rome Statute of the International Criminal Court, widespread or systematic forced sterilization is classified as a crime against humanity.
How It Is Defined Under International Law
International law distinguishes forced sterilization from voluntary procedures by one core element: meaningful consent. A sterilization is considered forced or coerced when the person did not agree to it, was pressured or deceived into agreeing, or lacked the capacity to understand what was being done. This includes situations where consent was obtained through threats, manipulation, withholding of other medical care, or language barriers that prevented the person from understanding the procedure.
The United Nations has recognized forced sterilization of people with disabilities as a form of torture. Despite this, legal systems in many countries still allow judges, healthcare providers, family members, or legal guardians to consent to sterilization on behalf of someone with a disability “in their own interest.” The UN Special Rapporteur on the rights of persons with disabilities has called this a form of systemic violence that must be criminalized and eradicated.
The US Eugenics Movement
Between 1907 and 1937, 32 US states passed eugenic sterilization laws. The stated goal was to eliminate “degeneracy” from the population. Over the six decades these laws were in force, more than 60,000 sterilizations were officially recorded, carried out primarily in state hospitals and institutions for people labeled “feebleminded” or “insane.” The actual number is likely higher, since not all procedures were documented.
The targets were disproportionately poor, Black, Latino, Indigenous, and disabled people. North Carolina sterilized roughly 8,000 people during the 20th century and in 2013 became one of the first states to pass a law compensating survivors. Virginia, where approximately 7,600 people were sterilized in state institutions, followed with its own efforts after advocacy from survivors and legal organizations.
California was the most prolific sterilizer of all US states. The state now runs a reparations program for survivors, offering qualified recipients $35,000 each. To be eligible, survivors of sterilization in state-run facilities must have been sterilized between 1909 and 1979 in a state hospital, home, or institution. A separate eligibility track covers people sterilized in California prisons after 1979, where the program recognizes cases where consent was absent, given less than 30 days before the procedure, obtained without counseling, or simply never documented.
Forced Sterilization Around the World
The practice is not limited to the United States. In Peru, an estimated 200,000 women were sterilized without free, prior, and informed consent between 1996 and 2000 under the Fujimori regime. The vast majority were Indigenous women living in rural areas, targeted through a national family planning program that framed mass sterilization as poverty reduction.
In the Czech Republic, coercive sterilization of Romani women was documented between at least 1987 and 2003. In 2004, the European Roma Rights Centre submitted 31 individual cases to the United Nations Committee against Torture, triggering an investigation by the Czech government’s ombudsperson. Despite an official government “expression of regret” in 2009, very few victims have received individual compensation. Norway, Sweden, and Switzerland have made more progress in providing remedies to their own sterilization survivors, though those efforts have unfolded in waves over decades rather than in a single comprehensive action.
In Canada, forced and coerced sterilization of Indigenous women has continued into the 21st century. In 2017, a proposed class-action lawsuit was filed in Saskatchewan on behalf of more than 100 women across the country who reported being sterilized against their will or under coercive pressure. A 2020 national gathering convened by the National Collaborating Centre for Indigenous Health specifically addressed the ongoing sterilization of Indigenous women and girls and explored how culturally safe healthcare practices could prevent it.
Gender Recognition Requirements
Some countries have required people to be sterilized before they can legally change their gender on identity documents. Japan mandated sterilization as a condition of legal gender recognition, a policy that drew widespread international criticism and was ultimately overturned. This type of requirement has been increasingly recognized as a human rights violation, even when it is framed as a procedural legal step rather than a punitive measure.
Allegations in US Immigration Detention
In 2020, a nurse whistleblower at the Irwin County Detention Center in Georgia alleged that detained immigrant women were being subjected to hysterectomies without informed consent. The nurse described one gynecologist as performing the procedure on nearly every patient he saw, calling him “the uterus collector.” One detainee reported that as many as 20 women had surgery recommended to them and that many were fearful of the physician’s rough treatment. The Government Accountability Project, which represented the whistleblower, reported that some detainees did not understand why they were having the procedure and that consent was sometimes obtained by nurses who did not speak Spanish and simply used an online translation tool.
The gynecologist in question stated he had only performed “one or two” hysterectomies over the prior two to three years, with full patient consent. The medical director of the ICE Health Service Corps said that since 2018, only two women at the facility had been referred for hysterectomies. The gap between these official statements and the accounts of detainees and staff drew significant scrutiny.
Physical and Psychological Effects on Survivors
Forced sterilization causes lasting harm that extends far beyond the loss of fertility. Research on women living with HIV who were forcibly sterilized in Namibia found that every participant experienced anxiety, stress, feelings of helplessness, hopelessness, sadness, and self-blame. Six out of seven reported isolation and disrupted sleep. Five experienced feelings of worthlessness and significant weight changes. The psychological profile closely resembles what clinicians see in survivors of other forms of gender-based violence.
The physical consequences are also severe. Survivors in the Namibia study reported heavy menstrual bleeding, severe abdominal and back pain, weakness, and problems with their lower limbs. One woman described bleeding so heavily that she filled three buckets a day and relied on adult diapers. Beyond the direct surgical complications, survivors frequently reported receiving poor healthcare after the procedure, compounding their suffering.
The social consequences amplify the damage further. Survivors in multiple countries have reported discrimination, victimization, and domestic violence linked to their inability to bear children. In communities where fertility is closely tied to a woman’s social standing, sterilization can lead to abandonment by partners, rejection by extended family, and economic precarity. The trauma is not a single event but a cascading disruption of a person’s physical health, mental health, relationships, and place in their community.