Sterilization of Women and Girls with Disabilities

Earlier this month, the Open Society Foundation’s Campaign to Stop Torture in Health Care released a briefing paper titled Sterilization of Women and Girls with Disabilities, bringing attention to how such forced sterilization is commonly justified as being in the person’s “best interest.” It is extremely alarming that this coercive practice remains widely unchallenged, despite numerous international precedents explicitly stating that it violates the rights of disabled people. As the brief notes:

The Committee on Economic, Social and Cultural Rights has stated that forced sterilization of girls and women with disabilities is a breach of Article 10, protecting the family, of the International Covenant on Economic, Social and Cultural Rights … The Committee on the Rights of the Child has identified forced sterilization of girls with disabilities as a form of violence and noted that State parties to the Convention on the Rights of the Child are expected to prohibit by law the forced sterilization of children with disabilities … The United Nations Special Rapporteur on torture has emphasized that forced sterilization of women with disabilities may constitute torture or cruel or inhuman treatment, and that forced sterilization constitutes a crime against humanity when committed as part of a widespread or systematic attack directed against any civilian population. (p.2-3)

Upon reading the brief, I was immediately reminded of the Ashley X treatment a family’s controversial, publicized decision to subject their disabled daughter to several medical procedures- including removing her uterus and breast buds. Ashley’s parents established a website in order to defend these medical decisions made without their daughter’s consent.  Their main arguments included an imperative to prevent perceived discomfort due to breast development and menstruation, as well as protect her from potential sexual abuse perpetrated by caregivers, which they argued could likely occur if she was allowed to become “sexualized.”

What is particularly alarming is the outright refusal to put their daughter’s wishes into consideration at all, claiming God “wants her parents to be diligent about using every resource at their disposal (including the brains He endowed them with) to maximize her quality of life.” This is just one example of nonconsensual sterilization targeting people with disabilities being portrayed as in our “best interest,” because we are seen as unfit to make our own decisions about our bodies.

As the Open Society Foundation brief articulately states, using this justification for the forced sterilization of people with disabilities is inexcusable  — especially considering that it negates our right to bodily autonomy and actively avoids holding caregivers who commit acts of sexual violence accountable.

The reasoning of families and medical personnel advocating these procedures smacks of population control rhetoric. In particular, that people with disabilities are considered “burdens” to society whose fertility must be controlled so that we will no longer “monopolize” resources or become “further burdens” if we choose to parent.

This way of thinking is alarming, perpetuating the idea that we are inherently worthless simply because our bodies to not adhere to standards of what is considered to be “normal”. It’s also frighteningly deceptive: the needs of people with disabilities are in reality often underserviced. The even fewer number of services available to us rarely receive adequate funding, are affordable, covered by insurance, or located in already-marginalized communities. With the mere existence of our bodies and reproductive organs perceived as the crisis, such institutional barriers remain unaddressed.

The Open Society Foundation recommends that sterilization procedures require consent from the disabled person; that they receive accessible information about the procedure; that the sterilization of children must cease and that potential future pregnancy cannot be considered a valid justification; and that people with disabilities must be included in these national conversations. All of these recommendations are essential in achieving reproductive justice.

Yet for these recommendations to become a reality, we must also shift current societal notions about disability. This includes confronting the current eugenics culture which justifies such population control. It is disappointing that few reproductive freedom-oriented organizations or coalitions actively work to combat such eugenic-minded policies or consciously incorporate an anti-ableist framework.

As much as I disagree with the decisions of Ashley X and other families to subject their disabled children to such degrading medical procedures, it’s important to remember that our ableist society is also at fault. We absorb the cultural message that people with disabilities don’t deserve the right to bodily autonomy. When many families have little to no access to adequate services for their children, sterilization continues to be perceived as a “reasonable” option in navigating the very real difficulties in providing care- obstacles in place due to our ableist society.

As reproductive justice activists, we need to make sure ableism is fully integrated into our anti-oppression framework. This includes challenging forced sterilization along with other eugenics-minded policies.

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