Governments Are Still Sterilizing People

History has a way of convincing us that we’ve outgrown our worst impulses. That we really do learn from the past. But do we?

We look at the 20th century, at the grainy footage of eugenics boards and state-sponsored “purity” programs, and we treat those moments as very much behind us. We tell ourselves that in the modern world, the most private decision a person can make—whether or not to bring life into this world—belongs only to them.

While the “Eugenics Offices” of the 1930s may have closed their doors, that doesn’t mean eugenics just disappeared. Instead, it moved into the hurried signatures on hospital forms, the fine print of guardianship laws, and the high-pressure environment of immigration detention centers.

From the remote provinces of Canada to the heart of the European Union—not exactly the places you expected—there are states sometimes still deciding who is “fit” to be a parent. It happens to the women whose languages aren’t spoken by their doctors, to the disabled who are deemed “incapable” of consent, and to the incarcerated.

So let’s start looking at the persistent, global reality of forced and coerced sterilization—a world that never actually went away.

What Counts as Sterilisation?

Let’s start by looking at the language used by the systems that do this. The distinction between “forced” and “coerced” is often the difference between a blatant crime and a bureaucratic loophole.

A 2021 report from the Senate of Canada provides a clear framework. Forced sterilization is the most direct: it is the removal of reproductive capacity without any consent, or where a person’s explicit refusal is simply ignored. This can be verbal, or even non-verbal—such as a patient physically pushing away a needle or a form while on an operating table.

Coerced sterilization is more subtle, and in many ways, more common. This is where a signature exists on a page, but the consent was never truly free. It is extracted through misinformation—like telling a patient the procedure is reversible when it isn’t. It is extracted through threats—such as telling a mother she will lose her welfare benefits or her existing children if she does not comply. Or it is made a condition for life-saving care: “sign this, or we won’t perform the C-section.”

Medical ethics relies on the concept of “free, prior, and informed consent.” To be valid, a patient needs the mental capacity to decide, full information about the risks, enough time to think without being in active pain or under sedation, and a complete absence of pressure.

When those elements are missing, the UN Committee Against Torture and other international bodies characterize these practices as more than just medical malpractice—they label them as cruel, inhuman, or degrading treatment, or even torture.

The Genocide Convention includes “imposing measures intended to prevent births within the group” as a defining act of genocide. When scholars and UN experts look at the systematic targeting of Indigenous women or minority populations in Xinjiang, this is the legal standard they are measuring against.

The Old Blueprint: Eugenics That Never Quite Went Away

To understand where we are now, we have to look at the blueprint that was laid down decades ago. For a large part of the 20th century, eugenics wasn’t some fringe theory—it was mainstream policy.

Governments across North America and Europe established formal eugenics boards with a very specific goal: to prevent the “unfit” from reproducing. In the US and Canada, these boards targeted Indigenous women and the poor. In Sweden, a mid-century program saw 63,000 people sterilized. The logic was always the same: protecting the “quality” of the national gene pool.

But if you want to see how these ideas survived into the modern era, look at Japan. Their Eugenic Protection Law was enacted in 1948 and it wasn’t repealed until 1996. Under that law, around 25,000 people were sterilized, and about 16,500 of them never gave their consent.

Japan serves as a bridge between the old world and the new. It took until 2019 for the government to pass a compensation law for survivors, and it wasn’t until 2024 that the Supreme Court finally declared the old law unconstitutional. They even lifted the statute of limitations, acknowledging that victims couldn’t have been expected to sue while the state was still actively denying their rights.

That long shadow is exactly why survivors are only now finding the breath to speak. And as we move further into the 21st century, we start to see that the old logic didn’t actually vanish.

Canada: Indigenous Women “Robbed of Their Sacred Ability”

You might think a wealthy, rights-respecting democracy like Canada would have closed this chapter along with the old eugenics boards of the mid-20th century. But for many Indigenous women, the reality of the public health system hasn’t actually caught up.

A 2017 external review in Saskatoon uncovered a pattern that is difficult to ignore. Indigenous women described being in the middle of active labor, or still woozy on an operating table after a C-section, when they were suddenly presented with forms for a tubal ligation.

In those moments of intense physical pain and extreme vulnerability, they were pressured to sign. Some weren’t told the procedure was permanent. Others were made to believe they couldn’t see their newborn baby until they agreed. This isn’t ancient history—some of these allegations date as recently as the late 2010s.

And the scale of this is finally starting to surface. Over 100 women across at least five provinces have joined class-action lawsuits, alleging they were sterilized without their free or informed consent. They describe a system that essentially “robbed them of their sacred ability” to carry life, often treating their reproductive future as a problem to be managed by the state.

And it isn’t just Indigenous communities. A 2021 Senate report flagged that other groups are at high risk too, including women with disabilities, people living with HIV, and those in institutional care.

The international community has started to take notice. In 2018, the UN Committee Against Torture urged Canada to criminalize forced sterilization and ensure reparations for the victims. They were clear that these practices can amount to torture—but so far, a formal change to the criminal code remains stuck in the legislative process.

Roma Women in Czechia: Threats, Bribes and “Life-Saving” Lies

Cross the Atlantic to Central Europe, and we find a very different landscape—but a strikingly similar pattern of medical control. From 1966 until at least 2012, hundreds of women in what is now the Czech Republic were sterilized under circumstances that were anything but voluntary. Most of them were Roma.

In many cases, the pressure came from social workers. They would visit Roma families and offer “bribes” in the form of social benefits, or they would threaten to take away their existing children if the mother didn’t agree to the procedure. But for others, the deception happened right in the delivery room.

Imagine being in the middle of a C-section or recovering from anesthesia, and being told you have to sign a “life-saving” form. Many of these women only realized years later that the document they signed wasn’t for a routine procedure—it was a permanent end to their fertility.

The Czech Ombudsman began investigating this in 2005, collecting over 80 testimonies from women who never gave valid consent. It took another 16 years of tireless activism by Roma women to force the state to acknowledge its role. In 2021, the Czech government finally passed a law offering a one-off compensation of 300,000 crowns—roughly 13,000 US dollars—to survivors.

While that money is something of a victory, the process is still an uphill battle. Survivors have to prove the circumstances of their sterilization from decades ago, often using hospital records that have been lost or destroyed. And while the Czech Republic has moved to fix that, its neighbor Slovakia—where similar abuses occurred—has yet to enact any comparable compensation scheme for its own victims.

Activists like Elena Gorolová argue that a check from the government doesn’t erase the underlying racism that allowed this to happen in the first place. And well, it doesn’t.

India: Sterilisation Camps and the Price on a Woman’s Womb

Moving further East to India, and the scale of this changes completely.

Every year, around five million women in India undergo sterilization. It is the primary way the country handles family planning—but the way they get women into the clinics is rarely about a simple medical choice.

The government sets population targets for local districts. To meet those numbers, they use a system of cash incentives. Health workers get a payment for every woman they bring in, and they can even face pay cuts if they do not meet their monthly quotas.

For the women themselves—who are often from poor, rural villages—they are offered a small sum of money to have the surgery. When you are struggling to buy food, that cash feels less like a bonus and more like a necessity.

The danger of this assembly-line approach became clear in November 2014. In the state of Chhattisgarh, a mass sterilization “camp” was set up in an abandoned hospital building. There was no running water, the equipment was rusty, and a single doctor performed 83 surgeries in just a few hours.

The official safety limit is 30 surgeries per day. This doctor did nearly triple that amount—basically one operation every few minutes.

Thirteen women died following the surgeries. The investigation found they had suffered from massive infections and were given drugs which were allegedly contaminated with rat poison. Brilliant work by the local health department.

In 2016, the Indian Supreme Court issued the Devika Biswas ruling. They said these mass camps violated a woman’s right to health and dignity, and they ordered the government to stop the camps within three years. They also called for much stronger rules on informed consent.

But while the big “camps” are technically gone, the informal targets still exist. Local officials still feel the pressure to keep the birth rate down, so the same assembly-line logic just moves into smaller, permanent clinics.

For millions of women in India, the decision to stop having children is still wrapped up in government quotas and the desperate need for a few extra rupees.

HIV, Hospitals and “Consent” Under Duress

When you add a medical diagnosis into the mix, the pressure from the state can get even more intense. For women living with HIV, especially in southern Africa, the hospital isn’t always a place of healing—sometimes, it’s a place where their rights are traded for their medicine.

In Namibia, three women decided to take the government to court. They all had one thing in common: they were living with HIV and had gone to public hospitals to give birth. While they were in the middle of active labor, and in massive amounts of pain, they were told to sign consent forms for sterilization.

They argued that they didn’t really understand what they were signing, and that nobody explained the alternatives. In 2012, the High Court agreed with them, saying their consent was not informed. Then, in 2014, the Supreme Court upheld that ruling—a landmark ruling.

But UN agencies have found that this wasn’t just a one-off mistake in Namibia. In other places, like Kenya, women living with HIV have alleged that doctors made sterilization a requirement for getting their life-saving antiretroviral treatment. Or, they were told that because of their status, they simply “shouldn’t” have any more kids—which ignores the fact that modern medicine makes it very safe for HIV-positive mothers to have healthy babies.

The stigma around the virus is being used as a tool for coercion. When a doctor tells a patient that they have to “protect” the community by not having children, they are using their power to take away a choice that belongs to the mother—not the hospital.

Europe Now: Disability, Guardianship and “Protective” Violence

Even in the heart of this modern continent, there is a very specific loophole that allows the state to step in and make decisions for people with disabilities. It is often wrapped up in the language of “protection” and “best interests”—but the result is a permanent loss of reproductive rights.

Take the story of Cristina Paredero in Spain. Cristina has autism. When she was 18, her parents pressured her to undergo sterilization, and at the time, Spanish law actually allowed guardians to give consent on behalf of disabled adults who were deemed “incapable.” She didn’t want the surgery, but the system didn’t require her to agree.

Cristina eventually became an activist and helped draft Spain’s 2020 law that finally banned this practice.

But Spain is actually an exception in Europe. According to a 2024 Reuters investigation, 12 EU member states still don’t have an explicit ban on the forced sterilization of people with disabilities. In countries like Hungary, Portugal, and Czechia, the law still allows a judge or a guardian to authorize the procedure—sometimes even for minors. That’s today, in 2026.

The logic here is deeply paternalistic. The system assumes that because someone has a disability, they cannot possibly handle the responsibilities of parenthood—or even the physical reality of their own menstrual cycle. It is a form of “protective violence” where the state decides it is better to eliminate a person’s future than to provide the support they might need to navigate it.

UN bodies have called for an outright ban on these practices for years, but many European governments still treat it as a private medical matter between a guardian and a doctor. It turns out that being a “modern democracy” doesn’t automatically mean your body actually belongs to you.

California’s Women Prisoners: “Do They Think We’re Animals?”

If you think this is a problem confined to other countries, you have to look at California. Despite its reputation as a progressive state, the California prison system has a very recent and very disturbing history of controlling who is allowed to give birth.

Between 2005 and 2013, 144 women in California prisons underwent tubal ligations. When the State Auditor looked into this in 2014, they found a complete failure of the rules meant to protect patients.

At least 39 of those women were sterilized in direct violation of informed-consent laws. In some cases, doctors didn’t even sign the forms. In others, the legal waiting periods were ignored—which meant the women didn’t have time to actually think about the permanent change they were making to their bodies.

Former inmates described a high-pressure environment where prison staff would “pitch” sterilization to them while they were still pregnant or recovering from a C-section. One woman even recalled a doctor telling her that the procedure would save the state money on welfare costs for “unwanted children.” It led one survivor to ask a haunting question: “Do they think we’re animals?”

The logic here wasn’t about the health of the mother—it was about the state’s bottom line. When a person is incarcerated, they lose many rights, but their bodily autonomy is supposed to be protected. In California, that protection was traded for a budget cut.

After the audit, California finally banned these procedures in prisons in 2014. They even created a compensation program for victims, acknowledging that the state was repeating the same mistakes it made during the height of the eugenics movement in the early 1900s. It turns out that when you put people behind bars, the line between “healthcare” and “population control” starts to get very thin.

ICE Detention and the “Uterus Collector”

When you combine immigration status with life behind bars, the vulnerability of the patient reaches its absolute peak. In 2020, a nurse named Dawn Wooten filed a whistleblower complaint that sent shockwaves through the US immigration system. She had been working at the Irwin County Detention Center in Georgia—a facility run by a private contractor under ICE oversight.

Her allegations were chilling. She described medical neglect and a total lack of safety, but the most disturbing claim involved an outside doctor whom staff allegedly nicknamed “the uterus collector.”

According to the complaint, a high number of Spanish-speaking women were being sent for hysterectomies—many of whom later said they had no idea why the surgery was happening or what it would do to them.

The investigation that followed was massive. In 2022, a US Senate subcommittee reviewed over 16,000 pages of medical records. They brought in independent OB-GYN experts to look at the files. What they found wasn’t necessarily a “mass sterilization” plot in the legal sense, but a total breakdown of medical ethics.

The experts called the doctor’s practice “too aggressive.” They found that many of these women were subjected to unnecessary surgeries for minor issues like ovarian cysts—issues that didn’t require removing their reproductive organs. The consent process was a huge mess. Because many of the women only spoke Spanish, and the staff were sometimes just “Googling” translations, the patients didn’t have the full information they needed to say no.

ICE officials eventually admitted there were “systemic oversight gaps.” The facility was closed to ICE detainees shortly after. But for the women involved, the damage was already done—and the “alleged” nature of some of the claims doesn’t change the fact that they were operated on in a system that didn’t even bother to speak their language.

Xinjiang: Birth Control as a Tool of Control

The most geopolitically charged case in the world today is happening in Xinjiang, where birth control has been described by some experts as a strategic tool of the state.

Researcher Adrian Zenz analyzed Chinese government documents and found that by 2019, the state planned to subject at least 80% of women of childbearing age in four rural minority areas to birth-prevention measures.

Many Uyghur women have provided testimonies to organizations like ASPI, alleging they were forced to get IUDs or received unknown injections while in detention. They say the choice was made very clear: submit to the procedure, or face re-internment in the “education camps.”

The official data seems to reflect these policies. Reuters reports that birth rates in minority-heavy areas of southern Xinjiang dropped by 48.7% between 2017 and 2019. That is almost half the births gone in just two years. Some projections suggest that if these trends continue, there could be up to 4.5 million fewer births over the next two decades.

Beijing calls these genocide accusations “nonsense” and “politically motivated.” They insist the drop in birth rates simply reflects “voluntary” family planning and the economic development of Uyghur women. Their position is that the policies are applied fairly and are meant to improve public health—not to target a specific ethnic group. Right.

While some governments have labeled these measures as genocide, pointing to the legal definition of “imposing measures intended to prevent births within a group,” others are waiting for the results of ongoing UN investigations.

Who Gets Targeted and Why

The 2014 UN inter-agency statement lists specific groups that face the highest risks of involuntary sterilization. The data shows that the policy often tracks with poverty and legal status—such as the targeting of poor rural women in India or detainees in US custody.

State documents from the California prison system and the Japanese eugenics era cite “fiscal responsibility” as a reason for these procedures. In California, medical staff explicitly discussed avoiding welfare costs for “unwanted children.” In India, the government pays cash bonuses to health workers who bring in patients, creating a financial incentive to meet population targets.

Medical records in European disability cases use the phrase “best interests” to justify operations on women who cannot legally consent for themselves. Organizations like Autism Europe report that these decisions are often made by guardians or judges rather than the individuals. Similarly, the UN documentation on women with HIV shows that doctors often use a “public health” argument, claiming that sterilization is a necessary step to prevent the virus from spreading to future children.

The WHO analysis highlights that these events are rarely the result of a single doctor acting alone. Instead, they occur in systems where governments have set birth-rate goals or where hospital funding is tied to specific medical outcomes. In Xinjiang and India, local officials are measured by how well they enforce birth quotas, while in Canada and the US, the procedures happen in facilities where oversight committees either do not exist or choose not to meet.

The Human Cost

The 2021 Canadian Senate report includes testimony from lawyer Alisa Lombard, who represents Indigenous survivors. She describes the procedure as more than just a medical event—she says these women were “robbed of their sacred ability to carry life.” This loss directly impacts their cultural roles as mothers and knowledge-keepers within their communities.

The 2017 Saskatoon external review found that many survivors stopped seeking medical care entirely. They reported avoiding hospitals for years after their surgeries, even when they were sick or injured, because they feared further violations by doctors. For these women, the hospital building itself became a site of trauma rather than a place for healing.

In the Czech Republic, Roma activist Elena Gorolová has spent two decades documenting the lives of women in her community. She notes that many survivors face severe depression and social stigma. Because Roma culture places a high value on family, many women felt they had been “marked” by the state as less than whole. Many of the original victims from the 1960s and 70s passed away before the 2021 compensation law was ever signed, leaving their families to continue the legal fight for recognition.

Disabled activists working with the European Disability Forum describe a similar impact on identity. They argue that when a guardian or a judge authorizes a sterilization, the state is sending a clear message that disabled people are not fit for love or for family. It is a decision that tells the individual their future is not worth the support it would require.

For many of these groups, the fallout is intergenerational. Community leaders in Canada and Xinjiang point to these birth-prevention policies as a method of cultural erasure. They view the loss of children not just as a personal tragedy, but as a deliberate attempt to thin out the future of their entire people.

And you can see why they think that, can’t you?

What Has Changed, What Hasn’t

Looking at the legal landscape in 2026, the world has finally started to document the damage. In Japan, the Supreme Court has cleared the way for massive compensation payouts to survivors of the old eugenics laws. The Czech Republic has opened a formal claims process for Roma women, and California has launched a state fund to pay those sterilized in its prisons and 20th-century institutions.

In 2020, Spain officially changed its Criminal Code to stop guardians from authorizing the sterilization of disabled people. This followed years of pressure from activists who argued that “protection” shouldn’t mean the end of a person’s reproductive future. The UN has also updated its own standards, now explicitly naming forced sterilization as a form of gender-based violence and, in some contexts, a crime against humanity.

But the 2024 Reuters data shows that 12 EU countries still have not passed an explicit ban. In Canada, despite a detailed Senate report and a push from the UN Committee Against Torture, there is still no specific law that makes forced sterilization a unique crime. In India, while the Supreme Court ordered an end to mass camps, the local health budgets still focus heavily on female sterilization targets, often bypassing other forms of birth control.

The focus of the state is starting to shift toward newer methods. Organizations like Autism Europe are now tracking “soft” coercion, where things like long-acting contraceptive implants or genetic screening are pitched to marginalized groups as a default setting. These new tools offer the same result as a surgery but are much harder to track through a legal system.

The ongoing investigations in Xinjiang and the class-action lawsuits in Saskatchewan are still moving through the courts. These cases are testing a very simple principle—whether a person’s body belongs to them or to the government they happen to live under.

For those with the least power, the answer to that question is still being written.

Key Takeaways

• Forced and coerced sterilization persists globally through bureaucratic loopholes, not just overt crimes, violating principles of free, prior, and informed consent.
• Indigenous women in Canada, Roma women in Czechia, and women with HIV in southern Africa face ongoing reproductive coercion in healthcare systems.
• Twelve EU member states still lack explicit bans on forced sterilization of people with disabilities, allowing guardians or judges to authorize procedures.
• California prisons sterilized 144 women between 2005-2013, with at least 39 cases violating informed-consent laws, driven by cost-cutting rather than health.
• China’s Xinjiang policies have reduced minority birth rates by 48.7% in two years, with experts measuring practices against the Genocide Convention’s legal standard.

Frequently Asked Questions

What is the difference between forced and coerced sterilization according to the 2021 Senate of Canada report?

Forced sterilization is the removal of reproductive capacity without any consent, or where a person’s explicit refusal is ignored (including non-verbal refusal like pushing away a needle). Coerced sterilization is where a signature exists but consent was never truly free—extracted through misinformation (e.g., claiming a procedure is reversible when it isn’t), threats (e.g., losing welfare benefits or children), or made a condition for life-saving care (e.g., ‘sign this, or we won’t perform the C-section’).

How many women in California prisons underwent tubal ligations between 2005 and 2013, and what violations were found?

144 women in California prisons underwent tubal ligations between 2005 and 2013. A 2014 State Auditor investigation found at least 39 were sterilized in direct violation of informed-consent laws, with doctors failing to sign forms and legal waiting periods being ignored. Women described high-pressure environments where staff pitched sterilization during pregnancy or C-section recovery, with one doctor citing welfare cost savings for ‘unwanted children.‘

What happened at the Irwin County Detention Center in Georgia regarding immigrant women and hysterectomies?

In 2020, nurse Dawn Wooten filed a whistleblower complaint alleging that a high number of Spanish-speaking women at the ICE-run facility were sent for hysterectomies by an outside doctor nicknamed ‘the uterus collector.’ Many women later said they didn’t understand why the surgery was happening. A 2022 US Senate subcommittee review of over 16,000 pages of medical records found a ‘total breakdown’ of medical ethics, with ‘too aggressive’ surgical practices for minor issues like ovarian cysts, and consent processes compromised by language barriers including staff ‘Googling’ translations. ICE admitted to ‘systemic oversight gaps’ and the facility was closed to ICE detainees.

What was the Devika Biswas ruling by the Indian Supreme Court in 2016?

In 2016, the Indian Supreme Court issued the Devika Biswas ruling, stating that mass sterilization camps violated women’s right to health and dignity. The Court ordered the government to stop the camps within three years and called for much stronger rules on informed consent. This followed a November 2014 incident in Chhattisgarh where 13 women died after a single doctor performed 83 surgeries in hours at a camp with no running water and rusty equipment, using drugs allegedly contaminated with rat poison.

How many EU member states still lack an explicit ban on forced sterilization of people with disabilities as of 2024?

According to a 2024 Reuters investigation, 12 EU member states still do not have an explicit ban on the forced sterilization of people with disabilities. In countries like Hungary, Portugal, and Czechia, law still allows a judge or guardian to authorize the procedure, sometimes even for minors.

What compensation did the Czech government offer Roma women sterilized without consent, and when?

In 2021, the Czech government passed a law offering a one-off compensation of 300,000 crowns (roughly $13,000 USD) to survivors of forced sterilization, most of whom were Roma women sterilized from 1966 until at least 2012. However, survivors must prove circumstances from decades ago using hospital records that are often lost or destroyed. Neighboring Slovakia, where similar abuses occurred, has not enacted any comparable compensation scheme.

What did the UN Committee Against Torture urge Canada to do in 2018 regarding forced sterilization?

In 2018, the UN Committee Against Torture urged Canada to criminalize forced sterilization and ensure reparations for victims, stating these practices can amount to torture. Despite this and a detailed 2021 Senate report, as of 2026 there is still no specific law making forced sterilization a unique crime in Canada’s criminal code.

What birth rate decline was reported in minority-heavy areas of southern Xinjiang between 2017 and 2019?

Reuters reports that birth rates in minority-heavy areas of southern Xinjiang dropped by 48.7% between 2017 and 2019—almost half the births gone in just two years. Researcher Adrian Zenz found that by 2019, the Chinese government planned to subject at least 80% of women of childbearing age in four rural minority areas to birth-prevention measures. Some projections suggest up to 4.5 million fewer births over the next two decades if trends continue.

What landmark ruling occurred in Namibia regarding HIV-positive women and sterilization?

In 2012, Namibia’s High Court ruled that three HIV-positive women who were pressured to sign sterilization consent forms during active labor had not given informed consent. The Supreme Court upheld this ruling in 2014. The women argued they didn’t understand what they were signing and weren’t explained alternatives. UN agencies later found similar patterns elsewhere, including in Kenya where women alleged sterilization was required for antiretroviral treatment.

How long did Japan’s Eugenic Protection Law remain in effect, and when was it finally declared unconstitutional?

Japan’s Eugenic Protection Law was enacted in 1948 and not repealed until 1996. Under it, around 25,000 people were sterilized, with about 16,500 never giving consent. It took until 2019 for a compensation law for survivors, and until 2024 for the Supreme Court to finally declare the old law unconstitutional, also lifting the statute of limitations because victims couldn’t have been expected to sue while the state was actively denying their rights.

Sources

• Original Scandal video: Governments Are Still Sterilizing People
• Hero image source by ProfReader / openverse, cc0.

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