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Forced sterilisation of persons with disabilities: a widespread violation of human rights across Europe

When it comes to reproductive and sexual rights, persons with disabilities (especially women and girls) are still experiencing gross violations of their bodily integrity. Forced sterilisation, along with forced use of contraception, are among them and are still widespread across Europe. Empowering persons with disabilities to make their own informed decisions about their lives would be the best way to combat these harmful practices – as the European Disability Forum has been calling for a while now.

Forced use of contraception and forced sterilisation of people with disabilities are still pressing human rights violations that Europe needs to address. Sterilisation can be defined as a process resulting in a permanent incapacity of sexual reproduction. This process is forced when a person undergoes sterilisation without their knowledge or their consent, or when they’re compelled to accept sterilisation by their family, medical professionals, policies or legislation – for example to access services (e.g., residential institution) or changes in legal documentation (e.g., modification of gender in legal document for trans people).

The European Disability Forum (EDF) has launched a campaign addressing European decision-makers (i.e., the European Parliament, the Council and the European Commission) to end these pervasive abuses in all the European Union’s Members States – see how to support their call here. EDF’s efforts recently caught the attention of European media outlets such as Euronews, which highlighted a long history of these harmful practices when applied without informed consent, showcasing how they are still widespread across different European countries. 

Some countries have been trying to redeem themselves over the last decades. After outlawing forced sterilisation in 1975 (the practice was ongoing since 1934 as part of a State-wide eugenics plan), Sweden set up a government body to compensate people who had been forcibly sterilised. In December 2020, Spain adopted a law to criminalise forced sterilisation – until then, forced sterilisation of persons ‘incapable of giving consent’ was authorised.

As of August 2022, nine EU Member States (Belgium, France, Luxembourg, Malta, Poland, Romania, Slovakia, Spain and Sweden) explicitly criminalise forced sterilisation as a distinct offence, either as a war crime, a crime against humanity or as a form of gender-based violence, each incurring different penalties. Five EU Member States also explicitly criminalise the sterilisation of minors: Austria, Estonia, France, Germany and Malta.

But these are only some small strokes in a sea of discrimination against persons with disabilities. The majority of EU Member States still don’t have a specific provision prohibiting forced sterilisation in their criminal law – and not much has been done so far to raise awareness of the issue. Here’s some recent data about the situation in the European Union (EU), as reported by the EDF in September 2022:

  • At least 13 EU Member States still allow some forms of forced sterilisation in their legislation, namely: Bulgaria, Croatia, Cyprus, Czechia, Denmark, Estonia, Finland, Hungary, Latvia, Lithuania, Malta, Portugal and Slovakia. They authorise either a guardian, a legal representative, an administrator or a doctor to consent to the sterilisation of a person with disabilities on their behalf.
  • 3 EU Member States (Czechia, Hungary and Portugal) authorise the forced sterilisation of minors.
  • In at least 3 EU Member States (Belgium, France and Hungary) the use of contraception or sterilisation can be a requirement for admission to residential institutions. This means that parents were pressured to consent to the sterilisation of their daughters faced with the prospect of no alternatives. It is not clear whether this is still the case in Belgium and France, since they eventually changed their legislation.

What does international law say about it?

As explained by the EDF, “forced sterilisation is a gross violation of fundamental rights. Moreover, it is a harmful practice and example of gender-based violence that is still inflicted mainly on people with disabilities, Roma and intersex people across Europe.” International human rights treaties prohibit forced sterilisation as it violates human rights, such as the rights to dignity, physical integrity, privacy and free and informed consent. Monitoring bodies have recommended banning forced sterilisation in several countries, including EU Member States.

It is prohibited under numerous international texts: the Council of Europe’s Convention on Preventing and Combating Violence against Women and Domestic Violence (the so-called Istanbul Convention, here’s translated in Easy-to-read version by Autism-Europe) and the Rome Statute of the International Criminal Court, among others.

The United Nations’ Convention on the Rights of Persons with Disabilities (CRPD) includes multiple provisions relevant to the issue of forced sterilisation. The United Nations’ Committee on the Rights of Persons with Disabilities has repeatedly called for the prohibition of forced sterilisation, asking at least 11 EU countries to adopt measures to ban and combat this violation of human rights.

Why is forced sterilisation targeting persons with disabilities?

This intrusive and irreversible practice is legitimated for its use on persons with disabilities based on different discriminatory reasons. As highlighted by the EDF, these reasons include: the so-called ‘best interest of the person’; medical reasons; to ‘protect the person against sexual abuse’; to ‘ease’ contraception and to avoid the ‘burden’ that some contraception methods may bring.

Therefore, forced sterilisation is presented as a means ‘to protect vulnerable persons.’ But these regimes violate persons with disabilities’ fundamental rights, undermining their autonomy and right to self-determination. Underneath this concern for ‘protection’, there’s the persistent paternalistic belief that a person with disabilities may not be capable of caring for a child – hence society’s will to prevent persons with disabilities from reproducing.

The same beliefs have brought violations of disabled women’s parenthood rights – as it was the case of the ‘Rachel affaire’ in France in 2015, where an autistic mother lost custody of her autistic children because of the ‘prehistoric vision of autism in France’. The same arguments have been used for substituted legal capacity regimes.

How to create a culture of consent for persons with disabilities?

Legal capacity and forced sterilisation are intrinsically linked, since forced sterilisation particularly concerns persons with intellectual and/or psychosocial disabilities, whose legal capacity is restricted. Decisions about their reproductive rights are left to their legal representatives, guardians or courts. The EDF witnessed that many EU Member States authorising forced sterilisation are also among those allowing substituted decision-making.

Sterilisation of persons with disabilities can therefore be seen as a way for society to exert control over them, as disabled people still struggle to receive the support and education they need to take power over their lives.

It is true that persons with disabilities (especially children and young people) may have an increased risk of acquiring sexually transmitted infections, experiencing unplanned pregnancy or falling victim to sexualised violence, but the solution to that can’t be human rights violations as forced sterilisation or contraception. Sex education instead can mitigate these risks by empowering persons with disabilities and bolstering their ability to seek support, as many recent studies highlight.