Editing Compulsory sterilization (section)

==By country==

=== International law ===
The [[Convention on preventing and combating violence against women and domestic violence|Istanbul Convention]] prohibits forced sterilization in most European countries (Article 39).<ref>{{cite web |url=https://rm.coe.int/168046031c |title= Council of Europe Convention on preventing and combating violence against women and domestic violence |access-date=2017-08-07 |url-status=live |archive-url=https://web.archive.org/web/20170531114057/https://rm.coe.int/168046031c |archive-date=2017-05-31 }}</ref>
Widespread or systematic forced sterilization has been recognized as a [[Crime against Humanity]] by the [[Rome Statute of the International Criminal Court]] in the explanatory memorandum. This memorandum defines the jurisdiction of the [[International Criminal Court]].<ref name="Horton">{{cite book |first=Guy |last=Horton |chapter-url=http://www.ibiblio.org/obl/docs3/Horton-2005.pdf |title=Dying Alive – A Legal Assessment of Human Rights Violations in Burma |archive-url=https://web.archive.org/web/20160113112157/http://www.ibiblio.org/obl/docs3/Horton-2005.pdf |archive-date=2016-01-13 |date=April 2005 |publisher=The Netherlands Ministry for Development Co-Operation |chapter=12.52 Crimes against humanity |page=201 }} Horton references RSICC/C, Vol. 1 p. 360</ref><ref>{{cite web |url=http://legal.un.org/icc/statute/romefra.htm |title=Rome Statute of the International Criminal Court |publisher=legal.un.org |access-date=2012-07-13 |url-status=live |archive-url=https://web.archive.org/web/20131019222329/http://legal.un.org/icc/statute/romefra.htm |archive-date=2013-10-19 }}</ref> It does not have universal jurisdiction, with the United States, Russia and China among the countries to exclude themselves.<ref>{{cite web |title=Rome Statute of the International Criminal Court |url=https://treaties.un.org/Pages/ViewDetails.aspx?src=TREATY&mtdsg_no=XVIII-10&chapter=18&clang=_en |website=United Nations Treaty Collection |publisher=United Nations |access-date=1 December 2019 |ref=Yes |language=EN |archive-url=https://web.archive.org/web/20191109001013/https://treaties.un.org/Pages/ViewDetails.aspx?src=TREATY&mtdsg_no=XVIII-10&chapter=18&clang=_en |archive-date=9 November 2019 |url-status=live }}</ref> Rebecca Lee wrote in the [[Berkeley Journal of International Law]] that, {{as of|2015|lc=y}}, twenty-one [[Council of Europe]] member states require proof of sterilization in order to change one's [[legal sex]] categorization. Lee wrote that requiring sterilization is a human rights violation and that LGBTQ-specific international treaties may need to be developed in order to protect LGBTQ human rights.<ref>{{cite journal | title=Forced Sterilization and Mandatory Divorce: How a Majority of Council of Europe Member States' Laws Regarding Gender Identity Violate the Internationally and Regionally Established Human Rights of Trans* People |journal=Berkeley Journal of International Law |volume=33 |issue=1 |date=2015 |url=https://lawcat.berkeley.edu/record/1126810?ln=en |quote=Unfortunately, this is not an anomaly: this is the lived experience of trans* people in dozens of countries throughout the world, including the twenty-one Council of Europe (COE) Member States that currently require proof of sterilization to change one's legal sex categorization. […] It would be advisable for LGBTQ activists to seriously consider developing LGBTQ-specific international and regional human rights treaties. |doi=10.15779/Z381W07 |doi-broken-date=1 November 2024}}</ref>

=== Bangladesh ===

==== Poverty ====
[[Bangladesh]] has a long-running government-operated civilian sterilization program as a part of its population control policy, which targets mainly poor women and men. The government offers 2,000 [[Bangladeshi taka|Bangladeshi Taka]] (US$18) for women who are persuaded to undergo [[tubal ligation]] and for men who are persuaded to undergo [[vasectomy]]. Women are also offered a [[sari]] and men are offered a [[kurta]] to wear for undergoing sterilization. The referrer, who persuades the woman or man to undergo sterilization gets 300 Bangladeshi Taka (US$2.70).<ref name=":4">{{Cite web|url=http://uttarkhanup.dhaka.gov.bd/site/field_office/3354b838-2016-11e7-8f57-286ed488c766|title=পরিবার পরিকল্পনা {{!}} উত্তরখান ইউনিয়ন {{!}} উত্তরখান ইউনিয়ন|website=uttarkhanup.dhaka.gov.bd|language=en|access-date=2017-11-11|url-status=live|archive-url=https://web.archive.org/web/20171112185603/http://uttarkhanup.dhaka.gov.bd/site/field_office/3354b838-2016-11e7-8f57-286ed488c766|archive-date=2017-11-12}}</ref>

In 1965, the targeted number of sterilizations per month was 600–1,000 in contrast to the insertion of 25,000 [[IUDs]], which was increased in 1978 to about 50,000 sterilizations per month on average.<ref>{{Cite journal|last1=AR|first1=Khan|last2=I|first2=Swenson|date=1978|title=Acceptability of male sterilization in Bangladesh: its problems and perspectives|url=https://www.popline.org/node/444385|journal=Bangladesh Development Studies|language=en|volume=6|issue=2|url-status=dead|archive-url=https://web.archive.org/web/20171113002952/https://www.popline.org/node/444385|archive-date=2017-11-13|access-date=2017-11-12}}</ref> A 50% rise in the amount paid to men coincided with a doubling of the number of vasectomies between 1980 and 1981.<ref>{{Cite journal|last1=L|first1=Liskin|last2=JM|first2=Pile|last3=WF|first3=Quillan|date=1983|title=Vasectomy—safe and simple|url=https://www.popline.org/node/402465|journal=Population Reports. Series D: Sterilization Male|language=en|issue=4|url-status=dead|archive-url=https://web.archive.org/web/20171112185640/https://www.popline.org/node/402465|archive-date=2017-11-12|access-date=2017-11-12}}</ref>

One study conducted in 1977, when incentives were only equivalent to US$1.10 (at that time), indicated that between 40% and 60% of the men chose vasectomy because of the payment, who otherwise did not have any serious urge to get sterilized.<ref name=":3">{{Cite journal|last1=Khan|first1=Atiqur Rahman|last2=Swenson|first2=Ingrid E.|last3=Rahman|first3=Azizur|date=1979-01-01|title=A Follow-up of Vasectomy Clients in Rural Bangladesh|journal=International Journal of Gynecology & Obstetrics|language=en|volume=17|issue=1|pages=11–14|doi=10.1002/j.1879-3479.1979.tb00108.x|issn=1879-3479|pmid=39831|s2cid=22375165}}</ref>

The "Bangladesh Association for Voluntary Sterilization", alone performed 67,000 tubal ligations and vasectomies in its 25 clinics in 1982. The rate of sterilization increased 25 percent each year.<ref name=":2">{{Cite news|url=https://www.washingtonpost.com/archive/politics/1983/01/28/bangladeshs-midwives-promote-birth-control/4fb06202-6ddc-4357-b0fa-7e5d7a4cebfb/|title=Bangladesh's Midwives Promote Birth Control|last=Claiborne|first=William|date=1983-01-28|newspaper=Washington Post|access-date=2017-11-12|language=en-US|issn=0190-8286|url-status=live|archive-url=https://web.archive.org/web/20171112185718/https://www.washingtonpost.com/archive/politics/1983/01/28/bangladeshs-midwives-promote-birth-control/4fb06202-6ddc-4357-b0fa-7e5d7a4cebfb/|archive-date=2017-11-12}}</ref>

On 16 December 1982, Bangladesh's military ruler [[Lieutenant general (Bangladesh)|Lieutenant General]] [[Hussain Muhammad Ershad]] launched a two-year mass sterilization program for Bangladeshi women and men. About 3,000 women and men were planned to be sterilized on 16 December 1982 (the opening day). Ershad's government trained 1,200 doctors and 25,000 field workers who must conduct two tubal ligations and two vasectomies each month to earn their salaries. The government wanted to persuade 1.4 million people, both women and men to undergo sterilization within two years.<ref>{{Cite news|url=https://www.upi.com/Archives/1982/12/14/The-Bangladesh-government-plans-a-mass-voluntary-sterilization-of/3265408690000/|title=The Bangladesh government plans a mass voluntary sterilization of...|work=UPI|access-date=2017-11-11|language=en|url-status=live|archive-url=https://web.archive.org/web/20171113002940/https://www.upi.com/Archives/1982/12/14/The-Bangladesh-government-plans-a-mass-voluntary-sterilization-of/3265408690000/|archive-date=2017-11-13}}</ref> One population control expert called it 'the largest sterilization program in the world'.<ref>{{Cite news|url=https://www.upi.com/Archives/1982/12/15/Impoverished-Bangladesh-plans-sterilization-program/6350408776400/|title=Impoverished Bangladesh plans sterilization program|work=UPI|access-date=2017-11-11|language=en|url-status=live|archive-url=https://web.archive.org/web/20171112185727/https://www.upi.com/Archives/1982/12/15/Impoverished-Bangladesh-plans-sterilization-program/6350408776400/|archive-date=2017-11-12}}</ref> By January 1983, 40,000 government field workers were employed in Bangladesh's 65,000 villages to persuade women and men to undergo sterilization and to promote usage of birth-control across the country.<ref name=":2" />

Food subsidies under the group feeding program (VGF) were given to only those women with certificates showing that they had undergone tubal ligation.<ref>Miles and Shiva 1993</ref>

There are reports that often when a woman had to undergo a [[gastrointestinal surgery]], doctors took this opportunity to sterilize her without her knowledge.<ref name=":5">{{Cite web|url=http://www.asianews.it/news-en/Healthcare-in-Bangladesh:-only-sterilization-and-vasectomies-are-free-21608.html|title=BANGLADESH Healthcare in Bangladesh: only sterilization and vasectomies are free|last=AsiaNews.it|website=AsiaNews|access-date=2017-11-12|url-status=live|archive-url=https://web.archive.org/web/20171112185811/http://www.asianews.it/news-en/Healthcare-in-Bangladesh:-only-sterilization-and-vasectomies-are-free-21608.html|archive-date=2017-11-12}}</ref> According to Bangladesh governmental website "National Emergency Service", the 2000 Bangladeshi Taka (US$24) and the sari/lungi given to the persons undergoing sterilizations are their "'''compensations'''". Where Bangladesh government also assures the poor people that it will cover all medical expenses if complications arise after the sterilization.<ref>{{Cite web|url=https://www.nhd.gov.bd/content/%E0%A6%B8%E0%A7%8D%E0%A6%A5%E0%A6%BE%E0%A7%9F%E0%A7%80_%E0%A6%9C%E0%A6%A8%E0%A7%8D%E0%A6%AE%E0%A6%A8%E0%A6%BF%E0%A7%9F%E0%A6%A8%E0%A7%8D%E0%A6%A4%E0%A7%8D%E0%A6%B0%E0%A6%A3_%E0%A6%AA%E0%A6%A6%E0%A7%8D%E0%A6%A7%E0%A6%A4%E0%A6%BF%E0%A6%B0_%E0%A6%B8%E0%A7%87%E0%A6%AC%E0%A6%BE|title=স্থায়ী জন্মনিয়ন্ত্রণ পদ্ধতির সেবা|website=www.nhd.gov.bd|language=en|access-date=2017-11-12|url-status=dead|archive-url=https://web.archive.org/web/20180104124213/https://www.nhd.gov.bd/content/%E0%A6%B8%E0%A7%8D%E0%A6%A5%E0%A6%BE%E0%A7%9F%E0%A7%80_%E0%A6%9C%E0%A6%A8%E0%A7%8D%E0%A6%AE%E0%A6%A8%E0%A6%BF%E0%A7%9F%E0%A6%A8%E0%A7%8D%E0%A6%A4%E0%A7%8D%E0%A6%B0%E0%A6%A3_%E0%A6%AA%E0%A6%A6%E0%A7%8D%E0%A6%A7%E0%A6%A4%E0%A6%BF%E0%A6%B0_%E0%A6%B8%E0%A7%87%E0%A6%AC%E0%A6%BE|archive-date=2018-01-04}}</ref>

For the women who are persuaded to have an IUD inserted into their [[uterus]], the government also offers 150 Bangladeshi Taka (US$1.80) after the procedure and 80+80+80=240 Bangladeshi Taka (0.96+0.96+0.96=2.88 USD) in three followups, where the referrer gets 50 Bangladeshi Taka (US$0.60). For the women who are persuaded to have an [[etonogestrel birth control implant]] placed under the skin in their upper arm, the government offers 150 Bangladeshi Taka (US$1.80) after the procedure and 70+70+70=210 Bangladeshi Taka (0.84+0.84+0.84=2.52 USD) in three followups, where the referrer gets 60 Bangladeshi Taka (US$0.72).<ref name=":4" />
===== Complications =====
In the 1977 study, a one-year follow-up of 585 men sterilized at vasectomy camps in Shibpur and Shalna in rural Bangladesh showed that almost half of the men were dissatisfied with their vasectomies.{{citation needed|date=September 2023}}

58% of the men said their ability to work had decreased in the last year. 2–7% of the men said their sexual performance decreases. 30.6% of the Shibpur and 18.9% of the Shalna men experienced severe pain during the vasectomy. The men also said they had not received all of the incentives they had been promised.<ref name=":3" />

According to another study on 5042 women and 264 men who underwent sterilization, complications such as painful urination, shaking chills, fever for at least two days, frequent urination, bleeding from the incision, sore with pus, stitches or skin breaking open, weakness and [[dizziness]] arose after the sterilization.{{citation needed|date=September 2023}}

The person's sex, the sponsor and workload in the sterilization center, and the dose of [[sedative]]s administered to women were significantly associated with specific postoperative complaints. Five women died during the study, resulting in a death-to-case rate of 9.9/10,000 tubectomies (tubal ligations); four deaths were due to [[respiratory arrest]] caused by overuse of sedatives. The death-to-case rate of 9.9/10,000 tubectomies (tubal ligation) in this study is similar to the 10.0 deaths/10,000 cases estimated on the basis of a 1979 follow-up study in an Indian female sterilization camp. The presence of a complaint before the operation was generally a good predictor of postoperative complaints. Centers performing fewer than 200 procedures were associated with more complaints.<ref>{{Cite journal|last1=Rosenberg|first1=M. J.|last2=Rochat|first2=R. W.|last3=Akbar|first3=J.|last4=Gould|first4=P.|last5=Khan|first5=A. R.|last6=Measham|first6=A.|last7=Jabeen|first7=S.|date=August 1982|title=Sterilization in Bangladesh: mortality, morbidity, and risk factors|journal=International Journal of Gynaecology and Obstetrics|volume=20|issue=4|pages=283–291|issn=0020-7292|pmid=6127262|doi=10.1016/0020-7292(82)90057-1|s2cid=26123485}}</ref>

According to another study based on 20 sterilization-attributable deaths in [[Dacca Division|Dacca]] (now Dhaka) and [[Rajshahi Division|Rajshahi]] Divisions in Bangladesh, from 1 January 1979, to 31 March 1980, overall, the sterilization-attributable death-to-case rate was 21.3 deaths/100,000 sterilizations. The death rate for vasectomy was 1.6 times higher than that for tubal ligation. [[Anesthesia]] overdosage was the leading cause of death following tubal ligation along with [[tetanus]] (24%), where intraperitoneal hemorrhage (14%), and infection other than tetanus (5%) was other leading causes of death.{{citation needed|date=September 2023}}

Two women (10%) died from [[pulmonary embolism]] after tubal ligation; one (5%) died from each of the following: [[anaphylaxis]] from anti-tetanus serum, [[heat stroke]], [[small bowel obstruction]], and aspiration of vomitus. All seven men died from scrotal infections after vasectomy.<ref>{{Cite journal|last1=Grimes|first1=D. A.|last2=Peterson|first2=H. B.|last3=Rosenberg|first3=M. J.|last4=Fishburne|first4=J. I.|last5=Rochat|first5=R. W.|last6=Khan|first6=A. R.|last7=Islam|first7=R.|date=April 1982|title=Sterilization-attributable deaths in bangladesh|journal=International Journal of Gynaecology and Obstetrics|volume=20|issue=2|pages=149–154|issn=0020-7292|pmid=6125437|doi=10.1016/0020-7292(82)90029-7|s2cid=24472598}}</ref>

According to a second epidemiologic investigation of deaths attributable to sterilization in Bangladesh, where all deaths resulting from sterilizations performed nationwide between 16 September 1980 and 15 April 1981, were investigated and analyzed, nineteen deaths from tubal ligation were attributed to 153,032 sterilizations (both tubal ligation and vasectomy), for an overall death-to-case rate of 12.4 deaths per 100,000 sterilizations. This rate was lower than that (21.3) for sterilizations performed in Dacca (now Dhaka) and Rajshahi Divisions from 1 January 1979 to 31 March 1980, although this difference was not statistically significant. Anesthesia overdosage, tetanus, and [[hemorrhage]] (bleeding) were the leading causes of death.<ref>{{Cite journal|last1=Grimes|first1=D. A.|last2=Satterthwaite|first2=A. P.|last3=Rochat|first3=R. W.|last4=Akhter|first4=N.|date=November 1982|title=Deaths from contraceptive sterilization in bangladesh: rates, causes, and prevention|journal=Obstetrics and Gynecology|volume=60|issue=5|pages=635–640|issn=0029-7844|pmid=7145254}}</ref>

===== Backers =====
These civilian sterilization programs are funded by the countries from [[northern Europe]] and the [[United States]].<ref name=":5" /> [[World Bank|World bank]] is also known to have sponsored these civilian exploitative sterilization programs in Bangladesh. Historically, World Bank is known to have pressured 3rd World governments to implement population control programs.<ref>{{Cite journal|last=Hartmann|first=B.|date=June 1991|title=[Children and bankers in Bangladesh]|journal=Temas de Poblacion|volume=1|issue=2|pages=51–55|pmid=12284143}}</ref>

Bangladesh has the highest [[population density]] in the world among the countries having at least 10 million people. The capital Dhaka is the 4th [[List of cities by population density|most densely populated city]] in the world, which ranked as the world's 2nd most unlivable city, just behind [[Damascus]], [[Syria]], according to the annual "[[World's most liveable cities|Liveability Ranking]]" 2015 by the [[Economist Intelligence Unit]] (EIU).<ref>{{Cite web|url=http://www.eiu.com/public/topical_report.aspx?campaignid=Liveability2015|title=Global Liveability Ranking 2015 – The Economist Intelligence Unit|last=solutions|first=EIU digital|website=www.eiu.com|language=en|access-date=2017-11-12|url-status=live|archive-url=https://web.archive.org/web/20170810090944/https://www.eiu.com/public/topical_report.aspx?campaignid=Liveability2015|archive-date=2017-08-10}}</ref><ref>{{Cite news|url=http://www.thedailystar.net/country/dhaka-second-least-livable-city-the-world-129154|title=Dhaka 2nd least liveable city in the world|date=2015-08-19|work=The Daily Star|access-date=2017-11-12|language=en|url-status=live|archive-url=https://web.archive.org/web/20170905180327/http://www.thedailystar.net/country/dhaka-second-least-livable-city-the-world-129154|archive-date=2017-09-05}}</ref>

==== Rohingya ====
Bangladesh is planning to introduce a sterilization program in its overcrowded [[Rohingya people|Rohingya]] refugee camps, where nearly a million refugees are fighting for space, after efforts to encourage birth control failed. Since 25 August 2017, more than 600,000 Rohingya Muslims have fled from [[Rakhine State|Rakhine state]], [[Myanmar]] to neighboring Bangladesh, which is a Muslim majority country, following a military crackdown against Rohingya Muslims in Rakhine. Sabura, a Rohingya mother of seven, said her husband believed the couple could support a large family.<ref name=AFP-Rohingya/>

<blockquote>I spoke to my husband about birth control measures. But he is not convinced. He was given two condoms but he did not use them. My husband said we need more children as we have land and property (in Rakhine). We don't have to worry to feed them.</blockquote>

District family planning authorities have managed to distribute just 549 packets of condoms among the refugees, amid reports they are reluctant to use them. They have asked the government to approve a plan to provide vasectomies for men and tubectomies (tubal ligation) for women in the camps.<ref name=AFP-Rohingya/>

One volunteer, Farhana Sultana, said the women she spoke to believed birth control was a sin and others saw it as against the tenets of Islam.<ref name=AFP-Rohingya/>

Bangladeshi officials say about 20,000 Rohingya refugee women are pregnant and 600 have given birth since arriving in the country, but this may not be accurate as many births take place without formal medical help.<ref name=AFP-Rohingya/>

Every month 250 Bangladeshis undergo sterilization routinely under the government's sterilization program in the border district of [[Cox's Bazar District|Cox's Bazar]], where the Rohingya refugee Muslims have taken shelter.<ref name=AFP-Rohingya>{{Cite news|url=https://www.theguardian.com/world/2017/oct/28/bangladesh-to-offer-sterilisation-to-rohingya-in-refugee-camps|title=Bangladesh to offer sterilisation to Rohingya in refugee camps|agency=Agence France-Presse|date=2017-10-28|work=The Guardian|access-date=2017-11-12|language=en-GB|issn=0261-3077|url-status=live|archive-url=https://web.archive.org/web/20171104150415/https://www.theguardian.com/world/2017/oct/28/bangladesh-to-offer-sterilisation-to-rohingya-in-refugee-camps|archive-date=2017-11-04}}</ref><ref>{{Cite news|url=https://www.independent.co.uk/news/world/asia/bangladesh-sterilise-rohingya-muslims-population-burma-refugee-camps-a8026076.html|title=Bangladesh 'plans to offer to sterilise Rohingya Muslims' as refugee population grows|date=2017-10-29|work=The Independent|access-date=2017-11-12|language=en-GB|url-status=live|archive-url=https://web.archive.org/web/20171113003155/http://www.independent.co.uk/news/world/asia/bangladesh-sterilise-rohingya-muslims-population-burma-refugee-camps-a8026076.html|archive-date=2017-11-13}}</ref>

=== Brazil ===
During the 1970s–80s, the U.S. government sponsored family planning campaigns in Brazil, although sterilization was illegal at the time there.<ref name=":8" /> Dalsgaard examined sterilization practices in Brazil; analyzing the choices of women who opt for this type of reproductive healthcare in order to prevent future pregnancies and so they can accurately plan their families.<ref>{{Cite book|title=Matters of Life and Longing: Female Sterilisation in Northeast Brazil|last=Dalsgaard|first=Anne Line|publisher=Museum Tusculanum Press|year=2004}}</ref> While many women choose this form of contraception, there are many societal factors that impact this decision, such as poor economic circumstances, low rates of employment, and Catholic religious mandates that stipulate sterilization as less harmful than abortion.<ref>{{Cite book|title=Reproductive and Sexual Rights: A Feminist Perspective |last1=Corrêa |author1-link=Sonia Corrêa |last2=Petchesky |first1=Sonia |first2= Rosalind |author2-link=Rosalind Petchesky |publisher=Routledge |year=1994 |location=United Kingdom |pages=134–147}}</ref>

An important case in the legal history of compulsory sterilization in Brazil is the 2018 São Paulo case.<ref>{{Cite journal|last1=Almeida|first1=Marina Nogueira|last2=Silva|first2=Adalene Ferreira Figueiredo da|date=2019-07-10|title=Voluntary and Compulsory Sterilization in Brazil and the Reproductive Rights of Women|url=https://riviste.unige.it/index.php/aboutgender/article/view/1056|journal=AG About Gender - Rivista internazionale di studi di genere|language=en|volume=8|issue=15|doi=10.15167/2279-5057/AG2019.8.15.1056|issn=2279-5057}}</ref> Prosecutors filed to have a mother of eight forcibly sterilized after she was arrested on charges of drug trafficking.<ref name=":6">{{Cite web|date=2018-06-21|title=Court-ordered sterilization investigated in Brazil|url=https://apnews.com/article/05722c77e51e4897aec3b85943102d60|access-date=2021-04-08|website=AP NEWS}}</ref> This motion was justified by the mother's poverty, substance abuse disorder, and inability to care for her children, and the judge ruled in favor of sterilization.<ref>{{Cite web|title=Who decides over Janaina's body? A case of forced sterilization in Brazil|url=https://www.opendemocracy.net/en/democraciaabierta/who-decides-over-janaina-s-body-case-of-forced-sterilizati/|access-date=2021-04-08|website=openDemocracy|language=en}}</ref> The surgery was carried out, reportedly against the woman's will.<ref name=":6" /> Legal experts discussing the case have stated the sterilization of a woman in Brazil is legal when determined absolutely necessary, but it is not clear what qualifies as necessary.<ref name=":6" />

=== Canada ===
{{Main|Compulsory sterilization in Canada}}
{{Excerpt|Compulsory sterilization in Canada|hat=no|paragraph=1,2,3}}

===China===
{{See also|One-child policy|Two-child policy}}

In 1978, Chinese authorities became concerned with the possibility of a baby boom that the country could not handle, and they initialized the [[one-child policy]]. In order to effectively deal with the complex issues surrounding childbirth, the Chinese government placed great emphasis on family planning. Because this was such an important matter, the government thought it needed to be standardized, and so to this end laws were introduced in 2002.<ref name="Amnesty International">{{Cite news | title=Thousands at risk of forced sterilization in China | date=22 April 2010 | access-date=9 April 2012 | publisher=[[Amnesty International]] | url=https://www.amnesty.org/en/news-and-updates/thousands-risk-forced-sterilization-china-2010-04-22 | url-status=live | archive-url=https://web.archive.org/web/20120314193515/http://www.amnesty.org/en/news-and-updates/thousands-risk-forced-sterilization-china-2010-04-22 | archive-date=14 March 2012 }}</ref> These laws uphold the basic tenets of what was previously put into practice, outlining the rights of the individuals and outlining what the Chinese government can and cannot do to enforce policy.

However, accusations have been raised from groups such as [[Amnesty International]], who have claimed that practices of compulsory sterilization have been occurring for people who have already reached their one child quota.<ref name="Amnesty International" /> These practices run contrary to the stated principles of the law, and seem to differ on a local level.

The Chinese government appears to be aware of these discrepancies in policy implementation on a local level. For example, The National Population and Family Planning Commission put forth in a statement that, "Some persons concerned in a few counties and townships of Linyi did commit practices that violated law and infringed upon legitimate rights and interests of citizens while conducting family planning work." This statement comes in reference to some charges of forced sterilization and abortions in Linyi city of Shandong Province.<ref>{{Cite news | title=China acts on forced abortion | date=20 September 2005 | access-date=9 April 2012 | publisher=BBC | url=http://news.bbc.co.uk/1/hi/world/asia-pacific/4262890.stm | url-status=live | archive-url=https://web.archive.org/web/20090210000256/http://news.bbc.co.uk/1/hi/world/asia-pacific/4262890.stm | archive-date=10 February 2009 }}</ref>

The policy requires a "social compensation fee" for those who have more than the legal number of children. According to Forbes editor Heng Shao, critics claims this fee is a toll on the poor but not the rich.<ref>Enforcement of One-Child Policy Targets 'The Rich and Famous' in Zhangzhou, China, ''[[Forbes]]'', 20 September 2013. {{cite web |url=https://www.forbes.com/sites/hengshao/2013/09/20/enforcement-of-one-child-policy-targets-the-rich-and-famous-in-zhangzhou-china/ |title=Enforcement of One-Child Policy Targets 'The Rich and Famous' in Zhangzhou, China |website=[[Forbes]] |access-date=2017-09-29 |url-status=live |archive-url=https://web.archive.org/web/20170909011431/https://www.forbes.com/sites/hengshao/2013/09/20/enforcement-of-one-child-policy-targets-the-rich-and-famous-in-zhangzhou-china/ |archive-date=2017-09-09 }}</ref> But after 2016, the country has allowed parents to give birth to [[Two-child policy|two children]]. In 2017, the government offered to surgically remove the IUDs that had been implanted in women to force them to adhere to the one child policy, if they qualified to have a second child. The removal of these long used IUDs is a major surgery and many women are not informed of the risks that are associated with the surgery, such as bleeding, infection, and removal of the uterus.<ref name=":16">{{Cite web|date=2020-07-21|title=Neo-Malthusianism and Coercive Population Control in China and India: Overpopulation Concerns Often Result in Coercion|url=https://www.cato.org/policy-analysis/neo-malthusianism-coercive-population-control-china-india-overpopulation-concerns|access-date=2021-04-09|website=Cato Institute|language=en}}</ref>

==== Xinjiang ====
Beginning in 2019, reports of forced sterilization in [[Xinjiang]] began to surface.<ref>{{Cite news|last=Stavrou|first=David|date=17 October 2019|title=A Million People Are Jailed at China's Gulags. I Managed to Escape. Here's What Really Goes on Inside|work=[[Haaretz]]|url=https://www.haaretz.com/world-news/.premium.MAGAZINE-a-million-people-are-jailed-at-china-s-gulags-i-escaped-here-s-what-goes-on-inside-1.7994216|access-date=}}</ref><ref>{{Cite news|last=Handley|first=Erin|date=23 September 2019|title='Deeply disturbing' footage surfaces of blindfolded Uyghurs at train station in Xinjiang|work=[[ABC News (Australia)|ABC News]]|url=https://www.abc.net.au/news/2019-09-23/video-uyghurs-shaved-blindfolded-xinjiang-train-station-china/11537628|access-date=}}</ref><ref>{{Cite news|last=Fifield|first=Anna|date=28 November 2019|title=TikTok's owner is helping China's campaign of repression in Xinjiang, report finds|newspaper=[[The Washington Post]]|url=https://www.washingtonpost.com/world/tiktoks-owner-is-helping-chinas-campaign-of-repression-in-xinjiang-report-finds/2019/11/28/98e8d9e4-119f-11ea-bf62-eadd5d11f559_story.html|access-date=}}</ref> In 2020, public reporting continued to indicate that large-scale compulsory sterilization was being carried out.<ref name=":13">{{Cite web|date=2020-06-29|title=China cuts Uighur births with IUDs, abortion, sterilization|url=https://apnews.com/269b3de1af34e17c1941a514f78d764c|access-date=2020-07-01|website=Associated Press}}</ref><ref name=":15">{{Cite web|title=Pompeo calls report of forced sterilisation of Uighurs 'shocking'|url=https://www.aljazeera.com/news/2020/06/pompeo-calls-shocking-report-forced-sterilisation-uighurs-200629215350131.html|access-date=2020-08-11|website=www.aljazeera.com}}</ref> While national sterilization rates have fallen since the passing of the two child policy in 2016, there has been a sharp increase in the amount of sterilizations in Xinjiang.<ref name=":19">{{Cite web|date=2020-07-21|title=Uyghur Genocide Shows Urgency of Combating Neo-Malthusianism|url=https://www.cato.org/blog/uyghur-genocide-shows-urgency-combatting-neo-malthusianism|access-date=2021-04-09|website=Cato Institute|language=en}}</ref> Many of these surgeries have been forced according to reports, but this is difficult to confirm due to the closed off nature of the area.<ref name=":19" />  These measures have sometimes been characterised as part of an ongoing [[Persecution of Uyghurs in China|Uyghur genocide]] in the province.

=== Czechoslovakia and the Czech Republic ===
[[Czechoslovakia]] carried out a policy to sterilize [[Romani people|Romani]] women, starting in 1973 continuing through the [[Velvet Revolution]] of 1989. In some cases, the sterilization was in exchange for social welfare benefits, and the people who were affected were given written agreements which described what was to be done to them, but which they were unable to read due to their illiteracy.<ref>{{Cite news |date=2007-03-12 |title=Sterilised Roma accuse Czechs |url=http://news.bbc.co.uk/2/hi/europe/6409699.stm |archive-url=https://web.archive.org/web/20170915024859/http://news.bbc.co.uk/2/hi/europe/6409699.stm |archive-date=2017-09-15 |access-date=2025-02-25 |language=en-GB}}</ref> The dissidents of the [[Charter 77|Charter 77 movement]] denounced these practices in 1977–78 as a [[genocide]].<ref>{{Cite web |last=Staff |first=Newsdesk org |date=2006-06-12 |title=For Gypsies, Eugenics is a Modern Problem / Czech Practice Dates to Soviet Era |url=https://newsdesk.org/2006/06/12/for_gypsies_eug/ |archive-url=https://web.archive.org/web/20151016031746/http://newsdesk.org/2006/06/12/for_gypsies_eug/ |archive-date=2015-10-16 |access-date=2025-02-25 |website=newsdesk dot org |language=en-US}}</ref> A 2005 report by the Czech government's independent ombudsman, [[Otakar Motejl]], identified dozens of cases of coercive sterilization between 1979 and 2001, and called for criminal investigations and possible prosecution against several healthcare workers and administrators.<ref name="Czech">re Law on Atrocities relevant pre-1990, CR (ChR) [http://www.ochrance.cz/fileadmin/user_upload/ENGLISH/Sterilisation.pdf Final Statement of the Public Defender of Rights in the Matter of Sterilisations Performed in Contravention of the Law and Proposed Remedial Measures] {{webarchive|url=https://web.archive.org/web/20140809003521/http://www.ochrance.cz/fileadmin/user_upload/ENGLISH/Sterilisation.pdf|date=2014-08-09}}, Czech government, 2005</ref>

Beginning 2012 undergoing sterilization is a requirement for change of name and/or gender markers on official documents for all transgender people in Czechia.<ref>{{Cite web |date=2011-08-12 |title=373/2011 Sb. Zákon o specifických zdravotních službách |trans-title=Law No. 373/2011 Coll. Specific Health Services Act |url=https://www.zakonyprolidi.cz/translation/cs/2011-373?langid=1033 |access-date=2025-02-25 |website=Zákony pro lidi}}</ref> In May 2024 the constitutional court found the laws requiring sterilization to be in violation of EU human rights laws. The court established a deadline of June 2025 where the current government is to draft replacement laws.<ref>{{Cite web |title=Chirurgický zákrok včetně sterilizace jako podmínka úřední změny pohlaví neobstál před Ústavním soudem |url=https://www.usoud.cz/aktualne/chirurgicky-zakrok-vcetne-sterilizace-jako-podminka-uredni-zmeny-pohlavi-neobstal-pred-ustavnim-soudem |access-date=2025-02-23 |website=www.usoud.cz |language=cs}}</ref>{{Update after|2025|06}}

=== Colombia ===
The time period of 1964–1970 started Colombia's population policy development, including the foundation of PROFAMILIA and through the Ministry of Health the family planning program promoted the use of IUDs, the Pill, and sterilization as the main avenues for contraception. By 2005, Colombia had one of the world's highest contraceptive usage rates at 76.9%, with female sterilization being the highest percentage of use at just over 30% (second highest is the IUD at around 12% and the pill around 10%)<ref>{{Cite book|title=Against the Odds: Colombia's Role in the Family Planning Revolution|last=Measham and Lopez-Escobar|first=Anthony, Guillermo|publisher=World Bank Publisher|year=2007|pages=121–135}}</ref> (Measham and Lopez-Escobar 2007). In Colombia during the 1980s, sterilization was the second most popular choice of pregnancy prevention (after the Pill), and public healthcare organizations and funders (USAID, AVSC, IPPF) supported sterilization as a way to decrease abortions rates. While not directly forced into sterilization, women of lower socio-economic standing had significantly less options to afford family planning care as sterilizations were subsidized.<ref name=":8">{{Cite book|title=Reproductive Rights and Wrongs: The Global Politics of Population Control|last=Hartmann|first=Betsy|publisher=Haymarket Books|year=2016|location=Chicago}}</ref>

===Denmark===
11,000 people were sterilized in Denmark from 1929–67, about half were sterilized against their will.<ref name=":21">{{Cite news |last=Jan|first=Olsen|date=29 August 1997|title=Denmark to investigate its involuntary sterilization program|url=https://apnews.com/article/e1731db26be41810f79e7e148d087a04 |work=AP News}}</ref> The forced sterilization program was "mainly was directed at people who were mentally handicapped" because of the popularity of eugenics at the time in Denmark.<ref name=":21"/> During the 1960s and 1970s, thousands of [[Greenlandic Inuit]] women and girls had IUDs placed without their consent. The birth rate in Greenland was reduced by around 50%. In 2022, Denmark and Greenland agreed to hold a two-year investigation into the program, known as the [[spiral case]].<ref>{{cite news |last=Murray |first=Adrienne |title=Inuit Greenlanders demand answers over Danish birth control scandal |work=BBC News |url=https://www.bbc.com/news/world-europe-63049387 |date=30 September 2022 |access-date=5 November 2022}}</ref>

Until 11 June 2014, sterilization was requisite for legal sex change in Denmark.<ref>{{cite news
 |date         = 22 May 2018
 |title        = OVERBLIK: Transkønnedes kamp mod lovgivningen
 |url          = https://www.avisen.dk/overblik-transkoennedes-kamp-mod-lovgivningen_499227.aspx
 |language     = da
 |work         = avisen.dk
 |access-date  = 9 August 2018
 |archive-url  = https://web.archive.org/web/20180809184337/https://www.avisen.dk/overblik-transkoennedes-kamp-mod-lovgivningen_499227.aspx
 |archive-date = 9 August 2018
 |url-status   = live
}}</ref><ref>{{Cite web|title=Denmark Ends Forced Sterilisation for Sex Change|url=https://www.ndtv.com/india-news/denmark-ends-forced-sterilisation-for-sex-change-577321|access-date=2022-01-04|website=NDTV.com}}</ref><ref>{{Cite web|last=B|first=Matty|title=Denmark Ends Forced Sterilization Of Transgender People|url=https://www.queerty.com/denmark-ends-forced-sterilization-of-transgender-people-20140613|access-date=2022-01-04|website=Queerty|date=13 June 2014 }}</ref>

===Finland===
Finland required forced sterilization for adults to legally change their sex, until 3 April 2023 <ref>{{cite news
 |date         = 3 March 2023
 |title        = Finland to allow gender reassignment without sterilisation
 |url          = https://www.reuters.com/world/europe/finland-allow-gender-reassignment-without-sterilisation-2023-03-03/
 |language     = en
 |work         = reuters.com
 |access-date  = 8 May 2023
 }}</ref>

===Germany===<!-- This section is linked from January 1 -->
{{Main|Nazi eugenics}}
[[File:Bundesarchiv Bild 102-15664, Farbiger Junge.jpg|thumb|upright|A young Rhinelander who was classified as a ''bastard'' and ''hereditarily unfit'' under the Nazi regime]]

One of the first acts by [[Adolf Hitler]] after the [[Reichstag Fire Decree]] and the [[Enabling Act of 1933]] gave him de facto legal dictatorship over the [[Germany|German]] state was to pass the [[Law for the Prevention of Hereditarily Diseased Offspring]] (''Gesetz zur Verhütung erbkranken Nachwuchses'') in July 1933.<ref>{{Cite web |url=https://news.google.com/newspapers?id=jkswAAAAIBAJ&pg=3703%2C266241 |title=Eugenics Courts Named in Reich. The Montreal Gazette. January 3, 1934. |access-date=15 August 2017 |archive-url=https://web.archive.org/web/20200215090718/https://news.google.com/newspapers?id=jkswAAAAIBAJ&sjid=XKgFAAAAIBAJ&pg=3703,266241 |archive-date=15 February 2020 |url-status=live }}</ref><ref>{{Cite web|url=https://news.google.com/newspapers?id=ifwtAAAAIBAJ&sjid=hZgFAAAAIBAJ&pg=1639,2526515|title=The Montreal Gazette - Google News Archive Search|website=news.google.com}}</ref> The law was signed by Hitler himself, and over 200 eugenic courts were created specifically as a result of this law. Under it, all doctors in the [[Nazi Germany|Third Reich]] were required to report any patients of theirs who were deemed [[intellectual disability|intellectually disabled]], characterized [[mentally ill]] (including [[schizophrenia]] and [[manic depression]]), [[epilepsy|epileptic]], blind, deaf, or physically deformed, and a steep monetary penalty was imposed for any patients who were not properly reported. Individuals with [[alcoholism]] or [[Huntington's disease]] could also be sterilized. The individual's case was then presented in front of a court of [[Nazi]] officials and public health officers who would review their medical records, take testimony from friends and colleagues, and eventually decide whether or not to order a sterilization operation performed upon the individual, using force if necessary. Though not explicitly covered by the law, 400 mixed-race "[[Rhineland Bastard]]s" were also sterilized beginning in 1937.<ref>Robert Proctor, ''Racial hygiene: Medicine under the Nazis'' (Cambridge, MA: Harvard University Press, 1988), and Gisela Bock, "Nazi sterilization and reproductive policies" in Dieter Kuntz, ed., ''Deadly medicine: creating the master race'' (Washington, D.C.: United States Holocaust Memorial Museum, 2004).</ref><ref>{{Cite web|url=https://news.google.com/newspapers?id=zzsbAAAAIBAJ&sjid=50wEAAAAIBAJ&pg=1710,6396277|title=The Pittsburgh Press - Google News Archive Search|website=news.google.com}}</ref><ref>[https://www.researchgate.net/publication/339243252_From_Kraepelin_to_Karadzic_Psychiatry%27s_Long_Road_to_Genocide] "From Kraepelin to Karadzic: Psychiatry's Long Road to Genocide"  Author Robert Kaplan. From book title "Genocide Perspectives IV" (pp.122-165) Page 133. Date 2012.</ref> The sterilization program went on until the war started, with about 600,000 people sterilized.<ref>{{cite web |url=http://www.dnalc.org/view/15466-The-connection-between-American-eugenics-and-Nazi-Germany-James-Watson.html |title=The connection between American eugenics and Nazi Germany, James Watson :: DNA Learning Center |access-date=2014-02-05 |url-status=live |archive-url=https://web.archive.org/web/20140221173441/http://www.dnalc.org/view/15466-The-connection-between-American-eugenics-and-Nazi-Germany-James-Watson.html |archive-date=2014-02-21 }} |"The connection between American eugenics and Nazi Germany" [[James Watson]] speaks about Nazi eugenics</ref>

By the end of [[World War II]], over 400,000 individuals were sterilized under the German law and its revisions, most within its first four years of being enacted. When the issue of compulsory sterilization was brought-up at the [[Nuremberg trials]] after the war, many Nazis defended their actions on the matter by indicating that it was the United States itself from which they had taken inspiration. The Nazis had many other eugenics-inspired [[racial policy of Nazi Germany|racial policies]], including their [[T-4 Euthanasia Programme|T-4 euthanasia program]], in which around 70,000 people who were institutionalized or had birth defects were killed.<ref>[[Ian Kershaw]], ''Hitler: A Profile in Power'', Chapter VI, first section (London, 1991, rev. 2001)</ref>

=== Guatemala ===
Guatemala is one country that resisted family planning programs, largely due to lack of governmental support, including [[Guatemalan Civil War|civil war]] strife, and strong opposition from both the Catholic Church and Evangelical Christians until 2000, and as such, has the lowest prevalence of contraceptive usage in Latin America. In the 1980s, the archbishop of the country accused USAID of mass sterilizations of women without consent, but a President Reagan backed commission found the allegations to be false.<ref>{{Cite book|title=Guatemala: The Pioneering Days of the Family Planning Movement|last=Santiso-Galvez and Bertrand|first=Roberto; Jane T.|publisher=World Bank Publications|year=2007|pages=137–154}}</ref>

=== Iceland ===
Since 2019, nonconsensual sterilization is forbidden in Iceland unless deemed medically necessary. However, this law only addresses the procedures of tubal ligation and surgical blocking of the fallopian tubes, excluding hysterectomies from the ban. Iceland's laws surrounding legalization of sterilization practices also do not address consent of the disabled individuals undergoing these procedures. In March 2023, mother Hermina Hreidarsdottir authorized a hysterectomy for her severely cognitively impaired 20-year-old daughter due to her abnormal menstrual cycle. Ms. Hreidarsdottir took liberty of this decision for her daughter without consulting her because she believed that this sterilization procedure would improve her daughter's quality of life.<ref name=":12"/> 

=== India ===
[[The Emergency (India)|The Emergency]] in India from 1975 and 1977 resulted from internal and external conflict for the country, and resulted in misuse of power and human rights violations from the government.<ref name=":03">{{Cite news|date=11 May 2001|title=The Indira enigma|publisher=[[Frontline (US TV series)|Frontline]]|url=http://www.hinduonnet.com/fline/fl1809/18090740.htm|url-status=usurped|access-date=28 July 2006|archive-url=https://web.archive.org/web/20061110074114/http://www.hinduonnet.com/fline/fl1809/18090740.htm|archive-date=10 November 2006}}</ref>  On 6 August 1976, the state of [[Maharashtra]] became the first governmental unit to enact legislation mandating compulsory sterilization of men and women after the birth of a third child, passing the Family (Restrictions on Size) Bill on its third reading and sending it to the President of India for the required assent.  The President reacted favorably and sent the bill back to the Maharashtra government with suggested amendments that would be necessary for an enactment, but before the measure could be passed, new elections were called and the legislation was not passed.<ref>Leela Visaria and Rajani R. Ved, ''India's Family Planning Programme Policies, Practices and Challenges'' (Taylor & Francis, 2016) pp. 28-29</ref>

Stopping short of forced sterilization, the national government enacted an incentive program for a family planning initiative that began in 1976 in an attempt to lower the exponentially increasing population. This program focused on male citizens and used propaganda and monetary incentives to impoverished citizens to get sterilized.<ref>{{cite news|title=A generation of lost manhood|website=[[The Times of India]]|date=26 June 2015 |url=http://timesofindia.indiatimes.com/city/chandigarh/A-generation-of-lost-manhood/articleshow/47824811.cms|url-status=live|archive-url=https://web.archive.org/web/20160107221309/http://timesofindia.indiatimes.com/city/chandigarh/A-generation-of-lost-manhood/articleshow/47824811.cms|archive-date=2016-01-07}}</ref> People who agreed to get sterilized would receive land, housing, and money or loans.<ref name="Relyingonhardandsoftsells2">''Relying on Hard and Soft Sells India Pushes Sterilization'', New York Times, 22 June 2011.</ref> This program led millions of men to receive vasectomies, and an undetermined amount of these were coerced. There were reports of officials blocking off villages and dragging men to surgical centers for vasectomies.<ref name=":17">{{Cite news|date=2014-11-14|title=India's dark history of sterilisation|language=en-GB|work=BBC News|url=https://www.bbc.com/news/world-asia-india-30040790|access-date=2021-04-08}}</ref> However, after much protest and opposition, the country switched to targeting women through coercion, withholding welfare or ration card benefits, and bribing women with food and money.<ref name=":622">{{Cite journal|last=Wilson|first=Kalpana|date=2017-04-01|title=In the name of reproductive rights: race, neoliberalism and the embodied violence of population policies|url=https://eprints.bbk.ac.uk/20444/1/Kalpana%20Wilson%20New%20Formations%202017.pdf|url-status=live|journal=New Formations|volume=91|issue=91|pages=50–68|doi=10.3898/newf:91.03.2017|issn=0950-2378|archive-url=https://web.archive.org/web/20190428234457/http://eprints.bbk.ac.uk/20444/1/Kalpana%20Wilson%20New%20Formations%202017.pdf|archive-date=2019-04-28|access-date=2019-12-16|s2cid=148987919}}</ref> This switch was theorized to be based on the principle women are less likely to protest for their own rights.<ref name=":17" /> Many deaths occurred as a result of both the male and the female sterilization programs.<ref name=":17" /> These deaths were likely attributed to poor sanitation standards and quality standards in the Indian sterilization camps.

[[Sanjay Gandhi]], son of the then-Prime Minister [[Indira Gandhi]], was largely responsible for what turned out to be a failed program.<ref name=":03" /> A strong mistrust against family planning initiatives followed the highly controversial program, the effect of which continues into the 21st century.<ref>{{Cite news|date=September 1996|title=Male involvement and contraceptive methods for men|publisher=[[Frontline (US TV series)|Frontline]]|url=http://www.malecontraceptives.org/articles/ringheim_article.php|url-status=live|access-date=28 July 2006|archive-url=https://web.archive.org/web/20060811233229/http://www.malecontraceptives.org/articles/ringheim_article.php|archive-date=11 August 2006}}</ref> Sterilization policies are still enforced in India, targeting mostly indigenous and lower-class women who are herded into the sterilization camps.<ref name=":622" /> The most recent abuse of family planning systems was highlighted by the death of 15 lower-class women in a sterilization center in [[Chhattisgarh]] in 2014.<ref name=":622" /> Despite these deaths, sterilization is still the highest used method of birth control with 39% of women in India turning to sterilization in 2015.<ref>{{Cite web|title=Sterilization: The Standard Choice in India|url=https://www.globalhealthnow.org/2018-09/sterilization-standard-choice-india|access-date=2021-04-08|website=Global Health NOW|language=en|archive-date=15 June 2021|archive-url=https://web.archive.org/web/20210615071848/https://www.globalhealthnow.org/2018-09/sterilization-standard-choice-india|url-status=dead}}</ref>

According to [[Human Rights Law Network]]:{{blockquote|In September 2016, the Supreme Court of India directed the Union Government to ensure the discontinuation of 'sterilization camps' within the following three years and to induce the state governments to follow suit. It also charged the government to ensure proper monitoring of the programme, investigate sterilization failures, complications or deaths, and increase the compensation amount in these cases. It further ordered the implementation of established legal, medical and technical standards for sterilization [...] Women were made to lay on bare mattresses for the surgeries, with no post-surgery recuperation facilities. Often the women were made to wait up to five hours after registering, and by the time they reached the operating table their an aesthetic would have worn off. In places like Bhubaneshwar, Odisha and Ferozpur, Uttar Pradesh, the doctors conducting surgeries would use bicycle pumps instead of an insufflator, to introduce air into the women's abdomens (as reported by Shreelatha Menon). The doctor in Bhubaneshwar stated that he had done over 60,000 tubectomies and many of them with bicycle pumps. In Kaparfora, Bihar, a woman was operated upon, even though she was pregnant, and suffered a miscarriage as a result. [...] Today, while laws may not announce eugenic aims, hidden agenda to dispose of "undesirables" in society can still be discovered by looking beyond the face of the law. While many population control policies may appear benign on their face, upon further investigation the stated medical reasons for sterilization and the identification of groups to which the law applies are revealed to be morally and legally suspect. For example, compulsory sterilization law laws often target LGBT+ people, especially transgender people.<ref>{{Cite web|title=Mistreatment and Coercion: Unethical Sterilization in India|url=https://hrln.org/uploads/2018/10/Mistreatment-and-Coercion-Unethical-Sterilization-in-India.pdf|website=Human Rights Law Network|access-date=4 January 2022|archive-date=2 August 2021|archive-url=https://web.archive.org/web/20210802061259/https://hrln.org/uploads/2018/10/Mistreatment-and-Coercion-Unethical-Sterilization-in-India.pdf|url-status=dead}}</ref>{{long quote|date=October 2023}}}}Forced sterilization has been an issue that has also affected the disabled population of women in [[India]]. In 2016, the Right to Persons with Disabilities Act (RPWD) was introduced to legally address the problems faced by the disabled community and ensure equitable access to justice for all members of society:<ref name=":43">{{Cite journal |last=Goswami Vernal |first=Triveni |date=2023-02-28 |title=Rights of Persons with Disabilities in India: Provisions, Promises and Reality |url=https://digitalcommons.bau.edu.lb/schbjournal/vol4/iss2/4 |journal=BAU Journal - Society, Culture and Human Behavior |volume=4 |issue=2 |doi=10.54729/2789-8296.1069 |issn=2789-8296}}</ref><blockquote>"While the RPWD Act took a step towards recognizing the issue of forced abortions under Section 92(f)[1] which states that any medical procedure performed on a disabled woman without her express consent that leads to the termination of pregnancy is punishable with an imprisonment term, there is still no specific mention of forced sterilization as a problem."<ref name=":23">{{Cite news |last=Singh |first=Shivalika |date=March 20, 2023 |title=Forced Sterilization of Disabled Women in India: A Tale of Lost Autonomy |url=https://blogs.lse.ac.uk/humanrights/2023/03/20/forced-sterilization-of-disabled-women-in-india-a-tale-of-lost-autonomy/#:~:text=Women%20with%20disabilities%20in%20India,sterilization%20to%20regulate%20their%20fertility. |access-date=April 3, 2024 |website=LSE Human Rights}}</ref></blockquote>There is no clause in the RPWD that addresses the notion of "expressed consent."<ref name=":43" /> Consent in relation to family planning and sterilization practices has been a point of contention in India's history of reproductive justice of disabled individuals.

=== Israel ===
In the late 2000s, reports in the Israeli media claimed that injections of long-acting contraceptive [[Depo-Provera]] (the effects of which are temporary, lasting only 3 months)<ref>{{Cite web |last=Berger |first=Raymond M. |title=The Blogs: The Big Lie: Involuntary Sterilization of Black Ethiopian Women |url=https://blogs.timesofisrael.com/the-big-lie-involuntary-sterilization-of-black-ethiopian-women/ |access-date=2025-04-15 |website=blogs.timesofisrael.com |language=en-US}}</ref> had been forced on hundreds of [[Ethiopian Jews in Israel|Ethiopian-Jewish immigrants]] both in transit camps in Ethiopia and after their arrival in Israel.<ref>{{Cite news|last=Greenwood|first=Phoebe|date=28 February 2013|title=Ethiopian women in Israel 'given contraceptive without consent'|work=The Guardian|url=https://www.theguardian.com/world/2013/feb/28/ethiopian-women-given-contraceptives-israel}}</ref> In 2009, feminist NGO [[Haifa Women's Coalition]] published a first survey on the story, which was followed up by [[Israeli Educational Television]] a few years later.<ref>{{Cite news|last=Nesher|first=Talila|date=27 January 2013|title=Israel Admits Ethiopian Women Were Given Birth Control Shots|work=Haaretz|url=https://www.haaretz.com/israel-news/.premium-ethiopians-fooled-into-birth-control-1.5226424}}</ref> Ethiopian-Jewish women said they were intimidated or tricked into taking the shot every three months.{{Citation needed|date=April 2025}} In 2013, the [[Ministry of Health (Israel)|Israeli Health Ministry]] instructed [[Health maintenance organization|HMOs]] to stop automatically renewing Depo-Provera prescriptions for Ethiopian-Israelis if there was any chance that the patients did not fully understand the implications of the treatment.<ref>{{Cite web |last=Zeiger |first=Asher |title=Israel changes birth-control policy for Ethiopian immigrants |url=https://www.timesofisrael.com/israel-changes-birth-control-policy-for-ethiopian-immigrants/ |access-date=2025-04-15 |website=www.timesofisrael.com |language=en-US}}</ref>

=== Japan ===
{{Further|Eugenics in Japan}}

In the first part of the reign of Emperor Hirohito, Japanese governments promoted increasing the number of healthy Japanese, while simultaneously decreasing the number of people who were afflicted with mental retardation, disability, genetic disease, and other conditions that led to inferiority in the Japanese genepool.<ref name="renamed_from_1940_on_20131210024331"/><ref>{{cite book |editor1-first=R. J. |editor1-last=Srám |editor2-first=V. |editor2-last=Bulyzhenkov |editor3-first=L. |editor3-last=Prilipko |editor4-first=Y. |editor4-last=Christen |display-editors=3 |last=Kimura |first=Rihito |title=Ethical Issues of Molecular Genetics in Psychiatry |chapter=Jurisprudence in Genetics |chapter-url=http://www.bioethics.jp/licht_genetics.html |publisher=Springer-Verlag |year=1991 |pages=157–166 |url-status=live |url=http://www.bioethics.jp/licht_genetics.html |archive-url=https://web.archive.org/web/20151107030234/http://www.bioethics.jp/licht_genetics.html |archive-date=2015-11-07 }}</ref>

The ''Leprosy Prevention laws'' of 1907, 1931, and 1953 permitted the segregation of patients in sanitariums where forced abortions and sterilization were common, and authorized punishment of patients "disturbing peace".<ref>{{cite news |title=Hansen's sanitarium were houses of horrors |url=http://search.japantimes.co.jp/cgi-bin/nn20050128a1.html |newspaper=[[The Japan Times]] |date=2005-01-28 |url-status=live |archive-url=https://web.archive.org/web/20110606085432/http://search.japantimes.co.jp/cgi-bin/nn20050128a1.html |archive-date=2011-06-06 }}, {{cite journal |first=Hajime |last=Sato |title=Abolition of leprosy isolation policy in Japan: policy termination through leadership |journal=Policy Studies Journal |volume=30 |issue=1 |pages=29–46 |date=February 2002 |doi=10.1111/j.1541-0072.2002.tb02126.x}}</ref> Under the colonial Korean ''Leprosy prevention ordinance'', Korean patients were also subjected to hard labor.<ref>{{cite news |title=Korean Hansens patients seek redress |newspaper=[[The Japan Times]] |date=2004-02-26 |url=http://search.japantimes.co.jp/cgi-bin/nn20040226a4.html |url-status=live |archive-url=https://archive.today/20120605020715/http://search.japantimes.co.jp/cgi-bin/nn20040226a4.html |archive-date=2012-06-05 }}</ref>

The "National Eugenic Law" was promulgated in 1940 by the [[Fumimaro Konoe|Konoe]] government, after rejection of the original "Race Eugenic Protection Law" in 1938.<ref name="renamed_from_1940_on_20131210024331">{{cite web |trans-title=The Eugenic Protection Law |title=国民優生法 |quote=The 107th law that Japanese Government promulgated in 1940　(国民優生法) 第二条　本法ニ於テ優生手術ト称スルハ生殖ヲ不能ナラシムル手術又ハ処置ニシテ命令ヲ以テ定ムルモノヲ謂フ |url=http://www.res.otemon.ac.jp/~yamamoto/be/BE_law_04.htm |url-status=live |archive-url=https://web.archive.org/web/20140205110722/http://www.res.otemon.ac.jp/~yamamoto/be/BE_law_04.htm |archive-date=2014-02-05 }}</ref> From 1940 to 1945, sterilization was done to 454 Japanese persons under this law. Appx. 25,000 people, including 8,500 under (forced or spontaneous) consent, were surgically processed until 1995.<ref>{{Cite web|url=https://www.nichibenren.or.jp/library/ja/opinion/report/data/2018/opinion_181220_2.pdf|title=「旧優生保護法下における優生手術及び人工妊娠中絶等に対する補償立法措置に関する意見書」, 2018, 日本弁護士連合会}}</ref>

According to the ''Eugenic Protection Law'' (1948), sterilization could be enforced upon criminals "with genetic predisposition to commit crime", patients with genetic diseases including mild ones such as total color-blindness, [[hemophilia]], [[albinism]], [[ichthyosis]], and mental affections such as schizophrenia, manic-depression possibly deemed occurrent in their opposition and epilepsy.<ref>{{cite web |url=http://www.soshiren.org/shiryou/yuseihogohou.html |title=SOSHIREN / 資料・法律−優生保護法 |publisher=Soshiren.org |access-date=2012-07-13 |url-status=live |archive-url=https://web.archive.org/web/20120209082910/http://www.soshiren.org/shiryou/yuseihogohou.html |archive-date=2012-02-09 }}</ref> The mental sicknesses were added in 1952.

In early 2019, Japan's supreme court upheld a requirement that transgender people must have their reproductive organs removed.<ref>{{Cite news|url=https://www.economist.com/asia/2019/03/16/japan-says-transgender-people-must-be-sterilised|title=Japan says transgender people must be sterilised|date=2019-03-14|newspaper=The Economist|access-date=2019-03-20|issn=0013-0613|archive-url=https://web.archive.org/web/20190319233709/https://www.economist.com/asia/2019/03/16/japan-says-transgender-people-must-be-sterilised|archive-date=2019-03-19|url-status=live}}</ref><ref>{{Cite news|url=https://www.japantimes.co.jp/news/2019/03/20/national/social-issues/japan-urged-stop-requiring-transgender-people-sterilized-changing-gender-official-documents/|title=Japan urged to lift sterilization requirement for transgender recognition|date=2019-03-20|work=The Japan Times Online|access-date=2019-03-20|language=en-US|issn=0447-5763|archive-url=https://web.archive.org/web/20190320202743/https://www.japantimes.co.jp/news/2019/03/20/national/social-issues/japan-urged-stop-requiring-transgender-people-sterilized-changing-gender-official-documents/|archive-date=2019-03-20|url-status=live}}</ref><ref name="hrw.org">{{Cite journal |date=2019-03-19|title="A Really High Hurdle": Japan's Abusive Transgender Legal Recognition Process |website=Human Rights Watch |url=https://www.hrw.org/report/2019/03/19/really-high-hurdle/japans-abusive-transgender-legal-recognition-process|language=en}}</ref>

In March 2019, Japan's legal policy about transgender people was:{{blockquote|In Japan, transgender people who want to legally change their gender must appeal to a family court under the GID Act, which was introduced in 2004. The procedure is discriminatory, requiring applicants to be single and without children under age 20, to undergo a psychiatric evaluation to receive a diagnosis of "gender identity disorder," and to be sterilized. The requirements rest on an outdated and pejorative notion that a transgender identity is a mental health condition, and compel transgender people to undergo lengthy, expensive, invasive, and irreversible medical procedures.<ref>{{Cite web|date=2019-03-19|title=Japan: Compelled Sterilization of Transgender People|url=https://www.hrw.org/news/2019/03/19/japan-compelled-sterilization-transgender-people|access-date=2022-01-04|website=Human Rights Watch|language=en}}</ref><ref name="hrw.org"/><ref>{{Cite web|title=Japan's Supreme Court upholds transgender sterilization requirement|url=https://www.nbcnews.com/feature/nbc-out/japan-s-supreme-court-upholds-transgender-sterilization-requirement-n962721|access-date=2022-01-04|website=NBC News|date=25 January 2019 |language=en}}</ref>}}The last stipulation of the GID Act concerning forced sterilization was recently overturned in October 2023. Japan’s supreme court ruled that requiring transgender people to undergo sterilization so that they can legally change their gender identity is unconstitutional. The court stated that forcing the sterilization of the plaintiff, a transgender woman, as a requirement to change her gender on her Japanese family registry certificate was a restriction on "her freedom not to harm herself against her will".<ref name=":06">{{Cite web |last=Hida |first=Hikari |date=October 25, 2023 |title=Transgender Ruling Is Step Forward for L.G.B.T.Q. Rights in Japan |url=https://www.nytimes.com/2023/10/25/world/asia/japan-transgender.html |access-date=April 3, 2024 |website=New York Times}}</ref> The court did not address the other requirement under the GID Act, which outlines that transgender people must undergo transition surgery in order to legally register as the gender with which they identify.<ref name=":06" />

In July 2024, the [[Supreme Court of Japan]] ruled that the Eugenic Protection Law passed in 1948 was unconstitutional, and eliminated the 20-year statute of limitations for those affected by the law.<ref>{{Cite news|url=https://www.bbc.com/news/articles/c0krnjy72j0o|title=Japan's top court says forced sterilisation unconstitutional|first=Kelly|last=Ng|date=2024-07-03|work=[[BBC News]]|access-date=2024-07-03}}</ref><ref>{{Cite news|url=https://www.asahi.com/ajw/articles/15330707#:~:text=The%20Eugenic%20Protection%20Law%20was,diseases%20could%20be%20forcibly%20sterilized.|title=Top court rules old eugenic law unconstitutional, orders redress|first=Takashi|last=Endo|date=2024-07-03|work=[[The Asahi Shimbun]]|access-date=2024-07-03}}</ref>

===Kenya===
In Kenya, HIV was considered an ongoing issue, and the governor believed that compulsory sterilization of women infected with HIV could stop the spread of the virus. In 2012, a report titled "Robbed of Choice" sparked outrage. The report outlined the experiences of 40 women infected with HIV that had been sterilized against their will. 5 of the 40 women filed a lawsuit against the government of Kenya, claiming violations of their Health and Human Rights.<ref name="hhrjournal.org">{{Cite web|date=2015-07-16|title=High Court of Kenya to Address Forced Sterilization of HIV-Positive Women and Collection of Names of People Living With HIV|url=https://www.hhrjournal.org/2015/07/kenya-forced-sterilization-hiv/|access-date=2021-04-09|website=Health and Human Rights|language=en-us}}</ref><ref name="Boston">{{Cite web|date=2015-07-21|title=Kenya, Forced Sterilization, & Women with HIV|url=https://fxb.harvard.edu/2015/07/21/kenya-forced-sterilization-and-women-with-hiv/|access-date=2022-01-04|website=FXB Center for Health & Human Rights {{!}} Harvard University|language=en-us}}</ref> The majority of the women who were sterilized knew nothing about the procedure or its consequences, which was one reason they did not push the issue. The President thought it would be good to keep a list of women who had been infected with HIV, but by naming these women, many of them did not to want to receive medical treatment due to the shame associated with the virus. "The authors concluded that punitive and restrictive laws related to pregnancy have numerous adverse consequences—both health-related and socioeconomic—for women, and urged human rights groups to work with government institutions to protect and fulfill women's fundamental reproductive rights."<ref name="hhrjournal.org"/><ref name="Boston"/>

=== Nigeria ===
Laws in Ghana, Nigeria, and Tanzania involve references to medical operations where the intended benefit for the patient is not tied to any legal consequences for medical professionals involved. Specifically, the criminal Code of Nigeria States that: “Performing with good faith and with reasonable care and skill a surgical operation upon any person for his benefit, if the performance of the operation is reasonable, having regard to the patient’s state and to all the circumstances of the case.”<ref>Stephan, Jan; Kellogg, E. H. (1974). The world's laws concerning voluntary sterilization for family planning purposes. ''California Western International Law Journal, 5(1),'' 72-120.</ref>

In Nigeria, young girls with intellectual disabilities are susceptible to non consensual sterilization. No current laws explicitly prevent involuntary sterilization. And the laws that currently surround and may apply to the issue are not helpful in preventing it. The African Commission on Human and People’s Rights declared that involuntary sterilization violates the right to “equality and non-discrimination, dignity, liberty and security of the person.”<ref name=":33">{{Cite journal |last1=Jadhav |first1=Apoorva |last2=Vala-Haynes |first2=Emily |date=November 2018 |title=Informed Choice and Female Sterilization in South Asia and Latin America |url=https://www.cambridge.org/core/journals/journal-of-biosocial-science/article/abs/informed-choice-and-female-sterilization-in-south-asia-and-latin-america/57FE74D4DBE8CA1849EFFE9F5FD73AB9 |journal=Journal of Biosocial Science |language=en |volume=50 |issue=6 |pages=823–839 |doi=10.1017/S0021932017000621 |pmid=29343307 |issn=0021-9320|url-access=subscription }}</ref>

Involuntary sterilization in Nigeria is more common for girls with intellectual disabilities than for boys with intellectual disabilities and more common for those with intellectual disabilities specifically in comparison to other disabilities. Involuntary sterilization commonly occurs when relatives initiate it. In several studies involving parents of girls with disabilities who had initiated involuntary sterilization, respondents said that the primary reason for sterilization was to prevent pregnancy either for financial reasons or due to risk of offspring with intellectual disabilities. However, similar motivations for sterilization were not common for girls without intellectual disabilities. There is also a gendered element sterilization as the Nigeria law code penalizes emasculation, which makes it so that men cannot reproduce. There is no such penalization for sterilization of women.<ref name=":33" />

===Mexico===
Civil Society Organizations such as Balance, Promocion para el Desarrollo y Juventud, A.C., have received in the last years numerous testimonies of women living with HIV in which they inform that misinformation about the virus transmission has frequently lead to compulsory sterilization. Although there is enough evidence regarding the effectiveness of interventions aimed to reduce mother-to-child transmission risks, there are records of HIV-positive women forced to undergo sterilization or have agreed to be sterilized without adequate and sufficient information about their options."<ref name=":1">{{Cite book|title=El Estado como "aparato reproductor" de violencia contra las mujeres. Violencia contra las mujeres y tortura u otros malos tratos en ámbitos de salud sexual y reproductiva en América Latina y el Caribe|publisher=Amnesty International Publications|year=2016|location=United Kingdom|pages=28}}</ref>

A [http://www.jiasociety.org/index.php/jias/article/view/19462/html report] made in El Salvador, Honduras, Mexico, and Nicaragua concluded that women living with HIV, and whose health providers knew about it at the time of pregnancy, were six times more likely to experience forced or coerced sterilization in those countries. In addition, most of these women reported that health providers told them that living with HIV cancelled their right to choose the number and spacing of the children they want to have as well as the right to choose the contraceptive method of their choice; provided misleading information about the consequences for their health and that of their children and denied them access to treatments that reduce mother-to-child HIV transmission in order to coerce them into sterilization.<ref>{{Cite book|title=El Estado como "aparato reproductor" de violencia contra las mujeres. Violencia contra las mujeres y tortura u otros malos tratos en ámbitos de salud sexual y reproductiva en América Latina y el Caribe|publisher=Amnesty International Publications|year=2016|location=United Kingdom|pages=27|language=es}}</ref>

This happens even when the health norm [http://www.salud.gob.mx/unidades/cdi/nom/005ssa23.html NOM 005-SSA2-1993] {{Webarchive|url=https://web.archive.org/web/20090831081015/http://www.salud.gob.mx/unidades/cdi/nom/005ssa23.html |date=31 August 2009 }} states that family planning is "the right of everyone to decide freely, responsibly and in an informed way the number and spacing of their children and to obtain specialized information and proper services" and that "the exercise of this right is independent of gender, age, and social or legal status of persons".<ref name=":1" />

===Peru===
{{Further|Forced sterilization in Peru}}
{{see also|Plan Verde}}
In [[Peru]], President [[Alberto Fujimori]] (in office from 1990 to 2000) has been accused of [[genocide]] and [[crimes against humanity]] as a result of the ''[[Programa Nacional de Población]]'', a sterilization program put in place by his administration.<ref name="bbc">{{cite news | title=Mass sterilization scandal shocks Peru | date=24 July 2002 | access-date=30 April 2006 | work=[[BBC News]] | url=http://news.bbc.co.uk/1/hi/world/americas/2148793.stm | url-status=live | archive-url=https://web.archive.org/web/20060630062037/http://news.bbc.co.uk/1/hi/world/americas/2148793.stm | archive-date=30 June 2006 }}</ref><ref>{{Cite journal |last=Carranza Ko |first=Ñusta |date=2020-09-04 |title=Making the Case for Genocide, the Forced Sterilization of Indigenous Peoples of Peru |url=https://digitalcommons.usf.edu/gsp/vol14/iss2/8 |journal=Genocide Studies and Prevention|volume=14 |issue=2 |pages=90–103 |doi=10.5038/1911-9933.14.2.1740 |issn=1911-0359|doi-access=free }}</ref> During his presidency, Fujimori put in place a program of forced sterilizations against [[Indigenous peoples in Peru|indigenous people]] (mainly the [[Quechua people|Quechuas]] and the [[Aymara people|Aymaras]]), in the name of a "[[public health]] plan", presented on 28 July 1995. The plan was principally financed using funds from [[USAID]] (36 million dollars), the [[Nippon Foundation]], and later, the [[United Nations Population Fund]] (UNFPA).<ref name=Diplo>[http://www.monde-diplomatique.fr/2004/05/BARTHELEMY/11190 Stérilisations forcées des Indiennes du Pérou] {{webarchive|url=https://web.archive.org/web/20140510120620/http://www.monde-diplomatique.fr/2004/05/BARTHELEMY/11190 |date=2014-05-10 }}, ''[[Le Monde diplomatique]]'', May 2004</ref> On 9 September 1995, Fujimori presented a Bill that would revise the "General Law of Population", in order to allow sterilization. Several contraceptive methods were also legalized, all measures that were strongly opposed by the [[Catholic Church|Roman Catholic Church]], as well as the Catholic organization [[Opus Dei]]. In February 1996, the World Health Organization (WHO) itself congratulated Fujimori on his success in controlling demographic growth.<ref name=Diplo/>

On 25 February 1998, a representative for USAID testified before the U.S. government's [[United States House Committee on Foreign Affairs|House Committee on International Relations]], to address controversy surrounding Peru's program. He indicated that the government of Peru was making important changes to the program, in order to:

* Discontinue their campaigns in tubal ligations and vasectomies.
* Make clear to health workers that there are no provider targets for voluntary surgical contraception or any other method of contraception.
* Implement a comprehensive monitoring program to ensure compliance with family planning norms and informed consent procedures.
* Welcome Ombudsman Office investigations of complaints received and respond to any additional complaints that are submitted as a result of the public request for any additional concerns.
* Implement a 72-hour "waiting period" for people who choose tubal ligation or vasectomy. This waiting period will occur between the second counseling session and surgery.
* Require health facilities to be certified as appropriate for performing surgical contraception as a means to ensure that no operations are done in makeshift or substandard facilities.<ref>{{cite web|title=USAID Testimony: House International Relations Committee, Subcommittee on International Operations and Human Rights, 2/25/98|url=http://www.usaid.gov/press/spe_test/testimony/1998/test079.htm|publisher=USAID|access-date=23 August 2011|url-status=dead|archive-url=https://web.archive.org/web/20090906034940/http://www.usaid.gov/press/spe_test/testimony/1998/test079.htm|archive-date=6 September 2009}}</ref>

In September 2001, Minister of Health [[Luis Solari De La Fuente|Luis Solari]] launched a special commission into the activities of the voluntary surgical contraception, initiating a parliamentary commission tasked with inquiring into the "irregularities" of the program, and to put it on an acceptable footing. In July 2002, its final report ordered by the Minister of Health revealed that between 1995 and 2000, 331,600 women were sterilized, while 25,590 men submitted to vasectomies.<ref name="Diplo"/> The plan, which had the objective of diminishing the number of births in areas of poverty within Peru, was essentially directed at the indigenous people living in deprived areas (areas often involved in internal conflicts with the Peruvian government, as with the [[Shining Path]] guerilla group). Deputy Dora Núñez Dávila made the accusation in September 2003 that 400,000 indigenous people were sterilized during the 1990s. Documents proved that President Fujimori was informed, each month, of the number of sterilizations done, by his former Ministers of Health, Eduardo Yong Motta (1994–96), Marino Costa Bauer (1996–1999) and [[Alejandro Aguinaga]] (1999–2000).<ref name=Diplo/> A study by sociologist {{ill|Giulia Tamayo León|es}}, ''Nada Personal'' (in English: Nothing Personal), showed that doctors were required to meet quotas. According to ''[[Le Monde diplomatique]]'', "tubal ligation festivals" were organized through program publicity campaigns, held in the ''[[pueblos jóvenes]]'' (in English: shantytowns). In 1996 there were, according to official statistics, 81,762 tubal ligations performed on women, with a peak being reached the following year, with 109,689 ligatures, then only 25,995 in 1998.<ref name="bbc" />

On 21 October 2011, Peru's Attorney General José Bardales decided to reopen an investigation into the cases, which had been halted in 2009 under the statute of limitations, after the [[Inter-American Commission on Human Rights]] ruled that President Fujimori's sterilization program involved crimes against humanity, which are not time-limited.<ref>[http://impunitywatch.com/?p=21794 Thousands of Forced Sterilization Cases Reopened in Peru] {{webarchive|url=https://web.archive.org/web/20140426235249/http://impunitywatch.com/?p=21794 |date=2014-04-26 }} Impunity Watch, published 14 November 2011</ref><ref>{{Cite news|date=2021-03-01|title=Peru forced sterilisations case reaches key stage|language=en-GB|work=BBC News|url=https://www.bbc.com/news/world-latin-america-56201575|access-date=2022-01-04}}</ref> It is unclear as to any progress in matter of the execution (debido ejecución sumaria) of the suspect in the course of any proof of their relevant accusations in the legal sphere of the constituted people in vindication of the rights of the people of South America. It may carry a parallel to any suspect cases for international investigation in any other continent, and be in the sphere of medical genocide. As of 12 December 2021: {{blockquote|A Peruvian judge ruled last week that the 83-year-old could not be brought to court because of the forced sterilization, as the allegation was not included in an old extradition request for Fujimori. The ex-president was extradited from Chile to Peru in 2007. According to the judge, Chile's Supreme Court, which gave the go-ahead for extradition at the time, must agree to Fujimori's charge of forced sterilization.<ref>{{Cite web|last=thecanadian|date=2021-12-12|title=Forced sterilizations: Fujimori should go to court in Peru|url=https://thecanadian.news/2021/12/12/forced-sterilizations-fujimori-should-go-to-court-in-peru/|access-date=2022-01-04|website=The Canadian|language=en-US}}</ref>}}

=== Russia ===
Since children cannot legally live in psychoneurologic internats in Russia, and there are no institutions where internats' patients can live with their children, almost all pregnant women are aborted in PNIs. During abortions, PNI patients are also often subjected to forced sterilization - their [[Tubal ligation|fallopian tubes are tied]], motivated by allegedly detected "serious complications".<ref>{{Cite news |last1=Allenova |first1=Olga |last2=Tsvetkova |first2=Roza |date=4 April 2016 |title=ПНИ — это смесь больницы и тюрьмы |trans-title=PNI is a mixture of hospital and prison |url=https://www.kommersant.ru/doc/2950620 |access-date=7 February 2024 |work=Коммерсантъ-Власть |pages=12 |issue=13}}</ref>

===South Africa===
In [[South Africa]], there have been multiple reports of HIV-positive women sterilized without their informed consent and sometimes without their knowledge.<ref name="Essack">{{cite journal|last1=Essack|first1=Zaynab|last2=Strode|first2=Ann|year=2012|title='I feel like half a woman all the time': The impacts of coerced and forced sterilisations on HIV-positive women in South Africa|journal=Agenda: Empowering Women for Gender Equity|volume=26|issue=12|pages=24–34|doi=10.1080/10130950.2012.708583|s2cid=1141875|issn=1013-0950}}</ref> The Commission for Gender Equality investigated 48 sterilizations that were performed in fifteen state hospitals without patient consent from 2002 to 2005.<ref name=":20">{{Cite news|title=Dozens of HIV-positive S. African women forcibly sterilized|url=https://abcnews.go.com/International/wireStory/dozens-hiv-positive-african-women-forcibly-sterilized-69198404|access-date=2021-04-09|website=ABC News|language=en}}</ref> This investigation into these hospitals revealed that medical providers threatened to not assist women during birth if they did not sign consent forms to being sterilized.<ref name=":20" /> In most cases these forms were not explained to patients by medical personnel. However, the inquiry was hampered by hostile hospital staff and the sudden "disappearance" of patient files. An interview with one of these patients revealed that she did not learn that she had been sterilized during her C-section until a physician told her eleven years after that she had no uterus.<ref name=":22">{{Cite news|date=2020-02-27|title=Forced sterilisation in South Africa: They removed my uterus|language=en-GB|work=BBC News|url=https://www.bbc.com/news/world-africa-51637751|access-date=2021-04-05}}</ref> She went to the hospital were the surgery was performed and was told by a physician that it was done to save her life and consent was received from her mother.<ref name=":22" /> The patient did not have HIV or any other life-threatening condition, and her mother had not consented to the removal of her uterus.<ref name=":22" /> The report from the Commission for Gender Equality noted that some of the patients interviewed were given consent forms that they did not understand and were coerced to sign.<ref name=":32">{{Cite magazine|title=Report: South African Hospitals 'Forcibly' Sterilized Women With HIV|url=https://time.com/5790217/south-africa-hospitals-hiv-women-sterilization/|access-date=2021-04-05|magazine=Time}}</ref> The bulk of these operations were performed to prevent women who are HIV-positive from having more children.<ref name=":32" /> The HIV epidemic in South Africa has a prevalence of 13% and has largely affected the family structures in the country.<ref name=":32" /> Medical staff of these hospitals have justified their actions as an effort to stop the growing HIV numbers in the country that exhaust the healthcare systems.<ref name=":20" /> The Commission urged Health Minister Zweli Mkhize to take action against these state hospitals and to provide some form of redress to the many affected women.<ref name=":32" />

===Sweden===
{{Main|Compulsory sterilisation in Sweden}}
{{see also|LGBT rights in Sweden#Transgender rights}}

The eugenics program in Sweden was enacted in 1934 and was formally abolished in 1976. According to the 2000 governmental report, 21,000 were estimated to have been forcibly sterilized, 6,000 were coerced into a 'voluntary' sterilization while the nature of a further 4,000 cases could not be determined.<ref>[http://www.regeringen.se/content/1/c4/28/64/212fc81a.pdf Steriliseringsfrågan i Sverige 1935–1975] {{webarchive|url=https://web.archive.org/web/20120205055543/http://www.regeringen.se/content/1/c4/28/64/212fc81a.pdf|date=2012-02-05}}, SOU 2000:20, in Swedish with an English summary.</ref> Of those sterilized 93% were women.<ref>{{cite book|last=Tydén|first=Mattias|title=Från politik till praktik: de svenska steriliseringslagarna 1935–1975|publisher=Almqvist & Wiksell International|year=2002|isbn=978-91-22-01958-9|edition=2., utvidgade uppl.|series=Stockholm studies in history, 0491-0842; 63|location=Stockholm|page=59|language=sv}}</ref> The reasons given for these sterilizations included mental slowness, racial differences, antisocial behavior, promiscuous behavior, and other behaviors deemed inappropriate.<ref name=":42">{{Cite news|last=Balz|first=Dan|date=1997-08-29|title=SWEDEN STERILIZED THOUSANDS OF 'USELESS' CITIZENS FOR DECADES|language=en-US|newspaper=Washington Post|url=https://www.washingtonpost.com/archive/politics/1997/08/29/sweden-sterilized-thousands-of-useless-citizens-for-decades/3b9abaac-c2a6-4be9-9b77-a147f5dc841b/|access-date=2021-04-07|issn=0190-8286}}</ref> At the time, the government saw itself as a forward-thinking and enlightened welfare state.<ref name=":42" /> The Swedish state subsequently formed a commission of inquiry to determine victims that could claim compensation for trauma at the hands of the state. The sterilization program ended in the government paying over $22,000 in compensation to victims.<ref>{{Cite web|last=Pasulka|first=Nicole|title=Forced Sterilization for Transgender People in Sweden|url=https://www.motherjones.com/politics/2012/01/sweden-still-forcing-sterilization/|access-date=2021-04-07|website=Mother Jones|language=en-US}}</ref>

Until December 2012, Swedish law forced transgender individuals to be sterilized before having their legal documents updated.<ref name=":52">{{Cite news|last=Nelson|first=Rebecca|date=2013-01-14|title=Transgender People in Sweden No Longer Face Forced Sterilization|language=en-US|magazine=Time|url=https://newsfeed.time.com/2013/01/14/transgender-people-in-sweden-no-longer-face-forced-sterilization/|access-date=2021-04-07|issn=0040-781X}}</ref> After the law was repealed, those who were forcibly sterilized under the law began to demand compensation.<ref name=":52" /> In 2017, the government announced that it will pay these compensations.<ref>{{Cite web|date=2017-03-28|title=Sweden announces to pay compensation to trans people|url=https://tgeu.org/sweden-announces-to-pay-compensation-to-trans-people/|access-date=2021-04-07|website=TGEU|language=en}}</ref>

=== United Kingdom ===
In 1911, while he was serving as [[Home Secretary]], [[Winston Churchill]] favored the sterilization of [[feeble-minded]] persons. [[Reginald McKenna]], who succeeded Churchill as Home Secretary, introduced the [[Feeble-Minded Control Bill]], a bill that would enact forcible sterilization of such individuals; the bill gained the support of the [[Church of England|Anglican]] archbishops of [[Archbishop of Canterbury|Canterbury]] and [[Archbishop of York|York]], that included forced sterilization. Despite support for the bill by the Anglican [[Primates in the Anglican Communion|primates]], English writer [[G. K. Chesterton]] and the [[Catholic Church in the United Kingdom]] led a successful effort to defeat that clause's inclusion in what would eventually become the [[Mental Deficiency Act 1913|1913 Mental Deficiency Act]], though the final act did create a scheme for state-enforced [[Involuntary commitment|confinement of mentally disabled persons]] in specialized institutions.<ref>Gilbert, Martin. [http://www.winstonchurchill.org/support/the-churchill-centre/publications/finest-hour-online/594-churchill-and-eugenics Churchill and Eugenics] {{webarchive|url=https://web.archive.org/web/20131215071541/http://www.winstonchurchill.org/support/the-churchill-centre/publications/finest-hour-online/594-churchill-and-eugenics|date=2013-12-15}}</ref> In 1934, the [[Brock Report]] recommended sterilisation of people who were mentally and physically disabled, but its proposals did not gain enough support to be made law.<ref name=":05">{{Cite web |title=Eugenics in Britain |url=https://www.english-heritage.org.uk/visit/blue-plaques/blue-plaque-stories/eugenics/ |access-date=2024-02-14 |website=English Heritage}}</ref>

In one specific case in 2015, the [[Court of Protection]] of the [[United Kingdom]] ruled that a woman with six children and an IQ of 70 should be sterilized for her own safety because another pregnancy would have been a "significantly life-threatening event" for her and the fetus and was not related to eugenics.<ref>{{cite web |author=Gallagher |first=James |date=4 February 2015 |title=Mother of six 'can be sterilised' – court ruling |url=https://www.bbc.com/news/health-31128969 |url-status=live |archive-url=https://web.archive.org/web/20150208051831/http://www.bbc.com/news/health-31128969 |archive-date=8 February 2015 |access-date=12 February 2015 |website=[[BBC News]] |publisher=}}</ref>

=== United States ===
{{Further|Eugenics in the United States|Sterilization law in the United States|Sterilization of Native American women|Eugenics Biased Sterilization Cases in the United States}}
[[File:SOU 1929 14 Betänkande med förslag till steriliseringslag s 57 Laughlin.jpg|250px|thumb|right|A map from a 1929 Swedish royal commission report displays the U.S. states that had implemented sterilization legislation by then]]

During the [[Progressive Era]] ({{circa|1890}} to 1920), the United States was the first country to concertedly undertake compulsory sterilization programs for the purpose of eugenics.<ref>{{Cite journal |last=Iredale |first=Rachel |year=2000 |title=Eugenics And Its Relevance To Contemporary Health Care |journal=Nursing Ethics |volume=7 |issue=3 |pages=205–14 |doi=10.1177/096973300000700303 |pmid=10986944 |s2cid=37888613}}</ref> [[Thomas C. Leonard]], professor at Princeton University, describes American eugenics and sterilization as ultimately rooted in economic arguments and further as a central element of Progressivism alongside minimum wage laws, restricted immigration, and the introduction of [[pension]] programs.<ref name="Leonard2005">{{Cite journal |last=Leonard |first=Thomas C. |year=2005 |title=Retrospectives: Eugenics and Economics in the Progressive Era |url=https://www.princeton.edu/%7Etleonard/papers/retrospectives.pdf |url-status=live |journal=[[Journal of Economic Perspectives]] |volume=19 |issue=4 |pages=207–224 |doi=10.1257/089533005775196642 |archive-url=https://web.archive.org/web/20161218214328/http://www.princeton.edu/~tleonard/papers/retrospectives.pdf |archive-date=2016-12-18}}</ref> The heads of the programs were avid proponents of eugenics and frequently argued for their programs which achieved some success nationwide mainly in the first half of the 20th century.

[[Eugenics in the United States|Eugenics]] had two essential components. First, its advocates accepted as axiomatic that a range of mental and physical handicaps—blindness, deafness, and many forms of [[mental disorder|mental illness]]—were largely, if not entirely, hereditary in cause. Second, they assumed that these scientific hypotheses could be used as the basis of social engineering across several policy areas, including family planning, education, and immigration. The most direct policy implications of eugenic thought were that "mental defectives" should not produce children, since they would only replicate these deficiencies, and that such individuals from other countries should be kept out of the polity.<ref>{{Cite journal |last=Hansen, King |first=Randall, Desmond |date=Summer 2017 |title=Eugenic Ideas, Political Interests, and Policy Variance: Immigration and Sterilization Policy in Britain and the U.S |url=https://www.researchgate.net/publication/248650104 |url-status=live |journal=World Politics |volume=53 |issue=2 |pages=237–263 |doi=10.1353/wp.2001.0003 |pmid=18193564 |archive-url=https://web.archive.org/web/20170809053048/https://www.researchgate.net/profile/Randall_Hansen/publication/248650104_Eugenic_Ideas_Political_Interests_and_Policy_Variance_Immigration_and_Sterilization_Policy_in_Britain_and_the_US/links/5548bc640cf27c5000668062/Eugenic-Ideas-Political-Interests-and-Policy-Variance-Immigration-and-Sterilization-Policy-in-Britain-and-the-US.pdf |archive-date=2017-08-09 |access-date=2018-09-23 |s2cid=19634871}}</ref> The principal targets of the American sterilization programs were intellectually disabled people and the mentally ill, but also targeted under many state laws were the deaf, the blind, people with epilepsy, and the physically deformed. While the claim was that the focus was mainly the mentally ill and disabled, the definition of this during that time was much different from today's. At this time, there were many women that were sent to institutions under the guise of being "[[feeble-minded]]" because they were promiscuous or became pregnant while unmarried.

A relative minority of sterilizations targeting crime took place in [[Incarceration in the United States|prisons and other penal institutions]].<ref>Interview with [[Alexandra Stern|Alexandra Minna Stern]], Ph.D. of University of Michigan in Spanish newspaper [[El País]] published on 12 July 2013 [http://sociedad.elpais.com/sociedad/2013/07/12/actualidad/1373652806_358454.html] {{webarchive|url=https://web.archive.org/web/20130715102459/http://sociedad.elpais.com/sociedad/2013/07/12/actualidad/1373652806_358454.html|date=2013-07-15}}</ref> In the end, over 65,000 individuals were sterilized in 33 states under state compulsory sterilization programs in the United States.<ref name="Open WorldCat">{{Cite book |last=Kevles |first=Daniel |title=In the name of eugenics: Genetics and the uses of human heredity |date=12 April 1985 |publisher=Knopf |isbn=978-0-394-50702-6 |edition=1st |location=New York}}</ref>

The first state to introduce a compulsory sterilization bill was [[Michigan]], in 1897, but the proposed law failed to pass. Eight years later [[Pennsylvania]]'s state legislators passed a sterilization bill that was vetoed by the governor. [[Indiana]] became the first state to enact sterilization legislation in 1907,<ref>The Indiana Supreme Court overturned the law in 1921 in {{Cite journal |title=Williams et al v. Smith, 131 NE 2 (Ind.), 1921 |url=http://www.bioethics.iupui.edu/Eugenics/SMith%20vs%20Williams.pdf |journal=Northeastern Reporter |volume=131 |page=2 |archive-url=https://web.archive.org/web/20081001183035/http://www.bioethics.iupui.edu/Eugenics/SMith%20vs%20Williams.pdf |archive-date=2008-10-01}}</ref> followed closely by [[California]] and [[Washington (state)|Washington]] in 1909. Several other states followed, but such legislation remained controversial enough to be defeated in some cases, as in Wyoming in 1934.<ref>{{Cite book |last=McDaniel |first=Rodger |title=Dying for Joe McCarthy's Sins: The Suicide of Wyoming Senator Lester Hunt |publisher=WordsWorth |year=2013 |isbn=978-0983027591 |location=Cody, Wyoming |pages=40ff}}</ref> In the 1920s, Eugenicists were particularly interested in black women in the South and Latina women in the Southwest in order to break the chain of welfare dependency and curb the population rise of non-white citizens.<ref>{{Cite book |last=Kluchin |first=Rebecca |title=Fit to Be Tied: Sterilization and Reproductive Rights in America, 1950–1980 |publisher=Rutgers University Press |year=2009 |location=Rutgers}}</ref><ref name=":7" />

After World War II, public opinion towards eugenics and sterilization programs became more negative in the light of the connection with the [[genocide|genocidal]] policies of [[Nazi Germany]], though a significant number of sterilizations continued in a few states through the 1970s. Between 1970 and 1976, Indian Health Services sterilized between 25 and 42 percent of women of reproductive age who came in seeking healthcare services.<ref>{{Cite magazine |title=A 1970 Law Led to the Mass Sterilization of Native American Women. That History Still Matters |url=https://time.com/5737080/native-american-sterilization-history/ |access-date=2020-03-27 |magazine=Time |language=en}}</ref> In [[California]], ten women who delivered their children at [[Los Angeles General Medical Center|LAC-USC]] hospital between 1971-1974 and were sterilized without proper consent sued the hospital in the landmark ''[[Madrigal v. Quilligan]]'' case in 1975.{{citation needed|date=February 2022}}<ref>{{Cite book |last=Ruiz and Sanchez Korrol |first=Vicki L and Virginia |title=Latinas in the United States: A Historical Encyclopedia |publication-date=2006}}</ref> The plaintiffs lost the case, but numerous changes to the consent process were made following the ruling, such as offering consent forms in the patient's native language, and a 72-hour waiting period between giving consent and undergoing the procedure.{{citation needed|date=February 2022}}[[File:Stop Forced Sterilization English-Spanish political poster.jpg|thumb|<includeonly>upright|</includeonly>Bilingual poster in English and Spanish for a rally against forced sterilization ]]The [[Oregon]] Board of Eugenics, later renamed the Board of Social Protection, existed until 1983,<ref name="oregonapology">{{Cite web |last=Governor John Kitzhaber |author-link=John Kitzhaber |date=2 December 2002 |title=Proclamation of Human Rights Day, and apology for Oregon's forced sterilization of institutionalized patients |url=http://archivedwebsites.sos.state.or.us/Governor_Kitzhaber_2003/governor/speeches/s021202.htm |url-status=dead |archive-url=https://web.archive.org/web/20140528024042/http://archivedwebsites.sos.state.or.us/Governor_Kitzhaber_2003/governor/speeches/s021202.htm |archive-date=28 May 2014 |access-date=16 February 2012}}</ref> with the last forcible sterilization occurring in 1981.<ref>Julie Sullivan. (2002). "[https://news.google.com/newspapers?id=ZFBWAAAAIBAJ&sjid=jesDAAAAIBAJ&pg=6596,4132204 State will admit sterilization past] {{Webarchive|url=https://web.archive.org/web/20160107221309/https://news.google.com/newspapers?id=ZFBWAAAAIBAJ&sjid=jesDAAAAIBAJ&pg=6596,4132204 |date=2016-01-07 }}", ''Portland Oregonian'', 15 November 2002. (Mirrored in ''Eugene Register-Guard'', 16 November 2002, at [[Google News]].)</ref> The U.S. [[Commonwealth (U.S. insular area)|commonwealth]] of [[Puerto Rico]] had a sterilization program as well. Some states continued to have sterilization laws on the books for much longer after that, though they were rarely if ever used. California sterilized more than any other state by a wide margin, and was responsible for over a third of all sterilization operations. Information about the California sterilization program was produced into book form and widely disseminated by eugenicists [[E. S. Gosney]] and [[Paul Popenoe]], which was said by the government of Adolf Hitler to be of key importance in proving that large-scale compulsory sterilization programs were feasible.<ref>On California sterilizations and their connection to the Nazi program, see: Stefan Kühl, ''The Nazi connection: Eugenics, American racism, and German National Socialism'' (New York: Oxford University Press, 1994); Alexandra Stern, ''Eugenic nation: faults and frontiers of better breeding in modern America'' (Berkeley: University of California Press, 2005); and Wendy Kline, ''Building a better race: gender, sexuality, and eugenics from the turn of the century to the baby boom'' (Berkeley: University of California Press, 2001).</ref>
In recent years, the governors of many states have made public apologies for their past programs beginning with Virginia and followed by Oregon<ref name="oregonapology" /> and California. Few have offered to compensate those sterilized, however, citing that few are likely still living (and would of course have no affected offspring) and that inadequate records remain by which to verify them. At least one compensation case, ''[[Poe v. Lynchburg Training School & Hospital]]'' (1981), was filed in the courts on the grounds that the sterilization law was unconstitutional. It was rejected because the law was no longer in effect at the time of the filing. However, the petitioners were granted some compensation because the stipulations of the law itself, which required informing the patients about their operations, had not been carried out in many cases.
<ref>{{Cite web |title=Poe v. Lynchburg Training School and Hospital, 518 F. Supp. 789 (W.D. Va. 1981) |url=http://law.justia.com/cases/federal/district-courts/FSupp/518/789/2128853/ |url-status=live |archive-url=https://web.archive.org/web/20150929111215/http://law.justia.com/cases/federal/district-courts/FSupp/518/789/2128853/ |archive-date=2015-09-29 |website=Justia US Law}}</ref>
The 27 states where sterilization laws remained on the books (though not all were still in use) in 1956 were: [[Arizona]], [[California]], [[Connecticut]], [[Delaware]], [[Georgia (U.S. state)|Georgia]], [[Idaho]], [[Indiana]], [[Iowa]], [[Kansas]], [[Maine]], [[Michigan]], [[Minnesota]], [[Mississippi]], [[Montana]], [[Nebraska]], [[New Hampshire]], [[North Carolina]], [[North Dakota]], [[Oklahoma]], [[Oregon]], [[South Carolina]], [[South Dakota]], [[Utah]], [[Vermont]], [[Virginia]], [[Washington (state)|Washington]],<ref name="app.leg.wa.gov">{{Cite web |title=RCW 9.92.100: Prevention of procreation |url=http://app.leg.wa.gov/RCW/default.aspx?cite=9.92.100 |url-status=live |archive-url=https://web.archive.org/web/20180407121003/http://app.leg.wa.gov/RCW/default.aspx?cite=9.92.100 |archive-date=2018-04-07 |access-date=2018-04-07}}</ref> [[West Virginia]] and [[Wisconsin]].<ref>{{Cite web |title=Note that this is not a comprehensive list of states which had sterilization laws on the books at any given time (some states had their laws overturned in courts very early on) nor an indication of when states' laws were active (some ceased to be used much earlier) |url=http://www.toolan.com/hitler/append1.html |url-status=live |archive-url=https://web.archive.org/web/20120417184442/http://www.toolan.com/hitler/append1.html |archive-date=2012-04-17 |access-date=2012-07-13 |publisher=Toolan.com}}</ref>{{Better source needed|reason=This citation is to a non-academic personal blog and does not reference the source of the information.|date=June 2016}} Some states still have forced sterilization laws in effect, such as Washington state.{{Update inline|date=December 2023}}<ref name="app.leg.wa.gov" />

As of January 2011, discussions were under way regarding compensation for the victims of forced sterilization under the authorization of the [[Eugenics Board of North Carolina]]. Governor Bev Perdue formed the NC Justice for Sterilization Victims Foundation in 2010 in order "to provide justice and compensate victims who were forcibly sterilized by the State of North Carolina".<ref>{{Cite web |title=Office for Justice for Sterilization Victims |url=http://www.sterilizationvictims.nc.gov/ |url-status=live |archive-url=https://web.archive.org/web/20140402135129/http://www.sterilizationvictims.nc.gov/ |archive-date=2014-04-02 |publisher=North Carolina Department of Administration}}</ref> In 2013 North Carolina announced that it would spend $10 million beginning in June 2015 to compensate men and women who were sterilized in the state's eugenics program; North Carolina sterilized 7,600 people from 1929 to 1974 who were deemed socially or mentally unfit.<ref name="northcarolina">{{Cite news |date=27 July 2013 |title=North Carolina offers $10 million for victims of forced-sterilization program |publisher=[[Fox News]] |url=https://www.foxnews.com/us/north-carolina-offers-10-million-for-victims-of-forced-sterilization-program/ |url-status=live |access-date=3 August 2013 |archive-url=https://web.archive.org/web/20130801012025/http://www.foxnews.com/us/2013/07/27/north-carolina-offers-10-million-for-victims-forced-sterilization-program/#ixzz2b2soYWOu |archive-date=1 August 2013}}</ref>

The inability to pay for the cost of raising children has been a reason courts have ordered coercive or compulsory sterilization. In June 2014, a Virginia judge ruled that a man on probation for child endangerment must be able to pay for his seven children before having more children; the man agreed to get a vasectomy as part of his plea deal.<ref>VA Man Agrees to Get Vasectomy as Part of Plea Deal, Fox News Insider, 24 June 2014. {{Cite web |date=2014-06-24 |title=VA Man Agrees to Get Vasectomy as Part of Plea Deal |url=http://insider.foxnews.com/2014/06/24/va-man-required-get-vasectomy-part-plea-deal |url-status=live |archive-url=https://web.archive.org/web/20141020091323/http://insider.foxnews.com/2014/06/24/va-man-required-get-vasectomy-part-plea-deal |archive-date=2014-10-20 |access-date=2014-10-16}}</ref> In 2013, an Ohio judge ordered a man owing nearly $100,000 in unpaid child support to "make all reasonable efforts to avoid impregnating a woman" as a condition of his probation.<ref>{{Cite web |date=5 February 2013 |title='Stop Having Kids!': Judge Orders Man Owing $100K in Child Support Payments to Quit Procreating |url=http://insider.foxnews.com/2013/02/05/stop-having-kids-judge-orders-man-owing-100k-in-child-support-payments-to-quit-procreating |url-status=dead |archive-url=https://web.archive.org/web/20141020092013/http://insider.foxnews.com/2013/02/05/stop-having-kids-judge-orders-man-owing-100k-in-child-support-payments-to-quit-procreating |archive-date=2014-10-20 |access-date=2014-10-16 |publisher=Fox News Insider}}</ref> Kevin Maillard wrote that conditioning the right to reproduction on meeting child support obligations amounts to "constructive sterilization" for men unlikely to make the payments.<ref name="kevin">{{Cite journal |last=Maillard |first=Kevin |date=2013 |title=Serial Paternity |url=http://web.law.columbia.edu/sites/default/files/microsites/gender-sexuality/maillard_draft_0.pdf |url-status=live |journal=Mich. St. L. Rev. |volume=1369 |archive-url=https://web.archive.org/web/20170105235714/http://web.law.columbia.edu/sites/default/files/microsites/gender-sexuality/maillard_draft_0.pdf |archive-date=5 January 2017 |access-date=29 October 2016 |quote=By conditioning reproduction on an event unlikely to happen, this amounts to constructive sterilization—an indirect prohibition on reproduction.}}</ref> 

As of 19 July 2021 it was reported that:{{blockquote|"under new provisions signed into California's budget this week, the state will offer reparations for the thousands of people who were sterilized in California institutions, without adequate consent, often because they were deemed "criminal", "feeble-minded" or "deviant"."<ref name="theguardian.com">{{Cite web|date=2021-07-19|title=Survivors of California's forced sterilizations: 'It's like my life wasn't worth anything'|url=http://www.theguardian.com/us-news/2021/jul/19/california-forced-sterilization-prison-survivors-reparations|access-date=2022-01-04|website=the Guardian|language=en}}</ref>

and that

"The program will be the first in the nation to provide compensation to modern-day survivors of prison system sterilizations, like Dillon, whose attorney obtained medical records to show that, while she was an inmate in the Central California women's facility in Chowchilla, surgeons had removed her ovaries during what was supposed to be an operation to take a biopsy and remove a cyst.

The investigations sparked by her case, which is featured in the documentary Belly of the Beast, showed hundreds of inmates had been sterilized in prisons without proper consent as late as 2010, even though the practice was by then illegal.

The new California reparations program will also seek to compensate hundreds of living survivors of the state's earlier eugenics campaign, which was first codified into state law in 1909 and wasn't repealed until 1979."<ref>{{Citation|title=Independent Lens {{!}} Belly of the Beast {{!}} Season 22 {{!}} Episode 4|url=https://www.pbs.org/video/belly-of-the-beast-7puv5r/|language=en|access-date=2022-01-04}}</ref><ref name="theguardian.com"/>}}

==== Georgia immigration detention center 2020 ====
In 2020, four [[non-profit organizations]] (which are listed below) joined Dawn Wooten to accuse a [[private prison|privately-owned]] U.S. immigration detention center in the U.S. state of [[Georgia (U.S. state)|Georgia]] of forcibly sterilizing women. The reports claimed that a doctor conducted unauthorized medical procedures upon women who were detained by [[U.S. Immigration and Customs Enforcement|Immigration and Customs Enforcement]].<ref name=":14">{{Cite web |title=ICE detainees' alleged hysterectomies recall a long history of forced sterilizations {{!}} University of Toronto Mississauga |url=https://www.utm.utoronto.ca/main-news/ice-detainees-alleged-hysterectomies-recall-long-history-forced-sterilizations |access-date=2021-01-24 |website=www.utm.utoronto.ca |date=2 October 2020 |language=en}}</ref> Dawn Wooten was a nurse and former employee. She claims that a high rate of sterilizations were performed upon Spanish-speaking women and women who spoke various indigenous languages that are common in Latin America. Wooten said that the center did not obtain proper consent for these surgeries, or lied to women about the medical procedures. More than 40 women submitted testimony in writing to document these abuses.<ref>{{Cite web |date=2020-12-22 |title=More immigrant women say they were abused by Ice gynecologist |url=http://www.theguardian.com/us-news/2020/dec/22/ice-gynecologist-hysterectomies-georgia |access-date=2021-02-03 |website=The Guardian |language=en}}</ref>

In September 2020, [[Mexico]] demanded more information from U.S. authorities about medical procedures that were performed upon illegal immigrants in detention centers, after allegations that six Mexican women were sterilized without their consent. The ministry said that consulate personnel had interviewed 18 Mexican women who were detained at the center, none of which "claimed to have undergone a hysterectomy". Another woman said that she had undergone a gynecological operation, although there was nothing in her detention file to support that she agreed to the procedure.<ref>{{Cite web |date=2020-09-29 |title=Mexico demands the US for answers on alleged migrant hysterectomies |url=https://www.theyucatantimes.com/2020/09/mexico-demands-the-us-for-answers-on-alleged-migrant-hysterectomies/ |access-date=2021-01-24 |website=The Yucatan Times |language=en-US}}</ref>{{blockquote|The nurse said that detained women told her they did not fully understand why they had to get a hysterectomy.

[[Project South (organization)|Project South]], the Georgia Detention Watch, the Georgia Latino Alliance for Human Rights, and South Georgia Immigrant Support Network filed a complaint to the government on behalf of detained immigrants and the nurse.

The U.S. congresswoman [[Pramila Jayapal]] has called for an urgent investigation into allegations that at least 17 women were subjected to unnecessary gynecological procedures that she called "the most abhorrent of human rights violations".<ref>{{Cite web|date=2020-09-29|title=Mexico demands the US for answers on alleged migrant hysterectomies|url=https://www.theyucatantimes.com/2020/09/mexico-demands-the-us-for-answers-on-alleged-migrant-hysterectomies/|access-date=2022-01-04|website=The Yucatan Times|language=en-US}}</ref>}}

==== Effect on disabled persons ====
As stated previously, eugenics in the United States spread to target mentally disabled persons. Sterilization rates across the country were relatively low, with the sole exception of California, until the 1927 [[Supreme Court of the United States|U.S. Supreme Court]] decision in ''[[Buck v. Bell]]'', which upheld under the [[U.S. Constitution]] the forced sterilization of patients at a [[Virginia]] home for intellectually disabled people.<ref>{{Cite web |title=Buck v. Bell |url=https://www.law.cornell.edu/supremecourt/text/274/200 |url-status=live |archive-url=https://web.archive.org/web/20170623010556/https://www.law.cornell.edu/supremecourt/text/274/200 |archive-date=2017-06-23 |access-date=2017-06-27}}</ref> In the wake of that decision, over 62,000 people in the United States, most of them women, were sterilized.<ref>{{Cite book |last=Kluchin |first=Rebecca M |url=https://books.google.com/books?id=fbXeTqBPiP8C&pg=PA17 |title=Fit to be Tied: Sterilization and Reproductive Rights in America, 1950–1980 |year=2011 |publisher=Rutgers University Press |isbn=9780813549996 |access-date=2015-08-14 |archive-url=https://web.archive.org/web/20160610143115/https://books.google.com/books?id=fbXeTqBPiP8C&pg=PA17& |archive-date=2016-06-10 |url-status=live}}</ref> The number of sterilizations performed per year increased until another Supreme Court case, ''[[Skinner v. Oklahoma]]'', 1942, complicated the legal situation by ruling against sterilization of criminals if the equal protection clause of the constitution was violated. That is, if sterilization was to be performed, then it could not exempt [[White-collar crime|white-collar criminals]].<ref>On the legal history of eugenic sterilization in the U.S., see {{Cite web |last=Lombardo |first=Paul |title=Eugenic Sterilization Laws |url=http://www.eugenicsarchive.org/html/eugenics/essay8text.html |url-status=live |archive-url=https://web.archive.org/web/20170701030240/http://www.eugenicsarchive.org/html/eugenics/essay8text.html |archive-date=2017-07-01 |website=Eugenics Archive}}</ref> This case, however, does not directly overturn the decision made in ''Buck v. Bell''.<ref name=":04">{{Cite web |title=The Right to Self-Determination: Freedom from Involuntary Sterilization |url=https://disabilityjustice.org/right-to-self-determination-freedom-from-involuntary-sterilization/ |access-date=2021-03-12 |website=Disability Justice |date=11 March 2014 |language=en-US}}</ref> Instead, it invalidates the central argument of the decision, and has been used in several cases to deny guardians the right to sterilize the disabled person under their care.<ref name=":04" />

The [[American Congress of Obstetricians and Gynecologists|Congress of Obstetricians and Gynecologists]] (ACOG) believes that mental disability is not a reason to deny sterilization. The opinion of ACOG is that "the physician must consult with the patient's family, agents, and other caregivers" if sterilization is desired for a mentally limited patient.<ref>{{Cite journal |last=Committee on Ethics |year=2007 |title=ACOG Committee Opinion No. 371: Sterilization of Women, Including Those with Mental Disabilities |journal=Obstetrics & Gynecology |volume=110 |issue=1 |pages=217–220 |doi=10.1097/01.AOG.0000263915.70071.29 |pmid=17601925}}</ref> In 2003, Douglas Diekema wrote in Volume 9 of the journal Mental Retardation and Developmental Disabilities Research Reviews that "involuntary sterilization ought not be performed on mentally retarded persons who retain the capacity for reproductive decision-making, the ability to raise a child, or the capacity to provide valid consent to marriage."<ref>Involuntary sterilization of persons with mental retardation: An ethical analysis, Mental Retardation and Developmental Disabilities Research Reviews, Volume 9, Issue 1, pages 21–26, 2003. {{Cite journal |last=Diekema |first=Douglas S. |year=2003 |title=Involuntary sterilization of persons with mental retardation: An ethical analysis |journal=Mental Retardation and Developmental Disabilities Research Reviews |volume=9 |issue=1 |pages=21–26 |doi=10.1002/mrdd.10053 |pmid=12587134}}</ref> The ''[[Journal of Medical Ethics]]'' claimed, in a 1999 article, that doctors are regularly confronted with requests to sterilize mentally limited people who cannot give consent for themselves. The article recommend that sterilization should only occur when there is a "situation of necessity" and the "benefits of sterilization outweigh the drawbacks."<ref>{{Cite journal |last1=Denekens |first1=JP |last2=Nys |first2=H |last3=Stuer |first3=H |year=1999 |title=Sterilization of incompetent mentally handicapped persons: a model for decision making |journal=Journal of Medical Ethics |volume=25 |issue=3 |pages=237–241 |doi=10.1136/jme.25.3.237 |pmc=479215 |pmid=10390678}}</ref>

The ''[[American Journal of Bioethics]]'' published an article, in 2010, that concluded the interventions used in the [[Ashley treatment]] may benefit future patients.<ref>Ashley Revisited: A Response to the Critics, American Journal of Bioethics, Volume 10, Issue 1, January 2010. {{Cite web |title=Ashley Revisited: A Response to the Critics &#124; Bioethics.net |url=http://www.bioethics.net/articles/ashley-revisited-a-response-to-the-critics/ |url-status=live |archive-url=https://web.archive.org/web/20120807210745/http://www.bioethics.net/articles/ashley-revisited-a-response-to-the-critics/ |archive-date=2012-08-07 |access-date=2013-03-27}}</ref> These interventions, at the request of the parents and guidance from the physicians, included a [[hysterectomy]] and surgical removal of the [[Thelarche|breast buds]] of the mentally and physically disabled child.<ref>The Ashley Treatment, March 2007. {{Cite web |title=The "Ashley Treatment", Towards a Better Quality of Life for "Pillow Angels" |url=http://pillowangel.org/Ashley%20Treatment.pdf |url-status=live |archive-url=https://web.archive.org/web/20150216162353/http://pillowangel.org/Ashley%20Treatment.pdf |archive-date=2015-02-16 |access-date=2014-10-16}}</ref> Proponents of the treatments argue that it protects disabled persons from sexual assault, unwanted pregnancy, and difficulties of menstruation.<ref name=":18">{{Cite web |last=Reiter |first=Jesse |title=Involuntary Sterilization of Disabled Americans: An Historical Overview |url=https://www.abclawcenters.com/blog/2018/11/06/involuntary-sterilization-of-disabled-americans-an-historical-overview/ |access-date=2021-03-12 |website=www.abclawcenters.com |date=6 November 2018 |language=en-US}}</ref> The interventions are still legal in many states, despite the argument that it violates a person's constitutional right to avoid unwanted intrusions.<ref name=":18" /> Discussion on the involuntary sterilization of disabled persons is now largely focused on the right of a guardian to request sterilization.

==== Criminal justice system ====
{{Further|Compulsory sterilization of disabled people in the U.S. prison system}}
In addition to eugenics purposes, sterilization was used as a punitive measure against sex offenders, people identified as homosexual, or people deemed to masturbate too much.<ref name=":9">{{Cite journal |last1=Amy |first1=Jean-Jacques |last2=Rowlands |first2=Sam |date=2018-04-19 |title=Legalised non-consensual sterilisation – eugenics put into practice before 1945, and the aftermath. Part 2: Europe |url=http://eprints.bournemouth.ac.uk/30595/3/Forced%20sterilisation-EJCRHC-MS-Part%202%20SR%20comments%20addressed%20JJA.pdf |url-status=live |journal=The European Journal of Contraception & Reproductive Health Care |volume=23 |issue=3 |pages=194–200 |doi=10.1080/13625187.2018.1458227 |issn=1362-5187 |pmid=29671357 |archive-url=https://web.archive.org/web/20200305183759/http://eprints.bournemouth.ac.uk/30595/3/Forced%20sterilisation-EJCRHC-MS-Part%202%20SR%20comments%20addressed%20JJA.pdf |archive-date=2020-03-05 |access-date=2019-12-16 |s2cid=4981162}}</ref> California, the first state in the U.S. to enact compulsory sterilization based on eugenics, sterilized all prison inmates under the 1909 sterilization law.<ref name=":9" /> In the last 40 years, judges have offered lighter punishment (i.e. probation instead of jail sentences) to people willing to use contraception or be sterilized, particularly in child abuse/endangerment cases.<ref>{{Cite journal |last=Ginzberg |first=Janet F. |date=Fall 1992 |title=NOTE: COMPULSORY CONTRACEPTION AS A CONDITION OF PROBATION: THE USE AND ABUSE OF NORPLANT |journal=Brooklyn Law Review |volume=58}}</ref> One of the most famous cases of this was ''People v. Darlene Johnson'', during which Johnson, a woman charged with child abuse sentenced to seven years in prison, was offered probation and a reduced prison sentence if she agreed to use [[Norplant]].<ref name=":10">{{Cite journal |last=Berger |first=Emily |date=May 2007 |title=THE LEGAL RIGHTS OF THE POOR AND MINORITY TO HAVE FAMILIES: JUDGES AS FAMILY PLANNERS, THE VILIFICATION OF THE POOR, AND DESTRUCTION OF THE BLACK FAMILY |journal=Rutgers Race & the Law Review |volume=8 |pages=259–290}}</ref>

In addition to child abuse cases, some politicians proposed bills mandating Norplant use among women on public assistance as a requirement to maintain welfare benefits.<ref name=":10" /> As noted above, some judges offered probation in lieu of prison time to women who agreed to use Norplant, while other court cases have ordered parents to cease childbearing until regaining custody of their children after abuse cases. Some legal scholars and ethicists argue such practices are inherently coercive.<ref name=":10" /> Furthermore, such scholars link these practices to eugenic policies of the 19th and early 20th century, highlighting how such practices not only targeted poor people, but disproportionately impacted minority women and families in the U.S., particularly black women.

In the late 1970s, to acknowledge the history of forced and coercive sterilizations and prevent ongoing eugenics/population control efforts, the federal government implemented a standardized informed consent process and specific eligibility criteria for government funded sterilization procedures.<ref name=":11">{{Cite journal |last1=Borrero |first1=Sonya |last2=Zite |first2=Nikki |last3=Creinin |first3=Mitchell D. |date=October 2012 |title=Federally Funded Sterilization: Time to Rethink Policy? |journal=American Journal of Public Health |volume=102 |issue=10 |pages=1822–1825 |doi=10.2105/ajph.2012.300850 |issn=0090-0036 |pmc=3490665 |pmid=22897531}}</ref> Some scholars argue the extensive consent process and 30-day waiting period go beyond preventing instances of coercion and serve as a barrier to desired sterilization for women relying on public insurance.<ref name=":11" />

Though formal eugenics laws are no longer routinely implemented and have been removed from government documents, instances of reproductive coercion still take place in U.S. institutions today. In 2011, investigative news released a report revealing that between 2006 and 2011, 148 female prisoners in two California state prisons were sterilized without adequate informed consent.<ref>{{Cite web |last=Stern |first=Alex |date=23 July 2013 |title=Sterilization Abuse in State Prisons |url=https://www.huffpost.com/entry/sterilization-california-prisons_b_3631287 |url-status=live |archive-url=https://web.archive.org/web/20140421075350/http://www.huffingtonpost.com/alex-stern/sterilization-california-prisons_b_3631287.html |archive-date=2014-04-21 |website=Huffington Post}}</ref> In September 2014, California enacted Bill SB 1135 that bans sterilization in correctional facilities, unless the procedure shall be required in a medical emergency to preserve an inmate's life.<ref>{{Cite web |title=SB 1135 |url=http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140SB1135 |url-status=live |archive-url=https://web.archive.org/web/20141002061808/http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140SB1135 |archive-date=2 October 2014 |access-date=17 September 2014 |publisher=CA Gov}}</ref>

====Puerto Rico====
[[File:Puerto Rico-CIA WFB Map.png|thumb|upright=1.75|A political map of [[Puerto Rico]]]]

Puerto Rican physician Lanauze Rolón founded the League for Birth Control in [[Ponce, Puerto Rico]], in 1925, but the League was quickly squashed by opposition from the [[Catholic church]].<ref name=Mass>{{Cite journal |last=Mass |first=Bonnie |date=1 January 1977 |title=Puerto Rico: a Case Study of Population Control |journal=Latin American Perspectives |volume=4 |issue=4 |pages=66–79 |doi=10.1177/0094582x7700400405 |pmid=11619430 |s2cid=416021}}<!--|access-date=October 11, 2014--></ref><ref name=Nick>{{Cite journal |last=Thimmesch |first=Nick |date=May 1968 |title=Puerto Rico and Birth Control |journal=Journal of Marriage and Family |volume=30 |issue=2 |pages=252–262 |doi=10.2307/349251 |jstor=349251}}<!--|access-date=October 11, 2014--></ref> A similar League was founded seven years later, in 1932, in [[San Juan, Puerto Rico|San Juan]] and continued in operation for two years before opposition and lack of support forced its closure.<ref name="Mass" /><ref name="Nick" /> Yet another effort at establishing birth control clinics was made in 1934 by the [[Federal Emergency Relief Administration]] in a relief response to the conditions of the [[Great Depression]].<ref name="Nick" /> As a part of this effort, 68 birth control clinics were opened on the island.<ref name="Nick" /> The next mass opening of clinics occurred in January 1937 when American [[Clarence Gamble]], in association with a group of wealthy and influential Puerto Ricans, organized the Maternal and Infant Health Association and opened 22 birth control clinics.<ref name="Nick" />

The Governor of Puerto Rico, [[Blanton Winship]], enacted Law 116,<ref>{{Cite web |title=Forced Sterilization in Puerto Rico " Family Planning |url=https://stanford.edu/group/womenscourage/cgi-bin/blogs/familyplanning/2008/10/23/forced-sterilization-in-puerto-rico/ |url-status=live |archive-url=https://web.archive.org/web/20170721113445/http://stanford.edu/group/womenscourage/cgi-bin/blogs/familyplanning/2008/10/23/forced-sterilization-in-puerto-rico/ |archive-date=2017-07-21 |access-date=2017-07-25 |website=stanford.edu}}</ref> which went into effect on 13 May 1937.<ref>{{Cite web |title=Puerto Rico Revisited " Family Planning |url=https://stanford.edu/group/womenscourage/cgi-bin/blogs/familyplanning/2008/10/30/puerto-rico-revisited/ |url-status=live |archive-url=https://web.archive.org/web/20161208104209/http://stanford.edu/group/womenscourage/cgi-bin/blogs/familyplanning/2008/10/30/puerto-rico-revisited |archive-date=2016-12-08 |access-date=2017-07-25 |website=stanford.edu}}</ref> It was a [[birth control]] and eugenic sterilization law that allowed the dissemination of information regarding birth control methods and legalized the practice of birth control.<ref name="Mass" /><ref name="Nick" /> The government cited a growing population of the poor and unemployed as motivators for the law. Changers were made to the Penal Code in 1937 which made abortion effectively legal. It was allowed for health reasons, without specifying details in the law. This gave doctors discretion to interpret what constituted a health reason, effectively legalizing abortion.<ref>[https://www.tandfonline.com/doi/pdf/10.1016/S0968-8080%2897%2990006-9?needAccess=true Abortion in Puerto Rico: The limits of colonial legality], Yamila Azize-Vargas and Luis A. Avilés, ''Reproductive Health Matters 5''(9) 1 May 1997, page 56 (page 2 of the pdf)</ref> By 1965, approximately 34 percent of women of childbearing age had been sterilized, two thirds of whom were still in their early twenties. The law was repealed on 8 June 1960.<ref name="Mass" />

=====1940s–1950s=====

Unemployment and widespread poverty would continue to grow in Puerto Rico in the 40s, both threatening U.S. private investment in Puerto Rico and acting as a deterrent for future investment.<ref name="Mass" /> In an attempt to attract additional U.S. private investment in Puerto Rico, another round of liberalizing trade policies were implemented and referred to as "[[Operation Bootstrap]]."<ref name="Mass" /> Despite these policies and their relative success, unemployment and poverty in Puerto Rico remained high, high enough to prompt an increase in [[emigration]] from Puerto Rico to the United States between 1950 and 1955.<ref name="Mass" /> The issues of [[immigration]], Puerto Rican poverty, and threats to U.S. private investment made population control concerns a prime political and social issue for the United States.<ref name="Mass" />

The 50s also saw the production of social science research supporting sterilization procedures in Puerto Rico.<ref name="Mass" /> Princeton's [[Office of Population Research]], in collaboration with the Social Research Department at the University of Puerto Rico, conducted interviews with couples regarding sterilization and other birth control.<ref name="Mass" /> Their studies concluded that there was a significant need and desire for permanent birth control among Puerto Ricans.<ref name="Mass" /> In response, Puerto Rico's governor and Commissioner of health opened 160 private, temporary birth control clinics with the specific purpose of sterilization.<ref name="Mass" />

Also during this era, private birth control clinics were established in Puerto Rico with funds provided by wealthy Americans.<ref name="Mass" /><ref name="Nick" /> [[Joseph Sunnen]], a wealthy American Republican and industrialist, established the [[Sunnen Foundation]] in 1957.<ref name="Mass" /><ref name="Nick" /> The foundation funded new birth control clinics under the title "La Asociación Puertorriqueña el Biensestar de la Familia" and spent hundreds of thousands of dollars in an experimental project to determine if a formulaic program could be used to control population growth in Puerto Rico and beyond.<ref name="Mass" />

=====Sterilization procedures and [[coercion]]=====
From beginning of the 1900s, U.S. and Puerto Rican governments espoused rhetoric connecting the poverty of Puerto Rico with overpopulation and the "hyper-fertility" of Puerto Ricans.<ref name="Lopez">{{Cite journal |last=Lopez |first=Iris |date=1993 |title=Agency And Constraint: Sterilization And Reproductive Freedom Among Puerto Rican Women In New York City |journal=Urban Anthropology and Studies of Cultural Systems and World Economic Development |volume=22 |issue=3}}</ref> Such rhetoric combined with eugenics ideology of reducing "population growth among a particular class or ethnic group because they are considered...a social burden," was the philosophical basis for the 1937 birth control legislation enacted in Puerto Rico.<ref name="Lopez" /><ref name="Briggs" /> A Puerto Rican Eugenics Board, modeled after a similar board in the United States, was created as part of the bill, and officially ordered ninety-seven involuntary sterilizations.<ref name="Briggs">{{Cite book |last=Briggs |first=Laura |title=Reproducing Empire: Race, Sex, Science, and U.S. Imperialism in Puerto Rico |date=2002 |publisher=University of California Press |isbn=978-0-520-22255-7 |location=Berkeley and Los Angeles, California}}</ref>

The legalization of sterilization was followed by a steady increase in the popularity of the procedure, both among the Puerto Rican population and among physicians working in Puerto Rico.<ref name="Briggs" /><ref name="B">{{Cite book |last1=Ramirez de Arellano |first1=Annette B. |title=Colonialism, Catholicism, and Contraception: A History of Birth Control in Puerto Rico |last2=Seipp |first2=Conrad |date=1983 |publisher=The University of North Carolina Press |isbn=978-0-8078-1544-1}}</ref> Though sterilization could be performed on men and women, women were most likely to undergo the procedure.<ref name="Mass" /><ref name="Nick" /><ref name="Briggs" /><ref name="B" /> Sterilization was most frequently recommended by physicians because of a pervasive belief that Puerto Ricans and the poor were not intelligent enough to use other forms of contraception.<ref name="Briggs" /><ref name="B" /> Physicians and hospitals alike also implemented hospital policy to encourage sterilization, with some hospitals refusing to admit healthy pregnant women for delivery unless they consented to be sterilized.<ref name="Briggs" /><ref name="B" /> This has been best documented at Presbyterian Hospital, where the unofficial policy for a time was to refuse admittance for delivery to women who already had three living children unless she consented to sterilization.<ref name="Briggs" /><ref name="B" /> There is additional evidence that true [[informed consent]] was not obtained from patients before they underwent sterilization, if consent was solicited at all.<ref name="B" />

By 1949 a survey of Puerto Rican women found that 21% of women interviewed had been sterilized, with sterilizations being performed in 18% of all hospital births statewide as a routine post-partum procedure, with the sterilization operation performed before women left the hospitals after giving birth.<ref name="Mass" /> As for the birth control clinics founded by Sunnen, the Puerto Rican Family Planning Association reported that around 8,000 women and 3,000 men had been sterilized in Sunnen's privately funded clinics.<ref name="Mass" /> At one point, the levels of sterilization in Puerto Rico were so high that they alarmed the Joint Committee for Hospital Accreditation, who then demanded that Puerto Rican hospitals limit sterilizations to ten percent of all hospital deliveries in order to receive accreditation.<ref name="Mass" /> The high popularity of sterilization continued into the 60s and 70s, during which the Puerto Rican government made the procedures available for free and reduced fees.<ref name="Briggs" /> The effects of the sterilization and contraception campaigns of the 1900s in Puerto Rico are still felt in Puerto Rican cultural history today.<ref name="Lopez" />

======Controversy and opposing opinions======
There has been much debate and scholarly analysis concerning the legitimacy of choice given to Puerto Rican women in regard to sterilization, reproduction, and birth control, as well as with the ethics of economically motivated mass-sterilization programs.

Some scholars, such as Bonnie Mass<ref name="Mass" /> and Iris Lopez,<ref name="Lopez" /> have argued that the history and popularity of mass-sterilization in Puerto Rico represents a government-led eugenics initiative for [[population control]].<ref name="Mass" /><ref name="Lopez" /><ref name="B" /><ref name="Elena">{{Cite journal |last1=Gutierrez |first1=Elena R. |last2=Fuentes |first2=Liza |date=2009–2010 |title=Population Control by Sterilization: The Cases of Puerto Rican and Mexican-Origin Women in the United States |journal=Latino(a) Research Review |volume=7 |issue=3}}</ref> They cite the private and government funding of sterilization, coercive practices, and the eugenics ideology of Puerto Rican and American governments and physicians as evidence of a mass-sterilization campaign.<ref name="Lopez" /><ref name="B" /><ref name="Elena" />

On the other side of the debate, scholars like Laura Briggs<ref name="Briggs" /> have argued that evidence does not substantiate claims of a mass-sterilization program.<ref name="Briggs" /> She further argues that reducing the popularity of sterilization in Puerto Rico to a state initiative ignores the legacy of Puerto Rican feminist activism in favor of birth control legalization, and the individual agency of Puerto Rican women in making decisions about family planning.<ref name="Briggs" />

A system was proposed by the California state senator [[Nancy Skinner (California politician)|Nancy Skinner]] to compensate victims of the well-documented examples of [[compulsory sterilization#United States|prison sterilizations that resulted from California's eugenics programs]], but this did not pass by the bill's 2018 deadline in the legislature.<ref>{{cite book |title=SB-1190 – Eugenics Sterilization Compensation Program |first1=Nancy |last1=Skinner |publisher=[[State of California]] |url= https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180SB1190 |date=18 February 2019 |access-date=19 February 2019 |archive-date=19 February 2019 |archive-url= https://web.archive.org/web/20190219130233/https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180SB1190 |url-status=live}}</ref>

=====Effects=====
When the United States took census of Puerto Rico in 1899, the birth rate was 40 births per one thousand people.<ref name="Nick" /> By 1961, the birth rate had dropped to 30.8 per thousand.<ref name="Mass" /> In 1955, 16.5% of Puerto Rican women of childbearing age had been sterilized, this jumped to 34% in 1965.<ref name= "Mass" />

In 1969, sociologist [[Harriet Presser]] analyzed the 1965 Master Sample Survey of Health and Welfare in Puerto Rico.<ref name=Presser>{{Cite journal |last=Presser |first=Harriet B. |date=November 1969 |title=The Role of Sterilization in Controlling Puerto Rican Fertility |journal=Population Studies |volume=23 |issue=3 |pages=343–361 |doi=10.2307/2172875 |jstor=2172875 |pmid=22073953}}<!--|access-date=10 October 2014--></ref> She specifically analyzed data from the survey for women ages 20 to 49 who had at least one birth, resulting in an overall sample size of 1,071 women.<ref name="Presser" /> She found that over 34% of women aged 20–49 had been sterilized in Puerto Rico in 1965.<ref name="Presser" />

Presser's analysis also found that 46.7% of women who reported they were sterilized were between the ages of 34 and 39.<ref name="Presser" /> Of the sample of women sterilized, 46.6% had been married 15 to 19 years, 43.9% had been married for 10-to-14 years, and 42.7% had been married for 20-to-24 years.<ref name="Presser" /> Nearly 50% of women sterilized had three or four births.<ref name="Presser" /> Over 1/3 of women who reported being sterilized were sterilized in their twenties, with the average age of sterilization being 26.<ref name="Presser" />

A survey by a team of Americans in 1975 confirmed Presser's assessment that nearly 1/3 of Puerto Rican women of childbearing age had been sterilized.<ref name="Mass" /> As of 1977, Puerto Rico had the highest proportion of childbearing-aged persons sterilized in the world.<ref name="Mass" /> In 1993, [[ethnographic]] work done in New York by [[anthropologist]] Iris Lopez<ref name="Lopez" /> showed that the history of sterilization continued to effect the lives of Puerto Rican women even after they immigrated to the United States and lived there for generations.<ref name="Lopez" /> The history of the popularity of sterilization in Puerto Rico meant that Puerto Rican women living in America had high rates of female family members who had undergone sterilization, and it remained a highly popular form of birth control among Puerto Rican women living in New York.<ref name="Lopez" />

===Uzbekistan===
According to reports, {{as of|2012|lc=y}}, forced and coerced sterilization is the current governmental policy in [[Uzbekistan]] for women with two or three children, as a means of forcing population control and to improve maternal mortality rates.<ref name=bbc-news-2012-04-12>[https://www.bbc.co.uk/news/magazine-17612550 BBC News: Uzbekistan's policy of secretly sterilizing women] {{webarchive|url=https://web.archive.org/web/20150405112247/http://www.bbc.co.uk/news/magazine-17612550 |date=2015-04-05 }} [[BBC]], published 2012-04-12, accessed 2012-04-12</ref><ref name=bbc-cc-2012-04-12>[http://www.bbc.co.uk/programmes/b01fjx63 Crossing Continents: Forced Sterilization in Uzbekistan] {{webarchive|url=https://web.archive.org/web/20160903195248/http://www.bbc.co.uk/programmes/b01fjx63 |date=2016-09-03 }} [[BBC]], published 2012-04-12, accessed 2012-04-12</ref><ref name=moscow-2010-03-10>[http://www.themoscowtimes.com/news/article/uzbeks-face-forced-sterilization/401279.html Uzbeks Face Forced Sterilization] {{webarchive|url=https://web.archive.org/web/20131019203218/http://www.themoscowtimes.com/news/article/uzbeks-face-forced-sterilization/401279.html |date=2013-10-19 }} [[The Moscow Times]] published 2010-03-10, accessed 2012-04-12</ref><ref>{{cite news |last=Antelava |first=Natalia |date=12 April 2012 |title=Uzbekistan's policy of secretly sterilising women |url=https://www.bbc.com/news/magazine-17612550 |newspaper=BBC World Service |url-status=live |archive-url=https://web.archive.org/web/20150302071400/http://www.bbc.com/news/magazine-17612550 |archive-date=2 March 2015 }}</ref><ref>{{cite news |last=Antelava |first=Natalia |date=12 April 2012 |title=Uzbekistan's policy of secretly sterilising women |url=https://www.bbc.co.uk/news/magazine-17612550 |newspaper=BBC World Service |url-status=live |archive-url=https://web.archive.org/web/20150405112247/http://www.bbc.co.uk/news/magazine-17612550 |archive-date=5 April 2015 }}</ref> In November 2007, a report by the [[United Nations Committee Against Torture]] reported that "the large number of cases of forced sterilization and removal of reproductive organs of women at reproductive age after their first or second pregnancy indicate that the Uzbek government is trying to control the birth rate in the country" and noted that such actions were not against the national Criminal Code.<ref>[http://www2.ohchr.org/english/bodies/cat/docs/ngos/omctuzbekistan39.pdf Shadow Report: UN Committee Against Torture] {{webarchive|url=https://web.archive.org/web/20141109020604/http://www2.ohchr.org/english/bodies/cat/docs/ngos/omctuzbekistan39.pdf |date=2014-11-09 }} [[United Nations]], authors Rapid Response Group and OMCT, published November 2007, accessed 2012-04-12</ref> In response to that, the Uzbek delegation to the associated conference was "puzzled by the suggestion of forced sterilization, and could not see how this could be enforced".<ref>[http://www.unhchr.ch/huricane/huricane.nsf/view01/DDAD7F2786699CA7C12573910072F598?opendocument Press Release: Committee Against Torture Hears Response of Uzbekistan] {{webarchive|url=https://web.archive.org/web/20090113184223/http://www.unhchr.ch/huricane/huricane.nsf/view01/DDAD7F2786699CA7C12573910072F598?opendocument |date=2009-01-13 }} [[United Nations]], published 2007-10-12, accessed 2012-04-12</ref>

Reports of forced sterilizations, [[hysterectomy|hysterectomies]], and [[intrauterine device|IUD]]-insertions first emerged in 2005,<ref name=bbc-news-2012-04-12 /><ref name=bbc-cc-2012-04-12 /><ref name=moscow-2010-03-10 /><ref name=iwpr-2005-11-18>[http://iwpr.net/report-news/birth-control-decree-uzbekistan Birth Control by Decree in Uzbekistan] {{webarchive|url=https://web.archive.org/web/20131019132115/http://iwpr.net/report-news/birth-control-decree-uzbekistan |date=2013-10-19 }} [[Institute for War and Peace Reporting|IWPR Institute for War & Peace Reporting]], published 2005-11-18, accessed 2012-04-12</ref> although it is reported that the practice originated in the late 1990s,<ref>[https://www.independent.co.uk/news/world/asia/uzbek-women-accuse-state-of-mass-sterilizations-2028987.html Uzbek women accuse state of mass sterilizations] {{webarchive|url=https://web.archive.org/web/20170625061523/http://www.independent.co.uk/news/world/asia/uzbek-women-accuse-state-of-mass-sterilizations-2028987.html |date=2017-06-25 }} [[The Independent]], published 2010-07-17, accessed 2012-04-12</ref> with reports of a secret decree dating from 2000.<ref name=iwpr-2005-11-18 /> The current policy was allegedly instituted by [[Islam Karimov]] under Presidential [[Decree]] PP-1096, which is titled: "on additional measures to protect the health of the mother and child, the formation of a healthy generation",<ref>[http://www.eurasianet.org/node/64549 Uzbekistan: Presidential Decree on Birth Rate Leads to Increased Sterilization | EurasiaNet.org] {{webarchive|url=https://web.archive.org/web/20140427010426/http://www.eurasianet.org/node/64549 |date=2014-04-27 }} published 2011-11-14, accessed 2012-04-12</ref> and which came into force in 2009.<ref>[http://www.ourkids.uz/ Our Kids: EU Parliamentarians Applaud MCH Project in Uzbekistan] {{webarchive|url=https://web.archive.org/web/20100326161331/http://www.ourkids.uz/ |date=2010-03-26 }}, published 2010-10-28, accessed 2012-04-12</ref> In 2005, Deputy Health Minister Assomidin Ismoilov confirmed that doctors in Uzbekistan were being held responsible for increased birth rates.<ref name=iwpr-2005-11-18 />

Based upon a report by the journalist Natalia Antelava, doctors reported that the Ministry of Health told doctors that they must perform surgical sterilizations upon women. One doctor reported: "It's ruling number 1098, and it says that after two children, in some areas after three, a woman should be sterilized.", in a loss of the former surface decency of Central Asian mores in regard of female chastity.<ref name="theworld.org">{{cite web |last=Hackel |first=Joyce |title=Doctors in Uzbekistan Say Government Forcibly Sterilizing Women |website=PRI's The World |date=12 April 2012 |url=http://www.theworld.org/2012/04/doctors-in-uzbekistan-say-government-forcibly-sterilizing-women/ |publisher=Theworld.org |url-status=live |archive-url=https://web.archive.org/web/20130830133502/http://www.theworld.org/2012/04/doctors-in-uzbekistan-say-government-forcibly-sterilizing-women/ |archive-date=30 August 2013 }}</ref> In 2010, the Ministry of Health passed a decree stating all clinics in Uzbekistan should have sterilization equipment ready for use. The same report also states that sterilization is to be done on a voluntary basis with the informed consent of the patient.<ref name="theworld.org"/> In the 2010 Human Rights Report of Uzbekistan, there were many reports of forced sterilization of women along with allegations of the government pressuring doctors to sterilize women in order to control the population.<ref>{{cite web |url=https://2009-2017.state.gov/j/drl/rls/hrrpt/2010/sca/154489.htm |title=2010 Human Rights Report: Uzbekistan |publisher=[[United States Department of State]] [[Bureau of Democracy, Human Rights, and Labor]] |website=2010 Country Reports on Human Rights Practices |date=8 April 2011 |access-date=23 May 2019 |archive-url=https://web.archive.org/web/20200320140820/https://2009-2017.state.gov/j/drl/rls/hrrpt/2010/sca/154489.htm |archive-date=20 March 2020 |url-status=live }}</ref> Doctors also reported to Antelava that there are quotas they must reach every month on how many women they need to sterilize. These orders are passed on to them through their bosses and, allegedly, from the government.<ref name="theworld.org"/>

On 15 May 2012, during a meeting with the Russian president [[Vladimir Putin]] in [[Moscow]], the Uzbek president Islam Karimov said: "we are doing everything in our hands to make sure that the population growth rate [in Uzbekistan] does not exceed 1.2–1.3"<ref name="RFE/RL">{{cite news|title="Akhborot" censors Karimov|url=http://www.ozodlik.org/content/article/24584171.html|access-date=17 May 2012|newspaper=[[RFE/RL]]'s Uzbek Service|date=17 May 2012|url-status=live|archive-url=https://web.archive.org/web/20120529011406/http://www.ozodlik.org/content/article/24584171.html|archive-date=29 May 2012}}</ref> The Uzbek version of [[RFE/RL]] reported that, with this statement, Karimov indirectly admitted that forced sterilization of women is indeed taking place in Uzbekistan.<ref name="RFE/RL" /> The main Uzbek television channel, called O'zbekiston, cut-out Karimov's statement about the population growth rate while broadcasting his conversation with Putin.<ref name="RFE/RL" />

Despite international agreement concerning the inhumanity and illegality of forced sterilization, it has been suggested that the government of Uzbekistan continues to pursue such programs.<ref name=bbc-news-2012-04-12 />

===Other countries===
Eugenics programs including forced sterilization existed in most of the Northern European countries, as well as in other more-or-less [[Protestantism by country|Protestant countries]]. Other countries that had notably active sterilization programs include [[Denmark]] ("that country's forced sterilization of 60,000 people in 1935-76"),<ref name=":21"/><ref name="eurozine.com">{{Cite web|title=Sterilization in Norway - a dark chapter?|url=https://www.eurozine.com/sterilization-in-norway-a-dark-chapter/|access-date=2022-01-04|website=www.eurozine.com|date=9 April 2003 }}</ref> [[Norway]],<ref>{{Cite web|title=Norway passes Sterilization Law|url=http://eugenicsarchive.ca/discover/tree/5232a2b75c2ec50000000012|access-date=2022-01-04|website=The Eugenics Archives|language=en|archive-date=4 January 2022|archive-url=https://web.archive.org/web/20220104082423/http://eugenicsarchive.ca/discover/tree/5232a2b75c2ec50000000012|url-status=dead}}</ref><ref>{{Cite journal|last=Haave|first=Per|date=2007|title=Sterilization Under the Swastika: The Case of Norway|url=https://www.jstor.org/stable/41345200|journal=International Journal of Mental Health|volume=36|issue=1|pages=45–57|doi=10.2753/IMH0020-7411360104|jstor=41345200|s2cid=72843082|issn=0020-7411|url-access=subscription}}</ref><ref name="eurozine.com"/> [[Finland]]<ref>[[Gunnar Broberg]] and [[Nils Roll-Hansen]], eds., ''Eugenics And the Welfare State: Sterilization Policy in Denmark, Sweden, Norway, and Finland'' (Michigan State University Press, 2005), it is unclear whether genocide investigations in regard of Hun descendant and pure Aryan types has been undertaken, and if concealment is attempted through the prevalence of cremation and allegation of psychiatric treatment facial mimicry of Mongolian types.</ref><ref>{{Cite web|title=Finland|url=http://eugenicsarchive.ca/discover/world/530b988476f0db569b00000b|access-date=2022-01-04|website=The Eugenics Archives|language=en}}</ref><ref>{{Cite journal|last1=Hemminki|first1=Elina|last2=Rasimus|first2=Anja|last3=Forssas|first3=Erja|date=1997-12-01|title=Sterilization in Finland: From eugenics to contraception|url=https://www.sciencedirect.com/science/article/pii/S0277953697001263|journal=Social Science & Medicine|language=en|volume=45|issue=12|pages=1875–1884|doi=10.1016/S0277-9536(97)00126-3|pmid=9447636|issn=0277-9536|url-access=subscription}}</ref><ref name="sub.editors">{{Cite web|author=Tommy Haemaelainen|title=Trans people in Finland are still being forcibly sterilised|url=https://www.palatinate.org.uk/trans-people-in-finland-are-still-being-forcibly-sterilised/|access-date=2022-01-04|website=Palatinate|date=5 July 2020 |language=en-GB}}</ref>("In Finland, to change one's gender markers in the juridical system (also known as gender recognition), trans people are, still, ''forcibly sterilised.'' In the laws regarding gender recognition, this requirement is called the 'inability to reproduce', a choice of words that makes it sound a lot less threatening than 'forced sterilisation'"),<ref name="sub.editors"/> [[Estonia]],<ref>{{Cite journal|last=Patel|first=Priti|date=2017-07-14|title=Forced sterilization of women as discrimination|journal=Public Health Reviews|volume=38|pages=15|doi=10.1186/s40985-017-0060-9|issn=0301-0422|pmc=5809857|pmid=29450087 |doi-access=free }}</ref> [[Switzerland]],<ref>{{Cite journal|last=Wecker|first=Regina|date=2012|title=Eugenics in Switzerland before and after 1945 – a Continuum?|url=https://www.jstor.org/stable/26266047|journal=Journal of Modern European History / Zeitschrift für moderne europäische Geschichte / Revue d'histoire européenne contemporaine|volume=10|issue=4|pages=519–539|doi=10.17104/1611-8944_2012_4_519|jstor=26266047|s2cid=144049480|issn=1611-8944|url-access=subscription}}</ref><ref>{{Cite web|title=New laws to compensate victims of forced sterilisation|url=https://www.swissinfo.ch/eng/new-laws-to-compensate-victims-of-forced-sterilisation/2596540|access-date=2022-01-04|website=SWI swissinfo.ch|date=13 March 2002 |language=en}}</ref> [[Iceland]],<ref>{{Cite journal|title=Forced sterilization of women as discrimination |journal=Public Health Reviews|year=2017|doi=10.1186/s40985-017-0060-9 |doi-access=free |last1=Patel|first1=Priti|volume=38|page=15|pmid=29450087|pmc=5809857}}</ref> and some countries in [[Latin America]] (including [[Panama]]).{{citation needed|date=August 2013}}