Forced Sterilization: Who Should Be Targeted, And How Should It Be Implemented?

Forced Sterilization: Who Should Be Targeted, And How Should It Be Implemented?

Aditya Awasthi


This Blog is written by Aditya Awasthi from Asian Law College, NoidaEdited by Ravikiran Shukre.



Forced sterilization is the involuntary or coerced removal of a person’s ability to reproduce, often through a surgical procedure referred to as tubal ligation. Forced sterilization is a human rights violation and can constitute an act of genocide, gender-based violence, discrimination, and torture. For an overview of forced sterilization around the world.

When performed without informed consent, sterilization violates an individual’s rights to dignity, humane treatment, health, family, information, privacy, and to freely decide the number and spacing of children, among other rights. In recent years, human rights bodies have further clarified the steps States must take to prevent forced sterilization, protect survivors, and ensure access to redress.

India was the first country to launch its family planning program in 1952 to control the population. During the program, the government made available many contraceptive methods to the couples like condoms, IUD, diaphragm, and sterilization. The method of sterilization gained popularity soon after the implementation and during the emergency period, around 8 million sterilizations were reported, where majority of them were forced and performed on men. Due to the mass “forced” sterilization, the family planning program approach shifted to family welfare approach, and male sterilization almost disappeared from the family planning program and female sterilization emerged as the only permanent method of contraception in the country.

According to the UN, 19% of married or in-union women in the world relied on female sterilization. In India, during 2014–2015, more than 4 million sterilizations were done; out of which only 1 lakh were performed on men. The latest estimates provided by NFHS –4 (2015–2016), also showed a similar picture where 37% of currently married women in India relied on female sterilization.


The drive to sterilize began in the 1970s when encouraged by loans amounting to tens of millions of dollars from the World Bank, the Swedish International Development Authority, and the UN Population Fund, India embarked on an ambitious population control program.

During the 1975 Emergency – when civil liberties were suspended – Sanjay Gandhi, son of the former Prime Minister Indira Gandhi, began what was described by many as a “gruesome campaign” to sterilize poor men. There were reports of police cordoning off villages and virtually dragging the men to surgery.

An astonishing 6.2 million Indian men were sterilized in just a year, which was “15 times the number of people sterilized by the Nazis”, according to science journalist Mara Hvistendahl. Two thousand men died from botched operations.

Since family planning efforts began in the 1970s, India has focused its population control efforts on women, even though, as scientists say, sterilizations are easier to perform in men. India carried out nearly 4 million sterilizations during 2013-2014, according to official figures. Less than 100,000 of these surgeries were done on men. More than 700 deaths were reported due to botched surgeries between 2009 and 2012. There were 356 reported cases of complications arising out of the surgeries.

Though the government has adopted a raft of measures and standards for conducting safe sterilizations, an unseemly haste to meet high state-mandated quotas has often led to botched operations and deaths.

Women have died from forced sterilizations in China where population control was institutionalized since the 1980s. There have been reports of the appalling quality of tubectomies for many years now, and authorities still don’t seem to realize that it is an important reproductive health concern. And the shoddy surgeries continue, risking the lives of poor women.


Eventually, the onus of sterilization on men was reduced and women were more often forced into it—the idea that men’s fertility would be affected and reduced (which still exists), led to women being the ideal candidates for this drive. It may have also been because women were less likely to protest. These coercive sterilizations embodied gendered violence because they occurred even though vasectomies were much easier and safer than tubectomies. However, women saw lesser compensation for the sterilization themselves, sometimes not receiving any at all.

Cases that were the most “successful” were in Haryana, Rajasthan, Himachal Pradesh, Madhya Pradesh, and Uttar Pradesh, which highlights both the influence of the Centre in New Delhi over the programme and the higher targeting of those who were rural and migrant workers. The targeting of the poor and underprivileged, like the Muslims, Adivasis, and Dalits, showed the inherent bias in this structure, stating higher populations to be the cause of their poverty; also implying that they were more likely to have more children than others would.

Policies that were discriminatory to those with more children were enacted. The Population Research Institute highlights these examples—people with more than three children in Rajasthan were banned from holding any government job unless they had been sterilized. In Bihar, food under public rations was denied to families with more than two children.

This scheme of family planning, which initially was about raising awareness about contraception, providing access to the same, and educating people on the benefits of having fewer children, which was started off as a vasectomy drive, was now focused on getting as many people, men and women, sterilized.


V. v. Bolivia

The Inter-American Court of Human Rights (IACHR) examined for the first time the issue of informed consent to medical treatment and forced sterilization, in its judgment in I.V. v. Bolivia.

The case involves a Peruvian refugee who was sterilized by a tubal ligation performed without her informed consent in a Bolivian public hospital in 2000, resulting in permanent loss of her ability to conceive a child.

Scope of Judgment:

The IACHR’s judgment examined the parties’ allegations with respect to Articles 3 (juridical personality), 5.1. (personal integrity), 5.2. (torture or cruel treatment), 7.1. (personal liberty and security), 8.1 (due process), 11.1 (respect for honour and dignity), 11.2 (private and family life), 13.1 (freedom of thought and expression), 17.2 (marry and raise a family), 25.1 (judicial protection), and 25(2)(a) (a remedy) of the American Convention on Human Rights, as well as Article 7(a) (refrain from engaging in violence against women) and (b) (prevent and investigate violence against women) of the Inter-American Convention on the Prevention, Punishment, and Eradication of Violence against Women (Convention of Belém do Pará). The Court unanimously found Bolivia internationally responsible for violating all of these protections, except for that it declined to make a determination regarding Articles 3 and 25(2)(a) of the American Convention and the “right to truth.” Its conclusions rested on the State’s responsibility to respect I.V.’s rights in its public hospitals, its duty to prevent such violations through its regulation of health care providers, and its obligation not to discriminate on the basis of gender.

Its analysis heavily referenced statements and findings from other supranational human rights bodies, including the United Nations treaty bodies and European Court of Human Rights, that have addressed forced sterilization or women’s reproductive rights.

While the Court did not explicitly indicate it was adopting a holistic methodology in analysing the rights implicated by forced sterilization, it did consider the allegations in three groups of rights, related to: informed consent (including personal integrity, liberty, dignity, privacy and family life, and access to information), torture or cruel treatment, and judicial protection.


Apart from framing any law or legislation on population control, there are other measures that can be and are being taken by the Government to limit the population of the country. These measures are as follows-

• Raising the status of women is an important social measure for population control as it will end the gender discrimination and the orthodox will of the people to give birth to a son. Also, it will give an opportunity to the women to have a choice and a say in whether they want to give birth to a child or not. The choices of women would be respected.

• Educating the masses especially the people living in rural areas is another important aspect of controlling population as the people have to be made aware of the harmful consequences of overpopulation as well as the benefits of using contraceptive methods.

• The option of adoption should be popularized as there are many children who do not have families to take care of them. They have to live in orphanages or organizations that only help these children to stay alive and survive. Such children can have a family and proper upbringing while stabilizing the population too.

• The standard of living among people has to be improved. They need to understand the value of family planning and the advantages of having a small family where everyone lives in peace and harmony.

The government should provide families with incentives and financial aid for the adoption of birth control measures.


Global Population is increasing by about 1.5 per cent per year and if this continues, in less than half a century, the number of people living on this planet will double. People are already dependent on using resources like water and energy in their day to day lifestyle which is why causing a strain on these resources due to a rise in population will only lead to wars and conflicts in the future for those who get to use the last of the resources left.

In recent years, we can experience the adverse effects of overpopulation like economic instability, degradation of the environment, rising prices of coal and petroleum, global warming, and unemployment in some countries like India. Even the government policies dealing with these issues will only be able to solve these problems for a short period of time. In the long run, we have to control the rising population and bring stability in the birth and death rates so that the demands of the people match the available resources of that country. The world needs a strict population control law to limit the population growth as well as safeguard the rights of the individuals during this process.

It is more pertinent than ever to change the narrative around family planning as a whole, along with the stereotypes that turn into defining narratives. The poor aren’t poor due to having too many children, it’s due to the lack of a basic income, dependence on agriculture when agriculture fails due to a failing climate, and the lack of a failsafe mechanism when this happens. There also needs to be more of an effort made to get men into these programs as well, be it as the patient or as the educator.


(1) Eliminating Forced, Coercive and Otherwise Involuntary Sterilization: An Interagency Statement(2014).

(2) Ledbetter R. Thirty years of family planning in India. Asian Surv. 1984;24(7):736–58.

(3) Nivasan K. Population policies and programmes since independence: a saga of great expectations and poor performance. In: State of Natural and Human Resources (2 Vols. Set); 1998. p. 266.

(4) Percher J. Too much of a good thing? Female sterilization in India: a literature review. 2016 North Carolina at Chapel Hill.

(5) Matthews Z, Padmadas SS, Hutter I, McEachran J, Brown JJ. Does early childbearing and a sterilization-focused family planning programme in India fuel population growth? Demogr Res. 2009; 20:693–720.

(6) United Nation. (2015). The Millennium development goals report 2015.

(7) Women and Men in India (A statistical compilation of Gender related Indicators in India). New Delhi; 2018. Retrieved from

(8) Biswas S. India’s dark history of sterilization. BBC News World Edition. 2014.

(9) International Institute for Population Sciences (IIPS) and ICF. National family health survey (NFHS-4), 2015–16. India. Mumbai: IIPS; 2017.

(10) Report No. 40/08, Admissibility, Inter-American Commission on Human Rights, Petition 270-07 (July 23, 2008), para. 85.

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