I’ve spent most of my life wanting to be sterilised, and I’m excited about my upcoming surgery. But I’ve also spent a good chunk of my life thinking, talking and writing about the politics of sterilisation, which means that part of this process has also involved a lot of self-reflection.
Sterilisation as a free and independent choice can be a great tool for people who want to take control of their fertility. Yet, it doesn’t occur in a vacuum; you can’t talk about sterilisation without taking a look at the history of it, and some of that history is deep, dark and seriously dirty. It also directly influences the modern approach to sterilisation, because make no mistake, the sterilisation rabbit hole doesn’t rest firmly in the past.
As soon as reliable and effective methods of sterilisation were developed, they were being used to abuse members of minority groups through forced, compelled or heavily influenced sterilisations that most definitely did not take place as free and independent choices. Low-income people, people of colour, and people with disabilities were, and continue to be, targeted by sterilisation programs, from Nazi eugenics to current reproductive health policies.
Coercive sterilisation was historically justified by the argument that some people shouldn’t be allowed to reproduce, for a variety of reasons. Some proponents argued that people would pass on “defects” to future generations, and thus that they needed to be sterilised for the good of the human race. If that sounds a lot like eugenics to you, have a cigar, because that’s exactly what it was, and I’ll note that a lot of early women’s rights activists were eager participants in this kind of rhetoric. And make no mistake, people still say this.
Others suggested that it was for the good of their children; that children born into poverty had no chance of success, for example, or that disabled people couldn’t care for their children and might endanger them. These kinds of arguments persist, too.
In some cases, people were fully aware of the fact that they were being forcibly sterilised, subjected to court hearings and the trauma of the operating room. In others, the sterilisation was hidden and discovered years later, often when people were seeking treatment for infertility. An example of this kind of stealth sterilisation is the so-called Mississippi appendectomy, a procedure where people of colour went in for one surgery and came out with another. North Carolina is just getting around to compensating forced sterilisation victims, but other states haven’t taken any action on it.
My sterilisation is being paid for by a state programme that provides reproductive health services to low-income people. Intriguingly, once I am sterilised, the programme will no longer pay for cervical cancer screening and STI care. The primary objective, of making sure I can’t breed, will have been accomplished. Many other states have similar systems in place.
The sheer level of cynicism here is pretty mindblowing; the concern here is not protecting my health, but ensuring I don't reproduce. Fortunately there’s a secondary program I can take advantage of for cancer screenings, but this isn’t the case in all locations.
I may have had an easy time getting a referral letter because I was confident, in a progressive community, and working with a midwife. But it’s also because I’m disabled, and the fact that I’m mentally ill and on the spectrum definitely played a role in her decision, whether she was consciously aware of it or not. It’s impossible to avoid the implications of that, and what it means that the State of California is ready and willing to pay for it.
And, of course, there are programmes not directly sponsored by the government, like those paying drug addicts to get sterilised. Participants may be ostensibly participating with free will, but there’s considerable coercion involved there along with the cash incentive. Coerced sterilisation is not in the past.
Society in general continues to maintain attitudes about who should and should not have children. Almost all my disabled friends have stories about being told they shouldn’t have children. Low-income people and people of colour continue to be pressured to pursue sterilisation, both directly and indirectly, through rhetoric about “welfare queens” and attacks on large families as well as state programmes like the ones I’m participating in.
On a personal level, I’m benefiting from that programme, which pleases me. And more broadly, the programme is providing reproductive health services, which is awesome, because people need access to these services. But I can’t help but be uneasy as I prepare for my surgery, thinking about the loaded political implications of my own sterilisation.
That consent form I signed came with a bloody and complex history and it’s one that persists to this day. As Lesley pointed out in her article about forced abortion in China, the reproductive rights movement focuses primarily on the right not to have children, rather than the right to have children. I’m going with the flow of the narrative by talking about sterilisation and, in a sense, promoting it.
But I can’t let it stand there, because that’s deeply wrong to me. As I go under, I will be thinking about the thousands of people who did not undergo this procedure voluntarily, about the thousands in the future who will be forced, deceived, or compelled into sterilisation. And once I’m back on my feet after surgery, I will go right back to defending their rights, because I need to live in a world where all reproductive health choices are fully independent and fully supported, which means I’ll escort you to an abortion -- or help you advocate for your right to carry a pregnancy to term. And everything in between.