The Fight to End Forced Sterilization of Disabled Women and Girls in Europe

Sixteen women with intellectual disabilities who lived in Balti Psycho-neurological Hospital, Moldova, were repeatedly raped by the institute’s lead physician, Stanislav Florea. Two of these women became pregnant and were forced to end their pregnancies by a panel within the psychiatric institution — which included their rapist in his position as lead doctor — in order to cover up the abuse.

Following the abortions, one of the women was forcibly sterilized. The abuses came to light in 2013 after one of the victims revealed to a family member that she had been raped. “Because they were in an institution, nobody found out about the abuse. It could continue for years,” Šárka Dušková, legal manager at the Validity Foundation, commented via email.

The Validity Foundation was established in 2002 to advocate for people with mental disabilities in Eastern Europe. In 2021, Validity called for the European Court of Human Rights to consider the forced sterilizations and forced abortions that took place in this case as acts of torture. The court has not yet delivered a judgment.

The case was also taken to the Moldovan Supreme Court, and in 2016, Florea was sentenced to 13 years imprisonment. The sentence was appealed by the prosecution, and in 2019 the doctor was sentenced to an additional two years.

“While this is an extreme case, women with disabilities in institutions and/or under guardianship are typically invisible to the justice system and to the wider public,” explained Dušková, adding that “the human rights abuses occurring in these contexts thus often remain uncovered and unpunished.”

In Europe, progress in the fight against forced sterilization has been slow and unsteady. Activists have been working to raise awareness among policy makers, and lawmakers have been strengthening legislation to make forced sterilization illegal in many countries, but the forced sterilization of disabled women and girls persists in some places.

A Human Rights Violation

Forced sterilization — removing, without a person’s consent, their ability to reproduce — is a violation of many human rights, including the right to bodily autonomy and the right to legal capacity. It is a form of “torture” and “systematic violence” against girls with disabilities, according to the United Nations.

Although forced sterilization can be carried out on people of any sex and ability, women and girls with disabilities are the most likely to be targeted. Globally, forced sterilization often goes unreported, so there is next to no data on its prevalence.

On July 6 2022, the Sexual Rights Initiative, an international coalition of organizations advocating for human rights relating to sexuality at a U.N. level, ran an online event about reproductive injustice: population policies and denial of bodily autonomy. Melissa Upreti, chair of the UN Working Group on Discrimination Against Women and Girls, spoke at the event and characterized the forced sterilization of women and girls with disabilities as a “global phenomenon.”

“Disabled women and girls have been identified as in a persistent state of crisis relating to their rights,” said Upreti, “based on stereotypes, their exclusion from public life, and their treatment during humanitarian crises.”

Subjecting somebody to forced sterilization is thought to be “easier to justify” when a woman is disabled, explains Marine Uldry, senior human rights officer at the European Disability Forum (EDF). Uldry notes that this is due to the ingrained stereotype that disabled women could not be good mothers. Uldry says that forced sterilization of women and girls with disabilities is hard to document because “it is happening more often behind closed doors.” Because of this, the existing data on this subject is scarce, but Uldry notes that it is more widespread than most people realize.

Historic Roots

Europe has a long history of eugenics programs and policies — most notably during the Nazi regime, which lasted until 1945. These programs aimed to sterilize and euthanize people with genetic disabilities and psychosocial disorders, to prevent “defective” genes from being passed down, and to eliminate disabled people.

Soraya Post, Swedish activist, member of the political party Feminist Initiative, and former member of the European Parliament, believes that “people in general are not even aware of the history, and mostly it affects people who do not have any positions in society, like physically/mentally disabled people and ethnic groups who are not valued in this society.”

Post has been advocating against forced sterilization during her time as a politician. In 2017 she collaborated with EDF to host a meeting in the European Parliament on the forced sterilization of disabled women in Europe. With this event, Post helped to raise awareness of this issue and the need for the European Union to introduce stronger laws against forced sterilization.

Although the Nazi regime ended a long time ago, the issue of the forced sterilization of women and girls in Europe still persists. The U.N. has named Belgium, Croatia, Czechia, France, Germany, Lithuania, and Slovakia as countries whose legislation enables the forced sterilization of disabled women and girls. “We also like to think that we have learned a lot, and we are super civilized now,” continued Post, “but look at the political arena today — it is not very different from Europe 1930s.”

Sweden ended its forced sterilization program in 1976. The country’s government went to great lengths to compensate past victims and ensure the forced sterilization was made illegal in Sweden. Uldry believes that the dramatic change in Sweden’s forced sterilization legislation and its introduction of supported decision-making has made it one of the countries with the best practice in the EU. Supported decision-making protects the decision-making capacity of disabled people, and ensures active and informed participation of disabled people in the governing of their lives. Supported decision-making is enshrined in the United Nations Convention on the Rights of Persons with Disabilities.

Before Spain outlawed forced sterilization in 2020, it was revealed that the Spanish government was sterilizing women with disabilities without their consent. Under the previous legislation, people declared "disabled" by a doctor could be sterilized against their will.

As an example of the regression in some countries, the Armenian Ministry of Health is currently considering amending its voluntary sterilization legislation to allow the court to sign off on sterilization of disabled women.

Feminists Against Ableism (FAA), which started in 2019, is a Dutch grassroots movement of disabled people involved in the fight for bodily autonomy. “This we do by constantly educating and talking about ableism and its effects on our lives,” explained FAA member Jacquie Davis. FAA members have delivered public speeches about the sexual and reproductive rights of disabled women, and have published an op-ed on the EDF Website advocating for the end of forced sterilization in Europe.

In the Netherlands, the Mandatory Mental Health Act, which took effect in 2020, allows for forced contraception for women with intellectual or psychological disabilities. Although this is less severe than surgical sterilization, Davis pointed out that it still perpetuates the idea that disabled women shouldn’t have bodily autonomy.

Steps in the Right Direction

As well as being subject to various U.N. conventions — Convention on the Rights of Persons with Disabilities, Convention on the Elimination of All Forms of Discrimination Against Women, and the Convention on the Rights of the Child — European countries have the added protection of EU-specific legislation to protect women and girls, particularly against forced sterilization and other acts of violence.

The Council of Europe created the Istanbul Convention in 2011 to address and take action against violence against women and domestic violence in European countries. The Convention notes various forms of domestic and sexual violence perpetrated against women and girls, and specifically calls for states to put an end to forced abortion and forced sterilization.

Since the Moldovan case was brought to light, the country has made efforts to protect the rights of women with the ratification of the Istanbul Convention in 2022. Moldova is the most recent country to join the list of 35 states that have ratified the Convention. Armenia has not signed the Convention.

On International Women's Day 2022, EDF and CERMI, a Spanish coalition representing the interests of disabled people, collaborated to launch a campaign to put an end to forced sterilization of women and girls with disabilities with a proposed EU-wide directive to criminalize act of violence against women. The Convention and the directive would work in tandem to stop forced sterilization in EU member states on a legislative basis.

“Laws must be put in place to protect disabled people, and old laws that harmed us taken out,” said Davis, adding, “A lot of those laws are built on prejudices that exist about us. If you do not eradicate these prejudices, then the conversations surrounding this will simply not die down, and the chance history will repeat itself will remain.”

But legislation can only do so much, Uldry noted, commenting again on how a lot of forced sterilization takes place behind closed doors, and is often not reported to authorities, and so it is just as necessary to “change attitudes towards disabilities and to provide parents with disabilities with further support.”