Advocates praise criminalization of non-consensual sterilization

Advocates say they’re pleased a federal bill explicitly criminalizing non-consensual sterilization has passed, but told Cabin Radio more work is needed to address the issue.

MPs across political parties unanimously passed Bill S-228 last week, as first reported by The Canadian Press. The bill, introduced by Senator Yvonne Boyer, amends the Criminal Code to clarify that sterilization procedures without legal consent classify as aggravated assault.

It’s a change that survivors of forced and coerced sterilization – which has disproportionately impacted First Nations, Métis, and Inuit women – have sought for years.

“To add those words into the Criminal Code I think is so important,” said Harmony Redsky, executive director of the Survivors Circle for Reproductive Justice.

“It is not only bringing justice to the survivors of forced and coerced sterilization, but it is also going to prevent future harms from occurring,

“It’s a huge, huge accomplishment.”

The president of the Canadian Medical Association applauded the legislation’s passage in a press release.

“We stand with survivors of forced and coerced sterilizations and are committed to continuing our work in partnership with Indigenous people to put our reconciliation commitments into practice,” Dr Bolu Ogunyemi stated.

He pointed to an apology the medical association delivered to Indigenous people in 2024 for past and ongoing harms in Canada’s health system.

NWT health minister Lesa Semmler, a registered nurse and Indigenous woman, called the passage of Bill S-228 “an important milestone” in a statement to Cabin Radio.

“This legislation marks a significant step toward recognition, justice, and respect in addressing a deeply troubling practice that has gone unaddressed for far too long,” she said.

“Forced sterilization is not a practice of the distant past. Its impacts are present in our communities today. We live and work alongside those who have been affected, and there remains a responsibility to ensure accountability and support for survivors.”

Steven Cooper is a lawyer with Cooper Regel, one of the law firms that pursued class actions on behalf of survivors of forced and coerced sterilization in Alberta and BC.

He said while “it’s a shame that Canada has to criminalize something as obviously wrong” as coerced and forced sterilization, he’s “glad there’s an extra layer of protection” for people who could be affected.

“I hope that will give doctors extra incentive to be extra careful,” he said.

“I suspect that knowing there’s criminal sanction, not just civil sanction, will not prevent but certainly hopefully drastically reduce the instances that we’ve seen already in our history.”

What is forced and coerced sterilization?

Sterilization refers to surgical procedures to prevent pregnancy, such as tubal ligation and vasectomy. Forced and coerced sterilization is when such procedures are performed without a person’s free, prior and informed consent.

Redsky explained that forced sterilization is when a procedure is performed against someone’s will. She said coerced sterilization can happen in many different ways, including through threats, intimidation, misinformation, or seeking consent at inappropriate times such as during or after labour.

Imposed sterilization, Redsky said, is when a person is not given a choice and not told they will be sterilized.

Survivors and advocates have highlighted the power imbalance between patients and medical professionals, along with challenges such as language and cultural barriers, geographic isolation, fear of child welfare systems, and the history of state intervention in Indigenous peoples’ lives.

Redsky said forced and coerced sterilization of Indigenous people has involved racism and bias, and has a history in the residential schools system, “Indian hospitals,” TB sanatoriums and the child welfare system.

“There’s a lot of work to be done” on understanding what free, prior and informed consent means, she said, adding that consent must be ongoing and it’s a matter of bodily autonomy and people’s right to choose.

“For many doctors, they might think a signed consent form is all you need, but if the person doesn’t understand what they’re signing or the impact – the long-term and/or permanent impact of what is about to happen – that’s not informed consent,” she said.

The impacts of forced and coerced sterilization are lifelong, Redsky said, including physical, mental and spiritual damage, impacts to relationships and preventing people from passing on cultural knowledge.

“The teachings in Indigenous nations really revolve around the matriarchy and that respect toward women as the lifegivers in our community,” she said, “and so that disrupts that for many survivors and adds to their trauma.”

History of forced and coerced sterilization in Canada

Canada has a long history of forced and coerced sterilization, particularly affecting Indigenous and racialized women, intersex people, and people with disabilities. It is an issue that continues to affect people today.

The United Nations Convention Against Torture recognized sterilizing Indigenous women without consent as a form of torture in 2018, and called on Canada to adopt measures to prevent and criminalize the practice. It also said Canada should ensure all such allegations are “impartially investigated, that the persons responsible are held accountable and that adequate redress is provided to the victims.”

A Senate committee report published in 2022 describes forced and coerced sterilization as “a horrific and ongoing practice” in Canada that is both underreported and underestimated.

The Survivors Circle for Reproductive Justice has a national registry documenting cases of forced and coerced sterilization involving Indigenous people. Redsky said as more people come forward, she believes there could be more than 15,000 survivors in Canada.

“The experience is starting to present as being far more common than we could imagine,” she said.

Redsky said the organization is forming a baseline of data and has already identified clusters of cases across Canada. The organization’s most recently documented case occurred in 2024, she said, and there was a case in 2025 in which the coerced sterilization of a minor was prevented due to the intervention of family members.

Research has found thousands of sterilizations were performed across Canada during the eugenics movement from the 1920s to 1970s. Two provinces enacted formal sterilization legislation in that period: Alberta’s Sexual Sterilization Act was in force from 1928 to 1972, while British Columbia’s Sexual Sterilization Act was in effect from 1933 to 1973.

Karen Stote is an author and associate professor of women and gender studies at Wilfrid Laurier University who has researched forced and coerced sterilization in Canada. She has called the practice a human rights violation and an act of genocide.

Stote said historical records indicate more than 3,000 people were sterilized in Alberta and BC between 1928 and 1973.

Last year, the Alberta Court of King’s Bench dismissed certification of a class action filed on behalf of Indigenous women who were sterilized in the province without their consent.

Cooper said the Alberta court did not make a merit-based decision but determined the province was not responsible for the day-to-day operation of the hospitals or surgeons who performed operations. He said law firms subsequently withdrew a similar case in BC.

“Our dilemma as plaintiffs’ counsel was, well, who do we sue? The doctors, who were deceased in most instances in our case 20 or 30 years before, or largely non-existent hospital boards?” he said.

Proposed class actions related to the forced and coerced sterilization of Indigenous women have also been filed in Saskatchewan, Manitoba, Ontario, Quebec, New Brunswick and Nova Scotia.

In the NWT, Stote said there were two proposals to pass sterilization legislation, in 1939 and 1941, but no such laws were ultimately enacted.

She said she did find records indicating more than 1,200 people from 52 northern communities – mostly Indigenous women – were sterilized in federally operated “Indian hospitals” from 1966 to 1976.

“The files don’t tell us each person’s experience but they tell us that there were consistent problems with informed consent,” she said.

“There was a lack of policy or adequate policies on interpreters, there was pretty consistent racism and paternalism on the part of government officials and health professionals, and all of that informed Indigenous peoples’ experiences.”

In a more recent case, an Inuk woman is suing a doctor and the NWT health authority alleging she was sterilized against her wishes at Stanton Territorial Hospital in 2019. The NWT government and doctor have denied the allegations.

In 2023, the doctor released a written statement apologizing for “a serious error in judgement” after an NWT medical board of inquiry found him guilty of unprofessional conduct.

Concerns about unintended impacts

While many people have celebrated the passage of Bill S-228, two groups voiced concerns about the legislation while it was being considered in the House of Commons.

In briefs to a committee studying the bill, the Northern Association of Women and the Law, or NAWL, and Society of Obstetricians and Gynaecologists of Canada, or SOGC, said while they supported the intention behind the bill, they were worried it could impact access to reproductive care among other unintended consequences.

The SOGC argued the bill could create legal uncertainty in cases of medical emergency.

“Medical emergencies can unfold in minutes. In the setting of a massive postpartum hemorrhage or a ruptured ectopic pregnancy, life-saving interventions such as hysterectomy or removal of a fallopian tube may be required,” the society wrote.

“If there is even a perception these interventions could later be scrutinized as potential criminal offences, physicians may hesitate to perform necessary procedures or treatments. Those moments of hesitation could be the difference between life and death for a woman in an emergency.”

Supporters of the bill say the Criminal Code protects people who have performed surgery from criminal responsibility if an operation was reasonable in the circumstances and performed “with reasonable skill and care.”

The SOGC further raised concerns Bill S-228 could have a chilling effect and result in fewer physicians offering reproductive care options.

In its submission, NAWL argued the definition of sterilization in the bill is too narrow and could exclude men and non-binary and intersex people.

The organization pointed out that anti-transgender activists have used fertility loss as a reason to deny gender-affirming care. NAWL expressed worries the legislation could “empower governments, particularly in provinces that are already attempting to restrict access to gender-affirming care, to prosecute physicians by claiming that gender-affirming care amounts to forced/coerced sterilization.”

NAWL added the conduct “that underpins coerced sterilization” is already covered by the offence of aggravated assault in the Criminal Code. It asserted that raising the evidentiary burden for prosecution could place undue hardship on survivors, including potentially requiring invasive medical testing.

Finally, the association said the bill will not address the root causes of forced and coerced sterilization, including racism, colonialism and ableism in healthcare systems.

“Bill S-228 offers the appearance of action without the necessary structural change, and risks creating new harms while failing to prevent the very violations it seeks to address,” the organization wrote.

A spokesperson for NAWL declined Cabin Radio’s request for an interview but said in a statement that now Bill S-228 has passed, the organization hopes “the Department of Justice will make it clear that this legislation must not be used to restrict access to gender-affirming care or consensual permanent contraception.”

SOGC did not return Cabin Radio’s request for comment.

Speaking about the bill in the House last month, Jamie Schmale, the Conservative MP for Haliburton-Kawartha Lakes, disputed that it would “restrict voluntary sterilization, interfere with reproductive choice or affect gender-affirming care.”

“This legislation is meant to offer clarity to this issue, because that is essential. While existing assault provisions may technically apply, they have never been used to prosecute forced sterilization in Canada,” he said.

“Survivors have told us that the absence of clear legal recognition has contributed to silence, confusion and the lack of accountability.”

Further recommendations

Both of the organizations that raised concerns about Bill S-228 and those who backed it have said more is needed to adequately address forced and coerced sterilization in Canada.

“Health systems across Canada still have important work ahead to rebuild trust with Indigenous peoples and other marginalized communities,” NWT health minister Semmler stated.

She said the legislation “must be accompanied by continued action to ensure health systems are safe, respectful, and grounded in consent – places where people can access the care, healing, and dignity they deserve.”

Quoting an Indigenous midwife, Stote said the bill is “a colonial solution to a colonial problem.” She said consent over Indigenous bodies “must go hand in hand” with consent over what happens to Indigenous land.

“I know the majority of Indigenous people, their long-standing struggles are to be able to have reproductive and political sovereignty – to be able to live in relationships with their lands in healthy ways, without interference,” she said.

Potential solutions outlined by NAWL included:

• a formal apology;
• reparation in the form of financial, cultural and emotional support that is trauma-informed and survivor-led;
• culturally safe and trauma-informed reproductive health services for Indigenous women in their communities;
• funded and available Indigenous language interpreters;
• funding and development of an advisory council to assist women who have experienced forced or coerced sterilization;
• Indigenous women-led measures to hold medical authorities and federal and provincial governments accountable;
• educating health care providers on informed consent, Indigenous cultures, human rights, Indigenous rights, Indigenous reproductive health issues;
• developing a national data collection system on forced sterilization;
• a Canadawide investigation; and
• amendments to the Canada Health Act to ensure Bill S-228 is effective.

Recommendations in the 2022 Senate report included a formal apology and compensation, requiring medical associations to provide a clear consent framework, and ensuring all health practitioners undergo intensive training. The report also called on medical and nursing schools to have courses on Indigenous health issues and for Indigenous Services Canada to increase investments in community-based midwifery in northern and remote communities.

Cooper said Canada’s education system needs to be “revised to reflect the real history of our country, and part of that is coming to terms with the various forms of eugenics and other racist processes and institutions.”

“I wonder whether a doctor or surgeon that was educated from their youth in understanding the history of our country would be as inclined to engage in uninformed consent sterilization,” he said.

The Survivors Circle for Reproductive Justice has a healing support fund that helps with individual healing, community initiatives, and assisted reproductive technology for survivors.

Beyond greater education on informed consent, Redsky called for a reporting mechanism and advocates in medical care settings to prevent coerced and forced sterilizations.

The NWT Medical Association, Inuvialuit Regional Corporation and Dene Nation declined to comment for this article.

The Native Women’s Association of the NWT, Pauktuutit Inuit Women of Canada and Society of Rural Physicians of Canada did not respond to Cabin Radio’s requests for comment.