Involuntary sterilization: a means of torture against Roma women in Slovakia

Despite the extreme gravity of this violation and its dire consequences on the bodily and psychological integrity of a human being, it was not always seen as a ground to claim torture or ill-treatment. As Ms. Felice Gaer, Vice Chair of the CAT, pointed out in this same blog earlier this year, still at the beginning of the XXI century, “acts of gender-based violence were essentially invisible in the work of the Committee against Torture”. However, throughout its first 30 years of existence since 1984, the UN Convention against Torture, under the action of its monitoring body CAT has been evolutionarily interpreted and its scope broadened by progressively including new elements coming under the international spotlight. Since 2001, the expanding interpretation of the right to be free from torture started taking into account different harms faced by women at the hands of private persons.

Against this background, one year ago during his opening remarks on the occasion of the 30th anniversary of the Convention, the High Commissioner for Human Rights Mr. Zeid Ra’ad Zeid Al-Hussein mentioned among “contemporary forms of torture and ill-treatment […] gender-based violence, domestic violence, female genital mutilation and trafficking”.

In 2008, two important parallel steps were made by the CAT and the then Special Rapporteur on Torture. The treaty body highlighted in its General Comment N. 2 (para 12) that “gender is a key factor” to take into consideration in the fight against torture. Furthermore, it pointed out some contexts where women are particularly at risk, including “deprivation of liberty, medical treatment, particularly involving reproductive decisions, and violence by private actors in communities and homes”. Mr. Manfred Nowak, at the same time, stressed in his Annual Report to the Human Rights Council the need for a “gender-sensitive interpretation of torture” in order to strengthen the protection of women from torture, both in private and public spheres. Within this report, he included a Section (B.1.b) on “violence against pregnant women and denial of reproductive rights” and listed among the other violations in this field also sterilizations of women without their consent.

Following this line of authoritative interpretation of the scope of the Convention, the current UN Special Rapporteur on Torture, Mr. Juan Méndez, dedicated his 2013 Annual Report on the emerging recognition of different forms of abuses in health-care settings as amounting to torture or ill-treatment. The rationale for such a topic was founded in the “situation of powerlessness” intrinsic in the definition of victims of torture, as indicated by his predecessor Mr. Nowak. This “total control of another person” on the victim can perfectly reflect the condition of patients in health-care settings, who are reliant and dependent on health-care workers, especially in those cases where their own exercise of decision-making is taken away.

Among the listed abuses within medical settings, Mr. Méndez dedicated a whole section (IV.B, paras 45-50) to “reproductive rights violations”, considered as “gender-specific forms of torture” causing “tremendous and lasting physical and emotional suffering, inflicted on the basis of gender”. Examples of such violations are abusive and humiliating treatment, denial of legal abortion in case of rape, attempts of extorting confessions as a condition for post-abortion care, female genital mutilation, forced abortion and involuntary or forced sterilization.

In his report, Mr. Méndez analyzed the practice of forced sterilization, considering it as an intrusive and irreversible medical treatment, performed without the free and informed consent of the person concerned, and defined it as “an act of violence, a form of social control, and a violation of the right to be free from torture and other cruel, inhuman and degrading treatment or punishment” (para 48). Moreover, he particularly stressed the grave discriminatory character of forced sterilizations targeting women pertaining to ethnic and racial minorities or other marginalized communities.

Regarding this last phenomenon, the Special Rapporteur notably took as an example in his report the case of V.C. v Slovakia, the first of this kind brought before the ECtHR and won in 2011 by a Roma woman who was forcibly sterilized in a hospital after a cesarean section delivery. Other two similar cases (N.B. v Slovakia and I.G. and Others v Slovakia), this time regarding underage Roma teenagers sterilized without informed consent, were judged by the ECtHR the following year and drove to the same conclusions. The Court in all three cases found that Slovakia violated these women’s right to be free from inhuman and degrading treatment, guaranteed by Article 3 of the European Convention, along with their right to private and family life, protected under Article 8.

The increased vulnerability, causing a higher risk to be victims of torture or ill-treatment, deriving from the multiple discrimination suffered by women and girls belonging to the Roma minority in Slovakia has been particularly stressed by the Committee against Torture during the second review of the State Party in 2009, as well as in its 55th session in 2015. The Committee in its last Concluding Observations on Slovakia (para 12) reiterated its deep concern for the reports of continued involuntary sterilizations of Roma women without their free and informed consent and for the difficulties of victims to obtain compensation. The members of the Committee recommended Slovakia to “investigate promptly, impartially and effectively all allegations of involuntary sterilization of Roma women and provide victims with fair and adequate redress”. Following such investigations, medical practitioners found guilty of having performed involuntary sterilizations “should be held criminally liable, prosecuted and punished [and] should also be trained on appropriate means of how to obtain free and informed consent from women undergoing sterilization”. Particularly, Ms. Gaer, during the constructive dialogue with the Slovakian Delegation, stressed very strongly this crucial point of capacity building and thorough dissemination of Ministry of Health’s guidelines on consent as the very heart of the problem. Moreover, the Committee recommended, “all written materials relating to sterilization should be translated into the Roma language and other relevant languages” in order to be accessible to all.

The path is still long to walk to achieve the elimination of this extremely harmful practice, but the increasing international and regional recognition of the issue of involuntary sterilization as a means of torture and ill-treatment, is a first fundamental step. It gives value to the assertion that involuntary sterilization is a violation of a norm of jus cogens, and therefore should be given the right weight within International Human Rights Law.

Chiara Cosentino

Former OMCT staff and member of the Women's Rights Department of Amnesty International Italy