Bodily Autonomy in Crisis: The Sterilization of Dalit Women in India
By Anika Kanitkar; Edited by Andrew Ma
Introduction
In 2023, India leapfrogged China to become the world’s most populous country. Overpopulation has been a major concern for the country for nearly five decades, with sterilization emerging as a method of population control and family planning in 1951. In 1975, Prime Minister Indira Gandhi declared a state of emergency for two years on the grounds of internal disturbance, which saw the suspension of civil liberties and censorship of the press. Spearheaded by the son of the Prime Minister, Sanjay Gandhi, and equipped by foreign funding from organizations such as the World Bank, the Emergency saw millions of Indians sterilized in the name of development-improving population control.
Dalit, translating to “oppressed,” refers to the people formerly known as “untouchables.” Dalits have faced historic marginalization through the caste system, which categorizes them as the lowest rung on the social ladder, even with the legal abolishment of “untouchability.” Now classed in India as scheduled castes, the Dalit community continues to face systemic discrimination and high levels of poverty, even amidst government efforts to uplift the group through affirmative action policies.
Dalit women are marginalized in Indian society due to their unique experience with the intersection of caste-based discrimination, gender oppression, and state-sanctioned policies. They are routinely denied access to education, healthcare, and basic rights. This exclusion and marginalization make them prime targets for forced sterilization, which is viewed by some as a way to control the reproductive capacity of marginalized communities.
Caste and Gender Based Oppression
The Indian social order is one shaped by the intersection of caste, gender, and patriarchy. This intersection and its legacy of systemic marginalization have led to the dehumanization and exploitation of Dalit women for centuries. The caste system, though prohibited by the Indian constitution, continues to influence social norms greatly, and remains dominated by the brahmins, or priests, who sit at the top of the social order. One’s birth determines social standing in this stratification of Indian society into four varnas, with Dalits falling in the avarna category, outsiders to this four-fold system.
Upper-caste women in India tend to primarily face gender-based discrimination, while lower-caste women face both gender and caste-based violence perpetrated by their communities and the upper-castes. Dalit women face higher levels of sexual violence and remain more vulnerable to exploitation through sex trafficking and prostitution than upper-class women. Subjecting these women to high levels of violence and systemic dehumanization has contributed to the narrative that controlling their reproductive autonomy will further India’s economic development. This narrative is fueled by healthcare facilities’ systemic discrimination against Dalit women, which has resulted in a lack of respect, dignity, and informed consent regarding reproductive health.
A History of Exploitation and Coercion
During the aforementioned Emergency (1975-1977), Prime Minister Indira Gandhi’s government introduced various population control measures. Spearheaded by Sanjay Gandhi, these population control measures focused on aggressive family planning programs, significantly impacting the lives of marginalized communities. Sanjay Gandhi believed in compulsory sterilization as an answer to Indian poverty, the reduction of which would fuel economic development. He allocated sterilization quotas to the chief ministers of every Indian state, to be met by any means necessary, which entailed the use of direct and indirect force. The lower classes, including the Dalits, suffered the most and were frequently picked up by the police to be detained until they underwent sterilization procedures. Upwards of 8.1 million people, mostly men, were coerced into being sterilized during the Emergency, with large numbers undergoing these procedures in mass sterilization camps.
In the aftermath of this period, sterilization efforts were refocused to target lower-class women, who were seen as less likely than men to protest. Post 1970s, sterilization campaigns began to disproportionately target women from lower socio-economic backgrounds, such as the Dalit and Adivasi (tribal) populations. The reason women from lower-class socio-economic backgrounds were targeted is allegedly attributed to higher birth rates among the poor, but is also rooted in India’s history of using eugenics in population control measures, where sterilization was seen as a tool to improve the “quality of the population.” Vulnerable due to high levels of illiteracy and a lack of education on reproductive rights, lower-class women, such as the Dalits, were convinced to undergo sterilization procedures, usually tubectomies (the blocking or removing of the fallopian tubes), by being told that the procedure is in their best interest.
In 2014, fifteen lower-class women, many of whom were Dalits, died in sterilization camps located in Bilaspur, a district in the state of Chhattisgarh, after undergoing surgeries in appalling conditions. This highly publicized case highlights the prevalence of state-sanctioned sterilization camps, which continue to exist throughout 21st-century India, convincing women to give up their bodily autonomy for around 1,400 rupees, just over twenty American dollars.
The Legal and Human Rights Response
The forced sterilization of Dalit women is a violation of fundamental human rights, as the procedure restricts rights to bodily autonomy, lacks proper informed consent, and systemically discriminates against subsets of the Indian population. The UN’s International Conference on Population and Development, working with the Committee on the Elimination of Discrimination against Women (CEDAW), and social advocates, emphasize a human rights-based approach to Sexual and Reproductive Health and Rights (SRHR), noting that states violate article 10 (h) of CEDAW when they fail to provide proper information on family planning. The Indian government continues to promote sterilization as a means of family planning, with sterilization often being the only form of family planning promoted in certain areas. India carries out over 30% of the world’s sterilization procedures every year, with the government capitalizing on a lack of informed consent and illiteracy among lower-class women to promote the procedure, a stark violation of SRHR.
Civil society organizations and women’s rights groups have documented cases of forced sterilization and have advocated for legal reforms. In 2016, health-rights activist Devika Biswas used the courts to challenge the practice of sterilization based on improper protocol and lack of informed consent. In Devika Biswas v. Union of India, the Supreme Court of India found that these sterilization practices targeting poor, rural women violate Article 21 of the Indian Constitution, constituting a violation of the right to health and reproductive rights. However, this ruling has not prevented the continuation of the sterilization policy, and states continue to implement population control reforms. In 2021, Uttar Pradesh, known for its high fertility rate, launched the state's 2021-2030 population policy, which punishes those who have more than two children by making them ineligible for government welfare. The policy has been critiqued for attempting to solve a demographic issue while failing to address its socio-economic factors. Additionally, its approach, emphasizing incentives and disincentives, has been denounced by the National Human Rights Commission.
Current Situation and Ongoing Challenges
There has been slow progress in reforms to safeguard the reproductive rights of women in India, especially Dalit women. This is due to a combination of factors, primarily the inadequacy of family planning policies in preventing coercive sterilization practices, along with the state's failure to fulfill the responsibility of protecting reproductive rights. In rural, impoverished areas of India, other forms of contraception remain relatively inaccessible, and sterilization remains the primary way to control fertility. National Family Health Survey data shows that one in three women were not informed on the permanence of the procedure, while two in three were uninformed about its side effects.
Dalit women are further affected by these policies due to their caste. They face a legacy of exploitation compounded by both caste and gender-based violence. They also face a massive disparity in healthcare access, with Dalit women often receiving substandard care in rural or underfunded healthcare facilities. Health-care workers in India often subject Dalit women to caste-based discrimination, excluding them from care by refusing to even touch them. Incentivized by the government, these workers exploit high illiteracy rates and lack of informed consent among these Dalit women in order to meet sterilization quotas, as they are forced to sign forms consenting to sterilization procedures without being able to read them.
Compounding the problem is a lack of access to proper maternal healthcare in the case of pregnancy, and the harsh reality of sterilization linked to manual labor. In Beed, Maharashtra, impoverished women primarily find employment doing manual labor on sugarcane farms, undergoing sterilization procedures to stop menstruation. These women, most of whom are illiterate, do not realize the gravity of the procedure they are signing up for.
Conclusion
The practice of forced sterilization, especially targeting Dalit women, remains a pervasive issue in India, deeply rooted in the intersection of caste-based oppression, gender inequality, and state-sanctioned population control measures. Despite legal advancements and advocacy efforts, the exploitation and marginalization of Dalit women continue, as they remain vulnerable to coerced sterilization, inadequate healthcare, and systemic discrimination. Addressing this ongoing injustice requires not only legal reforms, but also a fundamental shift in societal attitudes toward caste and gender equality, and an unwavering commitment to protecting the reproductive rights of all women.
