Decades after many other rich countries stopped forcibly sterilizing Indigenous women, numerous activists, doctors, politicians and at least five class-action lawsuits say the practice has not ended in Canada.
A Senate report last year concluded “this horrific practice is not confined to the past, but clearly is continuing today.” In May, a doctor was penalized for forcibly sterilizing an Indigenous woman in 2019.
Indigenous leaders say the country has yet to fully reckon with its troubled colonial past — or put a stop to a decades-long practice that is considered a type of genocide.
There are no solid estimates on how many women are still being sterilized against their will or without their knowledge, but Indigenous experts say they regularly hear complaints about it. Sen. Yvonne Boyer, whose office is collecting the limited data available, says at least 12,000 women have been affected since the 1970s.
“Whenever I speak to an Indigenous community, I am swamped with women telling me that forced sterilization happened to them,” Boyer, who has Indigenous Metis heritage, told The Associated Press (AP).
Medical authorities in the Northwest Territories issued a series of punishments in May in what may be the first time a doctor has been sanctioned for forcibly sterilizing an Indigenous woman, according to documents obtained by the AP.
The case involves Dr. Andrew Kotaska, who performed an operation to relieve an Indigenous woman’s abdominal pain in November 2019. He had her written consent to remove her right fallopian tube, but the patient, an Inuk woman, had not agreed to the removal of her left tube losing both would leave her sterile.
Despite objections from other medical staff during the surgery, Kotaska took out both fallopian tubes.
The investigation concluded there was no medical justification for the sterilization, and Kotaska was found to have engaged in unprofessional conduct. Kotaska’s “severe error in surgical judgment” was unethical, cost the patient the chance to have more children and could undermine trust in the medical system, investigators said.
The case was likely not exceptional.
Thousands of Indigenous Canadian women over the past seven decades were coercively sterilized, in line with eugenics legislation that deemed them inferior.
Gerri Sharpe, president of Pauktuutit Inuit Women of Canada, said health centers serving Inuit women often aren’t staffed by Indigenous people, resulting in translation problems. For example, in Inuit culture, people often communicate with facial expressions, like raising their eyebrows for “yes” or wrinkling their nose for “no.”
“Doctors will be speaking, and they look to the woman to acknowledge something. When she (raises her eyebrows), the doctor labels it as `non-responsive,”’ Sharpe said.
Dr. Ewan Affleck, who made a 2021 film, ” The Unforgotten,” about the pervasive racism against Canada’s Indigenous people, said the way forced sterilization happens now is more subtle than in the past. He noted an ongoing “power imbalance” in the country’s health system. “If you have a white doctor saying to an Indigenous woman, `You should be sterilized,’ it may very likely happen,” he said.
Kotaska, the ob-gyn who carried out the surgery that left an Indigenous woman sterile in 2019, was the president of the Northwest Territories Medical Association and held teaching positions at several Canadian universities.
Documents show an anesthetist and surgical nurse became alarmed when Kotaska said during the surgery to remove the woman’s right fallopian tube: “Let’s see if I can find a reason to take the left tube as well.”
Kotaska told investigators he was “voicing his thought process out loud” that removing both tubes would lessen the woman’s pelvic pain, the documents say.
Describing Kotaska’s actions as “a violation of his ethical obligations,” investigators suspended Kotaska’s medical licence for five months, ordered him to take an ethics course and reimburse the cost of the inquiry. The Northwest Territories health department said it was the first time a “non-consensual medical procedure” had been referred for investigation.
The woman is suing Kotaska and hospital authorities for $6 million.
There was no suggestion in the documents that Kotaska was motivated by racism. Kotaska declined to comment to the AP.
The Canadian government would not comment on Kotaska’s actions but said forced sterilization is illegal and prosecutable under Canadian criminal law. The Royal Canadian Mounted Police in the Northwest Territories said there is no criminal investigation into Kotaska.
“People don’t want to believe things like this are happening in Canada, but cases like this explain why entire First Nations populations still feel unsafe,” said Dr. Unjali Malhotra, medical officer of the First Nations Health Authority in British Columbia.
—By Maria Cheng, The Associated Press