Victim of forced sterilisation to testify : experts contributions

(en français uniquement)

Intervention devant la commission des questions sociales de l’Assemblée parlementaire du Conseil de l’Europe, 16 septembre 2011

Bernadette Gächter

Mesdames, Messieurs

Je vous remercie de votre invitation et c’est avec plaisir que je m’adresse à vous.

En 1972, en Suisse, j’ai été contrainte à l’avortement et à la stérilisation à l’âge de 18 ans.

Voici les événements qui ont conduit à cette situation…

A ma naissance, ma mère, ne pouvant s’occuper de moi, s’est adressée à une institution catholique, le Seraphische Liebeswerk, qui m’a placée en famille d’accueil.

Ma prise en charge ne pouvant plus être assurée, j’ai été confiée, en vue de mon adoption, à une autre famille.

C’est ainsi que je suis arrivée chez un couple sans enfant, catholique fervent et très pieux. Ces personnes veillaient à ce que je sois toujours propre et bien habillée. J’avais quatre ans lorsque mes parents nourriciers ont eu eux-mêmes un enfant, de sorte qu’en vertu de la législation de l’époque mon adoption n’était plus envisageable.

En 1961, j’avais sept ans et mes parents d’accueil ont commencé à avoir des doutes à mon sujet. Comme j’étais une enfant impulsive et entêtée et qu’ils pensaient que je me masturbais en cachette, ils m’ont emmenée à l’hôpital pour enfants de Zurich sur les conseils du médecin de famille. L’interne de pédiatrie a posé son diagnostic : « psychosyndrome organique infantile ». Aujourd’hui on parle plutôt à cet égard de syndrome de déficit d’attention. Cette pathologie touche environ 10 % des enfants. Mais à ce jour, rien ne prouve que dans mon enfance j’ai été atteinte de ce syndrome.

Ce diagnostic m’a poursuivie durant des dizaines d’années. Même les experts consultés par la suite ne l’ont pas remis en cause, bien qu’ils n’en aient trouvé aucun symptôme.

A partir de ce moment, toutes les nuits, après la prière du soir, ma nourrice a pris l’habitude de m’attacher les jambes jusqu’aux hanches à l’aide d’une bande élastique. Elle se chargeait elle-même de ma toilette. Tous les samedis, elle me donnait un bain, me savonnait, me frottait et me rinçait comme un petit bébé. Mes protestations n’y faisaient rien. Lorsque je désobéissais, la punition tombait aussitôt : j’étais battue et enfermée à la cave ou dans les toilettes.

Durant toute ma scolarité, j’ai été régulièrement emmenée dans des cliniques psychiatriques où l’on me branchait des fils électriques et examinait mon cerveau. On me plaçait même des électrodes dans le nez, ce qui était extrêmement douloureux.

Après une année passée en Romandie, j’ai entamé un apprentissage comme employée de bureau. Et à 18 ans j’ai appris par hasard que je n’étais pas l’enfant biologique de la famille. Pour moi, le monde s’est écroulé et j’ai eu le sentiment de tomber dans un abîme. Aucune autre explication ne m’a été fournie quant à mes origines. J’ai eu l’impression d’être abandonnée, que personne ne s’intéressait à moi, j’étais convaincue qu’on ne m’avait jamais aimée.

J’ai commencé à sortir le soir sans respecter les horaires qui m’étaient imposés. Je pensais trouver auprès des hommes l’amour qui me manquait dans ma famille d’accueil. Lorsque je rentrais au beau milieu de la nuit, ma nourrice m’injuriait. Elle disait que j’étais la même catin, la même garce que ma mère, alors qu’elle ne l’avait jamais connue. C’était terrible. J’avais le sentiment d’avoir perdu mon identité.

Je suis tombée enceinte et j’ai essayé de le cacher, par crainte des reproches et des coups. Ma famille d’accueil en a cependant été informée par le médecin de famille auquel je m’étais confiée.

Mon tuteur est soudainement entré dans la pièce où je me trouvais et m’a interrogée : « Bernadette, qu’as tu fait ! ». Personne n’est venu à mon secours. Ils affirmaient tous que je devais aller chez le maire et lui déclarer ma grossesse. Pourquoi, je n’en savais rien. Ma nourrice m’a envoyée chez le curé pour que je me confesse. J’ai dû aussi me rendre chez le médecin de famille avec ma nourrice pour clarifier la situation. Je me suis retrouvée ainsi avec elle dans le cabinet de consultation, face au médecin, à maintes et maintes reprises. Je n’en garde qu’un seul souvenir très précis : l’annonce subite de ma prétendue lésion cérébrale et le fait qu’ils me considéraient comme folle. J’étais pourtant parvenue au terme de l’éducation primaire et secondaire sans grandes difficultés. Ma nourrice me disait, mot pour mot : « Tu sais, Bernadette, il vaudrait mieux te faire avorter, parce que tu souffres d’une lésion cérébrale. Et comme ce trouble est héréditaire, ton enfant naîtra aussi avec cette lésion. Comme ça t’est arrivé à toi. Tu ne veux certainement pas que ton enfant soit lui aussi fou ».

Harcelée par le médecin et ma nourrice jusqu’à n’en plus pouvoir, j’ai fini par abdiquer et signer un document qu’elle me tendait. Je venais d’accepter l’avortement et la stérilisation, mais sans mesurer à ce moment précis toutes les conséquences de mon acte. Je ne voulais pas de tout cela, mais n’étais pas en mesure de me défendre. J’étais seule face aux personnes « respectables » de mon enfance.

Famille d’accueil, médecin de famille, curé, psychiatres, tous étaient ligués. Accompagnée de mes parents nourriciers, j’ai été forcée de me rendre à la clinique psychiatrique cantonale Wil pour expliquer la situation. Je me vois encore aujourd’hui, assise à cette immense table ovale, entourée de psychiatres posant des questions bêtes et absurdes, sans aucun rapport avec ma grossesse ou ma prétendue lésion cérébrale. L’avortement et la stérilisation étaient des faits acquis, avant même que je les rencontre.

Plus tard, après m’être mariée, j’ai été opérée à deux reprises pour tenter de retrouver la possibilité d’avoir un enfant. Mon mari de l’époque et moi-même avons dû auparavant nous expliquer devant un psychiatre. Ce n’est qu’au terme de ces explications que l’opération a été autorisée, sachant que les deux tentatives se sont avérées vaines.

Des décennies plus tard, lorsque j’ai pu accéder à mes dossiers, toute l’étendue de l’injustice qu’on m’avait fait subir m’est clairement apparue : j’ai passé deux ans à analyser des dossiers et à faire des recherches, jusqu’à ce qu’en 1991 je découvre un article de plusieurs pages dans un hebdomadaire. Grâce aux documents parcourus auparavant, j’avais appris que ma mère biologique avait elle aussi été stérilisée, étiquetée comme pulsionnelle et fragile, et enfermée parce qu’elle n’entrait dans aucun des schémas prévus par les autorités et l’administration. L’expert de la clinique psychiatrique Wil avait fait état de ma mère, lorsqu’il s’était prononcé en faveur de mon avortement et de ma stérilisation pour raisons eugéniques. La lecture de tous ces documents a été une épreuve terrible. En 1972, quelqu’un avait écrit à propos de ma mère : « En plus, cette femme a, quelque part, une fille gravement handicapée et aliénée ».

Plus de dix ans après, Jolanda Spirig a consacré un livre à ma vie, intitulé « Widerspenstig. Zur Sterilisation gedrängt » (Indocile. Contrainte à la stérilisation) et paru en 2006 aux éditions Zürcher Chronos. 

Aujourd’hui, je sais que je ne suis qu’une victime parmi des milliers.

Je sais combien ce destin est difficile à supporter, si tant est qu’on le puisse.

Je sais toute l’énergie nécessaire pour survivre.

Je n’ai pas pu fonder de famille, avoir d’enfant, alors même que je le désirais plus que tout au monde. La vision de mamans accompagnées de leurs enfants m’était douloureuse. Et lorsque je vois aujourd’hui des grands-mères avec leurs petits-enfants, la douleur reste vive. Personne ne peut me rendre ce qui m’a été enlevé à l’époque. L’intervention était irréversible !

J’ai dû apprendre à vivre avec tout cela. A bien vivre. J’ai dû accepter l’idée d’être victime d’une incroyable injustice ayant entraîné des lésions corporelles graves. Sans cette acceptation, ma vie serait un enfer.

Depuis 34 ans, je travaille comme adjointe administrative dans une entreprise commerciale. On m’a souvent demandé comment je faisais pour vivre normalement. Et lorsque je me penche sur mon passé, il m’arrive de me poser la même question. J’ai toujours refusé une quelconque assistance, considérant les psychiatres comme mes ennemis.

Je n’ai pas tout surmonté. L’injustice m’accompagnera jusqu’à la fin de mes jours. Il n’y a qu’une solution : apprendre à vivre avec ce passé, et à bien vivre. J’ai accepté mon destin et m’y suis confrontée depuis 25 ans. Parfois dans une douleur extrême, à la limite du supportable. Mais je m’y suis résignée et ai appris à vivre avec.

Pour l’heure, les auteurs de ces actes n’ont jamais présenté aucune excuse. Pourtant les archives contiennent des montagnes de dossiers faisant état de mensonges incroyables. Et cela est pour moi un énorme souci, quand on sait la facilité avec laquelle de tels documents peuvent refaire surface !

Si je devais à l’avenir rencontrer des problèmes, personne ne s’intéressera au fait que je travaille depuis 34 ans dans la même entreprise, à la satisfaction de tous, et que je gagne ma vie sans aucune aide extérieure ou assistance. Tout ce qui comptera, c’est ce qui est écrit dans ces documents et on se fondera de nouveau sur eux pour juger de mon cas. C’est pourquoi je demande que l’on me restitue l’ensemble de ces documents. Je veux pouvoir décider seule de ce qu’il en adviendra.

Je vous remercie de votre attention.

* * * *

Coercive castrations of convicted sex offenders

Presentation by Stefan Krakowski

for the Social, Health and Family Affairs Committee

16 September 2011

There seems to be a growing trend from political quarters in at least some member States, demanding castration and I, as a member of the CPT, had an opportunity to have a closer look at this question during a recent mission to Germany.

There has also been a communication between the CPT and the Czech Republic concerning surgical castration.

I will come back to the German and Czech case a little later. One should also mention the fact that Polish MPs passed legislation in 2009 making it obligatory to chemically castrate certain sex offenders. Under this law, anyone found guilty of rape of children under 15, will be subjected to chemical castration.

Surgical castration on other than somatic indications is still legal in many countries but is either no longer carried out or has become extremely rare. One reason is alternative options in the combining of psychotherapy, anti-androgen treatment and intensive monitoring. It is very likely that the Czech Republic is the only State Party to the Convention which uses surgical castration extensively. The data is not complete but at least 47 men appear to have been surgically castrated during 2001-2007, (other data mention 94 men being castrated during the last decade). Also, data provided by the Ministry of Health indicated that in 2008 and 2009 at least six sex-offenders had undergone surgical castration in the course of their deprivation of liberty.

In the case of Germany, resort to surgical castration appears to be quite rare, not only in Berlin but throughout Germany. According to unofficial statistics available to the Committee, during the last ten years, the total number of surgical castrations of sexual offenders in Germany has been fewer than five per year. Moreover, in Berlin, more than half of the applications which had been submitted since 2001 (five out of nine) had been rejected by an expert commission, composed of two doctors (including one psychiatrist) and a lawyer with the qualification of a judge; and no application had been submitted to the expert commission during the past two years.

Notwithstanding this, the CPT has expressed its fundamental objections to the use of surgical castration as a means of treatment of sexual offenders.

Firstly, such an intervention has irreversible physical effects; it removes a person’s ability to procreate and may have serious physical and mental consequences.

Secondly, surgical castration is not in conformity with recognized international standards, and more specifically, is not mentioned in the authoritative “Standards of Care for the Treatment of Adult Sexual Offenders” drawn up by the International Association for the Treatment of Sexual Offenders (IATSO). As a matter of fact, new methods of treatment have been developed since the adoption of the Law on Voluntary Castration (in particular, anti-androgens with reversible effects as well as various methods of psychotherapy).

Thirdly, there is no guarantee that the result sought (i.e. lowering of the testosterone level) is lasting. As regards re-offending rates, the presumed positive effects are not based on sound scientific evaluation. In any event, the legitimate goal of lowering re-offending rates must be counterbalanced by ethical considerations linked to the fundamental rights of an individual.

Fourthly, given the context in which the intervention is offered, it is questionable whether consent to the option of surgical castration will always be truly free and informed. A situation can easily arise whereby patients or prisoners comply rather than consent, believing that it is the only available option to them to avoid indefinite confinement. To sum up, surgical castration is a mutilating, irreversible intervention and cannot be considered as a medical necessity in the context of the treatment of sexual offenders. In the CPT’s view, surgical castration of detained sexual offenders could easily be considered as amounting to degrading treatment.

There doesn´t seem to be any scientifically valid empirical evidence that castration lowers re-offending and even less evidence that it lowers serious violent sex-offender recidivism. Moreover, persons with bilateral orchidectomy[1] do re-offend and by consequence, re-offending cannot be regarded as solely dependent on the testosterone levels. Furthermore, surgical castration can easily be circumvented by administering testosterone supplements. So;

a.       The only certain consequence of surgical castration is the definite loss of the reproductive function and

b.       The intervention as such is irreversible

And; testosterone levels can be reduced by other that surgical means.

In our Czech report from 2009, the CPT reiterated its view that surgical castration of detained sex offenders amounts to degrading treatment and in order to facilitate the abolition of surgical castration, the Czech authorities should examine the manner and conditions, including conditions of a legal nature, under which testicular pulpectomy[2] can be replaced by other forms of treatment for sex-offenders. And the conclusion of the report was; “in the light of the above, the CPT once again calls upon the Czech authorities to bring an immediate end to the application of surgical castration in the context of the treatment of sex-offenders. Pending the abolition, a moratorium on its application should be imposed without delay”. 

I think that this sums up the position of the CPT.

* * *

Coercive Sterilizations of Romani Women in Council of Europe Member States

Presentation by Gwendolyn Albert

for the Social, Health and Family Affairs Committee

16 September 2011 

Tubal ligation, a surgical technique first proposed in early 19^th century England, has been developed and promoted as a permanent birth control method ever since[3]. As has been most recently documented by author and historian Matthew Connolly[4], such surgery has been forcibly performed upon women in marginalized populations worldwide, motivated all too often by frankly eugenic considerations[5].

This presentation reviews recent incidents of coercive sterilization of Romani women in the Czech Republic, Hungary, and Slovakia,[6] reviews new ethical guidelines from the International Federation of Gynecology and Obstetrics regarding female contraceptive sterilization, and proposes promoting those new guidelines in an effort to eradicate the ongoing practice of permanently depriving people of their reproductive capacity against their will.[7]

Former Czechoslovakia/Czech Republic

In communist Czechoslovakia, Romani women were forcibly sterilized starting in the 1970s, and the practice continued after the 1989 transition to democracy and the 1993 breakup of the country into the Czech Republic and Slovakia.[8] The Czech ombudsman has been quoted in the Czech press as estimating that, since the 1980s, as many as 90 000 women may have been affected by this practice throughout the entire territory of the former Czechoslovakia.[9]

During communism, tubal ligation was disproportionately promoted to Romani women by social workers, to address what was officially termed their “high, unhealthy” reproduction rate compared to the non-Romani population, using either the promise of financial incentives or the threat of various sanctions to coerce or force compliance.[10] After the Czechoslovak Prosecutor-General reviewed these incidents post-1989, incentive payments for sterilizations were discontinued.[11] Subsequent instances of forced sterilizations did not involve social workers; instead, doctors sterilized Romani women during C-section deliveries, often telling them that not only the C-section but the sterilization itself had been “emergency, life-saving” measures.[12]

In November 2009, the Czech Government expressed regret for “individual failures” in the performance of sterilizations by tubal ligation.[13] The practice had been described as genocidal by dissidents with the Charter 77 organization in communist Czechoslovakia, and following 1989, complaints about the program were filed with the ombudsman in 2004. After ordering a Czech Health Ministry investigation, the ombudsman then critiqued the ministry in 2005 for failing to conclude that the documented procedures violated not only human rights, but the law.

The ombudsman’s report became the basis for international human rights bodies[14] to recommend the Czech state take urgent action to redress the victims of these practices. Criminal investigations into these incidents were shelved and none of the perpetrators have been subjected to civil, criminal or professional sanction. Civil lawsuits brought by individuals have only rarely resulted in compensation awards due to statutes of limitations.

Former Czechoslovakia/Slovakia 

Romani women were also forcibly sterilized in the Slovak part of Czechoslovakia starting in the 1970s. Dissidents monitoring these incidents reported that in the region of East Slovakia, more than 1 000 Romani women and girls were sterilized during a single year in the 1980s. [15] By 2002, Romani women were still being sterilized without their informed consent, according to human rights activists.[16] The government investigated for “genocide” and found no evidence of it. International observers, including the U.S. Commission on Security and Cooperation in Europe, called the investigation flawed because human rights activists and potential victims were threatened with criminal charges for speaking out. In that same year, the Council of Europe’s Commissioner for Human Rights said he found the allegations credible, recommending that the government “offer a speedy, fair, efficient, and just redress” to the victims.[17] The Slovak Government has yet to act upon these recommendations, though they have revised the conditions under which sterilization may be performed and instituted high fees for tubal ligations – meaning this birth control method is now effectively out of reach for low-income women who might desire it in Slovakia.

In 2006, the Slovak Constitutional Court ruled that the government’s report had not adequately clarified the facts and ordered the investigation into forced sterilization re-opened, but in 2007, after interrogating the alleged perpetrators and victims, the Slovak Prosecutor announced no crime had been committed or rights violated, and discontinued the proceedings. Various international human rights bodies are still calling on the government to investigate the allegations, compensate the victims, and punish the perpetrators. A case (V.C. v Slovakia) is also currently pending before the European Court for Human Rights in Strasbourg.

Hungary

Compared to the Czech and Slovak examples, far fewer forced sterilizations of Romani women have been reported in Hungary. The apparently anomalous, isolated nature of these incidents may be why demands for redress were eventually met in the case of A.S., a Romani woman who was sterilized by tubal ligation in 2001 in a public hospital without her consent during emergency obstetrical services. The Hungarian courts acknowledged that the surgery had been performed without her informed consent, but claimed that her reproductive capacity had not been harmed, as the sterilization was purportedly “reversible.” In 2004, A.S. filed a complaint with the Committee for the Elimination of Discrimination against Women (CEDAW), which two years later found Hungary in breach of the Convention. In 2009, the state compensated A.S. after extensive civil society pressure.[18]

Hungary’s Public Health Act requires that patients receive information about tubal ligation’s “chances of reversibility” – phrasing that suggests doctors in Hungary view sterilization as potentially reversible. The European Roma Rights Centre is currently litigating another case of a Romani woman sterilized in Hungary without her consent, which came to light in 2008.

Romani women’s resistance

Romani survivors of forced sterilization have played a key role in bringing it to light and building a movement for justice. In the Czech Republic, Elena Gorolová, spokesperson for the Group of Women Harmed by Forced Sterilization, has been an outspoken advocate for Romani victims.[19] Sterilized during the C-section delivery of her second child in 1990, Gorolová cannot bring a civil suit because the statute of limitations has expired, as it has for many other women. This has not stopped her and other survivors from pursuing justice locally, nationally and internationally. Survivors of forced sterilization in the Czech city Ostrava demonstrated outside the hospital most known for having sterilized Romani women in their community. They have also raised these violations in face-to-face meetings with maternity ward staff, confronting some of the very doctors who sterilized them against their will.

Such public activism by the survivors of these human rights violations is an exception, and local tabloid publications have attempted to smear many of the women who have come forward. Some Romani members of Gorolová’s community have warned her that her cause is in vain, but she has not given up hope that one day the government will compensate the survivors of forced sterilization.

In Hungary and Slovakia, while survivors have taken legal action, they have been very careful to keep their identities private for a number of reasons. In the A.S. case, there were fears that publishing the amount of any eventual compensation could expose her to violent extortion attempts. In Slovakia, women who were pregnant and sterilized before reaching majority were threatened that they or their partners would be criminally prosecuted for statutory rape if they came forward.

New FIGO guidelines on sterilization

In 2011, the International Federation of Gynecology and Obstetrics (FIGO) adopted new ethical guidelines on female contraceptive sterilization as a result of these cases, and numerous others around the world involving imprisoned women, Indigenous women, women of color, and transgender people throughout the Americas; women with disabilities in Australia; HIV positive women in Chile and Namibia; and lower-caste men and women in India.[20]

The guidelines are innovative because they emphasize that:

1)       Sterilization should be considered irreversible and patients must be so informed.

2)       Consent to sterilization should never be a condition for access to medical care, HIV/AIDS treatment, natural or cesarean delivery, abortion, or to benefits such as medical insurance, social assistance, employment or release from an institution.

3)       Sterilization for prevention of future pregnancy cannot be ethically justified on grounds of medical emergency and is not an emergency procedure.

4)       Article 23(1) of the UN Convention on the Rights of Persons with Disabilities imposes the duty upon states to ensure that “persons with disabilities, including children, retain their fertility on an equal basis with others.”

The Committee would be doing the women of Europe an enormous service if it could assist FIGO in its efforts to bring these newly revised, higher ethical standards to the attention of gynecologists, hospital administrators, nurses and obstetricians around Europe, in particular to practitioners in countries and regions serving marginalized populations such as Romani women. An ideal opportunity to perform this outreach will be next year, when FIGO holds its 20^th World Congress in Rome, Italy in October 2012, and I would personally be very interested in assisting with this effort.

Forced sterilization is a serious human rights abuse that has gone unacknowledged and underreported for decades worldwide. It represents the ultimate violation of a woman’s right to determine her own reproductive destiny. The women of Europe and the world deserve doctors who will protect their rights as well as their health. Thank you for taking the time to review this important human rights issue.