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Peasant women in Cajamarca, Peru, who were sterilized by the Peruvian government in the 1990s, narrate their experiences of reproductive abuse using Andean medical principles of debilidad and fuerza (debility and strength) (Tapias 2006). In their narratives, many describe a generalized sense of loss of strength resulting from the procedure. This contrasts with the reproductive rights framework's emphasis on infertility as the main harm. In this article, I ponder the dissonance between these two frameworks and propose the concept of debilitated lifeworlds as decolonial feminist delinking (Mignolo 2007) from human fertility-centric narratives. This concept is methodologically significant as a decolonial attunement to local motifs to talk about abuse and for weaving a constellation of embodied, emotional, social, and family harms. This article contributes to the emerging field of "decolonial reproductive studies" (Smietana et al. 2018: 117).

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RESUMO

Resumen En 2017, las Naciones Unidas declaran que 38 países, entre ellos España, continuaban realizando esterilizaciones forzadas en mujeres y niñas con discapacidad, a pesar de tratarse de una práctica ampliamente condenada por diversos organismos internacionales de derechos humanos. Este estudio analizó la situación de esta práctica en España, desde la perspectiva de activistas, profesionales e investigadoras con experiencias vinculadas a este colectivo. La metodología empleada fue de tipo cualitativa basada en la Teoría Fundamentada Constructivista. Se aplicaron entrevistas semiestructuradas en profundidad a 22 informantes, que representaron a 6 comunidades autónomas del país. Las participantes identificaron un modelo de prácticas de salud de dominación y exclusión, donde la sexualidad y reproducción de mujeres con discapacidad ha sido objeto de expropiación, alienación y desprecio por parte de sistemas, estructuras y políticas diferenciadas, con escasa transferencia del marco global de derechos humanos a su realidad. La violencia sexual ha pasado inadvertida, naturalizándose por el entorno, han promovido mecanismos de exclusión social e inequidades en salud, al privarles de sus derechos humanos fundamentales. Al tratarse de una situación que se replica en diversos lugares del mundo, debiese considerarse un tema de relevancia para la salud pública internacional.

Abstract In 2017, the United Nations declared that 38 countries, including Spain, continued to practice forced sterilizations on women and girls with disabilities, despite it being a practice widely condemned by various international human rights organizations. This study analyzed the situation of this practice in Spain, from the perspective of activists, professionals and researchers with experiences related to this group. The methodology used was qualitative, based on Constructivist Grounded Theory. Semi-structured in-depth interviews were applied to 22 informants, representing 6 autonomous communities of the country. The participants identified a model of health practices of domination and exclusion, where the sexuality and reproduction of women with disabilities has been the object of expropriation, alienation and contempt by systems, structures and differentiated policies, with little transfer of the global framework of human rights to their reality. Sexual violence has gone unnoticed, becoming naturalized by the environment, and has promoted mechanisms of social exclusion and health inequities, depriving them of their fundamental human rights. As it is a situation that is replicated in various parts of the world, it should be considered an issue of relevance for international public health.

Assuntos

RESUMO

Resumen En 2017, las Naciones Unidas declaran que 38 países, entre ellos España, continuaban realizando esterilizaciones forzadas en mujeres y niñas con discapacidad, a pesar de tratarse de una práctica ampliamente condenada por diversos organismos internacionales de derechos humanos. Este estudio analizó la situación de esta práctica en España, desde la perspectiva de activistas, profesionales e investigadoras con experiencias vinculadas a este colectivo. La metodología empleada fue de tipo cualitativa basada en la Teoría Fundamentada Constructivista. Se aplicaron entrevistas semiestructuradas en profundidad a 22 informantes, que representaron a 6 comunidades autónomas del país. Las participantes identificaron un modelo de prácticas de salud de dominación y exclusión, donde la sexualidad y reproducción de mujeres con discapacidad ha sido objeto de expropiación, alienación y desprecio por parte de sistemas, estructuras y políticas diferenciadas, con escasa transferencia del marco global de derechos humanos a su realidad. La violencia sexual ha pasado inadvertida, naturalizándose por el entorno, han promovido mecanismos de exclusión social e inequidades en salud, al privarles de sus derechos humanos fundamentales. Al tratarse de una situación que se replica en diversos lugares del mundo, debiese considerarse un tema de relevancia para la salud pública internacional.

Abstract In 2017, the United Nations declared that 38 countries, including Spain, continued to practice forced sterilizations on women and girls with disabilities, despite it being a practice widely condemned by various international human rights organizations. This study analyzed the situation of this practice in Spain, from the perspective of activists, professionals and researchers with experiences related to this group. The methodology used was qualitative, based on Constructivist Grounded Theory. Semi-structured in-depth interviews were applied to 22 informants, representing 6 autonomous communities of the country. The participants identified a model of health practices of domination and exclusion, where the sexuality and reproduction of women with disabilities has been the object of expropriation, alienation and contempt by systems, structures and differentiated policies, with little transfer of the global framework of human rights to their reality. Sexual violence has gone unnoticed, becoming naturalized by the environment, and has promoted mechanisms of social exclusion and health inequities, depriving them of their fundamental human rights. As it is a situation that is replicated in various parts of the world, it should be considered an issue of relevance for international public health.

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RESUMO

Gender stereotypes surrounding women's reproductive health impede women's access to essential reproductive healthcare and contribute to inequality more generally. Stereotyping in healthcare settings impedes women's access to contraceptive information, services, and induced abortion, and lead to involuntary interventions in the context of sterilization. Decisions by human rights monitoring bodies, such as the Inter-American Court of Human Rights' case, IV v. Bolivia, which was a case concerned with the involuntary sterilization of a woman during childbirth, highlight how stereotypes in the context of providing health care can operate to strip women of their agency and decision-making authority, deny them their right to informed consent, reinforce gender hierarchies and violate their reproductive rights. In the present article, IV v. Bolivia is examined as a case study with the objective being to highlight how, in the context of coercive sterilization, human rights law has been used to advance legal and ethical guidelines, including the International Federation of Gynecology and Obstetrics' (FIGO) own guidelines, on gender stereotyping and reproductive healthcare. The Inter-American Court's judgment in IV v. Bolivia illustrates the important role FIGO's guidance can play in shaping human rights standards and provides guidance on the service provider's role and responsibility in eliminating gender stereotypes and upholding and fulfilling human rights.

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Eugenics was defined by Galton as 'the science which deals with all influences that improve the inborn qualities of a race'. In Peru, eugenics was related to social medicine and mental hygiene, in accordance with the neo-Lamarckian orientation, that predominated in Latin America. Peruvian eugenists assumed the mission of fighting hereditary and infectious diseases, malnutrition, alcoholism, drug addiction, prostitution, criminality and everything that threatened the future of the 'Peruvian race'. There were some enthusiastic advocates of 'hard' eugenic measures, such as forced sterilization and eugenic abortion, but these were never officially implemented in Peru (except for the compulsory sterilization campaign during the 1995-2000 period). Eugenics dominated scientific discourse during the first half of the twentieth century, but eugenic discourse did not disappear completely until the 1970s.

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