Better Reflecting Sexual and Reproductive Health Equity in Federal Sterilization Consent Policy
By Fajer Saeed Ebrahim and Lisa Stern
First instituted in the 1970s in response to community activism, policies guiding consent for federally funded sterilization procedures have been the subject of much discussion, debate, and research in the past decades. Many experts, including clinicians, ethicists, and people with lived experience, have pointed out that these policies, intended to protect individuals from coercion, pose barriers to desired sterilization procedures. Additionally and concerningly, coercion persists.
In collaboration with expert partners, CECA has developed a new set of recommendations on needed changes to federal sterilization consent policy. To help shape the recommendations, CECA reviewed evidence and past recommendations, participated in a government listening session, conducted expert workgroup meetings, held discussions with key stakeholders, and convened Lived Experience Panels (LEPs) with community members.
Recommended Areas of Change
Rooted in principles of sexual and reproductive health equity (SRHE), these recommendations aim to strike a balance between ensuring access to sterilization and preventing coercion. They include:
Lowering the minimum age of consent from 21 to 18
Allowing sterilization consent when seeking to obtain or obtaining an abortion
Extending the consent form validity period from 180 days to one year
Shortening the mandatory waiting period
Reassessing and streamlining data collection
Offering guidance on supported decision making (SDM)
As outlined in the report, implementation of these recommendations should be accompanied by a vigorous re-evaluation of the federal sterilization consent form, process, and monitoring strategy. Many organizations and individuals will need to play a part in implementation and achieving meaningful change, including policymakers, healthcare providers, advocates, researchers, community organizations, and the public at large.