Opinion by Emily Wesseling.
Perceptions and opinions of Canada internationally, notably on progressive subjects including gender, race, and supporting marginalized communities, has fared well. However, Canadian action – or inaction – on domestic issues pertaining to Indigenous peoples is starting to reveal cracks, widening the gap between Canada’s international reputation and domestic reality. One such issue, which has not made tremendous presence in the media, is the forced and coerced sterilization of Indigenous women, a subject that demands analysis and policy revision.
Filed in October of 2017, a class action lawsuit against the Saskatoon Regional Health Authority (SRHA) by Maurice Law brings forward the claims of dozens of Indigenous women alleging they underwent forced or coerced tubal ligation as recently as 2014.  Although women’s claims vary slightly, many refer to undergoing, either by force or coercion, the tubal ligation procedure after giving birth; victims were either not given information about other birth control options, weren’t told that the procedure is permanent, or gave “consent” for the procedure either during or immediately after giving birth.  Although a public apology has been issued with acknowledgement of racism, the SRHA has not made direct commitments nor reparations to address this systemic issue beyond revising their policies on informed consent. 
International pressures over the last few years indicate an international acknowledgment that Canada does not always practice what it preaches. In December of 2018, the UN Committee Against Torture expressed their concern over Canada’s forced and coerced sterilization, stating that, “adequate reparations ought to be provided to the victims in compliance with Canada's international commitments in line with its obligation of due diligence to protect, prevent and sanction violence against women.”  More recently, Canada openly declared China’s violation of the Genocide Convention by China on Uyghur and Turkic Muslim populations, while it has never officially recognized its historic and present genocide against Indigenous peoples. 
Canada has several policy options to consider in tackling this intersectional challenge, which could work independently or collectively to address this systemic problem and further engage in reconciliation with Indigenous peoples. Federal criminalization of forced and coerced sterilization in the Criminal Code of Canada is one option. Condemning this type of medical malpractice explicitly would assure an ongoing commitment to justice for Indigenous women or other marginalized groups, while also affirming the legal importance of consent for medical procedures.
Additionally, mandating a cultural competency education training through Health Canada, which emphasizes Indigenous cultural traditions and considerations pertaining to medical treatment and health care, is another option. This approach is more proactive in nature and could serve as a collaborative program between Indigenous and settler medical personnel, while reaffirming Canada’s commitment to the Truth and Reconciliation Commission and addressing Calls to Action 23 and 24.  There are numerous strategies Canada should consider moving forward, but evidently there is a need for reparations beyond the outcome of the pending lawsuit, strengthened in light of the tragic residential school mass burials and with rising sentiments in reconciliation.
Intersecting factors of race, gender, and colonialism have all contributed to insufficient health policies for Indigenous women and has been cited as a “modern-day genocide” in Canada. The pending lawsuit has further revealed a fractured relationship between the government and Indigenous peoples, bringing to light the gap between Canada’s perception, both at home and abroad. However, the country is faced with an opportunity to thoroughly and effectively address this injustice for Indigenous peoples while working towards realigning Canada’s domestic reality with its international reputation.
“Indigenous Women in Canada Continue to Be Coercively or Forcibly Sterilized.” Amnesty International Canada, November 13, 2018. https://www.amnesty.ca/blog/indigenous-women-canada-continue-be-coercively-or-forcibly-sterilized.
Director, Practitioner Staff Affairs and SHR Legal Counsel. “Consent/Informed Consent.” Saskatoon Health Region, March 4, 2015. https://www.saskatoonhealthregion.ca/about/RWPolicies/7311-50-002.pdf.
Government of Canada. “Canada's Health Care System.” September 17, 2019. http://www.canada.ca/en/health-canada/services/health-care-system/reports-publications/health-care-system/canada.html#a4.
Public Health Agency of Canada, and Pan-Canadian Public Health Network. “Key Health Inequalities in Canada: A National Portrait,” May 2018. https://www.canada.ca/content/dam/phac-aspc/documents/services/publications/science-research/hir-full-report-eng_Original_version.pdf
Inter-American Commission on Human Rights. “IACHR Expresses Its Deep Concern over the Claims of Forced Sterilizations against Indigenous Women in Canada.” OAS, January 18, 2019. https://www.oas.org/en/iachr/media_center/PReleases/2019/010.asp.
Lombard, Alisa & Samir Shaheen-Hussain. “Coerced and forced sterilization of Indigenous women and girls: This is what genocide looks like in Canada.” Toronto Star, March 9, 2021. https://www.thestar.com/opinion/contributors/2021/03/08/coerced-and-forced-stereilization-of-indigenous-women-and-girls-this-is-what-genocide-looks-like-in-canada.html
Mas, Susana. “Truth and Reconciliation offers 94 ‘calls to action’.” CBC, December 14, 2015. https://www.cbc.ca/news/politics/truth-and-reconciliation-94-calls-to-action-1.3362258