Our commitment to reconciliation
We stand for Truth and Reconciliation and commit to addressing the Calls to Action made by the Truth and Reconciliation Commission of Canada. We support and advocate for the Calls for Justice from the final report of the National Inquiry into Missing and Murdered Indigenous Women and Girls.
From ReachOut newsletter June 2025
Calls to Action
Shining a light on the legacy of Indian hospitals and their impact on Indigenous women’s health
The Truth and Reconciliation Commission’s Calls to Action implore us to recognize that the current state of Indigenous health in Canada is a direct result of previous government policies, including residential schools, and to uphold Indigenous peoples’ health-care rights as identified in international law, constitutional law, and under the Treaties (Truth and Reconciliation Commission of Canada, Call to Action 18). While residential schools have received increased public attention, another critical, and often less understood, element of this harmful legacy is the system of federal Indian hospitals. These institutions, separate from mainstream healthcare, significantly impacted the health and well-being of Indigenous peoples, particularly women, and are a stark example of state-directed violence and control rooted in colonialism.
The colonial roots of Indian Hospitals
Indian hospitals were established by the federal government, beginning in the 1930s, ostensibly to treat tuberculosis (TB) and other conditions, but their primary function was to isolate and segregate Indigenous patients from the non-Indigenous population. This segregation was fueled by racist ideologies that blamed Indigenous people for the spread of diseases like TB, portraying them as unfit and unnatural and a threat to white settlers. The government misrepresented data on TB rates to justify this segregation and institutionalization. Modelled after residential schools, these hospitals served as tools for assimilation, marginalization, and eradication of Indigenous people. They operated cheaply, with inadequate conditions, overcrowding, poor staffing, crumbling infrastructure, and infestations.
Targeting Indigenous women and disrupting matriarchy
Colonialism in Canada actively interfered with Indigenous matriarchal and egalitarian community values, establishing controlling mechanisms through institutions like Indian hospitals. The Indian Act aimed to replace matriarchal communities with patriarchal norms, restricting access to resources and status, whilst systematically marginalizing Indigenous women, as described in Indigenous Motherhood and Indian Hospitals by Emma Posca.
Gender and race-based discriminatory practices were perpetuated by the federal government to justify the existence of Indian hospitals and contribute to the disappearance of Indigenous people who didn’t fit into white patriarchal society. Negative stereotypes, portraying Indigenous women as hypersexual, amoral, and unorthodox, were used to blame them for disease and justify their control and eradication. These discriminatory views, rooted in a white settler colonial mentality, dictated that Indigenous bodies were disposable and needed regulation.
The colonial desire to eliminate Indigenous communities often began with the destruction of women’s roles, especially motherhood. In Indigenous communities, motherhood goes beyond biology, encompassing being raised within culture, community, and connection to the land. By targeting women and children, these hospitals aimed to sever these bonds and weaken the community.
Emma Posca documents harrowing accounts of the physical, psychological, and sexual abuse experienced by patients, including women and children, in Indian hospitals governed by colonial rule. Patients faced brutal treatment at the hands of staff, including forced sterilization and isolation.
Intergenerational trauma and ongoing impacts
The brutality and trauma inflicted in Indian hospitals had a devastating and lasting impact, leading to intergenerational trauma. Survivors, including Indigenous women and children, were traumatized not only by the abuse but also by being removed from their families and isolated. The trauma presented barriers to mothering for many Indigenous women, creating psychological and physical fears and insecurities. Those who could not psychologically process the trauma struggled to spiritually connect with their children.
Children who survived often felt disconnected from their mothers and communities. They developed a lack of trust towards adults in healthcare, perpetuating a cycle of trauma. Generations of Indigenous families continue to deal with the aftermath, including self-esteem issues, inability to communicate, feeling lonely and isolated, and psychological struggles like depression, anxiety, and shame. The Truth and Reconciliation Commission and other studies link the intergenerational effects of residential schools and/or Indian hospitals with high suicide rates in some First Nations communities.
Furthermore, the legacy of colonialism, including the Indian Act, continues to restrict Indigenous peoples’ access to basic resources like adequate healthcare, both Western and traditional. Lack of funding for holistic healthcare approaches, such as sweat lodges and spiritual ceremonies, persists. These ongoing inequalities demonstrate the entrenched social regulation and marginalization of Indigenous people, especially women.
A step towards acknowledgment: The proposed settlement
Recently, Canada reached a proposed $1.1 billion settlement with survivors of federal Indian hospitals. The proposed out-of-court settlement aims to compensate an estimated 100,000 Indigenous survivors. This includes individual compensation ranging from $10,000 to $200,000, depending on the level of abuse suffered. Compensation for immediate family members may also be available.
Beyond individual payments, the settlement proposes significant funds:
- $150 million for healing, wellness, reconciliation, language protection, education, and commemoration.
- $235.5 million for research, education, preserving hospital history, and locating burial sites.
- An additional $150 million from Indigenous Services Canada for mental health and legal support through the claims process.
While acknowledged as a meaningful day by representative plaintiff Ann Hardy, who shared her own traumatic experience of isolation and trauma at the Charles Camsell Hospital, Crown-Indigenous Relations Minister Gary Anandasangaree noted that the settlement will not erase the pain. The settlement requires Federal Court approval.
Moving forward
The proposed settlement is a necessary step in acknowledging the profound harm caused by Indian hospitals. However, the Calls to Action demand more than just compensation: they require a fundamental recognition and implementation of Indigenous peoples’ health-care rights and an acknowledgment that the current health disparities are a direct result of past policies like Indian hospitals.
Understanding the history of Indian hospitals, especially the gender-based violence and the targeted attacks on Indigenous women and their roles, is crucial for non-Indigenous people to grasp the full scope of colonial harm and their responsibilities towards decolonization.
Calls for Justice
Ending the ongoing forced and coerced sterilization of Indigenous women, girls and gender diverse people
Content warning: This article may be triggering or cause distress because it discusses colonial violence, human rights violations and obstetric violence towards Indigenous women, girls and gender diverse peoples. For support, contact Hope for Wellness or VictimLinkBC.
Since the 1920s, Indigenous women in Canada have experienced forced and coerced sterilization and continue to be disproportionately subjected to this heinous practice. This form of systemic violence is rooted in paternalistic and racist attitudes, colonization, forced assimilation and eugenics, i.e., those who were deemed to be “mentally defective,” to possess “undesirable elements” or to be part of “unfit groups” were sterilized to prevent their reproduction. Sterilization was seen as a way to alleviate poverty by reducing the number of people in poverty and “reliant on government-sponsored social programs.”
In British Columbia (1933) and Alberta (1928), sexual sterilization legislation targeted Indigenous women and women in correctional facilities and mental health institutions. Despite the absence of sterilization legislation in other provinces and territories, forced sterilization procedures took place across Canada.
Even though provincial sterilization laws were repealed in the 1970s, forced and coerced sterilization of Indigenous women continued in federally operated Indian hospitals until the early 1980s. It is estimated that, between the 1960s and early 1970s, 1150 Indigenous women were sterilized in Indian hospitals.
What is forced and coerced sterilization?
Sterilization is a permanent procedure to prevent pregnancy.
Forced sterilization occurs when a person is sterilized during or following childbirth without the mother’s free, prior and informed consent.
Coerced sterilization occurs when consent is obtained on the basis of false, misleading or inadequate information through the use of threats, harassment, intimidation or other forms of physical or psychological pressure. For instance, women being told to accept sterilization or they will risk having their children placed in the child welfare system is coerced sterilization.
Past and present forced sterilization of Indigenous people in Canada
Forced and coerced sterilization of Indigenous women, girls and gender diverse people is underreported and underestimated.
Lawyer Alisa Lombard, lead counsel representing Indigenous women in the Saskatchewan class action lawsuit over forced sterilization explains in Forced and Coerced Sterilization of Persons in Canada:
“There’s a lot of underreporting because there’s no trust. Various processes, including the Truth and Reconciliation Commission and the testimony before the Missing and Murdered Women’s inquiry, has repeated this over and over again. The reason for that is because, when women do come forward, they’re not believed. They are dismissed. They are told that people who are more important than them know more about what’s good for them than they do. That’s why they don’t come forward.”
Health data collected on sterilization procedures does not include information on patient ethnicity. Indigenous women may not want to self-identify for several reasons including: feelings of shame and self-blame; a lack of awareness that their reproductive rights have been violated; and focus on their own survival and their children.
The 2024 National Collaborating Centre for Indigenous Health Report on forced and coerced sterilization of Indigenous women and girls in Canada highlights the traumatic experiences of Indigenous women who underwent coerced sterilization:
- Indigenous women felt invisible, profiled and powerless; they were subjected to the abuse of power by healthcare providers who used misinformation, scare tactics, intimidation or women’s medical history to pressure them.
- Survivors spoke of the deliberate absence of information on consent forms, limited access to information on the permanency and impacts of sterilization procedures, and alternative forms of contraception.
- Many Indigenous women experienced depression, post-traumatic stress disorder, anxiety and fear which created a distrust of the healthcare system.
Holding healthcare providers accountable
Forced and coerced sterilization is internationally recognized as an act of genocide and a violation of human rights and medical ethics. We have a collective responsibility to recognize and protect the equitable rights to health and wellness of Indigenous women, girls and gender diverse people (see Call for Justice 3.1).
National committees, commissions and advocates have identified the following key policy recommendations to prevent and end the act of sterilizing Indigenous people against their will:
- Criminalization of forced and coerced sterilization – Senator Yvonne Boyer introduced Bill-250 An Act to amend the Criminal Code Sterilization Procedures in 2022. The Bill would amend section 268.1 of the Criminal Code to define sterilization procedures and safeguards for obtaining consent. The Bill would also make forced or coerced sterilization procedures an indictable offence, punishable by up to 14 years in prison. Because of prorogation of Parliament in January 2025, progress of the Bill through the House of Commons stopped; Senator Boyer says she intends to re-introduce the Bill as soon as possible.
- Healthcare provider training – Mandatory training for healthcare providers on the history of forced and coerced sterilization in Canada, informed choice and consent, anti-racism and women’s reproductive rights would support the provision of culturally safe care to Indigenous people.
- Establishing a consent framework – Developing a framework that clearly defines the requirements for free, prior and informed consent for sterilization, with a specific focus on cultural safety and the needs of Indigenous people, would help inform healthcare providers and staff, patients and their families and prevent future harm.
- Reparation for Indigenous survivors affected by unwanted sterilization – The Survivors Circle for Reproductive Justice provides supports to survivors and to advocate for reproductive justice for all First Nations, Inuit, and Métis in Canada. The Survivors Circle maintains a membership registry to preserve an official record of Indigenous people who have experienced forced sterilization; registry data will be used to support research on the prevalence of forced sterilization and preventative measures to prevent future harm to Indigenous people.
The Healing Support Fund offers vital resources for Indigenous survivors of forced and coerced sterilization including funding for therapy, traditional ceremonies, mental health services and reproductive health therapies. - Indigenous community-based maternal health services – Federal investments in Indigenous midwifery and other community-based birth and maternal health services will improve equitable, local and culturally safe access to sexual and reproductive health care for Indigenous people.
Making systemic change
Everyone has a part to play to make the systemic and cultural change needed to address the lack of cultural competence and systemic anti-Indigenous racism at the root of forced and coerced sterilization.
All levels of government, institutions, organizations for health care education, regulatory bodies, professional associations, Indigenous organizations, the anti-violence sector and other community organizations need to work together to prevent future harm to Indigenous people.
You can find more information in the following resources:
