Sterilization, Gender, and the Law in Costa Rica

Abstract

In 1999, the President and the Ministry of Health of Costa Rica issued a decree making contraceptive sterilization available upon demand, with informed consent. This event represented a vantage point from which to consider the evolution of sterilization law in Costa Rica, a project which I had the opportunity to undertake at the Women, Justice, and Gender Program of ILANUD, the United Nations Latin American Institute, in the summer of 2000. I learned at ILANUD that sterilization rights play a central role in Costa Rican women's reproductive autonomy. There, as in most of the world, women are sterilized at far greater rates than are men. In a 1997 study, for example, 20% of Costa Rican women relied on female sterilization, compared to 1% who relied on their partner being sterilized.' This wide and persistent disparity in sterilization rates means that even facially neutral laws regarding sterilization automatically affect more women than men. This greater reliance on female sterilization may stem from ignorance about vasectomy and women's more frequent contact with the healthcare system, but it also reflects the higher physical and sociological burdens that unwanted pregnancies place on women. Such burdens are particularly daunting in a country such as Costa Rica, where abortion is not legally available in most cases. Within this context, the option of sterilization rather than temporary forms of birth control is an appealing one to many women who want reliable control over their fertility. In this Note, I argue that both formal and informal laws regarding sterilization have reflected and created gender status in Costa Rica. Formal laws regulating access, though gender-neutral, have depended on societal conceptions of gender roles, and in turn have shaped those roles. At the same time, informal laws-the ways in which courts, agencies, service providers and the public have interpreted and applied laws about sterilization-have diverged sharply from the formal law but have just as powerful an effect on people's lives. Throughout the evolution of sterilization law in Costa Rica, the gendered effects of facially-neutral laws, compounded by highly gendered application and interpretation of the laws, have tightly controlled women's access to this form of contraception. However, advocacy rooted in demands for women's rights and autonomy has led to increased reproductive choice for women.