Moved second reading of Bill S-228, An Act to amend the Criminal Code (sterilization procedures).

She said: Honourable colleagues, I rise today on the traditional and unceded territories of the Anishinabe Algonquin Nation. I offer my sincere thanks to the nations whose land we are on and acknowledge the vital importance of humility and respect in reconciliation. As we begin this Forty-fifth Parliament, let us recommit ourselves to that work, not just in word, but in actions.

Today, I rise to introduce Bill S-228, An Act to amend the Criminal Code (sterilization procedures). This is a reintroduction of a bill that is identical to what the Senate passed unanimously as the amended version of Bill S-250, which was sent to the House of Commons in October 2024. Unfortunately, that bill died on the Order Paper when Parliament was prorogued. But the violence it seeks to prevent has not stopped, and our responsibility has not diminished.

This bill addresses a practice that is both unconscionable and ongoing: the forced and coerced sterilization of women and marginalized persons in Canada. Bill S-228 seeks to make it explicit in the Criminal Code that sterilizing someone without their consent constitutes aggravated assault under subsection 268(1) of the Criminal Code, which states, “Every one commits an aggravated assault who wounds, maims, disfigures or endangers the life of the complainant.”

Bill S-228 adds a “for greater certainty” clause to section 268 affirming that sterilization procedures fall under acts that wound or maim. It defines a “sterilization procedure” as any intervention that permanently prevents reproduction, regardless of whether it is technically reversible. The offence is serious; it also carries a maximum penalty of 14 years in prison.

Let me be clear: Forced sterilization is not a relic of the past. It is happening in Canada today. The first question I am always asked when people discover I am working on the topic of forced and coerced sterilization is this: “Is that still happening? That was a long time ago, wasn’t it?”

The answer is simple: no. It is happening today and at this very moment. Women are being coerced or forced into sterilization whether they are pregnant, have just given birth or are in another situation.

Some of the underlying reasons will be explained today.

Canada has a long, painful legacy of eugenics, of using sterilization to control and limit certain populations. From 1928 to 1973, Alberta and British Columbia had sexual sterilization acts that disproportionately targeted Indigenous women. Over 4,700 sterilizations were carried out in Alberta alone.

Indigenous women — once revered in their communities as the givers of life and the holders of cultural knowledge — were and are targeted because of colonial beliefs that devalue their bodies and autonomy. This oppression was justified through colonialism, paternalism and racism, and it did not stop with the repeal of those laws.

In 2017, I was commissioned by the Saskatoon Health Authority to provide an external review of their tubal ligation policies after several Indigenous women came forward and said that they were either forced or coerced into a tubal ligation after giving birth by Caesarean section.

I co-authored a report with Dr. Judith Bartlett documenting forced and coerced sterilizations in Saskatoon. Its publication created a national awakening to the reality faced by Indigenous women.

There are hundreds of stories, but one particularly dangerous example stands out for me. A woman told us that a doctor pressured her into signing a sterilization consent form by claiming her baby would be born with cerebral palsy if she didn’t. As you may know, cerebral palsy is caused by a lack of oxygen at birth.

Another was told she had no choice and gave consent while actively in labour. Others were told the babies they were about to deliver would be taken away by social services if they did not sign. Others were sterilized within hours of giving birth without being told the procedure was permanent. Others were simply sterilized without their knowledge.

Louise Delisle, a 15-year-old Black teenager in Nova Scotia, was given a partial hysterectomy without her or her guardian’s consent when she gave birth.

Dr. Josephine Etowa from the University of Ottawa testified that the issue of hysterectomy continually came up in her research interviews of 237 Black women from rural Nova Scotia.

These stories are horrifying, but they are not isolated. My office has counted at least 12,000 Indigenous women who were forcibly or coercively sterilized in Canada between 1971 and 2018.

Across Canada, ongoing class action lawsuits continue to shed light on the scale and persistence of forced and coerced sterilization. These class actions represent hundreds of Indigenous women who were sterilized without consent. The fact that these lawsuits span multiple jurisdictions and remain unresolved underscores the national scope of this crisis. Survivors are seeking justice not only for their personal trauma, but also for the systemic failures that allowed this practice to continue unchecked.

These cases are a stark legal and moral warning: Our health care and legal systems have not yet reckoned with the full weight of this violation, and until they do, the harm will continue.

A particularly heinous case that came to light recently involves Dr. Andrew Kotaska, who removed the ovaries and fallopian tubes of a 37-year-old Inuk woman without consent. Dr. Kotaska was the former Clinical Director of Obstetrics at Stanton Territorial Hospital in Yellowknife. Dr. Kotaska has served as President of the Northwest Territories Medical Association. He has spent years practising medicine and has had professorships with the Department of Obstetrics and Gynaecology at the University of Toronto, at the University of Manitoba and at the UBC School of Population and Public Health. He has published articles on caring for Indigenous patients and, surprisingly, informed consent and ethics.

Dr. Kotaska’s patient had pelvic pain, and she consented to having her right ovary and fallopian tube removed if necessary. While she was in surgery, Dr. Kotaska stated, “Let’s see if I can find a reason to take the left tube,” and he did. He permanently sterilized her. A complaint was lodged with the Northwest Territories Department of Health and Social Services, and a virtual hearing was held. The board of inquiry held that he violated the Canadian Medical Association’s Code of Ethics and Professional Responsibilities.

He was suspended for five months — his contract expired so he had already served that — and had to pay $20,000 for the legal costs of the hearing and take an ethics course. He and the Northwest Territories Health and Social Services Authority are being sued for $6.5 million, and I have heard he is now working in interior B.C. He is registered with the College of Physicians and Surgeons of British Columbia.

The bill I bring before you today may have stopped this from happening. Dr. Kotaska may have had that sober second thought before he sliced her remaining fallopian tube. He may have thought twice about the possible penalties in Bill S-228. Bill S-228 may have acted as a deterrent.

I have been working diligently since at least 2017 to eradicate forced and coerced sterilization. Early on, I was directed by survivors of this horrific practice to create a law that would criminalize sterilization without consent. I was initially reluctant because of the harms that have historically affected Indigenous people within the criminal justice system.

But I did introduce Bill S-250 after two studies conducted by the Standing Senate Committee on Human Rights in 2021 and 2022.

The first study brought together the disability community, the intersex community, Black women from Nova Scotia, lawyers and the government. From that study we learned how deep the problems go.

The second study, during which we heard directly from survivors of forced sterilization, was one of the most powerful, moving and heart-wrenching experiences of my time in the Senate. During this study, the survivors were clear and spoke with a unified voice, asking that this horrific practice be criminalized. This bill is a direct response to their calls for action.

This bill is also a response to Recommendation No. 1 from the Senate Standing Committee on Human Rights report entitled The Scars that We Carry: Forced and Coerced Sterilization of Persons in Canada —Part II. It reads, “That legislation be introduced to add a specific offence to the Criminal Code prohibiting forced and coerced sterilization.”

I introduced Bill S-250 in June 2022, and the Standing Senate Committee on Legal and Constitutional Affairs conducted a comprehensive and deeply moving study. Witnesses included Nicole Rabbit, a survivor and board member of the Survivors Circle for Reproductive Justice, who told us that she, her mother and her niece were all sterilized against their will.

We heard from representatives from the Canadian Medical Association, Society of Obstetricians and Gynecologists of Canada, National Council of Indigenous Midwives and Native Women’s Association of Canada, all of whom supported the bill’s objectives.

Experts from the Department of Justice and Indigenous Services Canada confirmed the bill’s legal clarity and necessity. My office also received countless emails and telephone calls supporting this bill.

During the committee study, there were some concerns raised about the unintended consequences and complexity of Bill S-250. After hearing concerns about the complexity of my bill from departmental experts and my colleagues, and listening carefully, I worked collaboratively with the Minister of Justice to amend the bill and streamline it from 55 to 14 lines, making its intent crystal clear and removing any chance of unintended consequences.

The amendment and the subsequent bill were quickly and unanimously adopted by committee and by the Senate Chamber before it was sent to the House of Commons for further study in October 2024. Bill S-228 is the amended version and is now before you.

Colleagues, I cannot overstate this: we must act now. Every day that passes without this bill becoming law is another day someone may be sterilized against their will. This is not theoretical. This is not historical. This is happening. The last forced and/or coerced sterilization I was consulted about was in December 2024.

Just recently, many of you watched the in-depth feature that CBC News North did on the issue of forced and coerced sterilization, focusing on the story of Katy Bear, a First Nations woman who had previously been sterilized without consent. Every time I have spoken on this issue, I have told the story of the pervasiveness of sterilization and about a young woman I met while checking into a hotel late at night in Saskatoon.

The clerk was alone, and the lobby was empty. She asked me if I was the “senator of sterilization.” I explained that it is an area in which I work.

She looked at me, her eyes filling with tears, and said:

They did it to me when I was 21. I am now 35 and my children are grown. I can’t afford in vitro fertilization, and I want more children. I have a new partner.

I became completely choked up and had many tears too. I said I would do what I could to help her.

Now, just a few years after that chance encounter, CBC News North tells her incredible story in March 2025. She was 41 years old and due to deliver in two weeks when I met up with her again. She underwent a tubal reanastomosis after a surprise ectopic pregnancy forced the removal of one of her Fallopian tubes. She had less than a 5% chance of conceiving, but she did conceive.

On March 20 of this year, having almost reached a full-term pregnancy, and being an experienced mother of four, she felt that there was something wrong. She went to the hospital in Saskatoon where she was immediately admitted to the emergency maternal trauma room. This was the same hospital in which she was sterilized 20 years earlier. The doctor who attended to her had her file, which showed what she had experienced so many years earlier and what she had gone through to become pregnant.

The doctor examined her and told her that the baby was breech and had to be turned; otherwise, a C-section was imminent. At that point, in the emergency room, the doctor asked her if she wanted to be sterilized while they were performing her C-section. This doctor was not just a doctor; he was also a professor of medicine at the University of Saskatchewan who was responsible for educating and training our future doctors.

This was not just an inappropriate question; it was a re‑traumatizing moment that reflected the deep systemic issues we have yet to confront. For someone like Katy, whose ability to carry a child had already been taken from her once, to be questioned at such a vulnerable time, or asked to give consent, was a chilling reminder that the attitudes and assumptions behind forced sterilization are still present in our health care system today.

This occurred on March 20, 2025 — 82 days ago. What this tells me is that forced or coerced sterilization is not simply going away and that more must be done.

Two days later Katy gave birth via a Caesarian section by her own trusted doctor and gave birth to a beautiful baby girl. Her name is Sage, meaning “good medicine.”

It is already extremely difficult for Indigenous women and other marginalized people to access culturally safe reproductive care. When they do, they are still being told, coerced, threatened or deceived into giving up their reproductive futures.

We cannot stand by. This is not a new conversation. The groundwork has been laid, the evidence is clear and the survivors are waiting. Let us not ask them to wait any longer.

I want to thank the hundreds of survivors who have entrusted me with their stories. I especially want to thank Tracey Banab, Brenda Pelletier, Nicole Rabbit, Katy Bear and the many others whose voices have shaped this bill. You have already changed the national conversation. Now, with Bill S-228, we can change the law.

Let us ensure that no woman — no person — is ever again robbed of their ability to decide if and when to have children. This is not just about criminal law. It is about human dignity. It is about justice. It is about our shared responsibility to ensure that our systems protect — not harm — the most vulnerable among us.

I respectfully urge my colleagues to refer this bill to committee without delay, and I call on the Standing Senate Committee on Legal and Constitutional Affairs to study this bill quickly and efficiently, building upon the extensive record already established.

During the last Parliament, the committee did significant and important work on this bill, shaping it alongside survivors to what stands before us here in the Senate today. It is imperative that their work does not go to waste. I urge the committee to consider the work that has previously been done, review the past reports and usher this bill through the committee in this Parliament with haste.

Let us act decisively. Let us act now. Let us be on the right side of history.

Meegwetch. Thank you. All our relations.

Thank you, senator. This is about a positive act. It does not remove the agency of a person to have a tubal ligation if they so wish; it doesn’t remove the agency of anyone to have a vasectomy. It only happens when there has been no consent to an assault. The consent falls within the assault provisions within the Criminal Code, and it’s clear. I believe that putting it into subsection 268 is the simplest and clearest solution, providing the clearest intent of what it is.

Thank you, senator. I believe that this bill will act as a deterrent for the doctors who believe that women should be sterilized without consent.

And it does not remove anyone’s agency to having a tubal ligation or a vasectomy.

Thank you, Senator Boyer, once again. We’ve been down this road before, and I thank you for your important work on this.

We, in the Senate over the years, have done a lot of bills on things that are important to Canada and to Canadians, but I can’t think of something more important than the work that you’ve brought to our chamber, and I thank you for that.

You know that I’m a critic of this bill, you know I was a critic of the bill in the last Parliament, Bill S-250, and you also know that I support the bill.

Could you talk a little bit, please, about what happens, aside from the legislation? And let’s assume it passes. Let’s assume it passes the Senate and the other place. It doesn’t have money attached to it, but there is clearly money required for the supports that come once the legislation has been enacted. Registries, healing support funds, public education, data and research.

You mentioned even just 82 days ago, even with the publicity around this in the last Parliament on Bill S-250, that people are still recommending it or suggesting it. So there has to be public education. What kind of things would you consider important in the next step once the bill passes?

Thank you, Senator Wells. There has been an organization that has been created called the Survivors Circle for Reproductive Justice. They were incorporated about a year ago and they are up and running, and they’ve created a registry for women to be registered with them and access healing. They are funded by the government, and I believe they’re at the beginning stages of being able to address many of these issues throughout Canada.

It is a national organization so they’re able to go from east to west and north to south. I foresee this organization being very helpful in relation to education and to being able to help people like Katy when things like this happen. They’ve certainly been very helpful for me because the last time I was consulted was December 2024. They’re taking over. They’re working very closely with Indigenous midwives as well, who are also funded by the government.

I’m hoping that between the midwives and a national organization that they are able to address many of these issues and provide support when it’s needed.

Will you take another question, Senator Boyer?

Yes.

So this is federal legislation and it would go under the Criminal Code. The doctors who do perform these practices, they fall under the provincial hospital and health systems.

Do you see any problems with the divide in getting information through the hospital system, through the clinic system, through the whole provincial medical care system that is required? Obviously, education is required. Do you see any issues with that? Is there a divide between what we’re doing federally under the Criminal Code and what is at practice provincially?

Thank you, Senator Wells.

I can tell you that I’ve worked over the past few years with British Columbia, and they have been very advanced as far as working with their doctors. And I’ve been on grand rounds with them talking about forced and coerced sterilization, what consent is and how it needs to be really tailored for an Indigenous mother who is about to give birth. To me, they are the leaders in provincial health care, as far as reproductive rights go.

Throughout the years, I’ve worked with the Canadian Medical Association, I’ve worked with Senator Osler, and she’s been vital. There’s been a lot of wonderful allies out there that are willing to work in the provincial system so that we can eradicate this, so that the doctors are understanding what sterilization is and what consent is.

Even for the doctor who asked Katy, she’s in the emergency room and she’s in distress, and she asked her if she wanted to be sterilized. She asked for consent. Well, that’s not consent, that’s under duress. So the doctors are being educated as well.

I think that this bill, like I just recently said, it’s going to act as a deterrent. I’m hoping that we will be able to take one more step in eradicating this. Thank you.

Would you take another question?

Yes, I will.

I might be coming at this from a naive perspective, but I certainly echo the thoughts that Senator Wells had, particularly the compliments to your work and everything you’re putting into this.

But we’ve listened to these things, and it was really mind-boggling to try to understand or comprehend — and here might be some of the naïveté — why a doctor who is under a Hippocratic oath would commit sterilization without consent or the right kind of consultation to get there? In many ways it’s forced sterilization.

But they’re not alone in that room. There are some assistants around there of a medical level, nurses and what have you. So maybe there’s a whistle-blower clause necessary.

But with the provinces, Senator Wells is correct because it’s their jurisdiction for the health side. But I cannot see any province, a premier of a province or the chief medical officer of a province not wanting to eradicate this. It just makes no sense to sterilize someone who hasn’t consented to the sterilization nor gotten the right advice to even think about or consider sterilization. So sometimes it takes tough consequences to eradicate something.

I don’t know if you’re thinking about what the strategy is to get the provinces to join you in this because I can’t see any electorate allowing this to happen in their province.

Thank you, Senator Klyne. I agree there is definitely work to be done, but it’s only a few doctors — it’s not all doctors, it’s the bad apples.

I think the provincial system, they’ve done work, they’ve been educating, they’ve been talking about culturally relevant health care, culturally relevant maternal care. There are programs happening. There is work going on. I believe that they truly do want to address this as well.

It’s mind-boggling to me how this happened with Katy, just in March. How that happened when we’ve done so much work. And there are so many people, so many allies out there that want to see this stopped as well.

I don’t have any answers, but I do know the provincial system is on board as well. The federal government had pulled together a round table of all the provinces to discuss this. The federal government has also pulled together racism in health care workshops around the country that I’ve been involved in. The education goes on. I believe that they want to stop it too, so I don’t know why. I wish it wasn’t happening.

Again, something like that needs consequences. Is anyone trying to formulate what the consequences could be for those “bad apples”?

I think Bill S-228 is a good deterrent; that’s a good place to start.

Let’s have some consequences because this has been going on for a very long time. It has been against the law; there are assault provisions in the Criminal Code. Every time somebody is sterilized without their consent, they can fall within these provisions, but they haven’t been prosecuted. Let’s have a deterrent out there. Let’s see if that will work.

It is just one tool in the tool box. There are so many other things that have to be done and that are being done, such as the Survivors Circle. They are working very hard at accessing all the women in Canada who have been sterilized.

It’s a national scope, and I think the bill is just one more tool.

First of all, a heartfelt thank you on behalf of the many people who tried to shed light on this tragedy during the National Inquiry into Missing and Murdered Indigenous Women and Girls. It should never have happened. Tomorrow will mark one year since the president of the Collège des médecins du Québec, Dr. Mauril Gaudreault, realized that, in Quebec alone, more than 30 First Nations and Inuit women were sterilized without their consent between 1980 and 2019.

Are you partnering with Professor Suzy Basile, who is working on these issues? Are you following the progress of the class-action lawsuit that has been filed to denounce this injustice that has also occurred in Quebec?

Thank you, Senator Audette. Yes, I have been working with Professor Suzy Basile for several years now. I know the class action in Quebec has been certified against three doctors and the health authority, as well. What’s happening there is just one more tool in the tool box, but that is going to affect whether the other class actions in the country are going to be certified. It has set a very good precedent, and the work that they’re doing in Quebec is phenomenal.

Senator, thank you for introducing this bill back into our chamber.

My question is a follow-up to Senator Simons’ question about the wording or lack of wording of “consent” in Bill S-228. I believe you had mentioned that the wording in the Criminal Code section 268 already covers consent. I was just having a look at it, and I believe the current wording talks about excluding those cases where consent was given, but the wording is very specific to surgical procedures on different parts of the anatomy and it doesn’t refer to sterilization procedures.

Can you expand upon that? Without changing the consent wording in section 268 — and there is no wording in your bill about consent — could an unintended consequence potentially be criminalizing sterilization procedures?

Thank you.

I think the key words here are “wounds” or “maims” a person, and that would certainly be without consent. So the key words that bring it into the aggravated assault provision are “wounds” and “maims.” It’s an assault when it’s wounding or maiming. There would be no consent, of course, because wounding and maiming would be without consent.

Honourable senators, as the critic of the bill, I plan to speak to this on Thursday.