Sterilization of Minors With Developmental Disabilities

Sterilization of persons with developmental disabilities has often been performed without appropriate regard for their decision-making capacities, abilities to care for children, feelings, or interests. In addition, sterilization sometimes has been performed with the mistaken belief that it will prevent expressions of sexuality, diminish the chances of sexual exploitation, or reduce the likelihood of acquiring sexually transmitted diseases. A decision to pursue sterilization of someone with developmental disabilities requires a careful assessment of the individual’s capacity to make decisions, the consequences of reproduction for the person and any child that might be born, the alternative means available to address the consequences of sexual maturation, and the applicable local, state, and federal laws. Pediatricians can facilitate good decision-making by raising these issues at the onset of puberty. ABBREVIATION. AAP, American Academy of Pediatrics. Parents or other legal guardians approach pediatricians, pediatric surgeons, obstetrician-gynecologists, or other health care professionals about the possibility of surgical sterilization of children, adolescents, and young adults with developmental disabilities. This policy statement updates the previous American Academy of Pediatrics (AAP) statement entitled “Sterilization of Women Who Are Mentally Handicapped,” published in 1990.1 That statement was published as a companion to policy from the American College of Obstetricians and Gynecologists.2 This revised policy relies on the concepts developed in the earlier statements, but applies to males and females.