The Celia Ramos case provides a critical opportunity for the Court to build upon and consolidate its jurisprudence concerning violations of reproductive autonomy as a form of gender-based violence and discrimination, in line with its own precedent and the findings of other international human rights bodies.

This has been an issue of increased international attention, as featured in the 2024 Opinio Juris symposium, where several blogs emphasized that reproductive violence constitutes a distinct form of harm, separate from, though often overlapping with, sexual violence. As argued by contributors to the symposium, accurately naming these crimes is crucial because it “prevents the unique harm suffered by the victims from being erased” and is a prerequisite for full accountability.

The most direct precedent within the Inter-American system is the Court’s 2016 judgment in I.V. v. Bolivia. In that case, the Court found that the sterilization of the victim without her free, full, and informed consent constituted a form of gender-based violence violating rights to personal integrity, liberty, privacy, and access to information. Celia Ramos allows the Court to recognize this violence not merely as an individual act or medical negligence but as a reflection of systematic state policy that instrumentalized women’s bodies for demographic control.

This analysis, moreover, aligns with the Committee on the Elimination of Discrimination against Women (CEDAW), which has consistently condemned forced sterilization. In its General Recommendation No. 35, the Committee affirmed that violations of women’s sexual and reproductive health and rights can amount to torture or cruel, inhuman, or degrading treatment.

In October 2024, the CEDAW found Peru responsible for violating the rights of five women forcibly sterilized under the same Fujimori-era program, highlighting the ongoing failure to provide an effective remedy (M.L. et al. v. Peru). As Committee member Leticia Bonifaz noted, “Forced sterilisations were carried out as part of a systematic and generalised attack against rural and Indigenous women, and the policy resulted in the nullification and substitution of their reproductive autonomy.” 

The decision was consistent with the Committee’s earlier decision in in A.S. v. Hungary (2006). In that case, the Committee found violations of Articles 10(h), 12, and 16 of the Convention after a Roma woman in medical shock signed a consent form without being informed of the procedure’s nature or irreversibility. The Committee held that “the mere fact that the author signed the consent form is not sufficient to show that she had given her informed consent” (Para. 11.2), thereby establishing that a signature alone cannot substitute for the State’s duty to ensure a patient’s truly informed choice.

The Scope of Reparations for Grave and Systemic Violations

Pursuant to Article 63(1) of the American Convention, a finding of a violation of the Convention entails an obligation to provide adequate reparation. Given the systemic nature of the violations, rooted in structural discrimination, the Court’s jurisprudence supports ordering transformative reparations. This concept, articulated in cases like González et al. (“Cotton Field”) v. Mexico, recognizes that effective remedies must not only compensate for individual harm but also aim to transform the underlying conditions that enabled the violations.

For the victims of Peru’s policy, this requires measures beyond monetary compensation. It calls for guarantees of non-repetition centered on the protection of sexual and reproductive health and rights. Such measures could include the establishment of a comprehensive and specialized public health program for survivors, the implementation of nationwide training for medical personnel on the standards of free, prior, and informed consent, and reforms to health policies to ensure that reproductive autonomy is explicitly protected and promoted, consistent with the UN Basic Principles and Guidelines on the Right to a Remedy and Reparation.

The Court’s judgment is essential to ensure that reparations are effectively granted to the victims, as all domestic efforts to secure redress have so far proved fruitless. Although domestic courts have, since 2022, ordered the Ministry of Justice to implement a reparations policy for victims of the forced sterilization program, no action has been taken.

Conclusion

The judgment in Celia Ramos v. Peru will be of profound importance. If the Court  classifies Peru’s forced sterilization program as a crime against humanity—as the evidence and applicable law compel—it will have delivered a landmark ruling for reproductive justice in the Americas. Such a finding would affirm that no statute of limitations can shield perpetrators of reproductive violence committed as part of systematic or widespread attach against a civilian population, and that states must ensure the reproductive autonomy of all persons is protected from such abuse. Anything less would represent a missed opportunity to consolidate decades of international jurisprudence on this issue, leave the thousands of indigenous women who were victims of these crimes without protection, and represent a step backward in the history of the Court. Overall, the  judgement in this case  will determine whether the Inter-American system can effectively shield victims from impunity for such crimes.