A note from Dr. Malhotra:
Consent is at the heart of ethical healthcare—it defines the boundary between support and violation, respect and coercion. As someone who has dedicated my career to women’s health, I’ve witnessed how fragile that boundary can be. That’s why I’ve focused my work on transforming consent from a legal formality into a process rooted in cultural humility, justice, and shared power.
During my time at the First Nations Health Authority (FNHA), I was the lead author of Informed Consent for Contraception: A Shared Decision-Making Guide and Form, a tool designed not just to document, but to re-humanize consent conversations in clinical care. It draws on lived experiences and the historical context of reproductive coercion in Indigenous communities, reframing consent as a relational dialogue—not just a signature on paper.
But this work isn’t theoretical. The Hon. Senator Boyer has dedicated decades to supporting victims of Coerced Sterilization. I had the honour of testifying twice before the Senate Standing Committee on Human Rights during its inquiry into forced and coerced sterilization in Canada. In those hearings, I detailed how survivors faced sterilizations “without free, prior, and informed consent,” often under duress or misinformation—moments where medical power became abuse. This wasn’t distant history. It is happening now, with ongoing cases in provinces like BC and Alberta.
These testimonies were included in the Senate’s report, The Scars That We Carry, which calls for legal reform, accountability, and culturally tailored consent practices, particularly for Indigenous people. I had the privilage of working with institutions like the College of Physicians and Surgeons of BC to co lead their “Consent to Treatment” standard to emphasize cultural safety, interpretation, shared decision-making, and the need to acknowledge historical harm in clinical relationships.
In menopause care specifically, consent is relevant daily. Many women—particularly women of colour—undergo surgeries such as oophorectomy, tubal ligation, or hysterectomy without fully understanding how these procedures may affect their long-term health, overall medical risks, quality of life, and deem them infertile. These procedure are undoubtedly necessary at times, but there must be a conversation about the outcomes on someones life post surgery that is understood by the person receiving the care.
Consent must be attained in a language and context that is safe and relevant. It is about knowing you can ask questions, change your mind, or say “not now” without judgment or pressure if a non emergency case.
Consent is not static. It’s a practice of respect, an act that reaches across centuries of silence and harm to forge a path toward healing. And it’s why I will keep writing, advocating, and pushing systems to do better to ensure informed, voluntary, continuous, and culturally safe consent is embedded for all.
Please read more about Senator Boyer’s extensive and critical work here.
Please read more about the work Dr. Malhotra has led here.
Further resources:
College of Physicians and Surgeons Standards