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Content warning: Rape, sexual assault.

It has only been six months since a shocking whistleblower allegation regarding forced hysterectomies and medical neglect at an Immigration and Customs Enforcement (“ICE”) detention center in Georgia. Dawn Wooten, a licensed nurse who previously worked at the ICE detention center — the privately-operated Irwin County Detention Center — filed a complaint regarding the numerous hysterectomies performed on Spanish-speaking immigrant women without any prior informed consent. She also expressed concern over the alleged deliberate “lack of medical care, unsafe work practices and absence of adequate protection against COVID-19.” In 2020, these allegations — reproductive organs being forcibly removed without the woman’s consent — almost sounded too inhumane to be true. These allegations, however, have brought to light that forced sterilizations are a remnant of the long legacy of eugenics in the United States and, contrary to popular belief, are not a relic of the past but a harsh reality even today.

Sir Francis Galton, Charles Darwin’s half-cousin, coined the term “eugenics” in 1883. The term stemmed from an inaccurate interpretation of Gregor Mendel’s pea pods and Darwin’s theories and stood for the idea that many social ills were perpetuated by rapid reproduction and growth of the “wrong sort of people.” This theory was somehow glorified through the façade of scientific veracity and “eugenics,” the so-called science of “improving humanity through better breeding,” emerged as the solution. The eugenics movement in the United States was a product of the early 1900s  and peaked in the 1920s. While the movement itself started losing steam in the 1940s, the practice of sterilizations for eugenics purposes continued well into the 1970s. Between 1907 to 1937, thirty-two U.S. states passed sterilization laws. These states’ sterilization programs were federally funded and government-created eugenics boards in several states were tasked with looking at petitions for sterilizations from government agencies or family members and mandating sterilizations accordingly. As such, almost 70,000 Americans — a lot of them women — were subject to forced sterilizations during the twentieth century.

As if the idea of forced sterilizations was not horrifying enough, a clear bias permeated the practice and the entire concept of eugenics. Not surprisingly, those who were considered “unfit” or “different” were usually immigrants, Blacks, Indigenous people, poor whites, and people with disabilities. The eugenics movement became a flagbearer of racism and sexism. Women and people of color were targeted disproportionately, as evidenced by North Carolina’s eugenics board ordering the forced sterilizations of more than 8,000 people, 65% of whom were Black women. In the South, forced hysterectomies on Black women became so prevalent that they were given a euphemism: a “Mississippi appendectomy.”

 The eugenics movement found its legal support in the 1927 Supreme Court case of Buck v. Bell, remembered for Justice Oliver Wendell Holmes’s parting thoughts: “Three generations of imbeciles are enough.” Carrie Buck had been committed to a state mental institution, the Virginia State Colony for Epileptics and Feebleminded, after giving birth to an illegitimate child who was the product of rape. In 1924, Virginia adopted a statute that authorized the state to sterilize “so-called mental defectives or imbeciles.” Albert Priddy, the physician superintendent at the state mental institution where Buck was committed, decided to test the legal validity of this newly-enacted eugenics law and selected Buck as the subject of the first sterilization. Under the Virginia law, a hearing was required to determine whether the sterilization was necessary. A sham hearing was held for Buck, in which Priddy declared Buck “congenitally and incurably defective.” The Board of Directors then ordered the sterilization, which Buck challenged initially in the Virginia court system, and then in the Supreme Court. In an eight-to-one decision, the Supreme Court upheld the Virginia statute and declared that it was in the state’s interest to have Buck sterilized. This decision, a huge victory for the eugenics movement, essentially legalized forced sterilizations for eugenics-motivated purposes in the United States.

 Buck, however, when interviewed by reporters years later, stated that she would have liked to have children and never really understood the nature of the sterilization procedure. Buck’s statement echoes a common feature of most forced sterilization procedures — a lack of information, and subsequently, the lack of informed consent. Either the procedure is administered without the woman’s knowledge, or her right to consent is taken away from her. The documentary No Más Bebés showcased how, in the late 1960s and early 1970s, doctors used coercion tactics to obtain consent from Mexican immigrant women to perform sterilizations on them in a Los Angeles hospital. The doctors threatened these non-English speaking women by withholding treatment or telling them their babies might die in order to force them to sign consent forms. The women only found out later that the barely discernable papers they had signed in a state of disorientation and pain actually resulted in the loss of  their reproductive rights. The doctors targeted vulnerable Latina women who woke up after the procedure confused and deprived of their reproductive rights due to coercion and a general lack of information. These instances in the documentary echo the descriptions of alleged forced sterilizations at the ICE detention center in 2020.

In the twenty-first century, most instances of forced sterilizations are illegal — doctors are required to follow established procedures and guidelines and inform patients of their reproductive rights. Additionally, forced sterilizations violate several international human rights standards. Despite these international regulations, the practice still continues, especially in jails, prisons, and detention centers. Between 2006 and 2010, nearly 150 women, the majority of whom were Black and Latina, were sterilized through tubal ligations against their consent in California prisons. Since federal funds could not be used to pay doctors for performing these sterilizations, California used state funds to pay these doctors almost $150,000. In discussing the payments to doctors to perform these sterilizations, one doctor noted that the nearly $150,000 of state funds used to pay the doctors “paled in comparison to ‘what you save in welfare,’” implying that the state would have paid more through its welfare program had these inmates had children after being released from prison. This kind of rationale has persisted, with a Tennessee judge, as recently as 2017, offering repeat offenders “reduced jail time in exchange for sterilization operations.”

Considering this country’s torrid history with eugenics and sterilizations, the recent ICE incident should hardly come as a surprise. The whistleblower allegations attracted widespread outrage, with Representative Ayanna Pressley and Representative Pramila Jayapal calling for a Congressional investigation into these unconstitutional human rights violations. Hopefully those responsible for the atrocities at the detention center will be held accountable. In the meantime, it cannot be emphasized enough that interferences with individuals’ reproductive rights and bodily autonomy are not a thing of the past. They are very much a reality, even today, and disproportionately target the “less fortunate and poorly educated.” Unless we collectively raise awareness to change policies, instigate and mobilize policy makers, and educate on the importance of informed consent, the reproductive freedom that we so desire is a far-fetched possibility in the battle against forced sterilizations.

Suggested Citation: Madhura Banerjee, Forced Sterilizations — A Discriminatory Reality, Not a Relic of the Past, Cornell J.L. & Pub. Pol’y, The Issue Spotter (Mar. 1, 2021), http://jlpp.org/blogzine/forced-sterilizations-a-discriminatory-reality-not-a-relic-of-the-past/.