The Involuntary Sterilization of Women in the United States Cameryn Richardson
Table Of Contents 3 What Is Sterilization? 5 Methods of Sterilization
7 Origins of Eugenic Sterilization 10 Sterilization of “Undesirable� Populations 11 Population Control in Puerto Rico
13 North Carolina Eugenics v. Black Communities
15 California & the Mexican Community
17 Sterilization & Institutionalization
19 Mass Sterilization of Native American Women
21 Sterilization & Reproductive Justice 23 List of Resources
What Is Sterilization?
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Sterilization (also spelled sterilisation) is the process of surgically preventing contraception by removing or interrupting the anatomical pathways that gametes travel through. While there are both surgical and nonsurgical methods of sterilization, the most permanent (and the one we are most concerned with) is surgical sterilization. The main two surgical sterilization procedures we will be focusing on in relation to the sterilization of women are tubal ligation and the hysterectomy.
Tubal ligation is a surgical procedure that closes the
fallopian tubes, blocking eggs from moving down the tubes to be fertilized. Tubal ligation can be completed in one of five ways: banding, cauterizing, tying and cutting, clipping, or complete tube removal. Recognized as a medical procedure in 1823 and first performed in 1880, tubal ligation is the oldest and most widely used sterilization method to this day.
This graphic depicts three of the five methods used to close the fallopian tubes.
Although tubal ligation can now be reversed, the procedure wasn’t available until the late 90s-early 2000s. Reversal surgery has a success rate of 65-80%, but the procedure can only be successfully done with less invasive methods (banding or clipping), and costs upwards of $10,000.
Fast Fact: This is Dr. James Blundell, the physician that got tubal ligation recognized as a viable sterilization procedure in 1823 by the Medical Society of London.
A hysterectomy is a procedure in which part of
or the entire uterus is removed. The three main types of hysterectomies are: Subtotal (Partial) Hysterectomy: removal of only the body of the uterus Total Hysterectomy: removal of the entire uterus, including the cervix Total Hysterectomy with Bilateral SalpingoOophorectomy: removal of the entire uterus, plus the fallopian tubes and ovaries. While Ellis Burnham was the first to successfully complete an official medical hysterectomy in 1853, vaginal hysterectomies date back to ancient times, as early as 120 A.D. Despite major advances, hysterectomies continue to be completely irreversible.
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Origins of Eugenic Sterilization
The Eugenics Movement in the United States
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Eugenics is a long-disproven pseudoscience created by British scholar Sir Francis Galton that claims it is possible to improve the human race through selective breeding. Eugenics encouraged people or populations with “desirable” traits to reproduce while discouraging people with “undesirable” traits to reproduce. The problem with eugenics is that it targets marginalized groups, the populations scientists claimed held “undesirable” traits.
To prevent targeted groups from procreating, the eugenics movement, spearheaded by biologist Charles Davenport, focused on pushing eugenic legislation for forced sterilization. The first state to enact a eugenic sterilization law was Indiana in 1907, with many states soon following suit. By 1934, 28 states had laws in full effect and 7 states had pending legislature, with full support from the Supreme Court (Buck v. Bell). The laws resulted in the forced or coerced sterilization of over 65,000 people in the United States, not including U.S. territories.
By the 1940s, the eugenics movement lost steam. After the horrors of World War II, eugenics was completely discredited. Despite the denunciation of eugenics, forced sterilization persists in many countries today, including the U.S. In 2013, the Center for Investigative Reporting found that 150 female inmates in California prisons had been forcibly sterilized without approval from 2006 to 2011. In 2020, US Immigration & Customs Enforcement (ICE) detention center nurse Dawn Wooten sent a formal complaint to the Department of Homeland Security. The report, officially filed by the nonprofit Project South, details the unneccessary hysterectomies given to many women detained in the Georgia facility.
Sterilization of “Undesirable” Populations
Population Control in Puerto Rico
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One of the first major eugenic sterilization efforts occured in Puerto Rico in the 1930s. Around that time, the United States cited concerns of overpopulation in Puerto Rico, claiming that it would cause catastrophic socioeconomic conditions. In 1937, Law 116 was passed under United States jurisdiction, a law that, instead of providing Puerto Rican women with reversible and safe forms of contraception, implemented permanent sterilization as a tool for population control. The program was created by the American Eugenics Board and financially backed by both the U.S. government and private individuals that supported the initiative. Fast Fact:
A 1968 study showed that 1/3 of Puerto Rican women surveyed didn’t know that tubal ligation was permanent; the euphemism “tying the tubes” led women to believe that the procedure was easily reversible.
Women were strongly engouraged to undergo tubal ligation or hysterectomies, leaving no room for informed consent. Coersion methods included door-to-door visits from healthcare workers, government assistance to pay for the operations, and employer favoritism towards sterilized women. By 1976, the US Department of Health, Education, & Welfare (HEW) reported that over 37% of Puerto Rican women of childbearing age had been sterilized, most of whom in their twenties.
North Carolina Eugenics v. Black Communities
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Many US eugenics programs disproportionately affected Black communities, but none as drastically as the program in North Carolina. In a 2020 Duke University study, researchers found that in the 1950s and ‘60s, counties in North Carolina with high concentrations of unemployed Black individuals had higher sterilization rates than counties with lower unemployed Black populations. According to researchers, the program was designed to “breed out” Black citizens, especially those on public welfare. “The United Nations’ official definition of genocide includes ‘imposing measures to prevent births within a (national, ethnically, racial or religious) group,’” Duke University professor and co-author William A. Darity Jr. states. “North Carolina’s disproportionate use of eugenic sterilization on its Black citizens was an act of genocide.” About 7,600 individuals were sterilized between 1933 and 1973 under the North Carolina Eugenics Board. 65% of those sterilizations were performed on Black women, even though Black women only accounted for about 25% of North Carolina’s total population.
California & the Mexican Community
At the height of the eugenics movement, California was considered the epicenter of American eugenics. Biases against Mexicans and Mexican Americans were especially prominent at the time. California institutional authorities explicitly stated that those of Mexican descent were “immigrants of an undesirable type.” California used institutionalization to cover up and get away with a number of forced sterilizations conducted. The program disproportionately targeted Latina women, who had a 59% higher risk of being forcibly sterilized than women of other racial or ethnic backgrounds. In 2015, University of California, Los Angeles professor Renee Tajima-Peña released the documentary “No Más Bebés,” reporting the ill treatment and involuntary sterilization of Mexican women in the ‘60s and ‘70s in California. “These women went to the hospital for emergency C-sections,” TajimaPeña states in an interview for the UCLA Newsroom, “They were distressed, terrified their babies would die, often hemorrhaging and medicated. Most did not speak English and they were often given these English-language consent forms, while in labor, before they could get care, and some of them did not consent at all.” In total, over 20,000 people were sterilized in California by the early 1970s, accounting for about a third of the number of sterilizations nationwide. Fast Fact: The California eugenics program was so successful that it inspired Hitler (yes, that Hitler) to “legitimize” his anti-Semitic views though science and medicine. Hitler and Nazi eugenicists often referenced American eugenics and collaborated with California eugenicists.
Sterilization &
Institutionalization
18 At the beginning of the eugenics movement, the main goal was to prevent those with mental disabilities and hereditary diseases from reproducing. To do this, eugenics programs in many states targeted mental institutions. It is important to note that from the establishment of the first institution up to this point, it was fairly easy to be admitted; what constituted as “mentally ill” was ill-defined. This resulted in individuals, organizations, and governments using that to institutionalize anyone that didn’t fit into society, such as immigrants, BIPOC, LGBTQ+ individuals, the disabled, and poor people. It was very easy for eugenics programs to target those populations for sterilization due to that development, which is why many state eugenics boards continued to push laws that enabled compulsory sterilization in state mental hospitals.
By the 1960s, institutionalization became widely politicized to target LGBT, women’s rights, and civil rights activists. Doctors used fake illnesses to “diagnose” dissenters and institutionalize them. In 1968, the American Psychiatric Association (APA) released a second edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). The DSM-II was revised to include terminology such as ‘projection,’ ‘projected anger,’ and ‘hostility’ in the definition of schizophrenia to justify the diagnosis and involuntary institutionalization of protesters, especially those who were African American. Despite the discreditation of eugenics, numerous states had compulsory sterilization laws still in place. Multiple activists, especially women, placed in state asylums reported being forcibly sterilized before their eventual release.
Mass Sterilization of Native American Women
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The US has used numerous aggressive methods to eradicate Native populations throughout the decades, including mass involuntary sterilization by the Indian Health Services (IHS). The IHS is a division of the US Department of Health and Human Services—previously HEW (see page 12)—that focuses on providing Alaska Native people and federally-recognized Native American tribes with public health and medical services. The IHS performed thousands of unnecessary hysterectomies and tubal ligation procedures under the guise of healthcare treatment. In 1976, a study by the U.S. General Accounting Office showed that four of the twelve IHS regions sterilized a total of 3,406 Native women between 1973 and 1976. All of these procedures were performed without the women’s knowledge or informed consent, and many women did not know they were sterilized until developing serious medical conditions or attempting to have children years later. According to an independent study by Dr. Connie Pinkerton-Uri, Choctaw/Cherokee, one in four Native American women had been sterilized without their consent by 1978.
Sterilization & Reproductive Justice
22 As people became more aware of the appalling Fast Fact: Buck v. Bell, the 1927 Supreme Court effects of eugenic decision that enabled eugenic sterilization, sterilization, calls for was never expressly overturned. Nazi reparations arose. By the defendants even cited Buck v. Bell at 2000s, multiple states, the Nuremburg Trials to justify their own sterilization efforts. California and North Carolina among them, issued formal apologies for their role in eugenics. In 2014, the state of North Carolina passed a law that issued $10 million to victims of sterilization, making it the first state to do so. Virginia followed shortly thereafter in 2015. California attempted to pass a similar bill in 2018, but it was unsuccessful. Today, all states have repealed their eugenic sterilization laws and denounced eugenics. Greater awareness of involuntary sterilization has recruited many activists and organizations in the fight for better reproductive rights. The World Health Organization released an interagency statement regarding involuntary sterilization in 2014. In it, they addressed how BIPOC, intersex, disabled, and HIV positive girls and women have been affected by this, and detailed provision guidelines for future sterilization practices. Grassroots organizations like Project South, the Center for Reproductive Rights, and Amnesty International Puerto Rico are actively involved in protests and calls for updated health and reproductive rights laws.
List of Resources
Robert K Zurawin, M. (2020, August 27). Tubal Sterilization: History of the Procedure. Retrieved November 2020, from https://emedicine.medscape.com/article/266799-overview Mayo Clinic Staff. (2020, March 04). Tubal Ligation Reversal. Retrieved November 2020, from https://www.mayoclinic.org/tests-procedures/tubal-ligation-reversal/about/pac-20395158 Hersh, E. (2018, November 29). What Is Tubal Ligation Reversal and How Successful Is It? (1114557878 842111015 K. Cross FNP, MSN, Ed.). Retrieved November 2020, from https://www. healthline.com/health/pregnancy/tubal-ligation-reversal#success-rate Sutton C. (1997). Hysterectomy: a historical perspective. Bailliere’s clinical obstetrics and gynaecology, 11(1), 1–22. https://doi.org/10.1016/s0950-3552(97)80047-8 Birnbaum M. (1961). Eugenic sterilization: a discussion of certain legal, medical, and moral aspects of present practices in our public mental institutions. JAMA, 175(11), 951–958. https://doi. org/10.1001/jama.1961.03040110015004 Rivard, L. (2014, September 18). America’s Hidden History: The Eugenics Movement. Retrieved November 2020, from https://www.nature.com/scitable/forums/genetics-generation/america-shidden-history-the-eugenics-movement-123919444/ Black, E. (2003, September). The Horrifying American Roots of Nazi Eugenics. Retrieved November 2020, from http://hnn.us/article/1796 Krase, K. (2014, October 1). The History of Forced Sterilization in the United States. Retrieved November 2020, from https://www.ourbodiesourselves.org/book-excerpts/health-article/forcedsterilization/ Lelliott J. (2004). War Against the Weak: Eugenics and America’s Campaign to Create a Master Race. BMJ : British Medical Journal, 328(7436), 411.
Stern, A. (2005). Eugenic Nation: Faults and Frontiers of Better Breeding in Modern America. University of California Press. Retrieved December 2020, from http://www.jstor.org/stable/10.1525/j. ctt1pn5jp Patel, P. Forced sterilization of women as discrimination. Public Health Rev 38, 15 (2017). https://doi. org/10.1186/s40985-017-0060-9 Kluchin, R. (2009). Sterilizing “Unfit” Women. In Fit to Be Tied: Sterilization and Reproductive Rights in America, 1950-1980 (pp. 73-113). Rutgers University Press. Retrieved December 2020, from http:// www.jstor.org/stable/j.ctt5hj13v.7 Price, Gregory & Darity, William & Sharpe, Rhonda. (2020). Did North Carolina Economically BreedOut Blacks During its Historical Eugenic Sterilization Campaign?. 10.38024/arpe.pds.6.28.20. Hubbard, L. (2020, July 21). New Paper Examines Disproportionate Effect of Eugenics on NC’s Black Population. Retrieved November, 2020, from https://today.duke.edu/2020/07/new-paper-examinesdisproportionate-effect-eugenics-nc%E2%80%99s-black-population Manian, M. (2020, September 29). Immigration Detention and Coerced Sterilization: History Tragically Repeats Itself. Retrieved November, 2020, from https://www.aclu.org/news/immigrants-rights/ immigration-detention-and-coerced-sterilization-history-tragically-repeats-itself/ Project South. (2020, September 14). Lack of Medical Care, Unsafe Work Practices, and Absence of Adequate Protection Against COVID-19 for Detained Immigrants and Employees Alike at the Irwin County Detention Center [PDF]. Atlanta, Georgia: Project South: Institute for the Elimination of Poverty & Genocide. Ordover, N. (2014, February 24). Puerto Rico. Retrieved December 9, 2020, from http:// eugenicsarchive.ca/discover/connections/530ba18176f0db569b00 Ordover, N. (2003). American Eugenics: Race, Queer Anatomy, and the Science of Nationalism. Minneapolis: University of Minnesota Press. https://doi.org/10.1086/433039
Chapin, A. (2020, September 15). Reports Of ICE’s Forced Hysterectomies Are Nothing New In America. Retrieved November 2020, from https://www.thecut.com/article/ices-forced-sterilizations-arenothing-new-in-america.html Castles, K. (2002). Quiet Eugenics: Sterilization in North Carolina’s Institutions for the Mentally Retarded, 1945-1965. The Journal of Southern History, 68(4), 849-878. doi:10.2307/3069776 Alonso, P. (n.d.). Autonomy Revoked: The Forced Sterilization of Women of Color in 20th Century America [PDF]. Denton, TX: Texas Woman’s University. Kaelber, L. (2010). Eugenics: Compulsory Sterilization in 50 American States. Retrieved December 2020, from https://www.uvm.edu/~lkaelber/eugenics/CA/CA.html Ko, L. (2016, January 29). Unwanted Sterilization and Eugenics Programs in the United States. Retrieved November 2020, from https://www.pbs.org/independentlens/blog/unwanted-sterilization-and-eugenicsprograms-in-the-united-states/ Reichel, C. (2018, April 27). Forced sterilization in California targeted Latina women. Retrieved November 2020, from https://journalistsresource.org/studies/society/race-society/eugenic-sterilizationcalifornia-latina/ Novak, N. L., Lira, N., O’Connor, K. E., Harlow, S. D., Kardia, S., & Stern, A. M. (2018). Disproportionate Sterilization of Latinos Under California’s Eugenic Sterilization Program, 1920-1945. American journal of public health, 108(5), 611–613. https://doi.org/10.2105/AJPH.2018.304369 Wolf, J. (2017, October 25). UCLA professor’s film documents forced sterilization of Mexican women in late ‘60s and early ‘70s L.A. Retrieved November 2020, from https://newsroom.ucla.edu/stories/uclaprofessor-s-film-documents-forced-sterilization-of-mexican-women-in-late-60s-l-a Price, Gregory & Darity, William. (2010). The economics of race and eugenic sterilization in North Carolina: 1958–1968. Economics and human biology. 8. 261-72. 10.1016/j.ehb.2010.01.002.
U.S. National Library of Medicine. (n.d.). Government admits forced sterilization of Indian Women - Timeline - Native Voices. Retrieved November 2020, from https://www.nlm.nih.gov/nativevoices/ timeline/543.html U.S. General Accounting Office. (1976, November 4). Investigation of Allegations Concerning Indian Health Service [PDF]. Washington, D.C.: United States General Accounting Office. Lawrence, J. (2000). The Indian Health Service and the Sterilization of Native American Women. American Indian Quarterly, 24(3), 400-419. Retrieved December 9, 2020, from http://www.jstor.org/ stable/1185911 Eghigian, Greg. “The Legacy of Political Persecution.� Psychiatric Times, Feb. 2020, www. psychiatrictimes.com/view/legacy-political-persecution. WHO, UN Women, UNICEF, UNAIDS, UNFPA, OHCHR, & UNDP. (2014). Eliminating forced, coercive and otherwise involuntary sterilization (United States, World Health Organization). Washington, D.C.: World Health Organization. Center for Reproductive Rights. https://beta.reproductiverights.org/ Project South. https://projectsouth.org/ Amnesty International Puerto Rico. https://www.amnesty.org/en/countries/americas/puerto-rico/