Coerced sterilization is a shameful part of America's history, and one doesn't have to go too far back to find examples of it. Used as a means of controlling "undesirable" populations – immigrants, people of color, poor people, unmarried mothers, the disabled, the mentally ill – federally-funded sterilization programs took place in 32 states throughout the 20th century. Driven by prejudiced notions of science and social control, these programs informed policies on immigration and segregation.

As historian William Deverell explains in a piece discussing the "Asexualization Acts" that led to the sterilization of more than 20,000 California men and women, "If you are sterilizing someone, you are saying, if not to them directly, 'Your possible progeny are inassimilable, and we choose not to deal with that.'"

According to Andrea Estrada at UC Santa Barbara , forced sterilization was particularly rampant in California (the state's eugenics program even inspired the Nazis ):

Beginning in 1909 and continuing for 70 years, California led the country in the number of sterilization procedures performed on men and women, often without their full knowledge and consent. Approximately 20,000 sterilizations took place in state institutions, comprising one-third of the total number performed in the 32 states where such action was legal. (from The UC Santa Barbara Current)

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"There is today one state," wrote Hitler, "in which at least weak beginnings toward a better conception [of citizenship] are noticeable. Of course, it is not our model German Republic, but the United States." (from The L.A. Times)

Researcher Alex Stern, author of the new bookEugenic Nation: Faults and Frontiers of Better Breeding in America, adds:

"In the early 20th century across the country, medical superintendents, legislators, and social reformers affiliated with an emerging eugenics movement joined forces to put sterilization laws on the books. Such legislation was motivated by crude theories of human heredity that posited the wholesale inheritance of traits associated with a panoply of feared conditions such as criminality, feeblemindedness, and sexual deviance. Many sterilization advocates viewed reproductive surgery as a necessary public health intervention that would protect society from deleterious genes and the social and economic costs of managing 'degenerate stock'."

Eugenicswas a commonly accepted means of protecting society from the offspring (and therefore equally suspect) of those individuals deemed inferior or dangerous – the poor, the disabled, the mentally ill, criminals, and people of color.

Eugenical Sterilization Map of the United States, 1935
Eugenical Sterilization Map of the United States, 1935

More recently, California prisons are said to have authorized sterilizations of nearly 150 female inmates between 2006 and 2010 . This article from the Center for Investigative reporting reveals how the state paid doctors $147,460 to perform tubal ligations that former inmates say were done under coercion.

But California is far from being the only state with such troubled practices. For a disturbing history lesson, check out this comprehensive database for your state's eugenics history. You can find out more information on state-by-state sterilization policies, the number of victims, institutions where sterilizations were performed, and leading opponents and proponents .

While California's eugenics programs were driven in part by anti-Asian and anti-Mexican prejudice, Southern states also employed sterilization as a means of controlling African American populations. "Mississippi appendectomies" was another name for unnecessary hysterectomies performed at teaching hospitals in the South on women of color as practice for medical students. This NBC news article discusses North Carolina's eugenics program, including stories from victims of forced sterilization like Elaine Riddick . A third of the sterilizations were done on girls under 18, even as young as 9. The state also targeted individuals seen as "delinquent" or "unwholesome."

For a closer look, see Belle Bogg's "For the Public Good ," withoriginal video by Olympia Stone that features Willis Lynch, who was sterilized at the age of 14 while living in a North Carolina juvenile detention facility.

Gregory W. Rutecki, MD writes about the forced sterilization of Native Americans , which persisted into the 1970s and 1980s, with examples of young women receiving tubal ligations when they were getting appendectomies. It's estimated that as many as 25-50 percent of Native American women were sterilized between 1970 and 1976.  Forced sterilization programs are also a part of history in Puerto Rico, where sterilization rates are said to be the highest in the world .

Landmark Cases

The film No Más Bebés follows the story of Mexican American women who were sterilized under duress while giving birth at Los Angeles County-USC Medical Center in the 1960s and 1970s. Madrigal v. Quilligan , the case portrayed in the film, is one of several landmark cases that's affected the reproductive rights of underserved populations, for better or for worse.

Here are some other important cases:

Buck v. Bell : In 1927, Carrie Buck, a poor white woman, was the first person to be sterilized in Virginia under a new law. Carrie's mother had been involuntarily institutionalized for being "feebleminded" and "promiscuous." Carrie was assumed to have inherited these traits, and was sterilized after giving birth. This Supreme Court case led to the sterilization of 65,000 Americans with mental illness or developmental disabilities from the 1920s to the '70s. (Justice Oliver Wendell Holmes wrote in reference to Carrie: "Three generations of imbeciles are enough.") The court ruling still stands today . [Note: This story was also the subject of a 1994 made-for-TV movie starring Marlee Matlin.]

Excerpt from the documentary Fixed to Fail: Buck vs. Bell:

Relf v. Weinberger : Mary Alice and Minnie Relf, poor African American sisters from Alabama, were sterilized at the ages of 14 and 12. Their mother, who was illiterate, had signed an "X" on a piece of paper she believed gave permission for her daughters, who were both mentally disabled, to receive birth control shots. In 1974, the Southern Poverty Law Center filed a lawsuit on behalf of the Relf sisters, revealing that 100,000 to 150,000 poor people were being sterilized each year under federally-funded programs.

Eugenics Compensation Act : In December 2015, the US Senate voted unanimously to help surviving victims of forced sterilization . North Carolina has paid $35,000 to 220 surviving victims of its eugenics program. Virginia agreed to give surviving victims $25,000 each.

Reproductive Justice Today

Anti-sterilization abuse protest, photo by Alva Nelms
Anti-sterilization abuse protest; photo by Alva Nelms

While the case in No Más Bebés occurred forty years ago, issues of reproductive justice are still relevant today, as state laws continue to restrict access to abortion and birth control. Deborah Reid of the National Health Law program writes :

"T he concept of reproductive justice , which is firmly rooted in a human rights framework that supports the ability of all women to make and direct their own reproductive decisions. These decisions could include obtaining contraception, abortion, sterilization, and/or maternity care. Accompanying that right is the obligation of the government and larger society to create laws, policies, and systems conducive to supporting those decisions."

For organizations such as the National Latina Institute for Reproductive Health , reproductive justice involves not only access to affordable birth control, abortion, and health care, but also providing access to women who are being held in immigration detention centers .

It's work that connects the dots between power inequities and bodily self-determination – something the eugenics movement sought to limit. As No Más Bebés  director Renee Tajima-Peña says in an interview with Colorlines : "The reproductive justice framework is to make sure that people listen to the needs and the voices of poor women, women of color and immigrant women who've been marginalized."

From a Kansas Senator's 1923 pro-Eugenics op-ed
Popular Science magazine, 1923.

2022 Update:

Read this comprehensive new article by Natalie Lira for PBS's American Experience and The Latino Experience : "Latinos and the Consequences of Eugenics."

2020 Updates:

The documentary Belly of the Beast tackles a more recent, equally shocking story of forced sterilizations — in this case in women's prisons. As the women who investigate these cases discover, despite it being nearly forty years after being banned— forced sterilization continued for decades in women's prisons, shielded by prison officials and doctors inside the correctional system. And may even still be happening. Read the interview with Belly of the Beast filmmaker Erika Cohn to learn more.

And as Cohn references in that interview, 2020 saw the revelation that there were forced sterilizations performed in an ICE detention center in Georgia. Learn more in this NPR piece, "ICE, A Whistleblower and Forced Sterilization."


For Further Reading:
Eugenic Nation: Faults and Frontiers of Better Breeding in Modern America, by Alex Stern
States of Delinquency: Race and Science in the Making of California's Juvenile Justice System, by Miroslava Chavez-Garcia
Fit to Be Citizens: Public Health and Race in Los Angeles, 1879-1939, by Natalia Molina

Lisa Ko is a New York City-based writer and editor. Her writing has appeared in The Los Angeles Review of Books, Apogee Journal, Narrative, Hyphen, and many other publications.