The Tumultuous Legal Journey of Forced Sterilization in the United States

Around the middle of September in 2020, a whistleblower exposed suspicions of unconsented sterilization of migrant women under ICE’s authority. The news garnered popularity amongst social media platforms and prominent political figures like House Speaker Nancy Pelosi. A report from NBC News, written by Danielle Campoamor, stated that while nurse Dawn Wooten was working in the ICE detention center’s medical department, she had several detained women question the hysterectomies performed on them. She could not answer with any valid reason.

A hysterectomy is a surgical operation to remove all or part of the uterus, which often renders the person unable to have menstrual periods and become pregnant, according to the Office on Women’s Health directory under the U.S. Department of Health and Human Services website. While this brought out an alarming reaction to the ears it reached (both nationally and internationally), when looking at the history of forced sterilization and practice of eugenics, it makes sense that these practices are not only legal but encouraged in our nation’s history.

Eugenics is the practice of improving the human species by selectively mating people with specific desirable hereditary traits–that are often based on discrimination. It aims to reduce human suffering by breeding out disease and undesirable characteristics from the human population ( The practice of eugenics is primarily used to exterminate the ‘inferior,’ which is usually racially based. Although the most prominent example of this atrocity is the Nazis during WWII, the United States is not precisely guilt-free. In the nation’s history, women of color over time repeatedly have been victimized by doctors who have performed forced sterilization procedures on them without their consent or have been forced to undergo these procedures.

After decades of senseless killings of Indigenous Peoples, officials signed treaties, and by the 1870s, federal responsibility for the provision of health care was established. However, due to the rise of the poor health conditions on reservations, eventually, the government could no longer dismiss these concerns and allowed for rudimentary hospitals to be built. These hospitals would soon become the most encouraging place for an Indigenous woman to give birth. By the 1950s, the women were most likely to give birth in a hospital, whether government-mandated or not. The Family Planning Services and Population Research Act of 1970 allowed the subsidized sterilizations for patients who received their health care through the Indian Health Service and black and Latina Medicaid patients. According to a Time’s article by Brianna Theobald, this specific law made these women targets of coercive sterilization. Evidence shows that more than 25 percent of Indigenous women of childbearing age were sterilized under pressure, unconscious, or without the women’s knowledge.

It is undeniable: forced sterilization is a modern-day genocide. Unfortunately, physicians and politicians who believe in eugenics have always played slick in allowing this to be legal. They are still allowing it to happen, as evidenced by the accounts of multiple detained migrant women in confinement, reported by the nurse. Often, the practice of eugenics in this nation have come after the poor, the mentally ill, the disabled, women of color, and prisoners. Due to the lack of laws set in protection for women from the start, fundamental women’s rights are decided by landmark Supreme Court cases. These cases often expose the woman’s experience or push to set a precedent in ensuring any similar incident does not happen again under the law. However, the journey to attain these protections is usually a stumble, as with every other right gained for marginalized groups in America.

In 1927, Carrie Buck, a poor White woman in Virginia, was committed to a state mental institution due to her “feeble mental state.” Since her condition has been present in the family for the past three generations, a law allowed for the inmates’ sterilization, which was justified as it promoted welfare to charity and a safer patient. However, before the procedure was performed, a hearing was required to determine whether the operation was the best decision. The Court actually ruled that Buck was not denied the right to due process of the law and the equal protection of the laws as protected by the Fourteenth Amendment by the statute in Buck v. Bell as her condition justified this protection to be withheld from her. It was even stated by Justice Holmes that the nation was “being swamped with incompetence ,” and that “Three generations of imbeciles are enough,” in reference to Buck’s case. The state law was enough to decide for her, and for the next 50 years, 65,000 Americans with mental illness or developmental disabilities were sterilized without permission with this ruling.

Carrie Buck and mother, Emma Buck

In 1942, Skinner, who had been convicted for the third time, was ordered to be sterilized as the Oklahoma Criminal Sterilization Act of 1935 allowed for the sterilization of a person who had been convicted three or more times of crimes “amounting to felonies involving moral turpitude.” The Fourteenth Amendment brought up a court case regarding sterilization with one difference: this time, the defendant was a man.  In Skinner V. Oklahoma, the Court unanimously ruled that the state Act violated the Equal Protection Clause of the Fourteenth Amendment and reasoned that Skinner’s crimes — embezzlement —  were to be excluded due to their lack of severity in wrongness. It is also crucial to note that the Court set a precedent that compulsory sterilization laws should be subject to strict scrutiny due to their “social and biological implications of reproduction and the irreversibility of sterilization operations.” The conclusion to be drawn here is that when it was a woman, it did not seem to matter that she would also have complications after the procedure. Still, forced sterilization was ruled to be illegal for the first time. 

Mary Alice and Minnie Lee Relf

In 1973, Minnie Lee and Mary Alice Relf were sterilized without their consent at ages 14 and 12, as their illiterate mother had signed an “X” on what she believed to be the birth control shots for them.  The children sued a Family Planning Clinic in Montgomery, Alabama, and their case exposed federally-backed programs that sterilized up to 150,000 other women just like them. Most of these women were used as guinea pigs for Depo-Provera injections- about twenty years before the Food and Drug Administration approved the birth control, this was a common scenario. Doctors often administered female children uncleared drugs without their consent that would end up sterilizing them. The ruling for Relf V. Weinberger eventually led to the requirement of informed consent–no coercing, misleading, or threatening–before these. Federal funding for involuntary sterilization came to a slow halt.

Another case in the 1970s that changed the perception of coerced sterilization to be also defined as forced sterilization was Madrigal V. Quilligan. After evidence of sterilization abuse at a Medical Center was leaked, a group of women filed a lawsuit alleging that the personnel systematically coerced Mexican American women into submitting to sterilization. These women had undergone a tubal ligation after childbirth by cesarean section. The hospital staff repeatedly asked the women for consent to sterilization mid labor and often heavily medicated. Since their primary language was Spanish, the women were eventually forced into signing English language consent forms that they could not understand under the pretense that they were offered painkillers for their labor. The court case came to a close in 1978, where Judge Cutis ruled that the women’s accusations were false. In the end, the incidents were viewed as a misunderstanding and stated that the doctors had no intention to hurt these women deliberately. The case made one thing clear: eugenics’ practice was very much prevalent and had a high risk of being ignored by the government.

On October 7, 2016, President Obama signed The Treatment of Certain Payments in Eugenics Compensation Act into law after the first proposed legislation the previous year. The law would protect any living victims of eugenics by ensuring they receive compensation payments by excluding said payments from determining eligibility for any sort of federal safety net programs like Medicaid. However, since every case might not reach its justified ruling, as seen in Madrigal v. Quilligan, this law’s extent may still exclude many citizens. The detained migrant women that were unconsensually sterilized under ICE authority are not protected as they are not citizens. As seen in the Madrigal case, the Irwin County Detention Center in Georgia’s allegations raises the concern that the personnel were targeting the vulnerable women with forced sterilization based on their race, economic status, and immigration status. With the history that the United States has in violating women’s rights, it is disappointing and enraging (but not shocking) to see the same applied discrimination against migrant refugees, aiming to strip away yet another trait of human dignity.

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