Earlier this September, a licensed nurse at a Georgia detention facility filed a whistleblower complaint revealing that a contracted doctor had been performing a high rate of hysterectomies on migrant women without their consent. As justifiable outrage ensued, there were many comparisons between these forced sterilizations in ICE facilities to the eugenics programs of Nazi Germany. While these comparisons are certainly accurate, they ignore the fact that forced sterilizations are a tactic of genocide that cannot only be attributed to fascist regimes. Furthermore, these comparisons specifically overlook the fact that forced sterilization already has a historical foundation within the United States as it has been used as a means of controlling certain “undesirable” segments of the population from reproducing. The proliferation of eugenics programs in the United States throughout the 20th century was a violent reinforcement of the power of white, able-bodied men on both the domestic and international level. The hysterectomies that were forced upon migrant women were not an aberration or a horrific, singular example of a lack of accountability: they are a specific tool that the United States government has repeatedly employed to control various populations and strengthen a status quo that favors the white patriarchy above all else.
Eugenics Programs: An American Tradition
In the early 20th century, proponents of eugenics, which is defined as the belief of ‘improving’ society by preventing certain groups of people who have been deemed inferior from reproducing, saw two threats to the gene pool: external threats, which were neutralized through immigration laws, and internal threats, which were eventually addressed through sterilization. Eugenics was seen as an appropriate response to the alleged issue of protecting society from those deemed inferior, which was often racialized. The parallels between early 20th century and 21st century immigration laws are already apparent- the government utilizes white supremacy and eugenics logic to legitimate their treatment of immigrants from the Global South. The hysterectomies performed on unwilling migrant women are just another example of the government attempting to exert control over certain populations and protect the white gene pool.
Nevertheless, there was some initial debate as to what solution should be employed to eliminate the public health threat of“criminality, feeblemindedness, and sexual deviance.” The first eugenics law was passed in Connecticut in 1895, which prohibited certain types of marriage; however, they quickly realized that “undesirable” people would simply reproduce despite not having a marriage certificate. While segregation was seen as the next step towards achieving societal purity, this specific solution, which involved institutionalizing women through their reproductive years, was too expensive to properly implement. The forced sterilization of certain segments of the population was the final, and most effective, solution, due to the fact that it was relatively inexpensive to perform a one-time procedure and then release the individual back into society without the means for reproducing.
Throughout the 20th century, 32 states had federally funded sterilization programs as a means of social control. These eugenics programs were constitutionally upheld through the 1927 Supreme Court case, Buck v Bell, which solidified the Racial Integrity Act of 1924 which allowed institutionalized people in Virginia to be sterilized in order to protect the “health of the patient and the welfare of society.” The decision led to 70,000 people being formally sterilized in the United States. Sterilization was often done on the grounds of mental illness, but physical disability, economic status, and race were also significant factors. By itself, California accounted for approximately one-third of forced sterilizations in the county as the state performed approximately 20,000 sterilizations; the Asexualization Act of 1909 legitimized the procedure of eugenic sterilization on unwilling participants who were diagnosed with being “mentally ill” and “deficient.”
It should be noted that the eugenics programs that were implemented across the country during the 20th century inspired the Nazi’s forced sterilization programs in the Holocaust; Adolf Hitler viewed states such as California as a starting point for implementing “a better conception of citizenship.” While the concepts of eugenics and forced sterilization evoke imagery of fascist regimes, it is once again important to remember that they are also tools that the American government implemented to ‘protect’ white, able-bodied society from the perceived threat of certain groups. The comparisons that have been drawn between the practices of ICE and Nazi Germany are accurate, however it is more accurate to recognize that sterilizing female detainees without their consent is not an outlier, but a continuation of American policy.
The Reinforcement of White Supremacy and Patriarchy
Though mental health played a large part in justifying these procedures, these eugenics programs were explicitly racialized. For example, the sterilizations in California were driven by anti-Asian and anti-Mexican sentiments; Black and Mexican people were more affected than is suggested in official data. In particular, thousands of Mexican women who had immigrated to the United States had been sterilized between the 1920s and 1950s as they were deemed to be an “undesirable type.” In the latter half of the decade, Mexican women were tricked into being sterilized under the guise of receiving medical care or having their babies delivered. These women who were admitted to the Los Angeles County-USC Medical Center were confronted with a choice: in order to receive care, whether it be painkillers or an operation, they had to sign a slip of paper. Unbeknownst to these women, who were often in too much medical distress to comprehend what was going on and/or did not understand English, they were signing a consent form for sterilization.
The Southern United States, however, did not pretend that sterilization programs were for any other purpose beyond controlling their Black populations. In the example of the South, every solution to protecting ‘society,’ was implemented: this included Jim Crow laws prohibiting interracial marriage, physical segregation of the races, and the forced sterilizations of Black women. “Mississippi appendectomies” was a name given to the hysterectomies performed in the South on Black women as practice for medical students; North Carolina was known to practice on girls as young as nine years old. Furthermore, as the South began to desegregate, sterilization rates for Black women increased.
Even after these eugenics programs came to an end, forced sterilization was performed on Indigenous women in the 1970s and 80s; an estimated 25 to 50 percent of indigenous women were sterilized between 1970 and 1976 through the Indian Health Service (IHS). When the Government Accounting Office released the results of an investigation into these events, they found that they occurred at one-third of all IHS facilities. Additionally, the number of Indigenous women who were sterilized is the proportional equivalent of sterilizing 452,000 non-Native women; however, the number of sterilizations is most likely even higher as the IHS at the Albuquerque site contracted non-IHS doctors to perform these procedures and inaccurately added zero procedures to the official count. These statistics are especially jarring when taking into consideration the fact that the United States government has repeatedly tried to eradicate the Indigenous population, whether it be through the Trail of Tears, attacks on ancestral homelands, or the massacre at Wounded Knee; the forced sterilization of Native women is another example of a genocidal tactic.
The United States also used sterilization on populations within their colonized territories. Between the 1930s and 1970s, nearly one-third of women in Puerto Rico were sterilized as a result of a eugenics campaign. Since its invasion of Puerto Rico in 1898, the United States has maintained control over the island’s economic development. Until 1952, the Governor of Puerto Rico was appointed by the President and veto power over a local House of Representatives; government entities, including the civil services, social programs, and armed forces, were all under US supervision.
During this time, as population control research was being carried out, it was believed that the root of economic problems in underdeveloped countries was overpopulation. Subsequently, it was proposed that if the growth could be controlled, the standard of living would improve. Within the context of economic development, Puerto Rico had a high unemployment rate that remained consistent throughout the 20th century; in order to address this issue, it was believed that they had to “reduce the growth of the working sector.” This included forced migration of Puerto Rican workers and the mass sterilization of working-class women. As a result, there was a federally-funded sterilization campaign where medical professionals were told that if a woman came in to give birth and already had two or more children, she must have her tubes tied; most sterilizations were done postpartum. Puerto Rico had the highest sterilization rate in the world.
It has been made clear that forced sterilizations disproportionately affected people of color and Indigenous people. This was done in an attempt to ‘protect’ American society which has largely been conceived to be white, able-bodied, and male. It cannot be forgotten that while forced sterilizations were performed on men, they disproportionately affected women. There is a clear intersection between white supremacy and the patriarchy that is evident in both the historical examples given and in the ICE detention facilities. It has largely been women of color who have been deemed ‘undesirable’ and have subsequently had their reproductive rights forcibly taken from them. Considering that forced sterilization is often recognized as a tactic of genocide, it is important to remember that institutionalized violence has played a defining role in the government’s treatment of marginalized peoples.
A Step Towards Reproductive Justice
In light of the knowledge that forced sterilization has been a continuous policy that has inflicted violence upon women of color, in both a domestic and international context, it is necessary to consider what steps need to be taken in order to begin righting the wrongs that have been committed. It is obvious that forced sterilizations need to be stopped in their entirety, but we must go further: any proposed solution must be rooted in reproductive justice. This term was coined by Black women and essentially advocates for the “freedom to reproduce on your own terms and to be provided with the support and access to do so.” The ability to control their reproductive lives is something that must be restored to women of color, Indigenous women, and immigrants from the Global South- this necessitates a solution that ensures that those who have been formally denied access to governing their own body are given full control. This goes beyond simply ending forced sterilization: it also requires full access to fair and equitable reproductive health care and education, access to affordable childcare, and more. The migrant women who were forcibly sterilized are not the first women to go through this, but we should make them the last.