Eugenics Behind Bars

This article was originally published at RH Reality Check. It has been reprinted with permission.

I was sterilized in 1976 when I was 23 years old. My paternalistic doctor visited me the day after la operación and assumed I would be relieved to not have the ​“burden” of using birth control or worrying about periods.

He was so wrong. I sued him, and the manufacturers of the Dalkon Shield that caused my sterilization. After winning a settlement that opened the door for thousands of women to initiate malpractice lawsuits against this defective intrauterine device (IUD), I naively thought we had seen the end of sterilization atrocities. After all, the first federal guidelines prohibiting sterilization abuse were also implemented in 1976. Not only should these guidelines have ended sterilization abuses, they should have ended the racist, sexist, and classist eugenical thinking my doctor shared that underlay such policies.

Unfortunately, that is not so, at least in California.

According to the prisoners’ rights advocacy group Justice Now, people in California women’s prisons have been illegally sterilized, nearly four decades after sterilization abuse guidelines were implemented at the state and the federal level. Justice Now’s investigations revealed that between 2006 and 2010 at least 116 people in two California prisons were sterilized as a form of birth control via tubal ligation during labor and delivery. At least a couple dozen more prisoners — predominantly Black, Latina, and indigent women and transgender people—reported being sterilized by hysterectomy and oophorectomy under highly questionable and abusive circumstances. Reports include patients being falsely diagnosed with cervical cancer and later finding out from medical records that the cancer never existed, undergoing sterilization surgery without their knowledge, being asked to sign consent forms while under sedation, being denied less-invasive, often more appropriate treatment options that would not take away their ability to have children, and being denied second medical opinions and proper follow-up care. Later research from the Center for Investigative Reporting found that nearly 250 prison tubal ligations occurred since 1997.

In 2005, U.S. District Judge Thelton Henderson mandated federal oversight over California’s prison healthcare system after documenting that one person dies each day in California prisons due to extreme medical malpractice or neglect. While people in prison, like all people, know what’s best for their body and are fully capable of making their own healthcare choices, obtaining fully informed, voluntary consent for the permanent termination of the fundamental human right to family cannot realistically occur in the neglectful, coercive, controlling context of prison healthcare. By law, people in California prisons are barred from access to all non-permanent forms of birth control, and do not have free choice of a healthcare provider. Authorities can and have threatened women with loss of healthcare access or access to their children in order to coercively impose sterilization measures, thereby enhancing their prison sentences with reproductive punishments. This is reproductive oppression meeting the prison industrial complex in which prisons, like sterilizations, are used to address perceived social problems.

Justice Now is working with people in prison to pass SB 1135, a ​“Sunshine” bill in California that will strengthen state bans on sterilizations done for the purpose of birth control. The bill also includes safeguards for medically necessary procedures, such as access to less-invasive remedies, consultation, a second medical opinion from a doctor not employed by the prison, and appropriate follow-up medical and mental healthcare. Federal law already prohibits any healthcare provider that receives federal grants or contracts from sterilizing imprisoned people for birth control reasons. The California Department of Corrections and Rehabilitation clearly breaks the law when it sterilizes imprisoned women, but has not been held accountable. The campaign by Justice Now is aimed at holding state-funded human rights violators accountable and protecting the human rights of imprisoned people so that they can retain the ability to make important choices about their body, family, and future free from the coercion, threats, and force endemic to the prison environment.

Forty years ago, while the women’s movement was celebrating the 1973 Roe v. Wade decision legalizing abortion, thousands of vulnerable women and men were surgically sterilized through state and federal eugenics programs begun in the 1920s. Supporters of the eugenics movement believed they could improve the human race through selective breeding, by encouraging white, middle- and upper-class Protestants to have more children, while imposing measures to keep all others from reproducing. People were targeted because of their race, mental and physical disabilities, class, ethnicity, immigration status, education level, religion, or age. Anyone whose freedom was impaired — those in prisons, jails, and mental health institutions — were especially vulnerable to this selective, state-sanctioned reproductive oppression. At the height of the eugenics movement, 32 states enforced compulsory sterilizations through both legal and extralegal means. The United States was the first country in the world to concertedly undertake compulsory sterilization programs. During the height of the eugenics movement, California sterilized more people than any other state by a wide margin, and was responsible for over a third of all sterilization operations in the United States, and inspiring Nazis during their genocidal reign of World War II.

Activists — particularly women of color — challenged the ideology and practices of the eugenics movement from the beginning, understanding the importance of reproductive self-determination. In 1973, Latin@, Native American, and African-American activists formed the Committee to End Sterilization Abuse (CESA), and worked to demand mandatory waiting periods, an end to coercive sterilization procedures during childbirth, informed consent in the languages needed, and effective unbiased counseling for women. In the mid-1970s, welfare recipients were twice as likely to be sterilized by state officials than anyone else. By the end of the 1970s, state health departments were challenged to change their guidelines for surgically sterilizing women and men, leading to a significant reduction in reported cases.

These reproductive abuses were so egregious and widespread that the state of North Carolina — that forcibly sterilized more than 7,600 people it deemed mentally or socially unfit — announced in 2013 that it would spend $10 million beginning in June 2015 to compensate men and women who were sterilized in the state’s eugenics program.

California state officials in charge of prisons seem not to recognize that taking away the right to have children is an immoral act of genocide. Since 1948, widespread or systematic forced sterilization has been recognized as a crime against humanity by human rights bodies around the world. This is an ugly history repeating itself.

Even now, new eugenical rationales are emerging for using coercion to thwart reproductive control by women. Sterilization proponents claim to be concerned by the environment, about ending poverty, limiting welfare costs, or about the threat of crime or terrorism. Frighteningly, some of our problematic feminist allies suggest that we do away with sterilization guidelines altogether because women who want voluntary sterilizations are being inconvenienced by these protective rules. Somehow, it’s not hard to imagine that the majority of these ​“inconvenienced” women are white, and middle- to upper-class. Not to mention the hordes of misogynist trolls who believe that even more people should be sterilized to fulfill whatever fantasy they have about who should be allowed to reproduce. This proves an alarming enduring historical continuity of prejudices — eugenicists never retreat; they just regroup.

After my sterilization, I felt empty, lost, and butchered. I was in shock and felt powerless.

In her testimony to the California state legislature organized by Justice Now, one woman survivor said, ​“I was treated like I was less than human.”

Whether imprisoned or not, we are not throwaway people without voice and without rights. Like her, I recovered my dignity and my power by fighting for my human rights in the women’s movement. We are fighting in California and anywhere else against those who believe they can destroy our bodies to solve their problems. We can name our violations and our violators, and we will hold them accountable.