Eugenics Biased Sterilization Cases in the United States

Eugenics biased sterilization in the United States refers to the practice of forcibly or coercively sterilizing individuals—primarily women—based on their perceived race, ethnicity, or social status in ways that affirm eugenics principles based on white supremacy, class hierarchy and ableism.^[1] Throughout the 20th century, state-sanctioned sterilization policies disproportionately targeted women of color, including Black, Latinx, and Indigenous populations, under the guise of eugenics and public health. These practices, often justified by discriminatory beliefs about reproductive fitness, have been recognized as violations of human rights and bodily autonomy. The legacy of these policies continues to impact marginalized communities and shapes ongoing discussions about reproductive justice and state accountability.^[2][1][3]

Early 20th-century eugenics movements in the United States promoted the idea of improving society by preventing those deemed "unfit" from reproducing.^[2] State laws enabled forced sterilization, often without informed consent, targeting marginalized groups based on pseudoscientific and discriminatory beliefs.^[2] The Human Betterment Foundation, among others, actively promoted these policies, framing them as medically and socially beneficial while ignoring their racial and ethical implications.

Coercive sterilization refers to the practice of performing sterilization procedures on individuals without their full, informed, and voluntary consent. This practice has been widely condemned as a violation of human rights and bodily autonomy, and it disproportionately affects marginalized populations. Coercive sterilization is internationally recognized as a serious violation of human rights and medical ethics. It infringes upon bodily integrity and has been classified in some instances as a form of torture or cruel, inhuman, and degrading treatment under international human rights law.^[3][4][5]

A core feature of coercive sterilization is the absence of informed consent. Procedures are often carried out without the individual's knowledge, understanding, or voluntary agreement. In some cases, consent is obtained under false pretenses, through misinformation or intimidation, or while the individual is under duress or even anesthesia, rendering the consent neither informed nor voluntary.^[1][5]

Coercive sterilization may involve explicit or implicit threats and incentives. Individuals have reported being threatened with the loss of welfare benefits, denial of medical care, or employment opportunities if they refuse sterilization. Conversely, some are offered incentives such as financial compensation or improved access to healthcare in exchange for agreeing to the procedure.^[1]

This practice disproportionately impacts marginalized communities. Women of color, women living with HIV, Indigenous women, women with disabilities, and those living in poverty are particularly vulnerable to coercive sterilization. The systemic nature of this issue reflects broader patterns of inequality and discrimination based on race, ethnicity, health status, and socioeconomic position.^[6][4][7]

Coercive sterilization is often supported or facilitated by institutional structures, including governmental policies, medical institutions, and social welfare systems. These practices are embedded in and perpetuate systemic discrimination, particularly along lines of race, disability, and economic status.^[7][8][9][2]

In many cases, sterilizations are performed without providing individuals a meaningful opportunity to reconsider. Procedures may be carried out hastily, sometimes immediately before or after childbirth, or without the individual’s knowledge—only discovered after the fact. This deprives individuals of adequate time to understand the long-term implications of sterilization and to make an autonomous decision.^[2]

California Eugenics Program (1909 - 1979)^[10] California implemented one of the most extensive sterilization programs in the country, sterilizing over 20,000 individuals, with women of color disproportionately affected. The program was justified through eugenic ideologies that labeled certain populations as "unfit" to reproduce. The Human Betterment Foundation’s 1937 pamphlet promoted eugenic sterilization in California as a protective measure endorsed by medical and social professionals, reporting that over 11,000 individuals deemed "unfit" to reproduce had been sterilized by that year.

Madrigal v. Quilligan (1978) This landmark federal lawsuit was brought by ten Mexican-American women who were sterilized without proper consent at Los Angeles County-USC Medical Center. The case exposed systemic abuses in obtaining informed consent and highlighted the intersection of race, language barriers, and reproductive rights.^[11] Despite the plaintiffs not receiving damages, Madrigal v. Quilligan led to significant reforms in California’s sterilization policies-such as strengthened informed consent procedures and mandatory waiting periods.^[11]

Sterilization of Women in Puerto Rico (1937 - 1974) Puerto Rico saw widespread sterilization of women, often promoted as birth control, with up to one-third of women sterilized by the 1970s.^[7] This is part of a larger campaign aimed at the sterilization of Latinas. Latinx resource guide provides a comprehensive overview of significant civil rights cases and events affecting Latinx communities in the United States during the 20th and 21st centuries.^[12] Ana Maria Garcia’s documentary La Operación (1982) investigates these practices and their social consequences.^[13]

Sterilization of Black Women in the South. Throughout the 20th century, Black women in Southern states were frequently subjected to involuntary sterilization, often under threat of losing welfare benefits or as a condition of medical care. This practice became known as the "Mississippi Appendectomy," a term coined by civil rights activist Fannie Lou Hamer to describe the routine sterilization of Black women without their knowledge or consent.

Sterilization of Native American Women^[8] Native American women were targeted for sterilization, particularly in the 1960s and 1970s, through Indian Health Service facilities and state hospitals. Many were sterilized without adequate information or consent, reflecting broader patterns of systemic discrimination.^[14][8] 1970s reports indicate that the Indian Health Service sterilized an estimated 25 percent of Native American women aged 15 to 44, often without adequate information or consent.^[15]

Sterilization of Women and Girls with Disabilities^[9] Women and girls with disabilities, particularly those from marginalized racial and ethnic backgrounds, have been subjected to coerced sterilization based on assumptions about their capacity for parenthood. Reports highlight ongoing human rights concerns and the need for stronger legal protections. The 2011 Human Rights Watch report documents the widespread forced and coerced sterilization of women and girls with disabilities, describing it as a violation of reproductive rights, bodily autonomy, and international human rights standards.^[9] This stated violation is part of the Convention on the Rights of Persons with Disabilities.

The 1942 Supreme Court decision in Skinner v. Oklahoma acknowledged the dangers of state power to sterilize, warning of its potential for abuse against marginalized groups.^[8]

International human rights frameworks, such as those discussed in the CEDAW Committee’s review of A.S. v. Hungary, emphasize state obligations to prevent involuntary sterilization and address intersectional discrimination.^[16]

• La Operación (1982)^[17] - Sterilization of Puerto Rican women^[13]
• No más bebés (2016) - Madrigal v. Quilligan and coerced sterilization of Mexican-American women.
• Belly of the Beast ^[18] - Contemporary cases of coerced sterilizations in California prisons.
• Wicked Silence: The North Carolina Forced Sterilization Program & Bioethics – Center for Bioethics, Health & Society.^[19][20] - Documentary Film - North Carolina's forced sterilization program

• Lawrence, Jane (2000). "The Indian Health Service and the Sterilization of Native American Women". The American Indian Quarterly. 24 (3): 400–419. doi:10.1353/aiq.2000.0008. ISSN 1534-1828. PMID 17089462.
• "5. The Politics of Sterilization, 1937–1974", Reproducing Empire, University of California Press, pp. 142–161, 2019-12-31, doi:10.1525/9780520936317-007, ISBN 978-0-520-93631-7, retrieved 2025-04-24