Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present by Harriet Washington describes the life of Fannie Lou Hamer, a Black woman living on a plantation in 1961 trying to help get rid of her family’s debt. One day she entered a Mississippi hospital to have–what was most likely–a benign uterine fibroid tumor removed but left the hospital sterilized. She had not been informed of the procedure, but through a train of gossip had eventually found out that she had been sterilized against her will under the guise of a different procedure.

This practice was incredibly common and came to be known as a “Mississippi appendectomy,” signaling the pattern of mostly Black women going to the hospital for an innocuous procedure who were then sterilized without consent. Many of them were never told this was done. Many had only found out after the fact similar to Fannie Lou Hamer, through trails of gossip throughout the community.

However, it was also frequently the case that those being sterilized were aware it was happening though had not consented. In the 20th century, and especially in the 1930s, forced and coerced sterilization of Black women was a rapidly spreading phenomenon. There were many cases of the government along with physicians pressuring Black women to get long term or permanent birth control, oftentimes with remuneration.

Biological determinism is the theory that the biology of a person or group (racial, ethnic, etc) determines their social behaviors and traits. While this theory has now been scientifically discredited, it propelled the eugenics movement forward. Eugenics is the study of how to manipulate reproduction to produce inheritable traits that are seen as desirable by the social and moral values of the time. More concretely, eugenics aims to reproduce “desirable” traits and remove “undesirable” ones from the population. This practice demonizes people who are seen as undesirable by dominant society, specifically BIPOC communities, poor and disenfranchised people, those who are physically and/or developmentally disabled, immigrants, mentally ill people, and more. Eugenics is an effort to suppress and eventually remove marginalized people from our world. The forced and coerced sterilization of Black women is one of many examples of the rising popularity of eugenics in the 1930s.

There were, of course, alternative methods to limiting the reproduction of those deemed undesirable, such as restricting or prohibiting the marriage rights of certain individuals, and institutionalization as a method of isolating people and keeping them from reproducing. However, forced and coerced sterilization was especially widespread during the rise of eugenics, and has continued to be pervasive in the United States even while other methods of limiting reproduction were dismissed (such as legalizing marriage for queer people, as one example).

There were several notable court cases that allowed for the pervasiveness of forced sterilization in the U.S., such as Buck v. Bell (1927), in which the Supreme Court ruled 8-1 that states had the right to forcibly sterilize people who were deemed unfit to reproduce, or people who were considered “feebleminded.” While this term refers to people of lowered intelligence and perpetuates the idea that unintelligent people were supposedly taking over society, “feebleminded” itself is a very malleable term that allows for the categorization of anyone deemed “undesirable” to be seen as unfit to reproduce, including disabled and sick people, minorities, poor people, and women who were seen as “promiscuous.”

Additionally, the Family Planning Services and Population Research Act of 1970 was a major legislative turning point. The act serves a federal grant program that assists with comprehensive family planning services to low income and uninsured families; however, it also subsidized sterilizations for people who received healthcare through the Indian Health Service and Medicaid, meaning Black, Indigenous, and Latina women were specifically targeted by forced and coerced sterilization. Six years after the act was passed, physicians had sterilized over 25% of Indigenous women of childbearing age. This was extremely devastating for Indigenous communities and is one example of a long history of the state’s efforts to control the reproduction of Indigenous people. In the 19th century, as Indigenous people were forced onto reservations by the United States government, there was increased illness and death since the U.S. government did not provide basic and substantial healthcare; as a result, the reservations had incredibly poor health conditions. Indigenous women rebelled against their situation by having more children even with their compromised health at unprecedentedly high rates. The government constructed rudimentary hospitals in which Native women could give birth. However, many forced sterilizations were also performed in these hospitals and other facilities outside of reservations that were contracted  to treat tribal members.

This history has continued over time. In the 1970s the Los Angeles County-USC Medical Center forcibly sterilized Latina women who came into the hospital for emergency C-sections. They were thrown consent papers that they were told authorized the doctor to give them pain medication, but in reality the consent forms were to perform tubal ligations. Most of the women didn’t know what they were reading or did not  have time to read the document properly because of their emergent situation. Additionally, the consent forms were in English and many of the women did not know what they were reading due to a language barrier. Many of them were urged by medical staff speaking Spanish to sign the consent form in order to ensure the health of their baby.

More recently, in 2020 and 2021, allegations surfaced against ICE detention centers. It was shared that ICE performed forced sterilizations on the people being detained. ICE maintained that people should be wary of the allegations; however, the pervasiveness of allegations span over years. Many of the people who spoke up about their forced sterilizations faced retaliation within the detention centers–many of whom faced a punishment of deportation.

Today, 31 states in the U.S. and Washington D.C. allow forced sterilizations. Forced sterilization, while a part of our past, is still heavily entangled in our present. And, it has great potential for damage in our future. Dobbs showed us the gross neglect of legislators to protect people’s bodily autonomy. It paved the way for future implementation of legislation that targets the reproductive rights of marginalized people. Looking at the effects of forced sterilization in the past and its eugenic motivations, it is a danger to the wellbeing of marginalized communities and their ability to thrive. Reproductive justice must include the right to have a child and further the right to sustain, maintain, and nourish the futures of marginalized peoples through procreation.

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