September 14, 2020 — Project South, a social justice advocacy organization based in Atlanta, reported allegations that Dr. Mahendra Amin, an obstetrician-gynecologist, performed involuntary hysterectomies on several immigrant women detained in an Immigration and Customs Enforcement (ICE) detention facility in Irwin County, Georgia.
In the complaint, many women wrote that Amin did not properly inform them about the procedure and most women did not fully understand why they received a hysterectomy.
Dawn Wooten, the whistleblower nurse who originally filed the complaint to Project South, said that the call nurse tried to communicate with the detained immigrants by using Google or asking another detained immigrant to help interpret instead of using a medical interpreter, breaking medical protocol.
When the patients’ medical files were reviewed by other gynecologists, they found that Amin listed symptoms, such as heavy bleeding with clots and chronic pelvic pain, to justify surgery. However, the patients said that they never experienced or reported these symptoms.
In addition, Dr. Deborah Ottenheimer, a New York City- based obstetrician-gynecologist who reviewed the files, said that Amin was overly aggressive in his treatment. She said that he surgically intervened before fully exploring medical management methods, leading to unnecessary and permanent hysterectomies.
“When I met all these women who had had surgeries, I thought this was like an experimental concentration camp. It was like they’re experimenting with our bodies.” said a female detainee in the official complaint.
According to Natalia Molina, American historian and professor of American Studies and Ethnicity at the University of Southern California, if these allegations are true, this is only the latest of the United States’ long-standing history of forced sterilization practices, disproportionately affecting immigrants, people of color, people with mental and physical disabilities and incarcerated individuals.
These sterilization practices began in 1907 with the Indiana Eugenics Law, widely considered the world’s first eugenics sterilization legislation. This law sanctioned the sterilization of individuals living in institutions who were viewed as unfit to reproduce. Since then, over 60,000 involuntary sterilization procedures have occurred in the United States alone until most of the practices ended when these laws were repealed and deemed unconstitutional in the 1970s.
Forced sterilization, also referred to as coerced sterilization, is the process of permanently removing someone’s ability to reproduce without complete or informed consent. A commonly cited theme regarding forced sterilizations is eugenics, the idea of improving the human population by eliminating the offspring of those individuals considered “inferior.”
Sterilization of Inmates
The government rationalized compulsory sterilization practices as measures for “the protection of the public health” and “the health security of the citizens of every state.” Specifically, the government wrote that the marriage of “handicapped citizens” would be unwise or disastrous without sterilization.
In Buck v. Bell, the Supreme Court allowed states to sterilize inmates of public institutions diagnosed with “hereditary traits” such as feeblemindedness, epilepsy and “imbecility,” which was clinically used to classify someone with the mental development of a 7-year-old child.
In the majority opinion of this case, Justice Oliver Wendell Holmes said, “It is better for the world, if instead of waiting to execute degenerate offspring for crime, or to let them starve for their imbecility, society can prevent those who are manifestly unfit from continuing their kind.”
This landmark case initiated the establishment of federally-funded sterilization programs in over 30 more states.
Sterilization of Hispanic People
In particular, California had the largest number of sterilizations with approximately 20,000 operations performed on patients in state institutions between 1909 and 1979. A 1920s study conducted by Paul Popenoe, an American scientist who specialized in heredity and eugenics, found that immigrants were disproportionately targeted; they comprised 39% and 31% of sterilized men and women, respectively. The data also revealed that African Americans constituted 1% of California’s population but accounted for 4% of the sterilizations, and people of Hispanic descent constituted 4% of the state’s population but accounted for 7% to 8% of those sterilized.
Sterilization reports collected from 11 California state institutions between 1920 to 1945 show that Hispanic men were at 23% greater risk of sterilization than non-Hispanic men. Hispanic women were at a 59% greater risk of sterilization than non-Hispanic. According to the sterilization records of Sonoma State Home, an institution in Northern California, while the Latino population in the state was just under 6.5% according to the 1910 and 1930 census, Latino patients constituted nearly 20% of all sterilizations performed between 1937 and 1948.
Until the 1920s, there was a massive growth of Mexicans migrating to the United States to provide cheap labor. Often, restrictionist politicians used eugenic arguments to advocate for stricter immigration policies.
Molina wrote that the increased sterilization rates of Mexicans were also justified by eugenicist beliefs that Mexican immigrants would cause the spread of diseases and that the women were overly fertile and had large families which would deplete the state’s fiscal resources. Moreover, there was the belief that criminal behavior, immorality and poverty were hereditary traits prevalent among Latinos in California, especially working-class Mexican-origin women and men. The restrictionist notion that Mexican immigrants entering America for work was a threat to the economy also contributed to the rationale for sterilization.
Sterilization of African Americans
The “Mississippi Appendectomies,” a term coined by American Civil Rights activist Fannie Lou Hamer, refers to the widespread practice of involuntary sterilization of black women in the South between the 1920s and 1970s. In this time period, 7,600 coerced sterilization procedures occurred in North Carolina alone. 85% of these procedures were performed on women and 40% were performed on women of color.
“I was raped by a perpetrator [who was never charged] and then I was raped by the state of North Carolina … The state of North Carolina, they took something so dearly from me, something that was God given,” said Elaine Riddick, a black woman who underwent a coerced sterilization after giving birth to her son, Tony. “[The state] also justified that my child or children would be feebleminded. My son is the president of his own semiconductor company, he has his own construction company and he has his own real estate company.”
Riddick was raped and impregnated at the age of 13 and during her Cesarean delivery, her doctor performed a tubal ligation without consent, sterilizing Riddick. The hospital staff rationalized Riddick’s sterilization by reporting her as “feebleminded” and claiming that she was unable to control herself and her promiscuity.
Johanna Schoen, a professor of history at Rutgers University-New Brunswick, wrote that racial prejudices reinforced the perception of black women as poor, uneducated and having high fertility rates. Because black women were presumed to be promiscuous, they became victims of government-funded sterilizations. Additionally, the increased number of black welfare recipients between 1950 and 1961 made them a significant target for sterilization as a measure for the state to save financial resources.
Sterilization of Indigenous People
Another demographic affected by government funded sterilizations were Natives. A 1976 study by the Government Accounting Office found that the Indian Health Service (IHS) performed 3,406 unconsented sterilizations on Native women in four of twelve IHS areas (Albuquerque, Aberdeen, Oklahoma City and Phoenix) between 1973 and 1976. Of these, 3,001 involved women of childbearing age (between 15 and 44) and only 100,000 Native women of childbearing age remained. Senator James Abourezk, a past chairman of American Indian Policy Review Commission, commented that, given the small population of Natives, 3,406 Native sterilizations would be proportional to 452,000 non-Native women.
The investigation also revealed the coercive tactics healthcare professionals would use to gain “consent” from these women. These tactics included threats of withdrawing healthcare supplements or taking custody of their children. A study by Dr. Connie Pinkerton-Uri, a Chocktaw/Cherokee physician, found that at least one in four Native women had been sterilized without consent.
“There are about only 100,000 [Native] women of childbearing age left. A 200 million population could support voluntary sterilization and survive, but for Native Americans it cannot be a preferred method of birth control. Where other minorities might have a gene pool in Africa or Asia, Native Americans do not. When we are gone, that’s it,” Pinkerton-Uri said.
A 1977 report released by the United Nations in conjunction with the Native American Solidarity Committee concluded that 24% of Native women had been sterilized and that 19% of the women were of child-bearing age.
“[The IHS] operated under historical assumptions that native people and people of color were morally mentally and socially defective,” wrote Erin Blakemore, a journalist for Smithsonian, The Washington Post and TIME.
In fact, some IHS doctors doubted the intelligence of Natives and other minority women by claiming that they could not use birth control effectively. They said there was already an excess of minority individuals depleting the nation’s resources.
William Deverell, a professor of History and Spatial Sciences at University of Southern California, said, “If you are sterilizing someone, you are saying, if not to them directly, ‘Your possible progeny are inassimilable, and we choose not to deal with that.’”