Eugenics and Other Threats to the Reproductive Autonomy of Minority Women
This research aims to highlight from the literature an analysis of instances where the reproductive autonomy of minority women has been threatened through eugenic social theory, gynecological violence, and forced sterilizations. Eugenics as a social ideology violates human rights. Yet, practices in medical violence and public policy continue to allow for the events to transpire, with the most recent case being exposed in 2015. Research articles, books, journals, websites, and documentary-style films were cultivated as part of the literature review for this research, then cultivated to present relevant quotes and information regarding historical threats to reproductive autonomy in minority women. This research is present for advocacy to prevent these types of abuses from occurring in the future and for understanding the diverse issues faced by women of minorities in the United States and its territories.
Keywords: Reproductive Autonomy, Minority Women, Eugenics, Diversity Issues, Forced Sterilization
Eugenics and Other Threats to the Reproductive Autonomy of Minority Women
“Eugenic theory did not transcend the American racial order; it was fed, nurtured, and sustained by racism” (Roberts, 1999:95)”
Eugenics and Forced Sterilization
The cost of eugenics was steep for the West and paid for by the blood of people of color, the disabled, the incarcerated, and the poor. The Eugenics Movement and white supremacy fed the ideology that was instrumental in the forced sterilization of minority women. In the United States, those most likely to undergo forced sterilization were those of minority groups. Whether incarcerated, seeking affordable reproductive medical care, or mentally disabled, these individuals were sterilized using forced or coercive consent. Women in these circumstances had their autonomy stolen, their bodies abused, and their trust broken
Eugenics was a pseudo-scientific movement popularized in the United States and other parts of the West during the nineteenth and twentieth centuries. Popularized by Sir Francis Galton in 1883. Sir Francis Galton was inspired by his cousin Charles Darwin and his study of Natural Selection. However, even Darwin warned of using idea from natural selection in the context of humans. Paola Alonso stated the issue well when she said:
“Much of this violence derives from beliefs of white supremacy, which perpetuates the notion that the lives of people of color are less important than the lives of the Anglo-Saxon population. This racism and xenophobia fueled the Eugenics Movement in the nineteenth and twentieth centuries. Eugenics is the belief that certain practices could improve the biology and genetics of the human race, with white, able-bodied people being considered the most “fit” representation of good genetics” (Alonso, 2020:1).
Reproductive Autonomy Relies on Individual Choice.
Eugenic theory aimed to reduce the population and reproduction of individuals who they deemed ‘unfit’, ‘menaces to society’ or who simply did not fit their ideal of good American breeding stock (American Eugenics Society, 1938). During the turn of the century, with an influx of immigrants in American cities, wealthy upper-class whites felt that the American way of life would be threatened by immigrant populations and “foreigners” procreating and bringing unfavorable characteristics into society. Entire scientific societies and journals were created to foster eugenic thinking, which continued the encouragement of forced sterilizations either as a means of population control or ridding the United States of ‘undesirable traits’ (Roberts, 1999). These publications often released volumes of literature about popular eugenic policy, education, and research. The American Eugenics Society was one of these scientific organizations until it eventually changed its name in 1972 to the Society for the Study of Social Biology (Roberts, 1999). The Society of Social Biology still publishes a journal titled Social Biology (Roberts, 1999). An excerpt from the American Eugenics Society in 1938 reads:
“Among people who are afflicted with defects that are a menace to society, the great majority cannot be trusted to refrain voluntarily from having children. For such people the only choice is between segregation and sterilization. The American Eugenics Society believes that in the great majority of cases sterilization is much to be preferred.” (American Eugenics Society, 1938: 13-14)
Early Victims of Threats to Reproductive Autonomy in The History of Modern Gynecology.
Eugenic thinking and forced sterilization were not the first occurrences of reproductive violence against minority women. Known as the ‘Father of Modern Gynecology’ Dr. James Marion Sims’ work is most often attributed to the invention of the speculum. The speculum is a device still used today to dilate and examine the vagina. Among his other works, Dr. Sims had a long history of research conducted on enslaved women without the aid of anesthesia. Many of Dr. Sims’ experiments violated ethical standards due to his operation on African American slaves as human experiments and his utilization of the racist notion that Black people did not feel pain. His surgical work included treatment for vesicovaginal fistulas, a common complication of childbirth. Sims’ operated in the best interest of the enslaved person’s master, not in the treatment of his patients. Although some historians insist that patients clamored for surgical relief by Dr. Sims, the masters or owners of these enslaved folks were most interested in having their property returned to continue their reproductive duties with little regard to the suffering endured by these women. Because the bulk of Sims’ human experiments were conducted on enslaved people, they could not give informed consent- as their masters were the ones consenting to the operation, not the patient. As stated in an article by Wall, “it was unethical “by any standard” to perform experimental surgical operations on slaves because slaves, by definition, could not have given voluntary informed consent for surgery” (Wall, 2006).
A documentary titled “Remembering Anarcha” memorializes the sacrifices made by the enslaved women victims of Dr. Sims (Carples, 2019). The titular woman is Anarcha Westcott, who endured over thirty procedures by the physician during his efforts to cure vesicovaginal and rectovaginal fistulas (Wall, 2006).
Little is known of Westcott except that at the time of the operation, she was a seventeen- year-old African American enslaved woman from Alabama who had a disfigured pelvis after suffering a severe case of rickets, a disease caused by malnutrition. After becoming pregnant and having a stillbirth, she suffered severe wounds and fistulas (Wall, 2006). Dr. Sims performed over thirty procedures on Anarcha without the comfort of anesthesia until eventually curing her fistulas (Wall, 2006). Although the ends of his treatment were eventually successful, they were a horrific example of the dehumanization of a minority population based on racial prejudices.
The issue of forced sterilization and the history of modern gynecology raise ethical questions involving informed consent. The American Medical Association defines informed consent as “The process of informed consent occurs when communication between a patient and physician results in the patient’s authorization or agreement to undergo a specific medical intervention” (AMA, 2022). Informed consent is a process with steps including accessing the patient’s ability to understand the given medical information and alternatives, and make a voluntary decision (AMA, 2022). Physicians must present information regarding known diagnosis, nature and purpose of available medical interventions, and the risks, burdens, and benefits of choosing these interventions, including what would happen if interventions are foregone. The physician then must have documentation of the patient or surrogate’s consent for the medical record (AMA, 2022).
Incidences of forced or coercive consent regularly occur where consent to medical intervention is given when a patient is under anesthesia (Cohn, 2022), under duress (in situations such as labor) or through deceit (Roberts, 1999; 161). Coercive consent involves the use threatening harm or removal of services. This force can be verbal or physical. The definition of coercion refers to the use of force to gain compliance.
Mississippi Appendectomy.
The practice of coercive sterilization, and it use as means of training doctors became so common in the South that the operation was nicknamed a “Mississippi Appendectomy.” (Roberts, 1999). Performed at teaching hospitals, physicians often had a financial incentive to perform total hysterectomies on their patients instead of tubal ligations due to the reimbursement by Medicare being $500 higher in 1975. Hysterectomies at this time also had a twenty-percent higher fatality rate.
“The director of obstetrics and gynecology at a New York municipal hospital reported similar outrageous practices: “In most major teaching hospitals in New York City, it is the unwritten policy to do elective hysterectomies on poor black and Puerto Rican women, with minimal indications, to train residents. (Roberts, 1999:141)
After the wave of eugenic social programs had stolen women’s autonomy in the United States, another form of darkness swept the nation. During the 1960s, as the Civil Rights Movement and Welfare Programs rose, many medical and political officials viewed sterilization as saving welfare dollars and reducing the population growth of racial minorities or the underprivileged. Sterilization rapidly became the prevalent form of birth control for minority women.
“In one case, a teenage girl who was twelve weeks pregnant came to the Boston hospital for an abortion. She was told that it was too late for her to have a regular abortion and that a hysterectomy was necessary. When the medical student who observed the operation asked a resident why such drastic action was taken, the resident replied that the doctor “wanted a hysterectomy done for the experience.” Another woman was given a tubal ligation without her knowledge following a cesarean section; the doctor falsely listed the procedure as an Appendectomy.” (Roberts, 1999;146).
The Sterilization of Incarcerated and Institutionalized Women
The South has not been the only state leading in-laws and atrocious acts against the reproductive autonomy of minorities. California passed its first sterilization law in 1909, which applied to all prison inmates. Incarcerated persons who were convicted twice for a sexual offense or thrice for any offense where evidence was presented of the convicting suffering from “sexual perversions” were considered candidates for forced sterilization. (Jean-Jacques, 2018). Of the forcibly sterilized, 7-8% were Mexican Americans. Disclosed in 2013, the Center for Investigative Reporting revealed that almost 150 incarcerated females were illegally sterilized in California Prisons between 2006 and 2010. (Jean-Jacques, 2018). Sterilizing incarcerated women using federal funds is illegal under federal law; special approval must be gained for the operation, and state funds are available for this purpose. (Jan-Jacques, 2018). Of the incarcerated population who were sterilized in California, a disproportionate number were immigrants or born outside of the United States. In the case of 2013 sterilizations, a federal law was broken, and legal procedures were ignored. (Jean-Jacques, 2018).
Oregon’s sterilization laws were harsh and intended to target those deemed ‘sexual deviants or perverts among other states on the pacific coast. However, this law did not only target those indicted on sexual offenses but included marginalized women, homosexuals, people with epilepsy, girls considered promiscuous, and people suffering from mental illnesses. A reported 2648 people were sterilized between 1923 and 1981 due to Oregon’s laws.
The film Belly of The Beast documents a series of illegal sterilizations occurring in the Central California Women's Facility, the country's largest women's correctional facility. Belly of The Beast aimed to expose the modern-day eugenic practices still occurring in our country, especially in women's prisons. The film stars Kelli Dillon, a survivor of forced sterilization, as she partners with her courageous lawyer to seek reproductive justice. This documentary presents the decade-long legal battles following the exposed injustices (Cohn, 2022).
Puerto Rican women have been the long-suffering targets of government-sanctioned sterilization. Surveys from 1996 of Puerto Rico have disclosed that one-third of women who already had children between the ages of twenty and forty-nine had been sterilized (Jean- Jacques, 2018). The United States government aired concerns that overpopulation threatened the island and worsened social and economic conditions (Jeans-Jacques, 2018). Due to these concerns, sterilization programs were created to limit the population size of Puerto Rico. Roberts discusses the institution of sterilization as a means of population control in Puerto Rico, stating: “Women on the island were encouraged to agree to “la operación” by armies of public health workers who offered it at minimal or no cost.” (Roberts, 1999; 102). Private agencies like International Planned Parenthood Federation, The Puerto Rican Government, and The United States Government used federal funding to sterilize the women on the island (Roberts, 1999). Roberts reports that the program was so widespread that the number of sterilized women was the highest percentage in the world (Roberts, 1999).
“The conservative eugenicists, mostly North American officials in powerful government and administrative positions, attributed Puerto Rican “backwardness to the tropical climate and their inferior stock” (Briggs 2002, 100). Like their European counterparts, they considered poor Puerto Ricans unfit for reproduction. Their solution to Puerto Rico’s overpopulation problem was sterilization and emigration.” (Lopez, 2008:9)
Coercive Sterilization of Native American Women
Native Americans and their women have been the victim of mass genocide at the hands of the United States Government and other institutions of colonization. One of these institutions, originally designed to provide medical care to these individuals, is the Indian Health Service. The IHS is an operating division within the U.S. Department of Health and Human Services. IHS is responsible for providing direct medical and public health services to members of federally- recognized Native American Tribes and Alaska Native people (Lawrence, 2000).
Unfortunately, their health services are wrought with human rights violations as many unsanctioned sterilizations have occurred to our native populations primarily in the years following the second world war and the 1970s. Efforts on Indian reservations to perform sterilizations in the 1970s resulted in infertility for more than twenty-five percent of Native American women (Roberts, 1999). An estimated 3,000 sterilization procedures occurred in four Indian Health services hospitals without adequate consent. The story of one survivor named Julie is recounted in The American Indian Quarterly, stating:
“In 1974, an IHS facility in Minnesota sterilized Julie when she was twenty-eight. While she was in labor, she signed a form that she thought was for a painkiller, Julie stated that she does not remember exactly what she signed because she “was in pain at the time and was not paying too much attention to [the forms].” She revealed that the nurses told her about sterilization throughout her pregnancy and while she was in labor. While Julie had a second healthy daughter in the hospital, she revealed that she and her husband wanted three children. Her husband left her shortly after he found out about the sterilization because he ‘wanted a real woman.’ “(Lawrence, 2000; 1).
Coercive sterilization efforts on native reservations are not only insidious, but they can be genocidal. The ability to bear children at a women’s discretion is a choice of the individual and the family not of that of the government. All individuals have the right to reproductive autonomy regardless of race, gender, sexual orientation, religion, disability status, free or incarcerated, without discrimination. Fertility and reproduction is the choice of the individual and family not that of larger government organizations.
“Women’s human rights include the rights to equality, to dignity, autonomy, information and bodily integrity and respect for private life and the highest attainable standard of health, including sexual and reproductive health, without discrimination; as well as the right to freedom from torture and cruel, inhuman and degrading treatment.” (Between recognition, backlash and regressive, 2017)
Reproductive autonomy is a human right that deserves to be guaranteed. Threats to bodily autonomy are ongoing, as such advocacy for human rights is imperative for protecting us all, especially those who are the most marginalized in society. The forced sterilization of minorities in the hands of eugenicists, doctors, and other officials through forced or coercive consent directly violates human rights, and it is essential for a society that it be prevented.
About the film. BELLY OF THE BEAST. (n.d.). Retrieved April 30, 2022, from https://www.bellyofthebeastfilm.com/about
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