The recent Black Lives Matter movement, the COVID-19 pandemic and the ongoing fight for reproductive health access have created a burgeoning sentiment of unrest across the United States. This unrest reached a high point in September, when nurse Dawn Wooten filed a formal complaint against Dr. Mahendra Amin, a Georgia physician working at an Immigration and Customs Enforcement (ICE) detention center, who she claims performed mass hysterectomies on detained immigrant women without consent. While the country reacted in shock, the reality is that coerced sterilization against communities of color is not new. The United States has a shameful history of exploiting Black and brown women’s bodies as part of a larger objective for population control rooted in white supremacy — and the medical field is partly to blame.
Many members of the medical community have been instrumental in devising research projects, medical devices and clinical practices that have been used to forcefully sterilize women of color. In the 1960s, birth control researchers experimented on Puerto Rican women largely because they regarded overcrowding as the fundamental cause of poverty. The researchers held deeply prejudiced beliefs that people living in poverty, including Puerto Ricans, should be extinguished from society in order to allow those deemed more “fit” to survive and reproduce.
Rather than focusing efforts on improving socioeconomic status to address poverty, head biologist Gregory Pincus gave women birth control with significantly higher doses of hormones than the modern day oral contraception in his mission to develop the first form of oral contraception. Despite women experiencing blood clots, nausea and even death, the experiment continued and the side effects were ignored. Women involved, many of whom were interested in avoiding pregnancy, did not know they were participating in a clinical trial or taking an experimental medication — only that the pills would prevent pregnancies.
Even after the passage of laws ending segregation and defining ethical research practices, attempts to control childbearing and reduce overpopulation continued throughout modern day America. In the 1970s, Mexican women living in Los Angeles were systematically targeted and sterilized because physicians decided they were a leading cause of the overpopulation problem. Dr. James Quilligan, an attending at Los Angeles County-USC Medical Center, was accused of privately admitting that, “[P]oor minority women in L.A. County were having too many babies … it was a strain on society … it was good that they be sterilized.” Women lacking English proficiency were coerced into signing documents to which they did not consent or did not fully understand. Other women who received postpartum tubal ligations were in the midst of labor or anesthetized and never remembered signing the legal documents. Despite this breach of patient consent, in the 1978 class action lawsuit, Madrigal v. Quilligan, the Judge ruled in favor of the County hospital.
This case echoes what occurred in 1960 in Puerto Rico and this year in the ICE facilities. While not always explicitly stated by the perpetrators, all of these tragedies reverberate the same, twisted logic: women of color are the root cause of overpopulation; therefore, it is morally acceptable to take away their bodily autonomy in order to stop them from reproducing. This reprehensible way of thinking has pervaded all levels of our society and medical professionals are clearly not immune. Members of the medical community, including Dr. Amin, those involved in the Puerto Rico and Los Angeles sterilizations, and anyone who was complicit in such unfathomable acts, have ignored their ethical oath to “do no harm” and instead enabled forced sterilization to occur within the present day.
Reproductive justice is not just about having a choice to abstain from reproducing — it also encompasses the choice to be a parent, have multiple children or none at all. The continuation of reproduction control efforts is a disgrace to our country. American exceptionalism is clouded by our history of reproductive racism, and this history is clearly far from over. As a profession, the only way to serve justice and move forward is to address the damage we have done. Therefore, we urge the medical community to take responsibility and hold Dr. Amin accountable by removing his medical license. We demand that the practice of forced sterilization be abolished to ensure that organizations, including ICE, never again allow this violation of basic human rights. Most importantly, we wish to acknowledge the women who endured unimaginable and unconsented pain and loss for the sake of medical sterilization. We urge that reparations be provided to these women and their families.