The U.S. Government's Role in Sterilizing Women of Color

Black, Puerto Rican, and Native American women have been victimized

An operating room showing a surgical bed and medical equipment
Mike LaCon / Flickr

Imagine going to the hospital for a common surgical procedure such as an appendectomy, only to find out afterward that you’d been sterilized. In the 20th century, untold numbers of women of color endured such life-altering experiences in part because of medical racism. Black, Native American, and Puerto Rican women report being sterilized without their consent after undergoing routine medical procedures or after giving birth.

Others say they unknowingly signed documentation allowing them to be sterilized or were coerced into doing so. The experiences of these women strained relations between people of color and healthcare personnel. In the 21st century, members of communities of color still widely distrust medical officials.

Black Women Sterilized in North Carolina

Countless numbers of Americans who were poor, mentally ill, from minority backgrounds or otherwise regarded as “undesirable” were sterilized as the eugenics movement gained momentum in the United States. Early 20th century eugenicists believed that measures should be taken to prevent "undesirables" from reproducing so that problems such as poverty and substance abuse would be eliminated in future generations. By the 1960s, tens of thousands of Americans were sterilized in state-run eugenics programs, according to investigative reporters for NBC News. North Carolina was one of 31 states to adopt such a program.

Between 1929 and 1974 in North Carolina, 7,600 people were sterilized. Out of those sterilized, 85% were women and girls, while 40% were people of color (most of whom were Black). The eugenics program was eliminated in 1977 but legislation permitting involuntary sterilization of residents remained on the books until 2003.

Since then, the state has tried to devise a way to compensate those it sterilized. Up to 2,000 victims were believed to be still living in 2011. Elaine Riddick, an African American woman, is one of the survivors. She says she was sterilized after giving birth in 1967 to a child she conceived after a neighbor raped her when she was just 13 years old.

“Got to the hospital and they put me in a room and that’s all I remember,” she told NBC News. “When I woke up, I woke up with bandages on my stomach.”

She didn’t discover that she’d been sterilized until a doctor informed her that she’d been “butchered” when Riddick was unable to have children with her husband. The state’s eugenics board ruled that she should be sterilized after she was described in records as “promiscuous” and “feeble-minded.”

Puerto Rican Women Robbed of Reproductive Rights

More than a third of women in the U.S. territory of Puerto Rico were sterilized from the 1930s to the 1970s as a result of a partnership between the U.S. government, Puerto Rican lawmakers and medical officials. The United States has ruled the island since 1898. In the decades following, Puerto Rico experienced a number of economic problems, including a high unemployment rate. Government officials decided that the island’s economy would experience a boost if the population were reduced.

Many of the women targeted for sterilization were reported to be of the working class, as doctors didn’t think women of a certain economic level could manage to effectively use contraception. Moreover, many women received sterilizations for free or for very little money as they entered the workforce. Before long, Puerto Rico won the dubious distinction of having the world’s highest sterilization rate. So common was the procedure that it was widely known as “La Operacion” among islanders.

Thousands of men in Puerto Rico underwent sterilizations as well. Roughly a third of Puerto Ricans sterilized reportedly did not understand the nature of the procedure, including that it meant they would not be able to bear children in the future.

Sterilization was not the only way in which Puerto Rican women’s reproductive rights were violated. U.S. pharmaceutical researchers also experimented on Puerto Rican women for human trials of the birth control pill in the 1950s. Many women experienced severe side effects such as nausea and vomiting. Three even died. The participants had not been told that the birth control pill was experimental and that they were participating in a clinical trial, only that they were taking medication to prevent pregnancy. The researchers in that study were later accused of exploiting women of color to acquire FDA approval of their drug.

The Sterilization of Native American Women

Native American women also report enduring government-ordered sterilizations. Jane Lawrence details their experiences in her Summer 2000 piece for American Indian Quarterly, “The Indian Health Service and the Sterilization of Native American Women.” Lawrence reports how two teenage girls had their tubes tied without their consent after undergoing appendectomies at an Indian Health Service (IHS) hospital in Montana. Also, a young American Indian woman visited a doctor asking for a “womb transplant,” apparently unaware that no such procedure exists and that the hysterectomy she’d had earlier meant that she and her husband would never have biological children.

“What happened to these three females was a common occurrence during the 1960s and 1970s,” Lawrence states. “Native Americans accused the Indian Health Service of sterilizing at least 25% of Native American women who were between the ages of 15 and 44 during the 1970s.”

Lawrence reports that Native American women say INS officials did not give them complete information about sterilization procedures, coerced them to sign paperwork consenting to such procedures, and gave them improper consent forms, to name a few. Lawrence says Native American women were targeted for sterilization because they had higher birthrates than White women and that White male doctors used minority women to gain expertise in performing gynecological procedures, among other dubious reasons.

Cecil Adams of the Straight Dope website has questioned whether as many Native American women were sterilized against their will as Lawrence cited in her piece. However, he does not deny that women of color were indeed targets of sterilization. Those women who were sterilized reportedly suffered greatly. Many marriages ended in divorce and the development of mental health problems ensued.


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Nittle, Nadra Kareem. "The U.S. Government's Role in Sterilizing Women of Color." ThoughtCo, Feb. 16, 2021, Nittle, Nadra Kareem. (2021, February 16). The U.S. Government's Role in Sterilizing Women of Color. Retrieved from Nittle, Nadra Kareem. "The U.S. Government's Role in Sterilizing Women of Color." ThoughtCo. (accessed May 30, 2023).