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Tied Up: Prison Sterilizations and One State’s Efforts to Make Amends

Original illustration by Grace Li' 23, an Economics major at Brown

In 1883, Francis Galton coined the term “eugenics” to mean, “the study of agencies under social control that may improve or impair the racial qualities of future generations.” 

Deeply grounded in racism, ableism, and sexism, eugenics was promoted by those who sought to breed out traits considered undesirable, including mental or physical disabilities, dark skin tones, and impoverishment. The eugenics movement originally gained popularity and credibility in the United States in the early 1900s, and ran rampant until the 1980s when most laws legalizing eugenics practices were revoked. Yet state-sanctioned forced sterilizations never ended. Today, the racist legacy of the horrific eugenics programs remains apparent in US prisons and detention centers.

Victims of nonconsensual sterilizations deserve reparations. California, bearing a particularly appalling record of coerced sterilization, is now offering one form of it: monetary payments. But in confronting America’s egregious history of eugenics and acknowledging the persisting ideologies that seek to limit reproductive healthcare for incarcerated people today, it becomes clear that monetary compensation alone is not enough. Attempting to secure justice for incarcerated women in California and beyond who have been victims of sterilization requires further action, even as the question remains of whether justice is attainable at all. 

In 1907, Indiana passed the first US sterilization law, sanctioning forced operations of those deemed unfit for procreation. Thirty-one states followed suit, and in 1927, the Supreme Court upheld states’ ability to sterilize individuals with supposedly undesirable traits in Buck v. Bell

Between 1907 and the 1970s, the United States sterilized over 60,000 people. The invasive surgery—entailing either a tubal ligation or a hysterectomy—often yields dangerous side effects. The former procedure, sometimes referred to as getting your “tubes tied,” requires a risky surgery to reverse, and the latter one is permanent. 

State-run hospitals, institutions, homes, and prisons conducted both procedures across the United States in the 1900s, but an estimated one-third of all US forced sterilizations were in California—roughly 20,000 people. California’s “success of sterilization laws” was appallingly referenced by German Nazis in proposing the “Law for the Prevention of Hereditarily Diseased Offspring” in 1933. Forced sterilizations continued in California well after 1979, when the state repealed the law sanctioning them. Prison hospitals became the setting for the practice’s subsequent continuations.

The Center for Investigative Reporting discovered that between 2006 and 2010, 148 female California inmates experienced unnecessary hysterectomies; several of the cases directly violated the informed consent process mandated by the state. A documentary filmmaker, Erika Cohn, found that from 1997 to 2013, as many as 1,400 people incarcerated in California faced nonconsensual sterilizations. These procedures disproportionately affected women of color. Despite African American women making up only 7 percent of California’s female population in 2005, they represented 29.8 percent of inmates in women’s correctional facilities, where they were targeted for the invasive procedure. 

Physicians were compensated well for the operations. Yet, Dr. James Heinrich, the OB-GYN at a California female correctional facility stated that these physicians saved taxpayer money due to reduced costs of “welfare paying for these unwanted children—as they procreated more.” The justification: A person’s reproductive freedom and bodily autonomy is less valuable than some quantity of money presumably saved by reducing the number of children born to an imprisoned parent. The biases and misaligned value systems evident in California’s sterilizations are heavily evocative of the United States’ “racial cleansing” eugenics ideals.

California is currently trying to make amends but has fallen woefully short thus far. 

In 2013, North Carolina became the first US state to offer reparations to living identified victims of state-sanctioned sterilizations. Following North Carolina and Virginia, California agreed in 2021 to grant monetary compensation to victims of 20th century eugenics efforts, and uniquely is also providing funds to those who underwent recent involuntary reproductive operations while behind bars. 

The 4.5 million dollar California Forced or Involuntary Sterilization Compensation Program has thus far approved payments to only 51 women out of the 310 who have applied, with roughly 600 people eligible. The program expires in December 2023, after which funding will no longer be available. The intent is evident, but the follow-through is not. 

The primary challenge to the success of the reparations program is the formidable amount of documentation and paperwork, which can be exceedingly difficult to locate, required to prove the operations. Additionally, Lynda Gledhill, as executive officer of the California Victim Compensation Board, said, “It’s a population that may not be very trusting of government, given what happened to them.” Going forward, California, and other states that develop compensation programs, must do more to ensure all victims receive the payment they deserve.

If done correctly, monetary compensation is better than nothing. But it’s not enough.

At 13 years old, an institute in California sterilized Mary Franco in 1934 for being “feeble-minded” because of “sexual deviance.” If she were alive today, she would be eligible for the benefits California is offering. Her niece, Stacy Cordova, who advocated for the state to provide payments, commented, “I don’t know if it is justice. Money doesn’t pay for what happened to them. But it’s great to know that this is being recognized. For me, this is not about the money. This is about the memory.”

In addition to distributing funds to those affected by state-sanctioned operations, both California and the federal government have to ensure that it will never happen again. 

In 2020, at least 40 female inmates in a Georgia ICE detention center were victims of unnecessary reproductive procedures. Each operation provided substantial earnings for the center’s doctor. If the center had enforced adequate oversight and employed medical consultants, the surgical violations could have been prevented. Federal and state authorities must hold public and private prisons and their doctors accountable to the law. 

Future reform efforts must consider the reproductive rights of incarcerated people. In American reproductive justice movements, people in prisons are often disregarded or left as an afterthought; likewise, criminal justice reform does not prioritize access to reproductive healthcare.

The US reproductive justice movement has historically not been inclusive. Planned Parenthood founder Margaret Sanger was famously a eugenics enthusiast.  And in the development of the birth control pill, Puerto Rican women were initially tested on without knowing the risks. Expansion in procreative healthcare has historically been for the benefit of white women, and the effects of its retractions hurt women of color the most.  Going forward, the reproductive justice movement must also include those behind bars, especially in the wake of the overturn of Roe v. Wade and a current national attack on reproductive rights. It is the responsibility of the US government to protect imprisoned people’s rights to reproductive resources. 

Prisons remain particularly hostile spaces for people with a female reproductive anatomy. Imprisonment already has traumatic, palpable effects on the body and psyche. Inflicting further harm is a disturbing abuse of power. No prison hospital should shackle a person while giving birth—a practice that is now banned in several states but is often unenforced and continues unregulated in others. No facility should be able to deny birth givers access to quality prenatal support. Likewise, in states that uphold the ability to terminate a pregnancy, the states’ imprisoned individuals should have access to the same abortion procedures as those who are not behind bars. 

Even long-term progress in the legal system may fall short of justice for victims of forced prison sterilizations. 

According to Brown University professor Dr. Gabreélla Friday, absolute justice under our current criminal justice system is not feasible. Dr. Friday studies long-term prison sentences as a form of sterilization in themselves because they prevent women from choosing to have children. “We have timely bodies,” she says, referring to the “biological clock” of fertility. As decade-long sentences persist for those incarcerated at younger ages, people will continue to lose reproductive choice. 

The denial of womens’ rights in  the prison system is unsurprising given that it was designed for men; it did not consider accommodating the needs of women and their bodily demands. In US prisons and jails, which only recently began seeing growing rates of imprisoned female populations, women were an afterthought. Dr. Friday elaborates, “the way that [prisons are] structured shows that there is no care put in for the specific needs of women’s bodies.” 

Moreover, constraints on bodily autonomy are as ingrained as profoundly in American society as its founding democratic ideals. Controlling female bodies—primarily Black, brown, and indigenous bodies—is rooted deeply in American history, extending well beyond the 20th century eugenics programs. Dorothy Roberts writes, in Killing the Black Body, “Whites’ domination of slave women’s wombs to sustain the system of slavery provided an early model of reproductive control.” Ditching the antiquated intention of trying to control wombs is just as necessary—if not more so—than reform policies and correctly implemented reparations programs for forced sterilization victims. 

Finally, even in the absence of harmful practices that directly target the reproductive autonomy of incarcerated people, the design of the prison system itself perpetuates constraints on procreative freedom. Perhaps true justice and meaningful change would entail reconsidering the United States’ entire prison structure.