Editing Compulsory sterilization (section)

=== United States ===
{{Further|Eugenics in the United States|Sterilization law in the United States|Sterilization of Native American women|Eugenics Biased Sterilization Cases in the United States}}
[[File:SOU 1929 14 Betänkande med förslag till steriliseringslag s 57 Laughlin.jpg|250px|thumb|right|A map from a 1929 Swedish royal commission report displays the U.S. states that had implemented sterilization legislation by then]]

During the [[Progressive Era]] ({{circa|1890}} to 1920), the United States was the first country to concertedly undertake compulsory sterilization programs for the purpose of eugenics.<ref>{{Cite journal |last=Iredale |first=Rachel |year=2000 |title=Eugenics And Its Relevance To Contemporary Health Care |journal=Nursing Ethics |volume=7 |issue=3 |pages=205–14 |doi=10.1177/096973300000700303 |pmid=10986944 |s2cid=37888613}}</ref> [[Thomas C. Leonard]], professor at Princeton University, describes American eugenics and sterilization as ultimately rooted in economic arguments and further as a central element of Progressivism alongside minimum wage laws, restricted immigration, and the introduction of [[pension]] programs.<ref name="Leonard2005">{{Cite journal |last=Leonard |first=Thomas C. |year=2005 |title=Retrospectives: Eugenics and Economics in the Progressive Era |url=https://www.princeton.edu/%7Etleonard/papers/retrospectives.pdf |url-status=live |journal=[[Journal of Economic Perspectives]] |volume=19 |issue=4 |pages=207–224 |doi=10.1257/089533005775196642 |archive-url=https://web.archive.org/web/20161218214328/http://www.princeton.edu/~tleonard/papers/retrospectives.pdf |archive-date=2016-12-18}}</ref> The heads of the programs were avid proponents of eugenics and frequently argued for their programs which achieved some success nationwide mainly in the first half of the 20th century.

[[Eugenics in the United States|Eugenics]] had two essential components. First, its advocates accepted as axiomatic that a range of mental and physical handicaps—blindness, deafness, and many forms of [[mental disorder|mental illness]]—were largely, if not entirely, hereditary in cause. Second, they assumed that these scientific hypotheses could be used as the basis of social engineering across several policy areas, including family planning, education, and immigration. The most direct policy implications of eugenic thought were that "mental defectives" should not produce children, since they would only replicate these deficiencies, and that such individuals from other countries should be kept out of the polity.<ref>{{Cite journal |last=Hansen, King |first=Randall, Desmond |date=Summer 2017 |title=Eugenic Ideas, Political Interests, and Policy Variance: Immigration and Sterilization Policy in Britain and the U.S |url=https://www.researchgate.net/publication/248650104 |url-status=live |journal=World Politics |volume=53 |issue=2 |pages=237–263 |doi=10.1353/wp.2001.0003 |pmid=18193564 |archive-url=https://web.archive.org/web/20170809053048/https://www.researchgate.net/profile/Randall_Hansen/publication/248650104_Eugenic_Ideas_Political_Interests_and_Policy_Variance_Immigration_and_Sterilization_Policy_in_Britain_and_the_US/links/5548bc640cf27c5000668062/Eugenic-Ideas-Political-Interests-and-Policy-Variance-Immigration-and-Sterilization-Policy-in-Britain-and-the-US.pdf |archive-date=2017-08-09 |access-date=2018-09-23 |s2cid=19634871}}</ref> The principal targets of the American sterilization programs were intellectually disabled people and the mentally ill, but also targeted under many state laws were the deaf, the blind, people with epilepsy, and the physically deformed. While the claim was that the focus was mainly the mentally ill and disabled, the definition of this during that time was much different from today's. At this time, there were many women that were sent to institutions under the guise of being "[[feeble-minded]]" because they were promiscuous or became pregnant while unmarried.

A relative minority of sterilizations targeting crime took place in [[Incarceration in the United States|prisons and other penal institutions]].<ref>Interview with [[Alexandra Stern|Alexandra Minna Stern]], Ph.D. of University of Michigan in Spanish newspaper [[El País]] published on 12 July 2013 [http://sociedad.elpais.com/sociedad/2013/07/12/actualidad/1373652806_358454.html] {{webarchive|url=https://web.archive.org/web/20130715102459/http://sociedad.elpais.com/sociedad/2013/07/12/actualidad/1373652806_358454.html|date=2013-07-15}}</ref> In the end, over 65,000 individuals were sterilized in 33 states under state compulsory sterilization programs in the United States.<ref name="Open WorldCat">{{Cite book |last=Kevles |first=Daniel |title=In the name of eugenics: Genetics and the uses of human heredity |date=12 April 1985 |publisher=Knopf |isbn=978-0-394-50702-6 |edition=1st |location=New York}}</ref>

The first state to introduce a compulsory sterilization bill was [[Michigan]], in 1897, but the proposed law failed to pass. Eight years later [[Pennsylvania]]'s state legislators passed a sterilization bill that was vetoed by the governor. [[Indiana]] became the first state to enact sterilization legislation in 1907,<ref>The Indiana Supreme Court overturned the law in 1921 in {{Cite journal |title=Williams et al v. Smith, 131 NE 2 (Ind.), 1921 |url=http://www.bioethics.iupui.edu/Eugenics/SMith%20vs%20Williams.pdf |journal=Northeastern Reporter |volume=131 |page=2 |archive-url=https://web.archive.org/web/20081001183035/http://www.bioethics.iupui.edu/Eugenics/SMith%20vs%20Williams.pdf |archive-date=2008-10-01}}</ref> followed closely by [[California]] and [[Washington (state)|Washington]] in 1909. Several other states followed, but such legislation remained controversial enough to be defeated in some cases, as in Wyoming in 1934.<ref>{{Cite book |last=McDaniel |first=Rodger |title=Dying for Joe McCarthy's Sins: The Suicide of Wyoming Senator Lester Hunt |publisher=WordsWorth |year=2013 |isbn=978-0983027591 |location=Cody, Wyoming |pages=40ff}}</ref> In the 1920s, Eugenicists were particularly interested in black women in the South and Latina women in the Southwest in order to break the chain of welfare dependency and curb the population rise of non-white citizens.<ref>{{Cite book |last=Kluchin |first=Rebecca |title=Fit to Be Tied: Sterilization and Reproductive Rights in America, 1950–1980 |publisher=Rutgers University Press |year=2009 |location=Rutgers}}</ref><ref name=":7" />

After World War II, public opinion towards eugenics and sterilization programs became more negative in the light of the connection with the [[genocide|genocidal]] policies of [[Nazi Germany]], though a significant number of sterilizations continued in a few states through the 1970s. Between 1970 and 1976, Indian Health Services sterilized between 25 and 42 percent of women of reproductive age who came in seeking healthcare services.<ref>{{Cite magazine |title=A 1970 Law Led to the Mass Sterilization of Native American Women. That History Still Matters |url=https://time.com/5737080/native-american-sterilization-history/ |access-date=2020-03-27 |magazine=Time |language=en}}</ref> In [[California]], ten women who delivered their children at [[Los Angeles General Medical Center|LAC-USC]] hospital between 1971-1974 and were sterilized without proper consent sued the hospital in the landmark ''[[Madrigal v. Quilligan]]'' case in 1975.{{citation needed|date=February 2022}}<ref>{{Cite book |last=Ruiz and Sanchez Korrol |first=Vicki L and Virginia |title=Latinas in the United States: A Historical Encyclopedia |publication-date=2006}}</ref> The plaintiffs lost the case, but numerous changes to the consent process were made following the ruling, such as offering consent forms in the patient's native language, and a 72-hour waiting period between giving consent and undergoing the procedure.{{citation needed|date=February 2022}}[[File:Stop Forced Sterilization English-Spanish political poster.jpg|thumb|<includeonly>upright|</includeonly>Bilingual poster in English and Spanish for a rally against forced sterilization ]]The [[Oregon]] Board of Eugenics, later renamed the Board of Social Protection, existed until 1983,<ref name="oregonapology">{{Cite web |last=Governor John Kitzhaber |author-link=John Kitzhaber |date=2 December 2002 |title=Proclamation of Human Rights Day, and apology for Oregon's forced sterilization of institutionalized patients |url=http://archivedwebsites.sos.state.or.us/Governor_Kitzhaber_2003/governor/speeches/s021202.htm |url-status=dead |archive-url=https://web.archive.org/web/20140528024042/http://archivedwebsites.sos.state.or.us/Governor_Kitzhaber_2003/governor/speeches/s021202.htm |archive-date=28 May 2014 |access-date=16 February 2012}}</ref> with the last forcible sterilization occurring in 1981.<ref>Julie Sullivan. (2002). "[https://news.google.com/newspapers?id=ZFBWAAAAIBAJ&sjid=jesDAAAAIBAJ&pg=6596,4132204 State will admit sterilization past] {{Webarchive|url=https://web.archive.org/web/20160107221309/https://news.google.com/newspapers?id=ZFBWAAAAIBAJ&sjid=jesDAAAAIBAJ&pg=6596,4132204 |date=2016-01-07 }}", ''Portland Oregonian'', 15 November 2002. (Mirrored in ''Eugene Register-Guard'', 16 November 2002, at [[Google News]].)</ref> The U.S. [[Commonwealth (U.S. insular area)|commonwealth]] of [[Puerto Rico]] had a sterilization program as well. Some states continued to have sterilization laws on the books for much longer after that, though they were rarely if ever used. California sterilized more than any other state by a wide margin, and was responsible for over a third of all sterilization operations. Information about the California sterilization program was produced into book form and widely disseminated by eugenicists [[E. S. Gosney]] and [[Paul Popenoe]], which was said by the government of Adolf Hitler to be of key importance in proving that large-scale compulsory sterilization programs were feasible.<ref>On California sterilizations and their connection to the Nazi program, see: Stefan Kühl, ''The Nazi connection: Eugenics, American racism, and German National Socialism'' (New York: Oxford University Press, 1994); Alexandra Stern, ''Eugenic nation: faults and frontiers of better breeding in modern America'' (Berkeley: University of California Press, 2005); and Wendy Kline, ''Building a better race: gender, sexuality, and eugenics from the turn of the century to the baby boom'' (Berkeley: University of California Press, 2001).</ref>
In recent years, the governors of many states have made public apologies for their past programs beginning with Virginia and followed by Oregon<ref name="oregonapology" /> and California. Few have offered to compensate those sterilized, however, citing that few are likely still living (and would of course have no affected offspring) and that inadequate records remain by which to verify them. At least one compensation case, ''[[Poe v. Lynchburg Training School & Hospital]]'' (1981), was filed in the courts on the grounds that the sterilization law was unconstitutional. It was rejected because the law was no longer in effect at the time of the filing. However, the petitioners were granted some compensation because the stipulations of the law itself, which required informing the patients about their operations, had not been carried out in many cases.
<ref>{{Cite web |title=Poe v. Lynchburg Training School and Hospital, 518 F. Supp. 789 (W.D. Va. 1981) |url=http://law.justia.com/cases/federal/district-courts/FSupp/518/789/2128853/ |url-status=live |archive-url=https://web.archive.org/web/20150929111215/http://law.justia.com/cases/federal/district-courts/FSupp/518/789/2128853/ |archive-date=2015-09-29 |website=Justia US Law}}</ref>
The 27 states where sterilization laws remained on the books (though not all were still in use) in 1956 were: [[Arizona]], [[California]], [[Connecticut]], [[Delaware]], [[Georgia (U.S. state)|Georgia]], [[Idaho]], [[Indiana]], [[Iowa]], [[Kansas]], [[Maine]], [[Michigan]], [[Minnesota]], [[Mississippi]], [[Montana]], [[Nebraska]], [[New Hampshire]], [[North Carolina]], [[North Dakota]], [[Oklahoma]], [[Oregon]], [[South Carolina]], [[South Dakota]], [[Utah]], [[Vermont]], [[Virginia]], [[Washington (state)|Washington]],<ref name="app.leg.wa.gov">{{Cite web |title=RCW 9.92.100: Prevention of procreation |url=http://app.leg.wa.gov/RCW/default.aspx?cite=9.92.100 |url-status=live |archive-url=https://web.archive.org/web/20180407121003/http://app.leg.wa.gov/RCW/default.aspx?cite=9.92.100 |archive-date=2018-04-07 |access-date=2018-04-07}}</ref> [[West Virginia]] and [[Wisconsin]].<ref>{{Cite web |title=Note that this is not a comprehensive list of states which had sterilization laws on the books at any given time (some states had their laws overturned in courts very early on) nor an indication of when states' laws were active (some ceased to be used much earlier) |url=http://www.toolan.com/hitler/append1.html |url-status=live |archive-url=https://web.archive.org/web/20120417184442/http://www.toolan.com/hitler/append1.html |archive-date=2012-04-17 |access-date=2012-07-13 |publisher=Toolan.com}}</ref>{{Better source needed|reason=This citation is to a non-academic personal blog and does not reference the source of the information.|date=June 2016}} Some states still have forced sterilization laws in effect, such as Washington state.{{Update inline|date=December 2023}}<ref name="app.leg.wa.gov" />

As of January 2011, discussions were under way regarding compensation for the victims of forced sterilization under the authorization of the [[Eugenics Board of North Carolina]]. Governor Bev Perdue formed the NC Justice for Sterilization Victims Foundation in 2010 in order "to provide justice and compensate victims who were forcibly sterilized by the State of North Carolina".<ref>{{Cite web |title=Office for Justice for Sterilization Victims |url=http://www.sterilizationvictims.nc.gov/ |url-status=live |archive-url=https://web.archive.org/web/20140402135129/http://www.sterilizationvictims.nc.gov/ |archive-date=2014-04-02 |publisher=North Carolina Department of Administration}}</ref> In 2013 North Carolina announced that it would spend $10 million beginning in June 2015 to compensate men and women who were sterilized in the state's eugenics program; North Carolina sterilized 7,600 people from 1929 to 1974 who were deemed socially or mentally unfit.<ref name="northcarolina">{{Cite news |date=27 July 2013 |title=North Carolina offers $10 million for victims of forced-sterilization program |publisher=[[Fox News]] |url=https://www.foxnews.com/us/north-carolina-offers-10-million-for-victims-of-forced-sterilization-program/ |url-status=live |access-date=3 August 2013 |archive-url=https://web.archive.org/web/20130801012025/http://www.foxnews.com/us/2013/07/27/north-carolina-offers-10-million-for-victims-forced-sterilization-program/#ixzz2b2soYWOu |archive-date=1 August 2013}}</ref>

The inability to pay for the cost of raising children has been a reason courts have ordered coercive or compulsory sterilization. In June 2014, a Virginia judge ruled that a man on probation for child endangerment must be able to pay for his seven children before having more children; the man agreed to get a vasectomy as part of his plea deal.<ref>VA Man Agrees to Get Vasectomy as Part of Plea Deal, Fox News Insider, 24 June 2014. {{Cite web |date=2014-06-24 |title=VA Man Agrees to Get Vasectomy as Part of Plea Deal |url=http://insider.foxnews.com/2014/06/24/va-man-required-get-vasectomy-part-plea-deal |url-status=live |archive-url=https://web.archive.org/web/20141020091323/http://insider.foxnews.com/2014/06/24/va-man-required-get-vasectomy-part-plea-deal |archive-date=2014-10-20 |access-date=2014-10-16}}</ref> In 2013, an Ohio judge ordered a man owing nearly $100,000 in unpaid child support to "make all reasonable efforts to avoid impregnating a woman" as a condition of his probation.<ref>{{Cite web |date=5 February 2013 |title='Stop Having Kids!': Judge Orders Man Owing $100K in Child Support Payments to Quit Procreating |url=http://insider.foxnews.com/2013/02/05/stop-having-kids-judge-orders-man-owing-100k-in-child-support-payments-to-quit-procreating |url-status=dead |archive-url=https://web.archive.org/web/20141020092013/http://insider.foxnews.com/2013/02/05/stop-having-kids-judge-orders-man-owing-100k-in-child-support-payments-to-quit-procreating |archive-date=2014-10-20 |access-date=2014-10-16 |publisher=Fox News Insider}}</ref> Kevin Maillard wrote that conditioning the right to reproduction on meeting child support obligations amounts to "constructive sterilization" for men unlikely to make the payments.<ref name="kevin">{{Cite journal |last=Maillard |first=Kevin |date=2013 |title=Serial Paternity |url=http://web.law.columbia.edu/sites/default/files/microsites/gender-sexuality/maillard_draft_0.pdf |url-status=live |journal=Mich. St. L. Rev. |volume=1369 |archive-url=https://web.archive.org/web/20170105235714/http://web.law.columbia.edu/sites/default/files/microsites/gender-sexuality/maillard_draft_0.pdf |archive-date=5 January 2017 |access-date=29 October 2016 |quote=By conditioning reproduction on an event unlikely to happen, this amounts to constructive sterilization—an indirect prohibition on reproduction.}}</ref> 

As of 19 July 2021 it was reported that:{{blockquote|"under new provisions signed into California's budget this week, the state will offer reparations for the thousands of people who were sterilized in California institutions, without adequate consent, often because they were deemed "criminal", "feeble-minded" or "deviant"."<ref name="theguardian.com">{{Cite web|date=2021-07-19|title=Survivors of California's forced sterilizations: 'It's like my life wasn't worth anything'|url=http://www.theguardian.com/us-news/2021/jul/19/california-forced-sterilization-prison-survivors-reparations|access-date=2022-01-04|website=the Guardian|language=en}}</ref>

and that

"The program will be the first in the nation to provide compensation to modern-day survivors of prison system sterilizations, like Dillon, whose attorney obtained medical records to show that, while she was an inmate in the Central California women's facility in Chowchilla, surgeons had removed her ovaries during what was supposed to be an operation to take a biopsy and remove a cyst.

The investigations sparked by her case, which is featured in the documentary Belly of the Beast, showed hundreds of inmates had been sterilized in prisons without proper consent as late as 2010, even though the practice was by then illegal.

The new California reparations program will also seek to compensate hundreds of living survivors of the state's earlier eugenics campaign, which was first codified into state law in 1909 and wasn't repealed until 1979."<ref>{{Citation|title=Independent Lens {{!}} Belly of the Beast {{!}} Season 22 {{!}} Episode 4|url=https://www.pbs.org/video/belly-of-the-beast-7puv5r/|language=en|access-date=2022-01-04}}</ref><ref name="theguardian.com"/>}}

==== Georgia immigration detention center 2020 ====
In 2020, four [[non-profit organizations]] (which are listed below) joined Dawn Wooten to accuse a [[private prison|privately-owned]] U.S. immigration detention center in the U.S. state of [[Georgia (U.S. state)|Georgia]] of forcibly sterilizing women. The reports claimed that a doctor conducted unauthorized medical procedures upon women who were detained by [[U.S. Immigration and Customs Enforcement|Immigration and Customs Enforcement]].<ref name=":14">{{Cite web |title=ICE detainees' alleged hysterectomies recall a long history of forced sterilizations {{!}} University of Toronto Mississauga |url=https://www.utm.utoronto.ca/main-news/ice-detainees-alleged-hysterectomies-recall-long-history-forced-sterilizations |access-date=2021-01-24 |website=www.utm.utoronto.ca |date=2 October 2020 |language=en}}</ref> Dawn Wooten was a nurse and former employee. She claims that a high rate of sterilizations were performed upon Spanish-speaking women and women who spoke various indigenous languages that are common in Latin America. Wooten said that the center did not obtain proper consent for these surgeries, or lied to women about the medical procedures. More than 40 women submitted testimony in writing to document these abuses.<ref>{{Cite web |date=2020-12-22 |title=More immigrant women say they were abused by Ice gynecologist |url=http://www.theguardian.com/us-news/2020/dec/22/ice-gynecologist-hysterectomies-georgia |access-date=2021-02-03 |website=The Guardian |language=en}}</ref>

In September 2020, [[Mexico]] demanded more information from U.S. authorities about medical procedures that were performed upon illegal immigrants in detention centers, after allegations that six Mexican women were sterilized without their consent. The ministry said that consulate personnel had interviewed 18 Mexican women who were detained at the center, none of which "claimed to have undergone a hysterectomy". Another woman said that she had undergone a gynecological operation, although there was nothing in her detention file to support that she agreed to the procedure.<ref>{{Cite web |date=2020-09-29 |title=Mexico demands the US for answers on alleged migrant hysterectomies |url=https://www.theyucatantimes.com/2020/09/mexico-demands-the-us-for-answers-on-alleged-migrant-hysterectomies/ |access-date=2021-01-24 |website=The Yucatan Times |language=en-US}}</ref>{{blockquote|The nurse said that detained women told her they did not fully understand why they had to get a hysterectomy.

[[Project South (organization)|Project South]], the Georgia Detention Watch, the Georgia Latino Alliance for Human Rights, and South Georgia Immigrant Support Network filed a complaint to the government on behalf of detained immigrants and the nurse.

The U.S. congresswoman [[Pramila Jayapal]] has called for an urgent investigation into allegations that at least 17 women were subjected to unnecessary gynecological procedures that she called "the most abhorrent of human rights violations".<ref>{{Cite web|date=2020-09-29|title=Mexico demands the US for answers on alleged migrant hysterectomies|url=https://www.theyucatantimes.com/2020/09/mexico-demands-the-us-for-answers-on-alleged-migrant-hysterectomies/|access-date=2022-01-04|website=The Yucatan Times|language=en-US}}</ref>}}

==== Effect on disabled persons ====
As stated previously, eugenics in the United States spread to target mentally disabled persons. Sterilization rates across the country were relatively low, with the sole exception of California, until the 1927 [[Supreme Court of the United States|U.S. Supreme Court]] decision in ''[[Buck v. Bell]]'', which upheld under the [[U.S. Constitution]] the forced sterilization of patients at a [[Virginia]] home for intellectually disabled people.<ref>{{Cite web |title=Buck v. Bell |url=https://www.law.cornell.edu/supremecourt/text/274/200 |url-status=live |archive-url=https://web.archive.org/web/20170623010556/https://www.law.cornell.edu/supremecourt/text/274/200 |archive-date=2017-06-23 |access-date=2017-06-27}}</ref> In the wake of that decision, over 62,000 people in the United States, most of them women, were sterilized.<ref>{{Cite book |last=Kluchin |first=Rebecca M |url=https://books.google.com/books?id=fbXeTqBPiP8C&pg=PA17 |title=Fit to be Tied: Sterilization and Reproductive Rights in America, 1950–1980 |year=2011 |publisher=Rutgers University Press |isbn=9780813549996 |access-date=2015-08-14 |archive-url=https://web.archive.org/web/20160610143115/https://books.google.com/books?id=fbXeTqBPiP8C&pg=PA17& |archive-date=2016-06-10 |url-status=live}}</ref> The number of sterilizations performed per year increased until another Supreme Court case, ''[[Skinner v. Oklahoma]]'', 1942, complicated the legal situation by ruling against sterilization of criminals if the equal protection clause of the constitution was violated. That is, if sterilization was to be performed, then it could not exempt [[White-collar crime|white-collar criminals]].<ref>On the legal history of eugenic sterilization in the U.S., see {{Cite web |last=Lombardo |first=Paul |title=Eugenic Sterilization Laws |url=http://www.eugenicsarchive.org/html/eugenics/essay8text.html |url-status=live |archive-url=https://web.archive.org/web/20170701030240/http://www.eugenicsarchive.org/html/eugenics/essay8text.html |archive-date=2017-07-01 |website=Eugenics Archive}}</ref> This case, however, does not directly overturn the decision made in ''Buck v. Bell''.<ref name=":04">{{Cite web |title=The Right to Self-Determination: Freedom from Involuntary Sterilization |url=https://disabilityjustice.org/right-to-self-determination-freedom-from-involuntary-sterilization/ |access-date=2021-03-12 |website=Disability Justice |date=11 March 2014 |language=en-US}}</ref> Instead, it invalidates the central argument of the decision, and has been used in several cases to deny guardians the right to sterilize the disabled person under their care.<ref name=":04" />

The [[American Congress of Obstetricians and Gynecologists|Congress of Obstetricians and Gynecologists]] (ACOG) believes that mental disability is not a reason to deny sterilization. The opinion of ACOG is that "the physician must consult with the patient's family, agents, and other caregivers" if sterilization is desired for a mentally limited patient.<ref>{{Cite journal |last=Committee on Ethics |year=2007 |title=ACOG Committee Opinion No. 371: Sterilization of Women, Including Those with Mental Disabilities |journal=Obstetrics & Gynecology |volume=110 |issue=1 |pages=217–220 |doi=10.1097/01.AOG.0000263915.70071.29 |pmid=17601925}}</ref> In 2003, Douglas Diekema wrote in Volume 9 of the journal Mental Retardation and Developmental Disabilities Research Reviews that "involuntary sterilization ought not be performed on mentally retarded persons who retain the capacity for reproductive decision-making, the ability to raise a child, or the capacity to provide valid consent to marriage."<ref>Involuntary sterilization of persons with mental retardation: An ethical analysis, Mental Retardation and Developmental Disabilities Research Reviews, Volume 9, Issue 1, pages 21–26, 2003. {{Cite journal |last=Diekema |first=Douglas S. |year=2003 |title=Involuntary sterilization of persons with mental retardation: An ethical analysis |journal=Mental Retardation and Developmental Disabilities Research Reviews |volume=9 |issue=1 |pages=21–26 |doi=10.1002/mrdd.10053 |pmid=12587134}}</ref> The ''[[Journal of Medical Ethics]]'' claimed, in a 1999 article, that doctors are regularly confronted with requests to sterilize mentally limited people who cannot give consent for themselves. The article recommend that sterilization should only occur when there is a "situation of necessity" and the "benefits of sterilization outweigh the drawbacks."<ref>{{Cite journal |last1=Denekens |first1=JP |last2=Nys |first2=H |last3=Stuer |first3=H |year=1999 |title=Sterilization of incompetent mentally handicapped persons: a model for decision making |journal=Journal of Medical Ethics |volume=25 |issue=3 |pages=237–241 |doi=10.1136/jme.25.3.237 |pmc=479215 |pmid=10390678}}</ref>

The ''[[American Journal of Bioethics]]'' published an article, in 2010, that concluded the interventions used in the [[Ashley treatment]] may benefit future patients.<ref>Ashley Revisited: A Response to the Critics, American Journal of Bioethics, Volume 10, Issue 1, January 2010. {{Cite web |title=Ashley Revisited: A Response to the Critics &#124; Bioethics.net |url=http://www.bioethics.net/articles/ashley-revisited-a-response-to-the-critics/ |url-status=live |archive-url=https://web.archive.org/web/20120807210745/http://www.bioethics.net/articles/ashley-revisited-a-response-to-the-critics/ |archive-date=2012-08-07 |access-date=2013-03-27}}</ref> These interventions, at the request of the parents and guidance from the physicians, included a [[hysterectomy]] and surgical removal of the [[Thelarche|breast buds]] of the mentally and physically disabled child.<ref>The Ashley Treatment, March 2007. {{Cite web |title=The "Ashley Treatment", Towards a Better Quality of Life for "Pillow Angels" |url=http://pillowangel.org/Ashley%20Treatment.pdf |url-status=live |archive-url=https://web.archive.org/web/20150216162353/http://pillowangel.org/Ashley%20Treatment.pdf |archive-date=2015-02-16 |access-date=2014-10-16}}</ref> Proponents of the treatments argue that it protects disabled persons from sexual assault, unwanted pregnancy, and difficulties of menstruation.<ref name=":18">{{Cite web |last=Reiter |first=Jesse |title=Involuntary Sterilization of Disabled Americans: An Historical Overview |url=https://www.abclawcenters.com/blog/2018/11/06/involuntary-sterilization-of-disabled-americans-an-historical-overview/ |access-date=2021-03-12 |website=www.abclawcenters.com |date=6 November 2018 |language=en-US}}</ref> The interventions are still legal in many states, despite the argument that it violates a person's constitutional right to avoid unwanted intrusions.<ref name=":18" /> Discussion on the involuntary sterilization of disabled persons is now largely focused on the right of a guardian to request sterilization.

==== Criminal justice system ====
{{Further|Compulsory sterilization of disabled people in the U.S. prison system}}
In addition to eugenics purposes, sterilization was used as a punitive measure against sex offenders, people identified as homosexual, or people deemed to masturbate too much.<ref name=":9">{{Cite journal |last1=Amy |first1=Jean-Jacques |last2=Rowlands |first2=Sam |date=2018-04-19 |title=Legalised non-consensual sterilisation – eugenics put into practice before 1945, and the aftermath. Part 2: Europe |url=http://eprints.bournemouth.ac.uk/30595/3/Forced%20sterilisation-EJCRHC-MS-Part%202%20SR%20comments%20addressed%20JJA.pdf |url-status=live |journal=The European Journal of Contraception & Reproductive Health Care |volume=23 |issue=3 |pages=194–200 |doi=10.1080/13625187.2018.1458227 |issn=1362-5187 |pmid=29671357 |archive-url=https://web.archive.org/web/20200305183759/http://eprints.bournemouth.ac.uk/30595/3/Forced%20sterilisation-EJCRHC-MS-Part%202%20SR%20comments%20addressed%20JJA.pdf |archive-date=2020-03-05 |access-date=2019-12-16 |s2cid=4981162}}</ref> California, the first state in the U.S. to enact compulsory sterilization based on eugenics, sterilized all prison inmates under the 1909 sterilization law.<ref name=":9" /> In the last 40 years, judges have offered lighter punishment (i.e. probation instead of jail sentences) to people willing to use contraception or be sterilized, particularly in child abuse/endangerment cases.<ref>{{Cite journal |last=Ginzberg |first=Janet F. |date=Fall 1992 |title=NOTE: COMPULSORY CONTRACEPTION AS A CONDITION OF PROBATION: THE USE AND ABUSE OF NORPLANT |journal=Brooklyn Law Review |volume=58}}</ref> One of the most famous cases of this was ''People v. Darlene Johnson'', during which Johnson, a woman charged with child abuse sentenced to seven years in prison, was offered probation and a reduced prison sentence if she agreed to use [[Norplant]].<ref name=":10">{{Cite journal |last=Berger |first=Emily |date=May 2007 |title=THE LEGAL RIGHTS OF THE POOR AND MINORITY TO HAVE FAMILIES: JUDGES AS FAMILY PLANNERS, THE VILIFICATION OF THE POOR, AND DESTRUCTION OF THE BLACK FAMILY |journal=Rutgers Race & the Law Review |volume=8 |pages=259–290}}</ref>

In addition to child abuse cases, some politicians proposed bills mandating Norplant use among women on public assistance as a requirement to maintain welfare benefits.<ref name=":10" /> As noted above, some judges offered probation in lieu of prison time to women who agreed to use Norplant, while other court cases have ordered parents to cease childbearing until regaining custody of their children after abuse cases. Some legal scholars and ethicists argue such practices are inherently coercive.<ref name=":10" /> Furthermore, such scholars link these practices to eugenic policies of the 19th and early 20th century, highlighting how such practices not only targeted poor people, but disproportionately impacted minority women and families in the U.S., particularly black women.

In the late 1970s, to acknowledge the history of forced and coercive sterilizations and prevent ongoing eugenics/population control efforts, the federal government implemented a standardized informed consent process and specific eligibility criteria for government funded sterilization procedures.<ref name=":11">{{Cite journal |last1=Borrero |first1=Sonya |last2=Zite |first2=Nikki |last3=Creinin |first3=Mitchell D. |date=October 2012 |title=Federally Funded Sterilization: Time to Rethink Policy? |journal=American Journal of Public Health |volume=102 |issue=10 |pages=1822–1825 |doi=10.2105/ajph.2012.300850 |issn=0090-0036 |pmc=3490665 |pmid=22897531}}</ref> Some scholars argue the extensive consent process and 30-day waiting period go beyond preventing instances of coercion and serve as a barrier to desired sterilization for women relying on public insurance.<ref name=":11" />

Though formal eugenics laws are no longer routinely implemented and have been removed from government documents, instances of reproductive coercion still take place in U.S. institutions today. In 2011, investigative news released a report revealing that between 2006 and 2011, 148 female prisoners in two California state prisons were sterilized without adequate informed consent.<ref>{{Cite web |last=Stern |first=Alex |date=23 July 2013 |title=Sterilization Abuse in State Prisons |url=https://www.huffpost.com/entry/sterilization-california-prisons_b_3631287 |url-status=live |archive-url=https://web.archive.org/web/20140421075350/http://www.huffingtonpost.com/alex-stern/sterilization-california-prisons_b_3631287.html |archive-date=2014-04-21 |website=Huffington Post}}</ref> In September 2014, California enacted Bill SB 1135 that bans sterilization in correctional facilities, unless the procedure shall be required in a medical emergency to preserve an inmate's life.<ref>{{Cite web |title=SB 1135 |url=http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140SB1135 |url-status=live |archive-url=https://web.archive.org/web/20141002061808/http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140SB1135 |archive-date=2 October 2014 |access-date=17 September 2014 |publisher=CA Gov}}</ref>

====Puerto Rico====
[[File:Puerto Rico-CIA WFB Map.png|thumb|upright=1.75|A political map of [[Puerto Rico]]]]

Puerto Rican physician Lanauze Rolón founded the League for Birth Control in [[Ponce, Puerto Rico]], in 1925, but the League was quickly squashed by opposition from the [[Catholic church]].<ref name=Mass>{{Cite journal |last=Mass |first=Bonnie |date=1 January 1977 |title=Puerto Rico: a Case Study of Population Control |journal=Latin American Perspectives |volume=4 |issue=4 |pages=66–79 |doi=10.1177/0094582x7700400405 |pmid=11619430 |s2cid=416021}}<!--|access-date=October 11, 2014--></ref><ref name=Nick>{{Cite journal |last=Thimmesch |first=Nick |date=May 1968 |title=Puerto Rico and Birth Control |journal=Journal of Marriage and Family |volume=30 |issue=2 |pages=252–262 |doi=10.2307/349251 |jstor=349251}}<!--|access-date=October 11, 2014--></ref> A similar League was founded seven years later, in 1932, in [[San Juan, Puerto Rico|San Juan]] and continued in operation for two years before opposition and lack of support forced its closure.<ref name="Mass" /><ref name="Nick" /> Yet another effort at establishing birth control clinics was made in 1934 by the [[Federal Emergency Relief Administration]] in a relief response to the conditions of the [[Great Depression]].<ref name="Nick" /> As a part of this effort, 68 birth control clinics were opened on the island.<ref name="Nick" /> The next mass opening of clinics occurred in January 1937 when American [[Clarence Gamble]], in association with a group of wealthy and influential Puerto Ricans, organized the Maternal and Infant Health Association and opened 22 birth control clinics.<ref name="Nick" />

The Governor of Puerto Rico, [[Blanton Winship]], enacted Law 116,<ref>{{Cite web |title=Forced Sterilization in Puerto Rico " Family Planning |url=https://stanford.edu/group/womenscourage/cgi-bin/blogs/familyplanning/2008/10/23/forced-sterilization-in-puerto-rico/ |url-status=live |archive-url=https://web.archive.org/web/20170721113445/http://stanford.edu/group/womenscourage/cgi-bin/blogs/familyplanning/2008/10/23/forced-sterilization-in-puerto-rico/ |archive-date=2017-07-21 |access-date=2017-07-25 |website=stanford.edu}}</ref> which went into effect on 13 May 1937.<ref>{{Cite web |title=Puerto Rico Revisited " Family Planning |url=https://stanford.edu/group/womenscourage/cgi-bin/blogs/familyplanning/2008/10/30/puerto-rico-revisited/ |url-status=live |archive-url=https://web.archive.org/web/20161208104209/http://stanford.edu/group/womenscourage/cgi-bin/blogs/familyplanning/2008/10/30/puerto-rico-revisited |archive-date=2016-12-08 |access-date=2017-07-25 |website=stanford.edu}}</ref> It was a [[birth control]] and eugenic sterilization law that allowed the dissemination of information regarding birth control methods and legalized the practice of birth control.<ref name="Mass" /><ref name="Nick" /> The government cited a growing population of the poor and unemployed as motivators for the law. Changers were made to the Penal Code in 1937 which made abortion effectively legal. It was allowed for health reasons, without specifying details in the law. This gave doctors discretion to interpret what constituted a health reason, effectively legalizing abortion.<ref>[https://www.tandfonline.com/doi/pdf/10.1016/S0968-8080%2897%2990006-9?needAccess=true Abortion in Puerto Rico: The limits of colonial legality], Yamila Azize-Vargas and Luis A. Avilés, ''Reproductive Health Matters 5''(9) 1 May 1997, page 56 (page 2 of the pdf)</ref> By 1965, approximately 34 percent of women of childbearing age had been sterilized, two thirds of whom were still in their early twenties. The law was repealed on 8 June 1960.<ref name="Mass" />

=====1940s–1950s=====

Unemployment and widespread poverty would continue to grow in Puerto Rico in the 40s, both threatening U.S. private investment in Puerto Rico and acting as a deterrent for future investment.<ref name="Mass" /> In an attempt to attract additional U.S. private investment in Puerto Rico, another round of liberalizing trade policies were implemented and referred to as "[[Operation Bootstrap]]."<ref name="Mass" /> Despite these policies and their relative success, unemployment and poverty in Puerto Rico remained high, high enough to prompt an increase in [[emigration]] from Puerto Rico to the United States between 1950 and 1955.<ref name="Mass" /> The issues of [[immigration]], Puerto Rican poverty, and threats to U.S. private investment made population control concerns a prime political and social issue for the United States.<ref name="Mass" />

The 50s also saw the production of social science research supporting sterilization procedures in Puerto Rico.<ref name="Mass" /> Princeton's [[Office of Population Research]], in collaboration with the Social Research Department at the University of Puerto Rico, conducted interviews with couples regarding sterilization and other birth control.<ref name="Mass" /> Their studies concluded that there was a significant need and desire for permanent birth control among Puerto Ricans.<ref name="Mass" /> In response, Puerto Rico's governor and Commissioner of health opened 160 private, temporary birth control clinics with the specific purpose of sterilization.<ref name="Mass" />

Also during this era, private birth control clinics were established in Puerto Rico with funds provided by wealthy Americans.<ref name="Mass" /><ref name="Nick" /> [[Joseph Sunnen]], a wealthy American Republican and industrialist, established the [[Sunnen Foundation]] in 1957.<ref name="Mass" /><ref name="Nick" /> The foundation funded new birth control clinics under the title "La Asociación Puertorriqueña el Biensestar de la Familia" and spent hundreds of thousands of dollars in an experimental project to determine if a formulaic program could be used to control population growth in Puerto Rico and beyond.<ref name="Mass" />

=====Sterilization procedures and [[coercion]]=====
From beginning of the 1900s, U.S. and Puerto Rican governments espoused rhetoric connecting the poverty of Puerto Rico with overpopulation and the "hyper-fertility" of Puerto Ricans.<ref name="Lopez">{{Cite journal |last=Lopez |first=Iris |date=1993 |title=Agency And Constraint: Sterilization And Reproductive Freedom Among Puerto Rican Women In New York City |journal=Urban Anthropology and Studies of Cultural Systems and World Economic Development |volume=22 |issue=3}}</ref> Such rhetoric combined with eugenics ideology of reducing "population growth among a particular class or ethnic group because they are considered...a social burden," was the philosophical basis for the 1937 birth control legislation enacted in Puerto Rico.<ref name="Lopez" /><ref name="Briggs" /> A Puerto Rican Eugenics Board, modeled after a similar board in the United States, was created as part of the bill, and officially ordered ninety-seven involuntary sterilizations.<ref name="Briggs">{{Cite book |last=Briggs |first=Laura |title=Reproducing Empire: Race, Sex, Science, and U.S. Imperialism in Puerto Rico |date=2002 |publisher=University of California Press |isbn=978-0-520-22255-7 |location=Berkeley and Los Angeles, California}}</ref>

The legalization of sterilization was followed by a steady increase in the popularity of the procedure, both among the Puerto Rican population and among physicians working in Puerto Rico.<ref name="Briggs" /><ref name="B">{{Cite book |last1=Ramirez de Arellano |first1=Annette B. |title=Colonialism, Catholicism, and Contraception: A History of Birth Control in Puerto Rico |last2=Seipp |first2=Conrad |date=1983 |publisher=The University of North Carolina Press |isbn=978-0-8078-1544-1}}</ref> Though sterilization could be performed on men and women, women were most likely to undergo the procedure.<ref name="Mass" /><ref name="Nick" /><ref name="Briggs" /><ref name="B" /> Sterilization was most frequently recommended by physicians because of a pervasive belief that Puerto Ricans and the poor were not intelligent enough to use other forms of contraception.<ref name="Briggs" /><ref name="B" /> Physicians and hospitals alike also implemented hospital policy to encourage sterilization, with some hospitals refusing to admit healthy pregnant women for delivery unless they consented to be sterilized.<ref name="Briggs" /><ref name="B" /> This has been best documented at Presbyterian Hospital, where the unofficial policy for a time was to refuse admittance for delivery to women who already had three living children unless she consented to sterilization.<ref name="Briggs" /><ref name="B" /> There is additional evidence that true [[informed consent]] was not obtained from patients before they underwent sterilization, if consent was solicited at all.<ref name="B" />

By 1949 a survey of Puerto Rican women found that 21% of women interviewed had been sterilized, with sterilizations being performed in 18% of all hospital births statewide as a routine post-partum procedure, with the sterilization operation performed before women left the hospitals after giving birth.<ref name="Mass" /> As for the birth control clinics founded by Sunnen, the Puerto Rican Family Planning Association reported that around 8,000 women and 3,000 men had been sterilized in Sunnen's privately funded clinics.<ref name="Mass" /> At one point, the levels of sterilization in Puerto Rico were so high that they alarmed the Joint Committee for Hospital Accreditation, who then demanded that Puerto Rican hospitals limit sterilizations to ten percent of all hospital deliveries in order to receive accreditation.<ref name="Mass" /> The high popularity of sterilization continued into the 60s and 70s, during which the Puerto Rican government made the procedures available for free and reduced fees.<ref name="Briggs" /> The effects of the sterilization and contraception campaigns of the 1900s in Puerto Rico are still felt in Puerto Rican cultural history today.<ref name="Lopez" />

======Controversy and opposing opinions======
There has been much debate and scholarly analysis concerning the legitimacy of choice given to Puerto Rican women in regard to sterilization, reproduction, and birth control, as well as with the ethics of economically motivated mass-sterilization programs.

Some scholars, such as Bonnie Mass<ref name="Mass" /> and Iris Lopez,<ref name="Lopez" /> have argued that the history and popularity of mass-sterilization in Puerto Rico represents a government-led eugenics initiative for [[population control]].<ref name="Mass" /><ref name="Lopez" /><ref name="B" /><ref name="Elena">{{Cite journal |last1=Gutierrez |first1=Elena R. |last2=Fuentes |first2=Liza |date=2009–2010 |title=Population Control by Sterilization: The Cases of Puerto Rican and Mexican-Origin Women in the United States |journal=Latino(a) Research Review |volume=7 |issue=3}}</ref> They cite the private and government funding of sterilization, coercive practices, and the eugenics ideology of Puerto Rican and American governments and physicians as evidence of a mass-sterilization campaign.<ref name="Lopez" /><ref name="B" /><ref name="Elena" />

On the other side of the debate, scholars like Laura Briggs<ref name="Briggs" /> have argued that evidence does not substantiate claims of a mass-sterilization program.<ref name="Briggs" /> She further argues that reducing the popularity of sterilization in Puerto Rico to a state initiative ignores the legacy of Puerto Rican feminist activism in favor of birth control legalization, and the individual agency of Puerto Rican women in making decisions about family planning.<ref name="Briggs" />

A system was proposed by the California state senator [[Nancy Skinner (California politician)|Nancy Skinner]] to compensate victims of the well-documented examples of [[compulsory sterilization#United States|prison sterilizations that resulted from California's eugenics programs]], but this did not pass by the bill's 2018 deadline in the legislature.<ref>{{cite book |title=SB-1190 – Eugenics Sterilization Compensation Program |first1=Nancy |last1=Skinner |publisher=[[State of California]] |url= https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180SB1190 |date=18 February 2019 |access-date=19 February 2019 |archive-date=19 February 2019 |archive-url= https://web.archive.org/web/20190219130233/https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180SB1190 |url-status=live}}</ref>

=====Effects=====
When the United States took census of Puerto Rico in 1899, the birth rate was 40 births per one thousand people.<ref name="Nick" /> By 1961, the birth rate had dropped to 30.8 per thousand.<ref name="Mass" /> In 1955, 16.5% of Puerto Rican women of childbearing age had been sterilized, this jumped to 34% in 1965.<ref name= "Mass" />

In 1969, sociologist [[Harriet Presser]] analyzed the 1965 Master Sample Survey of Health and Welfare in Puerto Rico.<ref name=Presser>{{Cite journal |last=Presser |first=Harriet B. |date=November 1969 |title=The Role of Sterilization in Controlling Puerto Rican Fertility |journal=Population Studies |volume=23 |issue=3 |pages=343–361 |doi=10.2307/2172875 |jstor=2172875 |pmid=22073953}}<!--|access-date=10 October 2014--></ref> She specifically analyzed data from the survey for women ages 20 to 49 who had at least one birth, resulting in an overall sample size of 1,071 women.<ref name="Presser" /> She found that over 34% of women aged 20–49 had been sterilized in Puerto Rico in 1965.<ref name="Presser" />

Presser's analysis also found that 46.7% of women who reported they were sterilized were between the ages of 34 and 39.<ref name="Presser" /> Of the sample of women sterilized, 46.6% had been married 15 to 19 years, 43.9% had been married for 10-to-14 years, and 42.7% had been married for 20-to-24 years.<ref name="Presser" /> Nearly 50% of women sterilized had three or four births.<ref name="Presser" /> Over 1/3 of women who reported being sterilized were sterilized in their twenties, with the average age of sterilization being 26.<ref name="Presser" />

A survey by a team of Americans in 1975 confirmed Presser's assessment that nearly 1/3 of Puerto Rican women of childbearing age had been sterilized.<ref name="Mass" /> As of 1977, Puerto Rico had the highest proportion of childbearing-aged persons sterilized in the world.<ref name="Mass" /> In 1993, [[ethnographic]] work done in New York by [[anthropologist]] Iris Lopez<ref name="Lopez" /> showed that the history of sterilization continued to effect the lives of Puerto Rican women even after they immigrated to the United States and lived there for generations.<ref name="Lopez" /> The history of the popularity of sterilization in Puerto Rico meant that Puerto Rican women living in America had high rates of female family members who had undergone sterilization, and it remained a highly popular form of birth control among Puerto Rican women living in New York.<ref name="Lopez" />