This article includes discussion of sterilization abuse that may be challenging for some readers.
July 17, 2023
By Annie Robles, Drexel University College of Medicine
In the scope of women’s reproductive rights in the United States, a topic that is often overlooked is the country’s history of sterilization abuse. Minoritized women in the U.S. have historically been more likely to be sterilized than other women, often without their knowledge or consent. One aspect of the women’s health movement in the 1970s was to address these injustices, and this fight was led by Helen Rodríguez Trías, MD.
A Puerto Rican woman who spent most of her early life between Puerto Rico and New York City, Rodríguez Trías was no stranger to racism, discrimination and activism. She participated in political movements for Puerto Rican independence during her college education and advocated for the interests of the local Puerto Rican community while heading the pediatrics department at Lincoln Hospital in the Bronx (Wilcox, 2002). Inspired by the struggles of her female family members and after witnessing the consequences of abortion restrictions among poor women in Puerto Rico, she joined the women’s health movement and the fight against sterilization abuse in 1970 (Wilcox, 2002). As a woman of color who came from a disadvantaged background, Rodríguez Trías worked to give voice to the experiences of women of color and poor women, who were the most disproportionately affected by sterilization abuse (Wilcox, 2002).
At the time of Rodriguez Trias’ involvement in the movement, sterilization abuse had run rampant in the United States for decades. It arose from the eugenics movement of the early 1900s, which saw sterilization as a necessary public health policy to prevent damage to society from the “feebleminded” or “deviant” (Ko, 2016). Sterilization laws were present in 31 states and even served as inspiration for Nazi Germany’s sterilization policies (Stern, 2020). Forced or nonconsensual sterilization specifically affected incarcerated, mentally or developmentally disabled, Black, Native American and Latino women as a manifestation of systemic racism (NWHN Staff, 2022; Ko, 2016).
Sterilization abuse was especially prominent in Puerto Rico, where U.S. public health policies aimed at preventing overpopulation promoted permanent sterilization instead of alternative, reversible forms of contraception (Krase, 1996). The operation was financially subsidized, employer favoritism was shown toward sterilized women, and many poor patients lacked access to necessary information on the procedure and its alternatives, making informed consent impossible (Krase, 1996). By 1965, one-third of all Puerto Rican mothers between the ages of 20 and 49 had been sterilized without their consent and without full knowledge of the consequences (NWHN Staff, 2020).
In the context of the long history of sterilization abuse in the U.S. and her home territory of Puerto Rico, Dr. Rodríguez Trías saw an opportunity for advocacy. She became a founding member of the Committee to End Sterilization Abuse (CESA) in 1970 and testified before the Department of Health, Education, and Welfare, advocating for the passage of federal sterilization guidelines (“Dr. Helen,” 2015). She made numerous other milestone achievements that helped shape the future of women’s reproductive health, and while her impact can still be felt today, much work is still needed to achieve total health equity.
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