Sterilization: Abuse vs. Access

This recent post on the very popular feminist blog generated a lot of discussion among their readers, and got me pretty angry at the same time. It dealt with the story of one 20-something woman and her search for a doctor who would sterilize her, because she knew she never wanted to have children. Pretty much everyone refused to perform the procedure, for varying reasons, most of which revolved around not trusting her to make the irreversable decision at such a young age.

This is not a new dilemma. Mostly white, middle class women have dealt with these challenges since the procedure was developed–doctors not wanting to sterilize them based on age, number of children, even permission from husbands. Women have even had problems getting doctors to give them long-term birth control, like IUDs, for similar reasons.

But there is a flip side to this debate, which I attempted to add to the discussion that arose from the Feministing post, but had little impact overall. The flip side is sterilization abuse: women who are forcibly or unknowingly sterilized against their will. Here is what I commented on the feministing post:

I think that you will find that for women of color, low income women, or immigrant women, this issue is completely different. Rather than having trouble getting sterilization surgeries, they are being FORCIBLY sterilized.

There is a long history of this in the United States. In the 1970s, it was discovered that hundreds of Mexican-origin women were being unknowingly sterilized at an LA hospital. They were being told the operation was reversible and given forms they couldn’t read (because they were in english) to sign.

These abuses promoted a campaign by a group called CESA (Committee to End Sterilization Abuse), spearheaded by Dr. Helen Rodriguez-Trias that was able to pass federal guidelines regarding sterilization–requiring forms in the person’s native language, and a waiting period to give consent. Many times these women were being asked if they wanted the procedure while in labor.

This created an outrage among white feminists, for exactly the reasons Ann mentions above–they felt it was an infringement on a woman’s right to choose sterilization and was a barrier to her access.

It’s a great example of when the feminist movement gets divided along racial lines–white women and women of color are experiencing this issue in opposite ways.

There are a number of more “legal” ways that women of color and low-income women continue to be subjected to coercive reproductive control policies. Undocumented women in PA were allowed access to tubal ligations (without cost) but no help for other shorter term birth control methods.

Generally I love the debates and discussions on Feministing, I think they provide a wide range of perspectives and foster great dialogue. I was really disappointed by this post however, and even more disappointed to see that in the more than 100 comments posted (mine was 20-something) only one other person even acknowledged the flip-side of this issue for women of color, low income women, and immigrants.

There are seriously racist and eugenist philosophies at work here, for both cases. Doctors don’t want to sterilize young smart white women, partially because these are the people everyone wants reproducing. Just take a look at egg donation advertising for further proof of this. And the government wants to sterilize young undocumented and poor women of color because they are all of the things I just mentioned: of color, undocumented and poor. Plus they are reproducing at a higher rate than white people, who are barely replacing themselves. So let’s call this what it is–racism at work on our access to reproductive health technologies.


28 thoughts on “Sterilization: Abuse vs. Access

  1. zuzu July 30, 2007 / 2:45 pm

    Great post. It’s easy to become blinkered as to your own experiences, especially when you’re blocked at every turn by people with an interest in having your reproduce. When I finally got someone who was willing to tie my tubes, I was pissed off about the waiting period, but since then I’ve learned about why those are in place — and it doesn’t have all that much to do with keeping *women* from changing their minds.

    The problem, at bottom, is a society that wants to dictate who should have children, and when, and how — and who should not have children, and when, and how. The decisions are taken out of the hands of individuals by people with some power and some screwed-up ideas about who can make reproductive decisions.

    You’d think that would be some common ground.

  2. Pockysmama July 30, 2007 / 4:09 pm

    I’m actually not surprise not to have read the “flip” side on Feministing. It seems to be one of those subjects that pits white, middle-class women against minority women because we generally have very different experiences with the same issue. Typically, they want white women to reproduce at all costs and minority women to limit their children.

    Although, I have had a slightly different experience as a black women. I am still trying to get sterilized (I’m 36) and it has been an uphill battle. I have been refused for about 12 years now, many physicians citing the same reasons as previously written about. Interestingly enough, my partner was able to obtain a vasectomy with fairly little trouble though they insisted on speaking with his “wife” to see if it was okay and to make sure I fully understood that I would have no more children with him. Uh, duh! (I also took offense that they would insist on involving someone with no legal right to interfere in another’s medical treatment, especially since we are not legally married but that’s another post.)

    For me however, it has been a very different story. I can’t take any hormonal methods so for years we struggled trying to have a sex life while I became increasingly terrified to have sex because of pregnancy concerns. The vasectomy did ease pregnancy worries but now I have menstruation issues which I would dearly love to solve with sterilization but can’t. I think it may be because I present as well-educated, articulate and upper-middle-class so I am turned down for being too young or only having one child.

    However, as my daughter has come of the age where she needs to think about contraception, etc. I noticed that she was always pushed toward some of the longer-term contraceptives such as depo provera, referred to “public” clinics for treatment though she has medical insurance and generally treated as if she was some raging slut. I attribute most of these instances to her being a young, black woman. In fact, we were told at one doctor’s visit that they preferred to give black girls the “3-month shot” because it was easier for “them” because they didn’t have to worry about taking a pill every day or changing a weekly patch and they refused to consider any other method. Curiosity got the better of me so I sent a friend in with her daughter (they were white) and lo and behold, 40 mins later they walked out a prescription for the patch. Not a word was mentioned about that teenager’s inability to take a pill on time or replace a patch nor did they ever mention depo provera to either of them.

    I do think there is a lot of institutionalized racism in medical treatment today but I would also argue that it also seems to be quite classist as well.

  3. NancyP July 30, 2007 / 4:55 pm

    Fine post. There are remnants of this attitude today, though not widely expressed by pressure salesmanship of TLs. I’d guess that the most common racially specific desire of ob/gyns and their nurses is a longlasting method (depo) used in teenagers, on the assumption (perhaps true in many instances) that teens aren’t that responsible about short-term bc (pill, barrier) and the undeniable truth that abortions aren’t easily available for poor women. Attitudes have improved but racism is still around in ob service providers.

  4. Gail Ann July 30, 2007 / 5:25 pm

    ZUZU is right on! THis is an issue of who will control reproduction. Who is trying to control reproduction? White heterosexual men. Who should be in controll? Women and their doctors.

  5. genevieve July 30, 2007 / 7:30 pm

    i think you make an excellent point about racial differences in types of birth control offered to women. in my own experience working for planned parenthood, i found that women of color were much more likley to be on riskier types of birth control i.e. depo provera. i think that tubal ligation was discussed more frequently with women of color as well.

    however as a women and a medical student, i must point to a common root of both the i-can’t-find -a-doc-to-do-a tubal ligation and the forced sterilization debate. doctors are not good at listening to women and trusting them with decisions regarding their own bodies. this is the problem that must be addressed.

  6. April July 30, 2007 / 8:43 pm

    I couldn’t agree with you more regarding the “flip side”.

  7. the frog queen July 31, 2007 / 7:17 am

    great post! i never read the comments on the feministing post. its cool that they link you. sucks you weren’t heards the first time.

  8. Cheshire Katz July 31, 2007 / 8:15 am

    Cross-posted at Feministing:

    While I acknowledge and respect the point made, biased application of a beneficial procedure does not identify a problem with the procedure, but with the doctors applying it. Those individuals eager to sterilize women of color, low income women, and immigrant women are the same ones likely to be pleased with the right to refuse to sterilize white, wealthy women, whom they’d like to see conscripted into the business of egg manufacturing & distribution, contributing to the ongoing bleaching of America. Meanwhile, other means will be utilized to discourage women of color, low income women, and immigrant women from having children, and simultaneously those that would like to be sterilized for the sake of their personal security, health, and autonomy are denied the opportunity.

    My sympathies go out to those forcibly sterilized as described above, but I am simply unpersuaded that blaming the technology (or accessibility to it) is the right solution. Would we say the same thing about abortion procedures if we found doctors disproportionately encouraging women of color, low income women, and immigrant women to get abortions, while discouraging white, wealthy women from doing so? I can’t imagine an anti-abortion camp building on this blog supported by that flawed reasoning.

  9. Emily July 31, 2007 / 8:16 am

    Re: undocumented immigrant women – I wonder if there is also a component to the push for tubal ligation that interprets reproduction by undocumented women as a kind of sneaky attempt to gain legal status/citizenship.

  10. Elaine Vigneault July 31, 2007 / 8:45 am

    Good post. Thank you for awakening us privileged white feminists.

  11. heatlight July 31, 2007 / 2:12 pm

    Very good post. Believe it or not, I heard John Piper speak on this in a sermon on Abortion a few months ago. Though we may stand on opposite sides of this debate, to some degree, I’m glad you’ve discovered how much race and class play into this issue. Congrats on a very good post. Keep blogging!

  12. NancyP July 31, 2007 / 2:55 pm

    Genevieve has hit on another problem – doctors having a hard time listening. Cultural expression may be as important as overt eugenicist racism – a black teenager who uses urban black slang and intonation but is serious and attentive may be seen as an airhead not ready for kids, while an equivalent suburban white teenager speaking white teen slang may be taken as potentially more responsible. Hence, depo for the former, the Pill for the latter. As well, class subconsciously or consciously affects doctors’ perception of patients’ abilities. The fix for this problem is some self-awareness on the part of the physician, and some exposure to non-clinic minority patients.

  13. Perkyshai August 1, 2007 / 11:53 am

    Basic ideas remain the same for feminism,overall. The ideal (as far as I see) has always been informed choice on the part of the person whose body is actually affected. Usually, that’s the woman. (The day they give a fetus a vote, I’ll quantify it as having a voice)
    That choice should not involve coercion or manipulation on the basis of race, class, income or sexual preference.

  14. Andrea August 2, 2007 / 3:44 pm

    Do you have any evidence of any kind that women of color are still being pushed into sterilization? Your only example is 30 years old and, by your own account, remedied.

    If this is a point worth making (and if it’s true, it certainly is worth making), it’s worth making right.

  15. YouOughtaKnow August 2, 2007 / 4:22 pm

    I’m sorry, but I think that there should be mandatory sterilization. psych testing and licensing to reproduce. People need licences to DRIVE, do electrical work, general contracting, plumbing, but NOT to have CHILDREN and potentially ruin lives? How backwards!

    I don’t think that most of the people in this country, INCLUDING middle-class white women, SHOULD be reproducing. We need to control the population and stop the stupid/poor/genetically inferior people from reproducing to help raise the consciousness and IQ of the population from being dominated by the stupid/poor/retarded people who are currently populating this world excessively.

    MANDATORY sterilization to EVERY woman on Welfare! ONE child limit PER PERSON in this country and NO ONE is exempt. That’s not racist. It’s common sense!

  16. Alma Ochoa September 13, 2007 / 1:03 pm

    The only thing that needs to be realized, is if all of you opinionated White low/middle/high Class women and men…. look back and think about Columbine & Jeffery Dahmer… so many more Young White Men that have committed awful crimes… they have come from good homes & educated parents. What good did they bring to our society?

    I can not comprehend how much racism plays in our day to day lives…and how tired I am of hearing so much negative of all the immigrants… on how they come here to steal jobs from all the White American’s that do not want to get off their lazy A$$ and go work for nothing picking our vegetalbes and fruits. These people are fed lies.. it’s all a conspiracy. This is the type of thing that is played out at School or Work, when someone is NOT like you they’re different maybe they’re gay.. they are pointed out and made fun of. It may seem childish but this is reality, these are the games we play. I am PROUD to say I am a Mexican American woman. I am now pregnant with my 5th child, I HAVE decided that I will not have anymore children after this one that’s coming. My husband and I do not consider us middle class.. but we do alright. My children are A and B students and someday if god permits, I hope for them to be good honest hard working people.. after all isn’t that why god created his children? I DOUBT that in God’s plans, in his world only White people shall succeed.

    May god have mercy for us all.

  17. s. Powell September 14, 2007 / 8:53 am

    to You OughtaKnow on your August 2 post: What you advocate, the control of reproduction for the purpose of raising the intelligence of a population—It was tried already. Take a look at the results of the Eugenics movement of Adolph Hitler. Then, as Alma O says, take a look at how difficult it is to predict what type human being will result from the most privileged upbringing by highly intelligent people. In my town where I now live, one of the most horrid murders of recent years took place in the home of a priveleged couple, a philantropic couple, both well educated and pillars of the community. Their son, a student in the most elite of the private high schools here murdered both parents and went to the prom.

  18. OnlyGODKnowsBest March 2, 2008 / 2:30 pm

    Well, reading all arguments everyone generating thoughts, some from, love, some, from opinion, fact, hate/ foolishness(yououghtaknow), and some just from experience. Well, I would like to just say that I am a young 23 year old female, no need to mention race cause it dosent matter. One thing we all have in common that God freely gave us CHOICE. You have a RIGHT to make what ever choice you make whether it’s right or wrong good or bad. We all allow something to influence what we think, how we look, talk, walk, act, everything. It was all learned behavior if not from home then somewhere. Some situation, person, crisis, etc. caused us to believe that we were less of importance or more of importance, inferior or superior. Whatever YOU do in life will always impact someone else even if you just say it. We are all connected, we all came in this world the same way A WOMAN LOVED YOU ENOUGH TO BRING YOU INTO THIS WORLD (you were not aborted). she didn’t ask you what is your view of you being here. she just pushed when they said it and thats it. We all have the same color blood. Babies are not born into this world saying im going to kill, be poor, racist, sexist, gay, black, white or green, boy or girl. With all the education we recieve, we still think and live foolishly and selfishly. It’s funny because I know that at the time that each of you wrote something in the blog you wanted to be heard, accepted, you wanted someone to be passionate about the same thing you were just like children do everyday. Instead of complaining about things why don’t we communicate it to each other respectively, without getting defensive or aggitated. Everyone is so in love with money Money generates evrything, but when you die money won’t say i’m going to stop going for you. It will continue, to hurt, disappoint, kill, save, restore, give and whatever else it does depending on the person who utilizes it properly. I have nothing bad to say about anyone. All of you ladies be blessed. WE NEED to Stop playing race cards, sexist cards, class cards etc. They exisit because we let them continue to exsist We’ll sorry ladies that card stopped here along time ago Love yall……….

  19. mmmm March 18, 2009 / 5:36 am

    i think i am proof that this is really going on ,i got pregnant and was going though a lot at the time i was pregnant and my doctor told me that i should think about adoption or get my tubes tied cause he and other people that was working should not have to take care of kids on mind you i was on prozac during the whole pregnancy going though hurt that i was having to take care of of a child by my self again. i feel him knowing that i was depressed ,cause he was the one that gave me the prozac and knew i was a single mother and peagnant and depressed that was not his place to make me feel bad about bringing life into this world!now he was able to put his input on my life that lead to a very bad choice at the age of 21! also i’m a very hard working single mother!he just got me when i was feeling very low!

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