HF01-02: Forced Sterilization in California: a Haunting Past and Persistent Inequity
Friday, May 3, 2024 1:57 PM to 2:04 PM · 7 min. (US/Central)
206
Abstract
History of Urology Forum
Information
Full Abstract and Figures
Author Block
Charles A Loeb, Abigail Lavold*, Thiago Pardini-Furtado, Jasper C Bash, Juan Andino, Jesse N Mills, Santa Monica, CA
Introduction
In California (CA), a state consent and mandatory waiting period is required before any sterilization procedure, such as tubal ligation or vasectomy. This abstract explores the historical background of CA’s state sterilization consent, aiming to understand its roots in eugenics and implications for health equity today.
Methods
A comprehensive review of historical literature was performed to shed light on the history of the CA eugenics movement and its role in shaping the state sterilization consent.
Results
California played an early and prominent role in the eugenics movement, becoming the third U.S. state to enact sterilization laws. By 1921, CA accounted for a staggering 80% of sterilizations in the nation. Between 1909 and 1979, an estimated 20,000 forced sterilizations occurred in state-run institutions. The Asexualization Act, CA’s eugenics law enacted in 1909, allowed state institutions to control the reproductive capacity of those considered “unfit,” primarily in state mental hospitals and the prison system. Medical superintendents were authorized to perform sterilizations without patient consent, and sterilization was even a prerequisite for release from certain institutions. The law remained in place until 1979, making it the legal framework for one of the most active sterilization programs in the U.S. A pivotal moment in the fight against forced sterilization was a class-action lawsuit in 1973. Ten Chicana women sued a medical center for being coerced into tubal ligation during labor. Despite a ruling in favor of the medical center, the case drew attention to the issue leading to significant reform. The practice ended in 1979 for state hospitals but persisted until 2010 in state prisons. In 2021, a compensation program was established, offering up to $25,000 per person. While hundreds of Californians may be eligible, public outreach to contact more victims has been challenging and it is unlikely that all will be compensated. CA currently mandates a 30-day waiting period prior to surgical sterilization. This can be reduced to 72 hours for many, but not by those with state-sponsored insurance, quietly perpetuating reproductive inequity. This disproportionately affects the underserved population which already struggles with access to care.
Conclusions
California’s history of forced sterilization, rooted in the eugenics movement, casts a shadow over current healthcare practices. The tiered waiting period for patients with different insurance plans, particularly Medi-Cal, highlights ongoing disparities. Recognizing this history is crucial for addressing health equity.
Source Of Funding
None
Author Block
Charles A Loeb, Abigail Lavold*, Thiago Pardini-Furtado, Jasper C Bash, Juan Andino, Jesse N Mills, Santa Monica, CA
Introduction
In California (CA), a state consent and mandatory waiting period is required before any sterilization procedure, such as tubal ligation or vasectomy. This abstract explores the historical background of CA’s state sterilization consent, aiming to understand its roots in eugenics and implications for health equity today.
Methods
A comprehensive review of historical literature was performed to shed light on the history of the CA eugenics movement and its role in shaping the state sterilization consent.
Results
California played an early and prominent role in the eugenics movement, becoming the third U.S. state to enact sterilization laws. By 1921, CA accounted for a staggering 80% of sterilizations in the nation. Between 1909 and 1979, an estimated 20,000 forced sterilizations occurred in state-run institutions. The Asexualization Act, CA’s eugenics law enacted in 1909, allowed state institutions to control the reproductive capacity of those considered “unfit,” primarily in state mental hospitals and the prison system. Medical superintendents were authorized to perform sterilizations without patient consent, and sterilization was even a prerequisite for release from certain institutions. The law remained in place until 1979, making it the legal framework for one of the most active sterilization programs in the U.S. A pivotal moment in the fight against forced sterilization was a class-action lawsuit in 1973. Ten Chicana women sued a medical center for being coerced into tubal ligation during labor. Despite a ruling in favor of the medical center, the case drew attention to the issue leading to significant reform. The practice ended in 1979 for state hospitals but persisted until 2010 in state prisons. In 2021, a compensation program was established, offering up to $25,000 per person. While hundreds of Californians may be eligible, public outreach to contact more victims has been challenging and it is unlikely that all will be compensated. CA currently mandates a 30-day waiting period prior to surgical sterilization. This can be reduced to 72 hours for many, but not by those with state-sponsored insurance, quietly perpetuating reproductive inequity. This disproportionately affects the underserved population which already struggles with access to care.
Conclusions
California’s history of forced sterilization, rooted in the eugenics movement, casts a shadow over current healthcare practices. The tiered waiting period for patients with different insurance plans, particularly Medi-Cal, highlights ongoing disparities. Recognizing this history is crucial for addressing health equity.
Source Of Funding
None
Sessions
History of Urology Forum
206