Elevate Difference

Fit to Be Tied: Sterilization and Reproductive Rights in America, 1950 – 1980

In 2004, at the age of twenty-three, I entered my gynecologist's office to request permanent sterilization. My doctor repeatedly refused my request, and would not honor my alternate request for an IUD. I tried changing doctors, but still encountered severe resistance to my wish to be permanently sterilized. Now that the IUD I did eventually obtain will be ready to come out at age thirty, my doctor has still indicated that she will not perform the procedure.

After reading Rebecca Kluchin's Fit to Be Tied, I am left wondering if my doctors' refusals to honor my wishes are, consciously or not, vestigial traces of America's bleak history involving positive and negative eugenics—separate categories for "fit" and "unfit" women. From the turn of the twentieth century to the late 1970s, social, legal, and medical authoritarianism and paternalism combined with white anxiety over losing social dominance in America to result in extraordinarily skewed, disparate policies of reproductive "rights" for white middle class women and poor women of color.

In the post-WWII era, concerns were raised about the population "explosion" and the resulting fear that poor, uneducated immigrants and people of color were "outbreeding" the white middle and upper classes. Griswold v. Connecticut, the landmark Supreme Court decision legalizing contraception for married couples, would not be decided until 1965, and few if any women had access to contraception at all. The solution put into effect by medical and legal authorities was to adopt a policy of eugenics: the undesirable minorities, often unwed, sunken into poverty, and with little to no recourse, were aggressively encouraged and often forced into unwanted sterilizations. Women were deceived, lied to, and even legally sentenced to sterilization under the white- and male-dominated cultural paradigm. The worst of these forced sterilization cases were known colloquially in the South as "Mississippi appendectomies," in which women deemed "unfit" to reproduce by physicians entered hospitals for routine surgeries (such as appendix removal) only to later find that their ovaries and uterus had been taken out as well.

Meanwhile, advances in sterilization procedures made the operation quite attractive to middle class white women who wanted to take control of their reproductive destiny. These women appealed to physicians and hospitals in order to obtain tubal ligations, only to find themselves rebuffed. Educated white women of privilege were denied sterilization because it was believed that they should give birth to as many children as possible, despite their own feelings on the matter. Many hospitals developed what was known as the "120 rule" of age/parity: if a reproductively "fit" woman's age multiplied by the number of children she had added up to 120, a sterilization was provided.

Sterilization for men is also touched upon in Fit to Be Tied. Infuriatingly, but perhaps not surprisingly, vasectomies have historically been provided on demand for men with little to no trepidation on the part of medical professionals.

On another personal note, I discussed this book with a friend of mine, who said it sounded interesting but "suspect." He did not know that eugenics was practiced openly in America for many decades, and believed that Kluchin's book was essentially feminist conspiracy theory. This sort of troubling ignorance of history only deepens the importance and necessitates the knowledge of medico-legal authoritarianism over women in America's past. Kluchin's work is straightforward, factual, academic, and exhaustively researched, but not intimidatingly so. It is a highly absorbing read and an incisive, grim but eminently necessary look into pre-Roe v. Wade America.

Written by: Natalie Ballard, October 11th 2009

[This very interesting post](http://contexts.org/socimages/2009/10/15/american-eugenics-images/" rel="nofollow) went up at Sociological Images today.

The issue is that history of misuse makes everyone gun-shy around the issue. I'm an african american minority. I know the history of many of the innocent medical surgeories that turn into something else. As genetic testing, and manipulation becomes more prevelant the issue of who is fit to breed is going to arise more and more. If a scientist says "For the greater good of humanity I will have to take a reproductive dna sample" or "For the good of humanity I can't allow you to procreate" it will lead to an upheaval.

I should also mention that the gyno was visibly relieved when I explained that my partner also wishes to remain childfree.

Ugh, just ugh! My doctor asked me "What if you meet Mr. Right?"

How very condescending and presumptuous on her part! I informed her that this putative "Mr. Right" would not want children, either. Not convincing enough for her.

I've heard so many horror stories about women trying to get sterilized that as much as I've always wanted it, I never tried until I got very lucky and moved abroad (my partner isn't a U.S. citizen, so for now, we live in his country). Here, tubal ligations are available to anyone over 25 pending doctor approval (my gyno signed the paperwork after only an intro visit), and I should only have a second visit at the hospital to be put on the list to have my fallopians singed shut. State-funded healthcare will cover the costs in full. I do not love living here, and we plan to come back to the U.S., but I will stay here until after my surgery for that reason alone. The barriers to elective sterilization in the U.S. are disgustingly paternalistic at best. I recognize the privilege in this situation. On the other hand, I think my situation illustrates how desperate some of us have felt. I should also mention that the gyno was visibly relieved when I explained that my partner also wishes to remain childfree. She's on my side, so to speak, but she still wanted to know that my man approved. [sigh]

While it would surely be easier for my partner to have a vasectomy, he has some surgical history in that area and would rather avoid elective surgery on his stuff. Since I'm the more adamantly childfree of the two of us (and of course, the one who would actually have to physically handle an unplanned pregnancy), I have no problem taking the surgical risks myself. I think our mutual decision respects us both.

Had the same experience of trying to get snipped in my early 30s, doctor told me she wouldn't do it until I was 40, I fired the doctor. I ended up with an IUD through my 30s and finally got the tubal at 41. I still bitterly resent that doctors would have given me Clomid in a heartbeat to enhance my ability to get pregnant, but refused to allow me to choose to end my fertility.

Thanks... that's one I've always wanted to read.

"Killing the Black Body" by Dorothy Roberts