RESEARCH STARTER

Sterilization laws

Sterilization laws are legal mandates that allow for the involuntary sterilization of individuals, often justified under the auspices of improving the genetic quality of a population. These laws emerged from the eugenics movement, which aimed to enhance desirable human traits while reducing those deemed undesirable. The movement gained traction in the early 20th century, with the first compulsory sterilization law passed in Indiana in 1907, targeting individuals in state institutions, including those with intellectual disabilities and behavioral issues.

By the end of the 1920s, a total of thirty-three states in the United States had enacted similar legislation. The U.S. Supreme Court's 1927 decision in Buck v. Bell upheld the legality of such laws, reinforcing the belief that society had a duty to prevent the reproduction of individuals identified as "unfit." This practice not only affected tens of thousands in the U.S. but also influenced sterilization policies in other countries, including Nazi Germany.

While many sterilization programs have been discontinued, concerns about involuntary sterilizations persist globally, particularly regarding marginalized populations. The legacy of these laws raises critical ethical questions about human rights, the definition of "desirable" traits, and the potential for new forms of eugenics in light of advances in genetic testing.

Full Article

SIGNIFICANCE: Forced sterilization for eugenic reasons became legal throughout much of the United States and many parts of the world during the first half of the twentieth century. Though sterilization is an ineffective mechanism for changing the genetic makeup of a population, various sterilization laws remain in effect in many countries throughout the world.

The Eugenics Movement and Sterilization Laws

The founder of the eugenics movement is considered to be Sir Francis Galton (1822–1911), who carried out extensive genetic studies of human traits. He thought that the human race would be improved by encouraging humans with desirable traits (such as intelligence, good character, and musical ability) to have more children than those people with less desirable traits (positive eugenics). With the development of Mendelian genetics shortly after the beginning of the twentieth century, research on improving the genetic quality of plants and animals was in full swing. Success with plants and domestic animals made it inevitable that interest would develop in applying those principles to the improvement of human beings. As some human traits became known to be under the control of single genes, some geneticists began to claim that all sorts of traits (including many behavioral traits and even social characteristics and preferences) were under the control of a single gene, with little regard for the possible impact of environmental factors.

The Eugenics Record Office at Cold Spring Harbor, New York, was set up by Charles Davenport to gather and collate information on human traits. The eugenics movement became a powerful political force that led to the creation and implementation of laws restricting immigration and regulating reproduction. Some geneticists and politicians reasoned that since mental retardation and other “undesirable” behavioral and physical traits were affected by genes, society had an obligation and a moral right to restrict the reproduction of individuals with “bad genes” (negative eugenics).

The state of Indiana passed the first compulsory sterilization law in 1907, which permitted the involuntary sterilization of inmates in state institutions. Inmates included not only “imbeciles,” “idiots,” and others with varying degrees of intellectual disability (described as “feeble-mindedness”) but also people who were committed for behavioral problems such as criminality, swearing, promiscuity, and slovenliness. By 1911, similar laws had been passed in six states, and by the end of the 1920s, twenty-four states had similar sterilization laws. Ultimately, thirty-three states enacted sterilization laws.

The US Supreme Court, in its 1927 Buck v. Bell decision, supported the eugenic principle that states could use involuntary sterilization to eliminate genetic defects from the population. The vote of the court was eight to one. The court’s reasoning went as follows:

We have seen more than once that the public welfare may call upon the best citizens for their lives. It would be strange if it could not call upon those who already sap the strength of the state for these lesser sacrifices, often not felt to be such by those concerned, in order to prevent our being swamped with incompetence. It is better for all the world, if instead of waiting to execute degenerate offspring for crime, or to let them starve for their imbecility, society can prevent those who are manifestly unfit from continuing their kind. The principle that sustains compulsory vaccination is broad enough to cover cutting the Fallopian tubes.

Ironically, the sterilization laws of the United States and Canada served as models for the eugenics movement in Nazi Germany in its program to ensure so-called racial purity and superiority.

Impact and Applications

Two problems associated with eugenics are the subjective nature of deciding which traits are desirable and determining who should decide. These concerns aside, the question of whether there is a sound scientific basis for the desire to manipulate the human gene pool remains. Does the sterilization of individuals who are intellectually disabled or who have some other mental or physical impairment improve the human genetic composition? Involuntary sterilization of affected individuals would quickly reduce the incidence of dominant genetic traits. Individuals who were homozygous for recessive traits would also be eliminated. However, most harmful recessive genes are carried by individuals who appear normal and, therefore, would not be “obvious” for sterilization purposes. These “normal” people would continue to pass on the “bad” gene to the next generation, and a certain number of affected people would again be born. It would take an extraordinary number of generations to significantly reduce the frequency of harmful genes.

The impact sterilization laws had on the US population by 1960 was far-reaching, as some sixty thousand people were sterilized. In 1978, the federal government passed regulations requiring full, informed consent and a waiting period of at least 30 days before a publicly funded sterilization may be performed, with limited exceptions. Other countries also had laws that allowed forced sterilizations, with many programs continuing into the 1970s. The province of Alberta, Canada, sterilized three thousand people before its law was repealed. Another sixty thousand were sterilized in Sweden. The story of sterilization and “euthanasia” in Germany needs no retelling. As the United Nations and World Health Organization stated in their interagency statement Eliminating Forced, Coercive and Otherwise Involuntary Sterilization (2014), involuntary and/or coercive sterilizations of specific populations, such as those with disabilities and those belonging to ethnic, racial, or sexual minority groups, continues around the world.

 In the 2020s, China, in particular, has faced international criticism for its policy of forced sterilization on its minority populations, most notably the Muslim Uighurs. With the ability to decipher the human genome and implement improved genetic testing procedures, a danger exists that new institutionalized programs of eugenics might once again emerge. The United States also came under fire in the 2020s for reports of medically unnecessary or improperly authorized gynecological procedures performed on detained immigrants under US Immigration and Customs Enforcement (ICE) care. A whistleblower complaint filed by a nurse alleged medical abuse and unnecessary gynecological procedures at a detention facility in Georgia, and federal investigators later found that ICE had not properly documented the medical necessity of at least two hysterectomies and had not followed proper authorization procedures for dozens of major surgeries. Other examples of eugenics in contemporary times have included offering time off sentences for prisoners in exchange for voluntary sterilization or long-term birth control. Human rights groups continue to monitor sterilization around the world and advocate for those targeted. In 2026, the Inter-American Court of Human Rights held Peru responsible in the forced sterilization and death of Celia Ramos, ruling that the state’s coercive family-planning program violated reproductive autonomy and other human rights.

Key Terms

  • negative eugenics: the effort to improve the human species by discouraging or eliminating reproduction among those deemed to be socially or physically unfit
  • positive eugenics: the effort to encourage more prolific breeding among “gifted” individuals
  • sterilization: an operation to make reproduction impossible; in tubal ligation, doctors sever the fallopian tubes so that a woman cannot conceive a child

Bibliography

Campbell, Annily. Childfree and Sterilized: Women’s Decisions and Medical Responses. Cassell, 1999.

“China Cuts Uighur Births with IUDs, Abortion, Sterilization.” Associated Press, 29 June 2020, apnews.com/article/ap-top-news-international-news-weekend-reads-china-health-269b3de1af34e17c1941a514f78d764c. Accessed 16 May 2026.

Cussins, Jessica. “Involuntary Sterilization Then and Now.” Psychology Today. Sussex, 5 Sept. 2013.

“42 CFR Part 441 Subpart F—Sterilizations.” Electronic Code of Federal Regulations, National Archives and Records Administration, www.ecfr.gov/current/title-42/chapter-IV/subchapter-C/part-441/subpart-F. Accessed 16 May 2026.

Gallagher, Nancy L. Breeding Better Vermonters: The Eugenics Program in the Green Mountain State. UP of New England, 2000.

Human Rights Watch. “Sterilization of Women and Girls with Disabilities: A Briefing Paper.” Human Rights Watch, 10 Nov. 2011. Accessed 16 May 2026.

“Inter-American Court Finds Peru Guilty of Forced Sterilization, Reproductive Violence, and Denial of Autonomy.” Center for Reproductive Rights, 6 Mar. 2026, reproductiverights.org/news/inter-american-court-finds-peru-guilty-of-forced-sterilization-reproductive-violence-and-denial-of-autonomy/. Accessed 16 May 2026.

Kevles, Daniel J. In the Name of Eugenics: Genetics and the Uses of Human Heredity. 1995. Harvard UP, 2004.

Levine, Sam. “US Immigration Officials Didn’t Properly Document Hysterectomies—Watchdog.” The Guardian, 26 Jan. 2024, www.theguardian.com/us-news/2024/jan/26/hysterectomies-migrant-women-dhs-watchdog. Accessed 16 May 2026.

Lombardo, Paul A. Three Generations, No Imbeciles: Eugenics, the Supreme Court, and Buck v. Bell. Johns Hopkins UP, 2010.

Manian, Maya. “Immigration Detention and Coerced Sterilization: History Tragically Repeats Itself.” ACLU, 29 Sept. 2020, www.aclu.org/news/immigrants-rights/immigration-detention-and-coerced-sterilization-history-tragically-repeats-itself. Accessed 16 May 2026.

Mason, J. K. “Unsuccessful Sterilization.” The Troubled Pregnancy: Legal Wrongs and Rights in Reproduction. Cambridge UP, 2007.

Medosch, Emily. “Not Just ICE: Forced Sterilization in the United States.” Immigration and Human Rights Law Review, 28 May 2021, lawblogs.uc.edu/ihrlr/2021/05/28/not-just-ice-forced-sterilization-in-the-united-states/. Accessed 16 May 2026.

Meyers, David W. The Human Body and the Law: A Medico-Legal Study. Aldine Transaction, 2006.

Office of the High Commissioner for Human Rights, et al. Eliminating Forced, Coercive and Otherwise Involuntary Sterilization. Department of Reproductive Health and Research, World Health Organization, 2014.

Rosenblatt, Kalhan. “Judge Offers Inmates Reduced Sentences in Exchange for Vasectomy.” NBC, 21 July 2017, www.nbcnews.com/news/us-news/judge-offers-inmates-reduced-sentences-exchange-vasectomy-n785256. Accessed 16 May 2026.

Samakow, Paul. “Forced Sterilization of Mentally Incompetent Man Legal in Britain.” Washington Times Communities. Washington Times, 2013. Accessed 16 May 2026.

Full Article

SIGNIFICANCE: Forced sterilization for eugenic reasons became legal throughout much of the United States and many parts of the world during the first half of the twentieth century. Though sterilization is an ineffective mechanism for changing the genetic makeup of a population, various sterilization laws remain in effect in many countries throughout the world.

The Eugenics Movement and Sterilization Laws

The founder of the eugenics movement is considered to be Sir Francis Galton (1822–1911), who carried out extensive genetic studies of human traits. He thought that the human race would be improved by encouraging humans with desirable traits (such as intelligence, good character, and musical ability) to have more children than those people with less desirable traits (positive eugenics). With the development of Mendelian genetics shortly after the beginning of the twentieth century, research on improving the genetic quality of plants and animals was in full swing. Success with plants and domestic animals made it inevitable that interest would develop in applying those principles to the improvement of human beings. As some human traits became known to be under the control of single genes, some geneticists began to claim that all sorts of traits (including many behavioral traits and even social characteristics and preferences) were under the control of a single gene, with little regard for the possible impact of environmental factors.

The Eugenics Record Office at Cold Spring Harbor, New York, was set up by Charles Davenport to gather and collate information on human traits. The eugenics movement became a powerful political force that led to the creation and implementation of laws restricting immigration and regulating reproduction. Some geneticists and politicians reasoned that since mental retardation and other “undesirable” behavioral and physical traits were affected by genes, society had an obligation and a moral right to restrict the reproduction of individuals with “bad genes” (negative eugenics).

The state of Indiana passed the first compulsory sterilization law in 1907, which permitted the involuntary sterilization of inmates in state institutions. Inmates included not only “imbeciles,” “idiots,” and others with varying degrees of intellectual disability (described as “feeble-mindedness”) but also people who were committed for behavioral problems such as criminality, swearing, promiscuity, and slovenliness. By 1911, similar laws had been passed in six states, and by the end of the 1920s, twenty-four states had similar sterilization laws. Ultimately, thirty-three states enacted sterilization laws.

The US Supreme Court, in its 1927 Buck v. Bell decision, supported the eugenic principle that states could use involuntary sterilization to eliminate genetic defects from the population. The vote of the court was eight to one. The court’s reasoning went as follows:

We have seen more than once that the public welfare may call upon the best citizens for their lives. It would be strange if it could not call upon those who already sap the strength of the state for these lesser sacrifices, often not felt to be such by those concerned, in order to prevent our being swamped with incompetence. It is better for all the world, if instead of waiting to execute degenerate offspring for crime, or to let them starve for their imbecility, society can prevent those who are manifestly unfit from continuing their kind. The principle that sustains compulsory vaccination is broad enough to cover cutting the Fallopian tubes.

Ironically, the sterilization laws of the United States and Canada served as models for the eugenics movement in Nazi Germany in its program to ensure so-called racial purity and superiority.

Impact and Applications

Two problems associated with eugenics are the subjective nature of deciding which traits are desirable and determining who should decide. These concerns aside, the question of whether there is a sound scientific basis for the desire to manipulate the human gene pool remains. Does the sterilization of individuals who are intellectually disabled or who have some other mental or physical impairment improve the human genetic composition? Involuntary sterilization of affected individuals would quickly reduce the incidence of dominant genetic traits. Individuals who were homozygous for recessive traits would also be eliminated. However, most harmful recessive genes are carried by individuals who appear normal and, therefore, would not be “obvious” for sterilization purposes. These “normal” people would continue to pass on the “bad” gene to the next generation, and a certain number of affected people would again be born. It would take an extraordinary number of generations to significantly reduce the frequency of harmful genes.

The impact sterilization laws had on the US population by 1960 was far-reaching, as some sixty thousand people were sterilized. In 1978, the federal government passed regulations requiring full, informed consent and a waiting period of at least 30 days before a publicly funded sterilization may be performed, with limited exceptions. Other countries also had laws that allowed forced sterilizations, with many programs continuing into the 1970s. The province of Alberta, Canada, sterilized three thousand people before its law was repealed. Another sixty thousand were sterilized in Sweden. The story of sterilization and “euthanasia” in Germany needs no retelling. As the United Nations and World Health Organization stated in their interagency statement Eliminating Forced, Coercive and Otherwise Involuntary Sterilization (2014), involuntary and/or coercive sterilizations of specific populations, such as those with disabilities and those belonging to ethnic, racial, or sexual minority groups, continues around the world.

 In the 2020s, China, in particular, has faced international criticism for its policy of forced sterilization on its minority populations, most notably the Muslim Uighurs. With the ability to decipher the human genome and implement improved genetic testing procedures, a danger exists that new institutionalized programs of eugenics might once again emerge. The United States also came under fire in the 2020s for reports of medically unnecessary or improperly authorized gynecological procedures performed on detained immigrants under US Immigration and Customs Enforcement (ICE) care. A whistleblower complaint filed by a nurse alleged medical abuse and unnecessary gynecological procedures at a detention facility in Georgia, and federal investigators later found that ICE had not properly documented the medical necessity of at least two hysterectomies and had not followed proper authorization procedures for dozens of major surgeries. Other examples of eugenics in contemporary times have included offering time off sentences for prisoners in exchange for voluntary sterilization or long-term birth control. Human rights groups continue to monitor sterilization around the world and advocate for those targeted. In 2026, the Inter-American Court of Human Rights held Peru responsible in the forced sterilization and death of Celia Ramos, ruling that the state’s coercive family-planning program violated reproductive autonomy and other human rights.

Key Terms

  • negative eugenics: the effort to improve the human species by discouraging or eliminating reproduction among those deemed to be socially or physically unfit
  • positive eugenics: the effort to encourage more prolific breeding among “gifted” individuals
  • sterilization: an operation to make reproduction impossible; in tubal ligation, doctors sever the fallopian tubes so that a woman cannot conceive a child

Bibliography

Campbell, Annily. Childfree and Sterilized: Women’s Decisions and Medical Responses. Cassell, 1999.

“China Cuts Uighur Births with IUDs, Abortion, Sterilization.” Associated Press, 29 June 2020, apnews.com/article/ap-top-news-international-news-weekend-reads-china-health-269b3de1af34e17c1941a514f78d764c. Accessed 16 May 2026.

Cussins, Jessica. “Involuntary Sterilization Then and Now.” Psychology Today. Sussex, 5 Sept. 2013.

“42 CFR Part 441 Subpart F—Sterilizations.” Electronic Code of Federal Regulations, National Archives and Records Administration, www.ecfr.gov/current/title-42/chapter-IV/subchapter-C/part-441/subpart-F. Accessed 16 May 2026.

Gallagher, Nancy L. Breeding Better Vermonters: The Eugenics Program in the Green Mountain State. UP of New England, 2000.

Human Rights Watch. “Sterilization of Women and Girls with Disabilities: A Briefing Paper.” Human Rights Watch, 10 Nov. 2011. Accessed 16 May 2026.

“Inter-American Court Finds Peru Guilty of Forced Sterilization, Reproductive Violence, and Denial of Autonomy.” Center for Reproductive Rights, 6 Mar. 2026, reproductiverights.org/news/inter-american-court-finds-peru-guilty-of-forced-sterilization-reproductive-violence-and-denial-of-autonomy/. Accessed 16 May 2026.

Kevles, Daniel J. In the Name of Eugenics: Genetics and the Uses of Human Heredity. 1995. Harvard UP, 2004.

Levine, Sam. “US Immigration Officials Didn’t Properly Document Hysterectomies—Watchdog.” The Guardian, 26 Jan. 2024, www.theguardian.com/us-news/2024/jan/26/hysterectomies-migrant-women-dhs-watchdog. Accessed 16 May 2026.

Lombardo, Paul A. Three Generations, No Imbeciles: Eugenics, the Supreme Court, and Buck v. Bell. Johns Hopkins UP, 2010.

Manian, Maya. “Immigration Detention and Coerced Sterilization: History Tragically Repeats Itself.” ACLU, 29 Sept. 2020, www.aclu.org/news/immigrants-rights/immigration-detention-and-coerced-sterilization-history-tragically-repeats-itself. Accessed 16 May 2026.

Mason, J. K. “Unsuccessful Sterilization.” The Troubled Pregnancy: Legal Wrongs and Rights in Reproduction. Cambridge UP, 2007.

Medosch, Emily. “Not Just ICE: Forced Sterilization in the United States.” Immigration and Human Rights Law Review, 28 May 2021, lawblogs.uc.edu/ihrlr/2021/05/28/not-just-ice-forced-sterilization-in-the-united-states/. Accessed 16 May 2026.

Meyers, David W. The Human Body and the Law: A Medico-Legal Study. Aldine Transaction, 2006.

Office of the High Commissioner for Human Rights, et al. Eliminating Forced, Coercive and Otherwise Involuntary Sterilization. Department of Reproductive Health and Research, World Health Organization, 2014.

Rosenblatt, Kalhan. “Judge Offers Inmates Reduced Sentences in Exchange for Vasectomy.” NBC, 21 July 2017, www.nbcnews.com/news/us-news/judge-offers-inmates-reduced-sentences-exchange-vasectomy-n785256. Accessed 16 May 2026.

Samakow, Paul. “Forced Sterilization of Mentally Incompetent Man Legal in Britain.” Washington Times Communities. Washington Times, 2013. Accessed 16 May 2026.

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