Unfit to Reproduce, Unfit to Parent, Unfit to Decide: The Evolving Rationale for Sterilizing People with Disabilities Without Their Consent

James Tabery – University of Utah; Aubrey Allen – University of Utah; Nicole Novak – University of Iowa; Lida Sarafraz – University of Texas at San Antonio

Abstract: Dozens of states controversially allow for non-consensually sterilizing people with disabilities. For critics, a practice that removes certain people’s ability to decide whether to have children harkens back to eugenics and the targeting of people with disabilities as “unfit.” For defenders, there’s a clear difference between the past eugenic sterilizations and the sterilizations of the present; they proceed now only through an independent review process charged with confirming that a sterilization will be in the patient’s best interest, and such process is triggered by a parent/guardian, not a state actor.

We draw on a century’s worth of state-level legislation to reveal how the rationale for sterilizing people with disabilities evolved over time. What began as an explicitly eugenic practice designed to target those who were “unfit to reproduce” morphed into one aimed at preventing those who were “unfit to parent” from having children they couldn’t raise, and then transitioned again to allow for sterilizing people who were deemed “unfit to decide” for themselves. The history reveals some ways that the contemporary practice is distinct from the sterilization programs of the eugenics era, but also other ways that the sterilizations performed today inherited and continue to share ethically problematic similarities to the past.

As more states reckon with their histories of eugenic sterilization by issuing apologies and funding compensation programs for sterilization survivors, getting clear about the historical relationship between the abhorrent past and the controversial present is essential.

Keywords: Disability, Eugenics, Sterilization