Written by Maria, RSEI Educator | Published October 28th, 2020

CW: forced sterilization, eugenics, racism, ableism

Let’s just get right into it – we need to talk about forced sterilization. If you joined us for our August webinar, you’ll know that we started to talk about the long and dark history of forced sterilization in the U.S. and Puerto Rico. So why are we choosing to continue the conversation here? The short answer is because the history of forced sterilization contextualizes sex education as it is provided today. Throughout history we have seen that white supremacy and ableism have been the driving factors for population control. And at the core of population control is reproductive control. Performing sterilization procedures without the patient’s informed consent is one way that governments and medical institutions have historically tried to control reproduction. Over time, they have also developed some less obvious ways to control reproduction, like financial coercion to accept permanent or semi-permanent birth control methods. We’re not going to delve deeply into this history, but we will provide resources to do your own learning at the end of this blog. What we do want to highlight here are the patterns that have existed throughout time.

Forced sterilizations have repeatedly invoked eugenic theories of who is and is not “fit” to be a parent. These theories were most often used to justify sterilizing Black, brown, Indigenous, and immigrant people as well as people with disabilities. The core beliefs of these eugenic theories are not gone. We know that today people still hold racist and ableist prejudices of who should and should not parent. We also know that forced sterilization itself is not gone. Just last month, news broke that immigration detention centers are performing hysterectomies on the people detained there (you can read more about it here). So let’s talk about how the historical and current context of forced sterilization affects the way we teach sex ed and what we, as youth-serving adults who teach sex education, can do about it.

We’ll start by reflecting. Why do we teach sex ed? Maybe it’s a career or maybe you’re someone who teaches sex ed once in a while. Maybe you’re passionate about comprehensive sex education. Maybe it’s a requirement of your job. But if you are a youth-serving adult, it’s likely that you are committed to serving the students you teach. So the question becomes, how do we best serve the students we teach? We don’t claim to have the answer to this question at RSEI. However, in a sex education setting, there are ways that we can check in with ourselves to make sure our program goals are aligned with what best serves our students.

So what are the goals of sex ed? Sex education can have a lot of goals. We could spend the rest of this blog talking about the learning objectives that may come with the curriculum we teach. But for argument’s sake, let’s go big picture: The goal of sex education is to educate. Yes that sounds redundant, but what it really means is that the goal of sex education is to give students all the information they need to make choices for themselves. And it’s important to name that this is different than making choices for students.

As sex educators, we are in a position of power – we are disseminating knowledge from a place of expertise. Our job is not to control what students choose to do, but we do have some control over what messages they get from us. So it is our responsibility to make sure those messages are affirming and equitable. Let’s explore this responsibility with an example: pregnancy prevention. Pregnancy prevention is often one of the big focuses of comprehensive sex education. From a public health standpoint, this makes sense. According to the Guttmacher Institute, 75% of pregnancies among 15-19 year-olds are unplanned. We know that many of the students we teach may indeed identify that their goal is to prevent unintended pregnancy, and yet, we don’t get to identify that goal for them. As sex educators, we may have more in-depth knowledge about the different outcomes of sexual decisions, but this is different than knowing what’s best for our students. If we start to think we know what’s best, we leave room for our personal biases to bleed into our teaching, and that can lead to some harmful messages. Remember at the beginning of this blog when we talked about forced sterilization? And how at the root of forced sterilization was prejudiced beliefs about who should and should not be pregnant? We’re not saying that teaching pregnancy prevention is the same thing as forced sterilization, but we need to make sure that the way we’re teaching pregnancy prevention doesn’t perpetuate prejudiced messages about who should and should not be pregnant.

It can be helpful to check ourselves for bias by asking ourselves the following questions:

When we teach about birth control options, do we frame some options as “better” than others? Specifically, are we framing long-acting reversible contraceptives (LARCs) like the IUD and the implant as more ideal options for youth of color? For lower-income youth? LARCs can be a great option for many people – they are highly effective, long-acting, and can be low-cost. But we also know that data suggest that providers are more likely to recommend IUDs to people who are poor and non-white (in many studies, notably Black or Latinx) compared to people who are white and wealthy. So how do we make sure that we aren’t providing racialized messaging about who benefits most from long-acting contraceptives?  How are we making sure that we’re centering students’ priorities for themselves?

When we teach pregnancy prevention, how do we explain why pregnancy prevention is important? Are we emphasizing that people should prevent pregnancy because of their age? Their race? Their gender? Their sexual orientation? Or are we letting students identify pregnancy prevention as a goal for themselves?

How do we frame the conversation around the outcomes of unintended pregnancies? Are we talking about unintended pregnancies as shameful? Are we framing any and all outcomes as consequences? “Consequences” are inherently negative and carry with them potentially serious judgments about what decisions are correct for people. If we’re framing outcomes as consequences, we could be robbing students of the opportunity to use their own judgment. So how do we make sure that we are giving students the information they need to decide what’s best for themselves without framing different outcomes as consequences?

Who gets the pregnancy prevention curriculum? Are we providing comprehensive sex education to all genders, races, and ethnicities? Are we offering birth control information to people with disabilities? Are we offering information that is relevant to LGBTQ+ communities? Do we have the tools to make sure all of our participants can be successful in learning our materials? 

Ultimately, we are here to support our students. That can look a lot of different ways, and these are just some of the ways we can reflect on what messages we are sending to our students. If you want to learn more about the history of forced sterilization, you can become a member to watch our August webinar on the topic or you can engage with the resources below. Thank you for taking this time to reflect on the legacy of forced sterilization in sex education.