"Call to Action: Insights from past sterilization practices shed light on the lack of underrepresentation of Latinx in Medical research:

by Camila Fravid - commentary provided by Dr. Lilyana Amezcua

The trust gap between the Latino community and medical research is deeply rooted in a troubling history. Picture being a young Latina during the early 20th century, awakening after childbirth, only to discover her ability to have more children has been taken away—this was the grim reality for thousands of Latina women, particularly of Mexican descent. Under the pretense of medical necessity and often through deceptive consent processes, many were coerced or unknowingly sterilized. This dark chapter in U.S. history, as documented in No Mas Bebes, illustrates a brutal violation of women’s rights and bodily autonomy. It also highlights the discriminatory practices embedded within society (systemic racism) and exploitation that the Latino community has experienced which is no short of reason to lost trust in medical research engagement.

The documentary No Mas Bebes intricately examines the traumatic experiences of Latina Women, both immigrant and nonimmigrant, who underwent sterilization without consent during the 1960s-70s. Many of these women were of Mexican origin, spoke minimal English, and experienced childbirth at the Los Angeles County Hospital. The film No Mas Bebes exposes how healthcare professionals exploited these vulnerable women, often framing sterilization as a necessary measure for population control or alleviating poverty, reflecting racist attitudes and stereotypes.

Such stereotypes included “Latina women have too many babies”. Consequently, many of these women described their experiences as dehumanizing culminating in alienation from their society and mistrust of the healthcare system and healthcare professionals.

In Virginia Espino’s article “Woman Sterilized As Gives Birth”: Forced Sterilization and Chicana Resistance in the 1970s”, further explores this historical and cultural landscape. It focuses on the Latina women and activists who resiliently fought for justice and went against the medical institutions and healthcare professionals during the forced sterilization period that occurred at Los Angeles County-USC Medical Center. Espino highlights the determination of Chicana activists and lawyers, such as Antonia Hernandez, who fought for justice for the victims. Hernandez specifically pointed out that “all of the victims…belonged to a racial minority, were poor, and could not readily understand the English language.” (Espino, 94)- factors that made them particularly susceptible to exploitation. Medical professionals, influenced by racist stereotypes and implicit biases, violated not only their bodies but also their mental well-being, contributing to an enduring barrier between Latina women and the medical community.

The forced Sterilization of Latina women in Los Angeles is a dark and harrowing part of U.S. history that was part of a pattern and a bigger goal embedded in eugenic ideologies to control the Latino population.

It also showcases how medical professionals abused their authority over marginalized communities. Activist Julia Arce states that Latinas have been targeted since the 20th century across the country, “From 1907 to the 1970s, state-sanctioned forced sterilizations were widespread with 33 states having eugenics boards that had the authority to order such procedures.” (Arce). These sterilizations left the Latino community with a sense of mistrust in the medical professionals and institutions who took care of them. This history has established a lack of mistrust within the Latino community to engage in medical research today. As a consequence, there is an underrepresentation and lack of inclusion of Latinx people in medical research studies.

While some argue that the mistrust has waned as healthcare institutions have made amends to implement diversity programs and protection of patients’ rights, the sterilization of Latina women in the early 20th century and the trauma cannot be overlooked. Despite efforts to foster trust, many remain hesitant to engage, as these painful historical events continue to resonate within their families.

The forced sterilization of Latina women is not only a significant part of history, but it should serve as a wake-up call for change and accountability. Acknowledgement of past mistakes from the institutions and medical professionals is a start. In 2003, the California healthcare centers issued a public apology for their role in the eugenics movement. In addition, to foster and restore trust, it is imperative to engage in dialogue with the Latino community. By increasing transparency, improving access to equitable healthcare and research opportunities, and promoting culturally sensitive care, Latinx communities may be able to be more inclined to participate in medical research. One crucial aspect that healthcare professionals should focus on is active engagement with the Latinx communities and ensuring their voices are heard and that they too have a place at the table. Minimizing systemic barriers, such as language, transportation, or financial is crucial as well as making medical research accessible in their communities. With these factors in motion, we can then be sure to hopefully one day erase these horrible injustices and restore trust between the medical community and the Latinx community.

Citations

Presch, Stephanie, and UnidosUS. “The Long History of Forced Sterilization of Latinas.” UnidosUS, 6 Jan. 2022, unidosus.org/blog/2021/12/16/the-long-history-of-forced-sterilization-of-latinas/.

“No Más Bebés | Documentary about Madrigal v. Quilligan Coerced Sterilization Case | Independent Lens | PBS.” Independent Lens, www.pbs.org/independentlens/documentaries/no-mas-bebes/.

Espino , Virginia . “Women Sterilized as Gives Birth”: Forced Sterilization and Chicana Resistance in the 1970s.

Latino LA

Lawson, Kimberly. “California’s Dark History of Forcibly Sterilizing Latinas.” VICE, 27 July 2024, www.vice.com/en/article/california-forced-sterilizations-latina-women-history/.

This Op-ed was written by Camila Farvid, a student at Loyola Marymount University.'

Commentaries:

"The Sterilization of Latinas and Eugenic policies had far-reaching effects on medical research and ethics. In a constructive sense, it led to the development of a number of regulations and guidelines that are now in place to protect research participants, this includes an emphasis on subject autonomy and the oversight role of the IRBs. “Lilyana Amezcua, MD, MS, FAAN, Associate Professor of Neurology and Division Chief of MS and Neuroimmunology at Keck School of Medicine of USC

“The past forced sterilization of Latina women and eugenic ideologies highlight a very dark and harrowing time in US history, which without doubt has had long-lasting implications. These unthinkable and dehumanizing practices resulted in profound mistrust of medical institutions by the Latinx community that is still visible in today’s physician-patient relationships and medical research. As mentioned, hopefully with the act of accountability and active approaches to change, we can move past these atrocities and look forward to renewed trust between medical institutions and the Latinx community.” - Andrea Martinez, MPH, Project Specialist at Keck School of Medicine of USC