The long history in the United States of forced sterilizations and medical abuses of communities of color and vulnerable populations once again came into view in September of 2020 when Project South and three other organizations filed a whistleblower complaint alleging medical abuse of detainees in an Immigration and Customs Enforcement (ICE) detention facility. The complaint, submitted on September 14, 2020 to the U.S. Department of Homeland Security (DHS), Immigration and Customs Enforcement, and the Irwin County Detention Center (ICDC) on behalf of detainees and a former nurse at ICDC in Ocilla, Georgia, alleges a number of abuses, including negligence in the facility’s handling of COVID-19 and, most severely, the forced sterilization of female detainees. ICDC is run by LaSalle Corrections, a private corporation that contracts with ICE and operates several immigrant detention facilities in Louisiana, Texas, New Mexico, Georgia, and Arizona.

This center has long been known for unsafe conditions, and a 2017 report by the ICE Office of Detention Oversight (ODO) noted several deficiencies. Among them was the following finding: “…[C]ells had graffiti on the walls, their vents and windows were covered with paper, garbage and refuse containers were not emptied, and the floors were dirty. In medical unit cells, ODO observed floors needed to be mopped, walls wiped down, toilets cleaned, and trash and refuse removed. Staff and detainees do not maintain a high standard of facility sanitation and general cleanliness” (p. 6). At the time, the facility had a bed capacity of 512, but its daily detainee population was 630 persons, reflecting considerable overcrowding.

In the immediate aftermath of the complaint, news outlets, social media users, a letter by four professional medical associations, and a letter to DHS signed by 173 members of Congress referred to “mass hysterectomies” at ICDC. The actual complaint, however, does not use the term, “mass hysterectomies,” and does not specify the number of forced sterilizations alleged to have taken place. The complaint does tie potentially “high rates” of hysterectomies to one specific doctor: “Several immigrant women have reported to Project South their concerns about how many women have received a hysterectomy while detained at ICDC. One woman told Project South in 2019 that Irwin sends many women to see a particular gynecologist outside the facility but that some women did not trust him” (p. 18). Dawn Wooten, the nurse named in the complaint, states, “Everybody he sees has a hysterectomy—just about everybody” (p. 19).

Spokespersons from ICE and LaSalle Corrections, as well as former Acting Secretary of Homeland Security, Chad Wolf, and a lawyer for Dr. Mahendra Amin, the gynecologist referred to but not named in the complaint, all deny these allegations. In the immediate wake of the complaint, Medical Director of the ICE Health Service Corps, Dr. Ada Rivera, claimed that since 2018 ICE data showed only two referrals of detainees at ICDC to medical professionals for hysterectomies. In early October, Wolf, disclosed that the number of referrals was higher than previously reported, with five total referrals since 2017, and three completed procedures, according to ICE data. He stated that these referrals were in compliance with National Commission on Correctional Health Care standards and shifted responsibility for any medical decisions to ICDC clinical authorities. Amin, who runs a private practice in Douglas, GA, claimed to The Intercept to have only performed “one or two hysterectomies in the past two [or] three years.”

However, dozens of women currently or previously detained at ICDC allege that they received unnecessary or aggressive procedures from Amin. On October 27, 2020, The Intercept reported that “the total number of women known to have been seen by the doctor since 2018 who say they underwent or were pressured to undergo unnecessary treatments has risen to 57.” An independent review of medical records of 19 of these women, led by the ALLGOOD Foundation, found “a disturbing pattern that warrants further investigation: one in which many women either underwent abdominal surgery or were pressured to have a surgery that was not medically indicated and to which they did not consent.” Only one of the 19 women had signed a consent form for her procedure, but the form was written in English while her primary language was Spanish.
As of January, more than 40 women had joined a class action lawsuit that names, among others, numerous ICE officials, Wolf, former Attorney General William Barr, representatives of ICDC and Irwin County Hospital, where procedures took place, and Amin. The suit reiterates the allegations against Amin, and further alleges retaliation from ICDC and ICE officers and officials against women who spoke out against medical abuse, including physical abuse, solitary confinement, and deportation or threats of deportation. By the time Trump left office, six of Amin’s accusers had been deported and deportation orders had been issued for seven more; lawyers for three women intervened mere hours before deportation orders could be carried out. ICE denies that deportations were an act of retaliation.

The details of the case remain murky, but the fact that accusations of forced sterilizations raised red flags for many comes as no surprise given the legacy in the U.S. of coerced sterilizations of women of color, immigrants, and other vulnerable populations. Between 1907 and 1937, over 30 U.S. states passed compulsory sterilization laws rooted in eugenic pseudoscience—in 1897, Michigan was the first state to introduce a compulsory sterilization bill, which did not pass, and Indiana’s eugenics-based sterilization law, passed in 1907, was the first in the world. These laws resulted in the forced or coerced sterilization of at least 60,000 people, mostly people of color, immigrants, people with disabilities, and the economically marginalized. In Puerto Rico, starting in the 1930s forced sterilizations were used as a means of population control, with a 1965 study finding that one-third of married women between the ages of 20 and 49 had been sterilized. In the 1970s, the federal Indian Health Service performed thousands of coerced sterilizations. Between 2006 and 2010, nearly 150 women held in California state prisons were sterilized without state approval, with an estimated 100 more women sterilized from 1997 to 2006. Alleged medical abuse of detained immigrant women, mostly Black and Latina, would only be a continuation of this history.

Forced sterilization as a means of social control reveals the extent to which the political class, medical institutions, and the justice system in the U.S. determine whose lives have value and who is considered a burden on our society. At the same time, the accusations against Amin and ICDC should be understood as a consequence of privatization of formerly public systems under a neoliberal economic regime.
In January of 2019, the Office of the Inspector General of DHS released a report showing that ICE’s multilayered practice of contracting out services that fall under its purview resulted in a failure to hold contractors accountable to performance standards. ICE’s failure to immediately respond to allegations against Amin, subcontracted by ICE contractor La Salle Corrections, that date back to 2018 is a clear example of ICE’s failure to hold its contractors accountable.

On January 26, 2021, a week into his presidency, Joseph Biden Jr. signed an executive order directing the Department of Justice to end its practice of incarcerating federal prisoners in privately run facilities. This order, though, does not include immigration detention facilities, which account for over 70 percent of people detained by ICE. The creation of a humane immigration system in which the alleged abuse and human rights violations at a LaSalle Corrections facility—as well as reported abuses at facilities operated by CoreCivic and the GEO Group—could not occur requires that President Biden take the additional step of ending all federal contracts with the private prison industry, including immigrant detention. The privatization of immigrant detention pits human rights and safety against cost-cutting measures that maximize profits generated from public funds.