Ma'ayan Anafi, Senior Counsel for Health Equity and Justice for the National Women's Law Center, joins host Rafa Kidvai to share the disturbing reality of forced sterilization laws still active in the majority of U.S. states. They discuss the historical roots of these laws, their impact on disabled people today, and opportunities for reform. Ma'ayan highlights the intersections of reproductive justice and disability justice, advocating for a future where every individual's autonomy and dignity are respected.
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Rafa Kidvai: This is No Body Criminalized. How the state controls our bodies, families, and communities. I'm Rafa Kidvai, director of the Repro Legal Defense Fund at If/When/How. On our podcast, we talk with experts, activists, and advocates whose daily work intersects with reproductive justice and the state's targeting of marginalized communities. The founding mothers of reproductive justice in the United States define the term as the human right to maintain personal bodily autonomy, have children, not have children, and parent the children we have in safe and sustainable communities.
You will hear us restate this shared commitment throughout our interviews, because, regardless of the issues guests focus on, that is, ultimately, the world we all intend to create. Our guest today is Ma'ayan Anafi. Ma'ayan is Senior Counsel for Health Equity and Justice for the National Women's Law Center. We started our conversation with the story of the forced sterilization of Kirsten Johnson, a disabled woman in Illinois, and their experience with state-sanctioned violence.
Ma'ayan Anafi: A few years ago, a disabled woman in Illinois, named Kirsten Johnson, found herself in a nightmare scenario. Her aunt thought she should undergo a sterilization procedure, but Kirsten didn't want to do that. So her aunt turned to an Illinois law allowing the forced sterilization of the disabled people, and she asked the judge to order the sterilization without Kirsten's consent. Kirsten was, ultimately, able to fight back. She was able to work with local advocates and, in the end, she won her case in court.
And what's unusual about the story isn't that Kirsten faced the threat of forced sterilization, and it's not that she was living in a state that allows forced sterilizations to happen. In fact, a majority of states, 31 states and D.C., have laws allowing the forced sterilization of disabled people. What's unusual about Kirsten's story is that she was able to share what she was going through, get public attention and actually avoid a forced sterilization in the end. So many disabled people facing the threat of forced sterilization don't have that opportunity. And, in fact, they are actively prevented from sharing their stories. And that's one of the reasons why forced sterilization laws have been able to stay under the radar for so long.
Rafa Kidvai: Thank you for sharing that. I really appreciate you framing it as the fact that it's actually more common than we all realized and that, actually, the unusual part is that it was paid attention to. I want to take a step back. For those who might not be familiar, what exactly is forced sterilization?
Ma'ayan Anafi: Here, when we're talking about forced sterilization, we're talking about sterilization that happens without the consent of the person being sterilized and, instead, gets ordered by a judge. So a judge might claim that a particular disabled person doesn't have the capacity to make a decision about sterilization, on their own, but they should be sterilized, because it's in their best interest. It's for their own good. So even if the disabled person doesn't want to be sterilized, even if they have no idea they're about to be sterilized, under these laws, a judge can put that all aside and say they should be sterilized anyways.
And, at its core, forced sterilization, under these laws, is a form of state-sanctioned violence against disabled people. There's sometimes this misconception that these laws are somehow benevolent, that they're there to help and protect disabled people, but this is not only deeply paternalistic, it also doesn't change the fact that forcing someone to be sterilized is a violation of their body, of their rights, of their dignity, of their ability to make some of the most fundamental decisions, all with the seal of approval of the state.
Rafa Kidvai: What motivated you to delve into this research and, ultimately, write your report about the forced sterilization of disabled people?
Ma'ayan Anafi: So I knew there were laws out there that allowed the forest sterilization of disabled people. I didn't know how widespread they were, but I was aware they existed, and it felt really troubling that almost no one was talking about it. The story that we're told about forced sterilization is that it's something that was confined to this dark period in history. And there was, certainly, state-sanctioned forced sterilization, on a massive scale, during the earlier parts of the 20th century, and that disproportionately impacted women of color, disabled women, poor women.
But the reality is also that laws explicitly allowing the forced sterilization of disabled people exist today, right now, not just in a handful of states, but in the majority of them. So, in our study, we found that 31 states plus D.C. Have these laws in place. These laws aren't relics from history, these aren't laws that were passed a hundred years ago and are still kind of kicking around, some laws were actually passed as recently as 2019. The goal of this work has really been to bring these laws to light to try to change the way we talk about forced sterilization.
Rafa Kidvai: You talked a little bit about who this impacts today. Can you tell me a little bit more about that and how, maybe, who has been targeted by these laws has changed over history?
Ma'ayan Anafi: Sure. So in terms of who is impacted by these laws, I'll first say that there is a lot we don't know. So, usually, forced sterilization cases are required to be sealed, so they're not available to the public. There is no tracking happening, no public oversight, and people who are at greatest risk of sterilization, under these laws, are often prevented from sharing their stories. So we don't know, for example, if people of color are more likely to be affected by these laws, even though everything we know about forced sterilization, past and present, suggests that might, very well, be true. But there are some things that we can glean from the cases that are publicly available and from the laws themselves.
We know that these laws primarily are used against people with intellectual disabilities, as well as, sometimes, people with developmental or mental health related disabilities. And that's based on the belief that people with these disabilities can't or shouldn't make their own decisions about sterilization and parenting and reproductive rights, more generally, and that other people needs to be making those decisions for them. And that assumption is simply wrong, because, with the right supports and accommodations, people across all types of disabilities can make their own decisions, including about sterilization.
It also seems that these laws mostly impact people who can get pregnant, so the justifications that are used for these forced sterilizations often zero in on issues related to pregnancy and childbirth. And so, that includes abusive sterilizations targeting Indigenous and Puerto Rican women. It includes sterilizations enforced through the criminal legal system in places like prisons and jails and immigration detention where people of color and disabled people are vastly overrepresented. So in California, for example, up until a few years ago, there were many instances of women, mostly Black women, facing forced or coercive sterilizations in state prisons. And some of the doctors were explicitly making eugenics-style arguments to justify that.
And a few years ago, it also came out that non-consensual and coercive sterilizations were happening in the immigration detention center in Georgia. And so, for all we know, that might just be the tip of the iceberg. And, finally, in most states that have forced sterilization laws, the laws can impact both disabled adults and children. And when a court orders the forced sterilization of a disabled child, they're denying that child the say over this procedure with lifelong consequences, and also, they're saying that this child and their decision-making abilities will never grow and change with time. And that really tells us a lot about how little power disabled children are given over what happens to their bodies, and also, how disabled people, more generally, are infantilized and seen as static and permanently childlike under the law.
Rafa Kidvai: Thank you for laying that out so clearly for us all. I'm thinking a lot about guardianship and conservatorship and how they might play a legal role in the forced sterilization of disabled people. Do you have any thoughts on that?
Ma'ayan Anafi: Absolutely. So to take a step back, guardianship is a system where a judge appoints someone to make decisions on your behalf, based on this assumption that you can't make those decisions yourself. And this is a system that is massively overused and abused, and guardians are often given sweeping powers over people's lives. People can lose many of their most basic rights when they're placed under guardianship. That can include everything from the right to get married and vote and see their children, to where they live and who they can associate with and how to spend their money.
And they can lose the rights to make decisions about what healthcare get. And that can include reproductive care, like birth control and abortion, and it can include permanent sterilization. And I should mention that the forced sterilization laws I've talked about don't only affect people under guardianship. In many states, disabled people, who aren't under guardianship, can also be forced to be sterilized, as well, but people who are under guardianship, or at risk of being under guardianship, are likely disproportionately affected, so there's a lot of overlap. And overhauling the guardianship system has to be a part of the broader strategy for tackling these forced sterilization laws.
Rafa Kidvai: I guess, I'm wondering, in the cases that you're seeing, if you feel like the state is, at all, adept at thinking about the power dynamics of the people that are asking for these decisions to be made or whether they're fairly deferential to guardians or fairly deferential to people who have been given authority over disabled people.
Ma'ayan Anafi: I think that even if all the procedural rights were there and perfectly implemented, forced sterilizations would still be abusive. It's still a violation of people's bodies. But what we're seeing, to make it even worse, is that courts are, very frequently, disregarding people's procedural rights. They are ordering forced sterilizations kind of as a matter of course, often just based on assumptions that, because someone has a particular disability, they can't make decisions or they shouldn't be trusted to make decisions about their bodies. We are seeing very little awareness of the power imbalance, both between the people who are bringing the petitions, whether it's a family member or a guardian or someone else, and between the judge and the state and the person who's being sterilized.
Rafa Kidvai: In the report that you wrote, you made the connection between forced sterilization laws on the books now and the history of eugenics laws that disproportionately impacted Black, Indigenous, Hispanic and other birthing people of color, both disabled and not. How does the issue of forced sterilization further perpetuate inequities?
Ma'ayan Anafi: There is a brutal history of forced sterilization in this country. So in the early part of the 20th century, when the eugenics movement was really in its heyday, nearly 70,000 people were forced to be sterilized. And that was, mostly, people who were disabled or perceived to be disabled, and disproportionately Black and Brown women. And that's far from a coincidence, because, at its root, eugenics and the forced sterilization practices it fueled are about disability and about race. Eugenics grew out of the belief that disabled people and Black and Brown people were less moral, less responsible, less human than white non-disabled people.
It grew out of the idea that if you're disabled and if you're a person of color, and, certainly, if you're both, you're going to contribute less to society, you're going to sap resources from the state, you're going to be a burden on white non-disabled people. And it grew out of the belief that disabled and Black and Brown people can't make good decisions about their bodies and about parenting, that they shouldn't be having children, and that the state is then justified in making those decisions for them. And so, forced sterilizations were weaponized against disabled and Black and Brown people in a really targeted way.
And the forced sterilization laws that exist today came about more recently after eugenics ostensibly fell out of favor. And some people have tried to say that these current laws are different from the forced sterilization that happened during the eugenics era, that these current laws are about forcing someone to be sterilized, because it's, supposedly, in their own best interest. But the reality is that many of the same narratives that fueled eugenics era sterilizations live on in today's forced sterilization laws. And we see similar narratives that disabled people can't or shouldn't be trusted to make decisions about their bodies and about parenting, that they are a burden or the children they might have would be a burden, and that they can't be responsible parents or shouldn't be having children, at all.
Rafa Kidvai: Something that I was thinking about, as you were talking, is that we often talk about care, not criminalization, at the RLDF and If/When/How. And what if the state's idea of care, they can't even imagine a version of care that doesn't include punishment, that so much of this is supposedly under the guise of protecting communities or community members from themselves. So much of this, even the idea of family court sort of stepping in and intervening in families and sort of creating separation within families, is then under the guise of some sort of protection of the family. And, really, it's just really terrifying that the state's imagination is so limited, that even when things are supposed to be framed as care, that they're actually, in practice, just punishment.
Ma'ayan Anafi: So forced sterilization laws are really one piece in a broader pattern of state-sanctioned policing and surveillance and criminalization of disabled people, of taking away disabled people's rights to make reproductive decisions and exercise bodily autonomy. And this pattern is really baked into our legal system. So when we're talking about institutionalization, for example, in congregate settings, then, a lot of times, that's framed as something that's supposed to help disabled people, as supposed to provide some services, when, in reality, a lot of these institutional settings can be incredibly restrictive and incredibly punitive, in many ways, and can take away people's basic autonomy and their basic rights to make decisions. And so, I think that that's just one example of ways that the state might step in and say, "We're going to try to help disabled people. We're going to try to protect disabled people." But, in fact, they're taking away rights from them.
Rafa Kidvai: Absolutely. How would you like to see the reproductive justice movement really ensuring that it's taking into account the concerns of disabled individuals deeper in our collective pursuit of justice?
Ma'ayan Anafi: I'll first say that I think that repro movements and disability rights and justice movements share a lot of foundational values. So values like bodily autonomy, and self-determination, and access to all the resources and supports you need to make meaningful decisions about your life. And I think that has provided a really strong basis for more and more conversations across movements. And these conversations are desperately needed, because these movements are really interdependent. The goals of the reproductive rights and justice movements can't be achieved so long as disabled people's bodies are subject to state control, so long as disabled people's reproductive autonomy is systematically compromised and denied.
And, I think, we're seeing a growing integration of disability justice in repro advocacy. We're seeing more and more disabled advocates shaping the direction of the repro movements and uplifting the ways that threats to reproductive freedom disproportionately impact disabled people. And, I think, we're also seeing a growing reckoning with the harms that disability communities have, historically, experienced from some in the repro movements, and that reckoning is a really necessary part of strengthening the foundation for cross-movement work, and for bringing a disability justice perspective into repro movements. There's still a lot of work to be done to have more integration of these movements, more cross-pollination, more representation of disabled people, and our concerns and our needs in the reproductive rights and justice movements, but I think that there's a solid foundation that we can build on.
Rafa Kidvai: I appreciate that. Similarly, I think we're seeing this with the sort of criminalization of gender-affirming care, nationally. It's the same sort of pursuit of controlling, of the state stepping in and controlling people's decision-making, and, basically, punishing them for exercising their bodily autonomy. Lastly, we ask everybody this, but our podcast is called No Body Criminalized. What does no body criminalized signify to you, and how does it intersect with the broader discourse on repro and disability justice?
Ma'ayan Anafi: For me, it speaks to a possibility where we've not only eliminated state-sanctioned violations of disabled people's bodies and rights, but we've also created a society where disabled people are valued and supported and celebrated as one of just the first steps. That means changing laws that target disabled people's autonomy, including forced sterilization laws, but it also means affirmatively making sure that disabled people can make meaningful decisions about their bodies, that they have all the supports and accommodations they need in order to do that.
So some people might need more intensive supports and accommodations to get to the point where they can make those meaningful decisions, and they should be able to access whatever resources they need to make sure that bodily autonomy is not just an abstract right. It also means changing the narratives that have been used to justify control over disabled people, like the assumptions that, as disabled people, we can't make our own decisions, that we can't understand our bodies or our needs, that our rights need to be curtailed to protect us from ourselves. And it means telling a different story about who disabled people are, one that recognizes the value of our lives, and the power we have to determine our own futures.
Rafa Kidvai: When you wrote the report, you were really intentional about using language that reflected how people describe their own experiences, and I would love to hear a little bit more about that.
Ma'ayan Anafi: We decided to write the report in something called plain language. So plain language is a style that is intended to be more accessible for a lot of people, including, in particular, people with intellectual disabilities. This is an issue that really disproportionately affects people with intellectual disabilities, many of whom might want to use plain language materials. And so, it was really important to make sure that this discourse is inclusive and accessible for people across all disabilities, including intellectual disabilities.
Part of what's gotten us to the current situation is this pervasive assumption that issues related to sterilization are just too complicated for some disabled people to understand. And we see that assumption play out both at the individual level where judges are presuming that many disabled people just won't understand sterilization enough to make their own decisions. So using plain language is one tool that can take us a step towards empowering more disabled people to engage in and to lead the conversation about forced sterilization.
Rafa Kidvai: It's been such a joy to speak with you. You are, obviously, so brilliant and thoughtful, and I really, really appreciate your framing around forced sterilization and making this accessible to our listeners.
Ma'ayan Anafi: Thank you so much for having me.
Rafa Kidvai: Here are some takeaways from our conversation. Forced sterilization is a form of state-sanctioned violence against people with disabilities. Legal mechanisms, like guardianship and conservatorship, often perpetuate violations of bodily autonomy, including reproductive health. Ma'ayan explains the historical roots of forced sterilization, particularly within the eugenics movement, and how contemporary laws continue to play off of these historical injustices. Ma'ayan also touches on the shared goals of reproductive justice and disability justice movements, and the importance of centering disabled voices, challenging paternalistic narratives, and advocating for policies that promote self-determination.
Ma'ayan Anafi is Senior Counsel for Health Equity and Justice for the National Women's Law Center. You can keep up with their work at nwlc.org. I'm Rafa Kidvai, the host of this podcast, and director of the Repro Legal Defense Fund at If/When/How. The Repro Legal Defense Fund funds bail and strong defenses for people being punished for abortion, miscarriage, stillbirth, and other pregnancy outcomes. Learn more at reprolegaledefensefund.org. If you have questions about your legal rights, go to reprolegalhelpline.org or call 844-868-2812. No Body Criminalized is produced by Phantom Center Media & Entertainment for the Repro Legal Defense Fund at If/When/How. Pamela Kirkland is the show's producer. Kojin Tashiro is lead producer and mixed this episode. And remember, keep your community safe, and don't talk to cops.