GRAD 219 Course – The Black Experience in American Medicine – Week 2

This is a guest post by Aris Tay, PhD Candidate, Bruce Wang and Diana Laird Labs, Developmental and Stem Cell Biology (DSCB)UCSF

Watching “Belly of the Beast: survivors of forced sterilizations in California’s prisons fight for justice” from an intersectional lens reminded me of social Darwinism. The theory of natural selection and survival of the fittest permeates biology and ecology. Faster lions are better at catching prey and thus are more likely to survive, so of course lions as a whole would prefer to select for speed and athletic prowess. However, does this apply to human society? It is theorized that humans implicitly select for attractiveness when choosing a partner and as a result the human race has supposedly gotten more attractive over the centuries. But with the industrial revolution, betterment of healthcare, and resultant increase in lifespan and quality of life, several “less fit” traits have been allowed to remain in the gene pool. There are several diseases, with genetic causes or predispositions, that are typically fatal without treatments. If these people died of such a disease, then the genetic mutation would not be passed on and eventually dwindle out from the gene pool. However, we are now able to treat such a disease and thus the mutation stays. 

From a purely logical, theoretical, and utilitarian standpoint, human society would probably be more “fit” if the people carrying these mutations were not treated and died. And because Darwinism and social Darwinism is such an accepted and prevalent theory in the medical community, parents undergoing in vitro fertilization are recommended to choose the embryo without any genetic mutation or harmful predispositions. Many disabilities, such as blindness, deafness, autism, and achondroplasia, are symptoms of or outright caused by genetics and are theoretically preventable during in vitro fertilization. However, many people in the disabled community take pride in their disability and the culture that has been created around it, not entirely unlike black American culture. If a medical professional did not discuss with the patients and chose to implant the undiseased embryo as opposed to one with a genetic mutation that could result in deafness, would this be equivalently morally reprehensible as the forced sterilization of incarcerated black women? Would this take society a step closer to eugenics? 

GRAD 219 Course – The Black Experience in American Medicine – Week 2

This is a guest post by Karissa Hansen, Ph.D. Candidate, UCSF Developmental and Stem Cell Biology (DSCB) Program

During class this week, one major topic of conversation was the forced sterilization of incarcerated individuals in California, often people of color, along with the eugenic principles that this thinking perpetuates. Dr. James Heinrich, an OB-GYN at one of these prisons, was quoted in an NPR article1 claiming that the amount of money spent on these procedures was minimal “compared to what you save in welfare paying for these unwanted children–as they procreated more.” My jaw dropped when I read this horribly prejudiced statement. Every individual is entitled to personal bodily autonomy. Although he appears to be referring to surgeries that were completed voluntarily, when a person in a powerless position is under coercive pressure, there clearly cannot be consent.

 Although the forced sterilizations in the prison system being discussed are said to have occurred between the years of 2006-2010, such atrocities were occurring long before and continue today. In September 2020, a nurse working at a US Immigration and Customs Enforcement center in Georgia alleged that detained women were undergoing similar procedures, including unnecessary hysterectomies2. As of December, more than 40 individuals had submitted written testimony in a legal petition against the facility3.

So where do we go from here? I don’t have a good answer. Shutting down one problematic facility doesn’t prevent such procedures from happening at a dozen more. We are clearly unable to rid this system of the discriminatory beliefs it was built upon. As we’ve discussed, the roots of the issue must be addressed—and there are many.


  1. Chappell, Bill. “California’s Prison Sterilizations Reportedly Echo Eugenics Era.” NPR, 9 July 2013,
  2. Narea, Nicole. “The Outcry over ICE and Hysterectomies, Explained.” Vox, 15 Sept. 2020,
  3. Bekiempis, Victoria. “More Immigrant Women Say They Were Abused by ICE Gynecologist.” The Guardian, Guardian News and Media, 22 Dec. 2020,