摘要：Objectives. To compare population-based sterilization rates between Latinas/os and non-Latinas/os sterilized under California’s eugenics law. Methods. We used data from 17 362 forms recommending institutionalized patients for sterilization between 1920 and 1945. We abstracted patient gender, age, and institution of residence into a data set. We extracted data on institution populations from US Census microdata from 1920, 1930, and 1940 and interpolated between census years. We used Spanish surnames to identify Latinas/os in the absence of data on race/ethnicity. We used Poisson regression with a random effect for each patient’s institution of residence to estimate incidence rate ratios (IRRs) and compare sterilization rates between Latinas/os and non-Latinas/os, stratifying on gender and adjusting for differences in age and year of sterilization. Results. Latino men were more likely to be sterilized than were non-Latino men (IRR = 1.23; 95% confidence interval [CI] = 1.15, 1.31), and Latina women experienced an even more disproportionate risk of sterilization relative to non-Latinas (IRR = 1.59; 95% CI = 1.48, 1.70). Conclusions. Eugenic sterilization laws were disproportionately applied to Latina/o patients, particularly Latina women and girls. Understanding historical injustices in public health can inform contemporary public health practice. The legacy of US eugenic sterilization laws, which 32 states used to prevent the reproduction of individuals deemed “unfit,” continues to surface in discussions of contemporary public health issues, including reproductive autonomy, 1 medical mistrust, 2 and prenatal genomic testing. Although public health professionals are periodically reminded of this history, 3 few studies document the scale and demographics of the population sterilized by state actors. Of particular concern is the disproportionate sterilization of people of color, which has been noted in historical literature but rarely quantified. 4 Disproportionate sterilization of racialized minorities is an important historical backdrop for ongoing conversations about reproductive health equity 1 and implicit bias 5 and structural racism 6 in health care. We used data from the California state eugenics program, the United States’ most active sterilization program, 7 to examine dynamics of sterilization for Californians of Latin American descent (today described as Latinas/os) relative to Californians of other origins. Although the historical context that resulted in disproportionate sterilization of Latinas/os, particularly those of Mexican origin, during this period has been articulated, 8 the total scope of anti-Latina/o bias in sterilization is unknown. California passed the nation’s third eugenic sterilization law in 1909 and performed one third, or 20 000, of all documented compulsory sterilizations conducted under state eugenics laws. 3 California’s eugenic sterilization law authorized medical superintendents in state homes and hospitals to sterilize patients classified as “feebleminded” or having conditions thought “likely to be transmitted to descendants.” 9 Sterilizations declined after the law was revised in the early 1950s. Although eugenic sterilization programs did not designate specific racial/ethnic groups for sterilization, existing racial taxonomies that constructed Whites as superior, along with class hierarchies and prejudices against people with disabilities, shaped who would be deemed fit and unfit in California’s eugenics program. 8 Biases against Mexicans and Mexican Americans were especially prominent: institutional authorities described Mexicans and their descendants as “immigrants of an undesirable type” and speculated that they were at a “lower racial level than is found among American Whites.” 10 To better understand the racialized implementation of California eugenics, we evaluated whether institution residents of Latina/o origin were disproportionately sterilized. The term “Latina/o” was not in use during this period, but we use it to refer to immigrant or US-born individuals of Latin American heritage, primarily Mexican origin, who were cast as racially inferior and unfit during the period examined.
