Welfare Activists Win Sterilization Case

Background: This 1974 article appeared in Triple Jeopardy, a newspaper published by the Third World Women’s Alliance, an organization dedicated to freeing women of color from inequalities caused by sexism, racism, and capitalism. It discussed the case of two Alabama sisters, Minnie Lee and Mary Alice Relf. The teenagers had been surgically sterilized after their mother consented to the procedure, believing she was authorizing birth control shots. Once the surgery became known, the family sought compensation from the federal Department of Health, Education, and Welfare, which funded the public agency whose staff had deceived Mrs. Relf. This article details the decision in their case, Relf v. Weinberger, which was filed by the National Welfare Rights Organization (NWRO). Between 1966 and 1975, the NWRO organized welfare recipients, many of them Black women, to demand changes to state and federal policies regarding the treatment of those who relied on public assistance to feed, clothe, and house their families. Along with seeking increased welfare allowances and more dignified public assistance, NWRO advocated for the legal and political rights of its members. After the NWRO and the Relfs won their case, HEW took four more years before releasing revised guidelines.

NWRO WINS STERILIZATION CASE

Washington (LNS) — In response to a suit filed by the National Welfare Rights Organization (NWRO), a Federal Judge ordered the Department of Health, Education & Welfare (HEW) to stop federal funding of sterilization operations for minors and people who are “mentally incompetent.” He also ordered, in his decision on March 15, that the new HEW regulations on sterilization that were to go into effect March 18 be rewritten to ensure that all sterilizations are voluntary.

The suit was originally initiated after a number of examples came out of young women (many of whom were on welfare) being sterilized either unknowingly or under threat that they would lose their welfare payment. Minnie Lee Relf, 14, and her sister Mary Alice Relf, 12—whose family is on welfare, and the first two cases to reach public attention—were sterilized last June 14. Their mother, who can neither read nor write, signed a consent form with an “X” for the operation, after being told by a federally funded family‐planning agency that it was for birth control shots.

As soon as their situation reached the papers after their father filed a damage suit, cases started being revealed of other women who had been sterilized unknowingly or because, according to welfare workers or doctors, they had “too many” children.

In response to the national furor, HEW issued a set of new regulations supposedly to protect poor women from forced sterilization. Though the new regulations required “consent” forms, there was no requirement that adequate information be given about exactly what sterilization is—for example, that it is permanent. The new regulations also set up a review committee selected by the local sterilization program’s officials to recommend whether a woman who they considered incompetent (either a minor or mentally incompetent) should be sterilized. As the Health Research Group in Washington put it, the new HEW regulations “create a procedure that will condone the illegal sterilization of millions of Americans.”

U.S. District Court Judge Gerhard A. Gesell agreed in his ruling:
“Federally assisted family planning sterilizations are permissible only with the voluntary, knowing and uncoerced consent of individuals competent for giving such consent.

“There is uncontroverted evidence in the records that minors and other incompetents have been sterilized with federal funds and that an indefinite number of poor people have been improperly coerced into accepting a sterilization operation under the threat that various federally supported welfare benefits would be withdrawn unless they submitted to irreversible sterilization.

“Even a fully‑informed individual cannot make a voluntary decision if (s)he has been subject to coercion by doctors or project officers.

“In order to prevent expressed or implied threats… the court concludes that the regulations must be amended to require that individuals seeking sterilization must be orally informed at the very outset that no federal benefits can be withdrawn because of a failure to accept sterilization.”

Gesell cited the cases of the Relf sisters, which he described as one of the “deplorable incidents.” He also pointed at the estimate (provided by NWRO in their suit) that 100,000 to 150,000 low‑income people have been sterilized annually under federally‑funded programs. Between 2,000 and 3,000 people under 18 have been sterilized each year, and there are no estimates of people who were judged mentally incompetent.

In outlawing the use of federal funds for the sterilization of minors he noted:
“Many girls of childbearing age are undoubtedly sufficiently aware of the relevant considerations to use temporary contraceptives that intrude far less on their fundamental rights.”
The welfare officials in the Relf case claimed that the two Relf sisters were not reliable enough to take contraceptives.

Must Tell People Their Rights

“Even though we got this favorable court decision,” said Faith Evans of NWRO, “I’m not expecting any great things of HEW. There are a lot of good court decisions. It’s the job of organizations like ours to take that information out to people, tell them what their rights are under the law and help them to demand those rights.

“Besides, when you go into the welfare offices there’s really no law there. And the question of what’s voluntary and what’s involuntary is hazy.”

Source: “NWRO Wins Sterilization Case,” Triple Jeopardy 3 no. 4 (March 1, 1974). https://jstor.org/stable/community.28045900.