by Ma’ayan Anafi
Last summer, Britney Spears stunned the public when she revealed that her father, acting as her conservator, prevented her from removing her IUD. What shocked many people wasn't only the blatant disregard for her right to make decisions about her body: it was that it was perfectly legal for her conservator to take that decision away. Propped up by laws all over the country, guardianship systems (sometimes called conservatorships) deprive primarily disabled people from making some of the most basic decisions about their lives.
The horrifying truth is that Britney's experience under guardianship and its legality is just the tip of the iceberg. Quietly embedded in legal codes across the country, many state laws grant courts a draconian power: the power to order disabled people to be permanently sterilized against their will.
I recently authored a new report that exposed just how far-reaching these threats to disabled people's reproductive rights are. The report, released by the National Women's Law Center with contributions from the Autistic Women and Nonbinary Network, detailed how the majority of states—31 states in addition to Washington, D.C.—explicitly allow court-ordered sterilization of disabled people.
These laws are not fossils of a bygone era. States have passed new forced sterilization laws well into the 21st century, including two laws passed as recently as 2019.
Under these laws, a court can order the forced sterilization of people who—according to the judge—cannot make an informed decision for themselves. When disabled people like me are empowered and supported, we can make our own decisions about sterilization. But those who end up before a judge are rarely given that support; many are not even given the chance to try at all. Disabled people—particularly those with intellectual and developmental disabilities, and often but not always those under guardianship—may find themselves declared "incapacitated" with little fanfare and as a matter of course.
What makes these laws even more insidious is that courts purportedly order the sterilization for the disabled person's own good. The judge, often with broad discretion, can force someone to be sterilized on the grounds that it is in their best interest. Based on little more than speculation and stereotypes, judges have claimed that having a baby would be a tragic burden for a disabled person, a burden the courts are benevolently alleviating by having them sterilized.
The paternalism undergirding these laws—the belief that disabled people can't or shouldn't make their own decisions about their bodies—is painfully familiar to many disabled people. It echoes the paternalism on display in the early 1900s, when states forcibly sterilized nearly 70,000 disabled women, women of color and other "undesirables"—often with the same claim that it is for their own good. It's the paternalism we see in routine interactions with health care providers, in court rulings that deprive parents of custody based solely on their disability and in laws that grant guardians barely-fettered powers to make decisions about our reproductive futures.
On the surface, forced sterilization laws seem designed to protect disabled people. These laws require a special process and a judge's green light before the extraordinary step of forced sterilization. But procedural safeguards do not transform a forced sterilization into a voluntary one. They do not change the fact that these laws take the decision out of disabled people's hands and put the state's seal of approval over the violation of our bodies. Special procedures for forced sterilization do little to give disabled people more control over our futures. For that, we need large-scale reform, starting with dismantling the guardianship system as it currently stands.
Britney Spears' case was unusual—not because of her conservatorship or her forced IUD, but because she had the platform to share her story, generate public outcry and ultimately win control over her body. There are many more people whose stories have gone unnoticed. These stories demand change. They demand a world where no one—not a guardian, nor a judge, nor a doctor—can force someone to be sterilized.
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