The IHS Forcibly Sterilized Thousands of Native American Women. No State Has Ever Investigated. Until Now.
In 1972, Jean Whitehorse went to the Indian Health Service hospital in Gallup, New Mexico, with a ruptured appendix. She was 22 years old and a new mother. She left unable to ever have children again.
“The nurse held the pen in my hand,” Whitehorse, a citizen of the Navajo Nation, told New Mexico lawmakers this month. “I just signed on the line.”
Whitehorse didn’t know she had undergone a tubal ligation until years later, when she returned to the hospital struggling to conceive a second child. She would not carry another pregnancy. Her father had risked his life as a Navajo Code Talker. Her government had answered that sacrifice by taking away her reproductive future without her knowledge.
Last week, New Mexico became the first state in the United States to formally commit to investigating the forced and coerced sterilization of Native American women. The memorial, Senate Memorial 014, was sponsored by five lawmakers including two Native American women, Sens. Shannon Pinto (Diné) and Angel Charley (Laguna/Diné). It directs the New Mexico Indian Affairs Department and the Commission on the Status of Women to investigate the scope and ongoing effects of the practice. Whitehorse testified in support.
What the Government Already Knew, and When
The federal government has not been without information on this. A 1976 report from the U.S. Government Accountability Office found that four of the twelve Indian Health Service areas sterilized 3,406 women between 1973 and 1976, including 36 women under the age of 21, despite a court-ordered moratorium on sterilizations of minors. The consent forms used did not comply with federal regulations. Physicians documented in the report said they had not received or understood the regulations, even though IHS records show they received written updates on at least three separate occasions between August 1973 and April 1974.
The GAO report examined only four of twelve IHS service areas. What happened in the other eight remains largely unaccounted for. Senate Memorial 014 states that coerced sterilizations at IHS facilities were reported as recently as 2018.
To understand how IHS sterilizations became possible at all, you have to go back further. In 1907, Indiana passed the first compulsory eugenics sterilization law in the United States. By 1939, more than 30,000 people in 29 states had been sterilized in prisons and psychiatric institutions, according to historical records cited by the National Indigenous Women’s Resource Center. The 1927 Supreme Court ruling in Buck v. Bell gave those practices constitutional cover, and that ruling has never been overturned. The IHS itself was not established until 1955, and it began providing family planning services, including sterilization, in 1965 under the authority of the Department of Health, Education, and Welfare, according to Jane Lawrence’s 2000 study in the American Indian Quarterly. The legal and institutional architecture was decades in the making before the peak of IHS sterilizations in the 1970s.
Two years before the GAO audit, Dr. Connie Redbird Uri, a Choctaw and Cherokee physician, had already raised the alarm. In 1974, Uri reviewed IHS records and found that the federal agency had sterilized as many as 25 percent of its female patients of childbearing age. Some of the women she interviewed were unaware they had been sterilized at all. Others said they were pressured into signing consent forms or told the procedures were reversible. Uri’s research indicated the IHS had “singled out full-blooded Indian women for sterilization procedures.”
By the 1970s, between 25 and 50 percent of Native women of childbearing age in the United States had been sterilized, mainly through IHS facilities, according to the memorial text. A significant share of those procedures was performed at IHS service areas including Albuquerque and Gallup, which serve thousands of Native people in the Four Corners region.
The Tactics
To understand the scale of what happened, it helps to know how it happened.
Providers told some women they were being treated for appendicitis, a rash, or another condition, and performed sterilizations while the patient was under anesthesia. Others were presented with consent forms to sign while already sedated or in acute pain and rushed through emergency procedures. Some were told the sterilization was reversible. Some were threatened with the loss of welfare benefits or health care access if they refused.
One theory documented in the historical record suggests that underpaid and overworked IHS physicians sterilized Native women to reduce their future patient load. In 1974, the ratio of doctors to patients at IHS facilities stood at roughly one physician per 1,700 reservation patients, according to historical records cited by researchers. Between 1971 and 1974, applications for vacant IHS positions dropped from 700 to 100. The practical incentive, according to this line of argument, was fewer deliveries and fewer children requiring ongoing care.
A broader legal foundation enabled the practice. A 1927 U.S. Supreme Court ruling in Buck v. Bell upheld states’ rights to sterilize people deemed “unfit” to reproduce, establishing the legal scaffolding for the forced sterilization of immigrants, people of color, disabled people, and other marginalized groups throughout the twentieth century. Buck v. Bell has never been overturned.
Sarah Deer, a professor at the University of Kansas School of Law, has called IHS sterilizations a campaign of “systemic” action against Native American communities. The Indian Health Service and its parent agency, the U.S. Department of Health and Human Services, did not respond to multiple requests for comment on New Mexico’s investigation, according to reporting by the Associated Press.
Dark Winds Got Here First
Most Americans first encountered this history not through a government report but through a television drama.
In the first episode of AMC’s Dark Winds, set in 1971 on the Navajo Nation, a nurse and midwife named Emma Leaphorn warns a pregnant teenager not to give birth at the IHS clinic. She delivers the warning in Diné, speaking over the head of a white doctor who thinks she is translating his instructions. She tells the girl that if she delivers at the facility, the doctor will sterilize her afterward without her consent. Emma knows because it happened to her after the birth of her own son.
Writer Maya Rose Dittloff, who co-wrote the episode, told Salon in 2022 that the scene reflected documented history. “Sometimes women would never find out that they had been forcibly sterilized,” Dittloff said. “They just thought they couldn’t ever have children, when in fact, at a normal trip to the doctor, this had happened.”
Dark Winds returned to the subject in Season 2, dedicating a full subplot to a reporter investigating the sterilization of Native women at IHS facilities. The show, developed by Graham Roland, a TV writer and producer of Chickasaw heritage, features an all-Native writers’ room. Chris Eyre, who is Cheyenne and Arapaho, directed the first season. AMC partnered with the Navajo Nation for Season 2, bringing in a Diné cultural consultant.
That a premium cable drama has done more to surface this history than any federal acknowledgment in fifty years is not an accident. It reflects how thoroughly the federal government has avoided formal accountability.
New Mexico Takes the First Step
New Mexico state Rep. Patricia Roybal Caballero (Piro-Manso-Tiwa), a trainer and sexual violence advocate with the Office of Family Representation and Advocacy, told lawmakers at a Feb. 3 Senate hearing that she came close to becoming a victim herself. Already under sedation during a procedure after a miscarriage, she was presented with consent forms that included a hysterectomy consent. Her husband caught it. She signed nothing. She did not speak publicly about the incident until last summer, after hearing testimony from other Native women who had been sterilized without consent.
“They gave me courage,” Caballero said.
Caballero told lawmakers that coerced and forced sterilization of Native women still occurs. “Because of language barriers, poverty barriers, because women of color are vulnerable in these ways,” she said, “we are being taken advantage of.”
Nicolle Gonzalez (Diné), a certified nurse-midwife and founder of the Changing Women Initiative, an Albuquerque-based birth center and reproductive rights organization serving Native families, told Native News Online she hopes the investigation leads to formal acknowledgment, apology, and funding for Native birth workers doing healing work.
“Part of the healing work that needs to happen is that they acknowledge the wrongdoing that happened, an official apology, and some sort of pathway forward of some reconciliation,” Gonzalez said, “whether that’s funding or opportunities for organizations who are doing that healing work and integrating culturally birth supported practices.”
Gonzalez added that a New Mexico investigation could set the stage for a national inquiry. “Is there a potential for Congress to put a hearing through the Senate committee of Indian Affairs? Yes,” she said. “Could there be a national study and an inquiry that really studies where this happened and what the implications for reconciliation repair? Absolutely.”
What Accountability Has Looked Like Elsewhere
New Mexico is not alone in attempting a reckoning with forced sterilization, though it is the first to focus specifically on Native women. In 2023, Vermont launched a truth and reconciliation commission to study the forced sterilization of marginalized groups, including Native Americans. In 2024, California began paying reparations to people sterilized without consent in state-run prisons and hospitals. In Canada, doctors were sanctioned as recently as 2023 for sterilizing Indigenous women without consent.
None of that has come from the federal government. The 1976 GAO report remains the only formal federal acknowledgment of what happened at IHS facilities. Whitehorse testified about the practice to the United Nations Permanent Forum on Indigenous Issues in 2025, calling for the United States to issue a formal apology. None has come.
The Limits of What New Mexico Can Do
The New Mexico investigation faces a structural problem: it has no authority to compel federal agencies to participate. Deer told the Associated Press that without cooperation from the IHS or the Department of Health and Human Services, the commission’s ability to gather records will be limited.
The GAO’s own 1976 investigation illustrates how long that problem has existed. Researchers at the time determined that interviewing women who had undergone sterilizations “would not be productive,” citing a single study of cardiac surgical patients in New York who struggled to recall conversations with doctors. The decision to exclude victim testimony from the audit was noted at the time as a significant limitation. It also meant the federal government’s first and only formal look at IHS sterilization practices never included the voices of the women most directly affected.
Rachael Lorenzo, executive director of Indigenous Women Rising, an Albuquerque-based sexual and reproductive health organization, told the Associated Press that any commission examining the sterilizations must be careful not to re-traumatize survivors in the process of documenting what was done to them.
Jean Whitehorse carried her story for nearly 40 years before telling it to her daughter, then to other family members, then to lawmakers and United Nations representatives. “Each time I tell my story, it relieves the shame, the guilt,” she told reporters. “Now I think, why should I be ashamed? It’s the government that should be ashamed of what they did to us.”
The commission’s investigation is just beginning. What it finds, and whether Washington responds to what New Mexico uncovers, remains unanswered.
If you or someone you know has been affected by coerced sterilization at an IHS facility and wants to contribute to the New Mexico investigation, the memorial directs inquiries to the New Mexico Indian Affairs Department and the Commission on the Status of Women. Know of other survivors whose stories should be part of the public record? Reply and let me know.