Mass Sterilization of Puerto Rican Women (1937-1970s)

Between the 1930s and 1970s, Puerto Rico experienced the highest rate of sterilization in the world. By 1965, an estimated one-third of Puerto Rican women of childbearing age had been sterilized — a rate so high that the procedure became colloquially known as "la operación" (the operation).

The program was driven by a convergence of colonial population control ideology, U.S. eugenics movements, and economic development policy:

1937: Law 116 legalized sterilization in Puerto Rico, establishing government-funded sterilization clinics across the island.

1940s-1950s: Governor Rexford Tugwell and planners associated with Operation Bootstrap promoted population reduction as essential to economic development. U.S. pharmaceutical companies and population control organizations funded sterilization campaigns.

Scale: By the late 1960s, Puerto Rico had the highest sterilization rate in the world. Studies found that:
- 35% of women aged 20-49 had been sterilized by 1965
- Many women reported not being fully informed about the permanence of the procedure
- Sterilization was often presented as the only available contraceptive option
- Women in public hospitals were sterilized at higher rates than those in private facilities
- Some women were sterilized without their knowledge during cesarean sections

The mass sterilization program was intertwined with the birth control pill trials of the 1950s — both reflected a colonial attitude that treated Puerto Rican women's bodies as sites for experimentation and population control. The program reflected eugenics ideology that viewed Puerto Rican reproduction as a problem to be managed rather than a right to be protected.

Historian Annette B. Ramírez de Arellano and Conrad Seipp documented the program in their landmark 1983 book "Colonialism, Catholicism, and Contraception: A History of Birth Control in Puerto Rico."