In the depths of Central California Women’s maximum-security prison, hundreds of the incarcerated women have had to undergo forced sterilizations, according to a new documentary shown last week as the opener to the Human Rights Watch (HRW) Film Festival.

Forced sterilization is defined as the involuntary medical “process or act that renders as individual incapable of sexual reproduction” and a grave human rights violation still occurring in many pockets around the world.

Erika Cohn's "Belly of the Beast" documentary states it occurred in the United States up until at least 2013.

The HRW film festival was a digital event this year due to the coronavirus pandemic.


The exposé highlights the irreversible injustices women who were made to undergo the procedure – called tubal ligation – now grapple with, and it underscores the glaring "lack of resources, attention and interest" inadequately dealing with the fallout.

​“Belly of the Beast” traces the story of one woman who was involuntarily sterilized at the California facility and teams up with lawyer Cynthia Chandler to bring a national spotlight to the issue.

​“Belly of the Beast” traces the story of one woman who was involuntarily sterilized at the California facility and teams up with lawyer Cynthia Chandler to bring a national spotlight to the issue. (Belly of the Beast/Erika Cohn)

Due to the remote location in the dead center of California's desert terrain, reproductive and human rights violations transpiring inside the Central California Women’s prison go mostly unnoticed, Cohn pointed out. She also noted that the procedure primarily targets women of color.

"It is pretty shocking that modern-day eugenics are still happening," Cohn told Fox News. "We calculated that 1,400 sterilization procedures happened between 1997 and 2013, and there is not a lot of information on what was medically necessary."

"Belly of the Beast" traces the story of Kelli Dillon, one of the women who said she was involuntarily sterilized at the California facility. She has teamed up with lawyer Cynthia Chandler to bring a national spotlight to the issue and stop the violations through investigations into crimes against women.

The duo maneuver in and out of courtrooms, fighting a system in which few believed such a practice still reigned and contending with the counter-argument from doctors and prison officials that the medical procedure was for the betterment of the individual.

"The invisibility of people in women's prisons is emblematic of a lack of value placed on the health and well-being of women and transgender people of color and impoverished people of all races," Chandler explained.

The case was given further credence several years ago following an in-depth probe by the Center for Investigative Reporting (CIR), which found that almost 150 women underwent tubal ligations in California prisons between 2004 and 2013. The center further exposed that "medical staffers at two prisons that housed pregnant women targeted individuals for sterilization who they deemed likely to return to prison. The medical staff had many of the women sign consent forms, causing a debate about the limitations of consent for incarcerated people once the practice was exposed."

The issue of consent sits at the heart of the debate. And it is not only California that has come under scrutiny over the matter in recent years.

In April 2018, a bipartisan bill to ensure Tennessee prisoners are no longer urged to undergo sterilization if they want to spend less time behind bars passed in the state legislature. The move came less than a year after a White County judge signed an order "allowing inmates to get out of jail 30 days early if they agreed to free vasectomies or long-acting birth-control implants."

"Dozens of inmates took the deal, according to at least one of several federal civil rights lawsuits filed as a result of the order," the Associated Press reported at the time.


Unconsented sterilization started in the United States more than 110 years ago in what was known as the "1907 Indiana Eugenics Law," when at least 30 state governments sanctioned the procedure as a form of eugenics to stamp out those deemed to have "undesirable traits" such as disabilities, mental illness, criminal records, or specific ethnic or racial backgrounds.

Over the ensuing decades, some 60,000 Americans are believed to have undergone the procedure until the legislation was steadily eliminated in the late 1970s. However, "Belly of the Beast" claims the practice did not precisely end when its legal justification did.

Six years ago, a California state auditor condemned officials on both federal and state levels after an investigation corroborated reporting that around one-third of the illegal surgeries and violations of the state's informed consent law had been breached.

In 27 cases, the inmate's physician did not ink the mandated consent form affirming that the required waiting period had been endured and that the patient was mentally competent and understood the indelible impact of the procedure.

(Belly of the Beast/Erika Cohn)

In some cases, physicians falsified the consent forms, indicating the proper waiting period had passed when it clearly had not. The audit also said the "true number" of illegal procedures might be higher, noting that it had found seven cases at one hospital for which health records were lost in a routine purging.

"This report concludes that during our eight-year audit period, 144 female inmates were sterilized by a procedure known as bilateral tubal ligation, a surgery generally performed for the sole purpose of sterilization," the report from the California auditor's office stated. "State regulations impose informed consent requirements that must be met before a woman can be sterilized; however, Corrections and the Receiver's Office sometimes failed to ensure that inmates' consent for sterilization was lawfully obtained."

It continued: "Among these 39 inmates were six who were sterilized following violations of both these requirements. Although neither Corrections nor the Receiver's Office's employees actually performed the sterilization procedures, we concluded that they had a responsibility to ensure that the informed consent requirements were followed in those instances in which their employees obtained inmates' consent, which was the case for at least 19 of the 39 inmates."

Although the practice was already illegal, in September of 2014, then-Gov. Jerry Brown went on to sign stricter legislation on the matter, prohibiting the sterilizations of inmates "as a means of birth control in correctional facilities except for when a patient's life is in danger or when there is a medical need and no less drastic alternatives are available."


While some states such as North Carolina and Virginia have passed reparation bills and provided financial compensation to those illegally sterilized in decades past, Cohn insisted that the conversation is still one punctured by shame and silence. And there are likely to be many more women, Cohn asserted, who have undergone the procedure and may not even be aware.

"The ramifications and trauma of this are life long. These women have been denied the basic human right of the right to a family, and they are forced to carry this shame and trauma," Cohn added. "And they're the ones who know; there are many more out there who still don't know this is what happened to them."