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Living Under Conservatorship: Women Forced To Take Birth Control, Get Sterilized

A package of estrogen/progestin birth control pills. (AP/Bedsider.org)
A package of estrogen/progestin birth control pills. (AP/Bedsider.org)

Britney Spears spoke out against her conservatorship for the first time this June when she made a stunning allegation that her father’s team prevented her from removing an IUD.

“I wanted to take the IUD out so I could start trying to have another baby. But this so-called team won’t let me go to the doctor to take it out because they don’t want me to have children — any more children,” Spears said in her testimony in June.

The claim sparked outrage online and horrified fans. Sara Luterman, a freelance journalist and commentator who covers disability, wrote in The Nation that forced birth control is routine for women under conservatorships.

Luterman says it’s so common that it’s almost never challenged. After speaking with disability rights lawyers, she says it’s rare for a person under a conservatorship to contest birth control and win.

“There isn’t any special permission needed for more temporary forms of birth control — like an IUD,” Luterman says. “There is supposed to be permission sought for sterilization surgery but even that the rules are rarely followed and is treated as routine by many medical professionals.”

In her piece, Luterman wrote people under conservatorships can be victims of permanent forced sterilizations. Every state has different laws regarding sterilization, she says, but it’s a poorly regulated system.

“It’s happening everywhere,” Luterman says, “it’s explicitly legal in about 25 states and it’s sort of a gray area in the other half of the states.”

The protections of women under conservatorships vary by state, she says. In California, women under conservatorships could refuse medical treatment. Spears could have refused the IUD when she was first receiving the implant, Luterman says, and the doctor would have obeyed her wishes.

However, a conservator controls so many aspects of the person’s life that it’s very common to coerce someone into making the medical decision. Just like in the case of Spears, Luterman says conservators can manipulate the person by convincing them everything they love will get taken away from them — friends, partners, outings.

There is a history of forced sterilizations for people with disabilities. The idea behind eugenics is to breed a better person — like the way people breed a type of dog or horse. California had one of the largest eugenic programs in the country.

“In the Southern United States, Black women and girls were often subjected to sterilization regardless of whether they had a mental health history,” Luterman says. “It was so common that it was called a Mississippi appendectomy and this ran until the 1970s.”

She says in Puerto Rico, sterilization from government-sponsored doctors was so widespread that about a third of the female population was sterilized at one point. The cycle continued into the 1970s.

Some conservators think it’s necessary to get a court order to put their wards with disabilities on birth control. Others have argued that conservators are protecting their ward with certain disabilities from exploitation or pregnancy through sterilizations.

“I find the argument around exploitation to be a little bit disturbing because sterilizing someone with a disability does not prevent them from being sexually assaulted,” Luterman says. “It just means they won’t get pregnant if they are sexually assaulted.”

She says when she talks in school about children with disabilities, the standard of treatment is called the least restrictive environment. The idea is to give the person as much freedom of choice as possible — a freedom that doesn’t always extend to adults with disabilities.

Many times people in conservatorships don’t speak out about the issues they are facing because of shame and the personal nature of the problem, she says. Many people don’t have the platform Spears has to express themselves the way they want.

“I feel optimistic about the future because just that people are having a conversation about it,” Luterman says, ”and that there’s interest is a huge step forward.”


Kalyani Saxena produced and edited this interview for broadcast with Jill RyanCamila Beiner adapted it for the web.

This article was originally published on WBUR.org.

Copyright 2021 NPR. To see more, visit https://www.npr.org.