Each January at Native News Online’s Health Equity desk, we sift through the past year of news coverage: breaking news on policies and legislation, trends in data, and feature articles created from listening when Indian Country tells us what matters. What emerges is a list of our best estimate of which stories will unfold over the next 12 months. It serves as a roadmap for where to focus our efforts and tells you, reader, “This is what you can count on us for.”
The story that topped our list for coverage in 2026 was the forced and coerced sterilization of Native women, a federally funded practice that amounted to biological and cultural genocide.
Last month, New Mexico lawmakers passed a memorial directing the state to investigate the history and ongoing impact of the sterilizations, making it the first in the nation to do so. We’ve published three articles and one opinion piece since the memorial was reviewed by New Mexico lawmakers last November. While the investigation will be focused on the Indian Health Service (IHS) Albuquerque and Navajo service areas, advocates hope it spurs federal legislation for a nationwide investigation into the abuse.
The story is just beginning. As we continue our coverage, here are six things you need to know.
It started in 1907.
At the beginning of the 20th century, Indiana became the first state to legalize the involuntary sterilization via tubal ligation or hysterectomy of people deemed “criminals, idiots, imbeciles and rapists.” Thirty states followed suit. Women of color, including Native American women, were disproportionately targeted.
Many of the sterilizations of Native women were performed by IHS doctors — meaning it was federally funded.
The federal agency tasked with providing health care to millions of Native people across the United States sterilized thousands of Native women.
Under Title X of the Family Planning Services and Population Research Act of 1970, the government began to pay for 90 percent of the cost of sterilizations performed at IHS facilities. The procedures earned hospitals far more money in subsidies than birth control, effectively incentivizing the practice.
Tens of thousands of Native women were victims.
It’s estimated that 70,000 Native women may have been sterilized at IHS hospitals and clinics throughout the 20th century. Some researchers estimate that nearly 50% of Native women of childbearing age were sterilized by the 1970s. By the end of that decade, birth rates in Native communities had plummeted by 75%.
Many women reported not knowing they were sterilized until years later.
Many of the sterilizations were performed during other, non-related surgeries. Women reported discovering during medical appointments that they had undergone tubal ligation or hysterectomies without their knowledge. Some report being told by doctors that their hysterectomies were reversible, when the procedure renders a woman permanently unable to bear children.
A Native woman sounded the alarm.
In 1972, Native American physician Dr. Connie Pinkerton-Uri (Cherokee, Choctaw) treated three Native women of childbearing age who underwent sterilization procedures by IHS: a 20-year-old who had a total hysterectomy, and two young women who received tubal ligations during appendectomies.
Pinkerton-Uri conducted her own independent investigation that found 1 in 4 Native women had been sterilized without consent between 1960 and 1978.
There is no sweeping law against forced or coerced sterilization.
In 1927, the Supreme Court ruled in Buck v. Bell that the sterilization of people deemed “unfit” does not violate the Fourteenth Amendment, which guarantees equal protection under the law. While subsequent SCOTUS rulings have weakened its precedent, it has never been overturned.
