Demonstrators in Minneapolis call for ICE to be abolished. June 23, 2018.

The ‘uterus collector’: the surgeon who performed coerced hysterectomies on detained migrant women

Forced sterilizations on detained migrant women is in line with the US’s long, sordid history of eugenics.

Last month, the Department of Homeland Security (DHS) briefed House Democrats on allegations concerning several gynecological procedures, including hysterectomies, that a physician performed on migrant women in Immigration and Customs Enforcement (ICE) custody at the Irwin County Detention Center in Ocilla, Georgia—allegedly without their informed consent. The incidents became public knowledge in September 2020, after a consortium of human rights groups filed an explosive report on behalf of Nurse Dawn Wooten, a whistleblower who worked at the detention center.

In a December 3 letter signed by the chairmen of the House Committees on Homeland Security and Oversight and Reform, legislators wrote: “We are concerned that Dr. [Mahendra] Amin may have been performing unnecessary surgical procedures to defraud DHS and the Federal government without consequences.” The letter, which is addressed to DHS Secretary Alejandro Mayorkas, also requested information on the steps the Department has taken to review treatment Dr. Amin provided and ensure migrants receive proper medical care in the future.

The Conversationalist confirmed a December 15 DHS briefing with two committee staffers, both of whom declined to share additional details about the information presented. A staffer from the Committee on Homeland Security clarified that this was a DHS review of the Irwin County Detention Center and not a general review of migrant detention facilities, although Congress requested the Department to brief them on the matter months ago.

The December 3 letter says, “the Committee on Homeland Security requested a briefing on August 10, 2021, on DHS’s efforts to review the suitability of detention facilities. To date, DHS has not fulfilled this request. We ask that you ensure the Committees receive this briefing without further delay.”

On January 3, the DHS released a report that found “the facility’s chronic care, continuity of care, and medical policies and procedures to be inadequate” but did not find that unnecessary or unwanted hysterectomies had been performed. The report does, however, quote an ICE employee who alleges that there is a systemic issue in the ICE leadership that makes the agency “unwilling to listen to concerns or complaints about detention facilities.”

Nurse Dawn Wooten worked at the Irwin County Detention Center (ICDC) for three years. She says that Dr. Amin, who was referred to as the “uterus collector,” had performed hysterectomies on at least 20 women without their consent. Many of these women did not speak English well enough to consent to the procedures or understand what had been done to them. Thirty-five women are now suing ICE over Dr. Amin’s abuse.ICDC, run by a for-profit prison company called LaSalle Corrections, also came under harsh scrutiny for their botched COVID-19 response, which sparked hunger strikes and protests among detainees early in the pandemic.

The Georgia-based advocacy group Project South filed the complaint, which describes a filthy, insect-infested facility with inadequate COVID-19 safety precautions, where staff refused to test symptomatic detainees and fabricated medical records. Detainees who protested the conditions were punished with beatings, pepper spray, and solitary confinement. Nurse Wooten told The Intercept that she was demoted after raising concerns with her supervisors.

“It is deeply concerning that neither DHS nor the private prison company running Irwin have yet to face accountability for the medical abuse that migrant women faced at Irwin,” Azadeh Shahshahani, the Legal and Advocacy Director with Project South said in an email statement to The Conversationalist. “This is setting an awful precedent. Congress and the Biden Administration must act now.”

The joint committee investigation subpoenaed LaSalle Corrections in November 2020 after the company refused to turn over medical records on the procedures Dr. Amin performed. Dr. Tony Ogburn, Department Chair of Obstetrics and Gynecology at the University of Texas Rio Grande Valley, reviewed those records. He concluded that Dr. Amin’s care “did not meet acceptable standards.”

“My concern is that he was not competent and simply did the same evaluation and treatment on most patients because that is what he knew how to do, and/or he did tests and treatments that generated a significant amount of reimbursement without benefitting most patients,” Dr. Ogburn concluded in a November 2021 letter to the Georgia Medical Board.

Following pressure from lawmakers, activists, and advocacy groups, DHS Secretary Mayorkas announced he would sever ties with LaSalle Corrections in May 2021, though migrants were not removed from the facilities until September 2021—a full year after Project South filed Nurse Wooten’s whistleblower complaint with the ICE administration.

While these abuses came to light during the Trump presidency the lack of accountability continues under the Biden Administration, with migrant arrests now at a 21-year high. The current administration has ramped up deportations under a Trump-era health policy that allows the government to expedite the process without giving migrants the opportunity to apply for asylum. The government claims the rushed deportations are a COVID-19 safety precaution.

Under Title 42, the Trump Administration expelled 444,000 migrants. Under Biden, this number has already reached 690,000. COVID-19 still runs rampant in migrant detention centers and in prisons such as New York City’s Rikers Island, where more than one-fifth of the incarcerated population has tested positive.

Immigration advocates have been disappointed with the new administration. Since taking office, Biden has filed 296 executive orders on immigration, 89 of which have reversed actions taken by the Trump administration such as the travel ban on Muslim majority nations and construction of the border wall.

When Dawn Wooten stepped forward to make a whistleblower complaint about the medical abuses at ICDC, international headlines about “mass hysterectomies” sparked outrage and comparisons to Nazi Germany. Others placed the story within a long history of American eugenics that targeted Black, brown, disabled, and indigenous women.

“People with Spanish surnames were disproportionately sterilized during the period of peak eugenics in the 1920s through the 1950s,” says Heather Dron, a Research Fellow at the Sterilization and Social Justice Lab at the University of Michigan.

During the twentieth century, U.S. states subjected over 60,000 people to sterilization without consent, with over 30 states establishing eugenics boards. State governments targeted minorities, the disabled, and others who did not fit into “social norms” for forced sterilization.

From 1929 to 1974 North Carolina ordered as many as 7,600 women sterilized— a majority of whom were Black women from low-income backgrounds. Margaret Sanger and Dr. Gregory Pincus exploited government birth control centers in Puerto Rico to subject one-third of the female population to sterilization procedures, often without their consent, purportedly to address “overpopulation” and poverty on the island. Under the Family Planning Services and Population Research Act of 1970 physicians sterilized an estimated 25 percent of Native American women of childbearing age in a six-year period.

Adolf Hitler writes admiringly in Mein Kampf of eugenics policies practiced in the U.S. “There is today one state in which at least weak beginnings toward a better conception [of immigration] are noticeable. Of course, it is not our model German Republic, but [the United States], in which an effort is made to consult reason at least partially. By refusing immigrants on principle to elements in poor health, by simply excluding certain races from naturalization, it professes in slow beginnings a view that is peculiar to the People’s State.”

Heather Dron’s research focuses on eugenic sterilization in California, where roughly 20,000, or one-third, of U.S. sterilizations were performed starting from 1909.

“There was a law on the books between 1909 and 1979 that allowed for the sterilization of institutionalized people housed in psychiatric hospitals, or in homes for what was then called the ‘feeble-minded,’” Dron says. “Sterilization was seen as a solution to all these other social problems. They saw it as a way to keep these people out of institutions.”

While eugenics laws in California have been repealed, sterilizations have continued. A 2013 investigation by Mother Jones revealed that 148 women in two California prisons were sterilized from 2006 to 2010.

“You get a similar dynamic there,” says Dron, referring to the recent ICE cases. “There were a few people who were performing a lot of procedures who seemed like they didn’t have a great ethical practice in general.”

There is no evidence to suggest that Dr. Mahendra Amin was motivated to perform these surgeries for anything other than financial compensation. Last month’s letter from House Democrats expressing concerns that Dr. Amin performed these surgeries to “defraud the government” further supports this theory.

“It sounds like there’s some sort of incentive to perform surgical interventions because you’re paid per intervention and some people took advantage of that,” Dron says of Dr. Amin’s case. “But you have to read that with a little bit of skepticism because often we point to these bad actors and say it’s just them as opposed to a system that systematically thinks that people who are incarcerated shouldn’t have kids.”

The breaking news of hysterectomies performed on migrant women in ICE custody barely made it through one news cycle before news of Ruth Bader Ginsberg’s death broke just days later. Her death was followed by a swift Republican push to nominate a third Supreme Court Justice under Trump just weeks ahead of the 2020 election.

The media might choose to remember the hysterectomies performed at the Georgia ICE facility as a particularly egregious act that happened under a uniquely evil administration. That would be a huge mistake.

According to a December 2021 article in The Texas Tribune, the number of immigrants held in ICE detention centers has increased by more than 50 percent since Biden took office. Moreover, the investigation into Dr. Amin’s medical practice has been conducted on Biden’s watch.

Detentions have been accompanied by a spike in border crossings in 2021. Biden has downplayed this as a seasonal phenomenon while Republicans have pointed to plans to offer 11 million migrants a path to citizenship as cause for the surge. Others say the migrants are motivated by growing instability in their home countries. With less attention on the issue of migration, Biden has gotten away with his continuation of the “remain in Mexico” policy by pointing to Title 42, which has been extended twice by the Centers for Disease Control and Prevention, as a matter of public health.

Under the Biden Administration, we no longer hear overtly fascist rhetoric from the White House aimed at migrants, but detainees at ICE facilities continue to suffer from extreme medical neglect and abuse as COVID-19 cases soar.

In order to prevent us from reliving the past, we need to understand the circumstances that led us to where we are today. Ending Trump’s remain in Mexico policies, fulfilling a campaign promise to offer migrants a path to citizenship, and holding Dr. Amin and LaSalle Corrections responsible for their medical abuses would be a great place to start.