It has taken EngenderHealth many decades—through many different names, missions, and leaders—to become who we are today: a global organization committed to gender equality, to choice, and to comprehensive sexual and reproductive health and rights.

Our history did not begin with those commitments, however. Although today we find some aspects of our origins abhorrent, EngenderHealth’s present-day organizational values of reflection and transformation require us to examine and confront our past; and, our commitment to integrity impels us to share both our history and our reflections on that history.

The organization now known as EngenderHealth was preceded by several organizations in the late 1930s and early 1940s, including the Sterilization League of New Jersey and Birthright, which promoted sterilization of people their founder deemed “unfit” for parenthood. According to founder Mariann Stephenson Olden,1 these included people with intellectual disabilities, psychiatric disease, criminal records, and congenital blindness. This stance was consistent with state laws for compulsory sterilization at the time, which disproportionately targeted Black, Native American, and poor women and girls.2 In 1948, board members who believed sterilization should be voluntary removed Olden from the organization she started.

During the 1950s and 1960s, the organization, variously named Human Betterment Association, Human Betterment Association for Voluntary Sterilization, and Association for Voluntary Sterilization, focused on increasing access to voluntary sterilization for those who chose it. Their strategies included reducing eligibility burdens and convincing insurance carriers and Medicaid agencies to cover the procedure. But their policy priorities did not include ensuring protections for women of color and poor women who still were frequently subjected to coercive sterilization.

The 1960s also saw the growth of a global family planning movement largely motivated by an interest in population control. This perspective was driven by the fear that unchecked population growth in poor countries would threaten the environment, the global economy, and political stability—a perspective we now understand as racist and colonialist. In the late 1960s, adoption of a national family planning program was a prerequisite for receiving US foreign aid.

It was in this context that the organization’s international work began in the early 1970s, with explicit attention to voluntarism and choice in surgical contraception. Association for Voluntary Sterilization innovated to make sterilization safer and more accessible and launched programs to expand training for healthcare providers outside the US. This was when the organization began to resemble who we are today, focusing internationally and identifying the right to control one’s fertility as a human right.

In the 1980s, as the Association for Voluntary Surgical Contraception (AVSC), the organization built a strong reputation for supporting training, service delivery, and quality assurance. In the 1990s, as AVSC International, the organization expanded its programming, recognizing and acting on links among a broader range of contraceptive methods and other aspects of health, including HIV prevention and maternal health. During this period AVSC International became known for developing resources and programs that emphasized informed choice and a rights-based approach to sexual and reproductive health.

Despite the research that our staff—none of us historians—have undertaken, our understanding of the details of our past projects is necessarily and unfortunately incomplete. Given the prevailing views and practices of the time, and abuses that occur around the world even today, we recognize the possibility that the tools and approaches that we used during this period may have been insufficient to fully protect people’s rights.

In 2001, we changed our name to EngenderHealth, reflecting a broader view, mission, and portfolio. Over the past two decades, we have continued to expand our work to encompass a more comprehensive definition of sexual and reproductive health and rights, including a full range of contraceptive options, safe abortion and postabortion care, maternal health and safe surgery, addressing gender-based violence, and more. Our current strategy, launched in 2019, is designed to advance gender equality in and through gender- and youth-transformative sexual and reproductive health and rights programming, in partnership with governments, local civil society, and communities.

As EngenderHealth looks toward the future, we are committed to ongoing critical reflection on our past and to learning from both our success and our mistakes, including likely or presumed mistakes, whether or not we have all the information about our past. Where we have fallen short in our long history, we are deeply sorry. We are proud of the organization we have become, and we are determined to keep improving our programs and our operations to help achieve a gender-equal world where all people achieve their sexual and reproductive health and rights.

  1. Olden, Mariann S. 1974. History of the Development of the First National Organization for Sterilization. Self-published memoir.
  2. OBOS Birth Control Contributors. 2020. A Brief History of Birth Control in the U.S. www.ourbodiesourselves.org/book-excerpts/health-article/a-brief-history-of-birth-control/.