The Early History of EngenderHealth

As the leader of EngenderHealth, an organization committed to reflection and transformation, I believe it is important to critically reflect on our history and evolution to inform our present and our future. Over the past year, a small group of our staff—none of us historians—made a concerted effort to learn more about our own organizational history. We consulted internal documents, selections from organizational archives on file at a university, external sources, and former staff and board members from the 1970s through the 1990s. We learned that many of the beliefs and motivations of our founder are exactly the opposite of what we believe now. Recognizing the harms that the organization caused in our early years further motivates us to act on our current commitments to equality, rights, and choice.

As summarized on our website, Mariann Stephenson Olden, the founder of the Sterilization League of New Jersey and Birthright (predecessor organizations to EngenderHealth), advocated for state laws in the United States to make surgical sterilization compulsory for people she deemed “unfit” for parenthood. At that time, judgments about “fitness” were made almost entirely by white people with financial means and in positions of power. According to Olden, the “unfit” included people with intellectual, mental, and physical disabilities. Her beliefs were unconscionably racist, classist, and ableist. And history shows that the concepts she promoted were often applied in ways that trampled on the rights of poor women and women of color.

Olden was pushed out of Birthright in 1948 by board members who believed sterilization should be voluntary and who subsequently advocated against state efforts to expand compulsory sterilization. Despite Olden’s limited tenure and forced departure, we must not gloss over the fact that our origins are rooted in her beliefs.

Additionally, we must recognize that the organization’s subsequent advocacy for voluntarism led to some unintended consequences. For example, in the 1970s, the Association for Voluntary Sterilization (another of our predecessor organizations) worked with the American Civil Liberties Union on lawsuits challenging New York City hospital policies that prevented women from choosing sterilization. While such challenges succeeded in increasing access to sterilization for some women, the lack of safeguards meant that greater access for those who wanted it also led to poor women and women of color being subjected to coercive sterilizations—abuses that also occurred internationally and which we have seen continue in some settings even recently. This dichotomy was powerfully described by the historian Dorothy Roberts in Killing the Black Body as a “clash of agendas.”1

What do I think of our early history, sitting here 50 to 80 years later? I struggle to really understand it—it is hard to see actions and motivations and to understand what the day-to-day was like in the organization at any given point. However, even though I cannot fully understand it, I cannot ignore the harm that the organization did, and I must recognize the likelihood of there being additional harms I am not aware of. I also reject the idea that the prevailing views of the times—including the promotion of forced sterilization or programs focused on population control—were normative and therefore acceptable. I do not accept them.

I do, however, appreciate the staff and board members who, from the late 1940s onward, stood up for choice and voluntarism. I spoke with a former staff member who told me about heated debates as late as the 1970s, which led to departures of those who continued to believe in contraception as a means of population control, rather than a right and choice.

I also appreciate that our predecessors set us on a path of embracing innovations in contraceptive technology (and later other reproductive health technologies) and worked to ensure access to high-quality care. Over more recent but still long-past decades, they also grounded the organization’s work in the context of choice and rights. Can I be sure that our programs always protected and upheld rights as fully as possible? No. But I can be confident that we can learn from this and use it to motivate us to always do better.

My commitment is this: within today’s EngenderHealth, we will use our knowledge of our history to provide extra motivation to live into our values and to put in place safeguards so that we continually assess our work and hold ourselves to the highest standards. As an example, we use a robust Do No Harm framework and tools such as our Gender/Youth Marker to continually improve in centering rights in all that we do, and to minimize, identify, and remediate any unintended harms resulting from our programs. We believe in equity, diversity, inclusion, choice, and justice in our work, as well as in our internal policies, processes, and culture. In fact, we don’t just believe, we do, and we are.

I am deeply sorry for harms that our predecessor organizations caused. I can’t (and don’t want to) make excuses for our founder, or for any of my predecessors’ views or actions. I do recognize, admire, and honor those who pushed back against efforts to coerce and control, and who drove our organization, community, and the sexual and reproductive health field toward its current emphasis on rights and justice. I hope that acknowledging our history directly and transparently will help us continue to be guided by our principles and values, including through questioning our environment and recognizing and correcting our mistakes.

  1. Roberts, Dorothy. 1998. Killing the Black Body: Race, Reproduction, and the Meaning of Liberty. New York: Vintage Books.