La Operación: the sterilization era in Puerto Rico

Puerto Rico's Legislative Assembly passed legislation promoting sterilization as early as 1937, but the practice became widespread only when Operation Bootstrap began in 1945. The government opened about 160 clinics and hospitals primarily to provide sterilizations, and by 1946 an estimated 6.5 percent of Puerto Rican women of childbearing age had already been sterilized. The Asociación Puertorriqueña Pro Bienestar de la Familia, known as Pro Familia, founded by feminist activists Carmen Rivera de Alvarado and Celestina Zalduondo with support from Planned Parenthood, expanded the clinic network further through the 1950s. By 1953 around 17 percent of women of childbearing age had been sterilized; by 1965 that figure had climbed to 34 percent, and most of those women were sterilized in their early twenties.

Governor Luis Muñoz Marín personally opposed compulsory sterilization even as his own administration supported private sterilization programs, driven by the same fear that population growth would erode the economic gains of Manos a la Obra. San Juan's Catholic bishop condemned the policy in public as early as 1947. By the late 1960s, the government offered free or low-cost tubal ligations, and the documented record of this period includes troubling practices: procedures performed under coercion or without full informed consent, and cases in which practitioners told women the procedure was reversible, describing it as simply "tying" the tubes, while actually performing an irreversible procedure that cut them.

Opposition grew louder in the 1970s. The Young Lords publicly framed the practice as a form of genocide, alongside mainland groups CESA and CARASA. By 1982, an estimated 39 percent of Puerto Rican women of childbearing age had been sterilized, a rate that a 1985 Population Today report described as the highest in the world at the time. Rates declined through the 1990s as attitudes shifted toward a reproductive-rights framing and more women gained access to non-permanent birth control.

Historians still actively disagree about how to characterize what happened. Some read the pattern as a coordinated coercive campaign; others describe a more complex mix of government policy pressure, medical system incentives, and individual choice within a limited set of options. This account presents the documented numbers and the honest disagreement over how to interpret them, rather than settling the question one way or the other. Both the scale of the practice and the historiographical dispute over its meaning are part of the real record.

Sources: Políticas de esterilización de EE. UU. en Puerto Rico. See Sources. Freeze 2026-08-22.