folded up and tucked in my wallet. It’s from a
1973 issue of Ebony magazine. The older of the
two sisters, Minnie Lee, stares hard at the cam-
era, her gaze direct and unsmiling but pleasant,
almost quizzical. Her hair is freshly pressed,
hot-curled and brushed into place, making her
look older than 14. In a clean white dress with
lacy zigzags, she seems ready for Sunday school.
Her left arm is draped around her baby sister,
Mary Alice, age 12, anchoring her in place. The
younger Relf sister cracks a big, playful smile, her
hair in braids — and not the usual three unruly
braids from other pictures of the sisters during
this time. Instead they are pinned down, neat
and tidy for the Ebony shoot. The bottom of
Mary Alice’s schoolgirl dress is hiked up as she
reaches up to rest her right arm, the one that’s
not fully formed, a disability she was born with,
on her sister’s shoulder.
That same picture lay on the passenger seat of
my rental car in February 2020 as I turned into the
Westport Apartments, a cluster of brick homes
situated behind a strip mall near the Mobile
Highway in south Montgomery, Ala. When
I knocked on the door of the Relfs’ home — a
cramped single-story apartment that looks like
all the others in the public-housing complex —
Mary Alice yanked it open with a big smile, the
same one in that picture from 49 years ago. She
pulled me into the house and said something I
didn’t quite understand, though after spending
time with her, I would come to better compre-
hend what on that day was a raspy collection of
sounds, resulting from a speech impediment and
an intellectual disability that make communica-
tion diffi cult for her.
On that afternoon, Minnie Lee sat resting
her elbows on their dining-room table, which
was covered with glass to keep it from getting
scratched. ‘‘I’m sorry, ma’am, I can’t stand up for
you,’’ she said politely, pointing down to her right
foot. It was in a bulky gray cast. While reaching
for a can of string beans in her kitchen cabinet the
week before, she lost her balance and fractured
it in three places.
Mary Alice pulled a chair close to her sister,
so they were nestled next to each other as in the
Ebony photo and nearly every other photo of
the Relf sisters. They are now 61 and 63; looking
at them pressed together as though attached, I
could still see the faces of the two young girls
forever memorialized a half century ago beneath
the headlines ‘‘Suit Says Girls Were Sterilized’’ in
The New York Times; ‘‘Sterilized, Why?’’ in Time
magazine; and, in Ebony, ‘‘Sterilization: Newest
Threat to the Poor.’’
In the summer of 1973, Minnie Lee and Mary
Alice were taken from their home in Montgom-
ery, cut open and sterilized against their will and
without the informed consent of their parents by
a physician working in a federally funded clinic.
The Relf case would change the course of history:
A lawsuit fi led on their behalf, Relf v. Weinberg-
er, helped reveal that more than 100,000 mostly
Black, Latina and Indigenous women were ster-
ilized under U.S. government programs over
decades. It also offi cially ended this practice
and forced doctors to obtain informed consent
before performing sterilization procedures —
though as it would turn out, forced sterilizations
by state governments would continue into the
21st century.
From 1907 to 1932, 32 states passed explicit
eugenics laws that allowed for the government
to sterilize the ‘‘insane,’’ the ‘‘feebleminded,’’ the
‘‘dependent’’ and the ‘‘diseased’’ — all of whom
were deemed incapable of making their own deci-
sions about reproduction. Nearly all of these laws
have been repealed (in Washington State, a version
of the law still remains on the books). Indiana, Vir-
ginia and North Carolina have created historical
markers to commemorate those who were steril-
ized through government-sanctioned programs.
Eight states have issued offi cial apologies.
‘‘While eugenics practices and policies are no
longer in existence, the impact and the legacydeeply remains today,’’ Jill Krowinski, speaker of
Vermont’s House of Representatives, said on the
Statehouse fl oor in Montpelier last October. Ver-
mont state legislators apologized for using forced
sterilizations and other practices to reduce popu-
lations deemed unfi t to have children — including
Indigenous and mixed-race people, people with
disabilities and low-income families. ‘‘For those
that were directly impacted, for their descen-
dants, and for all of the communities involved,
we cannot undo the trauma that this moment has
caused, but we can start by formally acknowledg-
ing this dark period in our state’s history. Today,
we publicly apologize for the Legislature’s role
in ever allowing this to occur.’’
Some states have begun to go beyond apolo-
gies. Three so far, Virginia, North Carolina and
California, have established programs to compen-
sate victims of forced sterilization. But Alabama,
where the Relf sisters were forcibly sterilized and
which has been their home all their lives, is not
one of those states, and the federal government
has made no such moves. The Relf sisters subsist
in obscurity on meager Social Security checks.
‘‘I can show you what they did to me,’’ Minnie
Lee said. She lifted up her T-shirt and revealed a
jagged horizontal scar that rips across her abdo-
men. ‘‘That’s where they cut me.’’ As she lowered
her shirt — which had the word ‘‘courage’’ print-
ed three times on the front — she dropped her
head. Mary Alice, sitting on a fl oral-patterned
chair next to her, with a poster of the Last Supper
displayed in an ornate plastic frame on a near-
by wall, watched intently, her glasses pushed up
on her face. Her half arm rested lightly on her
thigh as she leaned in to listen to her sister. ‘‘It
might have happened a long time ago, but it still
brings back memories,’’ Minnie Lee said, looking
at Mary Alice. ‘‘We’re still thinking about it.’’The history of legalized forced sterilization by
the government begins in 1907, when Indiana
became the fi rst state to pass a eugenics law
providing for the involuntary sterilization of
‘‘confi rmed criminals, idiots, imbeciles and rap-
ists.’’ Those aff ected early on were mainly men
viewed as criminalistic, including those whose
‘‘defect’’ was supposedly excessive masturbation
or homosexuality.
‘‘That fi rst law focused on vasectomizing poor
white men who were identifi ed as being sexu-
ally deviant,’’ says Dr. Alexandra Minna Stern,
a professor of American history and culture at
the University of Michigan and co-director of
the Sterilization and Social Justice Lab. Her
research team studies the history of eugenic
sterilization in the United States and has collect-
ed the records of more than 60,000 survivors in30 6.12.22
Th is article is adapted from ‘‘Under the Skin: e
Hidden Toll of Racism on American Lives and on
the Health of Our Nation,’’ published this month
by Doubleday.I keep a
sepia-tone photograph
of the Relf
sistersOpening pages: Photograph by Gary Settle/The New York Times