U.S. sterilization policies in Puerto Rico

U.S. sterilization policies in Puerto Rico involved attempts at population control influenced by neo-Malthusian principles. The United States and local Puerto Ricans first attempted to address the perceived problem of "overpopulation", believed to be the source of many of the island's problems, through birth control programs in the 1920s. In the 1930s, the local government passed legislation promoting sterilization. With the start of Operation Bootstrap in 1945, hundreds of clinics were established on the island to perform sterilizations, and by the 1950s, sterilization had become the primary means of birth control.

In the late 1960s, the Puerto Rican government began offering tubal ligations to women at free or reduced cost. Many of these procedures were performed under duress and without informed consent, and poor women were often pressured to undergo the procedure. This practice continued into at least the early 1970s, though reports on its prevalence afterward vary.

During this time, opposition to sterilization arose in the mainland United States from organizations such as the Young Lords, the Committee to End Sterilization Abuse (CESA), and the Committee for Abortion Rights and Against Sterilization Abuse (CARASA)—as well as from American conservatives. Sterilization rates continued to rise, reaching 39% among Puerto Rican women of childbearing age by 1982. However, these rates eventually fell in the 1990s as United States foreign policy shifted from a population control paradigm towards one of reproductive rights and Puerto Rican women began to prefer other birth control methods.

Knowledge of historical sterilization policies is inconsistent in Puerto Rico. However, the topic is discussed at length in books and journal articles published from the 1970s to the 2020s and covered in the documentary La Operación. Some consider coerced sterilization to be part of a genocidal population control campaign waged against Puerto Ricans. Others argue that coercion was more limited in scope and not systematic in nature.