"A study by the U.S. General Accounting Office finds that 4 of the 12 Indian Health Service regions sterilized 3,406 American Indian women without their permission between 1973 and 1976. The GAO finds that 36 women under age 21 had been forcibly sterilized during this period despite a court-ordered moratorium on sterilizations of women younger than 21." National Library of Medicine

This number might not seem too shocking but, per capita, it's the same as sterilizing 452,000 non-natives. There were cases where women would get in for an appendectomy and not even be aware that they had been sterilized in the surgery.

There are the most obvious reasons for this forced sterilization: 1. an undertone of a eugenics movement which began decades before and 2. the attempt to assimilate Native peoples into mainstream American culture. A California State University Professor of History, Lisa Emmerich, explains it was "easier to demonize native women, their communities, and their traditions than to cooperate with them to devise a solution,". Some of the alternative, unethical solutions, discovered by the General Accounting Office (GEO) 1976 investigation on a congressional order, had been to sterilize both female adults and minors, even going as far as to obtain inadequate and/or consent forms. The GEO found at least four areas the IHS had not been following standard procedures but had no concrete evidence that forced sterilization had taken place.

"However, GAO investigators acknowledged that many tribal women believed they would lose BIA benefits, access to services, or custody over their other children if they refused to do the procedure," said Emmerlich.