Mass hysterectomies? It might be a good idea to check the facts first

It’s the hot, election-season, too-good-to-check claim of the day: that ICE is sending women detained for immigration violations for “mass hysterectomies.” The Intercept, a left-wing gadfly publication, has pushed the story into the media. Gizmodo Australia, not going much further than a lot of other outlets, headlined the story, “U.S. Concentration Camp Sent Undocumented Women to Be Sterilised According to Whistleblower.” Elle headlined its story, “ICE Whistleblower Says A ‘Uterus Collector’ Is Reportedly Performing Hysterectomies On Immigrant Women.” Nancy Pelosi is demanding an investigation:

If true, the appalling conditions described in the whistleblower complaint — including allegations of mass hysterectomies being performed on vulnerable immigrant women — are a staggering abuse of human rights. This profoundly disturbing situation recalls some of the darkest moments of our nation’s history, from the exploitation of Henrietta Lacks, to the horror of the Tuskegee Syphilis Study, to the forced sterilizations of Black women that Fannie Lou Hamer and so many others underwent and fought.

If true, the most hyperbolic version of the story would be a colossal atrocity. As it turns out, the actual allegation is much narrower — but still a horrifying case of serial medical malpractice, if proven. As is often the case with wild allegations of institutional misconduct, it is wise to demand proof, but also urgent to insist that the charge be properly looked into. Conspiracy theories are often crazy, but sometimes true; outrageous theories of institutional misconduct, especially when involving matters touching on sex, are a fertile field for crazy but also sometimes borne out by the evidence. Just because QAnon is nuts does not mean that conspiracies to commit sexual abuses never happen. What we can do is clarify what exactly is alleged, and by whom, and about whom. Let the wheels of law and justice grind forward from there.

Here’s what we know. An alphabet soup of advocacy organizations (Project South, Georgia Detention Watch, Georgia Latino Alliance for Human Rights, South Georgia Immigrant Support Network, Government Accountability Project) teamed up to file an administrative complaint with the Department of Homeland Security, ICE, and the Irwin County, Ga., ICE Detention Center (ICDC). Much of the complaint is the routine stuff of prison litigation, with a COVID-19 overlay: complaints about the Irwin County Detention Center’s provision of medical services and sanitary conditions in light of the pandemic. The entire complaint focuses on a single detention center; it does not allege events at other ICE facilities, although it takes aim at LaSalle Corrections, the private prison company that runs ICDC, and asks for an investigation of ICDC “as well as all other LaSalle operated facilities.”

The complaint is based on the on-the-record allegations of Dawn Wooten, a whistleblowing nurse at ICDC, and a bunch of unnamed, unidentified sources interviewed by the advocacy groups. Wooten submitted a sworn declaration that is quoted in the complaint but, so far as I can tell, not posted on the Internet with the complaint. The allegations about hysterectomies do not appear at all in Project South’s press release on the complaint, and are not found until page 19 of the 27-page complaint. This is not how one would ordinarily handle an allegation of sensational misconduct if it was supported by substantial evidence. The most eye-popping quotes come from a source identified only as “one woman” who was interviewed “at the Irwin County Detention Center” in October 2019, with no further information as to what connection she may have to ICDC:

Several immigrant women have reported to Project South their concerns about how many women have received a hysterectomy while detained at ICDC. One woman told Project South in 2019 that Irwin sends many women to see a particular gynecologist outside the facility but that some women did not trust him. She also stated that “a lot of women here go through a hysterectomy” at ICDC . . . The woman told Project South that it was as though the women were “trying to tell themselves it’s going to be OK.” She further said: “When I met all these women who had had surgeries, I thought this was like an experimental concentration camp. It was like they’re experimenting with our bodies.”

Let’s pause before we go further. Hysterectomies are an entirely legitimate medical procedure, but they have grave implications for a woman’s health, and they make it impossible for the woman to bear children. In no case should a hysterectomy be performed on any woman without her voluntary, informed consent. If anyone, anywhere, is performing hysterectomies on women without that, it’s a legitimate scandal, at minimum medical malpractice, and quite likely a serious crime. Government authorities receiving a complaint making such an allegation about women in government custody, however flimsy its evidentiary basis, should ensure that it is vigorously investigated. obtained two statements from ICE. The first:

U.S. Immigration and Customs Enforcement (ICE) does not comment on matters presented to the Office of the Inspector General, which provides independent oversight and accountability within the U.S. Department of Homeland Security. ICE takes all allegations seriously and defers to the OIG regarding any potential investigation and/or results. That said, in general, anonymous, unproven allegations, made without any fact-checkable specifics, should be treated with the appropriate skepticism they deserve.

The second, an hour and ten minutes later:

Medical Director of the ICE Health Service Corps (IHSC) Dr. Ada Rivera said in a statement obtained by Law&Crime that ICE “vehemently disputes the implication that detainees are used for experimental medical procedures.” “ICE’s mission is to protect the homeland and to swiftly and quickly remove people from the country; the health, welfare and safety of ICE detainees is one of the agency’s highest priorities, any assertion or claim to the contrary is false and intentionally misleading,” the statement said. Rivera, citing ICE data, said that since 2018 “only two individuals at Irwin County Detention Center were referred to certified, credentialed medical professionals at gynecological and obstetrical health care facilities for hysterectomies in compliance with National Commission on Correctional Health Care (NCCHC) standards.” Rivera said detainees at ICE facilities are “afforded informed consent, and a medical procedure like a hysterectomy would never be performed against a detainee’s will.” The statement also said medical care decisions are made by medical personal, not law enforcement. The statement further said that it was “unfortunate” that the allegations contained in the whistleblower complaint were shared with the media “without allowing the government to examine or take appropriate action.” 

According to the complaint, the allegations relate entirely to a single gynecologist to whom ICDC has referred detained women. Wooten describes him with deep suspicion:

Ms. Wooten also expressed concern regarding the high numbers of detained immigrant women at ICDC receiving hysterectomies. She stated that while some women have heavy menstruation or other severe issues that would require hysterectomy, “everybody’s uterus cannot be that bad.” . . .

“Everybody he sees has a hysterectomy — just about everybody. He’s even taken out the wrong ovary on a young lady [detained immigrant woman]. . . . She had to go back to take out the left and she wound up with a total hysterectomy. She still wanted children — so she has to go back home now and tell her husband that she can’t bear kids . . . she said she was not all the way out under anesthesia and heard him [doctor] tell the nurse that he took the wrong ovary.”

Ms. Wooten also stated that detained women expressed to her that they didn’t fully understand why they had to get a hysterectomy. She said: “I’ve had several inmates tell me that they’ve been to see the doctor and they’ve had hysterectomies and they don’t know why they went or why they’re going.” And if the immigrants do understand what they’re getting done, “some of them a lot of times won’t even go, they say they’ll wait to get back to their country to go to the doctor.”

The rate at which the hysterectomies have occurred have been a red flag for Ms. Wooten and other nurses at ICDC. Ms. Wooten explained: “We’ve questioned among ourselves like goodness he’s taking everybody’s stuff out…That’s his specialty, he’s the uterus collector. I know that’s ugly…is he collecting these things or something…Everybody he sees, he’s taking all their uteruses out or he’s taken their tubes out. What in the world.”

Wooten seems to believe, in contrast to the ICE statement, that there are more than two cases involved. The complaint goes on, citing Wooten and unnamed sources, to suggest that ICDC and/or the gynecologist in question have fallen down on the job of providing adequate translation services to Spanish-speaking detainees. DailyKos claims to have identified the gynecologist at the center of the story, an immigrant himself with an Indian name who presumably is not a native Spanish speaker. It is impossible to know if the DailyKos poster’s information is accurate.

There are important facts we do not know from the available sources: Is the doctor correctly identified? Does the doctor have a sterling professional record, or a battery of red flags that should have been known to ICDC authorities? How many hysterectomies are at issue? Is there any evidence whatsoever — none is cited in the complaint — that this is anything larger than an issue with one doctor employed by one detention facility? It is hard for any fair reader of the complaint, from either a political or a legal perspective, to pronounce on this story without knowing those facts.

Locking people up is one of the most serious things a government does. It must sometimes be done, but it presents inevitable potential for both abuse and neglect. In a better world, nobody would be locked up by immigration authorities for more than a few days, but the sheer volume of illegal entrants to the United States and the time-consuming legal procedures afforded before deportation put the government to a choice: lock people up at length or give up entirely on enforcing the law. The Trump administration has refused to do the latter; in fact, even the Obama administration was unwilling to give up, which is why it pioneered the use of cages to hold children. Having locked people up at length, the government becomes inevitably entangled in questions of their care and accommodations such as whether they are being referred to bad doctors or given adequate information about their medical care. All of these are legitimate areas of investigation and oversight. Still, given the complete and total absence of evidence or even allegation that ICE as an institution — or the Trump administration — wished or chose to impose hysterectomies on unwilling women, it might be more responsible to wait for such evidence before writing screaming headlines claiming this to be true.