Mary Alice was 14 and Minnie was 12 when they became victims of the abusive practice of sterilizing poor, black women in the South. Their mother, who had very little education and was illiterate, signed an "X" on a piece of paper, expecting her daughters, who were both mentally disabled, would be given birth control shots. Instead, the young women were surgically sterilized and robbed of their right to ever bear children of their own.
The Center filed a lawsuit on behalf of the Relf sisters and exposed the wide-spread sterilization abuse funded by the federal government and practiced for decades. The district court found an estimated 100,000 to 150,000 poor people were sterilized annually under federally-funded programs. Countless others were forced to agree to be sterilized when doctors threatened to terminate their welfare benefits unless they consented to the procedures.
The judge prohibited the use of federal dollars for involuntary sterilizations and the practice of threatening women on welfare with the loss of their benefits if they refused to comply. As the litigation made its way through the courts, the U.S. Department of Health, Education and Welfare withdrew the challenged regulations (under which the government funded the forced sterilizations), and the lawsuit's exposure led to the requirement that doctors obtain "informed consent" before performing sterilization procedures.
The District Court declared certain HEW (now called the Department of Health and Human Services) regulations covering sterilizations were "arbitrary and unreasonable" and enjoined HEW from providing federal funds to be used for the sterilization of certain incompetent persons. The District Court also ordered HEW to amend its regulations. During the course of the litigation, HEW withdrew the challenged regulations and represented on appeal its intention to issue new regulations. The Court of Appeals held that the controversy was mooted out by HEW's actions and remanded the case back to the District Court for dismissal.