I grew up with Britney Spears. I wasn’t an avid listener of her music — respectfully, I was more into Destiny’s Child during those years — and I wasn’t a Mickey Mouse Club fan. I grew up watching the news consume Spears for entertainment. My primary knowledge of Spears came through the appalling way the media treated her and the obvious familial abuse that enabled those televised ambushes. According to Spears' June 23 testimony to a judge about her conservatorship, her father Jamie so tightly manages her public and private life that she has been unable to reveal abuse within the conservatorship itself. In a viral audio recording, Spears asked the judge to allow her to remove an IUD so that she could begin trying to grow her family.
After three decades of processing the impact my gender and neurodivergence has had on the medical treatment I receive, I identify with Spears much more than I did as a teen. Jamie Spears, the same person who subjects her to humiliating public appearances, is Britney Spears’ main conservator. “I wanted to take the IUD out, so I could start trying to have another baby, but ... they don’t want me to have ... any more children,” Spears told the judge in an impassioned plea to end her conservatorship. “I was told ... I’m not able to get married or have a baby.” Though Jamie Spears denies having any involvement in her “personal affairs,” — including any decisions about her reproductive health — the court, in supporting this legal hold over Britney, Jamie and those involved in her conservatorship also control what is effectively Britney’s’ state-sponsored medical sterilisation. The judge sided with Jamie in upholding the conservatorship and her continued sterilisation.
Medical sterilisation is just one legacy of the American eugenics movement, which campaigned for “fewer and better children.” Eugenicists successfully argued for decades that public health should encourage white Protestants to reproduce more, while taking numerous steps to prevent reproduction by Black Americans, immigrants, Catholics, and Native Americans. At the same time, they asserted the importance of preventing white people with physical, mental, and intellectual disabilities from procreating and, they believed, deteriorating the nascent “white race.” Eugenicists explicitly asserted that poor southern and other “unfit” whites were most likely to reproduce with Black people and that reproduction with Black people would produce an inferior white population over time. Eugenic theorists, among them the fathers of American medicine and public health, were as obsessed with producing a white population without mental or physical illness as they were with preventing children that had these idealised features while having Black ancestors.
In the landmark case of Buck v. Bell, Oliver Wendell Holmes, Jr. upheld the Virginia Sterilization Act of 1924 on the basis that such laws prevented both crime and the inevitable death by starvation of generations of people. States in the US have a long history of legislation that disrupts or removes the ability to reproduce from mentally and physically disabled people.
From unanesthetised experimentation on Black and Indigenous women to involuntary, secret sterilisation, gynecology is founded on centuries of coercion and racist beliefs about biology. J. Marion Sims, whose statue held pride of place across from the New York Academy of Medicine until 2018 performed more than 30 experimental surgeries on enslaved women Anarcha Westcott, Lucy, and Betsy — with no anesthesia. This is what is meant by calling him “the father of modern gynecology.” Yet discussing historical gynecological abuses, especially against disabled people, is verboten.
"Jamie Spears and the conservatorship over Britney Spears rely on an entire system designed to support the involuntary sterilization of people the state consigns to an unfit underclass."
Leslie Kay jones
When I’m at the gynecologist, I try not to be terrified, but the painting of Anarcha Westcott kneeling on an operation table in front of Sims and two other white men swims in my brain. Sims stated that Black women could sustain the pain necessary for his “progress,” unlike white women. Despite this history, Black women’s stories do not fit into the narrow confines of the pro-choice versus pro-life debate. Americans discuss Roe v. Wade, and we do not discuss the state-sponsored practice of removing the wombs from unconscious, unconsenting Black women so common that it was nicknamed the “Mississippi Appendectomy.” This practice continues today with the sterilisation of Native girls and women; and ‘Mississippi appendectomies’ performed on women imprisoned by the DOJ and ICE. When it comes to conservatorships, rather than ban sterilisation, modern law codifies guidelines for circumventing informed consent. According to the California Handbook for Conservators, conservatees are not allowed to have the conservatee sterilised. Only a judge can make that decision.”
Jamie Spears can leverage the language of health to sterilise his daughter in large part because we refuse to acknowledge the legacy of eugenics in American public health legislation. Conservatorship laws explicitly reframe the right to bodily autonomy as a right to bodily health, and then grant the power to determine what is helpful to a petitioner or to the state itself. Eugenicists argued that they are helping prevent suffering for people who cannot function in society. This is the same argument that was used to force Britney Spears to keep in her IUD, and the same system that requires her to prove mental fitness before controlling her own rights to reproduction.
Unlike Britney, no one forced me to get an IUD. Instead, I was motivated by the fear that the Trump administration and conservative government would make it difficult to access monthly birth control, especially on a student budget. I wasn’t the only one; the NYT reported increased demand for IUDs and birth control implants after the election. I did extensive research motivated by anxiety; the only negative information I encountered described nothing like the childbirth-like pain I experienced. But I had insufficient information and the utter disregard for my pain was traumatic. Even articles I read about pain during the procedure emphasised how happy everyone was after getting an IUD.
The day of insertion, I asked repeatedly, “Will it be painful?” I was reassured by doctors and nurses that my anxiety was unnecessary and the procedure would be quick and mildly uncomfortable. It was the worst pain of my life. I must have asked to stop because she cautioned me that she hadn’t made the actual insertion, which would be the painless part. No one told me they had dilated my cervix, or that they might. None of the pain minimisation strategies I encountered while researching for this article were explained or offered to me, not even preventive ibuprofen. I had to choose to keep going or experience this pain for nothing. I chose the IUD, beginning nearly a year of abdominal pain and cramping.
When I listened to Spears talk about being in denial, and faking it until you make it, it resonated with me as someone that copes with anxiety. Though I had been fantasising about snatching the IUD out of my body for relief, I talked myself out of my own pain for over a year, with the help of nurses and doctors who were already sceptical of my capacity for pain, my concern for my own physical health, and my intellectual ability to understand medical communications. The medical racism and sexism I experienced was bolstered by a dearth of research on reproductive pain that is experienced primarily by women, nonbinary people, and trans men. Consider that endometriosis research and treatment development has stalled due to lack of funding and institutional interest. IUDs are routinely prescribed to patients like me, with a hereditary risk of endometriosis.
Jamie Spears and the conservatorship over Britney Spears rely on an entire system designed to support the involuntary sterilisation of people the state consigns to an unfit underclass. “I want to sue my family,” Spears testified in court of the medical and legal violations she alleged against her family. “They should be in jail. I just want my life back.”
When the supposedly minimally invasive IUD finally became unbearable for me, I went to have it removed. At my removal appointment, the nurse practitioner told me it looked like my body was trying to eject it. I felt nothing during the procedure and an overwhelming sense of physical and mental relief immediately afterward.
I wish that relief for Britney. #FreeBritney