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Fear and Loathing in Puerto Rico:
A Foucauldian Analysis of Population Control and Contraceptive Experimentation
Mallory S. Edgar
University of Illinois at Urbana-Champaign
Sociology Undergraduate Student Paper Award
Spring 2009
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Fear and Loathing in Puerto Rico:
A Foucauldian Analysis of Population Control and Contraceptive Experimentation
Introduction
“We were motivated to have small families by our grammar school textbooks
which showed a family of four living in a beautiful house, the kind we country
people had never seen. We thought we had to be sterilized to have that. […] A
small family meant progress.”
-Puerto Rican woman, name unknown, in La Operación
(Garcia 1982)
Beginning in the early twentieth century, as development and expansion were taking
place in multiple social, political, and economic arenas, from the women’s movement to science
to international commerce, a deep concern with the magnitude of the world’s population and the
potential effects of its rapid growth into the future gripped people the world over with fear.
Conceptualizing the problem in terms of an arithmetic logic of too many people and too few
resources, scientists, businessmen, activists, and policy-makers in the wealthier Western world
sought to curb population growth and preserve their country’s own security and interests through
coercive family planning and population control programs aimed at poor, non-white nations.
Backed by the “truth” of scientific knowledge and deeply racist and sexist social discourses,
militant programs of sterilization and imperialistic forms of abuse and experimentation were
legitimized for use in the so-called “Third World.”
For the United States in particular, the biggest threat to the nation’s economic and social
stability was embodied in its quasi-colony, the island of Puerto Rico. Indeed, a survey of the
history of the relationship between the mainland United States and Puerto Rico during the
twentieth century reveals a tense association marked by fear, disdain, and abuse. In the text that
follows, I will address this strained relationship as it evolved throughout the early to midtwentieth century, focusing on the history of biomedical and social experimentation and abuse on
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the island and paying particular attention to issues of population control and contraception, as
exemplified by family planning programs and clinical trials of the first oral contraceptive pill.
With regard to methodology, the sources of information relied upon in conducting this analysis
include books, scholarly journal articles, and documentaries which discuss the history of
contraception, sterilization, and experimentation in Puerto Rico. In the context of this historical
study, I will be grounding my argument in an analysis of discursive production and power.
Specifically, I am interested in how discourses of sexuality, nationalism, imperialism, and
capitalism converge on women’s bodies and are realized through “family planning” efforts.
Further, I wish to discuss how normative sexuality, family, and nation were literally written in
and on the bodies of these Puerto Rican women, and how, through rhetoric and the practices
enacted as a response to rhetoric, these individuals were made subhuman and expendable.
In short, the question that this text attempts to answer is this: In what ways and through
what discourses and regimes of truth or fear were Puerto Rican women’s bodies inscribed with
power, policed, and made dispensable or vulnerable? With this goal in mind, I have chosen to
employ a Foucauldian theoretical framework as my method of analysis, approaching my topic
using Michel Foucault’s understanding of power, discourse, knowledge production,
subjectification, discipline, and control. The next section of this paper provides an overview of
the Foucauldian texts and concepts that are crucial to my analysis of the United States-Puerto
Rico relationship. I also reference discussions from Vandana Shiva and Shiv Visvanathan
regarding scientific discourses and violence. Following this discussion, a section dealing with
history will be provided, offering background information about the general political and
economic relationship between the United States and Puerto Rico, and historical information,
both general and specific to Puerto Rico, about population control and birth control. Next, I will
apply my Foucauldian analytic framework to the specific case study, analyzing the role and
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kinds of discourse utilized with regard to birth control and overpopulation. Finally, I will end
with a discussion of my project as a whole, its potential and its limitations.
Foucault: Understanding Power, Knowledge, and Discourse
In order to comprehend how I have conducted a Foucauldian analysis of discourses of
population control and family planning in Puerto Rico, one must first understand the specific
definition of power forwarded by philosopher Michel Foucault, for it is the main idea around
which his other concepts of interest revolve. In Discipline and Punish and The History of
Sexuality, Foucault addresses a transformation in punishment and the exercise of power that has
taken place since the seventeenth century. Up until this point, he explains, power was
symbolized by the sovereign and his “right to take life or let live” (Foucault 1990:136). “The
classical age discovered the body as object and target of power” (Foucault 1984:180) and
punishment was doled out in gruesome form as a public spectacle which served to conclude the
crime by marking the victim, through death or infamy, as criminal.
As humanity moved into the modern era, “one might say that the ancient right to take life
or let live was replaced by a power to foster life or disallow it to the point of death” (Foucault
1990:138). Power was no longer external and monarchical, and the body was no longer the
target of penal authority with punishment as spectacle. Rather, the soul and individual character
became the target, not of flagrant physical punishment, but of efforts at rehabilitation and
reshaping. Power became spatialized, exemplified by Bentham’s Panopticon, a prison where the
architecture itself produces a power relationship based on potential visibility, a dynamic in which
the prisoners become entangled, eventually internalizing the external gaze and regulating their
behavior through self-surveillance. “It is the fact of being constantly seen, of being able always
to be seen, that maintains the disciplined individual in his subjection” (Foucault 1984:199).
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People were subject no longer to an all-powerful sovereign, but to themselves and the
mechanisms of disciplinary power and self-regulation.
At the same time, power also became discursive, with the advent of scientific discourses
that aimed to study and classify “types” of people; to uncover the ontology of “the criminal” or
“the pervert”; “to form a body of knowledge about these individuals rather than to deploy the
ostentatious signs of sovereignty” (Foucault 1984:209). From birth, these categorizations and
relations of power are a part of people’s self-understanding; it becomes understood that
“discipline judges individuals ‘in truth’” (Foucault 1984:195). In this way, people are made
manageable; their lives and bodies can be controlled without the aforementioned “ostentatious
signs of sovereignty”; and they become part of a larger project of biopower, the aim of which is
ensuring the health and well-being of the population as a whole.
As Foucault explains further, “sex became a crucial target of power” (1990:147), a topic
at the center of a “discursive explosion” (1990:17). The project of biopower saw the necessity of
policing and regulating sex, with the well-being of humanity in mind. Through the public
discourses created with regard to sex, human beings learned to relate to themselves and their
sexualities in specific ways. Further, through the confessional technique and the disciplinary
power inherent in it which compels us to speak the “truth” about ourselves, we come to believe
there is a “truth” about our sexuality in the first place. If we learn to know ourselves through
such categorizations (e.g. “I am this kind of sexual being.”), we become more easily managed,
making us subject to a larger project of biopower. In short, for Foucault, power is not only about
oppression but about production, particularly discursive production. Thus, power and knowledge
are inseparable, and discourse and regimes of truth affect how we relate to ourselves and others
as particular “kinds” of people; subjects and particular kinds of knowledge objects are created in
a through discourse and power relations. As Foucault makes clear in The History of Sexuality,
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discourses about sex and sexuality are the main channels through which biopower achieves its
aim, and policing sexuality and the body becomes a major avenue of population control through
the process of truth-making.
The issues of truth/knowledge production and the material consequences of these
productions are similarly taken up by scholars of science and scientific discourse. As Vandana
Shiva and Shiv Visvanathan argue, there is a deep and clear connection between modern science,
development projects, and violence against nature, people of color, and women. In
“Reductionist Science as Epistemological Violence”, Shiva argues that although scientists
relying on a mechanical scientific method claim to produce unbiased, expert knowledge of the
world, the production of truth is not really what the scientific endeavor is about (1990). Rather,
science often resorts to violent misinformation and falsification in order to gain a monopoly on
knowledge and prove itself superior (Shiva 1990). Ultimately, reductionist science fails with
regard to nature and living organisms and, instead, “undergirds an economic structure based on
exploitation, profit maximization and capital accumulation” (Shiva 1990:232). Indeed, Shiva
argues, scientific “facts” are the product of the social world of scientists, not the world of nature,
making these productions not scientific but political. Scientific discourse is, thus, not about
aiding or understanding the natural world, but about exerting exploitative violence upon it and its
inhabitants (Shiva 1990).
Shiv Visvanathan forwards a similar argument in “On the Annals of the Laboratory
State,” where she wants to explain how science is itself a mode of violence and tyranny.
Specifically, Visvanathan focuses on the project of development and how it can be regarded as a
scientific project with four theses: 1) “the Hobbesian project,” within which society is
conceptualized through the framework of the scientific method, 2) “the imperatives of progress,
which legitimize the use of social engineering on all those objects defined as backward or
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retarded,” 3) “the vivisectional mandate,” which creates the “other” as an object of
experimentation upon which violence is inflicted in the name of science, and 4) “the idea of
triage,” where an entire group or subset of a group is, under the banner of rational judgment,
labeled useless and condemned to death (1990:259). With these themes in mind, Visvanathan
explains, one can see that modernity is about conquest and the violence of modernity comes at
least in part from the violence of science and the logic of power encoded in its very grammar
(1990). Pairing the works of Foucault with those of Visvanathan and Shiva, one can see how the
discursive power of scientific, social, and economic scripts can be used to justify the extreme
exploitation, stigmatization, and abuse of a particular group. In order to better understand how
this dynamic has taken place in Puerto Rico, the following section will provide a historical
context for this specific case study.
History: Overpopulation, Contraception, and the U.S.-Puerto Rico Relationship
In Reproductive Rights and Wrongs: The Global Politics of Population Control and
Contraceptive Choice, Betsy Hartmann provides a clear introduction to the roots of population
control, discussing Malthusianism, eugenics, and the birth control movement. Population control
as a development strategy is, indeed, a “relatively recent phenomenon” of the post-WWII era,
but its ideological origins can be traced to the work of political economist and demographer
Thomas Malthus at the end of the eighteenth century and “the intellectual currents and social
movements of the nineteenth and early twentieth centuries, which culminated in an organized
birth control movement in Europe and the United States” (Hartmann 1995:93). Methods of birth
control have been around for many centuries and have been available (although not always
socially acceptable) even in Europe and other Western countries, whose popular histories largely
tell a story of sexual conservatism.
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While it was not the first text ever written about population, Thomas Malthus’ An Essay
on the Principle of Population, originally published in 1798, was perhaps the most influential
work on population, citing the possibility of a catastrophic scenario in which the population,
which grows geometrically, would eventually outrun the carrying capacity of the earth and the
food supply, which only grows arithmetically. With this apocalyptic vision in mind, English
radical neo-Malthusians, under the banner of overpopulation as the cause of poverty and
economic insecurity, were the first public advocates of birth control. A man by the name of
Robert Dale Owen brought this radical neo-Malthusian push for birth control to the United
States, citing the necessity of birth control “on the grounds of women’s right to self
determination” (Hartmann 1995:95). Moving into the second decade of the twentieth century,
the U.S. birth control movement gained steam, sparked by a combination of the sexual rebellion
of sex radicals and the social rebellion of women workers’ push for unionization. It was at this
time that Margaret Sanger, the eventual founder of Planned Parenthood and, in many ways, the
face of the U.S. birth control movement, also became a presence in the radical movement for
voluntary motherhood and the distribution of contraceptives. With wartime anti-radical hysteria
and the fading of the feminist movement as suffrage was won, however, Sanger eventually split
from her alliance with radical social reformers and aligned with professionals and eugenicists in
an attempt to gain both respectability and a legal outlet for the distribution of contraceptive
materials (Hartmann 1995).
This shift in alliance entailed a simultaneous ideological shift, from “women’s rights” to
“racial superiority.” With Hitler’s Nazi regime carrying eugenics to its most radical conclusion,
however, eugenicists eventually became undesirable allies for the birth control movement,
individuals who turned contraception into a blatantly offensive weapon. The era of WWII and
the New Deal heralded yet another transformation for the birth control movement, creating
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contraception as a part of social welfare programs. This idea was then taken one step further
with the end of WWII and its subsequent “population boom”; the focus became explicitly about
overpopulation and its economic, social, and environmental consequences (Hartmann 1995). A
“population paranoia” was created at this time, with family planning dubbed the key to
development and the rhetoric of women’s rights used to legitimate the goal of progress. The idea
of sterilization and population control, according to Hartmann, first became a part of popular
knowledge with Paul Ehrlich’s The Population Bomb, in which the author described the
economic and social dangers of the ever-swelling world population (1995:4). During the
twentieth century, the world saw an unprecedented increase in population, something which,
according to Ehrlich and his contemporaries, posed a serious threat to the stability of the world
as a whole and industrialized nations in particular, who would have to deal with the
repercussions of the unchecked under-developed world. Thus, the Western, “developed” world
took a keen interest in the development and implementation (both voluntary and coercive) of
birth control and “family planning” methods that would protect their own economic and political
interests while stifling the growth of populations which posed a potential threat of rebellion.
For the United States, in particular, the island of Puerto Rico, located in the northeastern
Caribbean Sea, was unique in that it not only posed the most obvious threat to the mainland’s
stability but it also provided the perfect opportunity for new scientific and economic
developments that would ultimately benefit the United States and its citizens. North American
troops first landed in Puerto Rico in 1898, during the Spanish-American War (Garcia 1982). At
the end of this war, Puerto Rico, previously a colony of Spain, was ceded to the United States
under the Treaty of Paris. Thus, beginning at the end of the nineteenth century, the United States
forged a relationship with Puerto Rico that would continue into present day, with occasional
status revisions from a military-ruled colony to a self-governing unincorporated U.S.
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commonwealth. Throughout this century-long relationship, the United States has continually
exploited the land and people of Puerto Rico for its own gain. By 1930, U.S.-based corporations
already owned half of the island’s land, and by 1937, unemployment among Puerto Ricans was
at 37%; landless and jobless, Puerto Ricans began to be seen as a drain on society, the so-called
“excess population” (Garcia 1982). Also in 1937, to avoid this menace of overpopulation, the
North American governor of the island legalized the use of sterilization as a method of
population control. Coincidentally, the law legalizing sterilization was passed at precisely the
time that women’s piece-labor (i.e. needlework) was most needed by the economy, the European
textile industry decimated as it was by the war (Garcia 1982). The “excess population” was
further increased by the implementation of Operation Bootstrap in 1948, an economic model that
aimed to further industrialize the island; the jobs that this model would create, however, were not
enough for the population size, particularly the large amount of agricultural workers displaced by
industrialization (Garcia 1982). The answer, once again, was family planning, and by 1953, 17%
of all Puerto Rican women had already been sterilized (Garcia 1982).
Three years later, in 1956, the citizens of Puerto Rico proved useful to the United States
yet again, serving as the guinea pigs for testing Enovid, the first oral contraceptive pill. Guided
by the enthusiasm of Margaret Sanger and backed by the finances of philanthropist Katherine
McCormick and the scientific tests of reproductive biologist Gregory Pincus, Doctor John Rock
conducted his first study of the pill in the winter of 1954 on a group of fifty women (Gazit 2004).
The test was successful, showing a 100% effectiveness rate with not one of the women ovulating
while on the pill. In order to get the pill to market, however, the Food and Drug Administration
(FDA) required a large-scale test, something made nearly impossible by the existence of harsh
Comstock Laws in the U.S. which prohibited the distribution of contraceptive information or
devices (Gazit 2004). Puerto Rico, with a network of birth control clinics already established
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and no Comstock Laws, provided the “cage of ovulating females” that Sanger and her
compatriots so desired (Gazit 2004).
In April of 1956, the first experiment was launched on Puerto Rican women living in
government housing, and, after nine months of testing, Edris Rice-Wray and Penny
Satterthwaite, the medical directors of the experiment in Puerto Rico, informed Pincus that the
pill was 100% effective if taken correctly, but that it caused “too many side reactions to be
acceptable” (Schoen 2005:212). Pincus, however, “downplayed their concerns, contending that
Puerto Rican women’s complaints were largely psychosomatic and a result of their ‘emotional
superactivity’ [even though] both women physicians insisted that their warnings were valid, and
both recommended that the pill should not continue to be used further” (Schoen 2005:212). In
actuality, the contraceptive pills used in these experiments were nearly twenty times the strength
of those used today, but problems with the pill itself were not addressed in earnest until women
living in the U.S. began experiencing severe side-effects or death as a result of being on the pill
(Garcia 1982). Generally speaking, Puerto Rico was used as a laboratory for the development of
birth control technologies, and the bodies of Puerto Rican women were subjected to the
dangerous experimentation of forms of contraception that were intended to ultimately benefit
white, Western women. The island and its inhabitants were simultaneously demonized as an
economic and social threat, as the deviant standard against which Western normalcy could be
solidified, and exploited as a valuable resource, from the goods and services the island provided
to the biomedical experimentation that turned women into lab rats. In the next section, I will
continue this discussion by explaining how a Foucauldian analysis of discourse can be applied to
the U.S.-Puerto Rico relationship.
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Analysis: Subjectification, Objectification, and Discourse
As stated previously, the goal of biopower is to manage a population in such a way that
its general well-being is maintained. This goal is achieved, according to Foucault, through the
production and elaboration of discourses and regimes of truth, creating “types” of people with
“facts” to their identities, knowledge and schemata through which individuals or groups can
know themselves and be known by others. Through repetition and reinforcement, these
discourses become public knowledge, deeply ingrained in collective and individual belief
systems, and, at their most powerful, they become embedded in social institutions and policies,
producing tangible, often devastating consequences in the lives of real people. Such has been the
case on the island of Puerto Rico.
The mistreatment and abuse of Puerto Ricans, particularly women, through economic and
political policy reform, sterilization programs, and biomedical experimentation was predicated
on the production of a specific discourse about the island as a whole and on the creation of
“types” of people (the feeble-minded, the filthy savage, the hyper-fertile/sexual woman).
Discourses that constructed Puerto Ricans as having dangerous, pathological, or abnormal
reproductive behaviors and sexual beliefs served the function of reaffirming the superiority of
the (white) West and providing an excuse for U.S. involvement on the island. As scholars Faye
Ginsburg and Rayna Rapp suggest, “Throughout history, state power has depended directly and
indirectly on defining normative families and controlling populations” (1995:6). In doing so,
“regimes of representation can emerge in which particular groups are said to be pathological,
even ‘dangerous’ to the larger society” (Chavez 2004:174); this was the exact logic used in the
rhetoric of “overpopulation” which justified the use of coercive sterilization programs in a
number of Third World countries, including Puerto Rico.
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Indeed, from the moment the U.S. occupied Puerto Rico, it launched an attack on the
sexuality, “lifestyle”, and family structure of its inhabitants. As part of a moral panic, the United
States government cited irresponsible sex acts, female promiscuity, venereal disease,
overpopulation, and a host of other public health issues as justifications for its interference on the
island and its use of suppressive policies, of which forced sterilization was only one example. In
the narrative constructed in the U.S., the American presence in Puerto Rico was hailed as “a
benevolent event that had made Puerto Rico healthier” by protecting them from venereal disease
and introducing forms of birth control to the island (Briggs 2002:55).
That which was left out of the idyllic narrative on the mainland was, however, the most
important part of the story. What Western propaganda pegged as a simple show of good will on
the part of the U.S. was actually laced with ulterior motives. The U.S. needed to maintain the
notion of Puerto Ricans as “lesser” than “real” Americans and used images of Puerto Rican
women to do this. “For liberals, she was victimized by her endless children, and they longed to
rescue her from her own ignorance and ‘macho’ Puerto Rican men who proved their virility
through her suffering maternity; for conservatives, she was a ‘demon mother’ whose dangerous
fecundity could only be halted by strong measures – sterilization, high doses of hormones,
perhaps a contraceptive agent in the water” (Briggs 2002:110). Whatever the image, Puerto
Rican women were depicted as being essentially and markedly different from American women.
She was the “other” and, as such, needed fixing. Additionally, as the repository of her nation’s
culture, this problem with Puerto Rican women translated to a problem with the island as a
whole.
Notions of the hypersexual Puerto Rican woman translated to the idea of an
overpopulation problem on the island. The economic and public health threat that the possibility
of overpopulation posed to both Puerto Rico and the mainland U.S. created a sense of dread
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among everyone involved. Even though, as Briggs explains, no expert could definitively say
whether or not the island was indeed on the road to overpopulation, the sheer prospect of such a
problem was enough to create a scare. It served as a convenient excuse for the United States to
continue policing Puerto Rico and masked those actions on the island which could have been
viewed as less than exemplary. “The notion that through overpopulation poor women were
responsible for the economic ills of the island simultaneously served to mask U.S. capitalist
extraction and to provide an occasion for further U.S. involvement” (Briggs 2002:108). The
entrance of the overpopulation debate into the popular discourse about Puerto Rico marked the
beginning of the island’s stint as a social science laboratory, a sort of “test tube experiment” for
different types of birth control (both forced and unforced), including Depo Provera, IUDs, the
pill, and sterilization.
Throughout the past century, the mainland United States has had its proverbial nose in
Puerto Rico’s business. At once part of and separate from the U.S., Puerto Rico and its
inhabitants have been afforded very few options in fighting against the imperial power of its socalled protector. In popular discourse, “Puerto Rican sexuality has been defined by its deviance,
and the island as a whole has been defined by its sexuality” (Briggs 2002:4). Meanwhile, the
United States gets to carry the banner of superiority, “helping” people who are supposedly too
ignorant to know how to help themselves. From curbing the spread of venereal disease to
combating overpopulation, “colonizing men became chivalrous figures…”, Briggs explains, and
thus “…the violence of their role was erased, transformed into heroism” (2002:66-67). The
blame, so the story goes, lies with the island itself, its inhabitants whose extreme ignorance and
excessive and illogical reproductive behavior make them a danger to themselves and a threat to
the entire globe.
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Reflection: Alternative Frameworks and the Limitations of Foucault
The work of Michel Foucault has done much to make us interrogate the social narratives
and discursive categorizations that inform all facets of human life, from something as intimate as
our self-understandings to something as large as global economic policy. Furthermore, as this
case study in Puerto Rico has shown, understanding how discourse operates is important not just
on an academic, epistemological level, but also on a more practical level because they can
dramatically shape and alter the lives of real individuals. This issue of “real-life” consequences,
however, also points to one of the largest limitations of using a Foucauldian analytic framework.
In his focus on discourse, Foucault often becomes extremely abstract and, in many ways,
divorced from material reality and the specificities of lived experiences. In the case of
sterilization programs, for example, “While poor and minority women were more susceptible to
coercive sterilization and more likely as a group to suffer from sterilization abuse, women’s race
and class background alone did not determine the meaning sterilization held for them. Poor and
minority women did not share one outlook or experience in regard to the surgery” (Schoen
2005:79). These women were not always only victims; however, while some women used these
eugenic programs for their own ends, these ends were not unrelated to race or class in that they
were deeply connected to issues like lack of resources.
With these tensions in mind, perhaps an intersectional standpoint theory that brings us
back to materiality or a theory of embodiment that incorporates the reality of bodies in pain
could provide alternative insights into the case at hand. Additionally, while I have discussed
capitalism and economics in this study in terms of discourse, a historical materialist or Marxist
theoretical framework could be quite useful in elucidating the role of capitalism, and its relation
to patriarchy, in creating the conditions for family planning to be conflated with progress and for
development to take place via women’s bodies. Lastly, while I have touched briefly on the
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construction of Puerto Rican masculinity and its role in U.S. intervention on the island, there is
certainly much more work that could be done with regard to the role of Puerto Rican men in the
process of family planning and the use of controlling images of Puerto Rican men by the U.S. to
justify the mainland’s control of the island. Regardless of what analytic framework might be
chosen for further research in this area, however, I believe that it is imperative that the insights of
Foucault never fully drop out of the analysis, as his framework captures the operations of deeply
powerful processes of production, oppression, and resistance.
Conclusion
In this study, I have attempted to demonstrate, using the philosophical understandings of
Michel Foucault, how scientific regimes of truth and discourses of capitalist logic and imperialist
racism and sexism have created the people of Puerto Rico, especially women, as dangerous,
pathological, and expendable. With regard to the discourse of overpopulation, the fear of a
population explosion was, on the surface, grounded in basic demographic changes in population
size; however, this was based on a discursive falsehood. This “myth of overpopulation,” a
pervasive story in Western society, is compelling in its simplistic logic, but population dynamics
are far more complex than Malthusian arithmetic suggests. In truth, “the population ‘explosion’
is gradually fizzling out” (Hartmann 1995:6). The real destructiveness of overpopulation lies in
the simplistic rhetoric that envelopes it, a discourse in which constructive thinking and action is
pushed aside in favor of racism, sexism, and fear. Viewing human beings as ahistorical numbers
that must be reduced not only reinforces racism and sexism, but also removes social, economic,
and political power from the equation (Hartmann 1995:22). The politics of family planning and
sterilization in Puerto Rico is a perfect example of dehumanizing, stigmatizing, and medicalizing
discourses being used to exert control over and exploit an entire group of people. While the
mistreatment and abuse of Puerto Rico and its inhabitants can, ultimately, only be rectified by a
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combination of small-scale activism and large-scale political, economic, and social reform,
interrogating and disrupting the discourses that undergird these abuses is an important and
necessary first step.
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