Beautiful Strength: ‘Sobrevivir’ Pays Homage to the Women Coerced to Sterilization in 1960s and ’70s L.A. | Artbound | Arts & Culture

At a time when women’s rights to their own bodies are hotly contested, a new art installation at an open courtyard in the Los Angeles County + USC Medical Center seems even more urgent. “Sobrevivir (Survival)” by artist Phung Huynh is a massive Corten steel disk art installation made of 21 panels, each weighing about 300 lbs. Together, the panels make up a monumental disk 21 feet in diameter, etched with an image of La Virgen de Guadalupe’s praying hands at the center. Around La Virgen’s hands are gracefully curving leaves and roses. Beautiful and weathered, it is a testament to the gravity of tragedies that happened decades past and continuing tumult around women’s bodies today.

The sculptural piece is a physical expression of Los Angeles County’s apologies to the women and families harmed by its coercive sterilization practices between the 1960s and ’70s. It also remembers the courage of the ten working-class Mexican American women who filed a class-action civil rights suit against the LAC + USC Medical Center, alleging its doctors and nurses at the hospital used deceptive means to get them to sign consent forms for sterilization. Their case would be known as Madrigal v. Quilligan and would help shape the fail safes in maternal healthcare many families know today.

“LAC + USC Medical Center is a hospital that is so important to our community. We serve the most vulnerable people in Los Angeles. With that comes a lot of responsibility and accountability to our community,” said Jorge Orozco, Chief Executive Officer at LAC + USC. “It’s never been more important to support the creation of an equitable health care system in L.A. and this really includes reckoning with our past.”

Lights beneath the sculptural piece illuminate and define the etchings on the Corten steel disk at night. LAC + USC Medical Center stands behind the artwork in the distance. | Steven Lam / Courtesy of L.A. County Department of Arts and Culture

According to Huynh, the installation was partly inspired by a gorgeous pair of vintage leather-tooled boots, which she happened upon at a South Pasadena vintage shop while researching the events at LAC + USC hospital. The installation at the hospital is muscular and heavy in dimension, but its graceful lines also impart softness and elegance — a study of contrasts, much like the mothers of the Madrigal v. Quilligan case.

“It had everything in it, those shoes,” said Huynh. “It’s beautiful. It’s strong. I wondered, ‘Who walked in those shoes? Who were these women?’ Leather was so symbolic of skin, of transforming suffering and scarring. The beautiful patterns and details of flora and flowers — I think flowers are very symbolic of women and fertility and also like an offering of apologies to the mothers.”

The design’s floral and graceful curves also took cues from the patterns of the Mexican garment huipil. “The huipil also functioned as a form of resistance. Even after colonization, Indigenous Mexican women continued to use it,” said Huynh.

While the Corten steel disk is certainly a centerpiece of the installation, Huynh’s work does not end there. Lights beneath the sculptural piece illuminate a small seating area surrounded by words inspired by those of the bereaved mothers — not direct quotes, but a kind of “collective poem,” said Huynh.

Benches are placed against a half wall where the words, "Yo, por dentro, siento mucha tristeza. Se me acabó la canción," are mounted onto. In front of the benches are metal tiles forming a larger artwork on the ground. Etchings of flowers and folded hands are all over the art piece.

Words inspired by those of the bereaved mothers surround a small seating area adjacent to the Corten steel disk. | Steven Lam / Courtesy of L.A. County Department of Arts and Culture

Yo por dentro siento mucha tristeza. (I feel a lot of sadness inside.)”

Se me acabó la canción. (My song is finished.)”

“If you speak English, they treat you one way. If you don’t speak English, they treat you another way.”

A softer aspect of “Sobrevivir” is being planned for display inside the hospital as well. Four community quilts are displayed bearing images of hope and words of encouragement designed by mothers, activists, women who gave birth at the hospital and people in the community. Huynh has gathered over 60 contributions including those from The East Los Angeles Stitchers (TELAS) founder and former L.A. County Board Supervisor Gloria Molina; activist Evelyn Martinez-Sapata, a member of Comisión Femenil, a Mexican feminist organization that helped support the class-action lawsuit; as well as Cecelia Provencio, a retired LAC + USC Medical Center nurse.

“This issue is a painful one for me personally,” said Molina, who was also involved in the original lawsuit while president of Comisión Femenil. Molina and her organization helped document testimonies from the mothers involved in the lawsuit for the lawyers on the case. “[The hospital’s actions] violated everything. Here you are, a mother with love for your children, and this robs you completely and strips you of that ability to give birth. What’s so painful is that it’s done by the government, whom you’re supposed to trust.”

A quilt comprised of patch squares containing images of hope and words of encouragement relating to reproductive rights and motherhood. One of the patches include imagery of the Virgin Mary while another is a design of a mother kissing the forehead of a child. Another patch features imagery of uteruses.

Four community quilts bear images of hope and words of encouragement designed by community members is planned for display inside LAC + USC Medical Center. Over 60 contributions have been gathered by Huynh. | Courtesy of L.A. County Department of Arts and Culture

Molina contributed two quilt squares to the installation. One showed the original logo for Comisión Femenil — a woman in profile with a large red flower tied to her hair. In the second, the flower turned into a closed fist. “I wanted to show her flower differently,” said Molina, “with a fist of power. It shows that we as women can overcome these things, that as an organization we can come together, fight these things and be successful doing it.”

Created as part of a community engagement effort, the quilt squares are as much a part of “Sobrevivir” as the small circular clearing outdoors. They reflect the long history of women working in social justice. “If you think about the legacy of enslavement here in the United States, quilts were used to decode to help formerly enslaved African Americans to escape to the North,” said Huynh. What’s more, immigrant communities, such as those (like Huynh’s) that grew up in Old Chinatown, often relied on the making and selling of clothing to survive in a new country. The quilt squares also represent how individuals can come together collaboratively in support of a greater good.

A quilt square primarily comprised of a beige background fabric. On it, the words "My body, my choice," are sitched on with a black, bold lettering. Behind it, an outline of woman's body is stitched on with a dark brown thread. The "Y" from "body" lines up with the outline, serving as the woman's crotch. Colorful flowers decorate the inside of the "Y." Along one side of the body the words, "Ya basta" are stitched on in purple thread. Underneath, "My body, my choice," are the words, "Mi cuerpo, mi decision" in blue thread with a purple flower crocheted in the middle.

One of two quilt squares by Cecelia Provencio, a retired LAC + USC Medical Center nurse, contributed to the community quilt. | Courtesy of L.A. County Department of Arts and Culture

“This is the most important work of my life,” said Huynh, who has been working on this project since the end of 2019. A refugee and a mother, the artist identified with the hardships of the Mexican American mothers and connected it to her own family’s history. Huynh’s father is a Cambodian, who fled the genocide on a bicycle toward Vietnam. Huynh’s family would again flee from Vietnam to the United States, making their home in Los Angeles. To help support the family, Huynh’s mother would work in the garment industry, working with other immigrants, including Nellie Pavon, a second-generation Mexican American, who treated Huynh like family. “It was my grandma Nellie who talked about solidarity, who advocated for my mother,” said Huynh, whose activism was formed from these early experiences.

Though known for her portraits and paintings, the artist went beyond her comfort zone with this project, which involved digital design, structural planning and deciphering L.A.’s labyrinthine permitting process. “I could have easily proposed a mural or a terrazzo floor, which I’ve done for a Metro station,” said Huynh, “but I didn’t want to do something that I did before. I wanted to push myself to honor these moms.”

An image of La Virgen de Guadalupe's praying hands framed by a heart is etched onto orange and brown steel plates that resembling weathered leather.

An image of La Virgen de Guadalupe’s praying hands are etched at the center of Phung Huynh’s “Sobrevivir” art installation at LAC + USC Medical Center. | Steven Lam / Courtesy of L.A. County Department of Arts and Culture

Each step of the process involved a learning curve for the artist, who learned that her complex drawings would probably not translate well when cut into Corten steel or that exacting structural drawings would be needed to permit her proposed artwork or that just a handful of etched portraits would not do the stories of countless other unnamed women facing similar circumstances justice. But the challenges were worth the final outcome, said the artist, who credits the work of her many collaborators for the success of “Sobrevivir” — Peter Borrego, the architect Huynh worked with; Danny Valdez of Highland Park-based Noctum, who fabricated the massive disk; Pat Gomez and Lalena Vallenoweth, project managers at L.A. County Department of Arts and Culture; and the community who helped shape the artwork on the sculptural piece itself.

The community was an indispensable part of the project, said Huynh. She said that while working on this project, she met so many people with connections to LAC + USC Hospital, whose lives could have just as easily been profoundly altered by the events more than 50 years ago. For example, Huynh’s friend, Sergio Teran, who is now a professor of art at Cerritos College was born at the hospital. “While getting a blood test at the hospital, Teran’s mother was told she was at high risk of dying during childbirth and that she should ‘sign these papers,’ said Huynh. “She is a clairvoyant and raised her two sons through fortune telling. She refused to sign the papers.”

Sign, Sign

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Maria Hurtado, one of several women who were coerced into sterilization at the hands of the LAC + USC Medical Center, is featured in director Renee Tajima-Peña’s 2015 documentary, “No Más Bebés.” | Claudio Rocha

Teran’s is one of the few stories that ended well at the County hospital, but some were not as fortunate. On June 18, 1975, ten working-class Mexican American women filed a class-action civil rights suit against the LAC + USC Medical Center. Their stories were captured in the 2016 documentary, “No Más Bebés (No More Babies)” directed by Renee Tajima-Peña and produced by Virginia Espino. In the documentary, whistleblower Dr. Bernard Rosenfeld recounted, “[The mothers] were extremely fearful, being told that you need an emergency cesarean section and you can feel blood pouring down your leg, at that time signing a consent for tubal ligation.”

Former medical student, Dr. Karen Benker told the filmmakers how she saw a doctor cajole a mother-to-be in labor by holding up a syringe saying, “You want this shot? This will take away the pain. This will take away the pain. Sign, sign.”

In this excerpt from the Independent Lens documentary “No Más Bebés,” Maria Hurtado reveals how she underwent a tubal ligation at L.A. County-USC Medical Center in the 1960s while she was in great pain without the faculties to fully understand the consequences of the procedure. A medical student who witnessed this adds that women were told “this will take away the pain.”

No Más Bebés: Sign Here to Take Away the Pain

At the time, the nation was alarmed by the premise of the bestselling book “The Population Bomb,” published in 1968. The book forecasted worldwide famine and social upheavals in the 1970s and ’80s unless population growth was curbed. Coupled with increasing concerns on welfare dependency and illegitimacy, the book would help kickstart an influx of federal dollars for family planning programs as part of President Lyndon B. Johnson’s 1964 War on Poverty initiative, which would lead to coercive sterilizations across the nation in key cities, including Los Angeles. According to Benker, Dr. James Quilligan, then head of Obstetrics and Gynecology at LAC + USC, had declared “[P]oor minority women in L.A. County were having too many babies…it was a strain on society…it was good that they be sterilized.” He allegedly added that he intended to use the hospital’s share of a $2-billion federal grant to “cut the birth rate of the Negro and Mexican populations in Los Angeles County.”

The hospital made good on Quilligan’s words. “From July 1968 to July 1970,” Rosenfeld found “a 742% increase in elective hysterectomies, a 470% increase in elective tubal ligations and a 151% increase in post-delivery tubal ligations” coupled with “little evidence of informed consent by the patient.” These sharp increases compelled Rosenfeld, then a medical resident, to devote hours after his work at the hospital typing letters to anyone who might listen.

Abortion-rights protesters participate in the "Bans Off Our Bodies" reproductive rights rally at Los Angeles City Hall on May 14, 2022.

Rosenfeld wrote to government organizations, community groups and magazines — including the National Association for the Advancement of Colored People, Cosmopolitan and Reverend Jesse Jackson’s Operation PUSH. It was the Model Cities Center for Law and Justice that finally paid attention, assigning lawyers Antonia Hernandez, then “a kid out of East L.A., just graduated from UCLA School of Law” and Charles Navarette to the case. Hernandez and Navarette worked with Comisión Femenil to argue the case, which they had built on the now-overturned Roe v. Wade. The case claimed that women possessed reproductive rights and could choose to procreate or to abort births.

It took an Amazonian amount of effort to find the ten courageous mothers who were willing to submit themselves to public scrutiny on such a private matter, not to mention take the necessary time for testimonies and court appearances. As “No Más Bebés” makes painfully clear, the women suffered greatly both emotionally and socially because of what had happened to them. Some feared their husbands would repudiate them, associating their infertility with prostitution. One mother, Consuelo Hermosillo, said “I used to cry when I attended baby showers. I didn’t want to be at a baby shower and be asked, ‘Oh, when are you going to get pregnant?’ I wasn’t going to hang a tag and say I can’t have kids anymore.” Distress so affected Dolores Madrigal and her family that her husband turned to alcohol for solace. Their stories all read like tragedies and their stories are forever carved into the seating area of Huynh’s “Sobrevivir.”

Two quilt squares are side by side. The square on the left is a profile of a woman with a big, red flower on her ear. The profile of the woman is stitched onto a beige, canvas background. Above, reads, "1975 - Madrigal, Comisión Femenil, et al. v. Quilligan." Below, reads "Judge Cutis ruled against Plaintiffs...women were at fault — it was their cultural background." The square on the left is a profile of the same woman, but  the red flower in her hair has transformed into a fist with orange petals resembling flames behind it. The profile of the woman is also stitched onto a beige, canvas background. Above, reads, "1987 - Federal and state regulations - 3-Day waiting period-informed consent." Below, reads "Last the battle. Pero Ganamos la Guerra!"

Gloria Molina contributed two quilt squares to the installation. One, left, showed the original logo for Comisión Femenil. In the second, right, the flower turned into a closed fist. | Courtesy of L.A. County Department of Arts and Culture

It would have been an inspiring David and Goliath story had the women won their case, but California federal court judge Jesse W. Curtis found that the sterilizations were a result of miscommunication and a “clash of cultures.” The judge reasoned that the hospital was “acting in good faith and intended no harm.” But the women’s acts of courage were not in vain. The case paved the way for increased scrutiny on family planning and led to changes in healthcare procedures that continue to be practiced today including bilingual consent forms and a 72-hour waiting period between consent and operation.

Now almost 40 years after, Molina said that creating her quilt squares was cathartic and that she also felt “vindicated because even though we lost the case, at the end of the day, we were successful in stopping these sterilizations by creating a set of rules and regulations to stop sterilizations at the federal and state level.”

History That Keeps Repeating

An overhead shot of Phung Huynh's circular sculptural piece "Sobrevivir." A woman stands in the middle of the piece and looks down at the etchings on the sculpture. Another woman stands to the side and looks at the artwork from a seating area.

Phung Huynh’s “Sobrevivir” is a testament to the gravity of tragedies that happened at LAC + USC Medical Center decades past and continuing tumult around women’s bodies today. | Courtesy of L.A. County Department of Arts and Culture

Despite the gains made because of Madrigal v. Quilligan, history reminds us to keep vigilant. Time and again, how much a woman has to say about her own body continues to be thrown into question. Not only is this true of the recent Dobbs v. Jackson case, which overturned Roe v. Wade, but also when we look at how sterilization has been used against marginalized communities throughout history.

In her 2005 paper, historian Alexandra Minna Stern lays out a long, sordid lineage of coerced sterilizations in California. According to Stern, between 1909 and 1979, California’s sterilization law was used to sanction “over 20,000 nonconsensual sterilizations on patients in state-run homes and hospitals, or one-third of the more than 60,000 such procedures in the United States.” This law gave medical practitioners license to “asexualize” a patient at an asylum or inmate in prisons with the hopes that it would help improve their “physical, mental or moral condition.”

Players in California’s active pseudo-scientific eugenics movement would rally around this legislation. A leaflet on eugenic sterilization distributed from the late 1920s to the early 1940s by the Human Betterment Foundation in Pasadena unequivocally touted the operation’s beneficial effects.

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Decade after decade, in the name of public health, financial prudence and societal improvement, sterilization continues to be made a panacea, disproportionately affecting communities of color and the disabled.

While it is impossible to determine just how far-reaching its effects are, Stern points out that in a survey of state hospitals and homes conducted in the 1920s, “[social eugenicist Paul] Popenoe found that the foreign-born were disproportionately affected….immigrants from Scandinavia, Britain, Italy, Russia, Poland and Germany were most represented. These records also reveal that African Americans and Mexicans were operated on at rates that exceeded their population.” The 1920 census notes that Mexican men and women made up 4% of California’s population, but comprised 7% and 8% of those sterilized respectively. African Americans, who made 1% of the state population accounted for 4% of total sterilizations.

Until today, these continue to be practiced insidiously. Ericka Cohn’s “Belly of the Beast,” which premiered in the 2020 Human Rights Watch Film Festival, estimates that nearly 1,400 sterilizations happened between 1997 and 2013 in California state prisons. “Some of those procedures are questionable and the California Department of Corrections has found loopholes by classifying everything as medically necessary,” Cohn told “Independent Lens.”

Phung Huynh, left, stands next to Jorge Orozco, right. They're both standing on the "Sobrevivir" art installation, a metal sculpture piece on the ground with floral etchings. Behind the duo, the LAC + USC Medical Center stands tall.

Artist Phung Huynh, left, and LAC + USC Chief Executive Officer Jorge Orozco, right, stand on the “Sobrevivir” art installation. | Steven Lam / Courtesy of L.A. County Department of Arts and Culture

As recently as 2020, dozens of immigrant women detained by Immigration and Customs Enforcement (ICE) at Irwin County Detention Center have filed a class-action lawsuit, alleging “nonconsensual and invasive gynecological procedures and surgeries, that were later found to be unnecessary and, in some cases, left them unable to have children.”

Continued cases like these are why Huynh believes so strongly in the importance of this sculpture. “This piece is not only about honoring the survivors,” said Huynh, “but using history to make people remember this and learn from this. We can never forget this moment.”