In most states, eugenics-era laws still let doctors sterilize disabled patients—even against their will.

To this day, 31 states and Washington, DC, still have laws on the books that allow for the practice—and just two, Alaska and North Carolina, have laws that fully ban the nonconsensual sterilization of disabled people, according to a 2022 report from the National Women’s Law Center. There’s no official account of just how many disabled people have been sterilized under those laws.

Some of these laws aren’t even that old. In 2019, Iowa and Nevada passed new forced sterilization laws that applied to people under guardianship. Both bills passed unanimously, and the end result is consistent with laws on the books in other states. There was no discourse among politicians—let alone objections—about the ethics of sterilizing disabled people without their consent.