Helen Rodríguez-Trias Papers

Helen Rodríguez-Trías was a pediatrician, a public health advocate and a women’s rights activist whose career was dedicated to improving and expanding health care services for women and children, especially low-income women and families, in Puerto Rico and the United States. This commitment and dedication are evident in her efforts to improve neonatal care for low-income women, to raise cultural awareness among the medical community, to bring an end to coercive tactics in sterilization, to fight for reproductive justice, to advocate for women of color and low-income women in all aspects of public health and to develop policies and services for people with HIV/AIDS.

The youngest daughter of Damián Rodríguez and Josefa Trías, Helen Rodríguez-Trías was born July 7, 1929 in New York City. Her family returned to Puerto Rico when she was still a young child, the first of many moves between the two islands that Rodríguez-Trías would make throughout her life. At an early age, she learned first-hand about injustice and discrimination and the impact of fighting against it. Rodríguez-Trías witnessed her mother, a schoolteacher in Puerto Rico, successfully fight for education reforms ranging from advocating for a school lunch program to bringing Spanish back into the classroom, a practice banned since the United States took control of Puerto Rico in 1898.

In 1939, upon returning to New York City with her mother after her parents divorce, the two experienced the racism that was increasingly prevalent as Puerto Ricans migrated to New York City in greater numbers. Unable to get a teaching license although fully bilingual, Josefa Trías was forced to take low-wage work as a seamstress, a cook and, later, a housekeeper. Rodríguez-Trías was placed in remedial classes at school, not because of a perceived need or poor grades but due to her Spanish last name. Although a teacher recognized Rodríguez-Trías’ intellectual abilities early on and had her transferred to a gifted students class, she still suffered through the taunts and torments of her classmates and teachers. Undeterred and driven to excel in and out of the classroom, Rodríguez-Trías graduated high school and received a full scholarship to attend the University of Puerto Rico.

In college, she became involved in the Puerto Rican independence movement, activism that had begun to take shape alongside other Puerto Rican students in high school, and joined a student strike that closed down the university. Her older brother, alarmed by Helen’s political involvement, wielded his position as a source of financial support and insisted that she leave Puerto Rico immediately. While back in New York and still active in the struggle for Puerto Rican independence, she met and married a fellow activist, David Brainin, and together fought to challenge racist and discriminatory practices and policies that affected people of color during that time. The birth of their first child, Jo Ellen, proved to be a turning point in Rodríguez-Trías’ life – it was her first encounter with the health care system in the U.S. and the impetus for her to finish her college degree, go on to medical school, and pursue a career in pediatrics. Rodríguez-Trías’ birthing process was marred by pain, fear, isolation, and uncaring and unsympathetic physicians and nurses. She eventually discovered that she had been used as a guinea pig in a scientific experiment evaluating the effect of emotional support, or the lack thereof, on women giving birth for the first time. The dehumanizing experience left an imprint on her and she vowed to not only become a doctor who was caring and empathetic with her patients but to improve health care for women in general.

Although it took several years, two more children – Laura and David – and a divorce before Rodríguez-Trías embarked on this new phase of her life, she finally did return to Puerto Rico to finish her undergraduate studies and attend medical school. In 1960, she graduated first in her class from the School of Medicine at the University of Puerto Rico. Although pregnant with Daniel, her fourth child, she started her year long residency at the University Hospital after which she decided to pursue pediatrics as her specialty. Upon completing her two-year residency in pediatrics, she accepted her first leadership position in the medical field, Director of Newborn Service at University Hospital in Puerto Rico, where her reforms led to a 50% decrease in infant mortality rates. She remained with the Department of Pediatrics until 1970, when she moved back to New York City after the dissolution of her second marriage.

For the next 18 years, Rodríguez-Trías worked in various hospitals in New York and New Jersey, first at Lincoln Hospital in the Bronx during the Young Lords takeover (1970-1977), and later at St. Luke’s Roosevelt Hospital Center (1974-1985) and Newark Beth Israel Medical Center (1985-1988). She also taught pediatrics at several area medical schools including Albert Einstein College of Medicine at Yeshiva University (1970-1977), College of Physicians and Surgeons at Columbia University (1978-1985) and the University of Medicine and Dentistry of New Jersey (1985-1988).

It was her early years at Lincoln Hospital, however, that gave her the opportunity to develop her distinct leadership style. Arriving as an attending physician to a hospital serving a primarily Puerto Rican community in the South Bronx during a chaotic and tumultuous time was no easy task. The Young Lords, and the Pediatrics Collective that aligned themselves with them, had taken over the hospital to improve health care for the community. Rodríguez-Trías shared their ideology and their practical goals but differed in the methods and strategies used to achieve them. She believed that compromise was necessary to ensure action and change, and that in the end, reaching agreements with the various parties that had a stake in the hospital was in the best interest of the community. Over time, she won them all over using her political savvy, her practicality and her ability to bring disparate forces together and to find points of unity – characteristics that would serve her well many times throughout her career – and would go on to serve as Director of Pediatrics at Lincoln Hospital until 1974.

Her time at Lincoln Hospital also marked a greater involvement with the women’s rights movement. She attended conferences and meetings and even hosted a consciousness-raising group for Latinas. On a daily basis, Rodríguez-Trías bore witness to how low-income women of color lacked the same quality of health care that more affluent, generally white communities were able to access. She incorporated these real-life experiences in her discussions about public health or in meetings with other women’s rights activists in order to shed light on the health care realities of Latinas and other women of color under the current system.

For example, at the 1974 American Public Health Association’s annual meeting, she shared the story of a young, Puerto Rican woman who was denied medical care -- and later died at home -- because doctors believed that she was faking her symptoms. The reason for her neglect was appalling: a medical textbook had indexed “Puerto Rican Syndrome” as a term for hysteria. In a strongly worded letter of protest, Rodríguez-Trías demanded that future editions exclude such disparaging terminology; the editors of the textbook agreed. Although far from remedying all of the health care inequalities faced by Latinas, she believed that small steps like these created incremental changes in women’s daily lives.

Throughout the 1970s and 1980s, Rodríguez-Trías was active in the reproductive rights movement. One of her most significant contributions was expanding the overarching feminist movement’s understanding of reproductive rights to include coerced sterilization and establishing federal guidelines that would protect women at risk of being forced, directly and indirectly, into the procedure. While middle to upper class white women were fighting to gain access to sterilization, a practice often denied to them by a medical establishment that encouraged these women to have more children, many low-income women of color were pressured into the procedure as part of a subtle, but effective eugenics movement.

In fact, as Rodríguez-Trías researched the prevalence of sterilization in Puerto Rico, she unveiled a staggering picture. Between the late 1930s and the late 1960s, approximately one third of Puerto Rican women of childbearing age had been sterilized and, often, without information about the irreversible nature of the procedure. Studies on the practice uncovered that the Puerto Rican government had conducted an intensive sterilization program that included subsidized or free procedures, a sharp contrast to expensive and scarce birth control methods. In 1982, Rodríguez-Trías went on to participate in a documentary film project titled “La Operación” that discussed sterilization abuse in Puerto Rico. The film featured interviews with Rodríguez-Trías as well as with Puerto Rican women who described their experiences with the practice. Moreover, sterilization abuse in Puerto Rico was not an isolated case. Further research revealed that hospitals in the United States were also aggressively pushing sterilization among low-income women of color. By the mid 1970s, over 65 percent of sterilizations in U.S. hospitals were performed on women of color.

Responding to such rampant injustice and discrimination in the name of public health, Rodríguez-Trías, along with other activists, formed the Committee to End Sterilization Abuse (CESA) to engage in public education about coerced sterilization, to advocate for free birth control, to institute sterilization guidelines and to file legal challenges against individuals and institutions that employed coercive tactics. Indeed, CESA spent the next several years actively pursuing these goals which, ultimately, resulted in the 1979 passage of federal guidelines on sterilization that required written and informed consent and a thirty-day waiting period. By this time, CESA had evolved into another organization founded by Rodríguez-Trías, the Committee for Abortion Rights and Against Sterilization Abuse (CARASA), reflecting their participation and impact in the greater reproductive rights movement. In addition, Rodríguez-Trías’ efforts to improve women’s health led her to join others in establishing the Women’s Caucus of the American Public Health Association.

In 1988, she became the Medical Director of the New York State Department of Health AIDS Institute after working with many HIV-infected children at the Newark Beth Israel Medical Center and realizing that HIV prevention was an enormous public health issue that had not yet been fully integrated into the consciousness of health care providers as well as the general public. Her work at the AIDS Institute, which included policy and program development, contributed to the establishment of standards of care for people with HIV/AIDS in New York that became a model for the entire nation.

After nearly a decade together, Rodríguez-Trías married Edward González and moved to California in the late 1980s. Life in New York City had become too hectic and Rodríguez-Trías was feeling overwhelmed and overextended; she hoped to focus more of her time and energy on her political work. She announced her candidacy for President of the American Public Health Association (APHA) in 1992 and, as a twenty-year active and respected member of the organization, was elected in 1993, the first Latina to hold the position. The presidency became Rodríguez-Trías’ platform for urging the health care community to better address the health care needs of low-income families, uninsured individuals, Latinas and other women of color and people with HIV/AIDS. She traveled extensively throughout the country giving presentations to large and diverse audiences who heeded her message of health equity, reproductive freedom and women’s rights.

Rodríguez-Trías’ year-long presidency was followed by the co-direction of the Pacific Institute for Women’s Health until 1999, where she focused on research and advocacy on access to health care, reproductive health and health care policy at the local and global level. Specifically, she worked to integrate contraception and HIV prevention efforts, believing that the two areas were intrinsically linked, and to promote reproductive health programs in Latin America, Africa and Eastern Europe. Throughout the 1990s, she was also a consultant to agencies, organizations and foundations in various aspects of health care including program development, proposal evaluation, field studies and reports on health needs among underserved communities. This extensive writing, along with the numerous forewords and introductions for books that her expertise and experience attracted, is well-documented in this collection.

Rodríguez-Trías’ political, programmatic and leadership work was not limited to these activities. In 1994, she attended the International Conference on Population and Development in Cairo, Egypt, where she contributed to the drafting and adoption of Principle 4 of the Cairo Plan of Action, an internationally agreed upon statement on the advancement of women’s equality and rights and the empowerment of women. She attended the 1995 Fourth World Conference on Women in Beijing, China as a delegate of the United States. She also served on numerous Board of Directors throughout her career including the William Fitz Ryan Community Health Center (1975-1982), Center for Constitutional Rights (1984-1990), National Women’s Health Network (1988-1996), Latino Commission on AIDS (1991-1994) and twice sat on the American Public Health Association’s Executive Board (1985-1989, 1992-1994.)

Among the many additional awards and recognitions she received in honor of her years of service and activism in public health, and especially the health of low-income women of color, were the Distinguished Physicians Award (National Women’s Health Network, 1977), inclusion in the “Women Making History” book (New York City’s Commission on Women, 1984), Award for Service (ASPIRA of New York, 1986), Distinguished Service Recognition Award (National Coalition of Hispanic Health and Human Services Organizations, 1990) and a Lifetime Achievement Award (Latino Caucus of the American Public Health Association, 1993.)

Most notably, in January of 2001 and less than a year before succumbing to lung cancer, Rodríguez-Trías was awarded the Presidential Citizens Medal in recognition of her broad public service in the health field including improving neonatal care for low-income women, raising cultural awareness among the medical community to better serve Latino patients, ending coerced sterilization, fighting for reproductive rights, advocating for women of color and low-income women in all aspects of public health and improving policies and services for people with HIV/AIDS.

Rodríguez-Trías stayed true to her belief that, “…it is ultimately important to keep ourselves where the struggles are taking place, and to be part of the struggles.” She transformed this conviction into a lifelong commitment to service, activism and education in public health, in the broadest and most inclusive sense of the word, at the individual, community, national and international level. This collection, small in quantity but large in scope, offers researchers an overview of Rodríguez-Trías’ enduring legacy and the fruits of her struggles. In addition, researchers seeking information about Rodríguez-Trías’ life and work can examine the Edward González Papers for supplemental materials.