Prisoners at the White County jail in Sparta, TN, have recently been given a horrifying choice: Serve their entire sentence behind bars or agree to undergo a sterilization procedure, courtesy of the Tennessee Department of Health, in exchange for a reduced sentence.

The program, approved by local Judge Sam Benningfield in May, has divided local officials and raised serious concerns from rights groups who argue that coercing prisoners with medical procedures is wholly unconstitutional.

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As of May 15, more than 30 women have had Nexplanon—a small rod that can prevent pregnancies for up to four years—implanted in their arms, free of cost, in exchange for 30 fewer days in jail, according to News Channel 5. Thirty-eight men have also agreed to undergo vasectomy surgery as part of the same program.

“I hope to encourage [prisoners] to take personal responsibility and give them a chance, when they do get out, to not to be burdened with children,” Judge Benningfield told WVLT. “This gives them a chance to get on their feet and make something of themselves.”

The ACLU, however, has condemned the program. In a statement to News Channel 5, the group wrote:

Offering a so-called ‘choice’ between jail time and coerced contraception or sterilization is unconstitutional. Such a choice violates the fundamental constitutional right to reproductive autonomy and bodily integrity by interfering with the intimate decision of whether and when to have a child, imposing an intrusive medical procedure on individuals who are not in a position to reject it. Judges play an important role in our community – overseeing individuals’ childbearing capacity should not be part of that role.

White County District Attorney Bryant Dunaway also criticized the program, saying, “It’s concerning to me, my office doesn’t support this order.

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“It’s comprehensible that an 18-year-old gets this done,” he added. “It can’t get reversed and then that impacts the rest of their life.”

The White County Jail program is hardly Tennessee’s first controversy regarding the use of sterilization as a criminal justice bargaining chip. Between 2010 and 2015, Nashville saw four cases in which sterilization was offered in plea deals and criminal sentencing, the Associated Press reported.

Speaking with the AP, Georgia State University law professor and historian Paul Lombardo described the horrifying history of state-sponsored sterilization efforts in the United States.

“The history of sterilization in this country is that it is applied to the most despised people—criminals and the people we’re most afraid of, the mentally ill—and the one thing that these two groups usually share is that they are the most poor,” Lombardo explained. “That is what we’ve done in the past, and that’s a good reason not to do it now.”

In fact, it was the United States’ history of sterilization—particularly that which took place in California during much of the 20th century—that inspired Adolf Hitler to adopt the model Nazi Germany.

Still, despite its chilling history, Judge Benningfield remains optimistic about his county’s sterilization program.

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“I understand it won’t be entirely successful but if you reach two or three people, maybe that’s two or three kids not being born under the influence of drugs,” he told News Channel 5.

“I see it as a win-win.”