Historically, American Indians and Alaska Natives (AI/AN) have been subjected to a lack of control over various aspects of their lives, including their reproductive health. In discussions of family planning with AI/AN patients, clinicians must consider past violations of reproductive rights and the need for transparent consent. This article explores the following questions: What were historical violations of AI/AN women's reproductive rights? How should physicians express respect for this history and for the autonomy of AI/AN female patients regarding surgical sterilization procedures today?