A Century of Eugenics in America From The Indiana Experiment To The Human Genome Era Bioethics and The Humanities
A Century of Eugenics in America From The Indiana Experiment To The Human Genome Era Bioethics and The Humanities
Bioet h ic s a n d t h e H u m a n i t i e s
E r ic M . M e s l i n a n d R ic h a r d B . M i l l e r , e di t or s
A
c e n t u r y of
E u g E n i c s
in a m e r i c a
E di t e d b y
Pau l A . L om b a r d o
In 1907, Indiana passed the first involuntary sterilization law in the world
based on the theory of eugenics. In time more than 30 states and a dozen
foreign countries followed Indiana’s lead in passing sterilization laws;
those and other laws restricting immigration and regulating marriage
on “eugenic” grounds were still in effect in the United States as late as
the 1970s.
The centennial of Indiana’s pioneering enactment provided an oppor-
tune time to evaluate the historical significance of eugenics in America.
On April 12, 2007, after more than two and a half years of planning, a
group that included scholars, state officials, and members of the public
assembled in Indianapolis for the culmination of the Indiana Eugenics
Legacy Project. The project was designed to advance historical research
on eugenics, to deepen our understanding of the varied ways “eugenics”
was expressed intellectually, legally, and socially, and to help draw lessons
from history for current policy makers.
The project included several specific events. Foremost among them
was a public symposium held to mark the eugenic centennial. On that
occasion the Indiana State Library launched an exhibit on the history
of eugenics in Indiana as scholars engaged in panel discussions on the
implications of eugenic policies. Professor Daniel Kevles, historian and
author of In the Name of Eugenics (1985), provided a keynote lecture, as
did Joe Palca, science journalist for National Public Radio. The highlight
of the centenary activities was the unveiling of a historical marker that
now stands on the grounds of the State Library, explaining Indiana’s role
in the eugenics movement.
ix
xâ•… · â•… P r e fa c e a n d A c k n o w l e d g m e n t s
Paul A. Lombardo
April 2010
A century of Eugenics in America
I n t r oduc t ion
Pau l A . L om b a r d o
1
2â•… · â•… Pa u l L o m b a r d o
The essays in this book do not propose a single definition that cap-
tures the meaning of eugenics. They are instead attempts to describe and
analyze the many ways that term was used to justify cultural shifts, social
programs, and laws in the United States. There is no extended discussion
of the “eugenics movement” in these essays either, both because most of
the nationally prominent eugenic organizations have already been well
studied and because the general focus here is not on national trends but on
how those trends played out in ways that were unique and local. Eugenics
took many forms, and different agendas were launched “in the name of
eugenics.” 7 This book traces the career of several of those agendas, with
particular attention to legal activities at the state level. The first eight es-
says are by historians; seven of them are about features of sterilization law
in one or more states. While sterilization is clearly only one expression of
the group of ideas we think of as eugenics, it still draws historical attention
because it was practiced so regularly in the United States for so long. It
also generated legal and administrative records that are the raw material
of much historical study.
The eighth historical essay is about race and the way eugenic thinking
of one kind was adopted even by those who might have been victimized
under “eugenics” of another stripe. Race is touched upon in several other
chapters, and that is hardly surprising, since racially and ethnically dis-
criminatory laws, from Jim Crow to genocide, represent some of the most
notorious examples of the policies we understand as eugenics.
The book is completed with two essays from perspectives outside of
history: law and biomedical science. They too allude to history, but also
bring our inquiry up to date with reflections on the era of the human
genome. The book as a whole can be broken down into four parts, as
summarized below.
Two essays place Indiana as first among all the states to begin the “ex-
perimental stage” of eugenics, with specific attention to Dr. Harry Clay
Sharp, a prime mover in the legalization of eugenic surgery, followed
by an in-depth view of the state legislative process that yielded the first
sterilization law.
I n t r o du c t i o nâ•… · â•… 3
The next four chapters are case studies that further explain how eugenic
sterilization law was applied in key states. Alexandra Stern details the use
of eugenic sterilization in mental institutions in California and compares
western practices to the application of surgery in the correctional system
in Indiana. Her chapter introduces us to the lives of those most affected
by sterilization law—institutionalized patients. Their stories are revealed
through hospital records and other archival material containing accounts
of both resistance to sterilization and acquiescence to its application by
the families of those subject to sterilization laws.
Molly Ladd-Taylor looks at the control of sterilization by local welfare
officials in Minnesota during the New Deal. There, sterilization occurred
as part of a child welfare policy and was just one part of what its support-
ers considered a systematic approach to management of social conditions.
Procedures for commitment to state institutions as well as the process of
I n t r o du c t i o nâ•… · â•… 5
Par t 4. E ugenics in t he
H uman G enome E ra
The book is rounded out with two essays by scholars from the biomedical
sciences and law: reflections by a geneticist and a physician/geneticist on
6â•… · â•… Pa u l L o m b a r d o
the reappearance of eugenic thinking during the human genome era, and
a legal scholar’s analysis of the ways that eugenic motives are embedded
in modern law.
Linda and Edward McCabe approach their topic as scientists and
clinicians who are surveying the landscape in their own field of genetics.
They are aware that at its inception genetic science was closely aligned
with eugenics, and they ask how much our current attitudes and prac-
tices mirror those of their predecessors, who embraced toxic features of
hereditarian thinking. The McCabes find disquieting similarities in the
language of genetic determinism that has reappeared in the age of the Hu-
man Genome Project, and they decry both the oversimplified portrayal
of hereditary mechanisms and the exaggerated claims made on behalf
of “genomics” that have resulted. Government agencies or other enti-
ties (like insurance companies) raise particular concerns when they are
positioned to exert social or legal control to intrude on the reproductive
decisions of individuals.
The final essay, by Max Mehlman, subjects practices he describes
as “neoeugenic” to legal analysis. They involve situations when govern-
ment, through law or policy, encourages, discourages, prohibits, or re-
quires reproduction. Mehlman notes that governments are rarely neutral
about reproduction, and in this context active regulation in the form of
laws passed (e.g., sterilization laws), court cases decided (e.g., wrongful
birth claims), and programs funded (e.g., welfare payments for contra-
ception or tax credits for childbearing) must be considered along with
inaction—such as allowing private entities like internet dating services
or in vitro fertilization clinics to screen customers based on race, social
class, aptitude, or disability. The usual subjects appear as the objects of
regulation, and as always, they include the poor, minorities, criminals,
and the disabled, as well as those whose sexual practices deviate from
common norms.
In the attempt to accurately characterize the ideas and practices that have
come to be described as “eugenics,” this collection supplies us with much
to consider. Four points of particular importance emerge.
First, in practice—as it played out in law and social policy—the defi-
nition of eugenics was always changing. To some it meant cutting the tax
burden generated by welfare dependent mothers by preventing the birth
I n t r o du c t i o nâ•… · â•… 7
No t es
1.╇Dr. W. C. Rucker, “More ‘Eugenic Laws’: Four States Consider Sterilization
Legislation and Nine Contemplate Restrictions on Marriage—None of Proposed Laws
Satisfactory from Eugenic Viewpoint,” Journal of Heredity 6 (1915): 219.
8â•… · â•… Pa u l L o m b a r d o
2.╇Francis Galton, Inquiries into Human Faculty and Its Development (London:
Macmillan, 1883), 17.
3.╇For useful surveys of scholarship on eugenics, see Philip J. Pauly, “The Eugenics
Industry—Growth or Restructuring?” Journal of the History of Biology 26 (Spring 1993):
131–45; Frank Dikotter, “Race Culture: Recent Perspectives on the History of Eugenics,”
American Historical Review 103 (April 1998): 467–68.
4.╇ The entire quotation is: “We greatly want a brief word to express the science of
improving stock, which is by no means confined to questions of judicious mating, but
which, especially in the case of man, takes cognisance of all influences that tend in how-
ever remote a degree to give to the more suitable races or strains of blood a better chance
of prevailing speedily over the less suitable than they otherwise would have had. The
word eugenics would sufficiently express the idea.” Galton, Inquiries, 17n1.
5.╇ Mark Adams, ed., The Wellborn Science: Eugenics in Germany, France, Brazil, and
Russia (New York: Oxford University Press, 1990), 221.
6.╇ Paul Weindling, “The Survival of Eugenics in 20th-Century Germany,” 52
American Journal of Human Genetics 52, no. 3 (March 1993): 643–49.
7.╇ The title of Daniel Kevles’s now classic work, In the Name of Eugenics (Cam-
bridge: Harvard University Press, 1985), captures the diversity of objectives that various
people pursued, using eugenics as their rationale.
Pa r t on e
E l of A x e l C a r l s on
11
12â•… ·â•… E l of A x e l C a r l s o n
Even as the economy changed, ideas about the nature, scope, and
object of charity—a long-standing feature of America’s Christian tradi-
tion—shifted across the country. After the 1850s, many philanthropists
who had initially viewed the less fortunate as worthy objects of assis-
tance came to understand the poor, diseased, and physically infirm as
defective in body or mind, often undeserving of charity.4 This ideological
change led to a cultural divide, giving rise to a need among the advan-
taged (whether with power, health, or wealth) to control the increasingly
scorned disadvantaged.
Finally, the biological interpretation of life—holding that the physi-
ological imperfections that led to degeneracy were themselves marks of
an individual’s inherent biological inferiority—gained great social cur-
rency among educated elites who wielded political power. The theory
of French scientist Jean Baptiste Lamarck that characteristics acquired
during life would be passed down as a function of heredity, led some
scientists to the optimistic view that a good environment had the poten-
tial to reverse bad heredity. The Lamarckian view that prevailed into the
1880s was challenged and eventually supplanted by a view of heredity
developed by August Weismann in Germany. Weismann’s experiments
demonstrated that the key to heredity was lodged in the reproductive tis-
sue and that heredity was isolated from most environmental influences
that change our body tissues and organs. This more restrained notion of
genetic malleability from one generation to the next suggested more pes-
simistic conclusions about the likelihood of ameliorating the conditions
of human society.
These intellectual trends combined with new surgical procedures—
specifically, less-invasive sterilization techniques that did not castrate
the patient—to bolster the popularity of surgical eugenic intervention
as an enlightened public policy. The favored method for sterilization
in men was vasectomy, a procedure rarely used before the 1890s. 5 Va-
sectomy provided the means for breaking the chain of heredity not by
changing an individual’s genetic endowment but by ensuring that only
the most genetically fit would procreate, thereby increasing the quantity
and distribution of fit traits in the population. Preventing the unfit from
passing on their defective heredity was a kind of eugenic public health
program.6
T h e H o o s i e r C o n n e c t i o nâ•… · â•… 13
to meet their needs, and the facilities were forced to rely on local or state
taxes to cover their operating expenses. Sometimes the unfit were placed
in asylums, but that, too, was expensive. Increasing numbers of institu-
tionalized individuals required more generous state support to build and
maintain adequate facilities.7
Who were these unfit people? Some were children, too young (espe-
cially if orphaned) to support themselves. They may have suffered from
a chronic illness or birth defects that made their employment difficult
and their needs more than a family could provide. The fragile economic
balance of the family wage could be shattered when women lost their
husbands to accident, illness, or the all-too-common desertion. An adult
might be mentally retarded, blind, deaf, or physically or mentally inca-
pacitated. Before there was a science that could discern and interpret the
causes of these disorders, most people assumed that misfortune was an
act of God. As society secularized and advances in science and medicine
offered interpretations that seemed equally plausible or even superior to
religious determinism, degeneracy theory emerged, relying on the au-
thority of science to explain the existence and experience of society’s less
fortunate members.
Instead of asking, “Why does God allow bad things to happen to
good people?” American intellectuals increasingly asked, “What is it
about an individual’s inherent biology that makes him bad?” Was “na-
ture” or “nurture” responsible for misfortune? Bad environments could be
reversed, but often when that “social therapy” was done through charity
and asylum reform movements, the “treatment” was expensive, and many
of those treated did not respond. The blind remained blind. The retarded
remained retarded. The psychotic remained psychotic. Paupers lapsed
back into their impoverished neighborhoods and degraded, poverty-
stricken habits.
By the 1880s, many environmental reforms had been tried and found
wanting. The seeming intractability of degeneracy and its social conse-
quences frustrated those looking for a quick response to the problems of
modern living. At this point reformers and physicians, newly embold-
ened by their successes in public sanitation, public hygiene, and public
health, stepped in to promote a new, simple, preventive remedy for long-
standing social problems. Hygiene became the watchword of efficient
reform.8 Those who were most touched by degeneracy and therefore most
T h e H o o s i e r C o n n e c t i o nâ•… · â•… 15
stand why they preferred to migrate rather than settle down. They lived
on the margins of society, paradoxically flouting the obvious benefits of
joining the middle class through thrift, industry, and sobriety. He felt
that their shiftless behavior evinced an essential degeneracy of character
and constitution.
McCulloch viewed the Tribe of Ishmael as a parasitic race with a peri-
patetic lifestyle. The Tribe grew in number because it was supported by the
charity of others, rather than its own thrift and industry. The Ishmaelites
were inordinately represented on the tax rolls because their chronic pen-
ury, exacerbated by winters in economic lean times, left them dependent
on public assistance. McCulloch thought the Ishmaelites incorrigibly de-
fective and believed they should be isolated and prevented from reproduc-
ing. Taking a page from the Bureau of Indian Affairs, McCulloch even en-
tertained the idea of removing Ishmaelite children from their parents and
raising them in “upstanding” foster homes to see if the cycle of nomadic
living could be overcome by a proper environment. Ultimately, emphasiz-
ing his judgment that the Ishmaelites were subhuman, he compared them
to “devil grass” or weeds that could only be controlled by being uprooted.
During regular conversations, David Starr Jordan, a biologist who had
joined McCulloch’s church, confirmed the minister’s conclusions.10
Sharp was born and raised in Indiana, but he completed medical school in
Louisville, Kentucky, in 1896. As a student, he learned of the new public
hygiene movement initiated by German medical schools, relying to a
major degree on the work of bacteriologist Rudolf Virchow. In addition to
his cytological discoveries, Virchow had championed the novel idea that
it is a government’s duty to protect and care for the health of its citizens.
He initiated meat inspections, garbage disposal, purification of water
supplies, and free health examinations for all schoolchildren in the name
of public health and hygiene.
The state of American medical education in the late nineteenth cen-
tury was generally unsophisticated, and the most promising American
physicians did postgraduate work in Europe, especially seeking out ap-
pointments in Germany to study with Virchow or his students. Although
Sharp never made this intellectual pilgrimage, he did the next best thing:
he read and studied the latest publications about preventive medicine in
the important and increasingly reliable American medical journals.
Sharp’s first job was prison physician in Jeffersonville, across the
Ohio River from Louisville. The physical conditions of the prison and its
inmates, suffering from endemic disease and malnourishment, appalled
Sharp. Many prisoners died of tuberculosis, typhus, and typhoid fever.
The kitchen was inadequate to prepare proper meals, and prisoners ate a
watery swill better suited for feeding pigs. At night, inmates tossed their
excrement into a trough that ran between the cells; in the morning, a
guard would hose the urine and feces out of the trough.
Sharp documented the horrid abuses he witnessed in biannual reports
to the governor, prepared in the prison print shop. He charged that by
neglecting the health of those for whom it cared, the state was guilty of ho-
micide. While prisoners paid their debt to society, they surrendered their
freedom but need not surrender their humanity, Sharp said. He argued that
the prison’s inflated death rate was largely preventable by simple, relatively
inexpensive reforms. He asked for sanitary privies to be installed in the
cells, the construction of an adequate kitchen, and the provision of a bal-
anced diet. The governor and the legislature acquiesced, and in later years
Sharp was pleased to report a dramatic reduction in the death rate.14
T h e H o o s i e r C o n n e c t i o nâ•… · â•… 19
In 1899, Sharp read an article in the Journal of the American Medical Asso-
ciation by Albert Ochsner (1858–1925), a physician at the Chicago Medical
School who had studied with Rudolf Virchow. Ochsner was a founder
of the College of Surgeons, and he had been using vasectomies—a pro-
cedure developed in Sweden and England in 1890—as an experimental
treatment for enlarged prostate glands. Ochsner had several patients who
were in their forties or fifties, and they resumed sexual activity after their
surgery. This suggested to Ochsner that degeneracy, too, could be treated
by vasectomies: severing an otherwise healthy person’s spermatic cord
resulted only in sterilization, not impotence. Vasectomy offered the possi-
bility of rendering men infertile without subjecting them to the cruelty of
destroying their sexual function. Ochsner argued that degeneracy would
rapidly disappear if degenerates were sterilized as a routine procedure; ac-
cepting the then-current notion that “like begets like,” vasectomy would
prevent defective men from reproducing “more of their kind.”15
After reading Ochsner’s article, Sharp initiated his own eugenic pro-
gram by operating on a young man named Clawson. According to Sharp,
Clawson’s problem was excessive masturbation. Sharp had learned in
medical school that masturbation was a cause of degeneracy. That belief
was more than two centuries old and held that loss of semen through
any sexual excess, including masturbation, would lead to physical and
mental degeneracy that would subsequently reappear in the next genera-
20â•… · â•… E l of A x e l C a r l s o n
one who exhibited negative traits would have a limited effect on curbing
the incidence of unexpressed, recessive factors carried by healthy people.
The economic disaster of the Great Depression multiplied the number
of poor, homeless, disabled, and mentally disordered wandering outside
of institutions—those who were formerly called “unfit.” Moreover, the
economic cataclysm laid low many erstwhile “superior” professionals in
fields as varied as law, finance, banking, politics, business, and education.
In responding to the widespread deprivation, the Roosevelt administra-
tion shifted legislators’ and the public’s views regarding social problems,
their origins, and the most efficacious modes of amelioration. Relief and
recovery, not prevention and sterilization, became the watchwords of the
government’s approach to the economic catastrophe.
and calumny, but instead to understand why solutions that today appear
obviously flawed held such immense appeal in the past.
Yet, although one should acknowledge the ways in which Mc-
Culloch, Jordan, and Sharp were merely “men of their times,” one must
admit that they shared a false view of the relationship between society
and heredity. The notion that those individuals they described as “unfit
to reproduce” would rapidly spread their defects to an innocent popula-
tion was and is simply false. Ultimately, civilization and human rights
were far less imperiled by “the unfit” than by the authoritarian solutions
promoted by those who saw in eugenics an anodyne for the problems
of modern living. While no one is born with an inerrant Promethean
foresight, it is not beyond our capacity to listen to critics, to open legal
proposals to vigor�ous debate, and to go slowly as we adopt scientific
approaches to social and moral problems. 21 Better to err on the side of
caution and human dignity than to stumble blithely into the path of
tragedy and inhumanity.
Notes
1.╇ The best source on Jordan’s life is his autobiography: David Starr Jordan, The
Days of a Man, 2 vols. (Yonkers on the Hudson, N.Y.: World Book, 1922). For McCulloch,
see Genevieve C. Weeks, Oscar Carlton McCulloch, 1843–1891: Preacher and Practitioner
of Applied Christianity (Indianapolis: Indiana Historical Society, 1976). No biography
of Sharp exists beyond William M. Kantor, “Beginnings of Sterilization in America: An
Interview with Dr. Harry C. Sharp,” Journal of Heredity 28 (1937): 374–76.
2.╇ For a comprehensive history of this transition, see Elof Axel Carlson, The Unfit:
A History of a Bad Idea (Cold Spring Harbor, N.Y.: Cold Spring Harbor Laboratory
Press, 2001).
3.╇ The first book-length treatment of degeneracy theory was offered by Benedict
A. Morel, Traité des Dégénérescences de l’Éspèce Humaine (Paris: Chez J. B. Balliére,
1857). Max Nordau, Degeneration (New York: D. Appleton, 1895) was also influential
on middle-class thinking in the 1890s. His popularization of neurasthenia as a modern
induced disease began in Nordau, Conventional Lies of Our Civilization (Chicago: Laird
and Lee, 1884).
4.╇ Richard Dugdale, The Jukes: A Study in Crime, Pauperism, and Disease (New
York: G. P. Putnam’s Sons, 1875). While a careful reading of this book shows Dugdale
to be an environmentalist, his interpretations were ignored and the work was used to
justify hereditarian notions of degeneracy. See Elof A. Carlson, “Richard L. Dugdale
and the Jukes Family: A Historical Injustice Corrected,” Bioscience 30 (1980): 535–39.
See also Henry M. Boies, Prisoners and Paupers (New York: G. P. Putnam’s Sons, 1893).
Boies accepted the view that criminals and the poor represented instances of hereditary
degeneracy.
24â•… ·â•… E l of A x e l C a r l s o n
5.╇ David Wolfers and Helen Wolfers, Vasectomy and Vasectomania (St. Albans,
UK: Mayflower Books, 1974). This polemical book gives a good overview of the proce-
dure’s development in Europe and then in the United States. The authors err in depict-
ing Dr. Sharp as a somewhat demented and idiosyncratic physician.
6.╇ The surgical procedures for women were salpingectomy and salpingotomy, in-
volving partial excision or removal of the fallopian tubes and subsequent ligation.
7.╇ E. M. Leonard, The Early History of English Poor Laws (Cambridge: Cambridge
University Press, 1900).
8.╇ Philip R. Reilly, The Surgical Solution: A History of Involuntary Sterilization in the
United States (Baltimore: Johns Hopkins University Press, 1991).
9.╇ Oscar C. McCulloch, “The Tribe of Ishmael: A Study in Social Degradation,”
in Proceedings of the National Conference of Charities and Correction, Held at Buffalo,
July 1888 (Indianapolis: Charity Organization Society, Plymouth Church Building,
1888). See also Hugo B. Leaming, “The Ben Ishmael Tribe: A Fugitive Nation of the
Old Northwest,” in The Ethnic Frontier, ed. Melvin G. Holli and Peter d’A. Jones (Grand
Rapids, Mich.: Wm. B. Eerdmans, 1977), 97–142. The most thorough explication of the
Ishmael story to date is Nathaniel Deutsch, Inventing America’s “Worst” Family: Eugen-
ics, Islam, and the Fall and Rise of the Tribe of Ishmael (Berkeley: University of California
Press, 2009).
10.╇ See David Starr Jordan, Footnotes to Evolution: A Series of Popular Addresses
on the Evolution of Life (New York: Appleton, 1898), chapters 11 (“Degeneration”) and
12 (“Hereditary Inefficiency”). Jordan’s ideas about pauperism being a form of human
parasitism were reinforced by E. Ray Lancaster, Degeneration: A Chapter in Darwinism
(London: Macmillan, 1880).
11.╇ The Herman B Wells Library at Indiana University, Bloomington, has several of
these unpublished commencement addresses in its collection.
12.╇ The American Breeders Association was founded in 1903 in response to the
rising interest in Mendel’s Laws, rediscovered in 1900 by three European investigators:
Karl Correns, Hugo DeVries, and Eric von Tschermak. The association established its
own journal and in 1909 set up a eugenics committee as a third wing of its interests in
heredity—the other two being plant and animal heredity. See American Breeders Maga-
zine 1 (1913): 126–29.
13.╇ Jordan expressed his eugenic views in “The Blood of the Nation,” Popular Sci-
ence Monthly 59 (1901): 90–100, 129–40; Jordan, The Human Harvest (Boston: American
Unitarian Association, 1907); Jordan, Unseen Empire: The Plight of Nations That Do Not
Pay Their Debts (Boston: American Unitarian Association, 1912); and Jordan, The Hered-
ity of Richard Roe (Boston: American Unitarian Association, 1913). For his pacifist eu-
genics, see Jordan and Harvey Ernest Jordan, War’s Aftermath: A Preliminary Study of the
Eugenics of War (Boston: Houghton Mifflin, 1914).
14.╇ Sharp’s reports to the governor (1896–1912) are included in the biannual Com-
munication of the State Prison Reformatory at Jeffersonville; copies may be found in the
Herman B Wells Library.
15.╇ S. A. J. Ochsner, “Surgical Treatment of Habitual Criminals,” Journal of the
American Medical Association 32 (1899): 867–68.
16.╇ Harry C. Sharp, “Vasectomy as a Means of Preventing Procreation in Defec-
tives,” Journal of the American Medical Association 53 (1909): 1897–1902.
17.╇ Kantor, “Beginnings of Sterilization in America,” 376.
T h e H o o s i e r C o n n e c t i o nâ•… · â•… 25
18.╇ On Laughlin and Sharp, see Frances Janet Hassencahl, “Harry M. Laughlin,
‘Expert Eugenics Agent’ for the House Committee on Immigration and Naturalization,
1921 to 1931” (Ph.D. diss., Case Western Reserve University, 1971).
19.╇ Kantor, “Beginnings of Sterilization in America,” 376.
20.╇ Paul A. Lombardo, Three Generations, No Imbeciles: Eugenics, the Supreme Court,
and Buck v. Bell (Baltimore: Johns Hopkins University Press, 2008).
21.╇ See Elof Axel Carlson, Times of Triumph, Times of Doubt: Science and the Battle
for Public Trust (Cold Spring Harbor, N.Y.: Cold Spring Harbor Laboratory Press,
2006).
t wo
J a s on S . L a n t z e r
The 1907 passage of the world’s first eugenic sterilization law was an ex-
ample of interest group–initiated legislation. However, it was also unlike
similar legislation during the Progressive Era, such as the prohibition
of alcohol, because it did not originate or grow from a grassroots move-
ment.1 Rather, the legislation passed because a small group of reformers
persuaded politicians of both parties to enact the law. While the people
who used scientific, moral, agricultural, and economic arguments to get
the law passed are important, they are not the whole story. They then
built support for sterilization among the general population after the law
passed, helping to keep it on the books for nearly 70 years. Analyzing the
political processes that produced laws like this is vital to understanding
not only the society within which eugenicists lived but also the type of
society they hoped to create.
Although there has been relatively little historical attention to In-
diana’s eugenic past, the state was on the cutting edge of Progressive
reforms, including eugenics. Hoosier reformers—both inside and out-
side the legislature—possessed the necessary mixture of zeal, belief in
scientific progress, activist government, and fear of the future for eugenic
sterilization to become a reality. At first, the newly enacted law was con-
troversial, and it lacked widespread support among the public, which
doubted the well-born science’s ability to remake society. After the courts
ruled the initial law unconstitutional, its replacement, which integrated
relevant scientific advances, enjoyed wider acceptance. With the passage
of time and quiet enforcement, the sterilization law no longer attracted
political attention. It benefited from the power of inertia; opponents con-
26
T h e I n d i a n a Wa y o f E u g e n i c s â•… · â•… 27
C reat i ng t he Wor l d ’ s
F ir s t S t eri l i z at ion Law
delinquent, and dependent classes.” They wasted both private and public
philanthropy and, some thought, threatened to destroy American civi-
lization itself. Many eugenicists argued that since people could not es-
cape their eugenic destiny, the only solution was to stop the “unfit” from
procreating. Eugenic reformers made common cause with public health
advocates on the basis of seeking “to strengthen family and civilization
by regulating fertility” and promoting the birth of people biologically
predisposed to physical and mental health. The question facing eugenic
reformers was whether or not society had the will to obey the iron dic-
tates of heredity and do what was necessary to stop the multiplication
of the unfit.6
The support of many in the scientific community not only gave the
champions of eugenic sterilization an aura of prestige but also conferred
the power of moral authority. Eugenics became a secular faith among the
scientifically inclined who asserted that by obeying the commandments
of biology, humanity could usher in a social millennium. Drawing on a
quasi-Christian idiom of human perfectibility and salvation, the eugenics
message also struck a chord with many religious people, including many
liberal, mainline Protestants. In Indiana, where mainline Protestantism
(though not always liberal theology) was dominant, the blending of sci-
ence and religion by eugenicists facilitated eventual cultural acceptance.
In fact, the man who helped bring eugenics to Indiana was a minister. The
Reverend Oscar C. McCulloch was the senior pastor of Indianapolis’s
Plymouth Congregational Church. His duties brought him into contact
with a group of families he labeled the “Tribe of Ishmael,” whom he be-
lieved were at the root of the city’s criminal activity and social problems.
McCulloch concluded from his research on the Ishmaelites that some
harsh remedies were in order.7
McCulloch’s work stimulated elite support for reform. He counted
among his friends, admirers, and parishioners some of the most influen-
tial people in the state. Among them were David Starr Jordan, the noted
biologist and president of Indiana University.8 Other allies included
Governor (and later Vice President) Thomas Hendricks, Congressman
William H. English, and Senator (and later President) Benjamin Harri-
son. Together, these men represented an early bipartisan consensus that
would continue for decades and contribute to the support that eugenic
measures received at the statehouse.9
T h e I n d i a n a Wa y o f E u g e n i c s â•… · â•… 29
tive agenda. Both Dr. Sharp and Whittaker, who had supported Sharp’s
early surgeries, lobbied legislators. Sharp told lawmakers that his patients
thus far had volunteered for the procedure and that his operations were
quick and, though done without anesthesia, relatively pain-free. Whit-
taker argued that the procedure would prevent crime, cut institutional
costs, and free the state from a considerable economic burden. The doc-
tors’ advocacy and the lawmakers’ knowledge that they had to validate
an ongoing practice or face potential liability as well as scandal soon pro-
duced results.16
Supporters of the sterilization bill identified a fellow medical pro-
fessional to carry the legislation. Dr. Horace G. Read, the representa-
tive from Hamilton and Tipton counties, had been briefed by Whittaker
about the Jeffersonville experience and was convinced of the need for a
sterilization bill. Perhaps more important, according to one Indianapolis
paper, “it is understood that Governor Hanly is in sympathy with the
measure and will sign the bill.”17
Indiana sterilization supporters were aided in their legislative ef-
forts by earlier attempts to pass sterilization laws in other states. Both
Michigan (1897) and Pennsylvania (in 1901 and 1905) had attempted and
ultimately failed to enact some form of sterilization statute. In Pennsyl-
vania’s case, the law had been vetoed despite the support it had in the
medical and scientific communities.18 Indiana sterilization boosters took
note. They lined up both legislative and gubernatorial support before
they submitted a virtual copy of the bill that failed in Pennsylvania in
1907.19
Even with this planning, Read’s bill did not have an easy time in the
state legislature. It was first sent to the Committee on Medicine, Health,
and Vital Statistics. When opposition formed, Read withdrew it and had
it sent to his Committee on Benevolent and Scientific Institutions in-
stead. In the end, the House voted in favor of the bill by a margin of 59
to 22.20 The bill also faced some initial Senate opposition, and in the vote
there, the margin was closer still, with 28 senators supporting the legisla-
tion while 16 objected.21 Governor J. Frank Hanly’s signature made the
bill the world’s first eugenic sterilization law. All these legislative mach-
inations provided eugenic reform with a democratic veneer, although
the law passed with virtually no public input and relatively little public
discussion.
T h e I n d i a n a Wa y o f E u g e n i c s â•… · â•… 31
C ha l l e ng e s to t he New Or der
The Indiana law became the benchmark for the rest of the nation. Sup-
porters believed it would allow the state to resolve its “degenerate prob-
lem” and become a national model of social reform. Sharp even wrote
an instructional pamphlet on vasectomy that he distributed around the
country as he gave public talks on the need for sterilization. Sharp’s ex-
pert opinion was sought for testimony in legal cases about sterilization.
“The Indiana Plan, as it was sometimes called, was appealing because it
seemed rational and required no more than an office visit to carry out
the operation.”22
The eugenics cadre worked hard to safeguard their pet reform. To
deflect attention from Sharp’s early extralegal surgeries, W. H. Whittaker
promised Governor Hanley that only inmates sentenced to Jeffersonville
after the law’s passage would be candidates for sterilization. Whittaker
also pledged to use surgery in a “conservative” manner, by establishing
procedures that would ensure that only those prisoners who would actu-
ally benefit from the operation would be considered. Whittaker assured
Hanly that public sentiment favored eugenic sterilization, and he cited
letters he had received.23 But despite these efforts, the law remained vul-
nerable to changes in the political climate.
In 1908, Democrats won control of the statehouse. The new gov-
ernor was Thomas Marshall, a lawyer from Columbia City, who soon
expressed doubts about the law’s constitutionality. Sharp struggled to
protect the law as it faced attack. He crafted guidelines to aid his suc-
cessors at Jeffersonville to continue the sterilization program. 24 Sharp
assured the governor that the law was safe from challenge and that none
of the men he had operated on would sue since there was “no damage
done.” 25
But Marshall also heard from sterilization opponents. One letter he
received from a Plymouth, Indiana, lumberyard owner asked Marshall
to “stop the brutal mutilation of the inmates of the Indiana State insti-
tutions.” Noting the powers of institutional officials, the lumberman
claimed: “It is an easy matter to get the consent of a man when you have
him in your power.” Setting aside Sharp’s entreaties, Marshall ordered a
halt to sterilizations shortly after taking office, and the moratorium lasted
for over a decade.26
32â•… · â•… J a s o n S . L a n t z e r
More than the governor’s misgivings about the law were at work in
halting Indiana sterilizations. Nationally, eugenic sterilization advocates
realized that the number of operations would need to increase dramati-
cally for laws to have the predicted societal impact.27 This would require
expanding the scope of the law to increase the number of people liable
to be sterilized, which would require building support for enhanced leg-
islation at the grassroots level. Additionally, more information must be
gathered on the “feebleminded problem” in the state.
Several states had mounted eugenic surveys meant to assess states’
“mental hygiene” and identify the “feebleminded” in the 1910s. Demo-
cratic governor Samuel Ralston followed this trend in 1915, establishing
the Committee on Mental Defectives (CMD) to study degeneracy in
Indiana. Composed of lawmakers and doctors, the CMD confirmed the
position of the medical community regarding the wisdom of instituting
state eugenic policies. With the aid of New York’s Eugenics Record Of-
fice (ERO) and the U.S. Public Health Service, the committee eventually
classified over 56,000 Hoosiers as prospective candidates for steriliza-
tion because of their feeblemindedness, insanity, or epilepsy.28 Repeat-
edly invoking the “menace of the feebleminded,” the CMD’s surveys
described the state’s problems in such dramatic terms that the otherwise
radical nature of eugenic policies was submerged beneath a rhetoric of
fear. The committee believed that increased state control of relief efforts
was needed to curb local charitable policies that provided an incentive
for multiplication of the “degenerate” classes. Although short-term tax in-
creases might be needed to fund the state bureaucracy that would manage
the feebleminded, the committee claimed that the costs of eliminating
them in future generations would eventually yield savings.29
The CMD published reports in 1918 and 1919, but before its final 1922
report was completed, sterilization seemed to be in jeopardy. At the be-
hest of Republican governor James Goodrich, the law’s constitutional-
ity finally faced a formal challenge. In 1921 Justice Howard Townsend, a
Goodrich appointee, led the Indiana Supreme Court in ruling the 1907
law unconstitutional. The Court decided that denying a public hearing
to inmates who faced sterilization violated the Constitution’s due pro-
cess clause. 30 Despite these policy setbacks, voices arguing for eugenic
solutions continued to be heard. After a decade of popular discussion of
eugenics in the press, in schools, and in churches, most of America was fa-
T h e I n d i a n a Wa y o f E u g e n i c s â•… · â•… 33
miliar with the language of eugenics. The outbreak of the First World War
and concern about the mental fitness of draftees also prompted increased
discussion on the topic. 31 The CMD was only a local manifestation of this
larger national trend.
Although Indiana’s highest court had invalidated the 1907 law, later
in the 1920s sentiment in favor of sterilization again ripened. Senator C.
Oliver Holmes of Gary, a member of the CMD, became sterilization’s new
legislative champion. His hometown newspaper, the Gary Post-Tribune,
advocated a return to sterilization. The paper pointed to the apparently
increasing number of feebleminded people in the state and the taxpayer
expense that their care represented, arguing that mass sterilization rep-
resented the state’s only hope. 32
In 1925, Holmes authored Senate Bill 86, proposing reinstatement of
the sterilization policy and creation of the post of “state eugenicist” to
oversee its widespread enforcement. The proposal encountered problems
shortly after the bill was introduced. Alarmed, Holmes offered amend-
ments that he hoped would mollify the opposition. The Senate voted 31
to 12 in favor of the bill, but the House tabled it. 33 In 1927, Holmes tried
again. While the 1925 bill would have granted the state’s eugenics officer
the authority to sterilize virtually anyone, the 1927 bill authorized only
the sterilization of people in institutions and granted them the right to
a review process. Holmes found willing sponsors for this less expansive
legislation; the Senate passed the bill “with little objection,” 35 to 10.
The House followed the Senate’s lead, passing the bill by a margin of 78
to 8. 34
The restoration of sterilization in Indiana coincided with a larger
national push for new laws that followed Buck v. Bell, one of the most
infamous United States Supreme Court decisions. The majority decision,
written by Justice Oliver Wendell Holmes Jr., placed sterilization of the
feebleminded squarely under the police power of the government’s public
health mandate. The procedure would prevent successive generations
of “imbeciles” from burdening the state and society. 35 But Indiana’s law
was not an echo of Buck’s success; the Supreme Court ruling in Buck oc-
curred after Indiana updated its eugenics law. What happened in Indiana
resulted from success in popularizing and normalizing eugenics. 36
The eugenic message adapted to changing social and political con-
text. Eugenic reforms had overcome initial opposition by blending moral,
34â•… ·â•… J a s o n S . L a n t z e r
M a k i ng t he Law F i t t he Time
The 1927 sterilization law was not Indiana’s final act of eugenic legislation.
Despite general acceptance of eugenic tenets, state-sponsored steriliza-
tion needed consistent revision in the years ahead. In the 1930s, Indiana’s
Democratic governor Paul V. McNutt was urged by advocates to create
“a sterilization law with teeth.” In response to similar entreaties, in the
span of six years the law was updated three times, in 1931, 1935, and 1937.
The House actually passed two different sterilization bills in 1931: one
dealt with the procedure for institutionalizing sterilization candidates;
the other authorized the “sterilization of all persons convicted of com-
mitting a felony in which human life has been threatened.” The Senate
endorsed the first by a margin of 31 to 8 but balked at supporting the latter
measure. 38
In 1935, the House considered a bill crafted by a coalition of urban
and rural representatives that would permit the “sterilization of persons
committed to insane hospitals.” Language borrowed from Harry Laugh-
lin’s 1914 Model Sterilization Act and incorporated into the Virginia stat-
ute upheld in the Buck case was repeated in the bill, which prescribed
eugenic sterilization to prevent reproduction among “probable poten-
tial parents of mentally incompetent or socially inadequate children.” A
court-appointed physician would “certify as to whether he believes the
best interest of society and the individual will be served by sexual ster-
ilization.” While the bill created the right to appeal, it also immunized
officials and doctors involved from being sued for participating in the
process. The bill was sent to the Committee on State Medicine and Public
Health, chaired by a physician who was also one of the sponsors, Horace
R. Willan, of Martinsville in Morgan County. The committee favorably
reported the bill four days later. On March 5, the House passed the bill
61 to 22, with 30 to 9 Senate ratification quickly following. 39 The steriliza-
T h e I n d i a n a Wa y o f E u g e n i c s â•… · â•… 35
tion bill’s easy passage in the upper house can perhaps be explained by
the fate of Senate Bill 304, which had called for “the castration of persons
convicted of certain crimes.” Though this bill had initial support, the
controversial nature of asexualizing criminals engendered lengthy de-
bate and narrow defeat (21–23). The House measure, which eliminated
procreative capacity while leaving sexual function intact, seemed much
more moderate.40
In 1937, Hoosier politicians passed legislation that added epilepsy
and incurable “primary and secondary” types of feeblemindedness to
the list of conditions justifying sterilization. The House passed the two
bills 68–15 and 69–12, respectively; the Senate followed suit by margins of
32–8 and 26–12.41 Only in the 1933 and 1939 legislative sessions did eugenic
reformers fail to amend their laws. In 1933, the House considered two bills
that dealt with sterilization. House Bill 265 called for the sterilization of
criminals in Indiana’s prison system. Although the Committee on State
Medicine and Public Health recommended the bill’s passage, it was even-
tually withdrawn.
In some ways, the Second World War was a reckoning for the Ameri-
can eugenics movement as it came face to face with the horrors of the Nazi
final solution. But in other ways, the 1940s remained an active period for
sterilization advocates in both Indiana and the nation. Indiana’s steriliza-
tion rate hit its highpoints during and just after the war, recording 132, 123,
and 159 procedures in 1940, 1945, and 1946. The three-year total of 414
equaled 26 percent of all people sterilized in Indiana between 1936 and
1962. The war did have an indirect impact: as doctors entered the armed
forces, it was often difficult to find surgeons to perform the procedures—
perhaps explaining the dip between 1940 and 1945.42
Sterilization of criminals suffered a setback in Skinner v. Oklahoma
(1942),43 when the United States Supreme Court struck down a law to
sterilize three-time offenders on “equal protection” grounds. The flaw in
Oklahoma’s law was that white-collar felons were spared surgery, whereas
it was prescribed for petty criminals such as chicken thieves. The Court
doubted the value of eugenics in fighting crime, though its skepticism was
not extended to the sterilization of the “mentally defective.”44
In the post-Skinner environment, the Indiana Senate attempted to
cede all “powers and duties in connection with sexual sterilization” to
the Indiana Council for Mental Health. While the legislation cleared the
36â•… · â•… J a s o n S . L a n t z e r
Senate 43–0, the House sent the bill to its Committee on Social Security,
where it died from inattention.45
In 1951, the legislature adopted new procedures for appealing a ster-
ilization order. Representatives George S. Diener of Marion County and
Betty Malinka of Lake County introduced House Bill 275 to expand the
appeals process to include both the local circuit court and the Indiana
Council for Mental Health. The bill was approved by the House by a vote
of 78 to 10. The Senate also passed it, 32 to 15. On March 5, Democratic
governor Henry F. Schricker signed the bill into law.46 It was the final
amendment of eugenic sterilization procedures in Indiana, and it gave
more rather than fewer rights to patients. By then it was clear that Indiana
lawmakers had gone as far as they were going to go in expanding the reach
of sterilization law. When the House attempted to enlarge sterilization’s
scope in 1955 by extending sterilization to patients in state psychiatric
hospitals, the measure died in committee.47
R epe a l
The law was now functioning primarily under the control of medical pro-
fessionals, a policy that had been urged when Sharp and his cadre first
pushed for a sterilization law. Indiana’s Mental Health Department, cre-
ated in 1945, oversaw the state’s sterilization program. Largely thought
to operate above the political fray, the sterilization board consisted of a
circuit court judge, a doctor in general practice, a doctor who specialized
in the treatment and care of mental diseases, the chief executive officer of
the State Welfare Department, and the chief executive officer of the State
Board of Health. Each member of this bureaucracy was appointed by the
governor. But like most other states, by the late 1950s, Indiana saw fewer
and fewer institutionalized sterilizations. Medical professionals and oth-
ers were starting to question the value of the law.48
In a routine legislative cleanup of the statute books, the state legisla-
ture formally repealed the 1907 sterilization law in 1963, over 40 years after
it was declared unconstitutional.49 Opponents of sterilization would wait
more than 10 years before the remaining sterilization law was repealed.
In 1972 Speaker of the House Otis Bowen was elected governor of
Indiana. Midway through Bowen’s first term in 1974, James Drews, the
representative from LaPorte, Marshall, and Starke counties, authored a
T h e I n d i a n a Wa y o f E u g e n i c s â•… · â•… 37
repeal measure, House Bill 1238. It passed 65 to 29. In the Senate, the bill
was cosponsored by Senators Walter Helmke of Allen and DeKalb coun-
ties and Robert Garton of Bartholomew and Johnson counties, giving it
statewide support. It passed by a margin of 45 to 5. 50 Garton recalled the
repeal process:
My primary recollection of House Bill 1238 . . . was my feeling at the time
that we had made a lot of progress in treating and caring for individuals
who were mentally ill or suffered with epilepsy. I realized the old laws
allowed the superintendent of a mental health institution or hospital to
sterilize patients who were mentally ill or suffering from epilepsy. Even
though the superintendent had to receive approval from the institution’s
governing board, the patient’s legal guardian or next of kin, and a Circuit
Court judge, it was still amazing that sterilization could be considered as
treatment in the best interests of an individual or society. It was equally
surprising that the law was not repealed until 1974. . . . If nothing else, the
repeal of Public Law 60-1974 proved that public sentiment and even ex-
pert advice are sometimes wrong, resulting in unforeseen consequences. 51
No t e s
1.╇ Jason S. Lantzer, Prohibition Is Here to Stay (Notre Dame, Ind.: University of
Notre Dame Press, 2009).
2.╇ Alexandra Minna Stern, “We Cannot Make a Silk Purse Out of a Sow’s Ear”:
Eugenics in the Hoosier Heartland,” Indiana Magazine of History 103 (March 2007):
3–38.
3.╇Diane B. Paul, Controlling Human Heredity: 1865 to the Present (Amherst, N.Y.:
Humanity Books, 1995), 11.
4.╇ Robert M. Crunden, Ministers of Reform: The Progressives’ Achievement in Ameri-
can Civilization, 1889–1920 (Urbana: University of Illinois Press, 1984); La Reine Helen
Baker, Race Improvement of Eugenics: A Little Book on a Great Subject (New York: Dodd,
Mead, 1912), 108–11.
38â•… · â•… J a s o n S . L a n t z e r
20.╇ Journal of the House of Representatives of the State of Indiana, 65th Session of the
General Assembly (Indianapolis: William B. Burford, 1907), 367, 437, 613, 1341–42.
21.╇ Journal of the Indiana State Senate, 65th Session of the General Assembly (India-
napolis: William B. Burford, 1907), 1302, 1317, 1723, 2220.
22.╇ Anderson Herald-Bulletin, February 26, 1996; Harry C. Sharp, “Vasectomy: A
Means of Preventing Defective Procreation” (Jeffersonville, Ind., 1909); Osborn v. Board
of Examiners, 169 N.Y.S. 638 (1918).
23.╇ W. H. Whittaker to Governor J. Frank Hanly, February 8, 1908, “Temporary
File: Governor Marshall Papers in Regards to Sterilization,” Indiana State Archives,
Indianapolis.
24.╇Gugliotta, “‘Dr. Sharp with His Little Knife,’” 396–400.
25.╇Sharp to Marshall, May 13, 1909, Temporary File: Governor Marshall Papers in
Regards to Sterilization, Indiana State Archives.
26.╇ William O’Keefee to Marshall, January 12, 1909, Temporary File: Governor
Marshall Papers in Regards to Sterilization, Indiana State Archives; Jason S. Lantzer
and Alexandra M. Stern, “Building a Fit Society: Indiana’s Eugenics Crusaders,” Traces
of Indiana and Midwestern History 19 (Winter 2007): 4–11.
27.╇ H. E. Jordan, “Surgical Sex-Sterilization: Its Value as a Eugenic Measure,” Amer-
ican Journal of Clinical Medicine 20 (1913): 983–87.
28.╇Lantzer and Stern, “Building a Fit Society”; Robert L. Osgood, “The Menace of
the Feebleminded: George Bliss, Amos Butler, and the Indiana Committee on Mental
Defectives,” Indiana Magazine of History 97 (December 2001): 253–77; Indianapolis Star,
December 7, 1923, May 30, 1928, October 23, 1932, September 27, 1938; Anderson Herald-
Bulletin, February 26, 1996. Members included Dr. S. E. Smith, Dr. Charles P. Emerson,
Dr. George F. Edenharter, and Monsignor Francis H. Gavisk.
29.╇Lantzer and Stern, “Building a Fit Society”; Meetings, December 17, 1915, March
17, 1916, Minutes Committee on Mental Defectives 1915 folder, Committee on Mental
Defectives, Indiana State Archives, Indianapolis; Field Worker Files, Series VII, box
1, Eugenics Record Office Papers, Manuscript Collection 77, American Philosophical
Society Library, Philadelphia; F. D. and F. H. Streighthoff, “Indiana: A Social and Eco-
nomic Survey” (Indianapolis: W. K. Stewart, 1916), 200–203; Anderson Herald-Bulletin,
February 26, 1996.
30.╇George A. H. Shideler to Governor James P. Goodrich, September 9, 1919,
folder 2, box 159, Indiana Reformatory Correspondence, Documents and Reports,
Papers of Governor James Goodrich, Indiana State Archives; Williams v. Smith, 190
Ind. 526 (1921).
31.╇ Rosen, Preaching Eugenics, 94–96, 111, 149.
32.╇ Meeting, August 8, 1924, Minutes Committee on Mental Defectives 1915 folder,
Committee on Mental Defectives, Indiana State Archives, Indianapolis; Gary Post-
Tribune, February 3, 1925.
33.╇ Journal of the Indiana State Senate, 74th Session of the General Assembly (India-
napolis: William B. Burford, 1925), 92, 197–98, 203, 321, 330–31, 394, 537–38; Indianapolis
Star, February 24, 1927; Journal of the House of Representatives of the State of Indiana, 74th
Session of the General Assembly (Indianapolis: William B. Burford, 1925), 452–53, 604.
34.╇ Indianapolis Star, February 24, 1927; Journal of the Senate of the State of Indiana,
75th Session of the General Assembly (Indianapolis: William B. Burford, 1927), 285, 356,
40â•… · â•… J a s o n S . L a n t z e r
618, 1018; Journal of the House of Representatives of the State of Indiana, 75th Session of the
General Assembly (Indianapolis: William B. Burford, 1927), 565, 601, 842.
35.╇ Buck v. Bell, 274 U.S. 200 (1927); Paul A. Lombardo, Three Generations, No Imbe-
ciles: Eugenics, the Supreme Court, and Buck v. Bell (Baltimore: Johns Hopkins Univer-
sity Press, 2008).
36.╇Daniel J. Kevles, In the Name of Eugenics: Genetics and the Uses of Human Hered-
ity (New York: Alfred A. Knopf, 1985), 61–63.
37.╇ Wendy Kline, Building a Better Race: Gender, Sexuality and Eugenics from the
Turn of the Century to the Baby Boom (Berkeley: University of California Press, 2001),
98–99, 107; New York Times, June 21, 1932.
38.╇ Indianapolis Star, February 3, 1931; Journal of the House of Representatives of
the State of Indiana during the 77th Session of the General Assembly (Ft. Wayne, Ind.: Ft.
Wayne Printing Co., 1931), 173, 229, 259, 386, 569; Journal of the Senate of the State of Indi-
ana during the 77th Session of the General Assembly (Ft. Wayne, Ind.: Ft. Wayne Printing
Co., 1931), 477, 695, 717.
39.╇ Indianapolis Star, February 23, 1935; Journal of the House of Representatives of
the State of Indiana during the 79th Session of the General Assembly (Ft. Wayne, Ind.: Ft.
Wayne Printing Co., 1935), 694, 770, 1082.
40.╇ Journal of the Senate of the State of Indiana during the 79th Session of the General
Assembly (Ft. Wayne, Ind.: Ft. Wayne Printing Co., 1935), 702, 931, 1025, 1027, 1059, 1068,
1221, 1302.
41.╇ New York Times, March 9, 1937; Journal of the House of Representatives of the State
of Indiana during the 80th Session of the General Assembly (Ft. Wayne, Ind.: Ft. Wayne
Printing Co., 1937), 165, 489–90; Journal of the Senate of the State of Indiana during the
80th Session of the General Assembly (Ft. Wayne, Ind.: Ft. Wayne Printing Co., 1937),
1191–92, 1215.
42.╇ “Eugenic Sterilization in Indiana,” Indiana Law Journal 38 (1962–63): 288;
Philip R. Reilly, The Surgical Solution: A History of Involuntary Sterilization in the United
States (Baltimore: Johns Hopkins University Press, 1991), 129.
43.╇ Skinner v. Oklahoma, 316 U.S. 535 (1942).
44.╇See generally Victoria F. Nourse, In Reckless Hands: Skinner v. Oklahoma and
the Near-Triumph of American Eugenics (New York: Norton, 2008).
45.╇ Journal of the Senate of the State of Indiana during the 86th Session of the General
Assembly (Indianapolis: Bookwalter, 1949), 247, 413.
46.╇ Journal of the House of Representatives of the State of Indiana during the 87th Ses-
sion of the General Assembly (Indianapolis: Bookwalter, 1951), 222–23, 529, 633–34, 710,
974, 1051; Journal of the Senate of the State of Indiana during the 87th Session of the General
Assembly (Indianapolis: Bookwalter, 1951), 522, 547, 586–87, 672–73, 747.
47.╇ Journal of the Senate of the State of Indiana during the 89th Session of the General
Assembly (Indianapolis: Bookwalter, 1955), 833; Journal of the House of Representatives of
the State of Indiana during the 89th Session of the General Assembly (Indianapolis: Book-
walter, 1955), 328, 910–11.
48.╇ C. O. McCormick, “Is the Indiana 1935 Sterilization of the Insane Act Function-
ing?” Journal of the Indiana State Medical Association 42 (September 1949): 919–20.
49.╇ Journal of the House of Representatives of the State of Indiana, 93rd Session of the
General Assembly (Indianapolis: Hollenbeck, 1963), 264, 273–74; Journal of the Senate
T h e I n d i a n a Wa y o f E u g e n i c s â•… · â•… 41
of the State of Indiana, 93rd Session of the General Assembly (Indianapolis: Hollenbeck,
1963), 58, 167, 499.
50.╇ Journal of the House of Representatives of the State of Indiana during the 98th Ses-
sion of the General Assembly, 32, 129, 803; Journal of the Senate of the State of Indiana during
the 98th Session of the General Assembly 310, 332, 348, 686.
51.╇ Hon. Robert Garton to author, August 14, 2006 (copy in author’s possession).
52.╇ Hon. Otis R. Bowen to author, September 28, 2005 (copy in author’s posses-
sion); Otis R. Bowen, Doc: Memories from a Life in Public Service (Bloomington: Indiana
University Press, 2000).
53.╇ Laws of the State of Indiana 1974 (Indianapolis: Central Publishing Co., 1974),
262; Laws of the State of Indiana 1975 (Indianapolis: Central Publishing Co., 1975), 738;
Stern, “We Cannot Make a Silk Purse Out of a Sow’s Ear,” 3–38, 182–210.
Pa r t t wo
Pau l A . L om b a r d o
E ug e n ic s a n d P opu l a r C u lt u r e
From the first decade of the twentieth century until approximately 1940,
eugenics was a word that most Americans could expect to encounter regu-
larly. Important citizens made the term respectable, and repetition by
schoolteachers, doctors, politicians, and preachers made it an expansive
term of reference and eventually a part of popular culture. Mentions of
“the well-born science” were common in newspapers and popular maga-
zines, in novels, movies, and plays. Yet there was no universal, uniform
definition for eugenics; the term encompassed everything from proud
pedigrees to healthy births. Over time the invocation of “eugenics” be-
came almost clichéd, as it was employed to signal approval for a wide va-
riety of public policy initiatives. By the time a Chicago politician decided
in 1915 to run for alderman as “the eugenic candidate,” the term had come
to stand for “not just ‘good heredity’ but goodness itself.”1
In recent years, historians of American literature and popular culture
have identified how pervasive eugenic language and themes became in
the first third of the past century. 2 As a result of this scholarship, allusions
to eugenics in the novels of F. Scott Fitzgerald or its satiric invocation
by Sinclair Lewis or Ernest Hemingway are no longer unusual. 3 While
such references have increased, fiction writers are rarely credited with
affecting the passage of law. One underexplored link in the history of
eugenics concerns just such a relationship between the Georgia steriliza-
tion law, passed in 1937, and Georgia native son Erskine Caldwell. Both
the personal and literary dimensions of Caldwell’s life were touched by
45
46â•… · â•… Pa u l A . L o m b a r d o
E ug e n ic s i n Ge org i a
The political history of the sterilization movement in the South was ana-
lyzed in detail by Edward Larson in Sex, Race, and Science, a work that
placed Georgia in the context of several “Deep South” states that took
up eugenics. 5 More recently, scholars such as Karen Keely and Betty Nies
have described the intersection of popular culture and eugenics, focus-
ing on themes in the work of novelists like Erskine Caldwell.6 This essay
builds upon the insights of those scholars, linking the popular to the
political and showing that while Georgia seemed slow to adopt eugenic
legislation, it nevertheless was in the forefront among states where “eu-
genics” was a familiar topic and a mainstay of popular culture. Voices
from the press and the pulpit explored the eugenic value of vital statistics
and public health, the proper place of eugenics in the schools, the eu-
genic importance of “fitter families,” and the place of eugenic themes in
entertainment. Those voices were heard alongside the more commonly
remembered, but later articulated, arguments for marriage restriction
laws to protect “racial integrity” or laws to impose sterilization on the
“unfit” in the name of eugenics. This survey of eugenics in Georgia culmi-
nates in an account of Erskine Caldwell’s role in the sterilization debates
in the 1930s.
From the first years of the twentieth century, news reports focusing
on eugenics in Georgia were extensive. Georgians learned that classes
on eugenics would be part of the National Corn Exposition in 1913 and
that a “department of eugenics” was a critical need within the planned
Child Welfare Exhibit in Atlanta that year.7 When the 1914 Better Ba-
bies show proved a “splendid success,” leaders of the Women’s Christian
Temperance Union saw it as the “first step toward eugenics in Atlanta”
and predicted that the capital city would be the “pioneer southern city” to
embrace the new science.8 Not everyone welcomed the “wave of agitation
over eugenics” that America was experiencing, and some felt that religion
was being displaced by a materialistic fetish.9
F r o m B e t t e r B a b i e s t o t h e B u n g l e r s â•… · â•… 47
E ug e n ic M a r r i ag e : M e dic a l Ce r t i f ic at e s
But it was hard to escape popular curiosity about eugenics when even
baseball-star-turned-preacher Billy Sunday used it to emphasize inter-
generational guilt as part of his “sins of the fathers” evangelism.12 The
language of eugenics boosters, mixing nineteenth-century degeneration
theory with the newest in Mendelian heredity and Galtonian biometry,
provided a convenient shorthand for attacking drunkenness, sexual ex-
cess, and socially problematic behaviors of all kinds.
One legislator declared himself a believer in eugenics after seeing
Damaged Goods, a film billed as a lesson of “sin’s consequences” that
played in Atlanta to record crowds.13 Describing the movie as a “won-
derful sermon,” Colonel Walter Andrews was converted to the need for
“strong laws upon the subject of eugenics.” He planned to introduce a
bill to require a syphilis test and a medical certificate as a requirement of
marriage licensing “for the sake of future generations.”14
When legislation to require a “bill of clean health” of men before
marriage was proposed, it generated great controversy. One lawmaker
objected that there was “entirely too much reformatory legislation” be-
ing introduced. He resisted making couples dependent on the medical
profession and “quack doctors” who had no scruples about issuing bogus
medical certificates.15 When an amendment was offered to extend the
scope of required testing to women, the bill died after two days of de-
bate.16 Similar measures designed to protect “the children of tomorrow”
were rejected in 1921, 1923, and 1924, often following attempts to expand
the required health tests to women.17 The Georgia Medical Society of-
fered yet another bill in 1928.18 But like other attempts to enact mar-
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To most Georgians living at the turn of the twentieth century, white su-
premacy was a settled reality. There was, however, always the threat that
the “supremacy of the Caucasian” could be undermined in the future by
“degrading strains of alien blood.” Even though southern states main-
tained antique laws of racial separation, most having been adopted during
the colonial era, the need to be vigilant in forestalling the “unspeakable
evils that would follow race amalgamation” was an issue revisited regu-
larly. Some even called for national laws to penalize racial interbreeding
or “miscegenation.”20 Comparing interracial relations to polygamy, con-
cerned Georgians argued that just as the Mormons had been forced by
federal courts to give up plural marriage, Congress could stop race mixers
by passing national legislation.21
Members of Georgia’s medical profession joined their colleagues
elsewhere and argued for racial separation by linking public health and
eugenics. An infrastructure for more stringent “racial integrity” enforce-
ment was created with the passage of Georgia’s public health and vital
statistics laws in 1914. Regularly maintained records of birth, death, and
marriage provided the framework for tracking data on race and doubled
as a way to emphasize the importance of keeping the “germ-plasm” of
F r o m B e t t e r B a b i e s t o t h e B u n g l e r s â•… · â•… 49
The Davis Racial Integrity Bill was introduced in the 1925 Georgia
legislative session. Although it passed the House of Representatives, it
reached the Georgia Senate too late for serious consideration and failed to
pass. In 1927, the next full legislative year, Davis shepherded the bill suc-
cessfully through the process and eventually had the pleasure of report-
ing to Powell and Cox that it enjoyed unanimous support in the Senate,
attracted only three negative votes in the House, and had been signed
into law by the governor. 30 Eugenics lent a scientific gloss to legislation to
uphold “racial integrity” in Georgia, but its ultimate effect was merely to
support existing social relations and bolster a culture of white supremacy.
Proposals to enact sterilization laws for eugenic purposes were more radi-
cal. Their supporters eventually overcame opposition by amplifying fears
of spreading degeneracy and inflating concerns about the moral, social,
and economic threats of crime and mental defect.
The P ol i t ic s of S u rg e r y: C u t t i ng
Co s ts a n d C u t t i ng Pat i e n ts
The first stirrings of interest about a sterilization law for Georgia appeared
in the 1912 comments of a physician at the Milledgeville State Asylum
speaking on “Sterilization: The Only Logical Means of Retarding the
Progress of Insanity and Degeneracy.”31 Within a year, Georgia physi-
cians took up the cry for state-sponsored sterilization. Their concern was
focused on increasing numbers of the “criminally insane, idiots, rapists
or moral degenerates” lodged in state institutions, and their bill was ad-
vanced by a physician/legislator as “a wise and humane” version of “sci-
entific legislation.”32
Declaring that “heredity governs the development of the human race,”
Dr. W. L. Champion urged his legislative colleagues to “safeguard the
inÂ�terests of the unborn” and guarantee “the priceless heritage of physical
perfection and masterful mind” to future generations. He argued that
“confirmed criminals” and rapists should be castrated. 33 But as with ear-
lier attempts at eugenic lawmaking, some criticized mandatory surgery,
calling it “premature faddism” and “hair-trigger” experimentation. 34 The
bill failed.
Proclaiming the “medical gospel,” one doctor declared eugenic ster-
ilization the centerpiece of the movement for public health laws. Holy
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Scripture demanded eugenics laws, he said, “so that the creature of the
future may be a better specimen of manhood and womanhood; that there
may be fewer inebriates and cripples, that our alms houses, hospitals,
penitentiaries, chain gangs and asylums may have fewer inmates, and that
our streets may be free of beggars and perverts.”35
Since the next best thing to sterilization was segregation of the “unfit”
to contain their fertility, some pressed for more extensive use of intel-
ligence tests in the public schools to identify “feebleminded children”
and place them in state institutions.36 Soon there was lobbying for an
institution to house mentally deficient children. Institution building was
expensive, but supporters were quick to point out that the cost of housing
was less than the cost of caring for criminals who would be the inevitable
children of “defectives” living at large. Provision for the feebleminded was
sold as a step in the battle against crime. 37
In a series of essays printed in the Atlanta Constitution, the superin-
tendent of Georgia’s Gracewood Training School for Mental Defectives
reemphasized the need to identify and segregate feebleminded people
living in the community. Repeating conventional wisdom among eu-
genicists, he argued that feebleminded girls were the source of venereal
disease and illegitimacy, that more than 40 percent of prostitutes were
feebleminded, and that “30 percent of the children in orphanages were
defective.”38 The social costs generated by the feebleminded were the
lynchpin of his argument for institutionalization. He said that money was
wasted on attempting to rehabilitate defectives in reformatories, or trying
to educate the defective in schools, yet too little money had been spent to
maintain or expand the state facility that would—by quarantining defec-
tives and preventing their mating—represent a step in preventing those
costs. 39 Society should look at the “occasional fool” not as a curiosity
that each community should tolerate but as an “active, dynamic enemy
to the community life, who goes on propagating his kind with terrible
fertility, corrupting the law, morals and health of society, never paying
his way, and always living at the expense of others.”40 But the ultimate
preventative, embodied in a eugenic sterilization law, remained elusive
to Georgia’s eugenic reformers. By 1929 more than 20 states had adopted
sterilization laws; that same year the Georgia State Asylum was carrying
a deficit of almost $2.5 million. As the budget shortfall was announced, a
sterilization law was proposed.41 But again, it failed to pass. Three years
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later, the Georgia Medical Society offered another sterilization bill. It in-
cluded provisions for appointment of a medical board that would choose
candidates for sexual surgery.42 It also failed.
The year 1932 was the deepest point of economic crisis for most of the
United States. Although the cloud of worldwide depression settled over
Georgia earlier and lasted longer than it would for the rest of the country,
serious consideration of sterilization in Georgia did not gain traction un-
til most other states already had sterilization laws. Perhaps at first Georgia
lawmakers were unconvinced by the eugenicists’ apocalyptic vision; per-
haps voters did not favor drastic medical interventions—even upon the
most marginal citizens. But when those convictions finally changed, at
least part of the reason for the popular acceptance of sterilization in Geor-
gia was due to the controversy engendered by novelist Erskine Caldwell,
a Georgia native.
Caldwell’s father, Ira, was a teacher and a Presbyterian minister who also
worked as a journalist. Beginning in 1926, he wrote a weekly column for the
Augusta Chronicle in which he invited his readers to consider the issues of
the day. “Let’s Think This Over” became a regular feature of the paper, and
as Erskine Caldwell’s reputation as a writer matured, the senior Caldwell
developed a following of his own, writing about topics as varied as lynch-
ing, the chain gang, and high interest rates. He invariably took the position
of social progressive, a bold posture from his home in rural Georgia.
In 1929, Dr. John Bell spoke to the national meeting of the American
Psychiatric Association in Atlanta. Bell was well known for his victory in
the famous U.S. Supreme Court case of Buck v. Bell, which had settled the
constitutionality of eugenic sterilization laws. Bell’s talk, advocating the
sterilization of epileptics, was reported in the press.43 Only a week later,
Ira Caldwell raised “The Eugenics Question” in his column. He doubted
the value of eugenic sterilization, noting that some state experiments in
surgery were launched with the expectation that “the race could be lifted
to higher levels of intelligence” by surgery on “the mentally deficient.”
Caldwell claimed that new research showed many less promising children
had been born of prosperous parents, calling into question the surgical
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About the time the furor over Tobacco Road was settling, an article
appeared below a banner headline in the Atlanta Sunday paper. It ex-
plained that sterilization would be one of the major legislative objectives
of the Medical Association of Georgia for the year, and the program was
described by the Association’s president, Dr. Charles H. Richardson.
Richardson repeated the claim that institutional care for social defec-
tives was too expensive. The proposed law could eventually “save the
government a billion dollars a year.” Doctors who supported the pro-
posal wanted a commission of their colleagues to decide who would be
sterilized. “I would not be in favor of sterilization should it be within
the power of politicians to control any part of it,” said Dr. W. E. Barber,
a former president of the Fulton County Medical Society. Finding a
German example he hoped to emulate, another medical society spokes-
man proclaimed that the “sterilization project of Hitler in Germany is
a step in the right direction.” While the recent Nazi government enact-
ment “might seem a bit drastic on the surface,” he said, “it is being used
wisely,” and it actually was less expansive than sterilization laws in some
American states. 55
Doctors who initiated the sterilization campaign conceded that the
lay public might be able to do a better job of swaying legislators than the
professional men had. 56 To that end, Emory University biologist Robert C.
Rhodes lectured Rotarians and Masons about eugenics, calling steriliza-
tion a “matter of good citizenship.”57 Momentum built for the measure as
members of the Georgia Humane Society also pressed for a state steriliza-
tion law. 58 These pleas gained added force as the state cut back on funds for
institutionalization. E. E. Lindsey, chairman of the State Board of Control
for Charitable Institutions, announced that because of reduced state rev-
enue, there would be a 25 percent reduction in the budget appropriation for
his agency. That cut came despite the fact that “mental deficiency appear[s]
to be on the increase.” Lindsey identified sterilization as the best “means
of checking the rapid increase in insanity.” In Georgia, like other states,
sterilization was seen as a budget management, cost-cutting measure. 59
Lindsey argued that sterilizing institutional patients would help “to reduce
the burden of taxation.”↜60 Driving the point home, Lindsey emphasized
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that hereditary defects were a “financial problem for the state government
and the taxpayers.”↜61
While the campaign for sterilization in Georgia grew, Erskine Cald�
well was living in New York. Caldwell’s novel Tobacco Road had been
adapted for the stage and had been playing on Broadway for two years
when he wrote a newspaper series documenting the poverty he had por-
trayed in his fiction. The New York Post published his four articles, begin-
ning with a scene of a “poverty-swept” Georgia landscape, where “chil-
dren are seen deformed by nature and malnutrition, women in rags beg
for pennies, and men are so hungry that they eat snakes and cow-dung.”
According to Caldwell, the state stood idly by providing no relief as rural
citizens starved. Caldwell characterized Governor Eugene Talmadge as
a “dictator” who did not believe in “relief.” Caldwell charged that city-
dwelling Georgians denied the existence of the naked denizens of the
rural areas and their “deformed, starved, and diseased” children. 62
A subsequent Caldwell article decried the economic exploitation of
rural laborers under the oppressive sharecropping system that often re-
sulted in debt peonage.63 Other Caldwell dispatches portrayed teenage
girls dying from anemia and tenant farmers beyond the reach of govern-
ment relief.64 Caldwell’s final essay was the coup de grace. He described a
two-room house populated by three families of farm laborers. One small
child, afflicted with rickets and anemia, licked an empty paper bag that
held only the smell of its previous contents—hog fat. His belly was swol-
len with malnutrition; “he was starving to death.” In the other room, two
infants lay on the floor in front of the fire. With no other sustenance, they
attempted to nurse from the family dog, repeatedly returning to suck “the
dry teats of a mongrel bitch.”↜65
Caldwell had weathered earlier criticism from Georgians for his por-
trayal of life in his native South in novels like God’s Little Acre and To-
bacco Road. During occasional visits to family, the local press grudgingly
acknowledged him as “a writer of considerable note” who had “carved
himself a niche in the literary hall of fame.”↜66 But when reports of his new
crusade as muckraking reporter reached his home state, the locals took
great offense. Declaring Caldwell’s account “untrue” and “unfounded,”
they demanded an investigation of conditions in Jefferson County to
disprove Caldwell’s libelous portrait. Georgia boosters, “incensed” over
Caldwell’s “sordid tale of squalor and depravity,” rose to defend their
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in our great social problem.” 76 The bill created a state board of eugenics
and allowed superintendents of state asylums to recommend candidates
for sterilization. A final amendment also allowed chain gang wardens to
name cases for surgery.77
Not everyone agreed with the legislation. The New Republic followed
the Caldwell flap and congratulated the Augusta Chronicle on its “entire
truthfulness” in investigating local conditions. The review proved that
“there are Jeeter Lesters in the world and that something should be done
to remedy the conditions under which they are forced to live.” 78 Address-
ing rural conditions rather than the reproductive potential of the poor
seemed the best course to other outside observers. But back in Georgia
the Atlanta Constitution saluted the sterilization measure, saying it ap-
pealed to “the common sense and reason of the people.” The newspaper
also quoted the newly deceased Oliver Wendell Holmes Jr., whose famous
epigram a decade earlier signaled Supreme Court endorsement of eugenic
sterilization: “Three generations of imbeciles are enough.”79 Deep South-
erners seldom accorded such tribute to the opinions of former officers of
the Grand Army of the Republic.
Although the legislature had adopted the sterilization bill, in a pique
of partisan revenge, Governor Eugene Talmadge refused to sign it. Turn-
ing to Adjutant General Lindley W. Camp, Talmadge said: “Lindley, you
and I might go crazy some day and we don’t want them working on us.”80
His quip underscored the personal rather than policy concerns prompt-
ing his veto. The sterilization bill was only one of the more than 165 other
bills Talmadge vetoed that session.
Talmadge’s veto “turned back the hands of the clock,” declared the
Augusta Chronicle. The veto was one of the governor’s “most egregious
mistakes,” and it “struck a blow in behalf of illiteracy, degeneracy, imbe-
cility, insanity and crime.”81 Surely the governor’s spite was out of step
with the best southern traditions and most forward-looking boosters’
hopes. But in neighboring Alabama, Governor Bibb Graves also vetoed a
sterilization bill that year, while to Georgia’s northeast, a bill introduced
by freshman South Carolina state legislator Strom Thurmond became
law.82 Sterilization, it seemed, was an issue intensely sensitive to local
context.
After the veto of the Georgia sterilization law, Caldwell further in-
flamed local opinion when his 1935 dispatches from Georgia were collected
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medicine to “wipe out their malaria” and had access to “clean and sturdy
houses surrounded by a few fertile acres,” they could “lift themselves out
of their dilemma,” Caldwell argued.92
By then Tobacco Road had found a new incarnation as a movie, and
the senior Caldwell acted as tour guide to Hollywood filmmakers who
visited the region looking for authentic settings for the film.93 With an eye
to a possible windfall for the local economy, the people of eastern Geor-
gia seemed to forget their irritation with Erskine Caldwell. The Augusta
Merchants Association endorsed plans to bring the world premiere of the
movie to town.94 The local paper felt the “violent controversy” had passed
and there would be no protest.95
But the flap was hardly over. Some theater patrons were disappointed
that the film had been stripped of the salty language that provided such
scandal in the book and the play.96 On the other hand, the mayor of Au-
gusta complained that it was “the most degrading and unwholesome film”
he had ever seen. Perhaps more important, it portrayed his city as a small
“backwoods community” rather than the bustling metropolis of more
than 100,000 souls that it now was. Although he instructed the city at-
torney to sue the movie producers for $500,000 for their slanderous por-
trayal of Augusta, Caldwell apparently did not take the threat seriously,
and nothing came of the lawsuit.97 Erskine Caldwell, known for so long
as the narrator for the “unwashed, unshaved, unclothed, uneducated, and
unintelligent white trash of a poverty stricken district,” left the “vermin-
ous Georgia loafers” of Tobacco Road behind.98
No evidence remains of a federal response to Ira Caldwell’s pleas;
he died a few years later just as World War II was coming to an end, with
the country in the middle of its long climb out of the Great Depression.99
During the next three decades, some 3,300 Georgians endured surgery
under Georgia’s sterilization law. Though it was in place only 33 years, in
a tally of surgical statistics, Georgia ranks fifth among all states in the to-
tal number of eugenic operations. Between 1950 and 1960, approximately
200 involuntary operations occurred every year at the state’s mental hos-
pital. In 1959 a Pulitzer Prize–winning investigative series revealed that
sterilizations at Georgia’s Central State Hospital had been performed
routinely on any patient of childbearing age and that the surgeries were
often done not by a doctor but by a nurse. An advisory committee later
recommended that all eugenic sterilizations be discontinued.100
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No t e s
1.╇ Martin Pernick, The Black Stork: Eugenics and the Death of “Defective” Babies in
American Medicine and Motion Pictures since 1915 (New York: Oxford University Press,
1996), 54.
2.╇Some studies that have highlighted eugenic themes in literature are Donald
J. Childs, Modernism and Eugenics: Woolf, Eliot, Yeats, and the Culture of Degeneration
(Cambridge: Cambridge University Press, 2001); Daylanne K. English, Unnatural Selec-
tions: Eugenics in American Modernism and the Harlem Renaissance (Chapel Hill: Uni-
versity of North Carolina Press, 2004); Sylvia J. Cook, “Modernism from the Bottom
Up,” in Reading Erskine Caldwell: New Essays, ed. Robert L. McDonald (Jefferson, N.C.:
McFarland, 2006); and Karen Ann Keely, “The Pure Products of America: Eugenics and
Narrative in the Age of Sterilization” (Ph.D. diss., UCLA, 1999).
3.╇Among the most cited popular fiction that includes references to eugenics
are Sinclair Lewis, Main Street (1920), Babbitt (1922), and Arrowsmith (1925); F. Scott
Fitzgerald, The Great Gatsby (1925); and Ernest Hemingway, Torrents of Spring (1926).
Fitzgerald began his references to eugenics as a student at Princeton, where he wrote
the lyrics for a ditty entitled “Love or Eugenics” for a Triangle Club production. Banned
from participating in the play due to poor academic performance, Fitzgerald appeared
in drag, dressed as a chorus girl. See F. Scott Fitzgerald, Fie! Fie! Fi-Fi! A Facsimile of
the 1914 Acting Script and Musical Score (Columbia: University of South Carolina Press,
1996).
4.╇ This connection is suggested, for example, in Dan B. Miller’s biography Erskine
Caldwell: The Journey from Tobacco Road (New York: Alfred A. Knopf, 1995), 219.
5.╇ Edward J. Larson, Sex, Race, and Science: Eugenics in the Deep South (Baltimore:
Johns Hopkins University Press, 1995).
6.╇ Karen A. Keely, “Poverty, Sterilization, and Eugenics in Erskine Caldwell’s
Tobacco Road,” Journal of American Studies 36 (2002): 23–42; Betsy L. Nies, “Defending
Jeeter,” in Popular Eugenics: National Efficiency and American Mass Culture in the 1930s,
ed. Susan Currell and Christina Cogdell (Athens: Ohio University Press, 2006), 120–39.
7.╇ W. E. Gonzales, “National Corn Exposition and Its Big Meaning,” Atlanta Con-
stitution, January 25, 1913; “Need of Child Welfare Exhibit Is Arousing Much Interest,”
Atlanta Constitution, September 21, 1913.
64â•… ·â•… Pa u l A . L o m b a r d o
8.╇ “Eugenics for Atlanta Is Strong Prediction,” Atlanta Constitution, November 19,
1914.
9.╇A. T. Spaulding Jr., “How Mendel’s Laws Discredit Eugenics,” Atlanta Constitu-
tion, March 9, 1914. The Better Babies gave way to the more formally organized Fitter
Family contests run by the American Eugenics Society. In 1924, an important year for
Georgia eugenics, the family of a school principal took the gold medal at the Fitter Fami-
lies contest at the Georgia State Fair. See “School Principal and Family Take Fair Top
Honors,” Savannah Press, November 6, 1924.
10.╇ “Britain Is Opposed to Eugenics in Schools,” Atlanta Constitution, January 9,
1914.
11.╇ “No Eugenics in Schools,” editorial, Atlanta Constitution, January 11, 1914.
12.╇ Paul Jones, “Governor and Mayor Are Lauded by Sunday,” Atlanta Constitution,
November 5, 1917.
13.╇ “Damaged Goods,” Atlanta Constitution, January 8, 1916.
14.╇ “Walter Andrews Now Believer in Eugenics,” Atlanta Constitution, January 2,
1916.
15.╇ “Eugenics Bill Bitterly Fought by Senator Kea,” Atlanta Constitution, July 13, 1920.
16.╇ “Kill Marriage Bill after Two Day Fight: Senators Defeat Bill Requiring Certifi-
cate of Health before Issuance of License,” Atlanta Constitution, July 14, 1920.
17.╇ “Eugenics Bill Rejected,” Washington Post, August 2, 1921; “Kennedy Offers
Eugenics Bill,” Atlanta Constitution, July 7, 1923; “Legislators Open Determined Plan to
Clear Slate,” Atlanta Constitution, July 20, 1924.
18.╇ Journal of the Medical Association of Georgia 17 (1928): 308–309.
19.╇ Ellis Parker Butler, “Suzanne on Race Tinkering,” Atlanta Constitution, June 7,
1914.
20.╇ “Racial Integrity as a National Question,” editorial, Atlanta Constitution, Febru-
ary 7, 1907.
21.╇ “Racial Marriage a National Problem,” editorial, Atlanta Constitution, August
21, 1908.
22.╇ “The Two Go Hand in Hand,” editorial, Atlanta Constitution, June 21, 1914.
23.╇ “The Public Health Bill,” Atlanta Constitution, July 12, 1914.
24.╇ Paul A. Lombardo, “Miscegenation, Eugenics & Racism: Historical Footnotes
to Loving v. Virginia,” University of California, Davis Law Review 21 (1988): 422–52.
25.╇ Walter A. Plecker to Rev. Wendell White, May 10, 1924, E. S. Cox Papers, Duke
University [hereafter Cox Papers].
26.╇ James C. Davis to John Powell, May 25, 1925, John Powell Papers, University of
Virginia [hereafter Powell Papers].
27.╇ “Appeal Is Made to Keep Blood of Whites Pure,” Atlanta Constitution, February
13, 1924.
28.╇ Powell to Davis, May 30, 1925, Powell Papers.
29.╇Sam W. Small, “Wide Interest Is Aroused in Racial Integrity Bill,” Atlanta Con-
stitution, June 28, 1925.
30.╇Davis to Powell, August 22, 1927, Powell Papers.
31.╇Dr. G. I. Garrard, cited in Peter G. Cranford, But for the Grace of God: The Inside
Story of the World’s Largest Insane Asylum, Milledgeville! (Augusta, Ga.: Great Pyramid
Press, 1981), 68.
F r o m B e t t e r B a b i e s t o t h e B u n g l e r s â•… · â•… 65
32.╇ “Doctors of Georgia Plan Bill for Sterilization of the Criminally Insane,” At-
lanta Constitution, April 18, 1913; “A Worthy Measure,” Atlanta Constitution, May 30, 1913.
One out-of-state advocate of eugenic surgery described the operation as the solution for
the “vexing negro problem.” Since more than 50 percent of all convicted criminals are
blacks, he said, sterilization of the prison population would necessarily apply primarily
to that group. “Declares Sterilization Is Solution of Negro Problem,” Atlanta Constitu-
tion, April 20, 1913.
33.╇ W. L. Champion, “Sterilization of Confirmed Criminals, Idiots, Rapists, Feeble-
Minded, and Other Defectives,” Journal of the Medical Association of Georgia 3 (1913): 112–
14, at 113.
34.╇ “Remaking the Universe,” Atlanta Constitution, June 28, 1914.
35.╇ W. B. Hardman, “The Medical Gospel of the Twentieth Century,” Journal of the
Medical Association of Georgia 4 (1914): 71–75.
36.╇ “Anderson Urges Mentality Tests,” Atlanta Constitution, March 30, 1919.
37.╇ “The Feebleminded,” Atlanta Constitution, June 2, 1919.
38.╇ “The Cost of Feeblemindedness,” Atlanta Constitution, May 29, 1922.
39.╇ “Financial Aspect of Feeblemindedness,” Atlanta Constitution, May 31, 1922.
40.╇ “What Feeblemindedness Means to the Community and What the Community
Can Do to Protect Itself,” Atlanta Constitution, June 4, 1922.
41.╇ “State Sanitarium Short of Funds,” Augusta Chronicle, April 18, 1929.
42.╇ “State Legislation,” Journal of the Medical Association of Georgia 21 (1932): 335.
43.╇ “Sterilization of Epileptics Urged,” Augusta Chronicle, May 14, 1929.
44.╇I. S. Caldwell, “The Eugenics Question,” Augusta Chronicle, May 20, 1929; I. S.
Caldwell, “Are We Going Up or Down?” Augusta Chronicle, December 5, 1929.
45.╇ Miller, The Journey from Tobacco Road, 125.
46.╇I. S. Caldwell, “The Bunglers: A Narrative Study in Five Parts,” Eugenics 3 (1930):
202–10 (part 1); 247–51 (part 2); 293–99 (part 3); 332–36 (part 4); and 377–83 (part 5).
Comment on “quicksands of ignorance” on 295.
47.╇Ibid., 207.
48.╇Ibid., 332.
49.╇Ibid., 383.
50.╇R. J. Terry, “Robert Bennett Bean, 1874–1944,” American Anthropologist, n.s.,
48 (1946): 70–74; Miller, The Journey from Tobacco Road, 77. (Miller mistakenly thought
Caldwell had studied with Bean’s son, William.)
51.╇ Erskine Caldwell, Call It Experience: The Years of Learning How to Write (New
York: Duell, Sloan and Pierce, 1951), 34–35.
52.╇ Erskine Caldwell, “Georgia Cracker,” Haldeman-Julius Monthly 4 (November
1926): 39–43, at 41.
53.╇Caldwell, Call It Experience, 81.
54.╇See, for example, “Erskine Caldwell: Phenomenon,” Gastonia (N.C.) Daily GaÂ�
zette, March 2, 1935 (“a notch above the filthy little sex booklets”; “nice picking for the
literary rag man”; designed for “the entertainment of sex-greedy filth scavengers”).
55.╇ “Atlanta Doctors to Drive for Sterilization,” Atlanta Constitution, February 4,
1934.
56.╇ “Report of the Committee on Public Policy and Legislation,” Journal of the
Medical Association of Georgia 23 (1934): 304.
66â•… · â•… Pa u l A . L o m b a r d o
Gr e gory M ic h a e l Dor r a n d A ng e l a L og a n
68
“Qua l i t y, n o t m e r e Qua n t i t y, C ou n t s ” â•… · â•… 69
The second part of this essay analyzes the National Association for
the Advancement of Colored People’s baby contests, a key component of
the assimilationist eugenic agenda. More than infant beauty pageants,
these competitions blended ideology and activism. Baby contests popu-
larized race-neutral, class-inflected eugenic ideals, drafting these heredi-
tarian principles into the NAACP’s fight against the fruits of white eugen-
ics: segregation, antimiscegenation law, and lynching. The baby contests
highlight how middle-class African Americans co-opted and inverted
the repressive ideas and programs of “mainline” racist white eugenicists,
recasting them into arguments and policies that supported class-inflected
social justice through African American racial uplift. 5
Or ig i n s
From the moment Sir Francis Galton coined the word eugenics in 1883,
the notion of scientifically improving humanity through better breed-
ing captivated modern thinkers. Whether advocating increased pro-
creation among the “fit”—so-called positive eugenics—or demanding
negative eugenic interventions like immigration and marriage restriction,
sterilization, and segregation to reduce the propagation of the “unfit,”
theorists remained convinced that eugenics promised utopian improve-
ment for humanity. A host of social problems—alcoholism, criminal-
ity, pauperism, prostitution, tuberculosis, venereal disease, and above
all “feeblemindedness”—might be eradicated by preventing the birth of
those genetically predisposed to these maladies. Definitions of fitness and
unfitness corresponded to native-born, white Americans’ racial, class,
and ethnic prejudices, underscoring the eugenics movement’s overlap-
ping scientific and cultural imperatives. But despite affinities between
eugenics and white supremacy, black folk recognized promise and power
in the new science, too.
Any discussion of African Americans’ eugenic beliefs must be placed
against the backdrop of white and black support for “popular eugenics”:
the ambient, if nebulous, belief in the existence of “fit” and “unfit” babies
blessed or cursed with “good” or “bad” physical and behavioral charac-
teristics. Popular eugenics—like the more organized, white-dominated
“Qua l i t y, n o t m e r e Qua n t i t y, C ou n t s ” â•… · â•… 71
T h e or y
equal, that did not mean that there were not fit and unfit individuals
within each race—merely that the races, as groups, defied hierarchical
organization. Du Bois wrote that “the Negroes have their degenerate
types in the dwarfs and Hottentots—so have the Europeans; they have
their mixed types of all degrees and kinds of mixture—so have the Eu-
ropeans. But it is an unproved and to all appearance an unprovable thesis
that the physical development of men shows any color line below which
is black pelt and above the white.” That individuals might be ranked ac-
cording to innate ability, however, was both possible and, from Du Bois’s
self-proclaimed intellectual vantage point, self-evident.12
In 1910 Du Bois declared that “there are human stocks with whom it
is physically unwise to intermarry, but to think that these stocks are all
colored or that there are no such white stocks is unscientific and false.”
Perhaps thinking of his own multiracial heritage, Du Bois argued that ra-
cial intermarriage was “not necessarily undesirable and race blending may
lead, and often has led, to new, gifted, and desirable stocks and individu-
als.” Individual fitness, not race, was the yardstick for measuring biologi-
cal worth. This premise anchored Du Bois’s conception of the Talented
Tenth as “a carefully bred, selected, and trained elite.”13
Just as racial harmony could result, in the near term, from the leader-
ship of and cooperation among the “best” whites and blacks, long-term
African American advance depended upon the prolific reproduction of
the Talented Tenth. Social improvement and political equality would be
ensured as the multiplying fit gradually replaced the unfit. Instead of re-
gressing toward the mean, the future African American population would
be socially and biologically uplifted to the status of the present Talented
Tenth of all races. Assimilationist eugenics, like mainline white eugenics,
represented a call for biological meliorism to serve sociopolitical ends.14
The hereditary superiority of the Talented Tenth appears throughout
Du Bois’s writing, but he never neglects environment. He argued that
all environmental legacies of slavery (like disfranchisement, Jim Crow,
racism, and what today might be labeled “environmental racism”—the
shunting of blacks to unsanitary urban ghettos and parasite-infested rural
margins) must be removed to ensure the maximum attainment of black
potential. But heredity also deserved its due. Not all inequality stemmed
from the environment. In Souls of Black Folk, Du Bois confirmed his belief
in “the rule of inequality:—that of the million black youth, some were
“Qua l i t y, n o t m e r e Qua n t i t y, C ou n t s ” â•… · â•… 75
fitted to know and some to dig.” He made this inborn individual fitness
the basis of his call for education according to inborn ability, regardless
of race, class, gender, or other cultural considerations. He pronounced
in 1912 that, to achieve their rightful leadership role, “the Talented Tenth
must be created based upon the commitment of honest colored men and
women not to bring aimless rafts of children into the world, but, as many
as, with reasonable sacrifice, we can train to largest manhood.” Acknowl-
edging the coequality of heredity and environment, Du Bois further de-
clared that African Americans, “having procreated reasonably, must then
seek out colored children of ability and . . . find that Talented Tenth (in the
next and subsequent generations) and encourage it by the best and most
exhaustive training in order to supply the Negro race and the world with
leaders, thinkers and artists.” Reasonable, eugenic breeding and euthenic,
environmental conditioning would save the race.15
Environmental influences (training, social background) had to be
matched with hereditary ability (genius, inborn aptitudes). In the August
1922 issue of the Crisis, Du Bois further articulated his eugenic goals: “The
Negro has not been breeding for an object; therefore, he must begin to
train and breed for brains, for efficiency, for beauty.” He enlarged on this
theme in October, when he wrote, “Birth control is science and sense
applied to the bringing of children into the world, and of all who need
it we Negroes are the first.” Du Bois, like many of his white eugenicist
contemporaries, felt that “we in America are becoming sharply divided
into the mass who have endless children and the class who . . . have few or
none.” Surely upper-class folk could provide their children with enriched
environments and experiences. Their ability to do so, however, was predi-
cated on their success, which was itself grounded on their inborn fitness.
Fitness was both a cause and signifier of their upper-class status: a positive
hereditary legacy they would pass on to their children.16
Du Bois sought the widest audience for these ideas. The NAACP’s
house organ, the Crisis, under Du Bois’s founding editorial leadership,
became the mouthpiece for assimilationist eugenics and a “eugenic ‘fam-
ily album,’ a visual and literary blueprint for the ideal, modern black indi-
vidual.” The Crisis quoted psychologist Albert Sidney Beckham’s opinion:
“Eugenics will improve the Negro of the future.”17 The magazine also ad-
vanced assimilationist eugenics in subtle ways. The “Men of the Month”
issues, for instance, were devoted to “establishing the ‘college-bred,’
76â•… · â•… G r e g o r y M i c h a e l D o r r a n d A n g e l a L o g a n
T e ac h i ng
cally fit who should procreate to improve the black population. Turner
agreed with Du Bois that the “best” blacks were every bit as “fit” as the
“best” whites, ignoring race and accepting the class biases of white eu-
genicists. Asserting that educational and economic achievement signi-
fied the power of heredity allowed African American leaders to consider
themselves “racial exemplars” in the most essential biological terms. Their
intellectual and socioeconomic success became a self-justifying prescrip-
tion and prognosis for black eugenic salvation.
Assimilationist eugenic theory thus found a ready partner in the pe-
riod’s most widespread, class-based, intraracial reform ideology, known
colloquially as “racial uplift.” This impulse was characterized by the no-
blesse oblige of the Talented Tenth and encapsulated in the National
Association of Colored Women’s motto: “Lifting as We Climb.” Turner
argued that if African Americans used biology and eugenics to “uplift”
the race to meet white norms on the fundamental biological level, then
cultural disparities would vanish.
Eugenical uplift would undermine white appeals to biology as jus-
tification for black inequality, taking heredity out of the interracial na-
ture/nurture debate. Forced to admit human beings’ fundamental genetic
similarities, whites would have to concede that inequity resulted from the
environmental constraints of racism, not genetic essence. Assimilation-
ist eugenic uplift, in this context, provided a method for regaining black
citizenship.23
Turner taught mainline beliefs regarding the “inferiority” of the
feebleminded, even as he reconfigured these notions to create a scien-
tifically inflected liberation ideology for African Americans. He declared
the feebleminded “incapable of competing on equal terms” with normal
people. Most white eugenicists contended that this inability to compete
also characterized black/white group relationships, implying that all
blacks were inherently feebleminded. Turner rejected this suggestion,
asserting that “defectiveness is not a reversion but direct inheritance,”
debunking the white shibboleth that blacks were devolving to “savagery,”
and distancing “normal” fit blacks from “unfit,” “retarded” blacks and
whites. Defectives, according to Turner, existed in and should be elimi-
nated from both races—for the good of the entire human race. Eliminat-
ing the unfit would foster the interracial collaboration among elites that
Du Bois foretold in Souls.24
“Qua l i t y, n o t m e r e Qua n t i t y, C ou n t s ” â•… · â•… 79
For Turner and mainline eugenicists, all sound public policy must
stem from a biological understanding of life. Social reform must “look
to the improvement of the individual as well as to the improvement of
the race,” it must “make society better by working upon the individual
units of society,” and it would ideally “aim not only at ameliorating the
conditions of life but also at bettering life itself.” Just as white eugenicists
distrusted sociology’s environmental emphasis, Turner believed that the
sociologist “must be primarily a biologist,” if he hoped to achieve substan-
tive reforms.25
Ethical public policy and “sound citizenship” depended upon merg-
ing the scientific method with civics instruction. Turner averred that con-
temporary Americans were “nearer the goal of universal brotherhood”
than the founders, “because the pursuit of science has developed a larger
sympathy among men, by teaching them that they are truly of one flesh,
with a common parentage.” For Turner, biology explained humanity’s
phenotypic distinctions in terms of the underlying organic similarity of
all human beings.26
Turner recast racial disparities into an associational rather than a seg-
regationist framework. Inverting white eugenicists’ “race suicide” thesis,
Turner argued for the relative impermanence of “civilization” in the face
of the greater durability of human life. His ringing denunciation of cul-
tural superiority surely would have alarmed white readers even as it reas-
sured his black audience. He predicted, “The proud, haughty, domineer-
ing people of today may be the cringing, begging, sycophantic paupers of
tomorrow.” After all, he reasoned, “we have record of the rise to power and
the decadence of various human tribes—black, yellow, and white,” and
while we “cannot know what characteristics or lines of conduct have the
greatest survival value,” he felt that “it should be the chief aim of courses
in Human Biology to seek out and stress every factor which makes for
peaceful, harmonious cooperation among races and among nations.”
Turner thus refocused the eugenic quest away from ensuring racial supe-
riority, a quixotic venture requiring a static conception of fitness belied
by life’s dynamism. Turner’s assimilationist eugenics freed him from the
trap of biological superiority while acknowledging heredity’s power. 27
Turner taught assimilationist eugenics to thousands of students over
more than 30 years. Yet, for these ideas to perform their antiracist, socially
meliorative function, they had to be taught to those beyond the Talented
80â•… · â•… G r e g o r y M i c h a e l D o r r a n d A n g e l a L o g a n
On March 20, 1925, a precocious 5-year-old girl closed the Newport News,
Virginia, NAACP baby contest in verse:
Good friends, we welcome you tonight
To this our baby show,
Just what we are trying here to do
I’m sure that you all know.
These babies all are hard at work
For the National Association;
If you will help and do not shirk,
We’ll have a better nation.
Our mothers dear, as you can see,
Have worked to win the prize,
Just who will be the lucky one
We can not now surmise.
But whether the babies win or lose,
Let us all stop and pause,
And realize by buying votes
We’ve helped a worthy cause.
So once again we welcome you,
With hearts all full of glee,
Let us join in and give three cheers
For the N.A.A.C.P.29
The poem outlined the contest’s intended goals and hinted at its inspira-
tion, guiding rationales, and purposes. Held between 1924 and 1934, and
often overseen by NAACP Field Secretary William Pickens, these baby
contests were designed with a twofold agenda. First, the NAACP sought
to capitalize on a vogue in baby pageants and “Better Baby” and “Fitter
Family” contests sweeping the majority white populace, adapting them to
“Qua l i t y, n o t m e r e Qua n t i t y, C ou n t s ” â•… · â•… 81
the black community and using them to raise funds for the NAACP’s so-
cial justice campaigns. Second, these contests implicitly promulgated the
assimilationist eugenics promoted by thinkers like Du Bois and Turner.
Marrying eugenic theory with practical fund-raising, the NAACP’s baby
contests established a movement within the movement, one Du Bois
dubbed the “Tenth Crusade,” a sobriquet redolent with imagery of Chris-
tian salvation and noblesse oblige. The Tenth Crusade’s ultimate goals of
eugenic improvement might be understood as a class-biased attempt at
intraracial social control. Nevertheless, the movement’s proximate aim—
raising money to fund the NAACP’s battle against lynching—sought
to improve life for all African Americans, regardless of class, birth, or
“fitness.”
E ug e n ic C on t e s t s ac r o s s t h e C ol or L i n e
Scholars have traced the ways African American uplift ideology was
shaped by, and in return shaped, the mainstream white eugenics move-
ment. Yet, with the exception of Garveyite and white eugenic racial pu-
rity efforts, historians have overlooked programmatic similarities be-
tween black assimilationist and white mainline eugenics. Examining the
NAACP’s baby contests clarifies the structural affinities between black
and white eugenics.
White eugenicists pioneered “Better Babies” and “Fitter Families for
Future Firesides” competitions. Conducted at international expositions
and state fairs across the country, these competitions—and their atten-
dant eugenic exhibits—appeared at roughly 7 to 10 venues annually be-
tween the 1910s and the 1930s. Competitions peaked during the late 1920s,
when as many as 40 potential sponsors annually solicited the Eugenics
Record Office for guidance in hosting contests. Tens of thousands of
white (and some black) attendees learned about eugenics and the goal of
having a “goodly heritage” from these well-publicized competitions. 30
Staged in the “human stock” sections of the fairgrounds, eugenics
exhibits and contests explicitly analogized human and animal breeding.
As Mary T. Watts, the co-organizer of the first Fitter Families Contest,
said, “While the stock judges are testing the Holsteins, Jerseys, and white-
faces in the stock pavilion, we are judging the Joneses, Smiths, and the
Johns.” The stakes were high: contest brochures declared that the “science
82â•… · â•… G r e g o r y M i c h a e l D o r r a n d A n g e l a L o g a n
S t r a ng e F ru i t: Ho w Ly nc h i ng
P r om p t e d B a b y C on t e s t s
During the first third of the twentieth century, African Americans faced
more immediate dangers than the dropping birthrate or “race suicide”
that alarmed their white contemporaries. Between 1882 and 1944, Ameri-
can trees often bore “strange fruit”: the bodies of some 4,700 African
Americans, mostly men, often lynched by mobs, particularly in the South.
Between 1909 and 1918, lynching claimed the lives of 687 people, of whom
590 were African Americans. Combined with race riots that rocked cities
for days and the segregationist laws that whites insisted preserved peace
by managing interracial contact, the lynching epidemic represented the
nadir of American race relations. 33
“Qua l i t y, n o t m e r e Qua n t i t y, C ou n t s ” â•… · â•… 83
T h e T e n t h C ru s a de : C on t e s t L o g i s t ic s
ideology and the Fitter Family contests had on the white community, Du
Bois hoped to adapt similar competitions to promote his agenda. He had
already created something of a platform in the Crisis’s “Children’s Num-
ber.” Meant to demonstrate the innate fitness of African Americans, the
“Children’s Number” also subtly inculcated assimilationist eugenics by
valorizing youthful aspirants to the Talented Tenth as examples of sound
black reproduction. 37
Building on the success of the “Children’s Number,” Du Bois and
William Pickens, the NAACP’s national field secretary, launched a “Tenth
Crusade.” Eugenically fit African American infants and children would be
the foot soldiers in this campaign. Having witnessed the success of baby
contests as grassroots benefits for local chapters in Dayton, Cleveland,
and Jersey City, Du Bois and Pickens believed that national contests could
be cost-effective fund-raisers for the anti-lynching campaign. Presum-
ably, in addition to mobilizing anti-lynching sentiment, identifying and
voting for fit babies would help sensitize participants to the need for (and
benefits of) rational eugenic procreation. 38
The “nationalization” of the contests, and the merging of eugenic
and financial priorities, complicated the straightforward logistics of the
local competitions. At first, proud parents had paid an entrance fee to the
sponsoring chapter to enroll their child in a contest; volunteer judges then
selected the “best” baby. Winners were awarded gold coins; the chapter
retained the proceeds. In July 1924, Pickens circulated a pamphlet outlin-
ing new, uniform competition guidelines.
In “How to Conduct a Baby Contest,” Pickens created a hierarchy
that privileged members of the Talented Tenth. Pickens stipulated that a
sponsoring chapter must organize an executive committee—chaired by
the chapter president’s wife and composed of other influential members
of the community—to oversee the competition. The executive commit-
tee would then appoint a publicity and meetings committee. Committee
members and the chapter’s officers importuned mothers to enter their fit
babies in the contest; they simultaneously recruited the mothers as volun-
teer contest workers. Parent-volunteers were instructed to secure at least
10 additional workers for their child’s “campaign”; each worker should
raise $10 by selling votes for the child at a nickel apiece, NAACP member-
ships, and subscriptions to the Crisis. Theoretically, the “honor” of having
one’s baby selected would translate into a windfall for the association, as
“Qua l i t y, n o t m e r e Qua n t i t y, C ou n t s ” â•… · â•… 85
N A AC P C on t e s t R e s u lt s ,
C on t r ov e r s i e s , a n d L e g ac y
Pickens was beginning to realize the full potential of what was before
him. Local chapters were clamoring for additional recognition and pub-
licity. Given “the money, pains, and loyalty” the chapters had thus far
given the national headquarters, Pickens and Du Bois used the Crisis to
reward local efforts and build momentum. By promoting the Cleveland
chapter’s contest of early 1925, for instance, Pickens hoped to “stimu-
late all pending contests,” as well as “help him organize others.” Du Bois
featured the top three contestants, “along with the names of all chief
contestants, brief notes of the contests, and the names of the officers of
the organizing committees,” in the “Weekly Press Stories” section of the
Crisis. Such public recognition gratified grassroots activists, inspired ad-
ditional contests, increased the overall financial yield, and popularized
assimilationist eugenic precepts.41
86â•… · â•… G r e g o r y M i c h a e l D o r r a n d A n g e l a L o g a n
This strategy worked well. By January 13, 1926, “the Colored Babies
of the United States had raised more than $31,000.00 to fight for their
own future.” Pickens hoped that “every branch of the Association and
every group interested in its work” would hold contests by early 1926.
Additionally, he felt that “any branches that had held contests in previous
years could and should repeat them,” for “there are always new babies!”
Pickens believed that contests represented “the least expensive and most
successful way for local branches” to raise funds. By June 1926, 156 of the
300 local NAACP branches had held contests, raising another $10,000.
This left “144 branches and a million babies” that should compete by the
fall of 1926 or early 1927, according to Pickens. To spur action, Pickens
mailed a letter claiming that organizing a competition was “simpler than
riding a tricycle.” Not afraid to tap into parental guilt, Pickens wrote that
“any baby” would “enlist in the Crusade” against “color prejudice, unless
some grown-ups stood in the way.”
The Tenth Crusade was so successful that, by the 1930s, Pickens en-
couraged chapters to “expand their market,” and consider hosting age-
group contests for children ages 4–8, 9–12, and 13–15; “Young Women,
Young Widows, Bachelors, Debutantes”; and even pastors. The possibili-
ties seemed endless. Swept up in his own enthusiasm, Pickens apparently
forgot that association members had finite personal finances.42 Each new
category of “eugenically fit” blackness offered the possibility of modeling
eugenic ideals and raising revenue, but proliferating contests also began
to raise tension along with funds. By exercising his editorial prerogatives
through provocative opinion pieces and by promoting certain contest
winners, with little or no input from other association officials, Du Bois
often strained his relationship with the NAACP. Tensions came to a head
in 1934, as Du Bois wrote a controversial series of editorials, “Segrega-
tion—A Symposium.” His May editorial, in which he argued that “there
should never be an opposition to segregation pure and simple unless that
segregation does involve discrimination,” seemed to announce a reversal
of everything he and the NAACP had stood for over the preceding 25
years.
In actuality, Du Bois had simply returned to the arguments he had
made 37 years earlier in “The Conservation of↜Races”: that racial solidarity
(what a later generation would refer to as “self-segregation” or “congre-
gation in segregation”) ultimately offered the power to “smash all race
“Qua l i t y, n o t m e r e Qua n t i t y, C ou n t s ” â•… · â•… 87
Notes
1.╇ War against the Weak, 35 mm, 93 min., Endless Films, New York, 2009; Expelled:
No Intelligence Allowed, 35 mm, 97 min., Rocky Mountain Pictures, Salt Lake City, 2008.
2.╇ See, for example, Mark H. Haller, Eugenics: Hereditarian Attitudes in American
Thought (New Brunswick, N.J.: Rutgers University Press, 1962); Daniel J. Kevles, In the
Name of Eugenics: Genetics and the Uses of Human Heredity (New York: Alfred A. Knopf,
1988); Nancy L. Gallagher, Breeding Better Vermonters: The Eugenics Project in the Green
Mountain State (Hanover, N.H.: University Press of New England, 1999); Gregory Mi-
chael Dorr, Segregation’s Science: Eugenics and Society in Virginia (Charlottesville: Uni-
versity of Virginia Press, 2008).
3.╇ John David Smith, Black Judas: William Hannibal Thomas and the American
Negro (Athens: University of Georgia Press, 2000); Martha F. Lee, The Nation of Islam:
An American Millenarian Movement (Syracuse: Syracuse University Press, 1996); Wil-
liam A. Edwards, “Racial Purity in Black and White: The Case of Marcus Garvey and
Earnest Cox,” Journal of Ethnic Studies 15 (1987): 117–42. On Garvey and eugenics, see
Michele Mitchell, Righteous Propagation: African Americans and the Politics of Racial
Destiny after Reconstruction (Chapel Hill: University of North Carolina Press, 2004),
230–36.
4.╇ This section builds on the work of Marouf A. Hasian Jr., The Rhetoric of Eugenics
in Anglo-American Thought (Athens: University of Georgia Press, 1996), 51–71; Kevin K.
Gaines, Uplifting the Race: Black Leadership, Politics, and Culture in the Twentieth Century
(Chapel Hill: University of North Carolina Press, 1996); and Mitchell, Righteous Propa-
gation, 86–88.
5.╇ On “mainline” eugenics, see Kevles, In the Name of Eugenics, 88.
6.╇ Susan Currell and Christina Cogdell, eds., Popular Eugenics: National Efficiency
and American Mass Culture in the 1930s (Athens: Ohio University Press, 2006); Steven
Selden, Inheriting Shame: The Story of Eugenics and Racism in America (New York: Teach-
ers College Press, 1999), 39–62. On African Americans and popular eugenics, see Mitch-
ell, Righteous Propagation, 75, 80–81, 86–88, 100–106. On fairs and contests, see Laura
Lovett, Conceiving the Future: Pronatalism, Reproduction, and the Family in the United
States, 1890–1938 (Chapel Hill: University of North Carolina Press, 2007), 131–62; and
Steven Selden, “Transforming Better Babies into Fitter Families: Archival Resources
and the History of the American Eugenics Movement, 1908–1930,” Proceedings of the
American Philosophical Society 149 (June 2005): 199–225.
7.╇ Gaines, Uplifting the Race, 80–83; Gregory Michael Dorr, “Beyond Racial Pu-
rity: African Americans and Integrationist Eugenics” (paper presented at the annual
meeting of the Organization of American Historians, Memphis, Tenn., April 2003);
Gregory Michael Dorr, “Fighting Fire with Fire: African American Intellectuals and
90â•… ·â•… G r e g o r y M i c h a e l D o r r a n d A n g e l a L o g a n
Hereditarian Thought, 1890–1942” (invited address, Wake Forest University Social Sci-
ence Research Seminar, Wake Forest, N.C., October 2004).
8.╇ On African Americans and nature/nurture (or eugenic/euthenics) distinc-
tions, see Mitchell, Righteous Propagation, 147–49, 230; Du Bois, “The Talented Tenth,”
in Writings by W.E.B. Du Bois in Non-periodical Literature Edited by Others, ed. Herbert
Aptheker (Millwood, N.Y.: Kraus-Thomson, 1982), 17–29; Du Bois, Souls of Black Folk
(Millwood, N.Y.: Kraus-Thomson, 1989), 74–90, especially 87.
9.╇ David Levering Lewis, W.E.B. Du Bois: Biography of a Race, 1868–1919 (New
York: Henry Holt, 1994), 170–74. Quotations from Du Bois, “The Conservation of
Races,” in Pamphlets and Leaflets, ed. Herbert Aptheker (White Plains, N.Y.: Kraus-
Thomson, 1986), 2–3, 4, 5.
10.╇ Du Bois, “Conservation of Races,” 6; Du Bois, Souls, 9.
11.╇ Du Bois, “The Talented Tenth,” 17–18.
12.╇ Du Bois, “Heredity and the Public Schools,” in Pamphlets and Leaflets, 50, 51.
13.╇ On the “submerged tenth,” see English, Unnatural Selections, 45. For dysgenic
whites, see Paul A. Lombardo, Three Generations, No Imbeciles: Eugenics, the Supreme
Court, and Buck v. Bell (Baltimore: Johns Hopkins University Press, 2008), 134; Du Bois,
“Marrying of Black Folk,” Independent 69 (October 13, 1910): quotations 812, 813; English,
Unnatural Selections, 44.
14.╇ On relations between the “best stocks,” Du Bois wrote, “Here I suddenly saw
that not only in some far future world our Talented Tenth with the talented of all nations
leads all people to salvation.” Non-periodical Literature, 196; see also “Sociology and
Industry in Southern Education,” in Writings by W.E.B. Du Bois in Periodicals Edited by
Others, 4 vols., ed. Herbert Aptheker (Millwood, N.Y.: Kraus-Thomson, 1982), 371; Du
Bois, Souls, 48, 71–72, 136.
15.╇ Du Bois, Souls, 70; Du Bois, “Editorial,” Crisis 4 (October 1912): 287; Du Bois,
“The Immediate Program of the American Negro,” Crisis 9 (April 1915): 311.
16.╇ Du Bois, “Opinion,” Crisis 24 (August 1922): 152–53; Du Bois, “Opinion,” Crisis
24 (October 1922): 199.
17.╇ English, Unnatural Selections, 48; Albert Sidney Beckham, “Applied Eugenics,”
Crisis 26 (1924): 177; Hasian, Rhetoric of Eugenics, 64–69.
18.╇ English, Unnatural Selections, 55, 53.
19.╇ Ibid., 49. “Five Exceptional Negro Children,” Crisis 34 (October 1927): 258.
20.╇ Hasian, Rhetoric of Eugenics, 69–70; W.E.B. Du Bois, “Black Folk and Birth
Control,” Birth Control Review 16 (1932): 166, 167; Du Bois, “Opinion,” Crisis 24 (August
1922): 153.
21.╇ Dorr, Segregation’s Science, 98–104.
22.╇ Ibid., 101. The exams are in the Thomas Wyatt Turner Papers, University Ar-
chives, Hampton University. Turner probably also taught eugenics at Tuskegee, but
documentary evidence of this is lacking.
23.╇ On uplift, see Gaines, Uplifting the Race, xiv–xv; Du Bois, Souls, 79; English, Un-
natural Selections, 35–36. See also Daylanne K. English, “W.E.B. Du Bois’s Family Crisis,”
American Literature 72 (2000): 292. For eugenics and club women, see “Child Welfare
and Mat[e]rnity” (1928), in Records of the National Association of Colored Women’s Clubs,
1895–1992, ed. Lillian Serece Williams (Bethesda, Md., 1993), reel 7, frames 00355–58.
24.╇ Thomas Wyatt Turner, “Feeblemindedness” and “Lecture X—Eugenics,” Turner
Papers.
“Qua l i t y, n o t m e r e Qua n t i t y, C ou n t s ” â•… · â•… 91
25.╇ Thomas Wyatt Turner, “The Biological Laboratory and Human Welfare,” How-
ard University Record, January 1924, 4, 5.
26.╇ Ibid., 7.
27.╇ Thomas W. Turner, “The Curriculum and Aims in Biological Teaching,” School
Science and Mathematics 27 (October 1927): 689–90.
28.╇ American Eugenics Society, “A List of Eugenics Lecturers (1927),” 14, in “AES
Printing Orders, 1926–1942” folder, American Eugenics Society Records, American
Philosophical Society Library, Philadelphia.
29.╇ William H. Pickens to James Weldon Johnson, March 10, 1925, Records of the
NAACP, “Branch Files: 1910–1947,” Part I, box I:G208, Records of the National Associa-
tion for the Advancement of Colored People, Manuscript Division, Library of Congress,
Washington, D.C.
30.╇Lovett, Conceiving the Future, 131–62; Selden, Inheriting Shame, 22–38.
31.╇ Quotations from Lovett, Conceiving the Future, 144; Kevles, In the Name of Eu-
genics, 62. Individuals with averages of B+ but with even one subscore lower than B did
not win medals. Selden, Inheriting Shame, 32–33 (and image of medal).
32.╇ On earlier beauty contests and black popular eugenics, see Mitchell, Righteous
Propagation, 213–14.
33.╇ English, Unnatural Selections, 119. The literature on lynching is massive; estimates
of numbers vary based on the definition of what constitutes a lynching. See Grace Eliza-
beth Hale, Making Whiteness: The Culture of Segregation in the South, 1890–1940 (New
York: Pantheon Books, 1998), chapter 5 and 355n4. For statistics, see Arthur F. Raper, The
Tragedy of Lynching (New York: Dover, 1970), 480–84.
34.╇ English, Unnatural Selections, 27.
35.╇ Hale, Making Whiteness, 214–15; Lewis, Du Bois: Biography, 226; Ida B. Wells-
Barnett, A Red Record: Tabulated Statistics and Alleged Causes of Lynching in the United
States, 1892, 1893, 1894 (Chicago: Donohue and Henneberry, 1895).
36.╇ Robert L. Zangrando, The NAACP Crusade against Lynching, 1909–1950 (Phila-
delphia: Temple University Press, 1980); Patricia A. Schecter, “Unsettled Business:
Ida B. Wells against Lynching; or, How Lynching Got Its Gender,” in Under Sentence
of Death: Lynching in the South, ed. W. Fitzhugh Brundage (Chapel Hill: University of
North Carolina Press, 1997), 309.
37.╇ See NAACP, “Crusade 1922” and “Crusade 1923” folders in “Administrative
Files: 1885–1949,” Part I, boxes I:C206 and I:C207, Records of the National Association
for the Advancement of Colored People, Manuscript Division, Library of Congress,
Washington, D.C.; Du Bois, “The Ninth Crusade,” Crisis 25 (March 1923): 214. The Chil-
dren’s Number ran every October.
38.╇ See “Benefits—Baby Contests 1924–1932” folders in box I:C215, NAACP Ad-
ministrative Files. Hereafter baby contest files.
39.╇ William Pickens, “How to Conduct a Baby Contest,” baby contest files; Du
Bois, “Opinion,” Crisis 26 (September 1924): 199. For examples of the photos, see EnÂ�
glish, Unnatural Selections, 50–51.
40.╇ Baby contest files.
41.╇ Ibid.
42.╇ Ibid.
43.╇ Du Bois, “Segregation,” Crisis 36 (May 1934), quoted in David Levering Lewis,
W.E.B. Du Bois: The Fight for Equality and the American Century, 1919–1963 (New York:
92â•… ·â•… G r e g o r y M i c h a e l D o r r a n d A n g e l a L o g a n
Henry Holt), 336; Du Bois, “Counsels of Despair,” Crisis 36 (June 1934), quoted in ibid.,
345. Du Bois’s resignation and the board’s acceptance appear in Selections from the Crisis,
vol. 2, 1926–1934, ed. Herbert Aptheker (Millwood, N.Y.: Kraus-Thomson, 1983), 770–72.
This paragraph accepts and extends Lewis’s interpretations of this pivotal struggle be-
tween Du Bois and the organization he founded.
44.╇ Baby contest files. Total fund-raising figures could not be calculated.
45.╇ Michelle Brattain, “Race, Racism, and Anti-Racism: UNESCO and the Politics
of Presenting Race to the Postwar Public,” American Historical Review 112 (December
2007): 1386–1413.
Pa r t t h r e e
State Studies of
Eugenic Sterilization
five
A l e x a n dr a M i n n a S t e r n
In February 1950, the Fort Wayne State School in Indiana held a steriliza-
tion hearing for Vernon, a young biracial man. Since his original commit-
ment a decade earlier, at the age of 9, Vernon had managed multiple es-
capes from the institution, and it was during one of his recent flights that
the superintendent decided it was necessary to sterilize Vernon “for the
protection of the community.”1 Following the requirements of Indiana’s
sterilization law, the superintendent filed a petition with the Fort Wayne
State School’s Board of Supervisors, asking them to approve Vernon’s
vasectomy based on the medical judgment that he was “definitely feeble-
minded and incurable” and that his welfare and that of society would be
promoted by his sterilization. In addition, notices about Vernon’s steril-
ization hearing were served on him and his parents and sent to Indiana’s
Public Welfare Department. Assuming the surgery occurred 30 days after
the hearing, which was the protocol, Vernon was one of 84 inmates steril-
ized at Fort Wayne in 1950.
One month earlier and 2,000 miles away, the sterilization of a 14-year-
old Latina at the Pacific Colony in Spadra, California, was approved by
the director of the Department of Mental Hygiene. In compliance with
the state’s legal provisions, Pacific Colony’s superintendent checked the
boxes on the sterilization order form indicating that the operation was
warranted because Esperanza, who had spent three years at the institu-
tion, was afflicted with “feeble-mindedness” of the “imbecile grade” and
“perversions or marked departures from normal mentality.” 2 Following
departmental procedures, written consent for Esperanza’s operation had
been obtained from her father. Given that her sterilization request was
95
96â•… · â•… A l e x a n dr a M i n n a S t e r n
legislators revised the law again, adding more overt eugenic language.
Now the act pertained to those “afflicted with mental disease which may
have been inherited and is likely to be transmitted to descendents, the
various degrees of feeblemindedness, those suffering from perversion or
marked departures from normal mentality or from disease of a syphilitic
nature.”20 The 1917 amendment also made sterilization a precondition for
institutional release and incorporated the newly approved Pacific Colony,
where Esperanza would be sterilized 33 years later, to the list of affected
institutions. Finally, this revision stipulated that the written consent of,
or a written request from, the parent or guardian was needed to operate
on “any idiot, if a minor.”21 In other words, according to the law, only in
the most extreme circumstances—of a child with a presumed mental age
under three—was consent nonnegotiable.
Performed sporadically at first, the number of sterilizations in Cali-
fornia gradually climbed while the legislation was being revised and ex-
panded. By 1921, California accounted for 2,248 sterilizations—over 80
percent of all cases nationwide.22 This trend continued into the 1920s, as
an extensive eugenics network consolidated in the state, and accelerated
in the 1930s. 23 The pervasive acceptance of a preventive health rationale
for reproductive surgery, the pressures of institutional overcrowding, and
the fiscal constraints caused by the Great Depression led to a consider-
able rise in sterilizations in California in the 1930s. Like in other states,
sterilization was embraced by superintendents as a remedy for excess
commitments, by psychiatrists as a prophylactic measure needed to re-
lease patients into supervised settings, by some inmates and patients as
a viable ticket out of the institution, and by some relatives as a credible
method of normalization and behavioral control. The country as a whole
saw a marked rise in sterilizations during this period, fueled in part by
the 1927 landmark decision Buck v. Bell, in which the U.S. Supreme Court
upheld Virginia’s sterilization statute.24 By 1932, 27 states had laws on the
books, and the annual number of operations nationwide peaked at just
over 3,900.25 Mimicking these trends, operations in California climbed
from several per year in the early 1920s to over 800 by the 1930s; by 1950
over 18,000 sterilizations had been performed in the Golden State.26 In
the end, more than 20,000 surgeries, or one-third of all those nationwide,
were carried out in California institutions, easily making the state the
leader in overall sterilization statistics.
F r o m L e g i s l a t i o n t o L i v e d E x p e r i e n c eâ•… · â•… 101
I n s t i t u t ion al L ives
One month after she was committed to California’s Patton State Hospital
in February 1939, Rhonda, a white 26-year-old mother of three children,
was sterilized.43 According to her sterilization order, Rhonda qualified
for salpingectomy under the law on three counts: she was schizophrenic
and catatonic, infected with gonorrhea, and categorized as an imbecile
with an IQ of 46. Given that Rhonda’s personal history noted that she “got
drunk, left home,” and “associated with other men,” it is not surprising
that her husband provided written consent for the operation just three
days after her commitment.44
Rhonda’s operation took place at the apex of California’s steriliza-
tions, fiscal year 1939, when 828 procedures were performed in nine insti-
tutions. Patton accounted for 180 of these, 98 on men, and 82 on women.45
Located in San Bernardino and established as the main mental hospital
F r o m L e g i s l a t i o n t o L i v e d E x p e r i e n c eâ•… · â•… 105
decision reluctantly, and iterating that the two petitioners could file an
appeal if desired, the board contended that it was merely following the
law, which had been crafted with “the thought of protection of the inmate
as well as society.”57 Eleven years later, the board heard from another
patient’s mother, who testified that her late husband had professed his
resistance to the sterilization of their institutionalized son, an opinion
with which she concurred. She told the board, “Because I feel when he
[her son] is released from this place, he will want to get married and he
and his wife would like to raise a family.” When the board asked the boy,
also present at the hearing, if he would agree to a vasectomy, he stated
plainly, “I don’t want it.” Given this opposition, the board placed this
decision in abeyance, and extant records indicate that this patient was
never sterilized. 58
The success in thwarting sterilization requests that a small number
of relatives in Indiana achieved was much more elusive in California.
Although superintendents almost always sought written consents from
the parents or adult guardians of their charges, this interaction ended on
a two-dimensional piece of paper. With no board hearings to attend and
legal avenues closed, relatives could do very little to voice their dissent.
For example, in November 1931, Butler wrote to Mr. Romero, the father of
Juan, a minor at the Preston School of Industry, asking him to consent to
his son’s sterilization at Sonoma so “he can never reproduce his kind, for
we know from experience that individuals of his mentality should never
bear off-spring, as they are usually defective in some manner.”59 One of
Mr. Romero’s three sons, Javier, had already been sterilized, and in the
same communication, Butler reminded him that Sonoma was still await-
ing approval for his third son, Pablo. Butler asserted that having three
boys in one family who ended up in correctional facilities was evidence
that “there is a hereditary thread” and that any grandchildren born of
these boys would certainly be defective.60
In order to express his opinion about Butler’s request, Mr. Romero
went to talk to the health officer at the San Francisco Detention Hospital
who had admitted Juan to the Preston School of Industry. According to
the health officer, Mr. Romero was “violently opposed” to Juan’s steriliza-
tion and rejected the claim that he was feebleminded. In the end, racial
discrimination against Mr. Romero and his boys converged with Butler’s
legal authority to sterilize without consent. As the health officer explained
F r o m L e g i s l a t i o n t o L i v e d E x p e r i e n c eâ•… · â•… 109
No t es
1.╇ “Indiana Sterilization Hearing, 1950, in the Case of ╇╇╇╇ â•›, Medical Depart-
ment, Fort Wayne State School, Fort Wayne, Indiana,” Fort Wayne State School, Patient
Files, Indiana State Archives (ISA). Names have been changed to protect the privacy of
patients.
2.╇ “Recommendation and Approval for Vasectomy or Salpingectomy for the Pur-
pose of Sterilization,” Pacific Colony, 1950. This is one of approximately 15,000 steriliza-
tion orders contained in microfilm reels housed at the California Department of Mental
Health, accessed per IRB approval for Project #07-06-51, from the Committee for the
Protection of Human Subjects, California Health and Human Services Agency. Names
have been changed to protect the privacy of patients.
3.╇ See sterilization numbers and statistics in Lisa M. Matocq, ed., California’s
Compulsory Sterilization Policies, 1909–1979, July 16, 2003, Informational Hearing, Califor-
nia legislative report of the Senate Select Committee on Genetics, Genetic Technolo-
gies, and Public Policy (December 2003).
4.╇ See, for example, James W. Trent Jr., Inventing the Feeble Mind: A History of
Mental Retardation in the United States (Berkeley: University of California Press, 1994);
Steven Noll and James W. Trent Jr., eds., Mental Retardation in America: A Historical
Anthology (New York: New York University Press, 2004), 281–99; Joel Braslow, Mental
Ills and Bodily Cures: Psychiatric Treatment in the First Half of the Twentieth Century
(Berkeley: University of California Press, 1997); Wendy Kline, Building a Better Race:
Gender, Sexuality, and Eugenics from the Turn of the Century to the Baby Boom (Berkeley:
University of California Press, 2001).
5.╇ See Harry H. Laughlin, Eugenical Sterilization in the United States (Chicago: Psy�
chopathic Laboratory of the Municipal Court of Chicago, 1922); Philip R. Reilly, The Sur-
gical Solution: A History of Involuntary Sterilization in the United States (Baltimore: Johns
Hopkins University Press, 1991).
F r o m L e g i s l a t i o n t o L i v e d E x p e r i e n c eâ•… · â•… 113
6.╇ On Sharp’s initial rationale for vasectomy, see Elof Axel Carlson, The Unfit: A
History of a Bad Idea (Cold Spring Harbor, N.Y.: Cold Spring Harbor Laboratory Press,
2001), and Angela Gugliotta, “‘Dr. Sharp with His Little Knife’: Therapeutic and Puni-
tive Origins of Eugenic Vasectomy—Indiana, 1892–1911,” Journal of the History of Medi-
cine 53:4 (1998): 371–406.
7.╇ Harry C. Sharp, Vasectomy: A Means of Preventing Defective Procreation (Jeffer-
sonville: Indiana Reformatory Print, 1909), 6.
8.╇ “An Act Entitled to Prevent Procreation of Confirmed Criminals, Idiots, Im-
beciles, and Rapists,” Laws of the State of Indiana (Indianapolis: Wm. B. Buford, 1907),
377–78. For a political and legislative analysis of Indiana’s sterilization laws, see Jason
Lanzter, this volume.
9.╇ “Surgeons to Deal with Criminals,” Indianapolis Morning Star, March 7, 1907, 10.
10.╇ Sharp, Vasectomy, 2–3.
11.╇ See Gugliotta, “‘Dr. Sharp with His Little Knife.’” Figures for 1908 were calcu-
lated by archivist Vicki Casteel, Sterilization File, ISA.
12.╇ See Correspondence Folder, Thomas R. Marshall Papers, ISA; Gugliotta, “‘Dr.
Sharp with His Little Knife’”; Carlson, The Unfit, 207–22.
13.╇ See Reilly, The Surgical Solution; Laughlin, Eugenical Sterilization.
14.╇ George A. H. Shideler to Governor J. P. Goodrich, September 9, 1909, folder 2,
box 159, Indiana Reformatory Correspondence, Documents and Reports, Papers of Gov-
ernor James Goodrich, ISA.
15.╇ Williams v. Smith, No. 23,709, State of Indiana in the Supreme Court, Brief of
Appellee, 4–5; Smith v. Williams, No. 12,106, Appeal from the Clark Circuit Court to the
Supreme Court of Indiana, Sterilization File, ISA; “Eugenic Sterilization in Indiana,”
Indiana Law Journal 38:2 (1963): 275–89.
16.╇ See Sixty-first Annual Report of the Fort Wayne State School, Fort Wayne, Indiana,
for the Fiscal Year Ending June 30, 1939 (Indianapolis: Wm. B. Burford Printing Co., 1939),
5. Nearly every annual report included a brief historical profile of the institution.
17.╇ See Fifty-third Annual Report of the Fort Wayne State School (also Twelfth Annual
Report of the Muscatatuck Colony) for the Fiscal Year Ending September 30, 1931 (India-
napolis: Wm. B. Burford Printing Co., 1932).
18.╇ Ibid., 12; Fifty-fourth Annual Report of the Fort Wayne State School (also Thir-
teenth Annual Report of the Muscatatuck Colony) for the Fiscal Year Ending September 30,
1931 (Indianapolis: Wm. B. Burford Printing Co., 1933), 35.
19.╇ Laughlin, Eugenical Sterilization, 17; on Hatch, see Braslow, Mental Ills and
Bodily Cures, 56.
20.╇ Laughlin, Eugenical Sterilization, 18, 19.
21.╇ Third Biennial Report of the Department of Institutions of the State of California,
Two Years Ending June 30, 1926 (Sacramento: California State Printing Office, 1926),
92.
22.╇ Braslow, Mental Ills and Bodily Cures, 56.
23.╇ See Stern, Eugenic Nation: Faults and Frontiers of Better Breeding in Modern
America (Berkeley: University of California Press, 2005).
24.╇ See Paul A. Lombardo, Three Generations, No Imbeciles: Eugenics, the Supreme
Court, and Buck v. Bell (Baltimore: Johns Hopkins University Press, 2008).
25.╇Reilly, The Surgical Solution, 97–101.
114â•… · â•… A l e x a n dr a M i n n a S t e r n
26.╇ See Statistical Report of the Department of Institutions of the State of California,
Year Ending June 30, 1935 (Sacramento: California State Printing Office, 1936); Statistical
Report of the Department of Institutions of the State of California, Year Ending June 30, 1942
(Sacramento: California State Printing Office, 1943), 98; Matocq, ed., California’s Com-
pulsory Sterilization Policies.
27.╇ See, for example, Seventh Biennial Report of the State Commission in Lunacy for
the Two Years Ending June 30, 1910 (Sacramento: Superintendent State Printing, 1910),
19–23; Third Biennial Report, 93–94; Fred O. Butler, “A Quarter of a Century’s Experi-
ence in Sterilization of Mental Defectives in California,” reprint from the American
Journal of Mental Deficiency (1945), contained in Matocq, ed., California’s Compulsory
Sterilization Policies.
28.╇ Although cases involving allegations of medical malpractice, demands for dam-
ages, and petitions for the state to provide nontherapeutic surgical sterilizations for the
indigent were heard in California’s supreme and appellate courts between 1930 and 1979,
only Sara Rosas Garcia v. State Department of Institutions challenged the constitutional-
ity of the sterilization law. See Jessin v. County of Shasta, Civ. No. 12,027, Court of Appeal
of California, Third Appellate District, 274 Cal. App. 2d 737; 79 Cal. Rptr. 359; 1969 Cal.
App. LEXIS 2107; 35 A.L.R.3d 1433, July 11, 1969; Kline, Building a Better Race, chap. 4.
29.╇ Petition for Writ of Prohibition of Mandate, Civ. 12533, in the District Court of
Appeal of the State of California, Second Appellate District, Sara Rosas Garcia vs. State
Department of Institutions of the State of California et al., December 13, 1939, on file at the
California State Archives. An abridged version is available through Lexis-Nexis: see
Sara Rosas Garcia v. State Department of Institutions, Civ. No. 12,533, Court of Appeal of
California, Second Appellate District, Division One, 36 Cal. App. 2nd 152; 97 P.2d 264;
1939 Cal. App. LEXIS.↜
30.╇ See Legislative History, Senate Bill 750, microfilm 3:2 (4); “Legislative Memo-
randum,” April 4, 1953, Legislative History, Assembly Bill 2683, microfilm reel 3:2 (10);
Frank F. Tallman to Honorable Earl Warren, March 31, 1953, Legislative History, Assem-
bly Bill 2683, microfilm reel 3:2 (10), CSA.
31.╇ For a discussion of Catholic opposition to sterilization, which solidified in the
1920s, see Christine Rosen, Preaching Eugenics: Religious Leaders and the American Eu-
genics Movement (New York: Oxford University Press, 2004).
32.╇ On Earl Warren’s gubernatorial administration in California and his rise to
Supreme Court justice, see Jim Newton, Justice for All: Earl Warren and the Nation He
Made (New York: Riverhead Books, 2006).
33.╇ See “Background Paper,” in Matocq, ed., California’s Compulsory Sterilization
Policies.
34.╇ “Background Paper,” and “Sterilization Operations in California State Hos-
pitals, April 26, 1909, through June 30, 1960,” in Matocq, ed., California’s Compulsory
Sterilization Policies. Also see “History, Description, and Evaluation of the Department
of Mental Hygiene,” (1962), Papers of Nathan Sloate, Department of Mental Hygiene
Records (DMH), CSA.
35.╇ “Sonoma State Hospital,” Biennial Report, 1952–54, Sonoma State Hospital,
Administrative Files, DMH, F3501, Loc D0419, box 154, CSA.
36.╇Not until the 1940s, when California claimed about 60 percent of all operations
nationwide, did a few places, such as Delaware, North Carolina, and Virginia, begin to
consistently overtake California in per capita or annual terms. Figures derived from
F r o m L e g i s l a t i o n t o L i v e d E x p e r i e n c eâ•… · â•… 115
“U.S. Maps Showing the States Having Sterilization Laws in 1910, 1920, 1930, 1940,” Pub-
lication No. 5 (Princeton: Birthright, n.d.), in Matocq, California’s Compulsory Steriliza-
tion Policies; Clarence J. Gamble, “Preventive Sterilization in 1948,” JAMA 141:11 (1949):
773; Gamble, “Sterilization of the Mentally Deficient under State Laws,” American Jour-
nal of Mental Deficiency 51:2 (1946): 164–69. Delaware was the only state that outpaced
California in per capita terms in the 1930s, with a rate ranging between about 80 and 100
sterilizations per 100,000 individuals.
37.╇ “Eugenic Sterilization in Indiana” notes inconsistent interpretations of criminal
immunity; “An Act to Provide for the Sexual Sterilization of Inmates” (1927), Steriliza-
tion File, ISA.
38.╇ See Fort Wayne Minutes, 1931–47, ISA.
39.╇ L. Potter Harshman, “Medical and Legal Aspects of Sterilization in Indiana,”
Journal of Psycho-Asthenics 39 (June 1933–June 1934): 189.
40.╇ See “Eugenical Sterilization in Indiana.”
41.╇ Sonoma State Hospital, interoffice memorandum, November 29, 1956, re: W & I
Code Changes, Sonoma State Hospital, Administrative Files, DMH, F3501, Loc D0419,
box 153, CSA.
42.╇ See Trent, Inventing the Feeble Mind, and Noll and Trent, Mental Retardation in
America; for an elaboration of this attitudinal change in California, see “Statement of
Progress, Department of Mental Hygiene for the Period 1943–1950,” November 1, 1950,
DMH, Papers of Nathan Sloate, CSA.
43.╇ “Sterilization Operations Performed, Patton State Hospital, during Month of
March 1939.” Her operation occurred on March 23, 1939.
44.╇ “Recommendation and Approval for Vasectomy or Salpingectomy for the Pur-
pose of Sterilization,” Patton State Hospital, 1939.
45.╇ Statistical Report of the Department of Institutions of the State of California, Year
Ending June 30, 1939 (Sacramento: California State Printing Office, 1939), 26.
46.╇ John A. Reily to John Randolph Haynes, February 19, 1916, box 193, Haynes Pa-
pers, 1241, Special Collections, UCLA.
47.╇ Third Biennial Report of the State Department of Institutions (1926), 83.
48.╇To be true to the historical era of eugenic sterilization, I use the terms employed
at the time. Today these kinds of facilities generally are referred to as developmental
centers (feebleminded homes) and state hospitals (mental hospitals).
49.╇ Statistical Report of the Department of Institutions of the State of California, Year
Ending June 30, 1940 (Sacramento: California State Printing Office, 1940), 12.
50.╇ Braslow, Mental Ills and Bodily Cures, 21, 80.
51.╇ Biennial Report (1939), 26.
52.╇ On Smyth’s ardent support of sterilization, see Margaret L. Smyth to John
Randolph Haynes, June 3, 1916, box 17, Haynes Papers, 1241, Special Collections, UCLA;
Smyth, “Psychiatric History and Development in California,” American Journal of Psy-
chiatry 94 (1938): 1223–36.
53.╇ See Stern, Eugenic Nation, chap. 3.
54.╇ Sterilization order in the form of a letter, Butler to Earl E. Jensen, March 22, 1928.
55.╇ Sterilization order in the form of a letter, Butler to Dr. J. M. Toner, January 9,
1932.
56.╇ “Indiana Sterilization Hearing, 1950, in the Case of ╇╇╇╇ â•›, Muscatatuck State
School, Butlerville, Indiana,” April 16, 1942, Muscatatuck State School, Patient Files, ISA.
116â•… · â•… A l e x a n dr a M i n n a S t e r n
57.╇ See entries for 1942 in Fort Wayne State School Minutes, vol. 1, 1931–47, ISA.
58.╇ See entries for 1953 in Fort Wayne State School Minutes, vol. 2, 1948–55, ISA.
59.╇ For insight into California’s youth of color in state institutions, see Miroslava
Chávez-García, “Intelligence Testing at Whittier School, 1890-1920,” Pacific Historical
Review 76:2 (2007): 193–228.
60.╇ Butler to ╇╇╇╇ ╛, November 21, 1931, Inmate #13694, F3738:20, Inmate Records,
Inmates Histories, Papers of the Preston School of Industry, California Youth Author-
ity, CSA, consulted per confidentiality agreement signed at the CSA.
61.╇ J. C. Geiger to Butler, November 24, 1931, Inmate #13694, ibid.
62.╇ “Recommendation and Approval for Vasectomy or Salpingectomy for the Pur-
pose of Sterilization,” Pacific Colony, ╇╇╇╇ â•›, 1950.
63.╇ Fred O. Butler, “Report of Medical Superintendent of the Sonoma State Home,”
First Biennial Report of the Department of Institutions, 1920, 80.
64.╇ Paul Popenoe to Ezra S. Gosney, March 25, 1926, box 7, folder 2, Papers of Ezra
S. Gosney and the Human Betterment Foundation, Institute Archives, California Insti-
tute of Technology.
65.╇ See interview of Fred O. Butler; Butler, “A Quarter of a Century’s Experience.”
66.╇ Leonard Stocking to John Randolph Haynes, March 11, 1916, box 193, Haynes
Papers, 1241, Special Collections, UCLA.
67.╇ See “California’s Compulsory Sterilization Policies”; Braslow, Mental Ills and
Bodily Cures.
six
Mol ly L a dd - Tay l or
Tena and Stewart had “many good traits and were fond of their children,”
but social workers found their living conditions “impossible.” It was 1937,
and the couple “could not cope” with the “existing conditions” of depres-
sion and unemployment. He drank, and she was “stepping out”—despite
being pregnant with her fourth child. Their children appeared neglected
and abused. After IQ tests found both parents to be feebleminded,1 they
were committed to state guardianship, sent to the state institution, and
sterilized. Stewart’s parents quickly consented to his operation, and he
returned home after two months, but Tena’s parents “caused” her opera-
tion to be delayed. She was reunited with her family eight months later,
but the couple remained wards of the state. A social worker helped Stew-
art get New Deal work relief and kept in “close touch” with Tena as she
reestablished her home.2
Tena and Stewart were among the approximately 1,200 Minnesotans
sterilized during the Great Depression. 3 Their welfare dependency and
problematic parenting brought them to the attention of the county child
welfare board, and their low IQ scores provided proof of their mental
deficiency. Their case, which was unusual only because both husband
and wife were sterilized, was presented to the American Association for
Mental Deficiency as an example of successful casework. The write-up
made no reference to heredity or eugenics, however; the point was that
the couple’s economic circumstances and parenting skills could be im-
proved with positive social work intervention and surgery. Eugenic ster-
ilization, in this case, was a routine decision aimed at ensuring that a
welfare-dependent family did not have any more mouths to feed and that
117
118â•… · â•… M o l ly L a d d - T a y l o r
their children did not get into trouble. Their surgery was propelled less by
a eugenics-based “quest for racial purity” than by specific local concerns
about welfare dependency and social disorder.4
This essay examines the routine operation of eugenic sterilization
as a social welfare policy during the New Deal, the period of its great-
est activity. Although Minnesota’s sterilization law was enacted in 1925
and stayed on the books for 50 years, nearly 45 percent of the state’s re-
corded sterilizations were performed between 1933 and 1940, mostly on
white working-class women considered to be feebleminded. Sterilizations
dropped off during World War II because of a shortage of medical and
nursing personnel, and the program never returned to its earlier scale. By
1963, the last year for which statistics are available, at least 2,350 Minneso-
tans—78 percent of them women—had been sterilized, but Minnesota
accounted for just 4 percent of all sterilizations in the nation. 5
Many historians have commented on the relationship between eu-
genics and European welfare states, but little work has been done on the
relationship between eugenics, liberal social welfare policy, and day-to-
day sterilization routines in the United States.6 Minnesota is a good site
for investigation into this topic because its eugenic sterilization law was
considered voluntary (consent of kin was required), and it was adminis-
tered within a child welfare system that won national praise. Like public
welfare in general, eugenic sterilization was shaped by the social-control
goals of reducing dependency and disorder, and characterized by local
variation, political manipulation, and a gap between rhetoric and routini-
zation. Eugenics-inspired fears of the menace of the feebleminded were
clearly central to the passage of the 1925 sterilization law, but the bill’s ac-
tual administration over the years had as much to do with fiscal and wel-
fare politics as with an attempt to improve the human race. The eugenic
and welfare functions of Minnesota’s sterilization program overlapped
when the object of eliminating the unfit converged with keeping taxes and
relief costs low, yet at times the welfare goal of providing assistance to the
poor and the eugenics goal of reducing their numbers collided.7
The legal foundation for Minnesota’s eugenic sterilization law was
laid in its Children’s Code, a package of 35 laws passed in 1917 to modern-
ize the state’s child welfare system. According to one social work his-
torian, the code launched a “new era of child welfare work” and made
Minnesota “one of the leading states measured by its children’s laws.”
E u g e n i c s a n d S o c i a l W e l fa r e i n N e w D e a l M i n n e s o t a â•… · â•… 119
Thomson recalled. “With few exceptions the welfare boards gave first
consideration to other programs; supervision of the feebleminded was
done almost solely on an emergency basis.”28
The spectacular increase in federal welfare funding (and government
jobs ripe for patronage) raised the stakes in the bitter partisan battles over
taxation and relief. Traveling around the country for federal relief admin-
istrator Harry Hopkins, journalist Lorena Hickok reported that she had
a “pretty poor impression” of relief work in Minnesota. “The whole set-up
in this state was—pardon the vulgarity—lousy with politics.” Although
Olson was “about the smartest ‘Red’ in this country,” the Democrats were
weak, and “most of the money and the press are Republican and hostile.”
Charges of Communist influence in state government, and the internal
struggles that divided Farmer-Laborites after Olson’s sudden death from
cancer in 1936, added to the turmoil. The years from 1936 to 1939 were a
time of “change and also of considerable stress,” Thomson recalled with
characteristic understatement. There were deep divisions between “ex-
tremely conservative” social workers and “extremely radical” ones and a
“sense of uneasiness” in the state agencies. The Republicans regained the
governorship in 1938, and the new governor, Harold Stassen, embarked on
a major reorganization of state government that brought the 1939 elimina-
tion of the Board of Control. Suspected Communists were purged from
state government, and the control board was replaced by a Social Security
Board with two new departments, Social Welfare and Public Institutions.
Yet sterilizations did not stop.29
Despite the turmoil in the state bureaucracy, Minnesota’s program
for the feebleminded remained outside the political fray for much of this
period. Thomson’s bureaucratic disposition and detachment from party
politics—and the fact that her bureau had no direct money grants—likely
kept the program for the feebleminded from getting politicized. Yet the
inattention to her program also signals ideas about disability, dependency,
and gender that all three parties at every level of government shared. His-
torian Alice Kessler-Harris has remarked on what she calls a “gendered
imagination” which positioned men as independent workers and women
as dependent family members and constituted a crucial measure of “what
was fair” at a time when the social welfare functions of the federal govern-
ment were expanding. Despite being deeply divided over unions, taxa-
tion, and the New Deal, most Minnesotans held the same gendered ideas
E u g e n i c s a n d S o c i a l W e l fa r e i n N e w D e a l M i n n e s o t a â•… · â•… 127
form of birth control paid for by the state. A Twin Cities social worker,
who considered sterilization “questionable” when it came to eugenics,
admitted that it “has worked out well in families where there were already
enough children and the mother and father were convinced that there
should not be any more.” The state archives contain many examples of
women like Annie, the mother of ten children, who entered the insti-
tution “for sterilization” and returned home as soon as they recovered
from surgery. In their cases, the eugenics aim of preventing the births
of potentially feebleminded children, the welfare objective of provid-
ing (minimal) assistance to relief-dependent families, and poor women’s
desire for reproductive control converged. Yet state-funded sterilizations
could only be performed on feebleminded or insane persons under state
guardianship, so poor women seeking state-funded sterilization were
left exceedingly vulnerable. Countless women got stuck in the institu-
tion when outbreaks of influenza or the measles caused surgical delays
or when a family member would not sign the consent form. (The patient,
of course, could not legally sign for herself.) By the end of the decade,
Minnesota’s commitment-institutionalization-sterilization program was
winning few praises outside the Board of Control. But the operations
continued. 35
By the end of the 1930s, political turmoil, partisan charges of patron-
age and corruption, and constant criticisms of state government created
a space for a more open rebellion. In the early years of the sterilization
program, resistance was largely invisible; most people rebelled by refus-
ing to sign sterilization consent forms or simply by running away. Few
Minnesotans pursued the initial right to a hearing, and fewer still sued for
“restoration to capacity.” As the program expanded, however, the opposi-
tion grew increasingly vocal. Socialist feminist author Meridel Le Sueur
wrote about single pregnant working-class women struggling to escape
police matrons and social workers wanting to sterilize them. Except for
Le Sueur and a handful of Farmer-Labor radicals, however, there was little
evidence of concern about women’s reproductive or human rights. 36
Indeed, most public criticism of Minnesota’s program for the fee-
bleminded was motivated by political opposition to the leftist Farmer-
Labor regime. A particularly damning report, which focused partly on
misspending and administrative problems at the School for the Feeble-
minded, was released shortly after the Republicans regained control of
130â•… · â•… M o l ly L a d d - T a y l o r
The state placed too much emphasis on the social problems caused by
the feebleminded and failed to recognize that “higher-grade” mentally
deficient individuals could be rehabilitated and made self-supporting.
About 500 new commitments were made each year, but guardianship
meant little beyond facilitating admission or discharge from the state
institutions; it did nothing for feebleminded wards living in the com-
munity. There was “little justification for the state assuming ‘en masse’
responsibility for so many people . . . when [the state] has so little to offer,”
he concluded. 39
Kirkpatrick also condemned the “startling procedures” at the state
institutions. Crucial decisions about admission and discharge were not
made by physicians or the institutions’ medical superintendents, but by
the supervisor of the feebleminded (Thomson) and shaped largely by lo-
cal welfare needs. Discharge depended on the willingness of the county
of residence to provide economic and social support for the ward, yet
because counties paid only $40 per year to support wards who were in-
stitutionalized, Kirkpatrick surmised that there was “little likelihood that
they will stir themselves very violently” to help feebleminded persons
return to the community, where the cost of supervision was much greater.
Curiously, he did not mention sterilization.40
The Public Health Service, however, wrote disapprovingly that the
“sterilization of defectives is a vigorously advocated procedure.” It noted
that some Minnesota officials hung on to the “crudely unscientific notion”
that surgery could eliminate hereditary defect, but the more common ar-
gument was economic: “Sterilization for even one feeble-minded person
may save the community the cost of supporting another one . . . [and] su-
pervision is much cheaper if the morals of the person supervised are not a
matter of concern.” Like Kirkpatrick, the Public Health Service expressed
concern that state wards who returned to the community were not super-
vised by professionals trained to work with the mentally retarded, but by
county welfare boards “utterly inadequate” to the task.41
Thomson was stunned by the criticism. The release of the Kirkpatrick
report in January 1941 “gave me a shock!” she recalled in her memoirs;
“It was more than critical—it was devastating—in its estimate of the
program for the mentally deficient and epileptic.” But she dismissed the
criticism as a professional dispute between psychiatrists and psychiat-
ric social workers who wanted to “re-create the feebleminded in the im-
132â•… · â•… M o l ly L a d d - T a y l o r
age of the mentally ill” and those (like herself) who were more realistic.
Kirkpatrick had little understanding of the extent and permanence of the
feebleminded problem, Thomson complained; “he was assuming that if
you refused to recognize a problem, it did not exist.”↜42
In the end, the most important challenge to Minnesota’s eugenics
program came not from the politicians or professionals but from the
so-called feebleminded who had the most at stake. Lawsuits seeking
restoration to capacity appear to have increased in the late 1930s and
early 1940s, but one dramatic case sent shock waves through the state
bureaucracy. Rose Masters, a Catholic farm wife and mother of ten, took
her case all the way to the Minnesota Supreme Court—and won. Mrs.
Masters and her husband were poor but respectable tenant farmers who
married in 1923 and had a large family of “apparently normal children,”
but as the Depression continued and their family grew, they wound up on
county relief. Beginning in 1937, they received regular visits from agents
of the county welfare board, who grew increasingly frustrated with Mrs.
Masters’s poor housekeeping and the fact that she kept having babies
despite being on the dole. Several months after the birth of her ninth
child, the welfare board made its move. Mrs. Masters was committed
for the purpose of sterilization in 1940 and sent to the state institution
at Faribault two years later, when her tenth baby was seven months old.
Three months after that, her neighbors petitioned for her release. The
district court rejected their appeal, but its decision was reversed by the
Minnesota Supreme Court.43
The Masters case focused on the involuntary institutionalization and
mental capacity of the Catholic farm wife. Sterilization was not mentioned
in the court records, no doubt because the state could not act without the
family’s consent, and neighbors took action against commitment only
after Mrs. Masters was institutionalized. Still, the case is a powerful ex-
ample of the punitive welfare function of Minnesota’s eugenics program
and a useful illustration of three very different perspectives on welfare,
feeblemindedness, and mothering at a time when the relationships be-
tween families and governments were changing. On one side, testifying
for the state, was the control board psychologist who tested Mrs. Masters.
He saw her IQ score of 64 as incontrovertible proof that she was a moron
and could never be cured. In testimony that the Supreme Court found de-
cidedly unconvincing, the psychologist dismissed all social or behavioral
E u g e n i c s a n d S o c i a l W e l fa r e i n N e w D e a l M i n n e s o t a â•… · â•… 133
tion for more than a year, her condition has definitely improved.” While
the Masters case was a significant victory for welfare-dependent families
forcibly committed to state guardianship in the 1930s, it is clear that she
was restored to capacity only because she was a long-standing member of
the community, had respectable neighbors and a local doctor willing to
support her, and demonstrated her intelligence in court. Like thousands
of other Minnesotans during the Depression, Mrs. Masters was welfare-
dependent, but she was not mentally retarded. The court’s repudiation of
her feebleminded classification tells us as much about changing attitudes
toward welfare as it does about feeblemindedness and eugenics.45
As the Masters case was moving through the courts, Minnesota’s
sterilization program was winding down. A wartime staff shortage at the
Faribault Hospital made routine tubal ligations impossible, and a robust
economy created new employment opportunities for “retarded” citizens
outside the state institutions while weakening public fears of the feeble-
minded menace. Faribault officials reported only 33 sterilizations in 1944,
fewer than one-fifth of operations at the program’s peak. Yet sterilization
continued to be a political issue. In 1946, charges of mass sterilization at
the state institution became front-page news in a bitter primary election
campaign. Ironically, this time it was former Farmer-Labor governor
Hjalmar Petersen, now running as a Republican, who accused the Re-
publicans in government of mistreating inmates and sterilizing them
against their will. A grand jury was called to investigate the charges, but
found the complaints of “wholesale and unauthorized sterilization . . .
unwarranted and not substantiated.” Sterilizations were performed at
Faribault under the Republican administration, as they had been under
the Farmer-Laborites, but they were sanctioned by law.46
Thomson testified before the grand jury, but her attention was increas-
ingly focused on parent advocacy. By encouraging parent activists to start
their own organization, the National Association for Retarded Children,
instead of joining the professionally oriented American Association for
Mental Deficiency, she acted as midwife to the parent reform movement.
Years later, mental health reformer Gunnar Dybwad praised Thomson’s
“enlightened concern for the retarded that was far ahead of her time.” In
1959, the year she retired, a young reform-minded psychiatrist, David J.
Vail, became director of medical services at the Minnesota Department of
Welfare and launched a frontal assault on routine sterilization and other
E u g e n i c s a n d S o c i a l W e l fa r e i n N e w D e a l M i n n e s o t a â•… · â•… 135
Notes
1.╇ In this essay, I use problematic terms such as feebleminded, defective, and men-
tally retarded freely, usually without quotation marks. These words are recognized as
highly offensive today, but that is precisely the point: they capture the perceptions of
their time. They are also more inclusive than current terminology, like developmental
disability, because they refer to people and attributes now seen through a cultural or
psychological lens.
2.╇ Mildred Thomson, “Supervision of the Feeble-Minded by County Welfare
Boards,” paper given to the American Association of Mental Deficiency, May 1940, Re-
cords of the Minnesota Department of Public Welfare, Psychological Services Bureau
(DPW-PSB), Minnesota Historical Society, St. Paul (MHS).
3.╇ E. J. Engberg to Carl Swanson, June 22, 1946, Superintendent’s Correspondence,
Records of the Faribault State School and Hospital (FSSH), MHS.
4.╇ Harry Bruinius, Better for All the World: The Secret History of Forced Sterilization
and America’s Quest for Racial Purity (New York: Vintage Books, 2007).
5.╇ Some 1,930 sterilizations, or 82 percent of the total, were performed on persons
classed as mentally deficient. “Sterilizations Performed under U.S. State Sterilization
Statutes through December 31, 1963,” February 1964, Association for Voluntary Steril-
ization, Supplement, Social Welfare History Archives, University of Minnesota; Philip
R. Reilly, The Surgical Solution: A History of Involuntary Sterilization in the United States
(Baltimore: Johns Hopkins University Press, 1991), 140–43.
6.╇ Gunnar Broberg and Nils Roll-Hansen, Eugenics and the Welfare State: Steril-
ization Policy in Denmark, Sweden, Norway, and Finland (East Lansing: Michigan State
University Press, 1996). See, however, Johanna Schoen, Choice & Coercion: Birth Con-
trol, Sterilization, and Abortion in Public Health and Welfare (Chapel Hill: University of
North Carolina Press, 2005).
7.╇ Cheuh-Fang Ma, One Hundred Years of Public Services for Children in Minnesota
(Chicago: University of Chicago Press, 1948), 111. See also Molly Ladd-Taylor, “The ‘So-
ciological Advantages’ of Sterilization: Fiscal Politics and Feeble-Minded Women in
E u g e n i c s a n d S o c i a l W e l fa r e i n N e w D e a l M i n n e s o t a â•… · â•… 137
ness, see James W. Trent Jr., Inventing the Feeble Mind: A History of Mental Retardation
in the United States (Berkeley: University of California Press, 1994). On the culture of
poverty, see Alice O’Connor, Poverty Knowledge: Social Science, Social Policy, and the
Poor in Twentieth-Century U.S. History (Princeton, N.J.: Princeton University Press),
99–123.
22.╇ Mildred Thomson, “Social Aspects of Minnesota’s Program for the Feeble-
minded,” Proceedings from the American Association on Mental Deficiency 44 (1939–40):
238–43; Raymond Koch, “The Development of Public Relief Programs in Minnesota,
1929–1941” (Ph.D. diss., University of Minnesota, 1967).
23.╇ Thomson, Prologue, 6–13, 55–59, 95; “History of the Sterilization”; Mildred
Thomson, Memo to Members of the Child Welfare Boards of Minnesota, n.d., Gilman
(Robbins and Family) Papers, MHS.
24.╇ Thomson, Prologue, 170–71; “A History of the National Association for Retarded
Children, Inc.,” http://www.thearc.org/NetCommunity/Page.aspx?pid=272.
25.╇ Reilly, Surgical Solution, 118–22; Phelps, “Eugenics Crusade,” 108. See Sharon M.
Leon, “‘A Human Being, and Not a Mere Social Factor’: Catholic Strategies for Dealing
with Sterilization Statutes in the 1920s,” Church History 73 (June 2004): 383–411; D. Je-
rome Tweton, Depression: Minnesota in the Thirties (Fargo: North Dakota State Univer-
sity, Institute for Regional Studies, 1981).
26.╇ Reilly, Surgical Solution, 77–78; Diane B. Paul, Controlling Human Heredity:
1865 to the Present (Atlantic Highlands, N.J.: Humanities Press, 1995), 84–85; Daniel J.
Kevles, In the Name of Eugenics: Genetics and the Uses of Human Heredity, rev. ed. (Cam-
bridge, Mass.: Harvard University Press, 1995), 114–15.
27.╇ Engberg to Swanson. June 22, 1946.
28.╇ Koch, “Public Relief Programs”; Ma, One Hundred Years, 225–35; Thomson,
Prologue, 101.
29.╇ Richard Lowitt and Maurine Beasley, eds., One Third of a Nation: Lorena Hick-
ock Reports on the Great Depression (Urbana: University of Illinois Press, 1981), 134–35;
Thomson, Prologue, 101, 109.
30.╇ Thomson, Prologue, 109, 91–98; Mildred Thomson, “One of the most serious
welfare problems . . .” untitled typescript (c. 1937), DPW; Alice Kessler-Harris, In Pur-
suit of Equity: Women, Men, and the Quest for Economic Citizenship in Twentieth-Century
America (New York: Oxford University Press, 2002), 3–18; Elizabeth Faue, Community
of Suffering and Struggle: Women, Men, and the Labor Movement in Minneapolis, 1915–1945
(Chapel Hill: University of North Carolina Press, 1991). See also Deborah A. Stone, The
Disabled State (Philadelphia: Temple University Press, 1984).
31.╇ Thomson, “Social Aspects”; Thomson, Prologue, 79–80.
32.╇ Record of Sterilization Cases, 1916–37, FSSH; Elizabeth Piper, “Analysis of
Faribault Sterilization Records” (2003), unpublished report in author’s possession.
33.╇ Mildred Thomson, “To Child Welfare Board Members and Others Concerned
with Carrying Out the Sterilization Law,” December 12, 1934, DPW.
34.╇ Stella Hanson, “Outside Supervision of the Feebleminded,” c. 1940, DPW-PSB.
35.╇ Charles E. Dow, “The Problem of the Feeble-Minded III,” typescript, August 9,
1934, DPW Library; E. J. Engberg, “The Treatment of Mental Defectives in Minnesota,”
Minnesota Medicine 23 (May 1940), reprint, FSSH.
36.╇ Meridel Le Sueur, “Sequel to Love,” Anvil 9 (January/February 1935): 3–4.
E u g e n i c s a n d S o c i a l W e l fa r e i n N e w D e a l M i n n e s o t a â•… · â•… 139
37.╇ Minnesota Legislature, Joint Committee on Acts and Activities of the Various
Governmental Departments of the State of Minnesota, Report from the Joint Senate and
House Investigating Committee Covering the Acts and Activities of the Various Governmen-
tal Departments and Agencies of the State of Minnesota, A. O. Sletvold, chairman, 1939–40
interim, MHS; A. L. Haynes, memorandum re: Miss Blanche Harkner, June 19, 1939,
FSSH; Engberg to Swanson, June 22, 1946.
38.╇ Carl Swanson to E. J. Engberg, April 12, 1940, FSSH; United States Public
Health Service, Section X of a Survey of the State Hospitals of Minnesota, Section I,
Washington, D.C., 1939, typescript, DPW-PSB; “From Supplementary Report on the
Mental Health Program in Minnesota by the American Public Welfare Association,”
typescript, n.d., DPW-PSB; Thomson, Prologue, 125–30. See Gerald Grob, Mental Illness
and American Society, 1875–1940 (Princeton, N.J.: Princeton University Press, 1983).
39.╇ “Supplementary Report,” 4.
40.╇ “Supplementary Report,” 2.
41.╇ “Survey of the State Hospitals of Minnesota.”
42.╇ Thomson, Prologue, 127–29; Mildred Thomson to Walter W. Finke, “Report of
the American Public Welfare Association,” memorandum, January 7, 1941, DPW-PSB.
43.╇ In re Masters, Teubner et al. v. State, Supreme Court of Minnesota, March 3,
1944, 13 NW 2d, 487–94; “Petition for Restoration to Capacity of Rose Masters,” O.
M. Teubner and Lee Adams, Appellants vs. State of Minnesota, Martin County (17th
Judicial District), Case Files #33719, Minnesota Supreme Court, MHS; Martin County
Welfare Board, Minutes, December 8, 1938, MHS.
44.╇ Testimony from “Petition for Restoration to Capacity of Rose Masters”; In re
Masters, 487–89.
45.╇ In re Masters, 490–93.
46.╇ Thomson, Prologue, 147–48; Engberg to Swanson, June 22, 1946; “Cruelty in
State School Charged,” Veterans’ News (June 19, 1946), MHS.
47.╇ Gunnar Dybwad, “From Feeblemindedness to Self-Advocacy: A Half Century
of Growth and Self-Fulfillment,” paper presented at the Annual Meeting of the Ameri-
can Association of Mental Retardation, June 2, 1994, www.mncdd.org/parallels2/
pdf/98-FFA-HSU.pdf. See the excellent website of the Minnesota Governor’s Council
on Developmental Disabilities, “Parallels in Time: A History of Developmental Disabili-
ties,” http://www.mncdd.org/parallels/index.html.
48.╇ Elizabeth W. Reed and Sheldon C. Reed, Mental Retardation: A Family Study
(Philadelphia: W. B. Saunders, 1965), 77–78. Many academic reviewers expressed con-
cern about the Reeds’ subjective definition of mental retardation and the validity of
their data, and in 1985 the university distanced itself from eugenics by dropping “Dight”
from the institute’s name. See the review by Edgar A. Doll in the American Journal of
Psychology 79 (June 1966): 346–47, and “Institute May Be Renamed Due to Benefac-
tor’s Beliefs,” Minnesota Daily (May 2, 1985). See also Molly Ladd-Taylor, “‘A Kind of
Genetic Social Work’: Sheldon Reed and the Origins of Genetic Counseling,” in Women,
Health, and Nation: Canada and the United States since 1945, ed. Gina Feldberg, Molly
Ladd-Taylor, Alison Li, and Kathryn McPherson (Montreal: McGill-Queens University
Press, 2003), 67–83.
49.╇ Robert J. Levy, “Protecting the Mentally Retarded: An Empirical Survey and
Evaluation of the Establishment of Guardianship in Minnesota,” Minnesota Law Review
140â•… · â•… M o l ly L a d d - T a y l o r
49 (1965): 821–87, quotation on 877; Minnesota Statutes, Laws 1975, chapter 252A. Condi-
tions within the institutions were challenged by a 1972 lawsuit, Welsch v. Likins, which
led to a systemwide consent decree and contributed to the closure of the state institu-
tions. See “Parallels in Time” and Joseph P. Shapiro, No Pity: People with Disabilities
Forging a New Civil Rights Movement (New York: Three Rivers Press, 1994).
50.╇ See Dorothy Roberts, Shattered Bonds: The Color of Child Welfare (New York:
Basic Books, 2001) and Killing the Black Body: Race, Reproduction, and the Meaning of
Liberty (New York: Pantheon, 1997); Rachel Roth, “‘No New Babies?’ Gender Inequality
and Reproductive Control in the Criminal Justice and Prison Systems,” Journal of Gen-
der, Social Policy, and the Law 12 (2005): 391–425.
seven
Joh a n n a S c hoe n
141
142â•… · â•… J o h a n n a S c h o e n
With the passage of the state’s eugenic sterilization law, health and wel-
fare officials implementing the program brought their own policy goals
to the table. These goals could range from controlling welfare spending
to improving the health of sterilization candidates to easing institutional
overcrowding by sterilizing and then releasing inmates from the state’s
training schools. Having identified an individual as in need of eugenic
sterilization, petitioners put together a sterilization petition containing
information on the client’s social, medical, and eugenic history and sub-
mitted the application to the North Carolina Eugenics Board. At their
144â•… · â•… J o h a n n a S c h o e n
While health and welfare professionals had high hopes for eugenic ster-
ilization, the eugenic science that underlay it did not go unchallenged.
Starting in the 1920s, geneticists, anthropologists, physicians, and psy-
chologists began to engage in research that eventually undermined eu-
genic science’s basic assumptions. With the onset of World War II, interest
in eugenic sterilization began to decline. The country finally pulled out
of the Great Depression, and wartime production led to full employment
and a drastic reduction of the welfare rolls. The shortage of surgeons
during the war caused a sharp decline in the number of sterilization op-
148â•… ·â•… J o h a n n a S c h o e n
tinued both to offer a solution to social problems and to cut welfare rolls
by reducing the number of children born to welfare recipients. Thus as
welfare rolls grew in the 1950s and 1960s, eugenic sterilization programs
in a few states expanded. Continuing such programs became particularly
appealing in the postwar period, when sex outside marriage and rising il-
legitimacy rates seemed to threaten the stability of the American family.
The “rediscovery” of poverty in the early 1960s further fueled concerns
about the reproductive capacity of poor families and solidified the link
between illegitimacy and innate immorality. The focus on the “culture
of poverty” replaced hereditary theories as a justification for eugenic
sterilization and other measures while demanding similar interven-
tions. Almost formulaically, social workers emphasized the inadequate
supervision that daughters received from their mothers and warned of
the continuation of poverty and neglect from generation to generation.
“Sterilization,” they argued, “will prevent additional children who will
never be able to realize any potential they may have because adequate
care will be denied them and will restrict the third generation who are
caught in this cycle of poverty and neglect.”32 By the 1950s, social policy
had refashioned the theoretical foundations of eugenic sterilization to
meet its purposes.
Fears about the rising cost of the Aid to Dependent Children (ADC)
program led to a significant shift in the racial composition of those tar-
geted for eugenic sterilization. While the discriminatory welfare prac-
tices of the 1930s and 1940s had excluded African Americans from ADC
programs and left them largely outside social workers’ sphere of influ-
ence, federal pressure and a series of new requirements relating to the
implementation of ADC resulted in black women’s inclusion in social
service programs, bringing them into closer contact with social workers
and thus with state-supported sterilization. Nationwide, the percentage
of welfare recipients who were African American rose from 31 percent in
1950 to 48 percent in 1961. By the 1960s, the addition of Hispanics to the
rolls produced a nonwhite majority among welfare recipients. It seemed
especially pressing to save funds considering the “prevalence of illegiti-
macy among the lower-class Negro population” and the perception that
most nonwhite unwed mothers had “no means of support except through
public assistance.”33 As a result, the proportion of African Americans
sterilized under the auspices of the North Carolina Eugenics Board rose
150â•… · â•… J o h a n n a S c h o e n
from 23 percent in the 1930s and 1940s to 59 percent between 1958 and
1960 and finally to 64 percent between 1964 and 1966. 34 Overall, about
60 percent of sterilization candidates were white, and 40 percent were
African American.
To intensify the fight against poverty, Ellen Winston, North Caro-
lina’s commissioner of public welfare, recommended in 1951 that the state
expand its use of the eugenic sterilization program by following up on
ADC families in which one family member had been sterilized to deter-
mine if other members might benefit from the surgery. 35 This new policy
led not only to an increase in the number of noninstitutional steriliza-
tions but also to a sharp rise in the number of women sterilized who had
given birth to children prior to having the operation. Sixty-six percent of
patients sterilized in the 1950s and 1960s had had children prior to their
sterilization, and 52 percent of them had given birth outside marriage.
The new emphasis on socialization drew particular attention to the
behavior of teenage girls. Social workers considered girls reared in impov-
erished and immoral environments to be likely to perpetuate the pattern
set by their parents. As social workers began to draw up the eugenic ster-
ilization petitions of the 1950s and 1960s, this attention to young single
mothers led straight into the homes of girls such as Elaine Riddick.
the director of the state Board of Public Welfare, Ellen Winston, or her
representative, R. Eugene Brown; R. D. Higgins from the State Board of
Health; and W. R. Pierce from the State Attorney General’s Office.
It took until the late 1960s for North Carolina sterilization rates to de-
cline. Changes during that decade laid the groundwork for the disman-
tling of state-supported sterilization. The development of more reliable
contraceptives, the onset of the civil rights and women’s rights move-
ments, and a better understanding of mental disease and deficiency all
contributed to a significant shift in board members’ perceptions of eu-
genic sterilization. In 1974, North Carolina and Virginia finally repealed
their eugenic sterilization laws. That same year, the Office of Economic
Opportunity formulated and distributed sterilization guidelines to en-
sure that patients would receive adequate counseling and be given in-
formed consent to further safeguard the poor against the possibility of
sterilization abuse.
Clearly, the history of eugenic sterilization is a history of misguided
governmental policy that we do not want to see repeated. By thwarting
the most intimate interests of sterilization victims in their own physical
and mental health, the state did wrong as well as harm. State steriliza-
tion disappointed the most natural and realistic hopes and expectations
an individual might hold: the ability to determine the size of one’s fam-
ily. Moreover, as victims testify to a lifetime of depression, distrust, and
feelings of worthlessness as a result of sterilization, the surgery left them
worse off than they had been prior to the surgery. By infringing on the
victims’ interest in their own health and the normal functioning of their
bodies, the state violated the most important interests a person has. 52
North Carolina has come a long way in facilitating research of its his-
tory and acknowledging responsibility for its past. Following Governor
Easley’s 2002 apology for the program and his appointment of a eugenics
study commission, the state—through its Office of Minority Health and
Health Disparities—commissioned an exhibit to remember this history.
In 2009, the state erected a historical marker to call attention to the work
of the Eugenics Board. 53 Last but not least, North Carolina—like Sweden
and the Canadian province of Alberta before it—is considering restitu-
156â•… · â•… J o h a n n a S c h o e n
tion payments to its sterilization victims. These are steps of great signifi-
cance, and the state should be congratulated for having come so far. But
an acknowledgment of past wrongs means little unless it is accompanied
by serious attempts to avoid similar mistakes in the future. We need to
show both our humanity toward the sterilization victims and humility
toward the policy making process. This includes the study of and educa-
tion about past policy and thoughtful discussion about the principles that
should guide our social policy in the future.
The ability of poor women to exercise their reproductive rights
remains under constant attack. Many people continue to believe that
women should not have children while they receive public assistance.
As we think about these problems, we need to remember the legacy of
state sterilization programs. We have to prevent family planning policies
that force women to use any form of birth control against their will. And
we have to ensure that all have access to education about birth control,
sterilization, and abortion regardless of their race, class, age, and marital
status. Finally, we have to understand that women and men have the right
to decide to use or not to use such services, even if we disagree with their
decision. Rights are only as strong as our willingness to tolerate the deci-
sions of others. A full acknowledgment of the suffering of the women and
men sterilized under the auspices of the North Carolina Eugenics Board
must include a spirited defense of their reproductive rights.
Notes
1.╇ John Railey, interview with Elaine Riddick Jessie, Aug. 26, 2002. In author’s
possession.
2.╇ See R. Eugene Brown, Eugenical Sterilization in North Carolina (Raleigh, N.C.:
Eugenics Board of North Carolina, 1935); see also General Statute, chapter 35, article 7;
Biennial Reports of the Eugenics Board of North Carolina (Raleigh, N.C.: Eugenics Board
of North Carolina, June 30, 1934, to July 1, 1968). For general information on Buck v.
Bell, see J. David Smith and K. Ray Nelson, The Sterilization of Carrie Buck (Far Hills,
N.J.: Horizon Press, 1989); Allison C. Carey, “Gender and Compulsory Sterilization
Programs in America, 1907–1950,” Journal of Historical Sociology 11, no. 1 (March 1998):
74–105; Paul Lombardo, “Eugenic Sterilization in Virginia: Aubrey Strode and the Case
of Buck v. Bell” (Ph.D. diss., University of Virginia, 1982); Philip R. Reilly, The Surgical
Solution: A History of Involuntary Sterilization in the United States (Baltimore: Johns
Hopkins University Press, 1991), 88, 129, 137; Moya Woodside, Sterilization in North
Carolina: A Sociological and Psychological Study (Chapel Hill: University of North Caro-
lina Press, 1950), 194.
R e a s s e s s i n g E u g e n i c S t e r i l i z a t i o nâ•… · â•… 157
3.╇ Carey, “Gender and Compulsory Sterilization Programs”; Reilly, The Surgical
Solution, 129, 137, 158; Wendy Kline, Building a Better Race: Gender, Sexuality, and Eugen-
ics from the Turn of the Century to the Baby Boom (Berkeley: University of California
Press, 2001).
4.╇ See Paul Popenoe and Roswell Hill Johnson, Applied Eugenics (New York:
Macmillan, 1922), 74; Henry H. Goddard, The Kallikak Family: A Study in the Heredity of
Feeblemindedness (New York: Macmillan, 1921); Daniel J. Kevles, In the Name of Eugen-
ics: Genetics and the Uses of Human Heredity (New York: Alfred A. Knopf, 1985), 46–49.
5.╇ JoAnne Brown, The Definition of a Profession: The Authority of Metaphor in the
History of Intelligence Testing, 1890–1930 (Princeton, N.J.: Princeton University Press,
1992); Stephen Jay Gould, The Mismeasure of Man (New York: W. W. Norton, 1981),
146–233.
6.╇ Brown, Eugenical Sterilization, 21. My ability to analyze the policy making
process in North Carolina is limited by the fact that the state legislature does not keep
written records of its legislative sessions. Trying to understand the motivations of state
legislators who debated, formulated, and funded reproductive policy is difficult, and in
the case of the passage of and amendments to the state sterilization laws, it is impossible.
In fact, during most of the period under discussion, such issues were considered to be
private and were not debated publicly.
7.╇ See Brown, Eugenical Sterilization; General Statute, chapter 35, article 7.
8.╇ “Definitions of Feeblemindedness,” General File, box 7, file: Policies and Prac-
tices of the Eugenics Board, Social Services Record Group (SS), North Carolina State
Archives (NCSA). This 1908 definition is an excerpt of the British Royal Commission on
the Feebleminded and was provided for North Carolina officials concerned with identi-
fying the feebleminded for sterilization.
9.╇Lloyd J. Thompson, A Study of Mental Health in North Carolina (Raleigh, N.C.,
1937), 252–53. Also Carl N. Degler, In Search of Human Nature: The Decline and Revival
of Darwinism in American Social Thought (New York: Oxford University Press, 1991),
40. For similar calls, see Lydia Allen DeVilbiss to Margaret Sanger, September 10, 1935,
Margaret Sanger Papers, Sophia Smith Collection, reel S 10, Smith College, Northamp-
ton, N.H.
10.╇George H. Lawrence, “A Study Relating to Mental Illness, Mental Deficiency,
and Epilepsy in a Selected Rural County” (May 1948), 14, General File, box 7, file:
Woodside Study, SS-NCSA.
11.╇ DeVilbiss to Sanger, September 10, 1935. See also Eugenics Board meetings, Oc-
tober 24, 1961, October 23, 1962, and October 27, 1962, Eugenics Board (EB), NCSA.
12.╇ Brewer v. Valk, 204 N.C. 378 (1932), 13.
13.╇ Hearing Case 1, Eugenics Board meeting, August 17, 1938; Hearing Case 1, Eu-
genics Board meeting, December 2, 1936; Hearing Cases 2 and 3, Eugenics Board meet-
ing, April 20, 1938, EB-NCSA.
14.╇ Hearing Case 2, Eugenics Board meeting, December 2, 1936, EB-NCSA.
15.╇ Hearing Case 2, Eugenics Board meeting, June 15, 1938; Hearing Case 1, Eugen-
ics Board meeting, August 19, 1936; Hearing Case 1, Eugenics Board meeting, July 21,
1937; Hearing Case 2, Eugenics Board meeting, March 16, 1938, EB-NCSA.
16.╇ Marian S. Olden, The ABC of Human Conservation, publication no. 31 (Prince�
ton, N.J.: Birthright, [1946]), 6–7, copy consulted in series 1, box 2, folder 77,
Human Betterment League Papers, Southern Historical Collection (HBL-SHC).
158â•… · â•… J o h a n n a S c h o e n
17.╇ Report of the Committee on Caswell Training School in Its Relation to the Problem
of the Feebleminded of the State of North Carolina (Raleigh: Capitol Printing, 1926), 15.
18.╇ Hearing Case, Eugenics Board meeting, January 25, 1955, EB-NCSA. It was not
unusual for health and welfare professionals across the country to refer promiscuous
daughters to welfare departments for sterilization. See, for instance, the recommenda-
tion by an agent of the Farm Security Administration to leave such regulation of sexual-
ity to welfare departments. W. C. Morehead, “Outline of Talk Given to FSA Personnel in
Special Rural Projects Program,” September 19, 1940, Planned Parenthood Federation
of America I, series 3, box 45, folder: Birth Control, California, FSA Project, 1939–1941,
Margaret Sanger Papers, Sophia Smith Collection, Smith College.
19.╇Lawrence, “A Study Relating to Mental Illness,” 7, 10. Other states mirrored
these findings. Seventy-five percent of those sterilized in California, for instance, were
considered “sex delinquents.” E. S. Gosney and Paul Popenoe, Sterilization for Human
Betterment (New York: Macmillan, 1930), 40.
20.╇ In the case histories, 178 histories [22 percent] gave information on sexual be-
havior, and 142 of those clients were described as sexually promiscuous. In 44 petitions,
patients were described as victims of rape or incest or likely to be taken advantage of.
Several cases contain more than one observation.
21.╇ Reilly, The Surgical Solution, 94–95, 99; Carey, “Gender and Compulsory Ster-
ilization Programs,” 84–85, 101n11; Kline, Building a Better Race, 53. Other states also
had such a high percentage of female sterilizations. Seventy-nine percent of individuals
sterilized in Minnesota between 1926 and 1946, for instance, were female. Most steril-
ized women in that state fell into two general categories: sexual “delinquents” or older
women with a number of children on welfare. Molly Ladd-Taylor, “Saving Babies, Steril-
izing Mothers,” Social Politics 4, no. 1 (Spring 1997): 136–53, at 145, 149; Mary Bishop,
“Sterilization Survivors Speak Out,” Southern Exposure 23, no. 2 (Summer 1995): 12–17,
at 14.
22.╇ A study by eugenicist Paul Popenoe on sterilizations performed in California
between 1909 and 1929 shows that “economically dependent” men and women were
three times as likely to be sterilized as those who were more prosperous. Paul Popenoe,
“Economic and Social Status of the Sterilized Insane,” in Collected Papers on Eugenic
Sterilization in California, ed. E. S. Gosney (Pasadena, Calif.: Human Betterment
Foundation, 1930), 24. See also Ladd-Taylor, “Saving Babies, Sterilizing Mothers,” 144;
Bishop, “Sterilization Survivors Speak Out,” 15.
23.╇ Of 800 sterilization candidates—a sample of 10 percent of the total number of
sterilization petitions—147 (18.4 percent of the sample) gave information on clients’
work history; 41 (28 percent) of those households received ADC payments; 63 (43 per-
cent) received other benefits; 39 patients (26 percent) were described as unable to
work.
24.╇ Information on the physical condition of clients’ housing was available in 67
cases (8.4 percent of the overall sample). Of these, 57 (85 percent) lived in inadequate
housing and 37 (55 percent) in overcrowded housing. In 14 cases (21 percent), houses
were in poor repair; in 11 (16 percent), houses were poorly furnished. Six families (9 per-
cent) lacked some or all conveniences.
25.╇ Case 19, February 28, 1961; special meeting: Case 2, February 18, 1960; Hearing
Case 1, March 22, 1966.
R e a s s e s s i n g E u g e n i c S t e r i l i z a t i o nâ•… · â•… 159
26.╇ While overall rates of illiteracy had dropped to 13 percent in 1930, 27.7 percent
of African Americans over the age of 21 were illiterate. For the rural farm population,
white illiteracy rates stood at 10.4 percent and rates for African Americans stood at 32.6
percent. See 15th Census of the United States, 1930.
27.╇ See Hearing Case 2, Eugenics Board meeting, April 20, 1938, for a father’s inabil-
ity to pay book rent; Hearing Case 1, Eugenics Board meeting, September 21, 1938, for
children who couldn’t attend school because they were needed to help with the harvest;
also Hearing Case 2, Eugenics Board meeting, March 16, 1938, EB-NCSA.
28.╇ For more information on Gamble, see James Reed, From Private Vice to Public
Virtue: The Birth Control Movement and American Society, rev. ed. (Princeton, N.J.:
Princeton University Press, 1983), and Doone Williams and Greer Williams, Every Child
a Wanted Child: Clarence James Gamble, M.D., and His Work in the Birth Control Move-
ment (Cambridge: Harvard University Press, 1978). Also Johanna Schoen, Choice &
Coercion: Birth Control, Sterilization, and Abortion in Public Health and Welfare (Chapel
Hill: University of North Carolina Press, 2005).
29.╇ During the late 1940s, Clarence Gamble himself published at least 20 articles
in professional journals arguing for eugenic sterilization. Larson argues that Gamble
did as much as any one philanthropist could have done to implement eugenic steril-
ization programs. Edward Larson, Sex, Race, and Science: Eugenics in the Deep South
(Baltimore: Johns Hopkins University Press, 1995), 149–51, 155–57. See also Human Bet-
terment League of North Carolina, “25th Anniversary, 1947—25 Years of Human Better-
ment—1972,” series 3, box 4, folder 133 (1968–74), HBL-SHC.
30.╇ Evangeline Davis, “Alarming Mental Deficiency Rate Confronts State,” Char-
lotte News, March 27, 1945.
31.╇ Evangeline Davis, “Crowded Caswell Simply Can’t Handle Patients,” Charlotte
News, March 28, 1945.
32.╇ Case 3, EBM, June 11, 1964, EB-NCSA. See also Case 12, EBM, June 23, 1964,
and Case 1, EBM, August 25, 1964, both in EB-NCSA.
33.╇ Pax Davis, “Sterilization Funds Urged,” Raleigh News and Observer, August 27,
1950.
34.╇ See minutes of the Eugenic Board meetings, EB-NCSA. No comparable data for
other states is available.
35.╇ Winston to the Superintendent of Public Welfare, December 12, 1951, box 30A,
file: ADC-Eugenics Program, DSS-NCSA.
36.╇ Case 39, EBM, May 24, 1955, EB-NCSA.
37.╇ Case 16, EBM, November 26, 1954, EB-NCSA.
38.╇ Case 28, EBM, September 27, 1950, EB-NCSA.
39.╇ Case 13, EBM, March 22, 1955, EB-NCSA.
40.╇ Case 5, June 1952.
41.╇ Case 7, May 1964.
42.╇ Case 6, February 1952; Case 4, April 1952.
43.╇ A quarter of the cases providing observations about sex mentioned instances of
rape or incest.
44.╇ Case 10, November 22, 1960.
45.╇ Case 31, June 26, 1962.
46.╇ Case 7, July 24, 1962.
160â•… · â•… J o h a n n a S c h o e n
47.╇ Jakob Koomen, interview with Johanna Schoen, May 2, 1990, Chapel Hill, N.C.
48.╇ Murlene Wall, interview with Johanna Schoen, June 19, 1997, Charlotte, N.C.
49.╇ Koomen interview, 1990.
50.╇ Ibid.
51.╇ Ed Chapin, interview with Johanna Schoen, June 19, 1997, Charlotte, N.C.
52.╇ Joel Feinberg, Harm to Others, vol. 1 (New York: Oxford University Press, 1984),
3–64.
53.╇ See North Carolina Department of Cultural Resources (http://news.ncdcr.gov/
2009/06/18/historical-highway-marker-remembers-eugenics).
e ig h t
Protection or Control?
Women’s Health, Sterilization
Abuse, and Relf v. Weinberger
G r e g or y M ic h a e l D or r
On June 13, 1973, Mrs. Minnie Relf welcomed two representatives from the
Montgomery, Alabama, Community Action Council (MCAC) into her
home.1 According to Mrs. Relf, these social workers told her that they had
noticed boys “hanging around” her daughters, 14-year-old Minnie Lee
and 12-year-old Mary Alice. Worried that this social interaction would
lead to sexual intercourse, the welfare officials escorted Mrs. Relf and
the girls to a local hospital and presented Mrs. Relf with a bureaucratic
solution: they placed consent forms in front of her. Mrs. Relf’s illiteracy
rendered her unable to read the forms; her lack of education further con-
fused the officials’ explanations. Mrs. Relf believed that signing the forms
would authorize the MCAC’s family planning clinic to give her daughters
“some shots.” Her oldest daughter, 17-year-old Katie, had been receiving
injections of the then-experimental, long-term birth control drug Depo-
Provera from the clinic. Assuming that she was enrolling her youngest
daughters in the same program, Mrs. Relf made her mark, an uncertain
X, on the signature line of each consent form. A nurse then escorted Mrs.
Relf home. The next morning, Mary Alice and Minnie did indeed receive
shots—of sedatives—after which they were wheeled into an operating
room and surgically sterilized. Unbeknownst to Mrs. Relf, she had made
her mark on surgical consent forms authorizing the sterilizations. Two
weeks later, on June 27, the Southern Poverty Law Center (SPLC) filed a
$1 million lawsuit on the Relfs’ behalf, sparking furious protest. 2 Before
the year ended, Americans learned that doctors and overzealous social
workers had been targeting poor women, and especially poor women of
color, in a nationwide epidemic of sterilization.
161
162â•… · â•… G r e g o r y M i c h a e l D o r r
This essay examines the controversy touched off by the Relf sisters’
sterilization, an event that gained national notoriety through the federal
court case Relf v. Weinberger.3 Often only a footnote in histories about
reproductive rights, significant solely as the spark that ignited a politi-
cal tinderbox, Relf deserves closer attention for at least three reasons.4
First, locating Relf in its historical context reveals the social tensions that
merged quasi-Malthusian thinking with rising political animosity toward
federal welfare programs. Support for implicitly and explicitly eugenic
population controls emerged from the concern that the nation faced
a demographic explosion among the underclass, a “population bomb”
that threatened to destroy civilization in either a hail of welfare claims
or violent social revolution. Politically, the Nixon administration used
population anxiety to harmonize the demands of welfare activists and the
New Right on one hand, demographic alarmists and the emerging anti-
abortion lobby on the other—all in the name of reelecting the president.
This political opportunism had far-reaching consequences. 5
Second, Relf illustrates the persistence of eugenic ideology in Amer-
ican social policy. State and federal efforts to curb procreation in the
1960s and 1970s devolved from earlier attempts to improve the “human
stock” into operations purportedly “performed for the public benefit . . .
to maintain control within state institutions and to limit welfare costs.”↜6
Such operations, while not meant to purify the gene pool by filtering
out “undesirable” genetic traits, still amounted to eugenic interventions.
Some legislators, activists, and segments of the public argued that poverty
bred more poverty; preventing the poor from breeding seemed a solution.
Controlling procreation both defused the population bomb and offered a
panacea for a hot topic social problem: the birth of “illegitimate” children
to unwed mothers receiving welfare.
Finally, the revelation of the Relfs’ experience came hard on the heels
of another medical fiasco involving Alabama, African Americans, and the
federal government. Just a year earlier, in July 1972, journalists stunned the
nation with reports of the so-called Tuskegee syphilis experiment. Ameri-
cans had been horrified to learn that U.S. Public Health Service physi-
cians had watched 399 poor African American men in Macon County,
Alabama, sicken (and some die) from syphilitic infections, all the while
denying them antisyphilitic therapy. Investigators and the public quickly
associated the lack of informed consent in both the Tuskegee and Relf
P r o t e c t i o n o r C o n t r o l ? â•… · â•… 163
1960s and early 1970s, people drew parallels between starvation and war
in Indo-China and America’s crowded, dirty, and decrepit inner cities
that erupted in the violent “long hot summers” of the late 1960s. With
the Vietnam War and the Great Society sapping the treasury, the econ-
omy sagged. Soon Americans reeled under the new economic malaise,
“stagflation.” Ehrlich’s prognostications seemed to be coming true—
overpopulation was placing unsustainable demands on scarce resources,
threatening collapse.
Both the state and federal governmental response to the exploding
underclass often redounded to eugenics. A number of states considered
passing “punitive sterilization laws,” attempting to compel poor mothers
of “illegitimate” children to undergo sterilization.9 These legislative initia-
tives reflected ambient attitudes in America, enunciating a view of eugenic
sterilization that had been implicit since the 1910s—that the so-called
feebleminded, the original targets of sterilization, actually comprised a
catch-all category linked more closely to poverty and perceived antisocial
behavior than to organic mental deficiency.10 After Relf╃ broke, Americans
realized that coercive sterilization was not restricted to states with long-
standing eugenics programs or to state bureaucrats. Instead, support for
the sterilization of welfare mothers reached into private medical practices,
federally funded birth control clinics, and perhaps even into the Oval
Office itself.
While secondary to the Vietnam War, social unrest—and the failure
of President Johnson’s Great Society programs to engender tranquility—
emerged as a principal issue in the 1968 elections. Urban violence had
rocked the nation each summer since the Watts section of Los Angeles
burned in 1965. Blamed in part on crushing inner-city poverty, the vio-
lence spurred welfare activists to demand action; they swamped welfare
offices with applications for increased benefits and direct participation
by recipients in policy administration.11 As the Left argued for social
meliorism and the Right advocated “law and order,” population control
enthusiasts claimed that unfettered reproduction among the poor, en-
couraged by the promise of “government handouts,” fueled the social
crisis. Nixon determined to quell unrest, dismantle the Great Society,
and cure poverty in one stroke by linking welfare reform and population
control. Combined, these measures would lead to increased opportunity
and equity for all Americans.
P r o t e c t i o n o r C o n t r o l ? â•… · â•… 165
Thus population policy could reconcile the Left and the Right, solidifying
the GOP’s hold on government.
President Nixon turned to the Office of Economic Opportunity
(OEO) to administer programs aimed at poor women. Ironically, despite
its nominal congruence with the president’s economic enfranchisement
ideology, the OEO was the Great Society program Nixon hated most and
targeted for a “revamping” with the FAP. Although that overhaul failed,
Nixon was able to use Great Society programs like the OEO and the
Department of Health, Education, and Welfare (DHEW) to disseminate
family planning services—even as he sought their dissolution as govern-
mental agencies.
Nixon’s population initiatives recurred throughout his presidency.
In July 1969, the president unveiled his “birth curb” program that cre-
ated a federal population office to disburse $382 million to population
control groups. These funds subsidized contraceptive research, birth con-
trol counseling, and the distribution of contraceptives to the poor, first
through OEO-sponsored family planning services (including the MCAC
family planning clinic) and later through DHEW. In the fall of 1969, the
president had DHEW create a National Center for Family Planning Ser-
vices. Early in 1970, the administration almost doubled the budget for
contraceptive research. On Christmas Eve 1970, the president signed the
Family Planning Services and Population Research Act—the “birth curb
bill”—the first such law ever passed by Congress.22 On May 18, 1971, the
OEO began funding sterilizations (but never abortions, which were illegal
in most instances). Concerned that “patients be protected and provided
with high quality medical care,” the OEO sought “guidelines and clinical
standards” to “incorporate the necessary safeguards” in promulgating
sterilization. These guidelines were scheduled for release by September 1,
1971. Until that time, no OEO-funded program was supposed to provide
sterilizations.23
The administration’s increased funding and its rhetoric about pa-
tient safety were creatures of political calculus, not social conscience.
Although such spending might prime the flagging economy and reduce
welfare demand, it also “might help us politically, a thought that just oc-
curred to me,” the president wrote. Nixon once again used cross-cutting
political pressures to nullify each other. The program’s increased benefits
(in the form of federally sponsored birth control) looked good to welfare
168â•… · â•… G r e g o r y M i c h a e l D o r r
tion to the unfit, offsetting the dysgenic effect of fit couples’ use of con-
traceptives. Yet voluntary sterilization—long trammeled by so-called
age/parity requirements debarring young women, mothers with fewer
than three children, and women whose husbands would not also sign
the consent form—remained largely unavailable until the 1970s. 37 By
then, the heirs to the eugenics movement and their foes understood that
education about and access to contraception represented both a boon
to poor women (they could exercise greater reproductive freedom) and
a doorway to potential abuse (officials could force birth control or ster-
ilization on unwilling women). 38 Voluntarism would allow sterilization
to escape the stigma of eugenics; the definition of “voluntary,” however,
remained fluid—conditioned by emerging concepts of informed con-
sent. What constituted informed consent now became the fulcrum over
which women’s desires and societal imperatives teetered.
A bus e U nfolds
Relf ’s filing prompted other abused women to speak out, even as official
investigations revealed an ever-widening pattern of sterilization abuse. By
July 2, 1973, OEO investigators had determined that 11 women, all but 1
of whom were black, had been sterilized by the MCAC. 54 On July 13, Nial
Ruth Cox, a 26-year-old African American hospital worker, reported that
North Carolina officials had sterilized her when she became an unwed
mother at 18. Her case prompted scrutiny of the North Carolina State Eu-
genics Board, which routinely classified poor women as “feebleminded”
and ordered them sterilized. 55 On July 21, officials from the South Carolina
Department of Social Services and the Atlanta offices of DHEW began
investigating physicians in Aiken, South Carolina, especially Dr. Clovis
Pierce. Inspectors discovered that Pierce refused to provide obstetrical
services to poor women on welfare—unless the women consented to
sterilization during delivery. Rather than forgo obstetrical services, half
of the welfare mothers who delivered babies in Aiken County during 1973
received sterilizations. One woman sterilized by Pierce testified that he
told her “he worked hard to pay his taxes and was tired of having people
come to him to have babies he would have to support with his tax dollars,”
despite the fact that Medicaid had paid him over $60,000 in 1972 and the
first half of 1973 for serving poor women. 56 Pierce was not an ideological
wildcat. A 1972 survey showed that 94 percent of obstetrician-gynecolo-
gists supported “compulsory sterilization or the withholding of welfare
support for unwed mothers who already had three children.”57 The SPLC
brought two of Dr. Pierce’s patients into the Relf suit and represented
them in a federal tort case, Walker v. Pierce. 58
The federal government, responsible for subsidizing this cottage in-
dustry in sterilization, admitted that 16,000 women and 9,000 men had
been sterilized at public expense between 1972 and 1973. Government
officials, however, could not vouch for the degree of informed consent
in every case. Black women had special reason for concern. Beyond the
conventional wisdom about “Mississippi appendectomies” in the black
community (sterilizations performed under the guise of other abdominal
surgeries), independent studies demonstrated in 1970 that black women
were sterilized at more than twice the rate of white women (9 per 1,000
black patients compared with 4.1 per 1,000 white patients). 59 In the wake
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of Relf, Latinas and Native American women came forward with their
own stories of widespread sterilization abuse, too. 60 These revelations
proved to be only the tip of America’s deeply submerged sterilization
iceberg.
Between 1968 and 1973, America witnessed a sterilization explosion:
approximately two million Americans (one million men, one million
women) underwent sterilization in 1973, up from roughly 400,000 in
1968. This increase led to additional questions. Prompted by the work of
Dr. Bernard Rosenfeld, the Health Research Group (a watchdog agency
funded by Ralph Nader’s activist organization Public Citizen) discov-
ered a nationwide epidemic of abuse. As an intern at Oakland’s Highland
General Hospital, Rosenfeld witnessed doctors “selling” sterilization to
patients, particularly women of color. While helping a senior resident
deliver a woman who “in his opinion, had enough children,” Rosenfeld
heard the doctor ask the woman “‘What do you think about getting your
tubes tied now?’” The physician then advised the patient’s husband that
he “better tell his wife to get her tubes tied,” because, “‘With the pill she’ll
get a blood clot to her brain; with the I.U.D. a pregnancy in her tubes.’”
Sterilization was safer. When Rosenfeld objected to this advice, the resi-
dent responded, “‘Hell, man, don’t you realize we’re paying for her kids?’”
despite the fact that the woman was not on welfare. She just happened
to be African American and delivering in the publicly supported county
hospital.61
The Health Research Group found similar maltreatment occurring
at America’s best teaching hospitals. Often, when sterilization was on the
line, there existed “little evidence of informed consent by the patient,” and
it was clear that “these operations have been ‘sold’ to the public by sur-
geons in a manner not unlike many other deceptive marketing practices.”
Surgeons promoted sterilization for eugenic and professional reasons.
The eugenic reasons were reflected in the cases from Alabama and the
Carolinas. The professional impulse stemmed from interns’ and residents’
need to perform a certain number of surgical procedures as a prerequi-
site to taking their board examinations. As a resident told interns at the
University of Southern California Hospital, “I want you to ask every one
of the girls if they want their tubes tied, regardless of how old they are.
Remember everyone you get to get her tubes tied means two tubes for
some resident or intern,” moving them that much closer to certification.
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The report concluded, “It is probable that of the 2 million people who
undergo surgical sterilization each year, at least several hundred thousand
are considerably less than well informed about the irreversibility, risks
and alternative methods of family planning when the[y] ‘decide’ to have
these operations.”↜62 The arena for sterilization abuse was broad, indeed.
The Relf case broke at a critical juncture in the history of medical care
and human rights. Congress had just concluded its investigation into
the ethics of the Tuskegee syphilis experiment, and a federal court in
Alabama was reconsidering the constitutionality of the state’s moribund
1919 sterilization law in the case Wyatt v. Aderholt. 63 All of this occurred
amidst the civil rights and women’s rights turmoil of the early 1970s. Al-
though neither media pundits nor legal officials ever linked Tuskegee,
Relf, and Wyatt, exploring their commonalities is instructive. Two themes
emerge from the comparison. First, in all three cases, the central issue
was whether the victims—the Relf girls, the syphilitic men, and institu-
tionalized mental patients—had given their informed consent. In Relf
and Tuskegee, observers identified an abusive white power structure
subverting informed consent by exploiting female African American
healthcare workers. Digging deeper into this dynamic, however, reveals
that a class-based impulse, mirroring the effects of racism, might have
motivated members of an oppressed group to oppress others. The sec-
ond major theme arises from the fact that Relf and Wyatt connect earlier
eugenic policies to the sterilization abuses of 1973. While neither Relf nor
Wyatt overturned the precedent set in Buck v. Bell, they both implicitly
undermined the durable Progressive Era notion that, in the public inter-
est, the state can reliably substitute its judgment for individual decision
making. Analyzing these issues underscores the intended and unintended
consequences of Relf: a ruling that protected poor women from abuse at
the expense of controlling their access to birth control and hence curbing
their reproductive freedom.
Immediately after the Relfs’ story broke, officials started justifying
their actions. Joseph Conklin, director of the MCAC, claimed that a no-
tary public had “quizzed” Mrs. Relf, verifying that she understood the ef-
P r o t e c t i o n o r C o n t r o l ? â•… · â•… 177
Mrs. Dixon’s assertion carried a great deal of truth, but it also illu-
minates the double bind created by Relf. According to the Relfs’ lawyer,
Joseph Levin, there was no question that the MCAC clinic and the op-
erating physician believed they were acting in the best interests of their
patients.69 That said, it was the SPLC’s position that “mental retardation
and mental illness have been used as excuses for sterilization of poverty
level people where no such necessity existed; and the practice has been
widespread.” 70 Although the president of the National Council of Negro
Women (NCNW)—who decried the sterilization of the Relfs—urged
the SPLC to support renewal of the Family Planning Services and Popu-
lation Research Act as a “vitally needed health service,” Levin noted that
the SPLC felt the need to pursue increased protections. Intervention,
even at the risk of compromising women’s reproductive autonomy, was
needed “to insure that children and other persons who are unable to com-
prehend the consequences of sterilization and experimental drugs would
be protected.” 71 Poor women of color deserved access to all reproductive
technologies, but to ensure their freedom from abuse—and to protect mi-
nors and the mentally incompetent—they would have to clear additional
hurdles before they could obtain sterilizations.
Moreover, Mrs. Dixon and other commentators ignored how, even
within the community of black women, intragender and intraracial class
tensions could exactly mirror the effects of sexism and racism.72 Many
African Americans adhered to a cultural eugenics that projected white
eugenic judgments onto the black community. Just as whites viewed their
feebleminded and immoral as eugenically “unfit,” so too might black
middle-class officials have considered the Relfs unfit. Just as Carrie Buck
represented the “shiftless, ignorant, worthless class of anti-social whites
of the South,” so too the Relfs—obviously uneducated, on welfare, with
young Mary Alice both physically deformed (she was born without a right
hand) and apparently mentally retarded—represented the analogous seg-
ment of the black community.73
Comments from African American nurses in Montgomery suggest
that intraracial and intragender class dynamics that operated like racism
may well have been present in the Relf situation. One unnamed black
nurse from the MCAC told a reporter that the lack of birth control had
historically “kept back black people.” How could impoverished women
“provide for the education of two, much less a dozen children?” she asked
P r o t e c t i o n o r C o n t r o l ? â•… · â•… 179
rhetorically.74 This nurse’s logic elided the issue of consent in favor of pat-
ent economic considerations. Another black Montgomery County Heath
Department nurse remarked, “We’ve had the Relfs as clients for more
than five years, and for the longest time I was trying to explain that the
two elder girls should have their (fallopian) tubes tied. . . . The family al-
ways refused.” A Jet reporter submitted this comment as evidence that the
Relfs could not have given informed consent—they had always refused in
the past. Therefore, Mrs. Relf signed the consent form because her igno-
rance and her culturally ingrained deference to middle-class blacks and
whites created a coercive situation. While this dynamic may have been
operating, the Jet reporter neglected the undertones in the nurse’s state-
ment. The black public health nurse was in favor of sterilizing the elder
Relf girls, Katie and Minnie Lee; she merely had more scruples than the
MCAC officials (including the black nurses who visited the Relfs) and
refused to hoodwink Mrs. Relf into consent.75 That these intraracial and
intragender beliefs existed may explain why, almost four months after
the Relfs’ story broke, no “united effort on the part of blacks . . . to stop
the threat has been initiated. Apparently only one white woman, Gloria
Steinem, has publicly sounded the battlecry by urging that forced steril-
ization ‘be fought and fought as a coalition issue.’” 76 The race and gender
of the nurses directly involved in the Relfs’ sterilization immunized their
class-biased actions. Nurses in the MCAC may well have believed that
the Relfs were lucky to receive sterilization and should “thank God.”
The Montgomery County Health Department nurse’s response reflected
precisely this evaluation. The appalling lack of medical care facing gen-
erations of black southerners undoubtedly made even crumbs seem like
much more than half a loaf.77
Traditional racial mores, too, influenced these black nurses. MCAC
nurses remained subordinate to white officials, including Mrs. Dixon.
Even if they did not share class or racial biases against poor mothers,
these women might be “on Mrs. Dixon’s side” to protect their jobs. It
was not exactly a case of “White folks say do, come, go, don’t, and Blacks
do, come, go and don’t,” as Jet magazine reported. Instead, the suppos-
edly benign nature of these interventions may have obscured their ra-
cial overtones.78 In the end, the “moral astigmatism” created by class
bias made sterilization seem benignly eugenic, rather than eugenically
genocidal.79
180â•… ·â•… G r e g o r y M i c h a e l D o r r
this entire area lies the specter of overpopulation, with its possible impact
upon the food supply, interpersonal relations, privacy, and the enjoyment
of our ‘inalienable rights.’”83
Despite, or perhaps because of, the perilous nature of the situation,
Judge Gesell wrote, “Surely the Federal Government must move cau-
tiously in this area, under well-defined policies determined by Congress
after full consideration of constitutional and far-reaching social implica-
tions. The line between family planning and eugenics is murky.” Gesell
admonished, “Whatever might be the merits of limiting irresponsible
reproduction, which each year places increasing numbers of unwanted
or mentally defective children into tax supported institutions, it is for
Congress and not individual social workers and physicians to determine
the manner in which federal funds should be used to support such a
program.” Gesell decried the “drift into a policy which has unfathomed
implications and which permanently deprives unwilling or immature
citizens of their ability to procreate without adequate legal safeguards
and a legislative determination of the appropriate standards in light of
the general welfare and of individual rights.”84
Acting in the name of the inalienable individual rights that under-
pinned the civil rights and women’s health movements, Judge Gesell
struck down interim sterilization guidelines drafted by HEW and or-
dered the creation of new rules restricting the use of federal funds for
“voluntary” sterilization. Meanwhile, he enjoined the federal government
from providing funds for the sterilization of mentally or legally incom-
petent individuals.85 Activists at the time worried that these restrictions
might not lessen the incidence of abuse and that they might increase the
obstacles poor women faced in accessing reliable birth control. It would
take another four years and two more court rulings before the federal
sterilization guidelines fulfilled the need for informed consent, yet still
allowed maximal access to birth control services.
In November 1978, HEW issued regulations requiring a mandatory
30-day waiting period for federally funded sterilizations and the provision
of translators when necessary, and banned the signing of consent forms
while a patient was undergoing labor, childbirth, or abortion. 86 Informed
consent protected women from abuse, but the procedures to ensure the
uncoerced nature of that consent controlled women’s access to steriliza-
tion. Women, it seemed to many, faced yet another double bind. 87
182â•… · â•… G r e g o r y M i c h a e l D o r r
Not e s
Previous iterations of this chapter were delivered at the Social Science History As-
sociation (2002), Southern Association for the History of Medicine and Science (2004),
the University of Alabama–Birmingham (2005), the Suffolk Section of the Massachu-
setts Medical Society and Grand Rounds of the Vincent Obstetrics and Gynecology
Department, Massachusetts General Hospital (2006). The author thanks participants at
these meetings for helpful critiques. This narrative is distilled from newspaper reports,
court documents, and the Relf files of the Southern Poverty Law Center. The author
thanks Joseph J. Levin Jr., Center co-founder and president emeritus for granting unfet-
tered access to the extant files.
1.╇ “Suit Says Girls Were Sterilized,” New York Times, June 27, 1973, 44; “Clinic
Defends Sterilization of 2 Girls, 12 and 14,” New York Times, June 28, 1973, 14; “Racism,
Ethics, and Rights at Issue in Sterilization Case,” New York Times, July 2, 1973, 10; “Relfs
File Suit against U.S.,” Montgomery Advertiser, July 19, 1973, 1; Bruce Nichols, “Suit Seeks
Million,” Montgomery Advertiser, 1; Nichols, “Sterilization Case ‘Patient’s Choice,’”
Montgomery Advertiser, June 28, 1973, 1; Nichols, “Staff of Clinic Stunned by Suit,”
184â•… · â•… G r e g o r y M i c h a e l D o r r
Montgomery Advertiser, June 29, 1973, 1; Louis Berney, “Relfs Have Scant Understanding
of Happenings,” Montgomery Advertiser, July 1, 1973, 1; Nichols, “Relfs Leave by Plane
to Testify to Subcommittee,” Montgomery Advertiser, July 10, 1973, 1; “Authorization
for Sterilization” documents, Minnie Lee and Mary Alice Relf, box 2, Relf Case Files,
Southern Poverty Law Center, Montgomery, Ala. (hereinafter referred to as Relf Files);
“Complaint, Class Action,” Civil Action 1557-73, Relf Files, 8–10; “Class Defendant
Action, Class Plaintiff Action, Temporary Restraining Order Requested, Preliminary
Injunction Requested,” Civil Action 4099-N, Relf Files, 1–6.
2.╇ When MCAC workers returned for Katie, she locked herself in her room. “Com-
plaint, Class Action,” Relf Files, 9–10. Social workers from the St. Jude Social Service
Center, who had been assisting the Relfs, investigated the sterilizations and alerted the
Southern Poverty Law Center. These actions “didn’t have anything to do with Catholic
beliefs,” one social worker said. “It was just a personal reaction.” See “The Relfs: A Fam-
ily Caught Up in a National Controversy,” Washington Post, July 8, 1973, A4; “Statement
of Jessie Bly” (St. Jude’s social worker) and “Chronology of Case Contacts,” Relf Files.
3.╇ Relf v. Weinberger, 372 F. Supp. 1196 (1974); Relf v. Mathews, 403 F. Supp. 1235
(1975); Relf v. Weinberger, 565 F. 2d 722 (1977).
4.╇ The Relfs do not appear in landmark studies like David J. Garrow, Liberty and
Sexuality: The Right to Privacy and the Making of Roe v. Wade (New York: Macmillan,
1994) or Linda Gordon, Woman’s Body, Woman’s Right (New York: Penguin Books, 1990)
(although she does cover sterilization abuse, 433–36). Charlotte Rutherford, “Repro-
ductive Freedoms and African American Women,” Yale Journal of Law and Feminism 4
(1992): 273–75, omits the Relfs. A thumbnail sketch appears in Angela Y. Davis, Women,
Race, and Class (New York: Vintage Books, 1981), 215–16. A more complete treatment
appears in Donald T. Critchlow, Intended Consequences: Birth Control, Abortion, and
the Federal Government in America (New York: Oxford University Press, 1999), 144–47.
Jennifer Nelson provides a partial (and error-riven) account in Women of Color and the
Reproductive Rights Movement (New York: New York University Press, 2003), 65–67. Re-
becca Kluchin’s excellent Fit to Be Tied: Sterilization and Reproductive Rights in America,
1950–1980 (New Brunswick, N.J.: Rutgers University Press, 2009) provides the most
complete account and advances complementary arguments to this essay.
5.╇ Dean J. Kotlowski, “Deeds versus Words: Richard Nixon and Civil Rights
Policy,” New England Journal of History 56 (Winter 1999–Spring 2000): 122–44; Alan J.
Matusow, “Economics, Politics, and the Limits of Presidential Power: The Case of Rich-
ard Nixon,” ibid., 90–100.
6.╇Edward J. Larson and Leonard J. Nelson III, “Involuntary Sexual Sterilization
of Incompetents in Alabama: Past, Present, and Future,” Alabama Law Review 43 (1992):
399–444, at 403.
7.╇ Allan Chase, The Legacy of Malthus: The Social Costs of the New Scientific Racism
(New York: Alfred A. Knopf, 1975), 382–87; Critchlow, Intended Consequences, 150–66.
8.╇ “President Signs Birth Curb Bill,” New York Times, December 27, 1970.
9.╇ See “A bill to provide for the sterilization of females who give birth to certain il-
legitimate children. . . . ,” House Bill 494, February 12, 1960, Virginia Bills, House (1960);
Gregory Michael Dorr, Segregation’s Science: Eugenics and Society in Virginia (CharlottesÂ�
ville: University of Virginia Press, 2008), 211–13; and Julius Paul, “The Return of Puni-
tive Sterilization Proposals: Current Attacks on Illegitimacy and the AFDC Program,”
Law and Society Review 3 (August 1968): 77–106.
P r o t e c t i o n o r C o n t r o l ? â•… · â•… 185
10.╇ Steven Noll, Feeble-Minded in Our Midst: Institutions for the Mentally Retarded
in the South, 1900–1940 (Chapel Hill: University of North Carolina Press, 1995), 19, 75;
James W. Trent, Inventing the Feeble Mind: A History of Mental Retardation in the United
States (Berkeley: University of California Press, 1994), chapter 5. Noll downplays the
salience of race in southern eugenics. I believe Noll overstates his case for the early
period; undoubtedly, by the 1960s and 1970s many whites used specious claims of black
feeblemindedness to justify the extension of sterilization. See Gregory Michael Dorr,
“Defective or Disabled? Race, Medicine, and Eugenics in Progressive Era Virginia and
Alabama,” Journal of the Gilded Age and Progressive Era 5 (October 2006): 377. See also
Johanna Schoen, Choice & Coercion: Birth Control, Sterilization, and Abortion in Public
Health and Welfare (Chapel Hill: University of North Carolina Press, 2005).
11.╇ See generally Premilla Nadasen, Welfare Warriors: The Welfare Rights Movement
in the United States (New York: Routledge, 2005).
12.╇ Nixon quoted in Kotlowski, “Deeds versus Words,” 122–23.
13.╇ John Ehrlichman and Nixon, quoted in Simone Caron, “Richard M. Nixon: The
‘Problem of Population’ versus ‘The Sanctity of Human Life,’” New England Journal of
History 56 (Winter 1999–Spring 2000): 102–104.
14.╇ Nixon quoted in H. R. Haldeman’s diary entry for Monday, April 28, 1969 in
Kevin L. Yuill, Richard Nixon and the Rise of Affirmative Action: The Pursuit of Racial
Equality in an Era of Limits (Oxford: Rowman and Littlefield, 2006), 124.
15.╇ Richard M. Nixon, “Welfare Reform: Shared Responsibility,” in Welfare: A Doc-
umentary History of U.S. Policy and Politics, ed. Gwendolyn Mink and Rickie Solinger
(New York: New York University Press, 2003), 314–17.
16.╇ “Nixon: The First Year of His Presidency,” Congressional Quarterly (1970): 75-A;
Jill Quadagno, The Color of Welfare: How Racism Undermined the War on Poverty (New
York: Oxford University Press, 1994), 118; Michael B. Katz, In the Shadow of the Poorhouse:
A Social History of Welfare in America (New York: Basic Books, 1996), 277; Nadasen, Wel-
fare Warriors, 171–72, 176; Felicia Kornbluh, The Battle for Welfare Rights: Politics and Pov-
erty in Modern America (Philadelphia: University of Pennsylvania Press, 2007), 146–47.
17.╇ Nadasen, Welfare Warriors, 178–82.
18.╇ David Greenberg, Nixon’s Shadow: The History of an Image (New York: W. W.
Norton, 2003), 304–37.
19.╇ Nixon quoted in Bruce J. Schulman, The Seventies: The Great Shift in American
Culture, Society, and Politics (New York: Free Press, 2001), 23. My discussion of Nixon’s
presidency derives from Schulman, Michael Kazin, The Populist Persuasion (New York:
Basic Books, 1995), chapters 9 and 10, and Thomas Byrne Edsall and Mary D. Edsall,
Chain Reaction: The Impact of Race, Rights, and Taxes on American Politics (New York:
W. W. Norton, 1992).
20.╇ H. R. Haldeman paraphrasing Moynihan, quoted in Kotlowski, “Deeds versus
Words,” 125.
21.╇ Critchlow, Intended Consequences, 89–90; Nadasen, Welfare Warriors, 217–18.
22.╇ Critchlow, Intended Consequences, 92.
23.╇ Wesley J. Hjornevik, “OEO Instruction—Family Planning Activities,” May 18,
1971, Exhibit A; George Contis, M.D., to All OEO Community Action Agency Direc-
tors, June 28, 1971, Exhibit B in Relf Files.
24.╇ Simone Caron makes a similar point. Caron, “Richard M. Nixon: The ‘Problem
of Population,’” 105.
186â•… · â•… G r e g o r y M i c h a e l D o r r
25.╇ “Nominee to O.E.O. Backs Aid to Poor,” New York Times, July 21, 1973, 25;
“Health Official Quits in Protest,” New York Times, June 29, 1973, 28.
26.╇ “‘Cap the Knife’ Goes to Work,” New York Times, July 8, 1973, 4.
27.╇ United States Senate, Transcript of Proceedings before the Subcommittee on Health
of the Committee on Labor and Public Welfare (Washington, July 10, 1973), Relf Files,
92–107 (quotations 97, 98, 101); “Testimony Conflicts in Sterilization Case,” Washington
Post, July 11, 1973, A2; Leon Cooper, M.D., to Warren Hern, M.D. M.P.H., “Unauthor-
ized External Communications,” undated, Exhibit G; and Hern to Cooper, May 8, 1972,
Exhibit H, in Relf v. Weinberger, Civil Action 1557-73, “Class Action” pleading, Relf Files.
28.╇ “Guidelines Found on Sterilization,” New York Times, July 7, 1973, 5. For more
on Hern, see “The Last Abortion Doctor,” Esquire (online edition): http://www.esquire
.com/features/abortion-doctor-warren-hern-0909.
29.╇ “H.E.W. Chief Issues Guidelines to Protect Rights of Minors and Others in
SteriÂ�l ization Cases,” New York Times, July 20, 1973, 32; Critchlow, Intended Consequences,
145–46.
30.╇ Roe v. Wade 410 U.S. 113 (1973), argued December 13, 1971; reargued October 11,
1972; decided January 22, 1973.
31.╇ Charlie Savage, “On Nixon Tapes, Ambivalence over Abortion, Not Watergate,”
New York Times, June 24, 2009.
32.╇ “O.E.O Cuts Off Funds in Sterilization of Girls,” New York Times, June 29, 1973,
28; Bill Kovach, “H.E.W. Head Curbs Sterilization Aid,” New York Times, July 6, 1973, 54.
33.╇ Phillips quoted in “Testimony Conflicts in Sterilization Case,” Washington Post,
July 11, 1973, A2.
34.╇ Nicholas von Hoffman, “Life and Liberty in Alabama,” Washington Post, July 4,
1973, D1 and D4.
35.╇ Philip R. Reilly, The Surgical Solution: A History of Involuntary Sterilization in the
United States (Baltimore: Johns Hopkins University Press, 1991), 94.
36.╇ Schoen, Choice & Coercion, 28–29, 32.
37.╇ Virginia passed the first law making informed, voluntary sterilization explicitly
legal in 1962. See Dorr, Segregation’s Science. See also “Cost of Abortions, Vasectomies
and Pills Ruled Tax Deductible,” New York Times, April 11, 1973, 52. In the next decade,
sterilization quietly became the birth control method of choice for one in six American
families. See Harold M. Schmeck Jr., “More in U.S. Rely on Sterilization,” New York
Times, March 25, 1974, 17; Relf v. Weinberger 372 F. Supp 1196 (1974) at 1199; Jane E. Brody,
“Study Finds Sterilization Gains Fastest of Birth-Curb Methods,” New York Times, May
5, 1976, 22; and Gordon, Woman’s Body, 432. On Nixon’s political backpedaling, see
Critchlow, Intended Consequences, 166–73.
38.╇ Increased access to reliable contraception often resulted from being labeled
irresponsible or unfit. Andrea Tone, Devices and Desires: A History of Contraceptives in
America (New York: Hill and Wang, 2001), 85–87, 144–45, 268–69; Schoen, Choice &
Coercion, 32, 41–47.
39.╇ Bond quoted in “Racism, Ethics, and Rights at Issue in Sterilization Case,” New
York Times, July 2, 1973, 10.
40.╇ Skinner v. Oklahoma, 316 U.S. 535 (1941), 536, quotation 541. Skinner invali-
dated Oklahoma’s eugenic law mandating sterilization for certain classes of criminals
without overturning Buck. A constitutional right to privacy was first articulated in
Griswold v. Connecticut, 379 U.S. 479 (1965), which affirmed married couples’ right to
P r o t e c t i o n o r C o n t r o l ? â•… · â•… 187
even where the operation was in the incompetent’s best interest.” It reserved the right of
courts to order sterilization in the case of medical necessity. Larson and Nelson, “Invol-
untary Sexual Sterilization,” 431–32.
54.╇ See “Aide Says 11 May Have Been Sterilized,” New York Times, July 3, 1973, 6; Bill
Kovach, “H.E.W. Head Curbs Sterilization Aid,” New York Times, July 6, 1973, 54.
55.╇ Schoen, Choice & Coercion, 75–76.
56.╇ See “Inquiry in South Carolina,” appended at end of “H.E.W. Chief Issues
Guidelines to Protect the Rights of Minors and Others in Sterilization Cases,” New York
Times, July 20, 1973, 32; and “3 Carolina Doctors Are under Inquiry in Sterilization of
Welfare Mothers,” New York Times, July 22, 1973, 30; “Sterilization of Black Mother of 3
Stirs Aiken, S.C.,” New York Times, August 1, 1973, 27.
57.╇Elena R. Gutierrez, “Policing ‘Pregnant Pilgrims’: Welfare, Health Care, and the
Control of Mexican-Origin Women’s Fertility,” in Women, Health, and Nation: The U.S.
and Canada since 1945, ed. Georgina Feldberg, Molly Ladd-Taylor, Alison Li, and Kath-
ryn McPherson (Ithaca, N.Y.: Cornell University Press, 2003), 384.
58.╇ “Amended Complaint No. 1,” Civil Action No. 1557-73 (August 10, 1973), Relf
Files; Walker v. Pierce 560 F. 2d 609 (1977).
59.╇ Stephen Trombley, The Right to Reproduce (London: Weidenfeld and Nicolson,
1988), 177.
60.╇ Rickie Solinger, Pregnancy and Power: A Short History of Reproductive Politics
in America (New York: New York University Press, 2005), 194–200; Gutierrez, “Polic-
ing ‘Pregnant Pilgrims,’” 379–403; and Jane Lawrence, “The Indian Health Service and
the Sterilization of Native American Women,” American Indian Quarterly 24 (Summer
2000): 400–419.
61.╇ “Statement of Bernard Lloyd Rosenfeld, M.D., Ph.D.,” January 23, 1974, Relf
Files.
62.╇ Health Research Group, “A Health Research Group Study on Surgical Steriliza-
tion: Present Abuses and Proposed Regulations” (Washington, D.C.: Health Research
Group, October 1973), 2, 7, and 9.
63.╇ Wyatt v. Aderholt 368 F. Supp. 1382 (M.D. Ala. 1973) and Wyatt v. Aderholt 368 F.
Supp. 1383 (M.D. Ala. 1974). Inmates had filed suit over inhumane treatment, including
allegedly continued nonconsensual sterilization.
64.╇ “Clinic Defends Sterilization of 2 Girls, 12 and 14,” New York Times, June 28,
1973, 14. These assertions are contradicted by the girls’ medical records, which contain
both “signed” consent forms from Mrs. Relf authorizing the clinic to provide the girls
with the birth control pill and indications that Depo-Provera injections had been ad-
ministered to each girl at least twice. See “Medical Records,” Relf Files.
65.╇ Assistant Secretary of Health Charles C. Edwards, M.D., to The Secretary,
DHEW, memorandum, July 3, 1973, Relf Files; “Aide Says 11 May Have Been Sterilized,”
New York Times, July 3, 1973, 6; “H.E.W. Head Curbs Sterilization Aid,” New York Times,
July 6, 1973, 54.
66.╇ Bruce Nichols, “Whites in State Obtained Half of 82 Sterilizations,” Montgom-
ery Advertiser, June 29, 1973, 9. Later, health department officials acknowledged that
this number did not include eight other Alabama agencies, similar to the MCAC, that
provided sterilization services. J. Paul Till, “Abortion, Sterilizing Utilized in Alabama,”
Montgomery Advertiser, July 2, 1973, 1. Twenty-six men were sterilized through this
program.
P r o t e c t i o n o r C o n t r o l ? â•… · â•… 189
87.╇ The 1978 National Organization for Women convention condemned the waiting
period as an intolerable infringement on reproductive freedom. Ibid., 434.
88.╇ Melvin Belli to Morris Dees, June 21, 1977, Relf Files.
89.╇ Gregory Michael Dorr, interview with Joseph Levin.
90.╇ Robert E. McGarrah Jr. to Caspar Weinberger, January 20, 1975; Robert E.
McGarrah Jr., “Sterilization without Consent: Teaching Hospital Violations of HEW
Regulations” (unpublished report, Public Citizen, January 21, 1975), 1.
91.╇ Bogue and Sigelman, “Sterilization Report,” Family Planning Perspectives 11
(November–December 1979): 366–67.
92.╇ Walker v. Pierce 560 F. 2d (1977), 613.
93.╇ “Too Many Babies, Too Many Barriers,” Washington Post, February 19, 1998, 1, 11.
Pa r t fou r
L i n da L . Mc C a b e a n d E dwa r d R . B . Mc C a b e
The purpose of this volume is to consider the history and legacy of eu-
genics. No extant scientific or medical community is more conscious of
the burden of the eugenic bequest than human and medical geneticists,
since our discipline is historically rooted in eugenics and the eugenic
movement.1 Perhaps in response to this disciplinary origin, geneticists
often avoid discussions of eugenics, but such avoidance ignores the risk
of eugenic resurgence and may in fact foster its reemergence by avoiding
notice of the scientific, medical, and social factors that are realigning for
the “perfect storm.”
193
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Allen adds:
We seem to be increasingly unwilling to accept what we view as imper-
fection in ourselves and others. As health care costs skyrocket, we are
coming to accept a bottom-line, cost-benefit analysis of human life. This
mindset has serious implications for reproductive decisions. If a health
maintenance organization (HMO) requires in utero screening, and re-
fuses to cover the birth or care of a purportedly “defective” child, how
close is this to eugenics? . . . If eugenics means making reproductive deci-
sions primarily on the basis of social cost, then we are well on the road.4
S c i e n t i f ic C l a i m s a nd E x pe c tat ion s
Th e H u m a n G e nom e Proj e c t
Be com e s a n Icon
The Human Genome Project would become an icon of the last decade
of the twentieth century and the first years of the twenty-first century,
and who better to champion this iconic status than James Watson, for he
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had already accomplished this for the double helical structure of DNA,
as chronicled by Soraya de Chadarevian.10 De Chadarevian noted that
the photographs of Watson and Crick with their model of DNA are now
inseparable from their 1953 publication in which they deduced the struc-
ture of DNA.11 Those photographs, however, remained in deep obscurity
until the publication of Watson’s best seller, The Double Helix, in 1968.12 In
September 1988, the National Institutes of Health established the Office
of Human Genome Research with Watson as its leader. Watson would
sell the Human Genome Project to the American people and gain fund-
ing from Congress with statements like his 1989 quote in Time magazine:
“We used to believe our destiny was in the stars; now we know in large
measure our fate is in our genes.”13
Such hyperbole as Watson’s would become the public language of
the Human Genome Project, sprinkled generously with metaphors and
other comparisons.14 At times these metaphors can take on a life of their
own. For example, following the announcement of the “working draft” of
the human genome sequence on June 26, 2000, in a joint press conference
linking President Bill Clinton in the White House with Prime Minister
Tony Blair at 10 Downing Street, the “book of life” metaphor, though
not used in Clinton’s speech, was found in seven of nine major British
newspapers.15 Symbolic communication in this manner may insert ad-
ditional meaning with historical references, for example, bringing back
“old metaphors of the eugenics movement.”16
G e n et ic Det e r m i n i s m I s On e M e s s ag e
of t h e H u m a n G e nom e Proj e c t
so that these genes are not read, and these chemical modifications may
be maintained permanently for the life of the individual and perhaps
even beyond into the next generation(s). Therefore, an individual’s experi-
ences, or perhaps even the experiences of their progenitors, can influence
the way in which his/her genome is read throughout his/her life span.
Eugenics utilized genetic determinism to simplify the biological basis
of behavior and other exceedingly complex characteristics and general-
ized to entire ethnocultural groups these “biologically” constructed, per-
ceived deviations from acceptable norms. If one recognizes the complex-
ity of biology and the plasticity of genomic expression, then the simplistic
foundations of eugenics must crumble. Lionel Penrose, Galton Professor
of Human Genetics at the University College London, described the lack
of scientific support for eugenics in his Presidential Address to the Third
International Congress of Human Genetics in 1966. He stated, “Eugen-
ics was based upon arbitrary valuations of individuals and social groups,
supported by unjustified and premature assumptions about the nature of
hereditary influences,” and “At the moment . . . our knowledge of human
genes and their action is still so slight that it is presumptuous and fool-
ish to lay down the positive principles for human breeding.”17 Penrose
made these statements in 1966, but more than 30 years later the Dutch
philosopher of the mind, Huib Looren de Jong, said the position “that
genes determine development, inevitably leading towards certain types
of behavior or personality” is a consequence of “the Gene Myth: the view
that our nature (or even our fate) is in the genes, that genes determine
behavior like a puppeteer his puppets.”18 Thus the reductionism required
for the simplistic interpretation demanded by eugenics is fundamentally
flawed because of the complexity of biology and its mutability by its in-
timate and ongoing interactions with the environment. Genetic deter-
minism drives this simplification, because genetic determinism cannot
survive the nuanced reality of biology.
G e n et ic Di s c r i m i n at ion
G e nom ic M e dic i n e a nd E ug e n ic s
The basis for genomic medicine is care that will be predictive, preventive,
and personalized.23 One might expect such an individualized and antici-
patory approach for health care to celebrate all persons and to prevent
any discriminatory and eugenic misadventures. Consider, however, that
genetic testing of individuals and screening of populations is essential to
implement genomic medicine. If the results of these analytical methods
are used inappropriately, then the testing could lead to genetic discrimi-
nation and even to eugenic practices. It is not the power of the genetic
and genomic technologies that is the risk but how the output of these
technologies—an individual’s test result—is used.
A De f e n s e ag a i n s t E ug e n ic s:
R e s pe c t for Pe r son a l Au tonom y
a nd R e produc t i v e F r e e d om
Principles of personal autonomy and reproductive freedom are at the
center of geneticists’ discussions of whether or not genetics and genetic
testing can be considered eugenic. If eugenics involves “a social action
program,”24 then individual choice in the use of clinical genetics services
would be considered by some to block the claims that medical genetics is
eugenic as long as that choice is freely made and not coerced.25 Holtzman
would consider the following scenario to be an example of eugenics: a
U.S. health insurance carrier, as a requirement for insuring the baby, de-
manded that the mother have prenatal diagnosis and that if the fetus was
affected, she would terminate the pregnancy. The company would only
insure a “well-born” offspring and would force the mother’s compliance,
or else have her and not their shareholders accept the economic conse-
quences if she did not comply. As predicted by Allen, this example of a
resurgence of eugenics was driven by economic decisions and a “‘bottom-
line’ mentality.”26
Governments may also be perceived to exert coercive influences on
genetic decision making when these entities pay for the services and are
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I s “ Pro c r e at i v e Be n e f ic e nc e ”
a F u nda m e n ta l Obl ig at ion ?
At that stage of embryonic development the loss of a single cell does not
compromise subsequent development since any cell can give rise to a
complete fetus. PGD was developed to permit parents to identify em-
bryos with mutations or chromosomal abnormalities prior to implanta-
tion, rather than having to await prenatal diagnosis later in the pregnancy
with the option to abort affected fetuses.
Savulescu stated that the principle of procreative beneficence implied
that “couples should employ genetic tests for non-disease traits in select-
ing which child to bring into existence and that we should allow selection
of non-disease genes in some cases even if this maintains or increases
social inequality,” and added, “In the absence of some other reason for
action, a person who has good reason to have the best child is morally
required to have the best child.” Savulescu opened his article with the
statement, “Eugenic selection of embryos is now possible,” but presum-
ably this relates to the literal meaning of the term as well born or in his
terminology best life. This presumption is based on subsequent statements
that procreative beneficence would not be eugenic, since it would involve
decision making at the individual or couple level, whereas eugenics en-
gages populations and interferes with reproduction, for example, by eu-
genic sterilization, “to promote social goods.”32 Subsequently, Savulescu
argued emphatically for individual choice in reproductive decision mak-
ing and respect for the individual’s decision even when there might be
strong disagreement with doctors or others. 33
I s Pr e n ata l G e n et ic Di ag no s i s
L e a di ng to De s ig n e r B a bi e s?
Let us now look at experience in the United States and United Kingdom
with PGD that was carried out, not only for the benefit of the child being
born without a genetic disease, but also for advantage to a sibling. We will
consider the cases and also the differences in decision-making processes
between the two countries.
The first case of this type involved the Nash family in Englewood,
Colorado. 34 Molly Nash, daughter of Lisa and Jack, had a genetic dis-
order, Fanconi anemia, which is associated with birth defects, includ-
ing an absence of thumbs, and an anemia affecting red cells, white cells,
and platelets (the clotting elements), which eventually leads to leukemia.
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Th e “ Pr ac t ic e of M e dic i n e ”
Comm e rc i a l i z at ion of G e n et ic T e s t i ng
a nd R e produc t i v e T e c hnol o g i e s
cault and Franklin, that the “vital politics” of the twenty-first century
“is concerned with our growing capacities to control, manage, engineer,
reshape, and modulate the very vital capacities of human beings as living
creatures . . . , a politics of ‘life itself.’”56 If genes are so critical to our self-
understanding and our desire to control our future, then genetic testing
and reproductive technologies are the critical mediators to achieve this
understanding and control. And these mediators have become major
business influences. Let us examine the context of the markets in genes,
genetic testing, and ARTs, recognizing that human DNA and genes are
body parts.
All human parts have a price. Sales of body parts from cadavers have
received a tremendous amount of media attention. 57 According to John
M. Broder of the New York Times,
“It is illegal to sell cadavers or body parts. But it is legal to charge
‘reasonable’ fees for collecting, shipping, processing, marketing and im-
planting tissues from corpses. Tissue from one cadaver can be used in
50 to 100 different experiments or procedures, and a typical body can be
worth more than $220,000, medical researchers say.”58
Solid organ transplantation is coordinated in the United States by
the United Network for Organ Sharing (UNOS), and therefore data for
these types of transplants are readily available. For solid organ trans-
plants, the UNOS homepage lists 96,935 individuals as candidates on
their waiting list, and between January and May 2007, 11,746 transplants
were performed from 5,869 living and cadaveric donors.59 The cost of
organ or tissue procurement for transplantation is lowest for hematopoi-
etic stem cells at $18,900. For solid organ transplants, the procurement
costs range from a low of $41,700–48,500 for a single lung to a high of
$199,200–222,300 for a combination of liver, pancreas, and intestine. 60 A
significant number of candidates die each year awaiting their transplants,
estimated for kidneys as 3,000–5,000 individuals on the candidate list. 61
Therefore, serious consideration is being given to paying donors for or-
gans, particularly kidneys.62 Because of the lack of availability of an ad-
equate number of donor kidneys, it is estimated that “the voluntary sale
of purchased donor kidneys now accounts for thousands of black market
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transplants,”↜63 not only in the United States but also in other countries,
including India.64
Tissue and cell samples are essential for biomedical research, and the
ownership of these samples remains a controversial topic. The Office of
Human Research Protection (OHRP) and the Food and Drug Admin-
istration (FDA) are two agencies within the U.S. Department of Health
and Human Services (DHHS) that provide guidance to Institutional
Review Boards (IRBs) at each university or other institution carrying out
research on human subjects. Both the OHRP and FDA assert that the in-
formed consent documents, which must be read, understood, and signed
by each research subject, should not indicate that the subjects are giving
up any property rights to their tissue samples. However, in the three cases
(Moore v. Regents of The University of California, Greenberg et al. v. Miami:
Children’s Hospital, and Washington University v. Catalona) that have been
taken to court by research subjects to attempt to affirm ownership rights
over their research specimens, the decisions have all determined that the
samples are so valuable to biomedical research that ownership, including
the right to sell the samples and access to as well as products from the
specimens, belongs to the research institution. Therefore, these court
decisions indicate that tissue samples provided for research are commodi-
ties that are owned by the research institutions, with the research subjects
giving up property rights once they have provided the specimens. 65
Commodi f ic at ion of G e n e s
a nd G e n et ic T e s t i ng
Since cadaveric body parts for studies and organs and tissues for trans-
plantation and research all have been commodified, is this also true for
genes and genetic testing? The answer is a resounding yes. The U.S. Patent
and Trademark Office (PTO), which derives its authority from the Con-
stitution, has issued approximately 6,000 gene patents, many of which
were based solely on sequence information from the Human Genome
Project. This means that to use the sequence of a patented gene, the pat-
ent holder could demand payment of a licensing fee to anyone desiring to
profit from that gene’s sequence information. Patent holders may decide
that the best way to increase the value of the intellectual property they
own is to be extremely restrictive in licensing, perhaps even preventing
A r e W e E n t e r i n g a “ P e r f e c t S t o r m ”? â•… · â•… 209
the use of the sequence information by anyone, hoping that this will add
to the perceived value of the patented gene sequence information. The
consequence of such a decision to block access to a patented gene would
be that individuals desiring testing for mutations in that gene would not
be able to have the testing performed and that, even if testing was per-
mitted, the individuals being tested would pay for the right to have their
own DNA analyzed for a mutation in his/her gene. It is estimated that
each individual’s genome contains approximately 20,000–25,000 genes,
and therefore if approximately 6,000 patented genes are owned by some
other entity, then roughly 25 percent of each person’s gene complement
is the property not of that person but of someone else.66
Let us consider one measure of the value of this gene-based intellec-
tual property, to determine if it supports the view that genes have been
commodified. For if there is insufficient value in this commodity, then it
would be hard to argue for commodification of human genes. A website
that describes itself as “a publicly funded medical genetics information
resource developed for physicians, other healthcare providers, and re-
searchers” lists 618 laboratories testing for 1,430 genetic diseases, of which
1,143 are clinical tests and 287 are research-only tests.67 These are modest
numbers and do not give insight into volume or value of genetic testing.
Genzyme Corporation, a major supplier of genetic testing, in its 2007
second quarter earnings report stated that its Genetics segment, fueled in
part by clinical trials and diagnostic testing, showed a 21 percent increase
in revenue to $73.7 million, which compared with $61.0 million during the
same period of 2006; this represented 7.9 percent of their $933.4 million
in total revenue for the second quarter of 2007, similar to the 7.7 percent
of their $793.4 million in total revenue for that period in 2006, 68 and, in
2007 the Genetics sector of their business had revenues three percentage
points better than the overall revenue growth of 18 percent.69 If there were
no quarterly financial aberrations, and for the first two quarters of 2006
and 2007 there did not appear to be any significant differences in revenue,
then this would amount to an annual revenue in their Genetic business
of at least $280 million.
Another company, Myriad Genetics, has attempted to maintain ag-
gressive control of its breast cancer gene patents and has used these pat-
ents to develop its predictive medicine product line to utilize genetic
testing to identify cancer before it manifests clinically and to personalize
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Comm e rc e i n R e produc t i v e
T e c hnol o g i e s
ics performing ART in the United States during that year, representing
a steady increase in clinics since the CDC began collecting these data
in 1995. Of these clinics, 411 submitted information for 2004, which in-
cluded 127,977 ART cycles, 99 percent of which were IVF, and 49,458
infants born resulting from ART cycles performed in that year, which
the CDC estimated to represent “slightly more than 1 percent of total
U.S. births.” 72
Thus the volume of ARTs is impressive, but what about the commer-
cial value? Using April 2004 pharmaceutical costs, the average national
cost per cycle of ART was estimated to be $12,400.73 Correcting for the
number of clinics not reporting results (50 of 461 total, or 10.8 percent),
the estimated total number of ART cycles in 2004 would be 143,546.74
Therefore, the total cost for ART cycles in 2004 would be estimated to
be $1.78 billion.75 While this is a large dollar value, one could argue that
it is the service cost of preparing the women for ART. Alternatively, this
could be judged to be the investment of $1.78 billion in the ART com-
modity market that will lead to somewhat more than 1 percent of U.S.
births. This tension between services and objects as commodities is one
that permeates studies of these types of markets.76
The objects in the ART commodity market could be considered to be
the gametes, i.e., the eggs and sperm. Among the 143,546 estimated total
ART cycles in 2004, in 11.8 percent of the cycles, the “eggs or embryos
were donated by another woman,” 77 representing an estimated 16,938
cycles with donor eggs or embryos. Rene Almeling reported that in 2002
two “egg agencies,” one of which was among the largest in the United
States, charged the “recipient clients an agency fee of $3,500 in addition
to the donor’s fee and her medical and legal expenses,” with the donors’
fees ranging from $4,000 to 6,000,78 and medical fees averaging $12,400.79
Legal fees are not disclosed, but would be in addition to these other fees.
If we use a donor’s fee in the middle of the range for these two agencies
(e.g., $5,000), and assume one donor per ART cycle, then the sum of the
agency, donor, and medical fees would be $20,900. With an estimated
16,938 donor cycles per year and a minimum estimated cost of $20,900/
cycle, the estimated annual total cost of “donated” eggs and embryos to
recipient clients for ART cycles would be a minimum of $354 million.
The 2004 ART Success Rate report does not include data regarding
whether the sperm were provided by a partner or friend or purchased
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from a sperm bank. Almeling, however, described two sperm banks: the
larger of the two charged $215/vial and distributed approximately 30,000
vials/year, for a total of $6.45 million/year; and the smaller, a nonprofit
agency, charged $175/vial and distributed approximately 400 vials/year,
for a total of $70,000/year. 80 Therefore, while we do not know the total
annual volume and cost of sperm, nevertheless there are costs to some
clients for the procurement of male gametes.
Almeling argues, particularly for eggs in the case of postcycle gifts,
“the line between gift and sale [is] indistinguishable.” She describes the
gendered differences in the markets for eggs and sperm and concludes,
“The commodification of the human body can be expected to vary based
on the sex and gender of that body, as economic valuations intertwine
with the cultural norms in specific structural contexts.” Almeling in-
cludes the following cautionary note:
In this market [for eggs and sperm], race and ethnicity are biologized,
as in references to Asian eggs or Jewish sperm, and it is one of the primary
sorting mechanisms in donor catalogs, along with hair and eye color. This
routinized reinscription of race at the genetic and cellular level in dona-
tion programs, which as medicalized organizations offer a veneer of scien-
tific credibility to such claims, is worrisome given our eugenic history. 81
With the intimate relationship between our genes and our identities, we
would argue that the commodification of genes, genetic testing, and re-
productive technologies influence our concepts of individual identity.
Placing a value on these objects and services could be perceived as plac-
A r e W e E n t e r i n g a “ P e r f e c t S t o r m ”? â•… · â•… 213
It is concerning that Clinton does not know or consider the eugenic bag-
gage carried by the Progressive movement in the early twentieth cen-
tury, and that the freedoms and rights of individuals she attributes to this
movement were limited only to selected “well-born” persons.
How can we prevent being engulfed by this “perfect storm” for the re-
surgence of eugenics? We would propose that the following efforts could
bring relief and move us out of the path of this storm. We must recognize
the illegitimacy of genetic discrimination and support genetic nondis-
crimination legislation; respect personal autonomy and reproductive
freedom; recognize and resist the corrosive nature of commodification
of body parts, including genes and gametes, on social structure; guard
against policies from organized medicine, governments, and corporations
that could enshrine eugenic practices; and educate opinion leaders and
the populace regarding the risks of overpromising genetics/genomics and
the consequences of determinism and eugenics.
No t e s
1.╇See generally Daniel Kevles, In the Name of Eugenics: Genetics and the Uses of
Human Heredity (New York: Harvard University Press, 1985); Kenneth L. Garver and
Bettylee Garver, “Eugenics: Past, Present, and Future,” American Journal of Human Ge-
netics 49 (1991): 1109–18; Allen Buchanan, Dan W. Brock, Norman Daniels, and Daniel
Wikler, From Chance to Choice: Genetics and Justice (Cambridge: Cambridge University
Press, 2000); Nikolas Rose, The Politics of Life Itself: BioMedicine, Power, and Subjectivity
in the Twenty-first Century (Princeton, N.J.: Princeton University Press, 2007). Many
of the issues we analyze in this essay were raised in our earlier book: Linda L. McCabe
and Edward R. B. McCabe, DNA: Promise and Peril (Berkeley: University of California
Press, 2008).
2.╇Garland E. Allen, “The Social and Economic Origins of Genetic Determin-
ism: A Case History of the American Eugenics Movement, 1900–1940, and Its Lessons
for Today,” Genetica 99 (1997): 77–88, at 78–80; Garland E. Allen, “Is a New Eugenics
Afoot?” Science 294 (2001): 59–61.
3.╇Allen, “ Social and Economic Origins,” 85.
4.╇Allen, “Is a New Eugenics Afoot?” 61.
5.╇ Dorothy Nelkin, “Molecular Metaphors: The Gene in Popular Discourse,”
Nature Review Genetics 2 (2001): 555–59, at 557; Horace F. Judson, “Talking about the Ge-
nome: Biologists Must Take Responsibility for the Correct Use of Language in Genet-
ics,” Nature 409 (2001): 769; and Tania Bubela, “Science Communication in Transition:
Genomics Hype, Public Engagement, Education, and Commercialization Pressures,”
Clinical Genetics 70 (2006): 445–50, at 446.
6.╇Sandra Sabatini, “Mapping of the Human Genome: What Does It Mean for Our
Patients?” American Journal of the Medical Sciences 322 (2001): 175–78, at 175.
A r e W e E n t e r i n g a “ P e r f e c t S t o r m ”? â•… · â•… 215
25.╇ Neil Holtzman, “Eugenics and Genetic Testing,” Science in Context 11 (1998):
397–417, at 408–409; Charles J. Epstein, “Is Modern Genetics the New Eugenics?” Ge-
netics in Medicine 5 (2003): 469–75, at 474.
26.╇Allen, “Social and Economic Origins,” 85.
27.╇Allen, “Is a New Eugenics Afoot?” 59–61.
28.╇Epstein, “Is Modern Genetics the New Eugenics?” 473.
29.╇George C. Cunningham and D. Gwynne Tompkinson, “Cost and Effectiveness
of the California Triple Marker Prenatal Screening Program,” Genetics in Medicine 1
(1999): 199–206, at 199.
30.╇ Judson, “Talking about the Genome,” 769.
31.╇ Julian Savulescu, “Procreative Beneficence: Why We Should Select the Best
Children,” Bioethics 15 (2001): 413–26, at 415.
32.╇Ibid., 424.
33.╇ Julian Savulescu, “Deaf Lesbians, ‘Designer Disability,’ and the Future of Medi-
cine,” British Medical Journal 325 (2002): 771–73.
34.╇ Details of the Nash case may be found in Sarah Franklin and Celia Roberts,
Born and Made: An Ethnography of Preimplantation Genetic Diagnosis (Princeton, N.J.:
Princeton University Press, 2006), 35, 62.
35.╇T. Scheck, “A Question of Life,” Minneapolis Public Radio, October 18, 2000
(http://news.minnesota.publicradio.org/features/200010/18_scheckt_babies/).
36.╇Accounts of the Hashmi and Whitaker family cases are drawn from Franklin
and Roberts, Born and Made, 62, 65–66.
37.╇Technologies used to screen for neonatal blood conditions such as beta-thalas-
semia are described in Urvashi Bhardwaj, Yao-Hua Zhang, and Edward R. B. McCabe,
“Neonatal Hemoglobinopathy Screening: Molecular Genetic Technologies,” Molecular
Genetics and Metabolism 80 (2003): 129–37.
38.╇ Franklin and Roberts, Born and Made, 62–63.
39.╇ Online Mendelian Inheritance in Man (OMIM), “#105650, Diamond-Blackfan
Anemia; DBA.”
40.╇ Franklin and Roberts, Born and Made, 65–66.
41.╇Ibid., 65–67.
42.╇Ibid., 72–73.
43.╇Barbara J. Evans, “Distinguishing Product and Practice Regulation in Personal-
ized Medicine,” Clinical Pharmacology & Therapeutics 81 (2007) 288–93, at 288.
44.╇ Nicole Ansani, Carl Sirio, Thomas Smitherman, Bethany Fedutes-Henderson,
Susan Skledar, Robert J. Weber, Nathalie Zgheib, and Robert Branch, “Designing a
Strategy to Promote Safe, Innovative Off-Label Use of Medications,” American Journal
of Medical Quality 21 (2006): 255–61, at 255.
45.╇Barbara J. Evans and David A. Flockhart, “The Unfinished Business of U.S.
Drug Safety Regulation,” Food and Drug Law Journal 61 (2006): 753–94, at 775.
46.╇Alan D. Berkenwald, “In the Name of Medicine,” Annals of Internal Medicine 128
(1998): 246–50, at 248–49.
47.╇L. E. Smith, “The Practice of Medicine and Its Interface with Medical Regula-
tion,” Archives of Facial and Plastic Surgery 1 (1999): 58–59; James N. Thompson, “The Fu-
ture of Medical Licensure in the United States,” Academic Medicine 81 (2006): S36–S39,
at S38; J. T. Rannazzisi, “The DEA’s Balancing Act to Ensure Public Health and Safety,”
Clinical Pharmacology and Therapeutics 81 (2007): 805–806.
A r e W e E n t e r i n g a “ P e r f e c t S t o r m ”? â•… · â•… 217
76.╇Rene Almeling, “Selling Genes, Selling Genders: Egg Donors, Sperm Banks,
and Medical Marketing Genetic Material,” American Sociological Review 72 (2007):
319–40, at 321–22.
77.╇CDC et al., “2004 Assisted Reproduction Technology Success Rates.”
78.╇Almeling, “Selling Genes, Selling Genders,” 332;
79.╇Gustofson et al., “Cost Analysis of Ganirelix,” S118.
80.╇Almeling, “Selling Genes, Selling Genders,” 325–34.
81.╇Ibid., 337.
82.╇ McCabe and McCabe, DNA: Promise and Peril, 206.
83.╇Almeling, “Selling Genes, Selling Genders,” 327.
84.╇CNN 2007 (http://www.cnn.com/2007/politics/07/23/debate.transcript/
index.html).
ten
Modern Eugenics
and the Law
M a x w e l l J. M e h l m a n
One hundred years after the enactment of chapter 215 of the Indiana Acts
of 1907, the world’s first eugenic sterilization law, eugenics might be ex-
pected to be a thing of the past.1 Yet practices that might be considered
eugenic persist, and there is good reason to expect them to flourish in the
near future. This essay begins by discussing what is meant by “eugenic.”
It then describes modern practices that might be considered eugenic.
It concludes by foreshadowing future developments in technology and
public policy that might achieve eugenic objectives.
W h at Cou n ts a s a E ug e n ic Pr ac t ice?
Francis Galton, who originated the term eugenics in 1883, defined it as
“the science of improving stock, which is by no means confined to ques-
tions of judicious mating, but which, especially in the case of man, takes
cognisance of all influences that tend in however remote a degree to give
to the more suitable races or strains of blood a better chance of prevail-
ing speedily over the less suitable than they otherwise would have had.” 2
In 1904, he restated his understanding of eugenics as “the science which
deals with all influences that improve the inborn qualities of a race; also
with those that develop them to the utmost advantage.”3
There is widespread agreement now among geneticists that there is
no genetic basis for the concept of “race.” Members of the same “race”
can differ markedly, and people of different races can share more genes
in common than people of the same race.4 Hence we might be tempted
to think that, since eugenics is an effort to improve “races” or “strains of
blood,” there can be no true modern eugenic practices.
219
220â•… · â•… M a x w e l l J . M e h l m a n
tive decisions, the more frankly eugenic the law can be considered. This
is not meant to imply that forced sterilization is on par with government
inaction in the face of private behavior. Yet as the other chapters in this
book demonstrate, society has employed indirect as well as direct means
to control reproductive behavior in order to achieve eugenic goals. The
memory of the victims of the Indiana law and its successors would be
dishonored if we examined the current state of affairs using too narrow
a view of this history.
achieved, body build, eye color, hair color and texture, years of education
and major areas of study, occupation, Scholastic Aptitude Test (SAT)
scores and grade point averages, special interests, family medical history,
essays by donors, and personality typing based on the Keirsey test, which
uses a Jungian approach to classify temperaments into 12 categories, such
as “rational and reserved” or “artisan and introspective.” The California
Cryobank, Inc., provides purchasers of donor sperm with a 26-page donor
profile. A company called Fertility Alternatives pays a premium to “ex-
ceptional” egg donors. To qualify, the donor must have graduated from
a major university, or be currently attending one, preferably Ivy League;
have a GPA of 3.0 +; SAT scores of 1350+ or ACT scores of 30+; and have
a documented high IQ.
The degree to which the law accommodates these assisted reproduc-
tive practices is striking.12 Although health care is one of the most heav-
ily regulated industries in the country, the only federal law specifically
governing in vitro fertilization (IVF) services is the Fertility Clinic Suc-
cess Rate and Certification Act of 1992, which merely requires infertility
clinics to report success rates in a standardized fashion.13 State regulation
is minimal.14 The criticisms leveled at the recent IVF-assisted birth of
octuplets to an unmarried, unemployed woman illustrate this regulatory
lacuna.
Conceivably, state law might encourage selective breeding by permit-
ting parents to sue infertility clinics for negligence in failing properly to
screen gamete donors. The leading case is Harnicher v. University of Utah
Medical Center.15 The Harnichers purchased sperm from a fertility clinic
after closely matching the donor to the husband’s physical characteristics
and blood type and mixing the donor sperm with the husband’s, so that
the couple could more easily represent any child genetically as their own.
The parents sued after learning that the clinic had accidentally substituted
sperm from a different donor, resulting in triplets whose eye color, hair
color, and blood type did not match the husband’s. The court refused to
allow the parents to recover damages from the clinic on the grounds that
they had not suffered any physical injury and that they could not recover
for the emotional distress from “exposure to the truth” about their chil-
dren’s father.16 The court also rejected the parents’ claim that they had
been damaged by the fact that children from the donor they actually had
selected would have been better looking.17 So far it would appear that the
224â•… ·â•… M a x w e l l J . M e h l m a n
law was not lending itself to supporting the practice of selective breeding
through gamete donation. But the Supreme Court of Utah concluded its
opinion with a startling caveat: “The Harnichers do not allege that the
triplets are unhealthy, deformed, or deficient in any way. Nor do they
claim any racial or ethnic mismatch between the triplets and their par-
ents.”18 If any of these had been the case, presumably the law would have
afforded the parents the relief that they were seeking.
While the parents in the Harnicher case used selective breeding in the
hopes of achieving a positive neoeugenic goal, the law also countenances
a number of practices that might be deemed negative neoeugenics. One
obvious example is fetal testing followed by aborting the fetus for reasons
that do not relate to the mother’s health. Another is preimplantation ge-
netic diagnosis (PGD) of fertilized embryos in the course of IVF, where
only those embryos with the best genetic endowment are implanted in
the uterus and allowed to gestate. The law leaves IVF services essentially
unregulated. A third technique is community-based genetic testing for
matchmaking purposes, such as screening programs for Tay-Sachs and
other recessive genetic diseases prevalent in Jews of Ashkenazi descent.19
The pioneer program is Chevra Dor Yeshurim (Association of the Upright
Generation), which screens Orthodox Jewish adolescents in New York
and does not allow a matchmaker to arrange a marriage between two
individuals who both carry a recessive mutation. 20
Finally, there are private family planning initiatives. One is Project
Prevention (formerly CRACK). This was started in California in 1997 by
a woman who had adopted four children and who wanted to punish their
drug-addicted mother. When she failed to persuade the state legislature
to criminalize drug-addicted mothers, she created CRACK, which gives
drug addicts $200 if they undergo sterilization or use long-term birth
control. In 2003, the organization claimed to have 23 chapters nationwide
and had paid 907 women, including 361 who had tubal ligations. African
Americans and Hispanics accounted for 401 of the participants.21 At pres-
ent, there is no state or federal law that would interfere with this project.
In some instances, the law goes farther than turning a blind eye; it actu-
ally aids the practice of neoeugenics. One example is the ability of par-
M o d e r n E u g e n i c s a n d t h e L aw â•… · â•… 225
The very phrase “wrongful birth” suggests that the birth of the disabled
child was wrong and should have been prevented. If one accepts the prem-
ise that the birth of one “defective” child should have been prevented,
then it is but a short step to accepting the premise that the births of classes
of “defective” children should be similarly prevented, not just for the
benefit of the parents but also for the benefit of society as a whole through
the protection of the “public welfare.” This is the operating principle of
eugenics. 28
Any quality of life ethic favors the life of the healthy over the infirm, the
able-bodied over the disabled and the intelligent over the mentally chal-
lenged. If logically extended, it could produce a culture that condones
the extermination of the weak by the strong or the more powerful. The
Nazi regime under Adolph [sic] Hitler is a not too distant reminder of this
kind of eugenic approach. Unfortunately, such thoughts are not limited
to foreign nations but can also be found in the writings of Justice Oliver
Wendell Holmes in Buck v. Bell . . . , which approved of sterilization of the
mentally incompetent. Taylor, supra, calls to our attention the influence
that Hitler’s experiments with sterilization had on the American eugenics
movement. Eugenics espouses the reproduction of the fit over the unfit
and discourages the birth of the unfit. 32
In short, the judges in Kurapati and Grubbs did not want the ma-
chinery of the courts to contribute to what they felt was a eugenic goal,
the desire of some parents to avoid giving birth to a child with severe dis-
abilities. (Ironically, given their goal, they reached the wrong outcome.
Arguably, parents are less likely to abort fetuses with disabilities if they
can recover the costs of caring for the children through wrongful birth
actions. On the other hand, physicians who had to compensate parents
in wrongful birth cases might be more likely to encourage the parents to
abort the fetuses in marginal cases.)
Another method by which the government involves itself in what
might be considered neoeugenics is providing public funding for family-
planning programs aimed at preventing the birth of children to poor
mothers. According to the Alan Guttmacher Institute, the government
in 2001 spent $1.26 billion on reversible contraceptive services and $95
million on sterilization services. 33 These funds are distributed through
several programs: Medicaid, Title X, Title V (Maternal Child Block
Grants), Social Services Block Grants, and TANF (Temporary Assistance
for Needy Families). 34 These programs would not be particularly neoeu-
genic if they provided family-planning assistance to all socioeconomic
groups, but virtually all of these funds are earmarked for the poor. As Jane
Gilbert Mauldon writes, government-supported “family planning” efforts
have been linked to eugenics in the past, and they arguably continue to
pursue eugenic goals:
Eugenics seeks to improve social welfare by discouraging births of certain
types, or births among certain social groups, and by encouraging other
228â•… · â•… M a x w e l l J . M e h l m a n
types of births. This line of thinking has a long history in the United
States. Early in the twentieth century, explicitly eugenicist ideas, mani-
fested as exhortations to educated women to have large families so as not
to be out-bred by poor, immigrant or African American women, were
commonly accepted among elites in the United States. More than thirty
states had sterilization laws that provided for the involuntary sterilization
of so-called socially unfit individuals, which could mean simply women
who were poor and ill-educated. In 1958, Mississippi State Representa-
tive David H. Glass sponsored an unsuccessful bill to “. . . Discourage the
Immorality of Unmarried Females by Providing for Sterilization of the
Unwed Mother under Conditions of the Act; and for Related Purposes.”
Glass made clear the intended purpose of the act: “During the calendar
year 1957, there were born out of wedlock in Mississippi, more than seven
thousand Negro children . . . the Negro woman because of child welfare
assistance [is] making it a business, in some cases, of giving birth to ille-
gitimate children. . . . The purpose of my bill was to try to stop, slow down,
such traffic at its source.”
In some respects, contemporary policies still seem to reflect these elitist
assumptions and concerns about “excess” childbearing among disadvan-
taged women. If programs were exclusively intended to assure recipients
reproductive freedom, they might also include subsidized fertility ser-
vices, not just contraception and sexually transmitted disease preven-
tion. If they were entirely philanthropic programs intended to reduce
unplanned childbearing across the board, they might have been designed
to serve a larger group of people. 35
it can claim. The policy might be regarded as eugenic in that, since only
families with enough income to pay taxes benefit from the credit, the
policy creates an incentive for better-off families to have more children.
Contrast child tax credits with so-called family caps under state wel-
fare programs. Unlike child tax credits that encourage taxpaying fami-
lies to produce more offspring, family caps apply to families on welfare,
discouraging them from becoming larger by halting increases in welfare
benefits once there are more than a certain number of children. Currently
24 states have some version of this policy. 36 Dorothy Roberts observes
that “like birth control programs and reproductive punishments, contem-
porary welfare policies share features of eugenic thinking. . . . Of course,
the current welfare family caps are not premised on notions of recipients’
genetic inferiority. But, like eugenic programs of the past, they are seen as
a way of ridding America of the burden poor people pose.”37
In Dandridge v. Williams, the Supreme Court upheld family caps in
the face of constitutional challenge. 38 The Court ruled that the state of
Maryland did not violate the Equal Protection Clause of the Fourteenth
Amendment because it had a reasonable basis for the policy, namely, “the
state’s legitimate interest in encouraging employment and in avoiding
discrimination between welfare families and the families of the working
poor.”39 Interestingly, the state itself had articulated an additional goal,
“providing incentives for family planning,”↜40 on which, without com-
ment, the Court apparently declined to rely.
reports that some Medicaid programs had prescribed the drug for sex
offenders. But it also could have the effect of discouraging the poor from
reproducing.
After the FDA approved Norplant, a surgically implanted, long-
lasting contraceptive, legislators in a number of states proposed linking
Norplant use to eligibility for welfare benefits. In other words, women
on welfare could not receive benefits if they continued to have children.
Although no such requirement has been adopted, Norplant has been
covered under all state Medicaid programs.
The state-mandated initiative that most overtly raises eugenics con-
cerns, however, is newborn screening for nontreatable disorders. New-
born screening began in the 1960s after physician Robert Guthrie devel-
oped a screening test for PKU, an autosomal recessive metabolic disorder
that can be treated effectively if detected soon after birth. Guthrie also
pioneered a method for collecting and transporting on special filter paper
the blood samples used for screening, known as “Guthrie cards,” and he
insisted that the collection and analysis of the samples be performed
by state public health officials. Massachusetts adopted newborn screen-
ing on a voluntary basis in 1962, but after President Kennedy’s Advisory
Committee on Mental Retardation recommended mandatory screening,
states began to enact newborn screening as a legal requirement. By 1973,
newborn screening was compulsory in 43 states. Now it is universal.
The development of faster and cheaper technologies such as tandem
mass spectrometry and microchip arrays enable programs to screen for far
greater numbers of disorders, including many for which no readily effec-
tive treatments presently exist. Screening for these nontreatable disorders
can be beneficial, in that it could spare families years of uncertainty once
symptoms emerged; alert them to be on the watch for new discoveries
that could provide their children with treatment; provide children with
adjunctive if not curative interventions; and facilitate participation of the
children in research on their disorders. Yet some public health advocates
offer an additional rationale for screening for nontreatable disorders: that
it can serve as a valuable tool in family planning. One recent article ex-
plains, for example: “Arguments for considering broader benefits from
the early diagnosis that only newborn screening can provide include . . .
knowledge on which to base reproductive decision-making years before
a disease would be diagnosed for the affected child.”50
232â•… · â•… M a x w e l l J . M e h l m a n
tween this program and classic eugenic practices is, at the very least,
disconcerting.
In her 2008 book Heredity and Hope, historian Ruth Schwartz Cowan
defends medical genetics in general, and newborn screening in particular,
from being attacked as eugenic. Their intention is not, she explains, the
eugenic goal of preventing the genetically unfit from reproducing, but the
exact opposite: to help people reproduce who suspect that they are at risk
for having a genetically unfit child. According to Cowan, medical genetics
facilitates this by allowing these people to confirm through genetic test-
ing that they are not in fact at risk or, if testing shows that they are in fact at
risk, by enabling them to use prenatal diagnosis to bring only genetically
healthy fetuses to term. 53 Cowan is correct in that mandatory newborn
screening does not necessarily aim at preventing reproduction by persons
who may have undesirable genetic loads. But it does discourage the birth
of children with undesirable mutations, with the result that our genetic
stock will be improved. When this objective is extended to nontreatable
disorders and accomplished through compulsory government programs,
its neoeugenic pedigree is unmistakable, even if it is not intended.
T h e L aw of Mode r n Neoe ug e n ic s
approves a drug or medical device, physicians are free to use them in any
way they choose, subject only to liability for malpractice if their behav-
ior is deemed unreasonable. 59 So even if the agency refused to approve
a eugenic indication for a product—say, a label claim that a genetic test
was useful in making reproductive decisions—FDA rules would allow a
physician to perform the test for that purpose so long as the product had
been approved for any use. If Congress or the FDA were to change this
policy, however, the recent Abigail decision suggests that the new policy
would be upheld as constitutional.
Aside from concerns about constitutionality, from a practical stand-
point certain attempts to restrict neoeugenic practices would be unlikely
to succeed. The private nature of reproductive decision making which
lends it its cloak of constitutionality means that some enforcement ac-
tivities would have to intrude into the patient-physician relationship,
the internet, and the bedroom. Even if we were willing to permit such
invasions, the sheer difficulty of monitoring these spaces would require
enormous resources. Black markets offering banned genetic testing and
assisted reproductive services are bound to spring up as they did when
abortion was illegal. In 1962 alone, more than a million abortions were
believed to have been performed, half by physicians. 60 Reproductive
products and services that were illegal in the United States could be
obtained abroad.61
F u t u r e Developme n ts
give public health officials additional powers and discretion. With fund-
ing from the Robert Wood Johnson Foundation and the W. K. Kellogg
Foundation, they have drafted a Model State Public Health Act.63
An indication of the scope of the powers that would be conferred
on public health officials under this law can be obtained by considering
its provisions for mandatory public health screening and testing. Under
the act, a state or local public health agency may establish a compulsory
screening program for any “conditions of public health importance that
pose a significant risk or seriously threaten the public’s health” [section
5-106(d)(1)]. The terms significant risk and seriously threaten are not defined
in the act, but the term condition of public health importance is defined to
mean “a disease, syndrome, symptom, injury, or other threat to health
that is identifiable on an individual or community level and can reason-
ably be expected to lead to adverse health effects in the community” [sec-
tion 1-102(6)]. Under the model act, then, a public health agency could
make prenatal screening for genetic diseases and conditions mandatory
for all pregnant women, so long as the agency determined that the dis-
eases and conditions, if not detected in utero, posed a significant threat to
health that can reasonably be expected to lead to adverse health effects in
the community. Such a belief is not far-fetched. The American College of
Obstetrics and Gynecology recently called for “routine” prenatal screen-
ing for Down syndrome.64 Another provision of the model act states that a
public health agency may make participation in such a screening program
a condition “of participating in or receiving a service or privilege” [section
5-106(d)(2)]. Accordingly, women who refused to be screened could be
denied health and welfare benefits.
Renewed interest in universal health insurance also could act as a
spur to neoeugenic practices. Universal insurance provided by federal
or state governments would give them greater control over the alloca-
tion of health care resources, which could lead to greater efforts to save
money through eugenic measures. Even if the actual health insurers re-
mained private companies, they would have greater incentives to try to
reduce spending by refusing to cover genetic conditions that could have
been, but were not, prevented. Legislation prohibiting genetic discrimi-
nation might not prohibit such practices; it is not yet clear that laws like
the Genetic Information Nondiscrimination Act (GINA), for example,
would necessarily do so. On the other hand, universal health insurance
M o d e r n E u g e n i c s a n d t h e L aw â•… · â•… 237
could help reverse health disparities that cause higher rates of morbidity,
mortality, and infant mortality in poor and minority populations. By
improving their chances of reproducing, this could militate against the
achievement of neoeugenic objectives.
Although the development of human gene transfer technology—the
ability to install new genetic instructions into existing cells—has been
disappointing to date, a significant breakthrough could accelerate prog-
ress dramatically. This might lead to the development of genetic interven-
tions that could prevent diseases or disorders if applied in utero or during
IVF. In the same way that they mandate immunization, public health of-
ficials might require parents to employ these interventions, or they might
provide incentives for doing so, such as public funding or tax breaks.
If genetic interventions took place early enough in the life cycle, the
resulting changes in DNA would be incorporated into an individual’s
eggs or sperm and passed on to future generations. Societal pressure to
use this technology to improve the germ line could become overwhelm-
ing. Future developments in genetics also hold out the possibility of ma-
nipulating DNA to enhance non-disease traits. Researchers have already
created mice with genetically engineered improvements in strength 65
and cognitive ability.66 The question for public policy would be whether
to subsidize access to these technologies for those who cannot afford to
pay for them. Failure to do so would be an implicit form of neoeugen-
ics, since enhanced individuals would claim a greater share of societal
resources, increasing their chances of reproductive success over genetic
have-nots.
As we move forward 100 years after chapter 215 of the Indiana Acts of
1907, the question of how far the state may go in controlling reproduc-
tive decision making is bound to become more compelling. Some believe
that the future of the genetic revolution holds the possibility of enabling
people virtually to dictate the precise genetic endowment of their off-
spring. This would be nothing less than the ability to manage human
evolution, the holy grail of eugenics. If this capability actually emerged,
it would remain to be seen how the historical lessons of eugenics would
inform its use.
238â•… · â•… M a x w e l l J . M e h l m a n
No t e s
1.╇ In 1921, the Supreme Court of Indiana held that law to be unconstitutional in
Williams v. Smith, 131 N.E.2 (Ind. 1921). The Indiana legislature enacted a replacement
sterilization law, Ind. Acts 1927, ch 241, which responded to the lack of due process in the
first scheme.
2.╇ Francis Galton, Inquiries into Human Faculty and Its Development (London:
Macmillan, 1883), 17n1.
3.╇ Francis Galton, “Eugenics: Its Definition, Scope, and Aims,” American Journal
of Sociology 1 (1904).
4.╇ Michael J. Bamshad and Steve E. Olson, “Does Race Exist? An Overview/Ge-
netics of Race,” 289 Scientific American 78–85 (2003).
5.╇ Dorothy E. Roberts, “Crime, Race, and Reproduction,” 67 Tulane Law Review
1945, 1969 (1993).
6.╇Sonia Suter, “A Brave New World of Designer Babies?” 22 Berkeley Tech. L. J. 897,
968–69 (2007).
7.╇ Daniel J. Kevles, “Eugenics,” in 2 Encyclopedia of Bioethics 848 (3rd ed. 2004).
8.╇Troy Duster, “Eugenics: Ethical Issues,” in 2 Encyclopedia of Bioethics 854 (3rd ed.
2004) (emphasis in original).
9.╇ Skinner v. Oklahoma, 316 U.S. 535 (1942).
10.╇ Relf v. Weinberger, 372 F. Supp. 1196 (D.D.C. 1974), vacated as moot, 565 F.2d 722
(D.C. Cir. 1977).
11.╇Steve Weinberg, “Yao: China’s Gift to Basketball,” Christian Science Monitor,
Jan. 3, 2006, at 13.
12.╇See, e.g., Alicia Ouellette et al., “Lessons across the Pond: Assisted Reproduc-
tive Technology in the United Kingdom and the United States,” 31 Am. J. L. and Med 419
(2005).
13.╇ Fertility Clinic Success Rate and Certification Act of 1992, Pub. L. No. 102-493,
106 Stat. 3146 (codified at 42 U.S.C. §§ 263a-1 to a-7 (2000)).
14.╇ Ouellette, supra note 44, at 423.
15.╇ 962 P.2d 67 (Utah 1998),
16.╇ Id. at 72.
17.╇ Id.
18.╇ Id.
19.╇ Lori B. Andrews, “A Conceptual Framework for Genetic Policy: Comparing the
Medical, Public Health, and Fundamental Rights Models,” 79 Wash. U. L. Q. 221, 245
(2001).
20.╇ Beverly Merz, “Matchmaking Scheme Involves Tay-Sachs Problem,” 258 JAMA
2636 (1987).
21.╇See Renee Chelian, “Remarks on the “CRACK” Program: Coercing Women’s
Reproductive Choices,” 5 J. L. Soc’y 187 (2003).
22.╇ Molloy v. Meier, 679 N.W.2d 711 (Minn. 2004).
23.╇ Id. at 720.
24.╇ Taylor v. Kurapati, 600 N.W.2d 670 (Mich. App. 1999).
25.╇ Id. at 674.
26.╇ Id. at 688.
27.╇ Id.
M o d e r n E u g e n i c s a n d t h e L aw â•… · â•… 239
28.╇ Id.
29.╇ Id. at 690.
30.╇ Grubbs v. Barbourville Family Health Ctr., P.S.C., 120 S.W.3d 682 (Ky. 2003).
31.╇ Id. at 686.
32.╇ Id. at 692.
33.╇ Alan Guttmacher Institute, Public Funding for Contraceptive, Sterilization, and
Abortion Services (2005) (http://www.guttmacher.org/pubs/fpfunding/tables.pdf).
34.╇ Id., Table 1.
35.╇ Jane Gilbert Mauldon, “Providing Subsidies and Incentives for Norplant, Steril-
ization, and Other Contraception: Allowing Economic Theory to Inform Ethical Analy-
sis,” 31 J. L. Med. & Ethics 351, 353–54 (2003).
36.╇See Janet Simmons, “Coercion in California: Eugenics Reconstituted in Wel-
fare Reform, the Contracting of Reproductive Capacity, and Terms of Probation,” 17
Hastings Women’s L. J. 269, 277 (2006).
37.╇ Dorothy Roberts, Killing the Black Body: Race, Reproduction, and the Meaning of
Liberty (New York: Pantheon Books, 1997), 215–16.
38.╇ 397 U.S. 471 (1970).
39.╇ Id. at 486.
40.╇ Id. at 484.
41.╇ Cal. Penal Code sec. 645.
42.╇ For more on chemical castration, see Avital Stadler, Comment, “California In-
jects New Life into an Old Idea: Taking a Shot at Recidivism, Chemical Castration, and
the Constitution, “ 46 Emory L. J. 1285 (1997).
43.╇ Andrews, supra note 11, at 77, n.8.
44.╇ Buck v. Bell, 274 U.S. 200 (1927).
45.╇ Id. at 208 (quoted in Skinner, 316 U.S. at 542).
46.╇ Skinner, 316 U.S. at 542
47.╇Rachel Wyatt, Note: “Male Rape in U.S. Prisons: Are Conjugal Visits the An-
swer?” 37 Cas. W. Res. J. Int’l Law 579 (2006).
48.╇See, e.g., Paul A. Lombardo, Commentary: “‘The American Breed’: Nazi Eugen-
ics and the Origins of the Pioneer Fund,” 65 Alb. L. Rev. 743, 750 (2002).
49.╇ Cheryl G. Stolberg, “House Rejects Coverage of Impotence Pills,” New York
Times, June 25, 2005.
50.╇ Duane Alexander (NIH) and Peter C. van Dyck (HRSA) 2006: “A Vision of the
Future of Newborn Screening” 117 Pediatrics S350, 352.
51.╇ Douglas County v. Anaya, 694 N.W.2d 601 (Neb. 2005).
52.╇ Jeffrey Botkin, Testimony before the President’s Council in Bioethics, Feb. 3,
2006 (http://www.bioethics.gov/transcripts/feb06/feb3full.html).
53.╇Ruth Schwartz Cowan, Heredity and Hope: The Case for Genetic Screening (Cam-
bridge: Harvard University Press, 2008), 236–37.
54.╇ Skinner v. Oklahoma, 316 U.S. 535, 541 (1942).
55.╇See, e.g., John A. Robertson, Children of Choice: Freedom and the New Reproduc-
tive Technologies (Princeton: Princeton University Press, 1994).
56.╇ Griswold v. Connecticut, 381 U.S. 479 (1966).
57.╇ Roe v. Wade, 410 U.S. 113 (1973).
58.╇ Abigail Alliance v. von Eschenbach, 2007 U.S. App. LEXIS 18688 (Aug. 7,
2007).
240â•… ·â•… M a x w e l l J . M e h l m a n
59.╇ David A. Kessler, “Regulating the Prescribing of Human Drugs for Nonap-
proved Uses under the Food, Drug, and Cosmetic Act,” 15 Harv. J. Legis. 693 (1978).
60.╇See Zad Leavy and Jerome M. Kummer, “Criminal Abortion: Human Hardship
and Unyielding Laws,” 35 S. Cal. L. Rev. 123 (1962).
61.╇See Maxwell J. Mehlman and Kirsten M. Rabe, “Any DNA to Declare? Regulat-
ing Offshore Access to Genetic Enhancement,” 28 Am. J. L. and Med. 179 (2002).
62.╇ Ian Sample, “Embryo Test to Screen for 6,000 Inherited Diseases: Procedure
Hailed as Major Advance for IVF Couples: Doctors Will Be Able to Test for Genetic
Mutations,” Guardian, June 19, 2006, 7.
63.╇Turning Point Model State Public Health Act (http://www.turningpoint
program.org/Pages/pdfs/statute_mod/MSPHAfinal.pdf).
64.╇ American College of Obstetrics and Gynecology News Release (http://www
.acog.org/from_home/publications/press_releases/nr01-02-07-1.cfm).
65.╇ BBC News, Aug. 24, 2004 (http://news.bbc.co.uk/2/hi/science/nature/
3592976.stm).
66.╇ Y. Tang, E. Shimizu, G. Dube., C. Rampon, G. Kerchner, M. Zhuo, G. Liu, and
J. Tsien, “Genetic Enhancement of Learning and Memory in Mice,” Nature 1999, 401:
63–69.
C on t r i bu t or s
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242â•… · â•… c o n t r i b u t o r s
243
244â•… · â•… I n d e x
of, 135, 142; in Georgia, 51; hygiene in, 124–26; welfare dependency basis
movement, 19; inability to compete of, 117–23, 127, 132–34
grounds for, 78, 144; in Indiana, miscegenation, 48–50, 64n24, 70, 74, 88,
32–35, 95–99, 101–103, 106; job train- 111, 169
ing of, 99; in Minnesota, civil commit- Model Sterilization Act, 21, 34
ment of, 119–20, 122–23, 127; over- Molloy v. Meier, 225
view, 95–97, 106–107, 171; paradigm Montana, 229–30
shift regarding, 104; protection vs. Moore v. Regents of The University of Cali-
control issue, 176–81; public percep- fornia, 208
tions of, 173, 174; restoration to capac- Moynihan, Daniel, 166
ity, 122, 129, 132–34; social costs of, Muhammad, Elijah, 69
51, 56–57; statistics, 95–96, 99 Muscatatuck State School, 99, 106, 107
Mental Retardation: A Family Study Myriad Genetics, 209–210
(Reed), 135, 139n48
Mental Retardation Protection Act of NAACP baby contests: funds distri-
1975, 135–36 bution, 84–85; history of, 82–83;
Michigan sterilization statutes, 30 overview, 70, 80–82, 87–89; results,
Minnesota Eugenics Society, 120–21, controversies, legacy, 85–87; Tenth
125 Crusade, 81, 83–85
Minnesota sterilization laws: authority Nation of Islam (NOI), 69, 71
governing, 119–22, 124, 131; challeng- National Association for Retarded Chil-
es to, 129–35; Child Welfare Commis- dren, 124, 134
sion, 121; Children’s Code, 118–19, National Association of Colored Women,
121; civil commitment, 119–20, 78
122–23, 127; Dight Institute for Hu- National Center for Family Planning Ser-
man Genetics, 135, 139n48; disputes vices, 167
regarding, 120–21, 126, 136; enact- National Council of Negro Women
ment of, 118; Faribault School for the (NCNW), 178
Feebleminded, 119–20, 129–30, 132, Nazi eugenics program, 35, 56, 148, 163,
134, 136; gendered ideas in, 126–27; 171, 172
informed consent provisions, 118–20, neurasthenia, 19, 23n3
127–29; insane persons, 119–20, 129; New Deal, 4, 117, 120, 125, 126. See also
intelligence testing, 117, 119, 123, 127, Minnesota sterilization laws
132–33; legal foundation, 118–19; New Republic, 60
legal protections, 118–20, 127–29, New York Post, 58
135–36; Masters case, 132–34; Mental Nixon, Richard, 5, 162–70
Retardation Protection Act of 1975, Noll, Steven, 185n10
135–36; motivations, 118, 121–25; Nordau, Max, 23n3
overview, 4–5; paradigm shifts in, Norplant, 230, 231
124–25, 134–36; Public Health Ser- North Carolina: sexual promiscuity steril-
vice, 130–31; restoration to capacity, ization, 141, 145–47, 152, 158nn18,20
122, 129, 132–34; sexual promiscuity, North Carolina Eugenics Board, 141,
123, 158n21; State Board of Control, 143–44, 174
120, 122, 124–26; as state-funded North Carolina sterilization laws: abuse
birth control, 128–29; statistics, 118, of, 174–76; African Americans in,
120, 125, 134, 136n5, 158n21; termi- 149–50, 159n26; authority govern-
nology, 136n1; welfare administration ing, 143–44; candidate assessment,
I n d e x â•… · â•… 249
E r ic M . M e s l i n a n d R ic h a r d B . M i l l e r , e di t or s