The Tragic Tale of State-Sponsored Eugenics in America UPDATED

The Tragic Tale of State-Sponsored Eugenics in America UPDATED August 17, 2012

Rita Thompson Swords was sterilized by a doctor after delivering her second child. She was 21, unwed and poor, a combination that made her unfit for more children, according to the North Carolina Eugenics Board. Photo credit: Julie Rose for NPR.

There I was, making the commute home from work after a long day. The skies were overcast, yet the forecast rain had yet to start falling. I fired up the radio, and cycled through the channels listening to a snippet of a song here, and a song there. Traffic up ahead started slowing down, making tunes like Radar Love overkill as speeds dipped below 30 miles per hour.

So as the traffic congestion caused brake lights to flicker, I flipped the channel to NPR and learned that the state of North Carolina had once had a eugenics board in place, sterilizing “undesirables” from 1929 until 1973. Close to 8,000 procedures were done.


It is the part of our national history that is left out of the textbooks, and it’s the first time I had ever heard of sterilizations forced by the state on American citizens. I’m such a virgin in that way. Sheltered, gullible, simple, and childlike, it never occurred to me that things of this nature occurred in Uncle Sam’s paradise. Nazi Germany? Sure. Singapore? Sure. But North Carolina, right next door to me? Say it ain’t so.

Here’s a snippet from NPR’s website,

Few people have championed compensation for eugenics victims in North Carolina longer than John Railey. He writes editorials for the Winston-Salem Journal, but back in 2002, he was a reporter, standing out on the loading dock of the paper with his editor, who’d invited him out for a chat.

“And so, we’re standing here and he’s going, ‘I got a really big story.’ And I’m going like, ‘What could you have?’ And he said, ‘What if I told you that our state had a forced sterilization program, and Winston-Salem was right in the thick of it?’ And I’m just going, ‘B.S.’ ”

But up in the dingy filing room where the paper keeps yellowed clippings of stories dating back to the 1940s, he learned the truth: Articles referring to people as “morons” whom the North Carolina Eugenics Board had “saved from parenthood”; editorials extolling the board’s work.

“This program was always hiding in plain sight,” Railey says. “And now I’m the editorial page editor of my paper, pushing for compensation of these folks that guys who sat in my chair back in the day pushed to have sterilized, for all intents and purposes.”

The North Carolina Eugenics Board sterilized more than 7,600 men, women and children, often merely because they were poor or mentally ill. It went on until the mid-1970s. But no one seemed to know about it until the Winston-Salem Journal published a series in late 2002. North Carolina’s governor issued a formal apology. There was talk of compensating the victims.

But it went nowhere until Republican House Speaker Thom Tillis took up the cause.

“Sometimes we have to look at what the predecessors in this institution did and say, ‘That was wrong,’ ” he says.

Tillis was the most powerful lawmaker ever to back the compensation effort. A bill to pay living eugenics victims $50,000 each sailed through the North Carolina House, but senators refused to take it up. Tillis has vowed to bring it back with better luck next year.

But advocates like Railey worry time is running out. The victims are aging and ill. At least one has died since the compensation bill failed in June. Railey feels like he failed them. If only he’d been a better writer, he says.

“More persuasive, better read, something, anything,” Railey says. “God, they were wronged.”

Read the rest and listen to the broadcast.

They were wronged is an understatement. We were wronged, and they were treated like animals. The stark realization hit me as I pondered another thought: unwritten histories lie waiting to be discovered in archives all around the country, and all throughout the world. Things known to God and to man, but forgotten by the “march of progress,” and by generations uninterested in learning the secrets of the democracy of the dead.

When I got home, checked in with the family, exchanged pleasantries, etc., I wanted to learn more about the plainly named North Carolina Eugenics Board. As it turns out, North Carolina had the third highest number of enforced sterilizations in the country. And this sad chapter started in 1907 in the state of Indiana. The state with the most documented cases? California, which started their program in 1909 and kept it cranking up until 1963. In the Golden State, the conservative estimate is that at least 20,108 people were sterilized though, “because of the sensitive nature of sterilization records, many are difficult to access or have been altered.”

Thanks to the work of Lutz Kaelber, Associate Professor of Sociology, at the University of Vermont, and numbers of his students, much of the data on this silent tragedy is now available. Their hard work documenting the history of eugenics in the U.S., has made it possible to share detailed information like the kind below, for all 50 states, with footnotes to back up their findings. On the home page of the project, links to the history of eugenics policies in each state are available. I linger over the California case because it was the largest and because of how it evolved.

Eugenicist (sic) in California saw sterilization as a tool with a broad range of applications, all of which were applied to prevent the procreation of undesirable traits, overcrowding of state institutions, and to alleviate fiscal constraints on the state…

The driving force behind the statutes regarding sterilization in California was mainly eugenic in nature, although they were also allegedly designed to benefit inmates in a physical, mental, moral, or therapeutic manner. There was a somewhat punitive motivation behind them as well (see Laughlin, p.7). After World War I, and the change in the perception of “feeble-mindedness” from a crime to a disease, there was a noted shift across the country from “institutions” to “hospitals” and “inmates” to “patients” (Kline, p. 45). In the waning years of sterilization in California, the rationale shifted from eugenics to “fears of overpopulation, welfare dependency, and illegitimacy” (Stern, “Sterilized,” p. 1132).

The work of Professor Alexandra Minna Stern, publishing books and papers through the University of California Press in Berkeley, caught my attention particularly as she has taken pains to document this evolution in the case of California, where coerced sterilizations took place as late as the year 1975 at LA County/USC Medical Center. In a paper published in the American Journal of Public Health entitled “Sterilized in the name of Public Health: Race, Immigration, and Reproductive Control in Modern California,” Stern shares the story of a lawsuit I’m not likely to forget: Madrigal v Quilligan.

The plaintiffs in this class-action suit, Madrigal v Quilligan, were working-class Mexican-origin women who had been coerced into postpartum tubal ligations minutes or hours after undergoing cesarean deliveries. In contrast to the operations carried out at state institutions beginning in 1909, these procedures were financed by federal agencies that began to disperse funds in conjunction with the family planning initiatives of the War on Poverty, launched by President Lyndon B. Johnson in 1964.


For the most part, Madrigal v Quilligan has been understood in light of the thousands of unwanted sterilizations reported in the United States from the late 1960s to the mid-1970s. And certainly, the experiences of the Mexican-origin women who suffered at the scalpels of County General physicians mirror those of the African American, Puerto Rican, and Native American women who came forth with comparable stories during the same years. Yet Madrigal v Quilligan should also be analyzed longitudinally, as a concluding link in the history of forced sterilization in modern California. Just as this case highlights the confluence of factors that facilitated sterilization abuse in the early 1970s, it also illuminates the longevity and potency of prosterilization arguments predicated on the protection of the public’s health and resources.


Madrigal v Quilligan demonstrates shifts over the past century in terms of the rationale employed to authorize compulsory sterilizations and the uneven transition from state coercion to patient choice in matters pertaining to procreation and reproductive health. To offer historical insight into these complex patterns and better comprehend the fraught politics of reproductive control, I explore the intersections of race, sex, immigration, sterilization, and health policy by tracing the chronology and context of involuntary sterilization in modern California. I conclude by suggesting some of the implications of this history for contemporary public health programs.

The whole article is fascinating and I wish I could cut and paste the whole thing for you. It’s too long and involved for that, so I’ll give you a few more snippets and a link below. Here is why California is interesting,

Because of the state’s multi-faceted eugenics movement and the fact that it appreciably outpaced in absolute terms the other 32 states that passed sterilization laws at some point in the 20th century, California stands out when compared with the rest of the country. California carried out more than twice as many sterilizations as either of its nearest rivals, Virginia (approximately 8000) and North Carolina (approximately 7600). Furthermore, in many states, such as New Jersey and Iowa, sterilization laws were declared unconstitutional, judged to be “cruel and unusual punishment” or in violation of equal protection and due process. In contrast, California’s statute—although reworked over the years—remained in effect without interruption from initial passage until repeal (ed. 1979).

One of the reasons for this longevity was that, from the outset, California defined sterilization not as a punishment but as a prophylactic measure that could simultaneously defend the public health, preserve precious fiscal resources, and mitigate the menace of the “unfit” and “feebleminded.” California’s prescience was acknowledged in 1927, when the most powerful judiciary in the land, the US Supreme Court, ruled affirmatively on the constitutionality of Virginia’s sterilization statute in Buck v Bell, countenancing sterilization on behalf of the collective health of the citizenry. Shaped by the legal struggles over states’ rights to vaccinate that had played out in the 19th century, and drawing from Jacobson v Massachusetts (1905), which had ruled that maintaining the public health outweighed individual rights when it came to smallpox immunization, Justice Oliver Wendell Holmes wrote in his Buck v Bell opinion: “It is better for the world, if instead of waiting to execute degenerate offspring for crime, or to let them starve for their imbecility, society can prevent those who are manifestly unfit from continuing their kind. The principle that sustains compulsory vaccination is broad enough to cover cutting the Fallopian tubes. Three generations of imbeciles are enough.

Gulp. It gets uglier from there,

As scholars have shown, California’s sterilization program was propelled by deep-seated preoccupations about gender norms and female sexuality. Especially after the procedure of salpingectomy became faster and less medically risky in the 1920s, the sterilization of women and young girls categorized as immoral, loose, or unfit for motherhood intensified.

The peak numbers of forced sterilizations occurred in 1951, but continued up until the early 1970’s.

…By this time (the 1970’s), many eugenicists had conceded that earlier attempts to stamp out hereditary traits defined as recessive or latent, including alcoholism, immorality, and the catchall “feeblemindedness,” had been proven futile by the Hardy-Weinberg equilibrium principle, which demonstrated that the overwhelming tendency of gene frequencies and ratios was to remain constant from one generation to the next. Thus, targeted interventions, such as sterilization, could not breed out defects; even if viable, they would show results only after thousands of years of regulated procreation. More and more, eugenicists traded in “unit characters” for polygenic inheritance and genetic predispositions. Accompanying this realignment was a heightened interest in the manipulation and management of human heredity through population control, which postwar eugenicists and their allies pursued through groups such as the Population Council, Population Reference Bureau, and Planned Parenthood.

Planned Parenthood, and her allies, were in the vanguard. No surprise there. And the evolution to combating scary “population boom” models gained strength, just like it did in Singapore. And just like Singapore, California, and other states, added subjective criteria to the matrix as well. The judgement of devotees of Margaret Sanger cast a long shadow over the entire enterprise. Have a look at this flyer from The Human Betterment Foundation, from Pasadena California.

On the basis of a revamped rationale of bad parenthood and population burden, sterilizations increased in the 1950s and 1960s in southern states such as North Carolina and Virginia. Concurrently, sterilization often regained a punitive edge and, preponderantly aimed at African American and poor women, began to be wielded by state courts and legislatures as a punishment for bearing illegitimate children or as extortion to ensure ongoing receipt of family assistance. By the 1960s, the protracted history of state sterilization programs in the United States, and the consolidation of a rationale for reproductive surgery that was linked to fears of overpopulation, welfare dependency, and illegitimacy, set the stage for a new era of sterilization abuse. In California, which never explicitly endorsed a punitive model, the state program was fairly quiescent by the mid-1950s. However, when federal backing for reproductive surgery began to be distributed in the late 1960s, the eugenic refrains of previous decades resurfaced. The reproductive tendencies of working-class Mexican-origin women were reviled in accordance with long-standing ideas of public health protection, along with more recent claims that these fecund female immigrants were worsening an already severe overpopulation problem.

Today I learned that in the state of Oregon, due to the way their local laws are written, under the rules promulgated by the Affordable Care Act, the law allows  children from the age of 15 up can be granted sterilization procedures without parental consent. Which makes this next story from our recent past salient in the extreme,

One of the most well-known cases of sterilization abuse was that of the Relf sisters, aged 12 and 14, who were sterilized without consent in 1973 in Alabama in OEO-financed operations overseen by the Montgomery Community Action Committee. When the Southern Poverty Law Center sued on their behalf, it was revealed that their mother, who could not read, had unwittingly approved the procedures. Believing she was authorizing birth control for her daughters in the form of Depo-Provera injections, she signed an “X” on what was actually a sterilization release.

By the time the Relfs held a press conference in 1973, African American and Native American women from across the South and Southwest were coming forth with parallel allegations. When Relf v Weinberger was heard in federal district court, Judge Gerhard Gesell concluded that “an indefinite number of poor people have been improperly coerced into accepting a sterilization operation under the threat that variously supported welfare benefits would be withdrawn unless they submitted,” and added that “the dividing line between family planning and eugenics is murky.” Gesell estimated that over the past several years, 100,000 to 150,000 low-income women had been sterilized under federal programs.

And remember Madrigal v. Quilligan? The plaintiffs (spoiler alert) lost their case.

Even though the plaintiffs lost, Madrigal v Quilligan did have major consequences for the formulation of sterilization stipulations—most importantly, securing a clause that consent forms be bilingual. Now under many watchful eyes, County General began to comply with federal guidelines, including a 72-hour waiting period between consent and operation, a near moratorium on sterilization of persons younger than 21 years of age, and a signed statement of consent preceded by a clear explanation that welfare benefits would not be terminated if the patient declined the procedure. These guidelines officially took effect in 1974, although persistent violations and inconsistencies in hospitals across the country spurred over 50 organizations to meet in Washington, DC in 1977 to push for stricter enforcement and oversight by HEW.

Madrigal v Quilligan was one aspect of the federally funded sterilization abuse that unfolded in the United States between the mid-1960s and mid-1970s. Nonetheless, the language used to disparage these women, indeed to deprive them of their human rights, had a much older origin. As early as the 1920s, California eugenicists such as Goethe, Jordan, and Holmes asseverated that Mexicans were irresponsible breeders who flooded over the border in “hordes” and undeservingly sapped fiscal resources. In 1935, for example, Goethe wrote to Harry H. Laughlin, superintendent of the Eugenics Record Office, “It is this high birthrate that makes Mexican peon immigration such a menace. Peons multiply like rabbits.”

You’ll want to read the entire paper.

Am I alone in thinking that this historical information is relevant in light of the HHS Mandate and the push for “preventative services” that include sterilizations, birth-control pills, and abortions to all, regardless of whether some, such as the Catholic Church, and her allied hospitals and colleges, and individual Catholics in their own right, object to these practices? You may argue that the government isn’t forcing sterilizations on anyone through the Mandate, but only making sure that folks can be sterilized if they want to be. But how is that freedom if the practice is clearly sinful as determined by the Church in this case, and by Catholics who wish to be loyal to her teachings? How is this new level of coercion by the Federal government any less ham-handed than what is being described in Professor Stern’s paper above?

And why the big push now? According to the CIA World Factbook, the Total Fertility Rate of women in the United States is at 2.06, which is below the 2.10 margin demographers say is needed for a country’s population to maintain continuity. Actually, our social safety-net programs, like Social Security and Medicade, demand healthy population growth in order to fund these entitlement programs. Why the urgency to provide services that run the risk of further lowering our TFR?

I’m left saying the same thing I said at the conclusion of the post I wrote a fortnight ago about Singapore. The current Administration, though it may mean well, won’t be doing well by promoting the “preventive services” that seem like the cat’s meow today, but ruin all of our tomorrows. I’d prefer the government just stay out of these decisions altogether. Let us be free, romantic fools, and as G.K. Chesterton recommends, let us recall that,

a man ought to marry because he has fallen in love, and emphatically not because the world requires to be populated. The food will really renovate his tissues as long as he is not thinking about his tissues. The exercise will really get him into training so long as he is thinking about something else. And the marriage will really stand some chance of producing a generous-blooded generation if it had its origin in its own natural and generous excitement. It is the first law of health that our necessities should not be accepted as necessities; they should be accepted as luxuries. Let us, then, be careful about the small things, such as a scratch or a slight illness, or anything that can be managed with care. But in the name of all sanity, let us be careless about the important things, such as marriage, or the fountain of our very life will fail.

Anything else is a sham, the work of thieves, and a path to bondage. At the very least, the Administration should let Catholics out from underneath this lame-brained scheme for a selfish reason. As it stands, Catholic birthrates may be what helps save the republic in the long run. Otherwise, as Francis Beckwith put it when the HHS Mandate fight was joined, “we are all imbeciles now.

UPDATE: A reader alerted me about the following story on who helped lead the North Carolina Eugenics Board. Would you believe it was revered CBS Sunday Morning anchor Charles Kuralts’ father?  More available at the Raleigh News Observer.

UPDATE II: Putting a face on Eugenics in America.


Population control protesters, outside LA County/USC Medical Center. Photo credit: Los Angeles Times

Browse Our Archives