Involuntary Sterilization in the United States: a Surgical Solution

VOLUME 62, No.2 THE QUARTERLY REVIEW OF BIOLOGY JUNE 1987 INVOLUNTARY STERILIZATION IN THE UNITED STATES: A SURGICAL SOLUTION PHILIP R. REILLY Eunice Kennedy Shriver Center, Waltham) Massachusetts 02254 USA ABSTRACT Although the eugenics movement in the United Statesflourished during the first quarter ofthe 20th Century, its roots lie in concerns over the cost ofcaring for ((defective" persons, concerns that first became manifest in the 19th Century. The history ofstate-supported programs ofinvoluntary sterili zation indicates that this ((surgical solution" persisted until the 1950s. A review of the archives ofprominent eugenicists, the records ofeugenic organizations, important legal cases, and state reports indicates that public support for the involuntary sterilization ofinsane and retarded persons was broad and sustained. During the early 1930s there was a dramatic increase in the number ofsterilizations performed upon mildly retardedyoung women. This change in policy was aproduct ofthe Depression. Institu tional officials were concerned that such women might bear children for whom they could not provide adequate parental care, and thus would put more demands on strained sodal services. There is little evidence to suggest that the excesses of the J.Vazi sterilization program (initiated in 1934) altered American programs. Data are presented here to show that a number ofstate-supported eu genic sterilization programs were quite active long after scientists had refuted the eugenic thesis. BACKGROUND lums there was growing despair as the mid century thesis (Sequin, 1846) that the retarded T THE CLOSE of the 19th Century in and insane were educable faded. About 1880, Athe United States several distinct develop physicians who were doing research into the ments coalesced to create a climate favorable causes ofidiocy and insanity developed the no to the rise of sterilization programs aimed at tion ofa "neuropathic diathesis" (Kerlin, 1881) criminals, the insane, and feebleminded per that relied on hereditary factors to explain sons. Evolutionary theory demanded a biolog problems as diverse as alcoholism, epilepsy, ical view of man. Francis Galton (Darwin's and crime. As one investigator wrote, "there cousin), an eminent scientist, invented the is every reason to suppose epilepsy in the chil science ofeugenics (Galton, 1869, 1874, 1883) dren may have its hereditary predisposition in which he fitted to the tenets of Darwinism. some form ofhabitual crime on the part ofthe In the United States concern about defec parent" (Clarke, 1879). tive persons could be found in many quarters. The most important event preceding the rise Southern whites who opposed miscegenation of sterilization programs was probably the sought intellectual proof that the Negro was publication ofRichard Dugdale's (1875) study inferior. American criminologists and prison of the ':Jukes;' a New York family with a officials (Boies, 1893) were heavily influenced propensity for almshouses, taverns, brothels, by Lombroso's arguments that most criminal andjails. The ':Jukes" spawned a new field in behavior was biologically determined (Lom sociology: extended field studies of degener broso-Ferrero, 1972). Among the physicians ate families, a field that reached its apogee at and social workers who ran the nation's asy- the Eugenics Record Office (ERO) in Cold © 1987 by the Stony Brook Foundation, Inc. All rights reserved. 153 154 THE QUARTERLY REVIEW OF BIOLOGY VOLUME 62 Spring Harbor (Danielson and Davenport, tomy was published by Ochsner, a young 1912; Estabrook and Davenport, 1912). From Chicago surgeon. Dissatisfied with castration 1910 through 1914 more than 120 articles about as a therapy for severe prostatic hypertrophy, eugenics appeared in magazines, a volume of he guessed that cutting the vasa deferentia print making it one of the nation's favorite might cause the tissue to involute. But when topics. his patients told him that after the vasectomy Soon after becoming Director ofthe Station they noted no impairment ofsexual desire or for Experimental Evolution at Cold Spring function, he immediately grasped the eugenic Harbor, Charles B. Davenport, one of the implications ofthe new operation. Ochsner ar earliest American champions of Mendelian gued that vasectomy could eliminate criminal genetics, moved to apply the principle ofpar ity inherited from the "father's side" and that ticulate inheritance to humans. Among his it "could reasonably be suggested for chronic most important colleagues was H. H. God inebriates, imbeciles, perverts and paupers" dard, who published an immensely popular (Ochsner, 1899). study of the "Kallikaks:' a family that he Three years later Sharp, a surgeon at the claimed had an eminent line and a degener Indiana Reformatory, reported the first large ate line running in parallel over many genera study on the effects ofvasectomy. He claimed tions. The book did much to rationalize prin that his 42 vasectomized patients felt stronger, ciples of negative eugenics (Goddard, 1912). slept better, performed more satisfactorily in During the period from 1890 to 1917 the the prison school, and felt less desire to mastur United States was washed by a tidal wave of bate! Sharp urged physicians to lobby for a law immigrants. Assimilation was painful. The to empower directors of state institutions "to economy was so perturbed by the dramatic ex render every male sterile who passes its por pansion ofthe labor pool that, despite a com tals, whether it be almshouse, insane asylum, mitment to internationalism, even the great institute for the feebleminded, reformatory or unions called for restrictions on immigration prison" (Sharp, 1902:414). (Higham, 1965). From 1875 on, proposals to During the next few years there was a spate curb immigration were constantly before the of articles by physicians claiming that vasec Congress. Starting with the "Chinese Exclu tomy offered a solution to the problem oflim sion Acts" in the early 1880s, the federal iting the births ofdefective persons. Some phy government gradually built its legal seawalls sicians began to lobby vigorously for mass higher. Duringthe 1890s the Boston-based Im sterilization. For example, a Philadelphia urol migration Restriction League sought to justify ogist drafted a compulsory sterilization law legal barriers to entry on the grounds that some that passed both legislative bodies in Pennsyl races were inferior to the average American vania, but died under a gubernatorial veto stock (Ludmerer, 1972). This argument be (Mears, 1909). came a major issue in American eugenics. In 1907 the Governor ofIndiana signed the The late 19th Century spawned numerous nation's first sterilization law. It initiated the plans to control the "germ plasm" of unfit in involuntary sterilization ofany habitual crimi dividuals. In many states young retarded nal' rapist, idiot, or imbecile committed to a women were institutionalized during their state institution and diagnosed by physicians reproductive years. State laws were passed to as "unimprovable:' After having operated on forbid marriage by alcoholics, epileptics, the 200 Indiana prisoners, Sharp quickly emerged retarded, and persons with chronic diseases as the national authority on eugenic steriliza (Davenport, 1913a). Some legislatures consid tion. A tireless advocate, he even underwrote ered proposals to castrate criminals (Daniel, the publication of a pamphlet, "Vasectomy"~ 1907), and a few superintendents of asylums (Sharp, 1909). In it he affixed tear-out post actually engaged in mass castration (Daniel, cards so that readers could mail a preprinted 1894). It was at thisjuncture that a technolog statement supporting compulsory sterilization ical innovation helped to reorient social policy. laws to their legislative representatives! Although the simplicity of vasectomy fo THE SURGICAL SOLUTION cused their attention upon defective men, the The first American case report of a vasec- eugenicists were also concerned about defec- JUNE 1987 INVOLUNTARY STERILIZATION 155 tive women. Salpingectomy, the surgical clo spoken advocate of radical eugenics policies sure of the Fallopian tubes, or oviducts, was (Lydston, 1912). The editor ofthe Texas Medi not yet perfected as a surgical operation, and calJournal regularly published pro-sterilization the morbidity after intra-abdominal operations articles (Daniel, 1909). was high. Eugenic theoreticians had little Between 1907 and 1913, 16 legislatures choice but to support long-term segregation passed sterilization bills, 12 ofwhich became offeebleminded women. They were, however, law and 4 ofwhich were vetoed. The evidence comforted in their belief that most feeble is circumstantial but strong (Reilly, 1983a) that minded women became prostitutes and were a mere handful of activists played a key role frequently rendered sterile by pelvic inflam in pushing this legislation. Sharp's work in In matory disease (Ochsner, 1899). diana and Hatch's efforts in California were Pro-sterilization arguments peaked in the obviously influential. In NewJersey, Dr. David medical literature in 1910, when roughly one Weeks, Chief Physician at the Village for halfofthe 40 articles published since 1900 on Epileptics, lobbied for and later implemented the subject appeared. These articles almost a sterilization law (Smith v. Board ofExaminers, unanimously favored involuntary sterilization 1913). In Oregon, an activist woman physician of the feebleminded. As time went by, physi spearheaded a pro-sterilization

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