Race Purity and Sterilization in the U.S

The Annals of Internal Medicine has just published an interesting account of German and U.S. sterilization policies earlier this century. The authors underestimate the number of U.S. sterilizations, reckoning that the number of people neutered here was under 70,000 and that the practice stopped in the early 1960s.

Wrong. In 1974 Judge Gerhard Gesell said that "Over the last few years, an estimated 100,000 to 150,000 low-income persons have been sterilized annually in federally funded programs." The late Allan Chase quoted this in his great book The Legacy of Malthus, and noted that the U.S. rate equaled that of Nazi Germany where the 12-year career of the Third Reich after the German Sterilization Act of 1933 (inspired by U.S. laws) saw two million Germans sterilized as social inadequates. Gesell pointed out that although Congress had decreed that family planning programs function on a voluntary basis "an indefinite number of poor people have been improperly coerced into accepting a sterilization operation under the threat that various federally funded benefits would be withdrawn. Patients receiving Medicaid assistance at childbirth are evidently the most frequent targets of this pressure."

In the early 1990s poor women were allowed Medicaid funding to have Norplant inserted into their arms, then when they complained of pain and other unwelcome side effects they were told that no funding was available to have the Norplant rods taken out. Here, therefore, was involuntary sterilization in a later guise.

Though unaware of Chase's work or of Gesell's ruling, the authors of the Yale study have amassed some interesting material. For example, during the years when Americans were being involuntarily sterilized as part of a multi-state eugenics program, what did the leading medical journals here have to say on the topic in their editorials? The authors reviewed the relevant periodicals between 1930 and 1945. The American Journal of Medicine, the Annals of Internal Medicine and the American Journal of Psychiatry had nothing to say.

The American Journal of Public Health had one anonymous editorial on mental health that the authors describe as "relevant" probably because it suggested that rising rates of hospitalization for the mentally infirm didn't necessarily mean that Americans' mental IQ was falling--a widely held belief that was exploited by the advocates of eugenic sterlization. This was the most influential conclusion of a very influential report on eugenic sterilization put out by the American Neurological Association in 1935, which recommended that sterilization be voluntary. But the special committee convened by the Association did not contest the widely held view that mentally defective people were a drain on national resources. The committee took a positive view of feeble-mindedness on the grounds that it breeds "servile, useful people who do the dirty work of the race."

The committee also pointed out that an involuntary program such as that lawful in many American states would have sterilized the fathers of both Mozart and Tolstoy who are "worth more to [society] than the cost of maintenance of all state institutions put together. The committee reviewed the German sterilization law of 1933 and praised it for its precision and scientific grounding.

The editorial record of the New England Journal in the early 1930s was awful. Editorials lamented the supposed increase in the rate of American feeble-mindedness as dangerous and the economic burden of supporting the mentally feeble as "appalling." In 1934 the journal's editor, Morris Fishbein, wrote that "Germany is perhaps the most progressive nation in restricting fecundity among the unfit," and argued that the "individual must give way to the greater good."

But by the mid-1930s, particularly after the report from the Neurological Association and energetic interventions by the chairman of its special committee, Abraham Myerson, the New England Journal had a change of heart and declared that sterilization laws to prevent propagation were "unwise" and sterilization should not be mandatory. The Journal of the American Medical Association followed the same curve.

The issue never goes away. The eugenic impulse is always lurking. These days it's surfacing once again, this time in programs of genetic improvement, but also in old-fashioned coercive sterilization. In Monroe, Louisiana, Kathy Looney, 29, convicted of abusing three of her eight children, was ordered at the end of February to undergo medical sterilization or face ten years in jail. District Judge Carl V. Sharp issued a ten year suspended sentence and placed Looney on five years of probation. "I don't want to have to lock you up to keep you from having any more children, so some kind of medical procedure is needed to make sure you don't." Looney's lawyer has asked the judge to reconsider.