Sterilization is Not the Solution

This is the second in a two-part series responding to a recent report by The Center for Investigative Reporting (CIR) that is helping to bring to light the sterilization of at least 148 female inmates in California prisons between 2006 and 2010 without proper approval and against informed consent best practices. To get the most out of the series, you should begin with Tina Kibbe’s post from earlier this week and then continue with this one. (I also recommend reading the CIR report as well as the comments that follow it.)

The recent report from the Center for Investigative Reporting that California prisons failed to follow proper procedures in getting full consent and approval before sterilizing nearly 150 female inmates is both tragic and all too familiar. It raises questions about both the government’s role in controlling citizen’s childbearing decisions and the degree to which consent can be fully informed and voluntary for less privileged members of society who are often already considered irresponsible and, as many of these women reported, made to feel like they were “less than human” or “bad mother[s]” for saying no. It also calls up memories of America’s long history of eugenics, during which these sorts of actions would’ve not only been acceptable, but lauded.

Tina’s post yesterday nicely describes the continuities between the eugenics movement of the early 20th century and the California case. It wouldn’t be quite accurate to say that the California case is one of modern-day eugenics, because it isn’t clear that anyone involved thought that the children these women might have had were biologically predisposed to be a “burden” on society, but it is certainly a powerful echo.

The justifications that health administrators used, that sterilizing these women would reduce welfare costs, are very much in line with the justifications behind efforts throughout the 20th century to solve social issues by controlling who gets to have children and who doesn’t.

The history of eugenics in the United States is still not widely known, but even when it is addressed, it’s often treated as a “dark chapter in American history” — something regrettable, but over. Some parts of it are over, surely, but reverberations remain and the underlying motive to address social issues by controlling reproduction is certainly alive and well.

Eugenics After 1945

For a long time, historians and other scholars argued that eugenics all but died out after World War II. The pioneering work of historians such as Alexandra Minna Stern and Wendy Kline helped to overturn this belief by showing how eugenic ideology continued to shape legislation, education, and other wide-ranging parts of society well into the postwar years. Even as traditional eugenics came to be associated in the 1930s and 1940s with racial prejudice, poorly supported science, and Nazi atrocities during World War II, many people continued to adhere to its core principles. These adherents still believed that it was possible to improve the health and well-being of society through selective reproduction.[1]

The continuities are clear in a host of areas from education to marriage counseling to debates over birth control, but perhaps the best evidence for the continuity of eugenic ideology into the second half of the 20th century is that eugenic sterilization legislation remained on the books and in use into the 1970s.

The Supreme Court ruled in 1942 that prisons couldn’t force inmates to be sterilized because it infringed on “one of the basic civil rights of man,” arguing that “marriage and procreation are fundamental to the very existence and survival of the race.” But, as you’ve already read in Tina’s post, this didn’t lead to an end to compulsory sterilization in general, nor did it mean advocates didn’t continue to argue that it was the responsible way to address a host of social issues. Many state eugenics boards didn’t close until after 1970. Oregon’s board, for example, closed in 1983.

Sterilization In the 1970s

In 1973, the Southern Poverty Law Center, a non-profit civil rights organization, filed suit in federal court on behalf of the Relf sisters, Mary Alice and Minnie. They lived with their mother in Montgomery, Alabama, and were both diagnosed as mentally disabled. They were also recipients of federal aid. When Mary Alice was 14 and Minne was 12, they were taken to the federally funded Montgomery Family Planning Clinic. Their mother, who was illiterate and had to sign the consent forms with an “X,” testified later that she thought her daughters would receive temporary birth control shots. Instead, both young girls were surgically sterilized.

The Center got involved and filed a lawsuit on their behalf. The district court estimated that between 100,000 and 150,000 poor people were sterilized annually under federally funded programs. They also found that many others were forced to either agree to sterilization or give up their welfare benefits.[2]

The Relf’s case led to District Judge Frank M. Johnson establishing strict new guidelines for the sterilization of Alabama mental institution inmates that included full informed written consent.

This case in the 1970s was one of the first to help finally overturn laws across the country that allowed for compulsory and nearly compulsory sterilization.[3]

All of this sounds quite similar to the current situation in California: the people involved were underprivileged, they were under the care of the state, and they were expected to be a “burden” to the state in the future. I wonder whether the medical officials involved in encouraging female inmates to be sterilized in California between 2006 and 2010 were fully aware of their state’s troubling eugenic past. The fact that, according to Dr. Ricki Barnett, prison doctors and health administrators didn’t seem to know about their own state’s 16-year-old restriction on tubal ligation suggests they probably also weren’t aware of the eugenic legacy that made these restrictions necessary in the first place.

The Problem With Pseudoscience

Eugenics in the United States needs to be understood not as an aberration based on wacky pseudoscience, but as a set of ideas that wound their way into diverse elements of American culture including ideas of race, gender, sexuality, and reproduction, and that shifted over time to adapt to changing scientific and cultural understandings but never quite lost the root of hereditarianism.

The problem with thinking of eugenics purely as pseudoscience, then, is that it excuses us to think that we know better today.

As I’ve argued here before, eugenics was based for a time on the best science had to offer. In its time, it was as purely scientific as anything today. It’s only with the benefit of hindsight that we know differently. For all we know, in 25 or 50 years heart transplantation will be considered a crudely barbaric procedure. We operate with the science we have because it is what we have — but that doesn’t mean we shouldn’t question it.

The problem with eugenics was partly the science, but it was much more the application of that science. And while the science has moved from relying on family pedigrees to genetic testing, the application of the assumptions behind it are still very much alive.

Historian Nathaniel Comfort makes a similar point in a recent post (as well as in his book, The Science of Human Perfection and in this Chronicle piece. He writes:

[gblockquote]”Eugenicists have always said ‘Now we know enough to do it right.’ And the next generation always comes along and clucks its tongue at the naivete and ignorance of its forbears.

No, it’s not because we didn’t understand the science. It’s because we didn’t understand society well enough before. And for all the remarkable technological advances of the last century, there’s scant evidence that we understand society much better now.”[/gblockquote]

Some scientists still look for answers to complex social issues in our genes and some continue to use socially constructed categories like race as scientific determinants for things like genetic testing and drug development.[4]

And, if the comments section of the CIR report are any indication, a good number of people in the United States believe that being even partially dependent on the state for financial assistance or being in the process of rehabilitation in one of the nation’s prisons voids an individual’s right to make their own reproductive decisions. This stance has been the foundation of eugenics for much of American history, and is a position that needs more open and informed debate.

[gpullquote]”Eugenics is, at its most basic, a term for efforts to use the science of heredity — something we still know very little about — to address or even solve social issues like poverty, social welfare, tax obligations, and crime.”[/gpullquote]

Eugenics is based more on the notion that we can improve society through reproduction than on any particular scientific understanding. Eugenics is, at its most basic, an effort to use the science of heredity — something we still know very little about — to address or even solve social issues like poverty, social welfare, tax obligations, and crime. Any time we believe we can find absolute biological causes for complex human characteristics like violence, poverty, or intelligence we run the risk of repeating the same injustices that were committed against some 60,000 people in the name of eugenics.

The notion that it’s a legitimate use of government power to regulate citizen’s reproduction has a complicated past that is wrapped up with eugenics, birth control, and issues of race and gender. Crime, poverty, hunger, and drug addiction are real and present problems that we need to address as a society, not through medical interventions like sterilization, but through better education and more effective health services.

Notes

1. 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); Alexandra Stern, Eugenic Nation: Faults and Frontiers of Better Breeding in Modern America (Berkeley: University of California Press, 2005). Return to text.
2. “Relf v. Weinberger,” Southern Poverty Law Center, accessed July 18, 2013. Return to text.
3. Bruce Nichols, “Sterilization Guidelines Set Up, Replace State Law,” Montgomery Advertiser, January 9, 1974. Return to text.
4. Dorothy Roberts, for example, in her 2012 book Fatal Invention, compellingly describes how some scientists continue to revive the biological concept of race through genetic testing, DNA databases, and race-specific drugs, all by still assuming such social categories are biologically real. Return to text.