“It is better for all 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…Three generations of imbeciles are enough.”
-Justice Oliver Wendell Holmes Jr., Buck v Bell (274 US 200, 1927)
Who’s Counted?“In her paperwork, she was labeled as being feebleminded…By no means is she feebleminded.”[i]
-Stepdaughter of North Carolina survivor of eugenic sterilization
The Supreme Court case Buck v Bell provided legal authorization for more than 60,000 compulsory sterilization in the United States, and is often held up as both the zenith of eugenic sterilization practices and an “egregious example of governmental malfeasance”.[ii] Contemporary narratives present Buck v. Bell as representative of a time in American history in which pseudoscience, racism, and classism held a tight grip on law and medical practice. Similarly, contemporary condemnations of the eugenic movement often center on the historic conflation of cognitive disability with race, ethnicity, gender, and social standings – all falling under the ambiguous category of ‘feeble-mindedness’. Contemporary narratives highlighting racist and classist justifications are well-founded – in 1903, Alexander Johnson, the Superintendent of the School for the Feeble-Minded in Indiana, called for the institutionalization of all “degenerates,” whom he considered to be:
“the chronic insane, the epileptic, the paralytic, the imbecile and idiotic of various grades, the moral imbecile, the sexual pervert, the kleptomaniac; many, if not most, of the chronic inebriate; many of the prostitutes, tramps and minor criminals; many habitual paupers, especially the ignorant and irresponsible mothers of illegitimate children, so common in our poorhouses; many of the shiftless poor, ever on the verge of pauperism and often stepping over into it; some of the blind, some deaf-mutes, some consumptives.”[iii]
Perceptions like this were common in the early 20th century. The Kallikak Family: A Study in the Heredity of Feeble-Mindedness (1912) – which would later be called the “primal myth of the eugenics movement” for its far-flung reach and outright deceptive methodology[iv] – presented a narrative of “feeble-mindedness” that was as much linked to class and religion as to disability. Deborah Kallikak, the youngest member of the eponymous clan, spent her entire life confined to an institution for the transgression of being “destitute, poorly educated, and attractive at a time when society viewed this combination as a deadly cocktail.”[v] The Kallikak Family was later entered as evidence during Buck v Bell. Carrie Buck, who’s sterilization provided the base for that case, has now received a posthumous retribution, and is now most often characterized as young, poor, female (and pregnant by rape) rather than “feeble-minded.”[vi]
Racialized and gendered discrimination influenced eugenic sterilization practices. Deeply entrenched beliefs about the intellect, bodies, and value of people of color became entangled with perceptions of disability. Eugenic practices developed around “ableist racism,” or the process that “reinscribes disability as the standard according to which non-disabled people of color can be devalued,” and “racist ableism,” the “nineteenth-century scientific practice of devaluing white disabled people as less-than-white, and as throwbacks to the lesser evolutionary stage ascribed to people of color”.[vii]
There is substantial evidence suggesting that patients in California with Spanish surnames were more likely to be sterilized than others,[viii] and recent efforts to make reparations for survivors of sterilization in North Carolina have focused on the extreme racial and gender bias that contributed to hundreds of poor, black women being sterilized between 1929 and 1974.[ix] One North Carolina survivor’s sister spoke out in 2014, stating that “They labeled us as poor people, uneducated, black, being mentally retarded [sic].”[x] Couching the rhetoric of eugenics in medical terminology such as “feeble-mindedness” often obscured the racialized mechanics that drove sterilization practices, and contemporary narratives of wrong-doing contribute to the recognition of systematic, enduring racist and sexist power structures.
However, these contemporary narratives of race and class, while illuminating powerful and tragic stories of discrimination, implicitly create two categories: those who have been wrongfully diagnosed and sterilized, and those for whom sterilization was necessary. A narrative that insists on wrongful compulsory sterilization does not resist compulsory sterilization writ large. What these contemporary retellings of eugenic sterilization leave hidden, however, is the story of disabled survivors – both then and now.
The Enduring MalfeasanceDespite vocal criticism since the 1970s, Buck v Bell has never been overruled. While some legal scholars argue that Skinner v Oklahoma (316 US 535, 1942) rejected the logic of Buck v Bell such that the decision is no longer the law of the land, no official guidance has been issued. Indeed, Buck v Bell has been cited in federal court cases as recently as 2001.[xi],[xii]
While narratives of reparations for survivors of sterilization suggest an injustice that has passed, people with intellectual and developmental disabilities are still being subjected to compulsory sterilization across the country. Some examples from the last several decades include:
- In 1995, the Supreme Court refused to hear a case challenging Pennsylvania’s compulsory sterilization statute – in this case, the statute was being applied to a young woman with an intellectual disability. xii
- In 2001, a mother with an intellectual disability had her children removed by the state. A social worker for the state convinced the women to undergo sterilization under the auspices of improving her case to regain custody. After undergoing sterilization, the woman’s parental rights were terminated. Buck v Bell was cited in the decision, which explicitly noted that involuntary sterilization was not unconstitutional if there was a “compelling government interest”[xiii], xii
- In 2011, the parents of a woman in Massachusetts identified as having a psychiatric disability were given temporary guardianship in order to terminate the woman’s pregnancy despite her vehement opposition to abortion. The judge also ordered the facility performing the abortion should sterilize the woman. An appeals court later overturned the decision, stating that sterilization orders must have adequate notice, give the person in question an opportunity to be heard on the ability to give informed consent, and determine that the person is not competent to give consent. The overturning of the decision was primarily about the violation of due process rather than the issue of sterilization itself.[xiv], xii
What Makes a Mind Feeble?“Only by the sum total of these aptitudes and defects can we judge the individual. If the total is just a trifle too meagre for the complex demands of modern life, and cannot be made to develop further, then we confront morons, or the border-line feeble-minded, or the dull, or the retarded. All these terms designate different varieties of weak but often likable individuals. They are doomed to carry loads too heavy for them.”
‘The People of Moronia,’ Eleanor Wembridge (1926)[xv]
If some people were wrongfully sterilized, then whose compulsory sterilization is justified? In the early 20th century, diagnostic criteria for institutionalization and sterilization was often communicated through assigning the patient a mental age – if the age seemed incompatible with the ability to live independently or parent a future child, sterilization could mitigate future risks. The link between ‘mental age’ and paternalistic treatment seemed natural; how was a woman with the ‘mind of a child’ expected to live a productive life without supervision? French psychologists Alfred Binet and Theodore Simon developed the concept of ‘mental age’ in an effort to interpret newly designed intelligence testing. These tests first entered the United States in 1908 and saw widespread use categorizing incoming soldiers during World War I, leading to the controversial revelation that the average recruit had the ‘mental age’ of a young teenager.[xvi] Even as the scandal of “feeble-minded” soldiers blazed across headlines, the use of mental age received robust contemporaneous critique. One 1922 article excoriates people who perpetuate this claim by stating that “the average adult intelligence cannot be less than the average adult intelligence, and to anyone who knows what the words “mental age” mean Mr. Stoddard’s [contemporaneous author making 13-year old mental age claim] remark is precisely as silly as if he had written that the average mile was three quarters of a mile long.”[xvii] Mental age, however, remains a powerful narrative when discussing cognitive disability. Equating adults with cognitive disabilities to children continues to serve as justifications for infantilizing and paternalistic behaviors toward people with intellectual disabilities – including sterilization.
“Having her size be more appropriate to her developmental level will make her less of a “freak”…there is nothing repulsive about a 2 month old infant, despite its limited cognitive, motor, and social skills. But when the 2 month old baby is put into a 20 year old body, the disconnect is jarring.”[xviii]
These words, published in Scientific American in 2007, refer to a child named Ashley – known to the public only as Ashley X – who at the age of six underwent a full hysterectomy, mastectomy, and estrogen hormone treatment. The procedure was later deemed illegal because Ashley’s parents and doctors did not have a court order authorizing Ashley’s sterilization. Justifications for the Ashley Treatment often revolve evoke her “mental age” as justification, as exemplified by the above quote. This narrative infantilizes adults, justifies sterilization and social asexualization, and reinforces paternalistic attitudes and practices, despite the United Nations’ declaration of compulsory sterilization of people with disabilities “a form of violence and torture”[xix]
The New Eugenics
The term “rubicon” itself connotes a temporal distance – compulsory eugenic sterilization and other emerging “new eugenic” practices, remain a very current threat to many people with disabilities in the United States. According to disability theorist Alison Kafer, we are living in a curative time: an era in which the eugenic impulse results in “disabled people…continually being written out of the future”.[xx] Emerging genetic technologies such as prenatal genetic testing and preimplantation selection for in vitro fertilization may inadvertently reproduce eugenic practices through the routinization of these technologies which reifies the “scientific evidence of genetic inequality”.[xxi] Still deeply entangled in the utility of these new eugenic practices are issues of race and class – Miceli and Steele suggest that the attributes for which there are genetic tests and preimplantation decisions are “the characteristics by which people tend to be judged in Western capitalist economies – specifically, rationality, intelligence, and athleticism…attributes that Caucasian middle-class individuals see as valuable”.[xxii]
The legacy of eugenic sterilization laws has inextricably shaped the lives of disabled Americans. Beyond the intergenerational trauma of compulsory eugenic sterilization and how eugenic laws have shaped contemporary perceptions of disability, disabled people still experience coercive and nonconsensual sterilization. For disabled Americans, the legacy of eugenic sterilization is a living one.
 ’Disabled people’ is used rather than ‘people with disabilities’ in the tradition of critical disability studies. This identity-first language recognizes disability as integrated and valued. Further, ‘disability’ in this context refers not to just physiological impairment, but also the sociocultural and material elements through which impairment is mediated (See Siebers 2008 for more).
[i] Carmon, Irin (2014, June 27). For eugenic sterilization victims, belated justice. MSNBC. Retrieved from http://www.msnbc.com/all/eugenic-sterilization-victims-belated-justice, para 26.
[ii] Lombardo, P. (2008). Three generations, no imbeciles: Eugenics, the Supreme Court, and Buck v. Bell, p. xiv
[iii] Johnson, A. (1903). The segregation of defectives. Proceedings of the National Conference of Charities and Correction. Retrieved from http://disabilitymuseum.org/dhm/lib/detail.html?id=3251.
[iv] Gould, S. (1981). The Mismeasure of Man. New York, NY: WW Norton & Company, p. 198
[v] Smith, J. David, & Wehmeyer, Michael L. (2012). Who was deborah kallikak? Intellectual and Developmental Disabilities, 50(2), 169-178. (p. 6)
[vi] Gould, S. (1981). The Mismeasure of Man. New York, NY: WW Norton & Company.
[vii] Haritaworn, J. (2012). The Biopolitics of Mixing: Thai Multiracialities and Haunted Ascendencies. NJ: Routledge.
[viii] Stern – Eugenic Nation
[ix] Carmon, Irin (2014, June 27). For eugenic sterilization victims, belated justice. MSNBC. Retrieved from http://www.msnbc.com/all/eugenic-sterilization-victims-belated-justice
[x] Carmon, Irin (2014, June 27). For eugenic sterilization victims, belated justice. MSNBC. Retrieved from http://www.msnbc.com/all/eugenic-sterilization-victims-belated-justice, para 12
[xi] National Council on Disability, issuing body. (2012). Rocking the cradle: Ensuring the rights of parents with disabilities and their children.
[xii] Pfeiffer, D. (1994). Eugenics and disability discrimination. Independent Living Institute. Retrieved from https://www.independentliving.org/docs1/pfeiffe1.html.
[xiii] Vaughn v. Ruoff, 253 F.3d 1124 (8th Cir. 2001).
[xiv] Guardianship of Mary Moe, (81 Mass. App. Ct. 136, 2012). http://masscases.com/cases/app/81/81massappct136.html
[xv] Wembridge, E. (1926). The People of moronia, The American Mercury, 7 (25), 1-7.
[xvi] John Carson. (2004). The Science of Merit and the Merit of Science: Mental Order and Social Order in Early 20th Century United States and France in Jasanoff (Ed) States of Knowledge: The Co-Production of Science and Social Order. NJ: Routledge.
[xvii] Lippmann, W. (October 25 1922). The mental age of americans. The New Republic.
[xviii] Fost, N. (2007, January 5). in Mims, C. The Pillow angel case – Three bioethicists weigh in. Scientific American.
[xix] World Health Organization. (2014). Eliminating Forced, Coercive, and Otherwise Involuntary Sterilization: An Interagency Statement. Geneva, Switzerland: WHO, p. 5.
[xx] Kafer, A. (2013). Feminist, Crip, Queer. Bloomington, IN: Indiana Press, p. 46.
[xxi] Miceli, M. & Steele, J. (2007). Masking Eugenics as Science: A Critical Disability Studies Perspective of New Reproductive Technologies Commentary on Stowe et al., Journal on Developmental Disabilities, 13(2), 2007. Journal on Developmental Disabilities, 13 (2), p. 86.
[xxii] Ibid, p. 86.