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Eugenic States

The Eugenics Board of North Carolina

The North Carolina Supreme Court established the Eugenics Board of North Carolina in 1933 after the Brewer v. Valk case in 1933, where a 1929 law strengthening eugenic sterilization was ruled as unconstitutional. The decision claimed that sterilization proceedings in North Carolina did not have provisions to allow for a hearing or right to appeal for individuals ordered to undergo sterilization. Members of the Eugenics Board included the State Commissioner of Public Welfare, the Secretary of the State Board of Health, the Attorney General, and medical professionals from state hospitals and institutions for “feebleminded” patients. Meetings occurred once a month, except in special hearing cases, to consider sterilization petitions from institutional and non-institutional actors. The Board approved 6,802 sterilization operations between July 1933 and June 1966, although 49 additional operations reportedly took place prior to the formation of the Eugenics Board. (Eugenics Board of North Carolina, Biennial Report, 1966) Sterilizations did decrease after 1966, but the Eugenics Board was not disbanded until 1977.

In 2011, the Governor’s Eugenics Compensation Task Force created a system of restitution for sterilization victims and estimated that the Eugenics Board oversaw the sterilization of almost 7,600 total individuals between January 1929 and December 1974. (Governor’s Task Force, 2012, p.6) Although the annual number of sterilizations generally decreased on a national level after World War II, North Carolina’s Eugenics Board increased the number of performed operations during the 1950s and 1960s and reported the highest number of biennial operations between 1950 and 1952. (Schoen, 2005, p.80; Eugenics Board of North Carolina, Biennial Report, 1966, p.25) The Eugenics Board accepted sterilization petitions from a range of North Carolina’s institutions and actors including state hospitals, jails and prisons, youth reform schools, homes to address statewide poverty, local social workers, and public welfare agencies.

Reports from North Carolina showed that state’s eugenic sterilization program highly impacted young, single women, with a particular focus on women in poverty and recipients of public welfare. The Eugenics Boards’ approved operations demonstrated that race, class, and ideas about disability informed who was thought of as “unfit” for reproduction, and heavily impacted African American women. In promotional materials, the Board argued that sterilization would “protect persons from parenthood whose impairments seriously handicap them from assuming the responsibilities of parents.” Ideas that low intelligence, disabilities, poverty, criminal inclinations, and addiction could be inherited characterized eugenic beliefs about who should have children. Physicians and public health officials petitioned the Eugenics Board for patient sterilizations in state hospitals, but public welfare officials and social workers could also refer local welfare recipients for these procedures. Women who birthed children outside of marriage, had multiple children, or used public assistance funds to support their families were especially targeted for sterilization. Eugenicists in public health and social welfare programs argued that these women and their children were “public charges” and cost the state money to support, and warned that their children were likely repeat the same pattern.

Additionally, The Eugenics Board ordered sterilization procedures for African Americans throughout the twentieth century but after 1956, state officials began to sterilize more African American women than white women even though the white population in the state was much larger than the African American population. African Americans could not receive welfare relief in the 1930s and 1940s because of racial discrimination, but federal pressure in the 1950s to include African American people in social programs increased the population’s contact with public welfare officials who could refer clients for sterilization, even if the individuals were not in hospitals, prisons, or youth reform schools. North Carolina’s eugenic sterilization program’s actions to end the reproductive abilities of individuals deemed unfit on the basis of ability, class, and race were not unique when compared to other state programs, but it does shows us an example of how sterilization programs took place in a state with a notable African American population.

Social organizations that supported eugenic sterilization worked to publicly increase support for controlling the reproductive rights of “unfit” individuals. The Human Betterment League of North Carolina chapter was involved in various campaigns including sending pamphlets that advocated for sterilizing more individuals to lawmakers and powerful people in the state. The Human Betterment League also wrote opinion editorials in newspapers supporting sterilization and took out large spaces in newspapers across the state to convince the public that sterilization would limit the number of “mental defectives” that could reproduce and pass on “a needless and tragic heritage.” Eugenic groups described sterilization as a procedure that would only benefit society and potentially help prevent future generations. Dr. Clarence J. Gamble worked with the Human Betterment League to spread its influence, published eugenicist findings in medical journals, and offered funds to the Eugenics Board of North Carolina to support studies that would argue for the necessity of sterilization programs. These organizations thus established methods to influence the Eugenics Board and attempted to shape public perceptions of sterilization.

While some women and men asked for sterilization referrals to aide their family planning decisions, other individuals rejected the procedure and sometimes hearings occurred in cases when individuals or families refused consent. In 1950, sociologist Moya Woodside wrote Sterilization in North Carolina. While her work was in favor of eugenic sterilization and the Eugenics Board, it also shows that many medical professionals and social workers could not make people accept the idea that sterilization was a good decision for themselves or their families. Woodside noted that many social workers blamed “ignorance and superstition” and “uneducated country people” as complications to carrying out the sterilization program. (Woodside, 1950, p.61) One quoted welfare superintendent stated: “There is still so much ignorance and superstition and fear among feebleminded clients and relatives where any mention is made for sterilization that it is next to impossible help them dispel these reactions.” (Woodside, 1950, p.62) The interviews and social agency cases that Woodside quoted, however, showed that individuals in North Carolina had a great number of reasons to reject the operation. For example, one woman rejected a social worker’s suggestion for sterilization because she stated that her sister was sterilized when she was twenty-five years old and “lost her mind” after. (Woodside, 1950, p.62) Some individuals expressed religious opposition to sterilization and resisted the procedure. In other cases, Woodside explained that family members sometimes objected to the procedure and would not give consent. One welfare superintendent offered one instance in which “‘One [feebleminded] Negro girl had not been sterilized because of resistance from relatives. They did not think it fair to take away the right to have children.’” (Woodside, 1950, p.73) Although Woodside’s research was meant to support sterilization, we can read her work to see how people in North Carolina struggled against the Eugenics Board, social workers, and welfare agencies.

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Selective Sterilization Wednesday, May 18, 1949 SELECTIVE STERILIZATION WHY IS IT NEEDED? The responsibility of parenthood requires a sound mind and a healthy body. Even though some children born to mental defectives may possess normal minds, they are seldom given the training needed to produce well balanced adults who will be an asset to the community. Morons are now doubling their number with each generation; over half the hospital beds in this country are occupied by mentally ill or mentally defective patients, and overcrowded institutions cannot begin to accommodate their increasing numbers. (In Connecticut 1500 mental patients produced 498 defective children while they were awaiting admission to state institutions.) In 1930 the White House Conference on Child Health pointed out: “There should be no child in America that does not have the complete birthright of a sound mind in a sound body, and that has not been born under proper conditions.” Selective sterilization can help to attain this goal. WHEN SHOULD IT BE USED? • Whenever lifelong protection from parenthood is needed; • Whenever mothers need permanent protection from a pregnancy which would be fatal; • When children must be shielded from being born to a heritage of insanity or feeblemindedness; • When defenseless children must be saved the suffering and unhappiness of being brought up by an insane or feebleminded parent. WHAT EFFECT DOES IT HAVE? The person sterilized, whether man or woman, can detect no effect except that children are not born. The sexual characteristics remain unchanged. Sterilization permits many persons with mental deficiency to live outside of institutions, to enjoy a measure of independence, and to marry without the psychological and economic overload of parenthood and child care. Studies in California, New Hampshire and elsewhere have shown that sterilization does not increase sexual delinquency. The effect on the community is far reaching: Sterilization reduces the number who must live in our overcrowded, understaffed institutions; it decreases the number of children who must be taken from insane or feebleminded parents to be raised in foster homes at public expense; it protects the next generation from a needless and tragic heritage. HOW IS IT PERFORMED? Sterilization in both men and women is performed by tubectomy — the closing of the tiny tubes through which the life-producing cells must pass in order to unite. Nothing is removed from the body. The male operation — vasectomy — is extremely simple and can be performed under local anesthetic in a doctor’s office in ten minutes or less. Sterilization in women — salpingectomy — requires an abdominal incision not more than two inches long. The ovaries are not disturbed and menstruation continues normally. The risk in either operation is slight, there is no mutilation and the individual’s emotional life is in no way altered. There is no change in physical appearance nor in voice tone. WHERE IS IT LEGAL? Sterilization is legal in all states. Twenty-seven progressive states and Puerto Rico provide for the sterilization at state expense of persons suffering from insanity or feeblemindedness which may be inherited by their children. These states are: Arizona California Delaware Georgia Idaho Iowa Kansas Michigan Maine Minnesota Mississippi Montana Nebraska New Hampshire North Carolina North Dakota Oklahoma Oregon South Carolina South Dakota Utah Vermon Virginia West Virginia Wisconsin Other countries which provide for the sterilization of the mentally defective are: Canada, Denmark, Finland, Norway, Sweden, and Switzerland. WHO MAKES THE DECISION? Each individual need for this operation at state expense is carefully reviewed by a state board of medical and sociological experts and the consent of the patient or the patient’s family is sought. If not satisfied with the board’s decision, the patient may carry the matter to the civil courts. Such legal action is seldom taken, however, as the protection is almost always welcomed by those immediately concerned. It has been argued that legal sterilization might be abused and become a political instrument. The same objection can be applied to almost every legal regulation. Even prison parole, tax levies and school boards can be abused, but it is not suggested that these beneficial agencies be abolished because they can be occasionally misused. 50,193 sterilizations have been reported by state institutions in the 27 states without indication of abuse, 2,152 in North Carolina. [A graphic of a small, five-point black star is below the above text to establish a new section] KNOW AND UNDERSTAND THE STERILIZATION LAW OF NORTH CAROLINA Make sure that this law protects those who need protection and helps to spare children from a heritage of needless tragedy. HOW YOU CAN HELP Know and understand the sterilization laws of your state. Bring these laws to the attention of families who can be benefited by them. Encourage the discussion of Selective Sterilization by the civic and socially minded groups of which you are a member. Suggest that your public health, medical, educational and religious leaders investigate this important and far reaching better mental health measure. Write for additional copies of this and other pamphlets to distribute to your friends and community leads. [A graphic of a small, five-point black star is below the above text to establish a new section] For further information, address: HUMAN BETTERMENT LEAGUE OF NORTH CAROLINA Incorporated P. O. Box 3036 Winston-Salem, N. C.
Eugenics Sterilization Pamphlet The Eugenics Sterilization Program in North Carolina 1. What is the purpose of the sterilization program in North Carolina? The sterilization program as it is administered in North Carolina is intended to protect persons from parenthood whose impairments seriously handicap them from assuming the responsibilities of parents. 2. What are the legal provisions for the sterilization program? The North Carolina sterilization law provides for the sterilization of persons who are either mentally ill, or mentally retarded. In addition to either one of these impairments, it must be shown as the result of social, medical, psychiatric, and psychological study that sterilization is applicable to the needs of the particular individual. 3. Where can the individual go for help in planning this operation? Application can be made through the county departments of public welfare, the State hospitals for the mentally ill, and the State centers for the mentally retarded. These agencies and institutions are directly responsible for planning with the individual for the operation of sterilization. 4. How are the rights of the individual protect? The law protects the individual in that it requires the written consent of the husband or wife or the nearest relative. It also provides for the right of a hearing and appeal. These latter rights are seldom exercised due to the fact that the individual, husband or wife, or close relative participate in the plan and make their own decision in favor of the operation before signing the formal consent. 5. Are the petitioner, physician, and the hospital protected? The act provides that no person legal participating in sterilization proceedings as defined under the law shall be liable, either civilly or criminally, on account of such participation except in cases of negligence in performance of the operation. 6. Who administers the sterilization program? The program is administered by the Eugenics Board of North Carolina with the assistances of an Executive Secretary. The Board is composed of five members: The Commissioner of Public welfare of North Carolina; the Director of the State Board of Health; Commissioner of Mental Health; a Superintendent of a State hospital; and the Attorney General of North Carolina. 7. What are the functions of the Board? The Board reviews petitions for sterilization and orders or disapproves the operation. These petitions are submitted by the superintendents of State hospitals, and superintendents of centers for the mentally retarded. The Board also promotes an educational program with emphasis on the interpretation of the program in terms of the value of sterilization to the particular individual.
North Carolina Sterilizations A graph of sterilizations by race in North Carolina. The dates range from 1937–1966 and the number of people sterilized ranges from 0 – 350. Those categorized as white are depicted by a gray line, which appears to indicate a higher rate of sterilization above other races from 1937–1956. After that, the rate of African Americans sterilized increases above that of white individuals. African Americans are classified by a dotted black line and Native Americans are a straight line with a black box in between. The rate of Native American sterilizations is relatively low; only a few appear in the years between 1956–1966. A graph of sterilizations by race in North Carolina. The dates range from 1937–1966 and the number of people sterilized ranges from 0 – 350. Those categorized as white are depicted by a gray line, which appears to indicate a higher rate of sterilization above other races from 1937–1956. After that, the rate of African Americans sterilized increases above that of white individuals. African Americans are classified by a dotted black line and Native Americans are a straight line with a black box in between. The rate of Native American sterilizations is relatively low; only a few appear in the years between 1956–1966.
Woodside Excerpt [Section Title] IGNORANCE, PREJUDICE, AND SUPERSTITION Under North Carolina law, eugenic sterilization is not offered to normal individuals but applies exclusively to the feeble-minded and mentally afflicted. The understanding of thse4 people is limited, many of them are illiterate, and lacking any consistent sense of purpose, they can be easily influenced. Their relatives, drawn from similar social groups, if not themselves defective (as often happens) are unlikely to be more than dull normal in intelligence, slow to accept new ideas, and incapable of viewing a situation except in immediate personal terms. It is extremely difficult for case workers to explain eugenic sterilization to such clients, allay their fears, and convince them of its value; and we note that of the 85 county welfare departments who had handled sterilization cases, 71 of them check “resistance of client and relatives” as a major problem. (See Appendix C, analysis of questionnaire returns.) Ignorance and superstition were mentioned again and again by workers with practical experience of interpreting the program; and the mental limitations of their cli9ents apart, we must remember that such characteristics are common to uneducated country people all over the world. One public health nurse who had undertaken a special sterilization project in a rural county described her difficulties as follows: Ignorance and lack of education were the biggest obstacles, not only where sterilization was concerned but in relation to all sorts of things such as child welfare and personal health. Men and women will agree to the operation, then back out later. “They believe you when you are talking to them” but then they get confused through talking to friends and relatives. This occurs especially in the case of men, who don’t seem to be able to grasp the difference between vasectomy and castration even though they may apparently be convinced after you have explained it to them. Women are more receptive to the idea, but dislike going to the hospital and put off making arrangements; or their husbands may object on religious or selfish grounds. (Some notes on a visit made with this worker to the home of one of her clients will be found in Appendix D.) Confusion exists as to the exact nature of the operation, and analogies are drawn with familiar veterinary procedures on farm animals or with the effects of hysterectomy. Men are fearful that their sexual capacities may be impaired, women give heed to old wives’ tales about the dire results of interference with nature, and many of them are understandably reluctant to submit to a surgical operation which they cannot regard as urgent. The following extract from a social agency case record shows how firmly ingrained an irrational idea may become: Mrs. J., a white woman, wife of a butcher, has seven living and five dead children. One child was born with a deformed foot, another has a speech defect and is feeble-minded (I.Q. 60). Mrs. J. has been attending a psychiatric clinic for treatment of anxiety and depression and is considered of borderline intelligence. She also suffers from kidney trouble, backache, and hemorrhoids. The agency is trying to get her sterilized either on mental or physical grounds, but she will not agree to the operation because of what it may do to her. She has a sister who has been in the State mental hospital for about ten years. When this sister was 25 she had an operation and soon thereafter “lost her mind.” The doctor denied that he had removed the sister’s womb and the doctors at the State hospital say that the operation could not have affected the sister’s mind, but Mrs. J. and her relatives know better. They have asked “plenty of doctors” and they all say that the womb must have been removed. Mrs. J. is obviously convinced that this caused her sister’s mental condition. The case of Ada T. reported at length in the appendix, provides another example of ignorance, fear, and confused thinking on the part of a mentally defective unmarried mother, and the attempt to interpret sterilization to such people is indeed a discouraging and disappointing task. One welfare superintendent says: “There is still so much ignorance and superstition and fear among feeble-minded clients and relatives where any mention is made of sterilization that it is next to impossible to help them dispel these reactions.” Another, less pessimistic, says: “Clients and relatives require understanding, persuasion and encouragement. It takes plenty of time.”