North Carolina's Eugenics Board
A U.S. Supreme Court decision in 1927 that upheld a Virginia court order to sterilize seventeen-year-old Carrie Buck [JS2] for her supposed feeblemindedness encouraged promoters of sterilization programs throughout the United States. The Supreme Court decision was followed by a wave of new sterilization laws and by 1929 thirty states had passed sterilization laws inspired by eugenic science. During the initial years after North Carolina’s law passed, state officials made only half-hearted use of it. But in 1932, a lawsuit surrounding the sterilization of Mary Brewer, a-28 year old mother of five, [JS3] resulted in the redrafting of the state sterilization statute and the formalization of sterilization procedures. The new law, introduced by a member of the Board of Directors of Caswell Training School[JS4] , a state institution for the mentally retarded, established a state Eugenics Board composed of the commissioner of public welfare, the secretary of the State Board of Health, the chief medical officers of the State Hospital in Raleigh and of an institution of the feebleminded or the insane, and the attorney general of North Carolina. The board received petitions for sterilization from the state’s penal and charitable institutions and from county superintendents of public welfare, and it voted on the authorization of these petitions. As the only state in the nation that gave social workers[JS5] the power to file sterilization petitions, North Carolina’s eugenic sterilization program represented the state’s financial interest in sterilization [JS6] more clearly than any other state program did.
The wave of sterilization legislation in the 1910s and 1920s mainly addressed what eugenicists termed “inheritable feeblemindedness.” During the first decades of the 20th century, eugenic theorists thought that feeblemindedness was the result of defective “germ plasm.” This defective germ plasm, eugenicists believed, was carried from generation to generation.[JS7] As the existence of bad germ plasm could not be diagnosed medically, one could recognize feeblemindedness only by its social symptoms, which included poverty, promiscuity, criminality, alcoholism, and illegitimacy, phenomena that were considered to lie at the root of many social ills.[JS8] As eugenic scientists considered feeblemindedness, and thus undesirable social behaviors, to be hereditary, sterilization seemed to offer an easy medical solution to complex social problems. An IQ rating of seventy and below allowed health and welfare professionals to quickly identify the feebleminded and move from diagnosis to “treatment.”
Health and welfare authorities not only followed eugenic theory when implementing eugenic policies but had their own interests in the programs. Although they usually lacked formal training in eugenic science, they shared with eugenic scientists a common set of assumptions about the meaning of degeneracy and heredity[JS9] . Their work in public health and welfare led them to hope that eugenic sterilization could aid in the fight against social ills. State-sponsored sterilizations were thus driven as much by consensus among these professionals as they were by the theories of eugenic scientists.
With the passage of the state’s eugenic sterilization law, health and welfare officials in charge of implementing the program began to bring their own policy goals to the table. Since the directors of mental institutions as well as social workers could submit sterilization petitions, these goals ranged from controlling welfare spending to improving the health of sterilization candidates to easing institutional overcrowding by sterilization and then releasing inmates of the state’s training schools. Having identified an individual as being in need of eugenic sterilization, petitioners put together sterilization petitions that contained information about clients social, medical, and eugenic history and submitted the applications to the North Carolina Eugenics Board. [JS10] At monthly board meetings, Eugenic Board member would review these petitions and vote on sterilization decisions. [JS11] Once the board authorized a petition, the case was assigned to the hospital closest to the patient, where staff surgeons performed the sterilization. While some hospitals and surgeons might have been more likely than others to come in contact with eugenic sterilization, the surgeons assigned to such cases had no special link with the state sterilization program; they encountered the sterilizations as part of their regular workload.
Sterilization candidates or their legal guardians had to consent to a sterilization. If they failed to do so, the Eugenics Board would call a hearing [JS12] at which family members could voice their opposition to the procedure. Some family members took advantage of this opportunity and came with or without lawyers, to voice their objections or to seek further clarification about the surgery. If, following the hearing, board members still believed that eugenic sterilization was advisable, they could authorize the surgery over the patient’s or the patient’s guardian’s objections. Most patients and guardians, however, did not attend the hearing. In these cases, a hearing served as a legal formality that allowed the Eugenics Board to authorize a sterilization despite the lack of consent. Theoretically, the state had the power to force individuals by court order to submit to the surgery once it had been authorized. In practice, however, state authorities were hesitant to resort to outright force. If patients did not submit to sterilization orders, state authorities either rested the cases or filed new petitions at a later date in the hope that families would change their minds.
While health and welfare professionals had high hopes for eugenic sterilization, the eugenic science that underlay it did not go unchallenged. Starting in the 1920s, geneticists, anthropologists, physicians, and psychologists began to engage in research that eventually undermined eugenic science’s basic assumptions. With the onset of World War II, interest in eugenic sterilization began to decline. The country finally pulled out of the Great Depression, and wartime production led to full employment and a drastic reduction of the welfare rolls. The shortage of surgeons during the war caused a sharp decline in the number of sterilization operations performed and news of sterilization abuses in Nazi Germany helped to discredit the practice. In 1942, the U.S. Supreme Court struck down an Oklahoma law that had provided for the sterilization of thrice-convicted felons. Although this decision did not overturn Buck v. Bell, the 1927 Supreme Court decision that had upheld Virginia’s sterilization law, it did set a new precedent for judicial decisions. In most states, state ordered sterilizations had ceased completely by the late 1940s. But this decline was countered by an expansion of sterilization programs in Georgia, North Carolina, and Virginia.
To justify the continued operation of eugenic sterilization programs, officials promoted a loose variation of hereditary theories. While health and welfare professionals had argued earlier that social problems were passed on from generation to generation via genetic transmission, they now held that the same undesirable qualities were passed on through socialization; regardless of the mechanism they believed that the continued use of eugenic policies was warranted. As a Birthright publication [JS13] generalized, sterilization prevented “the birth of children who would have a bad heredity or a bad environment or both.” While socialization replaced genes as the medium, the inheritance of undesirable qualities remained inevitable.
Eugenic sterilization programs continued both to offer a medical solution to hereditary feeblemindedness and to cut welfare rolls by reducing the number of children born to welfare recipients. As welfare rolls grew in the 1950s and 1960s, eugenic sterilization programs in a few states expanded. Continuing such programs became particularly appealing in the postwar period, when sex outside of marriage and rising illegitimacy rates seemed to threaten the stability of the American family. The “rediscovery” of poverty in the early 1960s further fueled concerns about the reproductive capacity of poor families and solidified the link between illegitimacy and innate immorality. A focus on the “culture of poverty” replaced hereditary theories as a justification for eugenic sterilization while demanding similar interventions.
Fears about the rising cost of the ADC program led to a significant shift in the racial composition of those targeted for eugenic sterilization. The proportion of state-sterilized patients in North Carolina who were African American rose from 23 percent in the 1930s and 1940s to 59 percent between 1958 and 1960 and finally to 64 percent between 1964 and 1966. [JS14] While discriminatory welfare practices of the 1930s and 1940s had excluded African Americans from ADC programs and left them largely outside social workers’ sphere of influence, federal pressure and a series of new requirements relating to the implementation of ADC resulted in black women’s inclusion in social service programs, bringing them into closer contact with social workers and thus with state-supported sterilization. Nationwide, the percentage of welfare recipients who were African American rose from 31 percent in 1950 to 48 percent in 1961. The addition of Hispanics to the rolls produced a nonwhite majority among welfare recipients in the 1960s. It seemed especially pressing to save funds considering the “prevalence of illegitimacy among the lower-class Negro population” and the perception that most nonwhite unwed mothers had “no means of support except through public assistance.”
The emphasis on illegitimacy in the black community and on the presumably uncontrolled sexual behavior of black women reinforced racist stereotypes about the hypersexual black woman. As a larger number of African Americans became ADC recipients, the discourse about ADC mothers blamed black single mothers for urban plight, poverty, and social unrest. This discourse shifted attention away from the structural causes of poverty and crime and placed the blame for urban poverty and social unrest at the feet of African American women. Resentment of African American single mothers and the presumed burden they placed on the state culminated in a number of legislative proposals aimed at controlling the reproduction of ADC recipients.
To intensify the fight against poverty, Ellen Winston, North Carolina’s commissioner of public welfare, recommended in 1951 that the state expand its use of the eugenic sterilization program by following up on ADC families in which one family member had been sterilized to determine if other members might benefit from the surgery. This new policy not only led to an increase in the number of noninstitutional sterilizations but also to a sharp rise in the number of women sterilized who had given birth to children prior to having the operation. The proportion of noninstitutional sterilizations rose from 23 percent between 1937 and 1951 to 76 percent between 1952 and 1966. Sixty-six percent of patients sterilized in the 1950s and 1960s had had children prior to their sterilization, and 52 percent of them had given birth to these children outside marriage. [JS15]
The new emphasis on socialization drew particular attention to the behavior of teenage girls. Social workers considered girls reared in impoverished and immoral environments to be likely to perpetuate the pattern set by their parents. Almost formulaically, social workers emphasized the inadequate supervision daughters received from their mothers[JS16] ; they argued, “Sterilization will prevent additional children who will never be able to realize any potential they may have because adequate care will be denied them and will restrict the third generation who are caught in this cycle of poverty and neglect.”
It took until the late 1960s for North Carolina sterilization rates to decline. Changes during that decade laid the groundwork for the dismantling of state-supported sterilization. The development of more reliable contraceptives the onset of the civil rights and women’s rights movements, and a better understanding of mental disease and intellectual disabilities all contributed to a significant shift in board members’ perceptions of eugenic sterilization. In 1974, North Carolina finally repealed its eugenic sterilization law. That same year, the Office of Economic Opportunity formulated and distributed sterilization guidelines to ensure that patients would receive adequate counseling and be given informed consent to further safeguard the poor against the possibility of sterilization abuse. But it took the state until 2003 to remove the eugenic sterilization law from the books.
[JS1]Link to Eugenics Tree – Image 1
[JS2]We could have an entry on her. This might be useful.
[JS3]Link to narrative about Mary Brewer.
[JS4]Link to narrative about Caswell Training School – this needs to be written – a good job for my undergraduate research assistants next year.
[JS5]Link to narrative about social workers – I will write this.
[JS6]Link to narrative about state financial interest in sterilization – I will write this
[JS7]Link to family tree – Image 2
[JS8]Link to article about defective families – Image 3
[JS9]Link to entry about heredity.
[JS10]Link to sterilization petition and summary – Images 4 and 5
[JS11]Link to image of minutes recording sterilization decisions – Image 6
[JS12]Link to a hearing transcript/recording/something. I chose three Hearing Cases as possibilities.
[JS13]Link to publication: Marion Olden, The Survival of the Unfittest
[JS14]Link to graph showing changes in composition of race
[JS15]Link to data
[JS16]Insert images 7-9