Eugenic Nation

by Stern, Alexandra Minna

  Second-wave feminism converged on the clitoris, which was reclaimed as the primary site of erotic and sexual pleasure and an organ that detached female sexuality from the imperatives of reproduction.61 It also signified women’s biological difference from men, which became a font of celebration and identity-making. When they repudiated marriage counseling, whether in its psychoanalytic or hereditarian renditions, second-wave feminists paradoxically reaffirmed the notion that women were intrinsically unlike men. However, it was precisely because psychology and sex research had so badly misconstrued this distinction, shackling it to a misogynistic biology, that women needed to formulate new methods and theories to apprehend womanhood in all its complexity.62 In her classic essay “Kinder, Küche, Kirche as Scientific Law: Psychology Constructs the Female,” Naomi Weisstein, then a postdoctoral student and activist in Chicago, deplored the ignorance of male psychologists, who, she claimed, knew absolutely nothing about women and for years had explicated female maladies through androcentric theories and techniques. Although Weisstein’s critique is usually read as an indictment of Freudianism, she leveled biting criticism at biological theories of sex differentiation, which underlay, sometimes tacitly, scientific psychology. She was offended by the projection of primate behavior onto humans, a “patently irrelevant” reverse anthropomorphism that anticipated and rewarded greater male aggressiveness.63 Weisstein also debunked experimental psychology as performed in the laboratory, and pronounced “personality tests never yield consistent predictions.”64 Our Bodies, Ourselves, published in its first edition (under the title Women and Their Bodies) by the forerunner to the Boston Women’s Health Book Collective in 1970, was also emblematic of the cult of female distinctiveness.65 It was one of the most visible examples of feminist health activism, which emerged across the country in communities large and small in the late 1960s, taking up the issues of abortion, pregnancy and childbirth, contraception, sexuality, rape, mental health, and menopause, and striving to upset the coordinates of the traditional female patient–male doctor relationship.66 Through health collectives, publications written for and by women, and accompanying forms of sexual and erotic exploration, the body “came to symbolize the new citizen of the sixties revolutions: it was a body freed from the effects of racism, classism, technology, and sexual repression.”67

  The unfettered body also occupied center stage for gay liberationists, who had no choice but to construct their identity in opposition to scientific and medical depictions of deviancy and abnormality. Psychologists and physicians disagreed intensely about the etiology of homosexuality; some linked it to genetic predisposition, others to coddling mothers and “penis envy.” At the AIFR, Popenoe was so perturbed by homosexuality that, starting in the 1950s, he began to collect relatively obscure homophile pamphlets such as the Mattachine Review and One. He believed that, like women’s liberationists, homosexuals were a menace to civilization and, if allowed to “recruit” and proliferate, would destroy the modern family. The rigid box of his sex-gender hereditarianism could contain neither, and the AIFR found homosexuality much more enigmatic to diagnose and treat than frigidity or masculine protest. From the outset the institute’s counseling director, Roswell H. Johnson, thought it crucial to devise tests capable of identifying “passive male homosexuals” and traded letters with Terman on how best to develop such instruments. After over a decade of psychometric studies and observation, Johnson concluded that homosexuality was the consequence of a “variety of factors” including a constitutional inclination, which might be “direct from the gene” or stem from an “environmental physical-chemical effort.” Even though he conceded that homosexuality could be “eugenically useful in sterilizing many dysgenics,” Johnson asserted that the threat posed, particularly by “endogenous” or unrepentant homosexuals, was grave enough to warrant internment in an isolation colony. Over the years, he devoted a great deal of psychometric attention to the detection of homosexuality and after World War II claimed that he had finally figured out a secret formula to detect it with the Minnesota Multiphasic Personality Inventory.68

  Predispositional explanations for homosexuality diminished the possibility of efficacious treatment, while psychoanalytical causation veered too deeply into Freudian territory for Popenoe and the AIFR to fully endorse.69 Thus they straddled the fence and, depending on the counselor in question, viewed homosexuality writ large as detrimental to the survival of the human race and at the same time evaluated possible strategies for reconditioning and “cure,” which they assumed would be most promising for bisexuals or “ambi-verts.”70 In 1972, for example, Popenoe wrote to Barry Tanner at the Center for Behavior Change in Atlanta, Georgia, asking him to describe how he made use of electroshock therapy and to recommend equipment and treatment protocols.71 Although it is unclear whether the AIFR employed shock therapy, Popenoe spent much of the 1960s and 1970s excoriating the “homosexual revolution.” In 1962 he wrote that it “should be regarded as an intolerable evil that should not exist in a sound Society” and in 1967, that it deprived “the individual of the possibility of the fullest satisfaction of his nature.”

  On the eve of 1973, Popenoe stated that, analogous to women’s liberation, the increasing visibility of homosexuals was menacing society: “[T]he race is purified continually by the fact that the next generation is produced by family-minded persons, not by the enemies of family life. It is when the latter become too numerous, that the race is threatened.”72 By this point, Popenoe was probably cognizant of the fact that gay and lesbian activists were very close to winning the deletion of the classification of homosexuality as a mental disorder from the American Psychiatric Association’s Diagnostic and Statistical Manual, an emendation that occurred after explosive demonstrations and an internal vote in 1973.73

  As gay and lesbian activists assailed well-known psychiatrists such as Charles Socarides and Irving Bieber, who espoused the view that homosexuality was a psychopathology that warranted extensive therapy and the rechanneling of sexual desire, they also lambasted Popenoe and the stance of the AIFR.74 In 1971 Popenoe and four other institute staff participated in a twenty-four-hour discussion about homosexuality on KABC radio in Los Angeles. After this broadcast, in which Popenoe referred to same-sex desire as an illness that was “usually found in civilizations that are decaying,” he received a letter from an incensed member of the Los Angeles Gay Community Alliance.75 This activist attacked Popenoe for backing “hypocritical anti-sex laws” and for the circulation of the AIFR’s pamphlet Are Homosexuals Necessary? Invoking Alfred Kinsey’s theory of a continuum stretching from heterosexual to homosexual and replete with healthy variation, this young Angeleno stated that there were many people “in between.” He mocked Popenoe’s contention that homosexuality was a disease and rejected the premise that heterosexuality was innate, natural, or normal: “perhaps you do not really understand the basic nature of human sexuality. We are not dogs, cats, or rats. Unlike those animals, sexual behavior in man is learned rather than instinctive. We have no basic heterosexual drive.”76 Like feminists, many gay and lesbian activists cast their struggle in terms of the negative emotional and psychological effects of doctrines of psychosexual development and misplaced “object choice.” Their rage, however, was also vented against Popenoe and other anointed medical gurus, who operated outside of prominent psychoanalytic circuits but nonetheless profoundly influenced postwar attitudes about sex, gender, and the family.77

  STERILIZATION REDUX: MADRIGAL v. QUILLIGAN

  Close to fifteen years after students protested the naming of the CSUS science building, another group confronted the lingering presence of eugenics in California. This time it was legislators, who expunged the state’s seventy-year-old sterilization statute from the official record. Assemblyman Art Torres, chairman of the Health Committee, spearheaded this political action. In a letter to Governor Edmund G. Brown urging him to sign the repeal, Torres asserted that the sterilization law was “outdated” and that the criteria used to author
ize an operation—particularly the clause regarding the genetic origins of mental disease and the phrase “having a marked departure from normal mentality”—had “no meaning in modern medical terminology.”78 Backed by the Department of Developmental Services and the California Association for the Retarded, this bill was approved unanimously in the Assembly and Senate in committee and on the floor in August 1979.79

  Torres learned that California’s sterilization law was still on the books when, in the mid-1970s, several residents of his predominantly Latino Los Angeles district sued the Women’s Hospital at the University of Southern California/Los Angeles County General Hospital (hereinafter County Hospital) for nonconsensual sterilizations.80 The plaintiffs in this class-action suit, Madrigal v. Quilligan, were working-class Mexican-origin women who had been coerced into postpartum tubal ligations minutes or hours after delivering via cesarean section. In contrast to the operations carried out at state institutions beginning in 1909, these procedures were supported by federal agencies that began to disperse funds in conjunction with the family planning initiatives of the War on Poverty launched by Lyndon B. Johnson in 1964.

  For the most part, Madrigal v. Quilligan has been understood in light of the thousands of incidents of unwanted sterilizations reported in the United States from the late 1960s to the mid 1970s. And certainly, the experiences of the Mexican-origin women who suffered at the scalpels of County Hospital physicians mirror those of the African American, Puerto Rican, and Native American women who came forward with comparable stories during the same years. Nevertheless, Madrigal v. Quilligan has not been situated as a concluding link in California’s protracted history of eugenics. Yet, this case and its context can illuminate continuity and change, both in terms of the sterilization of poor women and Mexicans, male and female, and the longevity and potency of prosterilization arguments predicated on the protection of the public health and state resources.

  A series of overlapping developments created the milieu for widespread sterilization abuse in the late 1960s. First, there was increased availability of and access to birth control. For example, by 1970 North Carolina, Virginia, Oregon, and Georgia had passed voluntary sterilization laws, and Washington, D.C., and New York had legalized abortion.81 Quite simply, more women were using birth control, especially after the IUD and pill came on the market in the 1960s; voluntary sterilization rates rose in tandem so that in 1973 sterilization was the most common method of birth control by Americans in the thirty to forty-four age bracket.82 Second, partly in response to feminist demands, in 1969 the American College of Obstetricians and Surgeons dropped its age-parity stipulation, which required that a woman’s age multiplied by the number of her children equal 120 in order to qualify for voluntary sterilization. The following year, the College also retracted the proviso that a woman needed to consult two doctors and a psychiatrist before procuring surgery.83 Third, federal funding for birth control and family planning rose markedly in the late 1960s, most decisively with the passage of the Family Planning Services and Population Research Act in 1970 and the creation of the Office of Economic Opportunity (OEO), which was commissioned with introducing contraception and related education programs to millions of underserved women. Whereas in 1965 about 450,000 women had access to family planning projects, by 1975 this number had jumped to 3.8 million.84 In 1971, after heated debate over the degree to which the federal government should intrude into personal and bodily privacy (often disputed not by the left but by libertarian-leaning conservatives such as the OEO’s director, Donald Rumsfeld), the OEO incorporated sterilization into its medical armamentarium. Concurrently, Medicaid was authorized to reimburse up to 90 percent for a sterilization procedure.85 Factoring in the operations backed by Medicaid and the U.S. Department of Health, Education and Welfare (HEW) before the OEO’s decision, between the late 1960s and 1974, when federal guidelines were formally enacted, approximately one hundred thousand sterilizations were carried out annually.86 In theory, the advent of family planning resources and reproductive health clinics could provide millions of American women and men with heretofore scarce or nonexistent medical services. And many women took advantage of newly available OEO grants. In Pittsburgh, for example, African American women petitioned and received funds to set up a birth control clinic, a move that infuriated male black nationalists, who joined forces with the Catholic Church in a failed attempt to block its establishment.87

  The increasing access to contraception, however, overwhelmingly benefited middle-class white women.88 Against the injunction to define themselves primarily as breeders, mainstream feminists framed their struggle for reproductive and sexual autonomy in terms of the right to obtain birth control, above all abortion, elevating its federal legalization to their utmost goal.89 While many minority and working-class women also clamored for greater reproductive control, they often found themselves combating the reverse perception, namely, that they were destructive overbreeders whose procreative tendencies needed to be managed.90 Given that the family planning model was underpinned by the populationist paradigm and the nuclear ideal of two to three children per couple, a substantial influx of resources into birth control services and the absence of standardized consent protocols made the environment ripe for coercion.

  One of the most well-known cases was that of the Relf sisters, ages twelve and fourteen, who were sterilized without consent in 1973 in Alabama, in OEO-financed operations overseen by the Montgomery Community Action Committee. When the Southern Poverty Law Center sued on their behalf, it was revealed that their mother, who could not read, had unwittingly authorized the procedures. Believing she was authorizing birth control for her daughters, in the form of Depo-Provera injections, she signed an “X” on what was actually a sterilization release form.91 By the time the Relfs and their legal counsel held a press conference in 1973, African American and Native American women from across the South and Southwest were coming forward with parallel allegations.92 When Relf v. Weinberger was heard in federal district court, Judge Gerhard Gesell concluded that “an indefinite number of poor people have been improperly coerced into accepting a sterilization operation under the threat that variously supported welfare benefits would be withdrawn unless they submitted,” and added that “the dividing line between family planning and eugenics is murky.”93 He also estimated that over the past several years, 100,000 to 150,000 low-income women had been sterilized under the auspices of federal programs.94

  Along with African American women, who constituted 43 percent of all federally funded sterilization patients according to a 1973 survey, Native Americans were heavily affected by this aspect of the War on Poverty.95 For example, one study commissioned by the Government Accounting Office found that between 1973 and 1976 the Indian Health Service, usually with HEW backing, sterilized more than thirty-four hundred Native American women in the states of New Mexico, Arizona, Oklahoma, and South Dakota.96 In the late 1970s, spokespeople for several Native American tribes claimed that somewhere between 20 and 50 percent of women of childbearing age in their communities had been sterilized without their consent.97 Although Puerto Rican women, especially those on the island, had sought out and used sterilization as a reliable and practical form of contraception for several decades, they began to report nonconsensual surgeries. In New York City the vast majority of women sterilized at public hospitals were Puerto Rican, a predicament that spurred Dr. Helen Rodrigues-Triaz to cofound the Committee to End Sterilization Abuse in 1975.98 During the same period, the Young Lords in New York City, strongly influenced by Puerto Rican feminists, simultaneously waged campaigns against forced sterilization and for augmented birth control and abortion services, which they saw as two complementary sides of reproductive control.99

  If the surge of HEW-supported sterilizations was facilitated by a set of factors specific to the late 1960s, they were also enabled by the existence of state sterilization laws and the ongoing utilization of the psychometric labels of “feebleminded” and “mentally defective.”100
From the 1920s to the 1970s, the rationale for sterilization had gradually but never entirely shifted from one based on the transmission of faulty genes down the family line to one centered more and more on the purported negative consequences of unfit parenthood, dysfunctional families, and overpopulation. Nevertheless, there was one constant refrain throughout the twentieth century: reproductive surgery could serve as a techno-surgical fix that, in whatever instance, would save the state money, impede irresponsible parents from having more children, and boost the well-being of society.101 In some states, this translated into the criminalization of illegitimacy, whereby unmarried mothers were extorted into sterilization with the threat of terminated welfare support or forced to submit to an operation to avoid incarceration.102 In North Carolina, for example, Nial Cox, an eighteen-year-old unwed black mother, was forcibly sterilized in 1965 after her mother was told that unless Nial submitted to surgery, she would cease to receive welfare assistance for Nial’s siblings. North Carolina’s Eugenics Board heard Nial’s case, judged her to be feebleminded, and sent her to the operating table. Nial also held a press conference in 1973 to draw attention to her plight and filed a legal suit through the American Civil Liberties Union.103 The previous year, in Mississippi, the House had passed a bill (HB 180) that pronounced a woman who gave birth to a second illegitimate child a felon punishable by either one to five years in prison (depending on the total number of children) or reproductive surgery.104 The Student Nonviolent Coordinating Committee (SNCC) promptly issued a pamphlet condemning HB 180, which was clearly aimed at poor and African American women, as a “program of officially supported and sanctioned genocide.”105 SNCC was instrumental in putting this bill, and corresponding legislative attempts, on the civil rights agenda and in the national spotlight. Once under attack from many sides, the Mississippi Senate relented, although a less stringent bill that made “unmarried parenthood a crime” did become law.106 During the same period, Fannie Lou Hamer traveled the South, attacking the unwitting sterilization of black women—many of them underage—at Indianola’s Sunflower City Hospital in the name of public health and welfare protection. For civil disobedience and black power activists, “Mississippi appendectomies” became an electrifying cry of 1960s activism.107