Eugenic Nation

by Stern, Alexandra Minna

  This glaring absence raises intriguing questions about how eugenics can and will be remembered and forgotten in California. Without a dialogue between the state and those sterilized, seventy years of sterilization policy can be more readily placed in parentheses and regarded as an aberration. Governor Davis’s apology, still unacknowledged by sterilization victims or their relatives, has the capacity to inspire amnesia, as eugenics and sterilization are tucked away in the past and not discussed aloud by those whose lives were irrevocably altered by involuntary reproductive surgery. This is in contrast to what unfolded in Oregon, where the involvement of disability rights and mental health advocates helped to set the stage for the gubernatorial proclamation of a designated Human Rights Day, and in North Carolina, where journalists at the Winston-Salem Journal collaborated with legislators, activists, historians, and sterilization victims and their loved ones to produce a special investigative report titled “Against Their Will.”6 Given that it is highly unlikely that additional Charlie Folletts will come forward to recount their stories, I believe that it is critical to put California’s gubernatorial apology, and the awareness it has generated, to good use by encouraging wide-ranging conversations about and further inquiries into the history and legacy of the state’s eugenics program.

  It is heartening that several members of the California Senate have demonstrated a strong interest in exploring the dynamics of compulsory sterilization. Specifically, through a series of well-attended hearings, the Senate Select Committee on Genetics, Genetic Technologies and Public Policy has considered how the medical and legal abuse that occurred in state institutions under the authority of eugenics and the logic of public cost-saving may pertain to contemporary issues of health care and institutionalization. This is particularly significant because of California’s enduring role as a pioneer in genetic medicine and genetic technologies.

  If California was literally on the cutting edge of eugenic sterilization from 1909 to 1979, it has remained at the forefront of experiments in public health and genetics. For example, in 1986, California was the first state in the country to pass a law requiring that all pregnant mothers be offered MSAFP (maternal serum alpha-fetoprotein) screening to assess the probability that their fetuses would be affected by Down syndrome, spina bifida, or neural tube defects. Rather than making such testing mandatory, this law instead dictates that genetic counselors must inform patients of the availability of MSAFP. As studies have shown, however, societal demands to use extant medical technologies in order to do the “best” for one’s children are often so powerful that many women accede to prenatal testing even if, for linguistic or cultural reasons, the implications of testing or positive diagnosis are unclear.7 Indeed, in one study focused on California’s prenatal genetic testing program, two medical anthropologists have described scenarios in which Mexican-origin women are, usually inadvertently, receiving incomplete or distorted information about genetic screening and its meanings.8 This situation is exacerbated by a dearth of minority and bilingual genetic counselors scientifically and cross-culturally able to translate complex technical information to a diverse clientele. In addition, these interactions are shaped and sometimes limited by professional training that teaches genetic counselors to define themselves against anything that could be construed as heavy-handed or akin to the coercive eugenics of the past, a psychological technique referred to as “nondirectiveness.”9 Thus, even if motivated by noble goals, achieving such neutrality is virtually impossible not only given that social values and priorities are embedded in medical institutions and frameworks, but also because the insistence on impartiality can ultimately frustrate patients, some of whom want to receive expert advice from genetic practitioners.10 In a perversely counterintuitive fashion, the commonplace association of eugenics with state control and medical regulation, which is buttressed by most historical interpretations of eugenics, has helped to put genetic counselors in a communicative bind. While genetic counseling intervention is offered and all but required by California’s innovative and well-intended state program, conveying clear-cut advice, even when explicitly requested by patients, is officially disallowed.

  The passage of Proposition 71 in November 2004 also suggests that California’s protracted entanglement with eugenics in the twentieth century should not be overlooked. Approved by 59 percent of voters in defiance of President George W. Bush’s opposition to the federal funding of embryonic and new stem cell research, this initiative will distribute three billion dollars over the next ten years to support a multitude of stem cell projects and experiments.11 On the one hand, the California Stem Cell Research and Cures Initiative will attract top-notch scientists from around the world who are eager to embark on original research and develop promising therapies for debilitating and deadly chronic and degenerative diseases. Enterprising start-up companies such as Geron and StemCells, Inc., see the potential for a creative and financial boom similar to the biotechnology explosion of the 1970s, which was spearheaded by firms such as Genentech and Chiron.12 On the other hand, some scientists and policy makers have warned that in addition to raising false hopes about immediate cures for complicated ailments, Proposition 71 was not formulated with sufficient guarantees of public accountability and scientific responsibility. In particular, questions about who is most likely to supply the eggs for stem cell research were never systematically addressed. Concerned about the economic pressures that could compel poor women to become the majority of egg providers, as well as the possibility of the creation, with little or no ethical oversight, of clonal embryos, the Oakland-based Center for Genetics and Society stated in an assessment paper that “the development of stem cell and research cloning techniques could open the door to a new, high-tech eugenics.”13

  It could be argued, however, that California, the nation’s leader in artificial insemination, can already claim the crown of high-tech eugenics. Home to some of the first commercial sperm banks, such as the Repository for Germinal Choice, which was founded near San Diego in 1971, California currently has the greatest number of banks in the country (seven, followed by three in New York and three in Minnesota).14 California was at the frontier of the transition of artificial insemination with donor sperm (AID) from a procedure carried out primarily in specialized clinics with a doctor’s supervision to a product tailored to meet the popular eugenic desires of American customers. For example, a woman on the market for a sperm specimen can select a donor based on a long list of factors including health history, ethnic heritage, SAT scores, college grade point average, self-reported skills and hobbies, and even degrees of introversion and extroversion.15

  AID and many other genetic and fertility technologies, such as amniocentesis and chorionic villus sampling (CVS), have become routinized features of modern biomedicine, especially as many couples opt to have children after the age of thirty. These technologies enable people to make decisions about what kind of a child they hope to bring into the world. If, based on such criteria, individuals choose to reproduce only offspring calculated to possess an elevated chance of being categorized as “normal” or perhaps even “superior” in the eyes of mainstream society, is this eugenics?16 According to Galton’s definition, and above all the injunction “to improve the inborn qualities,” such attempts at normalization and optimization qualify as eugenic in outcome if not intent. Not surprisingly, disability rights activists, fearing that those labeled abnormal, burdensome, or otherwise undesirable will be bred into extinction, have contested the often-unquestioned acceptance of genetic testing as beneficial to families and society.17

  I believe that we should vigilantly strive to reveal the preconceptions that shape genetic technologies and testing, not to condemn these procedures, which ideally should be widely available health avenues, but in order to elucidate and perhaps challenge underlying assumptions about who and what is considered acceptable and normal or unacceptable and abnormal. Moreover, I would suggest that the problem we face today is less whether something is or is not
unequivocally eugenic, but whether reproductive and genetic practices or technologies are equitably distributed across the population. Clearly, in a country with enormous gaps in insurance coverage, medical care access, and health literacy, some can afford medical options that others cannot.18 America’s profound health disparities, which disproportionately hurt racial and ethnic minorities, the unemployed, and the working poor, provide fertile soil for a dangerous combination of the medical neglect of some and the physical and aesthetic enhancement of the few.

  Finally, there is another serious medical and moral paradox that shows little hope of resolution in the near future. Over the past three decades, genetic and reproductive technologies have expanded rapidly, providing American women with an increasing amount of information about potentially inheritable diseases and the existence of chromosomal abnormalities. Yet at the same time, the main procedure that a woman can choose to terminate a pregnancy, namely abortion, has been gradually recriminalized on both the state and federal levels. These countervailing forces place women of child-bearing age in an uncomfortable dilemma, as they are pulled betwixt and between the seeming autonomy of choice, diminishing reproductive control, and the burden of receiving consequential genetic and medical knowledge.

  Notes

  INTRODUCTION

  1. Laurence M. Cruz, “Eugenics Yields Dark Past,” (Oregon) Statesman Journal, Dec. 1, 2002, and “Governor Apologizes for Eugenics,” Statesman Journal, Dec. 3, 2002; Randi Bjornstad, “Sterilization Apology Offered in Oregon,” (Salem, Oregon) Register-Guard, Dec. 3, 2002.

  2. “Full Text of State’s Apology Regarding Eugenics,” (Oregon) Statesman Journal, Dec. 3, 2002.

  3. Peter Hardin, “Apology for Eugenics Set: Warner Action Makes Virginia First State to Denounce Movement,” Richmond Times-Dispatch, May 2, 2002; William Branigin, “Virginia Apologizes to the Victims of Sterilizations,” Washington Post, May 3, 2002.

  4. “Full Text of State’s Apology.”

  5. See Elazar Barkan, The Guilt of Nations: Restitution and Negotiating Historical Injustices (Baltimore: Johns Hopkins University Press, 2001).

  6. See Hannah Arendt, The Origins of Totalitarianism (1951; reprint, New York: Harcourt, Brace, 1973).

  7. See Peter Novick, The Holocaust in American Life (Boston: Houghton Mifflin, 1999).

  8. See Stefan Kühl, The Nazi Connection: Eugenics, American Racism, and German National Socialism (Oxford: Oxford University Press, 1994).

  9. See Edwin Black, War against the Weak: Eugenics and America’s Campaign to Create a Master Race (New York: Four Walls Eight Windows, 2003); and Elazar Barkan, The Retreat of Scientific Racism: Changing Concepts of Race in Britain and the United States between the World Wars (New York: Cambridge University Press, 1992). On German eugenics, see Robert Proctor, Racial Hygiene: Medicine under the Nazis (Cambridge, Mass.: Harvard University Press, 1988); and Paul Weindling, Health, Race, and German Politics between National Unification and Nazism, 1870–1945 (Cambridge: Cambridge University Press, 1989).

  10. See George W. Stocking, Race, Culture, and Evolution: Essays in the History of Anthropology (Chicago: University of Chicago Press, 1982).

  11. See Barkan, Retreat of Scientific Racism; L. C. Dunn and Th. Dobzhansky, Heredity, Race, and Society (New York: Mentor Books, 1946); and UNESCO, The Race Concept: Results of an Inquiry (Paris: UNESCO, 1952).

  12. See Daniel J. Kevles, In the Name of Eugenics: Genetics and the Uses of Human Heredity, rev. ed. (Cambridge, Mass.: Harvard University Press, 1995); and Adele E. Clarke, Disciplining Reproduction: Modernity, American Life Sciences, and “the Problems of Sex” (Berkeley and Los Angeles: University of California Press, 1998).

  13. See Molly Ladd-Taylor, “ ‘A Kind of Genetic Social Work’: Sheldon Reed and the Origins of Genetic Counseling,” in Women, Health, and Nation: Canada and the United States since 1945, ed. Georgina Feldberg, Molly Ladd-Taylor, Alison Li, and Kathryn McPherson (Montreal: McGill-Queen’s University Press, 2003), 67–83; and Diane B. Paul, The Politics of Heredity: Essays on Eugenics, Biomedicine, and the Nature-Nurture Debate (Albany: State University of New York Press, 1998).

  14. Genetic counselors were aware, however, that conveying information about the likelihood of transmitting identified genetic diseases sometimes would encourage couples to have more children in order to ensure the eventual production of “normal” offspring. As Diane Paul has noted, this is antithetical to a eugenic standpoint, which would discourage the proliferation of defects, especially those carried recessively and not phenotypically expressed. Genetic counselors, though, were confident that most of their middle-class clients would make sensible decisions for the sake of both their families’ future and the gene pool. See Paul, Politics of Heredity, 133–56.

  15. See Sarah W. Tracy, “An Evolving Science of Man: The Transformation and Demise of American Constitutional Medicine, 1920–1950,” in Greater Than the Parts: Holism in Biomedicine, 1920–1950, ed. Christopher Lawrence and George Weisz (New York: Oxford University Press, 1998), 161–88; Tracy, “George Draper and American Constitutional Medicine, 1916–1946: Reinventing the Sick Man,” Bulletin of the History of Medicine 66, no. 1 (Spring 1992): 53–89; and Alexandra Minna Stern, “From Mestizophilia to Biotypology: Racialization and Science in Mexico, 1920–1960,” in Race and Nation in Modern Latin America, ed. Nancy Applebaum, Anne S. MacPherson, and Karin Alejandra Rosemblatt (Chapel Hill: University of North Carolina Press, 2003), 187–210.

  16. The English Eugenics Society served as the London headquarters of the International Planned Parenthood Foundation. See Linda Gordon, Woman’s Body, Woman’s Right: Birth Control in America, rev. ed. (New York: Penguin Books, 1990), chap. 13.

  17. See Paul, Politics of Heredity; Kevles, In the Name of Eugenics; and Celeste Michelle Condit, The Meanings of the Gene: Public Debates about Human Heredity (Madison: University of Wisconsin Press, 1999).

  18. See William H. Tucker, The Funding of Scientific Racism: Wickliffe Draper and the Pioneer Fund (Urbana: University of Illinois Press, 2002).

  19. See Steven Selden, Inheriting Shame: The Story of Eugenics and Racism in America (New York: Teacher’s College, Columbia University, 1999); and Diane B. Paul, Controlling Human Heredity: 1865 to the Present (Atlantic Highlands, N.J.: Humanities Press, 1995).

  20. See Paul, Politics of Heredity, 4.

  21. See “A New Name—Society for the Study of Social Biology (formerly the American Eugenics Society),” Social Biology 20, no. 1 (1973): 1.

  22. See Philip R. Reilly, The Surgical Solution: A History of Involuntary Sterilization in the United States (Baltimore: Johns Hopkins University Press, 1991); and Julius Paul, “The Return of Punitive Sterilization Proposals: Current Attacks on Illegitimacy and the AFDC Program,” Law and Society Review 3, no. 1 (1968): 77–106.

  23. See Kenneth M. Ludmerer, Genetics and American Society: A Historical Appraisal (Baltimore: Johns Hopkins University Press, 1972); Mark H. Haller, Eugenics: Hereditarian Attitudes in American Thought (New Brunswick, N.J.: Rutgers University Press, 1963); Garland E. Allen, “The Eugenics Record Office at Cold Spring Harbor, 1910–1940,” Osiris, 2nd. ser., 2 (1986): 225–64, and Allen, “The Misuse of Biological Hierarchies: The American Eugenics Movement, 1900–1940,” History and Philosophy of the Life Sciences 5, no. 2 (1983): 105–28.

  24. See Race Betterment Foundation, Race Betterment Exhibit (Battle Creek, Mich., 1915).

  25. See Edward J. Larson, Sex, Race, and Science: Eugenics in the Deep South (Baltimore: Johns Hopkins University Press, 1995).

  26. See Nancy L. Gallagher, Breeding Better Vermonters: The Eugenics Project in the Green Mountain State (Hanover, N.H.: University Press of New England, 1999); Lisa Linquist Dorr, “Arm in Arm: Gender, Eugenics, and Virginia’s Racial Integrity Acts of the 1920s,” Journal of Women’s History 11, no. 1 (Spring 1999): 143–66; Gregory Michael Dorr, Segregation’s Science: Hereditarian Thought in Virginia, 1785 to the Present (Chapel Hill: University of North Carolina Press, in press); Johan
na Schoen, Choice and Coercion: Birth Control, Sterilization, and Abortion in Public Health and Welfare (Chapel Hill: University of North Carolina Press, 2005); Katherine Castles, “Quiet Eugenics: Sterilization in North Carolina’s Institutions for the Mentally Retarded, 1945–1965,” Journal of Southern History 68, no. 4 (Nov. 2002): 849–78; Molly Ladd-Taylor, “The ‘Sociological Advantages’ of Sterilization: Fiscal Policies and Feeble-Minded Women in Interwar Minnesota,” in Mental Retardation in America: A Historical Reader, ed. Steven Noll and James W. Trent Jr. (New York: New York University Press, 2004), 281–99; Mark A. Largent, “ ‘The Greatest Curse of the Race’: Eugenic Sterilization in Oregon, 1909–1983,” Oregon Historical Quarterly 103, no. 2 (2002): 188–209; and Alexandra Minna Stern, “Making Better Babies: Public Health and Race Betterment in Indiana, 1920–1935,” American Journal of Public Health 92, no. 5 (2002): 742–52.

  27. See Gunnar Broberg and Nils Roll-Hansen, Eugenics and the Welfare State: Sterilization Policy in Denmark, Sweden, Norway and Finland (East Lansing: Michigan State University Press, 1996); Jennifer Robertson, “Japan’s First Cyborg? Miss Nippon, Eugenics, and Wartime Technologies of Beauty, Body, and Blood,” Body and Society 7, no. 1 (2001): 1–34; Frank Dikötter, Imperfect Conceptions: Medical Knowledge, Birth Defects, and Eugenics in China (New York: Columbia University Press, 1998); Mark B. Adams, ed., The Wellborn Science: Eugenics in Germany, France, Brazil, and Russia (New York: Oxford University Press, 1990); Nancy Leys Stepan, “The Hour of Eugenics”: Race, Gender, and Nation in Latin America (Ithaca. N.Y.: Cornell University Press, 1991); Angus McLaren, Our Own Master Race: Eugenics in Canada, 1885–1945 (Toronto: McClelland & Stewart, 1990); and Richard Cleminson, “Eugenics by Names or by Nature? The Spanish Anarchist Sex Reform of the 1930s,” History of European Ideas 18, no. 5 (1994): 729–40. There are many other excellent articles and books on Romania, India, and Brazil, to name just a few.