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The American eugenics machine: the sterilization laws from Indiana 1907, the Supreme Court's Buck v. Bell blessing of 'three generations of imbeciles', the Nazi borrowing of the California model, and the tens of thousands sterilized, disproportionately Black...
The American eugenics machine: the sterilization laws from Indiana 1907, the Supreme Court's Buck v. Bell blessing of 'three generations of imbeciles', the Nazi borrowing of the California model, and the tens of thousands sterilized, disproportionately Black, Native, Latina, poor, and disabled, into the late apologies and reparations.
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Historians including Paul Lombardo and Alexandra Minna Stern have estimated that more than 60,000 Americans were sterilized under state eugenics laws between 1907 and the programs' effective end in the 1970s, with some researchers placing the number closer to 70,000 once undercounted institutional and welfare-linked sterilizations are included. California, North Carolina, and Virginia accounted for a large share of the total.
Indiana enacted the first eugenic sterilization law in the world, authorizing forced sterilization of people in state institutions judged "confirmed criminals, idiots, imbeciles and rapists." The law was signed by Governor J. Frank Hanly and applied to inmates of state prisons, reformatories, and homes for the "feeble-minded." It became the model that other states copied over the following decades.
California passed its own compulsory sterilization statute, allowing sterilization of people confined in state hospitals and prisons who were diagnosed as "feebleminded" or judged to have a hereditary disease or condition. Washington and Connecticut passed similar laws the same year. California went on to sterilize far more people than any other state, roughly a third of all sterilizations performed nationwide.
Following Indiana and California, states including New Jersey, Iowa, New York, North Dakota, Michigan, Kansas, Wisconsin, Nebraska, and Oregon passed compulsory sterilization laws in the years before World War I. By the 1930s, roughly thirty states had enacted eugenic sterilization statutes, backed by the American Eugenics Society and state boards of health.
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Eugenicist Harry Laughlin, of the Eugenics Record Office at Cold Spring Harbor, published a "Model Eugenical Sterilization Law" intended as a template for state legislatures. Virginia's 1924 sterilization act was drafted using Laughlin's model, and it was later cited by German officials drafting the Nazi sterilization law of 1933. Laughlin was awarded an honorary degree by the University of Heidelberg in 1936 in recognition of his eugenics work.
Virginia's General Assembly passed the Eugenical Sterilization Act, authorizing compulsory sterilization of patients at state institutions found to be "feebleminded" or otherwise hereditarily unfit. It was passed the same day as the state's Racial Integrity Act, which banned interracial marriage. The law's authors intended to create a test case that could withstand constitutional challenge, and chose a young patient named Carrie Buck for that purpose.
Carrie Buck, an eighteen-year-old woman who had been raped by a relative of her foster family and borne a child, was committed to the Virginia State Colony for Epileptics and Feebleminded. Colony officials labeled her, her mother Emma, and her infant daughter Vivian as "feebleminded" across three generations, and superintendent Albert Priddy selected Carrie's case to test Virginia's new sterilization law.
The U.S. Supreme Court ruled 8-1 in Buck v. Bell that Virginia's compulsory sterilization law was constitutional. Writing for the majority, Justice Oliver Wendell Holmes Jr. declared, "Three generations of imbeciles are enough," upholding the state's authority to sterilize institutionalized people without their consent. Justice Pierce Butler was the lone dissenter and did not write a dissenting opinion. The ruling has never been formally overturned.
Carrie Buck was surgically sterilized at the Virginia State Colony for Epileptics and Feebleminded, becoming the first person sterilized under the law upheld in Buck v. Bell. Later research found no evidence that Carrie, her mother, or her daughter Vivian, who died young and did well in school, were actually "feebleminded." Historians regard the case as built on fabricated evidence to secure a favorable precedent.
Businessman E.S. Gosney and psychologist Paul Popenoe founded the Human Betterment Foundation to study and promote California's sterilization program, which had already sterilized thousands of institutionalized people. The foundation's 1929 book "Sterilization for Human Betterment" was widely circulated and later cited approvingly by Nazi eugenicists as evidence that mass sterilization could work in practice.
North Carolina created a state Eugenics Board with authority to approve sterilizations of people in state custody and, eventually, people receiving public welfare assistance outside institutions. Unlike many states, North Carolina's program grew after World War II and increasingly targeted poor women and Black women referred by county welfare departments and social workers, sterilizing more than 7,600 people before it ended.
The Nazi government enacted the Law for the Prevention of Hereditarily Diseased Offspring, mandating compulsory sterilization of people with conditions including schizophrenia, epilepsy, and hereditary blindness or deafness. German eugenicists, including Eugen Fischer and Ernst Rudin, had studied American sterilization statutes and cited California's program in particular as proof such a law could be implemented at scale. The law took effect January 1, 1934, and roughly 400,000 people were sterilized under it.
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Nazi officials and eugenicists publicly credited American sterilization laws as their inspiration. Dr. Falk Ruttke, a Nazi legal official, and Dr. Fritz Lenz both praised California's program, and a German eugenics researcher wrote to Human Betterment Foundation co-founder Paul Popenoe that his organization's work "had been studied with great interest by the National Socialist Government." Historian Stefan Kuhl documented extensive correspondence and personal exchanges between American and German eugenicists in this period.
The Supreme Court struck down Oklahoma's Habitual Criminal Sterilization Act, ruling that sterilizing repeat criminals while exempting white-collar offenders violated equal protection. The Court called procreation "one of the basic civil rights of man," but the decision was narrow, addressing punitive sterilization of criminals rather than the broader eugenic sterilization of institutionalized and disabled people upheld in Buck v. Bell, which the Court did not revisit.
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At the Doctors' Trial, defendants and defense counsel invoked Buck v. Bell and American sterilization law to argue that Nazi Germany's sterilization program had followed an accepted legal and scientific precedent set by the United States. The tribunal rejected the comparison to Nazi mass murder and forced experimentation, but the episode underscored how directly American eugenics law had shaped Nazi policy a decade earlier.
By mid-century, California had sterilized more institutionalized people than any other state, historian Alexandra Minna Stern estimates roughly 20,000, about a third of the national total. Most were patients at state hospitals for the mentally ill and developmentally disabled, sterilized as a condition of release or institutional policy, with disproportionate effects on Mexican-American and other minority patients.
North Carolina's Eugenics Board increasingly approved sterilizations of poor women referred by county departments of public welfare rather than institutionalized patients. Historians have documented that by the 1960s a majority of those sterilized under the program were Black, far exceeding their share of the state population, as caseworkers used sterilization as a condition for continued welfare benefits.
Civil rights activist Fannie Lou Hamer went to a Sunflower County hospital for a minor tumor removal and had her uterus removed without her knowledge or consent by a white doctor. Hamer later said such unauthorized hysterectomies were common enough among Black women in the Mississippi Delta that they were known locally as a "Mississippi appendectomy." She became a leading voice against involuntary sterilization of Black women in the South.
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Minnie Lee Relf, age 14, and her sister Mary Alice, age 12, both Black girls from a low-income family, were surgically sterilized at a federally funded clinic in Montgomery, Alabama, after their illiterate mother was misled into signing a consent form with an X she believed authorized birth control shots. The case became a national symbol of coercive sterilization of poor Black women and girls under federally funded family planning programs.
The Southern Poverty Law Center sued the federal Department of Health, Education, and Welfare on behalf of the Relf sisters and other sterilization victims. The resulting case, Relf v. Weinberger, produced findings that an estimated 100,000 to 150,000 poor people had been sterilized annually under federally funded programs, and led a federal judge to order new consent safeguards and a temporary halt to sterilizations of minors and incompetent adults using federal funds.
North Carolina's Eugenics Board approved its last sterilization case around 1974, as tightened federal consent rules following Relf v. Weinberger and mounting public criticism ended the program's active use. The board itself was not formally abolished until 1977, when the state legislature repealed the eugenics statute that had authorized it since 1933.
Following the Relf v. Weinberger ruling, federal judge Gerhard Gesell ordered the Department of Health, Education, and Welfare to issue stricter regulations requiring informed, written consent before federally funded sterilizations, a mandatory waiting period, and a ban on sterilizing minors or coercing consent by threatening to withhold welfare benefits. The new rules, finalized in 1978, curbed but did not entirely stop coercive sterilization practices reported into the 1980s.
A U.S. General Accounting Office investigation, prompted by physician and Choctaw activist Connie Pinkerton-Uri, found that Indian Health Service facilities in four regions had sterilized 3,406 Native American women between 1973 and 1976 without adequate consent procedures. Later researchers, including Pinkerton-Uri, estimated that IHS facilities may have sterilized a quarter or more of Native American women of childbearing age during the 1970s.
Ten Mexican-American women sued doctors at the Los Angeles County-USC Medical Center, alleging they had been coerced or misled into consenting to tubal ligations during labor, often signing consent forms in English that they did not read or speak. Federal Judge Jesse Curtis ruled against the plaintiffs, but the case, filed in 1975, exposed widespread coercive sterilization of Spanish-speaking women and led California to adopt a state consent form printed in Spanish and stricter waiting periods.
California formally repealed the eugenic sterilization statute it had enacted in 1909, ending the legal authority state institutions had used to sterilize an estimated 20,000 people over seven decades, the largest such program of any U.S. state.
On the 75th anniversary of the Buck v. Bell decision, Virginia Governor Mark Warner issued a statement expressing "profound regret" for the state's eugenic sterilization program, which had sterilized more than 7,300 people. Virginia's action was among the first formal state acknowledgments of the harm caused by twentieth-century sterilization laws.
Governor John Kitzhaber issued a formal apology for Oregon's eugenic sterilization program, which had operated under a state Board of Eugenics from 1917 into the 1980s, one of the longest-running such programs in the country.
Governor Mike Easley issued a formal apology on behalf of North Carolina for the state's eugenics program, which had sterilized more than 7,600 people between 1929 and 1974. The apology did not include compensation, which would not come for another decade.
Governor Gray Davis apologized on behalf of California for the state's eugenic sterilization program, the largest in the nation, calling it "a sad and regrettable chapter" in the state's history. No compensation fund for survivors was created at the time.
Governor Beverly Perdue convened the North Carolina Justice for Sterilization Victims Foundation to locate living victims of the state's eugenics program and recommend compensation. The task force's work, built on years of investigative reporting by journalist Kevin Begos, led to legislative action three years later making North Carolina the first state to approve direct payments to sterilization survivors.
The Center for Investigative Reporting, in a story by journalist Corey G. Johnson, revealed that doctors under contract with the California Department of Corrections and Rehabilitation had sterilized at least 148 female inmates between 2006 and 2010 through tubal ligations that often lacked proper state-required consent and approval, decades after California's official eugenics program had ended.
North Carolina's state budget included a $10 million fund to compensate living victims of the state's eugenics sterilization program, making it the first state in the country to approve direct financial reparations for sterilization survivors. Eligible victims began receiving payments of roughly $20,000 each starting in 2014.
A California state audit confirmed that prison medical staff had performed tubal ligations on female inmates without following required state approval and consent procedures, corroborating the 2013 investigative reporting and finding that some women said they had been pressured into the procedure while in custody.
Governor Jerry Brown signed SB 1135, banning sterilization procedures in California prisons for the purpose of birth control unless there is a genuine medical need and the inmate has given informed, uncoerced consent, closing the loophole exposed by the 2013 prison sterilization investigation.
North Carolina issued its first compensation checks to living victims of its state eugenics sterilization program, part of the $10 million fund approved the previous year. Roughly 220 verified survivors ultimately received payments before later claims from additional victims expanded the program.
Virginia's General Assembly approved a state budget including $25,000 payments to living survivors of the state's eugenic sterilization program, signed into law by Governor Terry McAuliffe. Virginia had sterilized more than 7,300 people, including Carrie Buck, under the law upheld in Buck v. Bell.
Governor Gavin Newsom signed a state budget that included a $7.5 million fund to compensate living survivors of forced sterilization, covering both victims of California's early twentieth-century eugenics program and the women illegally sterilized in state prisons in the 2000s. California became one of the last states with a major sterilization program to establish direct compensation for survivors.
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