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Sterilization’s Cruel Inheritance

The eugenic legacy of a 1927 Supreme Court decision to sterilize “imbeciles.”

La bouche by Jean-Baptiste Miette

Last year, investigative reporters revealed that in Nashville, Tennessee, between 2010 and 2015, prosecutors had used sterilization as a bargaining chip in plea deals with female defendants. One of them was Jasmine Randers, who had a long history of depression, paranoia, and schizoaffective disorder. When her infant daughter died of mysterious causes in 2012, Randers was charged with child neglect. The prosecutor assigned to the case would not agree to a plea deal that avoided prison time unless Randers underwent sterilization surgery. Randers’s defense attorney complained, the prosecutor was taken off the case and later fired, and Randers was declared not guilty by reason of insanity. But coerced sterilizations do still occur: A 2013 report from the Center for Investigative Reporting found that in California between the late 1990s and 2010, hundreds of female prisoners were sterilized without proper state approval. As a result of the investigation, Governor Jerry Brown signed a law banning forced sterilizations in the California prison system.

Such a law was necessary because, in the twenty-first century, according to the United States Supreme Court, it is perfectly legal for a state to require a woman to be sterilized—the result of a nearly 90-year-old judgment in a case that remains on the books, Buck v. Bell. That case is the subject of an important new book by the journalist Adam Cohen, Imbeciles: The Supreme Court, American Eugenics, and the Sterilization of Carrie Buck, which details the eugenic horror that still haunts the American legal system.

It was the quiet work of Gregor Mendel, the Austrian botanist and monk who conducted experiments in the garden of his monastery in the 1850s and 1860s, that helped trigger the eugenic revolution in early twentieth-century America. Mendel discovered that when a green pea is crossed with a yellow pea, the resulting offspring are yellow—the “dominant” genetic trait—yet in the second generation, Mendel found, the “recessive” gene reappears, and a quarter of the offspring will be green. His work traced the genetic origins of hereditary characteristics and explained the mechanism through which farmers, for thousands of years, had selectively bred their crops.

Mendel died in 1884, virtually unknown. His paper “Experiments on Plant Hybrids” had been published but hardly noticed by the scientific community. Mendel’s research found a new audience at the turn of the twentieth century, promoted by English “social Darwinists” who hoped to apply theories of natural selection to humankind. American progressives like Teddy Roosevelt and Margaret Sanger were inspired by social Darwinism and became gripped by a fervor for eugenics, a pseudoscience that considered human poverty, criminality, disability, and sexual promiscuity to be heritable traits, as immutable as pea color. If the “unfit and undesirable” could be prevented from breeding, eugenists believed, the human race could be remade within several generations, mentally and morally pure.

Penguin, 402 pp., $28

Middle-class women’s clubs, the American Museum of Natural History, and even the U.S. State Department hosted lectures on eugenics. Over 300 American colleges, including Harvard, Columbia, Cornell, and Berkeley, offered classes on the subject. Cosmopolitan magazine enthused about the promise of preventing the birth of the “diseased or crippled or depraved,” and the Journal of the American Medical Association published articles in favor of eugenic sterilization. In the first decade of the twentieth century, state legislatures began considering laws that would allow certain people to be sterilized against their will.

Human beings, of course, are not like Mendel’s peas. Deaf parents give birth to babies who can hear; intellectuals have children with Down syndrome; ordinary people are astounded when their own offspring demonstrate prodigious talent in music or rock climbing or math. This is because we are shaped not only by our genes, but by our environment, and by complex interactions between genetics and environment—now termed “epigenetics”—that scientists are only today beginning to understand.

Cohen’s book takes us back to a rarely remembered era of our history, reminding us that Adolf Hitler regarded American eugenic law as an inspiration. By 1931, 28 states had statutes authorizing sterilization for eugenic purposes. The dominant surgical procedure was called a salpingectomy. Entering through the abdomen, doctors cut and partially removed a woman’s fallopian tubes, in order to prevent eggs from traveling from the ovaries to the uterus. The eugenic movement targeted women for sterilization, partly because castration of men was seen as cruel, but also because “feeble-minded” women were thought to have especially high sex drives. From 1907 to 1983, between 60,000 and 70,000 Americans, the majority of them women, were sterilized in mental hospitals, prisons, and under court orders, a movement the Supreme Court accelerated in the spring of 1927, when eight justices decided it was the state of Virginia’s right to sterilize a 21-year-old woman named Carrie Buck.

Cohen’s narrative of the legal case that enshrined these practices is a page-turner, and the story it tells is deeply, almost physically, infuriating. Carrie Buck was born in 1906 in Charlottesville, Virginia. Buck’s “white trash” mother was homeless and likely a drug addict, and Buck was raised from toddlerhood by foster parents who withdrew her from school in the sixth grade and put her to work as a servant. In 1924, when she was 17 years old, Buck became pregnant; the baby’s father was her foster mother’s nephew, and the pregnancy, Buck later said, was the result of rape.

Buck’s predicament aroused more shame and scorn than support. Her foster parents took custody of Buck’s daughter, Vivian, and successfully petitioned a local court to confine Buck at the Virginia State Colony for Epileptics and Feeble-Minded, though she was neither epileptic nor mentally disabled. When Buck arrived at the colony, her biological mother, Emma, was already living there after having been convicted of prostitution. Buck was given the Binet-Simon intelligence test, which had been originally developed in France in order to identify students who needed extra help in school. (Among other questions, the Binet-Simon required test takers to recognize the plots of fables.) Buck scored as having a “mental age” of nine years old, which classified her as a “middle-grade moron.”

Buck caught the eye of the colony’s director, Dr. Albert Priddy, a rabid eugenist. Like other doctors at mental hospitals across the country, Priddy had performed extralegal sterilizations of inmates for a decade, and he had been searching for a test case to bring to the Supreme Court, one that would give Virginia and other states the constitutional power to sterilize people against their will. Buck’s case was perfect because it offered three generations of females who could be used to prove that “imbecility” was heritable and led to sexual immorality: Emma Buck, Carrie Buck, and Carrie’s illegitimate baby daughter, Vivian.

Priddy filed a petition to sterilize Carrie Buck, and the state of Virginia approved it under a 1924 law that allowed sterilization in limited circumstances. But the plan had never been to sterilize Buck right away. Instead, Priddy’s allies appointed an attorney to represent Buck, Irving Whitehead, who appealed to prevent the sterilization. Whitehead was a Virginia good old boy, seemingly selected because of his willingness to present a weak case that would ultimately bolster the eugenic cause. That case became Buck v. Bell and it glided quickly through the lower courts. Whitehead’s arguments and briefs never presented basic evidence that showed Buck to be far from a “moron,” such as school records of Buck having been a good student. Nor did Whitehead raise questions about the questionable evidence on the record. Vivian Buck, Carrie’s daughter, was only eight months old when she was subjected to a sham examination that claimed to declare her mentally unfit and thus the inheritor of genetic imbecility via her mother and grandmother.

This was the faulty foundation upon which the Court built its ruling. The majority opinion in Buck was written by Justice Oliver Wendell Holmes Jr. and joined by Chief Justice William Howard Taft, Justice Louis Brandeis, and five other justices. Holmes wrote, “It is better for all the world, if instead of waiting to execute degenerate offspring for crime, or to let them starve for their imbecility, society can prevent those who are manifestly unfit from continuing their kind. … Three generations of imbeciles are enough.”

Cohen structures Imbeciles around the stories of four of the men who determined Carrie Buck’s fate, each representing a profession that failed to live up to its highest ideals: medicine, academia, law, and jurisprudence. Dr. Albert Priddy was obsessed with sterilizing “oversexed,” “immoral,” and “man-crazy” young women. He hired accomplished attorney and state legislator Aubrey Strode, a Jim Crow Democrat, to argue for Virginia’s right to sterilize Buck. Strode’s case relied on the research of Harry Laughlin, a starkly racist and anti-Semitic Nazi sympathizer who rose from intellectual backwaters to lead the Eugenics Record Office, an academic organization funded by the Carnegie Institution, John D. Rockefeller, and other leading philanthropists.

Cohen’s fourth male subject, Oliver Wendell Holmes, is the man for whom the author reserves the most ire. Holmes’s reputation as a liberal is almost entirely unearned, Cohen argues, since his sporadic progressive decisions in favor of civil liberties were “almost always about something else—generally deference to legislatures or larger social forces.” A Boston Brahmin, Holmes “had been raised to believe he and his peers were part of a hereditary aristocracy,” Cohen writes. “Eugenics was a movement of people who believed themselves to be inherently superior, and in Holmes it found a fitting judicial standard-bearer.” Holmes would recall Buck as “one decision that I wrote” that “gave me pleasure.”

Cohen demonstrates that many of Holmes’s contemporaries were well aware of the fundamental flaws of eugenic thinking. The Supreme Court justice socialized with the editors of this magazine, which in 1922 published Walter Lippmann’s devastating series on the false “science” of IQ testing. Prior to Buck, a federal judge had struck down Iowa’s sterilization law, calling it an example of “Dark Ages” thinking. Leading scientists of the day noted that eugenic “studies” were “uncontrolled by experiment and … based largely on uncritical data.” The Catholic Church lobbied forcefully against sterilization laws, emerging as the most effective opposition to the eugenic movement. One Catholic legislator in Louisiana, speaking against a proposed eugenic sterilization law said, “God created these poor unfortunates just the same as he did legislators.” Indeed, the Supreme Court’s one dissenting vote in Buck v. Bell came from Justice Pierce Butler, the conservative Catholic son of Irish immigrants. (Butler declined to write a dissenting opinion.)

Race was central to the sterilization movement. Poor white women like Buck, and white immigrant groups such as Jews and Poles, were initially targeted partially in an attempt to justify a white-black racial hierarchy. If “lesser” whites could be prevented from reproducing, then whiteness would supposedly retain the moral and sexual purity associated with the “Nordic” class. Eugenists understood white genetic superiority as a crucial rationale for maintaining the segregation of blacks, but once the Supreme Court accepted sterilization, it was used widely to prevent women of color, including Puerto Rican women, Native American women, and black women, from having children. Disabled and mentally ill women have also been disproportionately coerced into sterilization.

It is unfortunate that Carrie Buck remains a cipher at the center of her own story, one told through the well-documented lives of four powerful men. But considering the limited material Cohen had to work with—Buck is on the record as having uttered just one sentence at her initial sterilization hearing, and she gave only a few interviews to journalists, as an old woman—the format of Imbeciles makes sense, and Cohen deals with his subject sensitively. When Buck was 21, the state of Virginia cut her fallopian tubes. We do not know what, if anything, she understood about what was happening to her. Her biological sister, Doris Buck, was also forced to undergo the procedure, and was told she was having an appendectomy. Carrie and Doris were elderly in 1979, when psychologist Dr. K. Ray Nelson, then the director of the state mental institution where the Bucks had been sterilized, sought the sisters out to explain what had been done to them. As Nelson sat in Doris Buck’s home and told her and her husband the date she had been sterilized, the couple began to cry. They had been married for 39 years and had sought help for infertility; Doris had no idea why she was unable to conceive. Carrie, meanwhile, had married, been widowed, and then remarried to a sickly man named Charlie, whom she doted upon. She, too, expressed regret that she had never been able to raise children of her own. “They done me wrong,” she said.

Oliver Wendell Holmes thought keeping up with current events was a waste of time, but Carrie Buck “lived to get the paper,” according to a friend at the old-age home where she lived in her final years. She also enjoyed crossword puzzles, music, and theater, and participated in the home’s reading groups. “The final theme running through Carrie’s life was precisely what the Supreme Court had refused to see: a quiet intelligence,” Cohen writes.

Imbecile’s only significant weakness is its failure to situate Buck’s story within the history of reproductive and women’s rights (apart from two paragraphs noting that some prominent feminists allied themselves with eugenists in an effort to promote access to birth control). Cohen writes, “Carrie had never been an ‘immoral’ woman’—even as that term was understood in the 1920s. She had been a rape victim.” In fact, rape was widely understood then—and in some quarters, today, too—as a crime to which a good man could be tempted by a loose woman. Given the class difference between Buck and the man she accused, she almost certainly would have been disbelieved or, at the very least, held partially responsible for her own rape.

What’s more, in the 1920s, a woman had no right to sexual autonomy, either inside or outside of marriage, and no right to abortion or birth control. The sterilization movement was a direct product of women’s disempowerment, and eugenic thinking was, at its very core, misogynist. It entrusted male experts with the bodily decisions that rightfully belonged to women. Cohen should have plumbed these ideological connections more deeply, especially given the fact that Buck was cited in Roe v. Wade as setting the precedent that women’s bodily rights are never “unlimited.” That concept has, in turn, been used by today’s anti-abortion rights movement to bring cases that have successfully limited when and where women can access abortion.

Cohen never mentions abortion, but legal history shows that the right not to mother is inextricably linked to the right to carry a pregnancy to term. Both are essential human rights still partially denied by the law. As reproductive and genetic technology becomes more sophisticated and ethically complex, Imbeciles could hardly be a more urgent book, preferably read alongside Linda Gordon’s classic history of birth-control politics, The Moral Property of Women.

Cohen reminds us of the simple, shocking fact that while forced sterilizations are rare today, they remain legal because American courts have never overturned Buck v. Bell. As recently as 2001, in a case brought by a mildly intellectually disabled woman who said Clinton County, Missouri, coerced her into having her tubes tied, the Eighth Circuit Court of Appeals cited Buck, writing, “involuntary sterilization is not always unconstitutional.” It should be.