The Dark History of Forced Sterilization

The Idea That Started It All

Francis Galton coined the term "eugenics" in 1883, derived from the Greek for "good birth." He was Charles Darwin's cousin, and he believed that the same selective breeding principles that applied to animals could and should be applied to humans. His proposal was that society should encourage reproduction among the "fit" and discourage or prevent it among the "unfit."

The idea spread quickly through academic and political circles on both sides of the Atlantic. It arrived at the turn of the twentieth century carrying the authority of science, or what passed for science in an era when genetics was poorly understood and racial categories were treated as biological facts. It offered a simple explanation for complex social problems: poverty, crime, and mental illness were heritable conditions that could be bred out of the population.

Within three decades, this idea had been translated into law in dozens of countries. The result was one of the most sustained campaigns of state-sanctioned violence against vulnerable populations in modern history.

The United States: Eugenics Before the Nazis

The United States was not a passive observer of eugenics. It was a pioneer. By 1931, thirty American states had enacted compulsory sterilization laws targeting people classified as mentally ill, intellectually disabled, epileptic, deaf, blind, or "habitually criminal."

Indiana passed the first such law in 1907. California's program, established in 1909, became the most active in the country. By 1964, California had forcibly sterilized more than 20,000 people, roughly a third of the national total. The operations were performed primarily in state hospitals and prisons, on patients and inmates who often did not know what was being done to them or why.

The Supreme Court validated these programs in Buck v. Bell (1927). Carrie Buck was an 18-year-old woman from Virginia who had been placed in a state colony for the "epileptic and feebleminded." Her mother was in the same institution. Carrie herself had been the victim of rape by her foster family's nephew, which produced a daughter. The state used this daughter, Vivian, as evidence that feeblemindedness was hereditary in the Buck family.

Justice Oliver Wendell Holmes, writing for an 8-1 majority, upheld Virginia's sterilization law with words that have since become infamous: "Three generations of imbeciles are enough." Carrie Buck was sterilized. Her daughter Vivian, who was later reported by her schoolteacher to be "bright," died at eight years old from a childhood illness. Buck v. Bell has never been formally overturned.

Who Was Actually Targeted

The categories written into eugenics laws, "feeble-minded," "defective," "unfit," were defined and applied in ways that reflected existing racial and class hierarchies rather than any consistent scientific standard.

In practice, the sterilization programs fell hardest on poor white women, Black Americans, Native Americans, immigrant communities, and anyone whose behavior or social position made them legible as "undesirable" to local administrators. Women who had children out of wedlock, men who had been arrested for minor offenses, people who spoke limited English, and individuals who simply struggled to perform well on intelligence tests designed in English for English-speaking middle-class test-takers were all vulnerable.

Native American women were sterilized at particularly high rates by the Indian Health Service in the 1960s and 1970s, decades after the Nazi programs had been condemned at Nuremberg. A 1974 General Accounting Office investigation found that the IHS had sterilized more than 3,400 Native women in just four years, with some women coerced into signing consent forms while in labor or under anesthesia. Estimates of total numbers run as high as 25 to 50 percent of Native American women of childbearing age.

Nazi Germany: Eugenics as State Policy

Germany's Nazi eugenics program is the most thoroughly documented and the most extreme. The Law for the Prevention of Hereditarily Diseased Offspring, enacted in July 1933, six months after Hitler came to power, established hereditary health courts empowered to order sterilization for anyone diagnosed with one of nine conditions, including schizophrenia, manic-depressive disorder, hereditary epilepsy, hereditary deafness, severe alcoholism, and "feeblemindedness."

Between 1933 and 1945, approximately 400,000 people were forcibly sterilized under this law. Many died from the procedures or their complications. The law was explicitly modeled on American eugenics legislation. Nazi legal scholar Ernst Rudin wrote approvingly of the American programs. Hitler himself praised American eugenics in "Mein Kampf."

The sterilization program was the precursor to the T4 program, which between 1939 and 1941 murdered approximately 70,000 people with disabilities through centralized killing centers using carbon monoxide gas. The T4 program was the direct technical and organizational prototype for the Holocaust: the same personnel, the same facilities, the same methods were scaled up and redirected toward Jewish, Roma, and other targeted populations.

Eugenics in Sweden, Canada, and Beyond

The scope of forced sterilization programs extended far beyond Germany and the United States. Sweden, widely regarded as a model social democracy, sterilized approximately 63,000 people between 1934 and 1976. The Swedish program targeted Romani people and ethnic minorities at disproportionate rates but also affected poor Swedish women deemed unfit for motherhood.

Canada's western provinces, particularly Alberta, maintained active sterilization programs into the 1970s. The Sexual Sterilization Act of Alberta was not repealed until 1972, and legal actions by survivors continued for decades afterward. One survivor, Leilani Muir, sterilized at age 14 after being institutionalized at the Provincial Training School, won a landmark case against the Alberta government in 1996.

Japan's Eugenics Protection Law, passed in 1948, allowed for forced sterilization of people with genetic diseases, mental illness, and leprosy. The law remained in effect until 1996. In 2019, the Japanese government enacted legislation providing compensation of 3.2 million yen to survivors, acknowledging that at least 16,500 people had been sterilized without consent.

The Continuing Legacy

Forced sterilization did not end in the twentieth century. In 2020, a whistleblower complaint filed by a nurse at an Immigration and Customs Enforcement detention facility in Georgia alleged that a physician performing gynecological procedures on immigrant detainees had removed women's fallopian tubes without obtaining proper informed consent. An investigation confirmed multiple procedural failures. The case drew direct comparisons to the sterilization programs of the eugenics era.

Prison sterilization programs came to light in California as recently as 2013, when investigative reporting revealed that between 2006 and 2010, almost 150 women in California prisons had been sterilized, often without proper consent procedures and sometimes while women were on the operating table for unrelated procedures.

The history of forced sterilization is a history of what happens when states are given authority over bodies that are deemed socially undesirable. The populations targeted have always been the poor, the marginalized, the racially othered, and those whose behavior or condition placed them outside the circle of full citizenship. The scientific justification has always been a veneer over decisions that were fundamentally about power and belonging.

Understanding this history is not comfortable. It is necessary.