Sterilizing the Sick, Poor to Cut Welfare Costs: North Carolina's History of Eugenics

PHOTO: Elaine Riddick
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Poor, a victim of child molestation and pregnant from rape, young Elaine Riddick went into a North Carolina hospital in 1968 to give birth to her son. Though she wouldn't know it until years later, she would leave the hospital robbed of the ability to ever bear children again.

On top of the poverty, abuse, and neglect that marked her childhood, Riddick had the misfortune of becoming the target of the North Carolina eugenics board, a 5-person state committee responsible for ordering the sterilization of thousands of individuals in the name of social welfare during the last century.

Deemed "promiscuous" and "feebleminded" by a social worker at the hospital, Riddick, who came from a black family on welfare, was recommended to the state for sterilization shortly after arriving. Riddick's illiterate grandmother, told that they were doing a "procedure" that was necessary to help the young girl, signed the sterilization papers with an "X". The state authorized and paid for the procedure, and without her consent or even her knowledge, Riddick was sterilized shortly after giving birth. She was 14-year-old.

"They didn't have permission from me because I was too young and my grandmother didn't understand what was going on," Riddick, now 57, tells ABC News. "They said I was feebleminded, they said I would never be able to do anything for myself. I was a little bitty kid and they cut me open like a hog."

"I was raped twice," she says, "once by the perpetrator and once by the state of North Carolina."

Riddick is one of over 7,600 women, men, and children who were sterilized by choice, coercion, or most often, without consent during the North Carolina sterilization program's 45-year reign. At some point in the century, more than half of the states in the U.S. had similar programs that allowed for the sterilization of those the government deemed unfit to procreate.

When most programs began in the early 1930s, this usually meant those in institutions for mental illness or mental retardation, but over the decades criminals, the blind, the deaf, the disabled, alcoholics, those with epilepsy, and ultimately the rural poor on welfare would fall under the umbrella of "unfit to procreate."

In all, 65,000 Americans were sterilized before the last program was shut down in the early 1980s.

Though detailed, often meticulous records of these sterilizations survive in state archives, America's flirtation with selective sterilization has for the most part been a buried chapter in our nation's history.

"Eugenics in the U.S. is something that's still not nationally known. People associate it with Nazis; they don't realize that the U.S. did it too," says Rebecca Kluchin, an assistant professor of History at California State University, Sacramento who specializes in the U.S. eugenics programs.

Only seven of the 33 states who ran such programs have even publicly acknowledged or apologized to victims of sterilization. Only North Carolina, home to the third most prolific and arguably the most racist sterilization program in the nation, has recently made moves to compensate its victims.

In 2010, Gov. Bev Berdue established the N.C. Justice for Sterilization Victims Foundation, whose mission is to determine proper compensation for those still suffering from the state's mistakes. Fewer than 2,000 sterilization victims are estimated to still be alive today.

A sum of $20,000 to $50,000 compensation per living victim was floated in preliminary recommendations issued by the foundation's task force Monday.

Shaping the U.S. Gene Pool Through Sterilization

From today's vantage point, government-mandated sterilization feels more like science fiction than history, but during the 1930s and 1940s, the concept of eugenics was widely discussed and supported among many medical professionals and politicians. The concept was simple: don't let those with "bad genes" have kids, and over time the American gene pool will become healthier, stronger, better.

In a landmark 1927 Supreme Court case that legitimized compulsory sterilization of the "unfit", Justice Oliver Wendell Holmes, Jr 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."

Long-time proponent of eugenics, Dr. Clarence Gamble, of Proctor & Gamble fame, wrote in a 1947 article, "Tomorrow's population should be produced by today's best human material." He bemoans that only one in 41 people with severe mental illness have been sterilized to date, writing, "this means that for every one man or woman who has been sterilized, there are 40 others who can continue to pour defective genes in to the state's blood stream to pollute and degrade future generations."  

Though eugenics advocates at the time may have believed they were actually working towards a stronger gene pool, scientists' limited understanding of genes at that time meant that eugenics as public policy merely opened the doors to rampant discrimination against virtually anyone with an "undesirable" trait: alcoholics, those who were depressed, "promiscuous" women pregnant out of wedlock, and ultimately, poor men and women on welfare, who were often shuffled through the system under the vague and clinically meaningless diagnosis of "feeblemindedness."

This flexibility meant that some states kept their programs alive long after eugenics fell out of favor following World War II (a result of the glaring similarities noted between the Nazi sterilization programs and those in the U.S.). Especially in the south, sterilization programs merely shifted their focus on which populations were to be "controlled".

"Starting in the 1950s, I think a lot of sterilization was about racism," says Kluchin. "After WWII, welfare expands, the rate of illegitimacy expands and this anxiety grows among middle-class white people that a culture of poverty is being propagated in these rural, poor, black areas."

North Carolina sterilization program was at its peak during the civil unrest and exploding welfare costs of the 1960s, says Johanna Schoen, an associate professor of history at University of Iowa and expert in the North Carolina sterilization program.

It was the only state where social workers had the right to suggest "clients" for sterilization and the eugenics board seldom turned down those recommended -- they had a 95 percent acceptance rate. What's more, the program created a climate where doctors felt entitled to take sterilization into their own hands, doling them out when they saw fit, she says.

Instead of sterilizations taking place in mental institutions, in a few southern states they became more common in rural hospitals where poor unmarried women would be sterilized without their knowledge after coming in to give birth. In North Carolina, 85 percent of sterilization were performed on women as young as 9-years-old.

"Mississippi appendectomies, they were called," Kluchin says, "because they would tell women that they needed to get their appendix out, but then sterilize them." For women, the procedure involved an incision to the abdomen and the tying off of the fallopian tubes. If done correctly, this doesn't affect hormones or libido, making it possible for women to live their entire lives unaware that they had been sterilized.

Sterilization was seen as a way to cut welfare costs, "by sterilizing the daughters on welfare," says Schoen.

Though it's unlikely that the U.S. would ever return to this approach, the attitudes driving the sterilization of those on welfare isn't so foreign to us today, says Schoen: "Many people today think that women on welfare shouldn't have children outside of marriage." It's only a short jump to "shouldn't be allowed to have children," she says.

Is Healing Possible?

On June 30 of this year, 37 years after the North Carolina eugenics board was disbanded, victims and their loved ones gather in a conference room in Raleigh, N.C. to share their stores. The N.C. Justice for Sterilization Victims Foundation Task Force will hear their stories, en masse, for two and half hours, in hopes of determining what can be done today to help heal the wounds of the past.

One after another, stories of deception, coercion and mistreatment unravel from those speaking at the podium. Some were sterilized without their knowledge, others against their will, still others were told the procedure was reversible or that they would not continue to receive welfare assistance unless they cooperated.

Deborah Chesson delivers a letter on behalf of her mother, Nial Ramirez, who was sterilized after having her at age 17: "I was told if I had more children that my family would no longer be receiving public assistance." A social worker convinced Ramirez' mother to sign, not realizing she was setting her daughter up to be "sterilized like some unwanted animal." After the procedure, Ramirez writes, "My spirit died. I no longer felt complete as a human."

Karen Beck, 52, speaks on behalf of her grandmother and great aunt, Dottie and Flossie Bates, both of whom were sterilized in the 1930s. Beck's grandmother, Flossie, had been a victim of rape at age 16 and had become pregnant with Beck's mother. After giving birth, she was told she needed an appendectomy, but was instead sterilized without her knowledge or consent. Doctors told her afterward that she was "too small to have children." It wasn't until decades later that the family discovered the truth -- that the state had arranged to have her sterilized.

"Why her?" Beck relayed to ABC News after the Task Force meeting. "Her files reads, 'Flossie's morals are questionable,'" Beck says. The ever-present diagnosis of "feebleminded" was also in there, as was a notation that the Bates' were on welfare.

That particular narrative plays out again and again in the Eugenics Board records -- young women on welfare, the victims of rape, would be "diagnosed" as promiscuous and feebleminded when they came in to give birth and would be sterilized before being sent home with the baby.

Elaine Riddick, who knows this story too well, also shares her story with the Task Force. Following her sterilization she suffered years of undiagnosed gynecological problems -- excessive bleeding, pain, fainting from loss of blood. It wasn't until she was 19 and married that a doctor finally examined her and told her she had been "butchered" during the sterilization she didn't even know she had had. Four surgeries to attempt to fix the damage were unsuccessful and she eventually needed a full hysterectomy.

Riddick has been the strongest victim voice over the years -- she sued the state of North Carolina in 1979, but lost. She has been speaking out, with the help of the American Civil Liberties Union, against the North Carolina sterilization program for decades.

Listening to Riddick tell her story -- a story she has told again and again over the years as she continues her "mission from God" to see justice done for the victims of sterilization -- you can hear in her voice that what haunts her today goes beyond what was done to her physical body.

It's a similar chord that strikes in all the victims stories -- it's not just the act of the sterilization, it is the implications of it: that the state decided their progeny were unwanted, that, in effect, they were unwanted.

As if still trying to clear her name, Riddick, who has since put herself through college, repeats, sobbing: "They made a mistake. I'm not feeble-minded. I was never feeble-minded."

"They slandered me, they ridiculed and harassed me," Riddick tells the Task Force. "They cut me open. What do you think I'm worth? The kids I did not have, could not have, what are they worth? What is my son worth?"

The victims of sterilization "were treated like rats in a lab," Chesson adds. "These days, even the rats have someone to speak for them. What has been said for the victims of sterilization? They mean nothing."

The N.C.Sterilization Victims Foundation can be reached by their toll-free hotline, 1-877-550-6013, or on their website: www.sterilizationvictims.nc.gov.

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