Breeding Contempt: The History of Coerced Sterilization in the United States (review)

In the mid-nineteenth century, before Charles Darwin published On the Origin of Species and his cousin Francis Galton coined the word "eugenics," many American doctors had already begun to hail the scalpel as an important new tool in the quest for social good. Most believed they should be permitted to perform surgical castration on certain criminals and sexual "deviants," to both punish and prevent them from committing future crimes. Some also claimed the procedure could provide a therapeutic benefit for state wards suffering from various physical and emotional afflictions. And even then, there were many physicians who believed sexual surgeries could begin to engineer the hereditary traits of American citizens.

There have been a number of books in the last few decades that explore parts of this history, but most of them tie the emerging practice to the eugenics movement in the early twentieth century. In Breeding Contempt: The History of Coerced Sterilization in the United States, Mark A. Largent attempts to give a more precise social history of sexual sterilization in all its surgical forms, disentangling it from the tendency to demonize eugenics and trace sterilization's connection to the Holocaust. Instead of viewing advocates of compulsory sterilization as proto-Nazis or the movement as a bizarre aberration in American history, it is vital, Largent argues, to appreciate how we share many of the same assumptions and social pressures that once bred such contempt for those deemed "socially inadequate."

Tracing the various types of and justifications for coerced sterilization, Largent divides his history into three "fundamentally different eras," beginning with American physicians and their drive to "asexualize" criminals and deviants in the 1800s. After the turn of the century, when biologists joined the fray and bolstered these doctors' arguments with the authority of research science, legislators throughout the country sanctioned laws to forcibly sterilize so-called social inadequates. It's a tale that's been told quite a bit, but Largent wisely focuses on the emergence of organized resistance to coerced sterilization after Buck v. Bell (1927)1 and the decline of legislative and scientific support after the Second World War.

But coerced sterilization did not go away, and Largent documents how physicians continued to sterilize patients well into the 1970s and beyond. And in this third era—which includes the present day—doctors and state legislators are again arguing that sexual surgeries—including chemical castration—should be performed on rapists, child molesters, abusers, and "welfare queens." Such laws, focusing on punishing and preventing crime, rather than on improving the genetic stock of large populations, have again been offered in Washington, California, Texas, and other states in the last twenty years. Judges, too, have often given convicted criminals the option of surgical sterilization in exchange for reduced sentences.

Largent gives the fullest account to date of the tens of thousands of sterilizations performed in the United States, and in disentangling this history from the maligned eugenics movement, he reveals the varying motivations behind the practice over the last 150 years. We must "confront our connection" with the "problematic assumptions about other people's supposed social inadequacies," (p. 146) he writes, if we are to safeguard ourselves from the injustices of the past. Indeed, it is all too easy to dismiss the history of eugenics as well as coerced sterilization as part of a racist pseudo-science or Nazi-like experiment in social engineering. If these are to be useful histories as we grapple with the same disturbing social problems—or similar promises of genetic enhancement—it is crucial to understand how "good intentions and professional authority can lead to horrible results," even today.