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The 1960s ushered in a revolution in American contraceptive practice. The introduction of the birth control pill (the Pill) in 1960 and the redesign and return of the intrauterine device (IUD) in 1964 offered women contraception that was nearly 100 percent effective. No longer forced to rely upon messy diaphragms, jellies, and condoms with high failure rates, the IUD and the Pill offered women reliable birth control that did not interfere with the sex act. Contraceptive sterilization—tubal ligation and vasectomy—offered the same benefits, and between 1965 and 1975 this surgery gained public and medical acceptance as a legitimate and cost-effective method of birth control. By 1975, 7.9 million Americans had undergone sterilization, and sterilization had become the most popular method of contraception used by married couples.1 Before it became a popular method of birth control, sterilization was a tool of eugenics, the science of racial betterment that developed in America around the turn of the twentieth century. Most early eugenicists endorsed a rather crude notion of biological determinism that deemed mental, physical, and behavioral “defects” to be genetic and unalterable. Eugenicists believed poverty, criminality, illegitimacy, epilepsy, feeblemindedness, and alcoholism (among others) were inherited traits that could not be altered. Concerned about the quality of American citizens during a period of mass eastern and southern European immigration, industrialization, and urbanization, eugenicists sought to control the quality and quantity of the American population in order to prevent the country from being overrun by the “unfit.” By emphasizing the “natural” aptitude of white, native-born Americans, eugenicists sought to preserve this group’s social, economic, and political power. Biological determinism naturalized Introduction 1 racial and ethnic differences and secured middle- and upper-class white men’s position at the top of the social hierarchy. Eugenicists encouraged the reproduction of “fit” citizens, defined as those who were native-born, white, and middle class and who shared family histories free from “defects.” They discouraged the reproduction of “unfit” citizens—those with histories filled with “destructive” traits, who were not white (eastern and southern European immigrants were considered not white), and whose reproduction eugenicists defined as costly and harmful. To prevent the reproduction of the “unfit,” eugenicists first segregated them from the rest of the population. Eugenicists later came to favor the more cost-effective “solution” of sterilization (via tubal ligation and vasectomy). Unable to reproduce, the logic went, the negative impact of “unfit” individuals could be tempered over time. Eugenicists were especially concerned about the costs associated with caring for people who were poor, people with disabilities, criminals, and women who bore children out of wedlock. Biological determinism ensured that these groups would inevitably bear children afflicted with the same defects, and the state would be forced to fund their care. Sterilization prevented the “unfit” from reproducing and eliminated the financial burdens that future generations of “unfit” Americans would undoubtedly generate for the government and taxpayers. Responding to such concerns, states began to enact involuntary sterilization laws, and in 1927 the Supreme Court validated states’ right to sterilize their “unfit” citizens. By 1941, 38,087 Americans had been sterilized under eugenic statutes.2 Rates of eugenic sterilization fell during World War II, and the formal eugenics movement concluded by the end of the baby boom, but eugenicists’ preoccupation with reproductive “fitness”—a term used to describe the relative worth of a person’s genetic and cultural abilities—continued on in American culture, society, medicine, and law.3 Reproductive fitness evaluates the quality of a given individual and assigns a value to her or his reproduction. Eugenicists used race, class, ethnicity, intelligence, physical well-being, mental health, and sexual behavior as indicators of reproductive fitness. In the first half of the twentieth century, a white native-born middle-class woman with no family history of crime, illegitimacy, alcoholism, or other “defects” would be deemed “fit” to reproduce, and encouraged to do so in defense of the white race. A poor eastern European immigrant woman, in contrast, would be deemed “unfit” on the grounds of her ethnicity and poverty. If she bore a child out of wedlock or transgressed other sexual boundaries, her reproductive fitness would decline even further. Eugenicists considered “fit” women’s reproduction to be productive , healthy, and beneficial to the nation. They viewed “unfit” women’s reproduction as destructive, unhealthy, and debilitating because the children “unfit” 2 Fit to Be Tied [3.144.212...

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