Sterilization is a medical procedure that prevents pregnancy. Today it is the most popular form of permanent birth control worldwide for both men and women, but it has a complicated history due to its association with eugenics. In North America, Indiana enacted the first eugenic sterilization law in 1907; the only Canadian provinces to enact comparable legislation were Alberta (in 1928) and British Columbia (in 1933). Over the next thirty years, a wave of legislation in the United States and Canada enabled physicians to sterilize tens of thousands of people (with or without their consent) in the name of eugenics. The most common procedures were vasectomies (cutting of the vas deferens) for men and salpingectomies (removal of the fallopian tubes) for women.

Sterilization as a eugenic strategy
During the Progressive era, eugenicists and other moral reformers initially advocated the incarceration of so-called feebleminded women. If this small minority of the female population were segregated from society during their childbearing years, they theorized, then society would be protected from the potential burden of “defective” offspring. However, this soon led to overcrowding in state institutions, which, in turn, resulted in long waiting lists. Advocating for and implementing state sterilization laws promised to ease this overcrowding, as these patients could then be released from the institution without fear that they would reproduce.

Not all eugenicists were initially convinced that sterilization should replace segregation as a eugenic strategy. Believing that promiscuity and venereal disease were equally pressing issues to be controlled along with the procreation of the “unfit,” some opposed the use of an operation that might even increase promiscuity and infection. Without the fear of pregnancy, they argued, what was to stop women from increasing their illicit sexual activity?

By emphasizing practicality and preventive medicine, and through perseverance, sterilization advocates convinced their more conservative opposition within the movement, as well as much of the public, that sterilization was an effective strategy for advancing the race. Sterilization was more cost-effective, reached a wider clientele, and did not increase promiscuity, they argued, but actually reduced it.

The California example
California provides a useful example of how sterilization was implemented as a eugenic strategy. While the state enacted the first of a series of eugenic sterilization laws as early as 1909, sterilization was not practiced regularly until 1918, when eugenicists began to see it as the most effective way of combating race degeneracy. Changes in the sterilization law reflect the growing concern over mental deficiency as a threat to scientific and social progress, as well as the introduction of “normality” as a central and standard principle for measuring this progress. The original act provided for sterilizing inmates of state hospitals and Sonoma, as well as convicts in state prisons, when “such procedure is for the physical, moral, or mental welfare of the inmate.” Criticized by the Board of Charities and Corrections as “not broad enough in scope” and without “adequate legal protection,” the statute was repealed and replaced with a more effective law in 1913. General Superintendent Hatch announced that under the new law, “any inmate of the Sonoma State Home may, upon order of the Lunacy Commission, be asexualized [sterilized] whether with or without the consent of the patient.”

Finally, the law was widened even further in 1917 beyond those “afflicted with hereditary insanity or incurable chronic mania or dementia to all those suffering from perversion or marked departures from normal mentality or from disease of a syphilitic nature.” As intelligence became the modern natural resource for advancing civilization, “abnormal” mentality, or mental deficiency, suggested backwardness and primitivism.

Sterilization became law in California largely due to the efforts of one eugenicist, Dr. F. W. Hatch. As secretary of the State Commission in Lunacy in the 1900s, he drafted a version of the 1909 bill. After it passed, he was promoted to General Superintendent of California State Hospitals, where he oversaw implementation of the law. As superintendent, Hatch lost no time in promoting the procedure, ensuring that only sterilization advocates were hired as hospital officials and physicians. He oversaw the operations of seven state hospitals: six mental hospitals for the insane and the Sonoma State Home for the Feebleminded. Prior to 1918, only twelve patients were sterilized at Sonoma. From 1902 to 1918, Sonoma’s medical superintendent, Dr. William Dawson, refused to make use of the law. He opposed the measure not on humanitarian principles, but, like many eugenicists and physicians in the 1910s, because he feared the outcome; while he acknowledged that sterilization would “prevent procreation,” he also believed it had “a tendency to increase prostitution.” Dawson could not condone pre- or extra-marital sexual activity by removing the risk of pregnancy, which to him and others served as the last barrier between female sexual morality and sexual decay. Instead, he supported the original strategy of segregation, requesting more “appropriations for buildings to house the feebleminded so that the large number of applications [could be] admitted.”

When Dawson passed away in 1918, his former assistant, Dr. Fred Butler, took over the position, and remained at Sonoma for another twenty-six years. Butler envisioned an entirely different role for the institution and, once in power, he transformed the Home accordingly. Whereas Dawson’s strategy of segregation required expanding the facilities of the Home, Butler advocated not increased segregation but the widespread use of sterilization. He presented his strategy as not only more progressive, but also both financially and eugenically more effective, for a much larger clientele could be reached once the average commitment was a matter of months rather than years. Over the next twenty-six years, he performed 1,000 sterilizations himself and supervised a total of 5,400.

Apologies and compensation
Several governors of American states have recently issued formal apologies on behalf of the state for the forced sterilizations of constituents. Others have been awarded damages. In Canada, Leilani Muir became the first person to successfully sue the Alberta government for wrongful sterilization under the Sexual Sterilization Act of Alberta (repealed only in 1972). She won her case in 1995, and since then, more than 700 other Albertans have been awarded compensatory damages.

-Wendy Kline

• California State Commission in Lunacy, Biennial Reports (1914, 1916)

• California State Department of Institutions, Biennial Report (1926)

• Dyck, Erika, Facing Eugenics: Reproduction, Sterilization, and the Politics of Choice (Toronto: University of Toronto Press, 2013). http://www.acog.org/~/media/For%20Patients/faq011.pdf

• Kline, Wendy, Building a Better Race: Gender, Sexuality, and Eugenics from the Turn of the Century to the Baby Boom (Berkeley: University of California Press, 2001).

• Largent, Mark, Breeding Contempt: The History of Coerced Sterilization in the United States (Rutgers: Rutgers University Press, 2011).

• Stern, Alexandra Minna, Eugenic Nation: Faults and Frontiers of Better Breeding in Modern America (Berkeley: University of California Press, 2005).