soci 138
Chapter Title: “I Like to Keep My Body Whole”: Reconsidering Eugenic Sterilization in California Book Title: Eugenic Nation
Book Subtitle: Faults and Frontiers of Better Breeding in Modern America
Book Author(s): Alexandra Minna Stern
Published by: University of California Press
Stable URL: https://www.jstor.org/stable/10.1525/j.ctt19631sw.10
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111
In 1924 Hector Rivas was admitted to the Stockton State Hospital, an institution for the mentally ill, because of his “strange and unusual behavior.” Rivas had been piling up rocks “on the railroad tracks” and carrying them around in his pockets. More troubling, he muttered to himself and “says he is Jesus Christ.”1 A native of Mexico, Rivas was forty-six years old and lived in a rural county near Lake Tahoe. Like many patients at Stockton, he was diagnosed with manic-depressive insanity, in his case depressed phase.2 Adhering to the language in Cali- fornia’s revised 1917 sterilization law, Stockton’s medical superintend- ent recommended that Rivas be “operated on for the purpose of sterili- zation as he would likely transmit to descendants.”3 Per the policy in place at the time, the superintendent, the director of institutions, and the secretary of the state board of health approved Rivas’s sterilization, which almost surely was performed.
Twelve years later, Martina Suárez was committed to the Sonoma State Home, a facility designated for patients classifi ed as feeble- minded. Suárez was sixteen and had completed a seventh-grade educa- tion. Fred O. Butler, the long-serving medical superintendent, recom- mended sterilization based on her IQ of 60, which placed Suárez in the middle moron category. However, her parents objected to the opera- tion. To overcome this obstacle Butler wrote to the director of institu- tions to explain why such action was warranted: the parents were “low grade Mexicans” living in a common-law union, each with children
chapter 4
“I Like to Keep My Body Whole” Reconsidering Eugenic Sterilization in California
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112 | “I Like to Keep My Body Whole”
from previous relationships, and dependent on the Catholic Welfare Bureau. Butler requested pro forma permission to operate “above the parent’s consent,” on the grounds that Suárez was “suff ering from a mental disease which is likely to be transmitted to posterity.” She was sterilized eight days later on November 12, 1936.4
In 1947, Thomas Rogers, a Protestant clergyman, arrived to Patton State Hospital, one of the larger institutions for the mentally ill. Origi- nally from Ohio, Rogers was more educated than many patients, with four years of college. Apparently his wife, with whom he had two small children (ages two and three), had committed him to Patton because of dementia praecox, catatonic type. One month after arriving to Patton, the box was checked indicating that Rogers should be sterilized because of a “mental disease which may have been inherited and is likely to be transmitted to descendants.”5 His wife consented to the operation, but Rogers did not. Despite his presumed catatonic state, Rogers possessed enough composure and energy to send a handwritten objection to the Department of Institutions, now called the Department of Mental Hygiene. All indications are that his plea succeeded. Rogers’s name does not appear on the lists of surgical sterilizations at Patton in that or any subsequent year.
At the outset of the next decade, in 1950, Vernon Jones, a fourteen- year-old African American boy, was placed in Pacifi c Colony. Origi- nally from Texas, Jones had completed fi fth grade. His family history was tragic; his father had been killed and his mother ostensibly had psychological problems including three nervous breakdowns and at least two marital separations. Jones came from a large, blended family, with six half-siblings. Evidently he had been abused, receiving “injuries to head during childhood” that seemed to partially explain his classifi - cation as a moron with an IQ of 58. Jones had many run-ins with the law and was dubbed a “mentally defi cient, incorrigible runaway little Negro boy charged with petty thefts.”6 His mother off ered consent for the operation, and it is likely that Jones was sterilized within the year.7
These four snapshots from California homes and hospitals across the decades from the 1920s to the 1950s illustrate variations in sterilization experiences based on gender, age, ethnicity, diagnosis, institution, and family situation. These diff erences were related to manifold and inter- locking legal, social, and medical factors. California carried out twenty thousand sterilizations during this extended period, and over the years the wording and application of the law changed, administrative proce- dures were revised and updated, and state institutions shifted in tandem
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“I Like to Keep My Body Whole” | 113
with the approaches of the superintendent in charge. Analysis of sterili- zation patterns in state homes and hospitals from the 1920s to the 1950s reveals racial, gender, and disability discrimination, evolving mental health and medical practices, and the complex dynamics of decentral- ized public institutions characterized by insularity and their own idio- syncrasies.
Since the unearthing in 2007 of nineteen microfi lm reels stored in a fi le cabinet in the offi ces of what is now the Department of State Hospi- tals, scholars have access to an extraordinarily valuable resource that can illuminate the macro and micro dimensions of eugenic sterilization in California. Sometime in the 1950s, one of the statisticians in the Department of Mental Hygiene decided to use the increasingly popular technology of microfi lm to preserve about eighteen thousand steriliza- tion recommendations that had been sent from institutional superin- tendents to headquarters in Sacramento. In addition to the recommen- dations, he microfi lmed thousands of accompanying interdepartmental letters, lists of performed operations, consent forms, discharge sheets, and correspondence, all told comprising about thirty thousand indi- vidual documents. In 2012, my team of researchers at the University of Michigan digitized the content of these reels and embarked on the proc- ess of creating a data set, using REDCap, a HIPAA (Health Insurance Portability and Accountability Act)-compliant data capture system designed for quantitative and qualitative analysis. We identifi ed 212 unique variables, such as age, gender, diagnosis, and parental status, that could be coded. In addition to nationality and race (when noted), we used Spanish surname to identify the ethnicity of Latin American– origin patients, most of whom were of Mexican ancestry. As of the writing of this chapter in June 2015 we have entered seventeen thou- sand of the eighteen thousand records and have completed statistical analysis of a subset of eight thousand records that span the decade from 1935 to 1944.
Reconsidering California eugenics with this novel resource helps account for the Golden State’s leading role in sterilizations nationwide and underscores several defi ning dimensions of the state’s program. First, sterilizations occurred during an era and in institutions strongly infl uenced by medical paternalism. Health experts, from the personnel on site to agency directors in Sacramento, wielded inordinate power over the reproductive lives of patients. For example, the law explicitly stated that superintendents, in consultation with the director of the Department of Institutions, could “cause a person to be sterilized” even
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114 | “I Like to Keep My Body Whole”
if approval was not forthcoming from the patient, family member, or guardian.8 Compared with sterilization programs in other states, such as Indiana or Oregon, there was little room for appeal or resistance. Nev- ertheless, patients and their families opened wedges in the system, and by the late 1940s the supremacy of superintendents was faltering. Sec- ond, when we take the analysis to the granular level and examine the interpersonal and interactional dynamics of thousands of cases of steri- lization, the rationales for the procedure grow more heterogeneous. Over the course of four decades, as medical techniques advanced, and as successive superintendents directed the state’s nine diff erent institutions, the implicit and explicit reasons for sterilization shifted and included, sometimes simultaneously, hereditarian, therapeutic, punitive, eco- nomic, and pragmatic rationales. Some superintendents believed that the principal motivation of sterilization was to improve a patient’s psy- chiatric condition; others recommended reproductive surgery because of a concern about the fi nancial burden of any future children of patients deemed feebleminded; and others unreservedly advocated the operation as a preventive measure to ensure that the “unfi t” would not beget more of their kind. Sterilization also served as a method of punishment, meted out by superintendents to children and wards of the state deemed incor- rigible, unruly, and incapable of recovery or rehabilitation. Third, pre- liminary statistical analysis reveals elevated rates of the sterilization of Spanish-surnamed patients, most of Mexican origin. Given the anti- Mexican dimension that was pervasive in eugenic organizations and rhetoric in California, this is not surprising. Yet seeing the disarticula- tion of families and the denigration of Mexican reproductive bodies through the lens of institutional sterilization accentuates how scientifi c racism was put into medical practice. The profound implications of ster- ilization as an act of bodily desecration that infringed on legal rights, familial integrity, and religious beliefs was not lost on Mexican-origin patients and their parents, who waged the most vocal resistance to Cali- fornia’s sterilization regime.
Some scholars split hairs about whether sterilizations performed in institutions in California can be defi ned as eugenic. The answer to this question is an unequivocal yes. Sterilizations in California’s homes and hospitals were made possible in legal and administrative terms by state laws, which from 1909 until full-fl edged repeal in 1979 were fi rmly rooted in eugenic theories of hereditary improvement. Moreover, as this book and a growing body of scholarship suggests, eugenics encom- passed more than strict hereditary control, extending into strategies of
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“I Like to Keep My Body Whole” | 115
reproductive regulation such as institutional segregation (as in Illinois or New York, which had no sterilization statutes), patriarchal contain- ment of women who transgressed gender and sexual norms, and reme- dial vasectomies on men classed as homosexual who posed little threat of unrestrained procreation.9 Furthermore, patients and families that accepted sterilization as a therapeutic procedure or as a condition for release did so under the parameters of eugenic policies. The minority of patients who perhaps sought out sterilizations because they desired per- manent birth control during a period when contraception was illegal might have been exercising a constrained form of reproductive auton- omy. This does not make these sterilizations any less eugenic; it does, however, complicate our understanding of the slippery intersections between the desire for reproductive freedom and the imposition of reproductive control—or choice and coercion, in one scholar’s poignant phrasing.10
sterilization by the numbers
In the fi rst half of the twentieth century, thirty-two states passed eugenic sterilization laws, and according to offi cial statistics about sixty thou- sand operations occurred, overwhelmingly in institutional settings. Cal- ifornia carried out twenty thousand, or one-third, of this national total. This leadership can be explained partially by the high volume of activity in four institutions: Patton, Stockton, Sonoma, and Pacifi c Colony. The former two were hospitals for the mentally ill, whose patients were com- mitted primarily for dementia praecox (60 percent at Patton, 64 percent at Stockton) and secondarily for manic depressive anxiety (11 percent at Patton, 15 percent at Stockton). Although men and women were classi- fi ed as dementia praecox in equal numbers, during the period 1935 to 1944 there was a striking gender disparity in rates of manic-depressive diagnosis, with 72 percent of these cases attributed to women. Dementia praecox, a term popularized by the German psychiatrist Emil Kraepelin, was associated with a progressive and inexorable mental deterioration that often included delusions and hallucinations. Over the course of the twentieth century it was supplanted by schizophrenia, which sought to describe the split-mindedness of this disease. In contrast, manic-depres- sive insanity was characterized by phases of relative stability punctuated by extreme conditions of mental depression or exaltation.11
Reviewing the symptoms associated with these conditions shows minimal conformity and instead a wide array of conduct and behaviors
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116 | “I Like to Keep My Body Whole”
that might have led to commitment. These could have included stop- ping cars, as was the case with twenty-seven-year-old Ricardo García, a Spaniard who was committed to Stockton in 1924 because of his erratic and seemingly paranoid behavior. García had been stopping cars and kneeling down to pray on public highways, and he complained of “pains in his head which can only be cured by charms of a Spanish woman.”12 According to clinical notes, many patients in the mental hos- pitals experienced auditory sensations or heard voices that induced feel- ings ranging from righteousness to persecution, carried out seemingly delusional acts of violence against people or property, or participated in non-normative sexual activities such as excessive masturbation or the pursuit of same-sex encounters.
In comparison to institutions for the mentally ill such as Patton and Stockton, patients at Sonoma and Pacifi c Colony, homes for the feeble- minded, might be given a psychiatric diagnosis, but the foremost clas- sifi cation was feeblemindedness, as represented by IQ and mental grade, which was subtyped into “idiot” (0–25), “imbecile” (26–50), “moron” (51–70), and “borderline” (71–84). At some point along the journey to commitment—in the juvenile court, at the sending reformatory, or once in the institution—a patient’s IQ was assigned by an expert drawing on test scores or mental assessment, and she or he was then branded with that numeric and diagnostic marker.13
To gain a deeper understanding of patterns in and across institutions, we analyzed coded data from the decade 1935–44, when operations peaked. In total, 7,989 documented sterilizations were performed in nine institutions during this busy decade, or roughly the same number of sterilizations as occurred in Virginia (8,000) and North Carolina (7,600) during the entirety of their sterilization programs.14 The peak year was 1940, with 967 operations, followed by 949 in 1938 and 936 in 1935. In 1942 sterilizations began to decrease, to 737, and the fol- lowing year they decreased to 530. Sterilizations then steadily declined until 1951, after which they dropped considerably.
California maintained seven mental hospitals (Patton, Stockton, Agnews, Norwalk, Camarillo, Mendocino, and Napa) and two feeble- minded homes (Sonoma and Pacifi c Colony).15 Sonoma was the most active sterilizer between 1935 and 1944, carrying out 2,005 operations, followed by Patton with 1,859, Stockton with 1,256, and Pacifi c Col- ony with 1,003. Figure 7 illustrates the diff erences in sterilization rates from 1935 to 1944 across institutions and includes a background bar graph of total rates.
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“I Like to Keep My Body Whole” | 117
The divergence among facilities can be demonstrated by comparing occurrences during the year 1938, when Sonoma carried out 289 opera- tions, nearly 6 per week, while Norwalk performed 36 and Mendocino just 6. By a large amount, Sonoma and Patton were the most active. According to retrospective data compiled in the early 2000s, between 1909 and 1950 these two institutions sterilized a total of 10,115 peo- ple—5,530 at Sonoma and 4,585 at Patton.16
Taking into account the fi ve most common diagnoses of patients steri- lized between 1935 and 1944, fi gure 8 illustrates the diff erences between the mental hospitals and the feebleminded homes and confi rms that the vast majority of those sterilized were classifi ed as dementia praecox and feebleminded. These diagnoses corresponded with superintendents’ dif- fering perspectives on the social purpose and medical value of steriliza- tion. In general, superintendents at mental hospitals like Stockton and Patton were more likely to view sterilization as both a procedure for hereditarian improvement and an intervention with therapeutic benefi ts.17
The quantity of sterilizations at Patton cannot be explained by sheer population size. For example, in the peak year of 1940 Patton housed 3,913 patients, fewer than Stockton (4,389) and only slightly more than Napa (3,574) and Agnews (3,552).18 Nor can higher rates be explained
figure 7. Sterilizations in California state institutions by year, 1935–44. Source: Prepared from Eugenic Sterilization Data Set, California Department of State Hospitals, Sacramento, by author and researcher Kate O’Connor.
Agnews Camarillo
Mendocino Napa
Norwalk Pacific Colony
Patton Sonoma Stockton Total
0 100
200
300
400
500
600
700
800
900
1000
1935 1936 1937 1938 1939 1940 1941 1942 1943 1944
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118 | “I Like to Keep My Body Whole”
primarily by the problem of overcrowding. As a precondition for dis- charge or parole, sterilization could function as a release valve for insti- tutions. However, the crisis of excess patients was extreme across all institutions, including those that performed many sterilizations and those that performed only a few. Between 1910 and 1955 the total resi- dent population in all mental hospitals increased more than fi vefold, from 6,864 to 36,403.19 In absolute terms, Patton’s population growth, from 1,372 in 1910 to 4,128 in 1950, was in sync with this overall trend.20 In the 1930s, Patton did report an excess population upwards of 50 percent; in 1939, for instance, Patton held 3,843 patients despite a certifi ed capacity of 2,983.21 Yet in 1950, Patton’s excess of 888 patients (with a total of 4,128 patients) was 27.3 percent. This fell below the surpluses of 38.1 percent reported at Agnews and 31.4 percent at Nor- walk but exceeded the overcommitments of 15 percent at Stockton and 2.8 percent at Napa. In 1950, the two feebleminded homes, Sonoma and Pacifi c Colony, also reported excess populations, respectively, of 33.3 percent and 19.3 percent. In the 1930s and 1940s, Sonoma’s overcrowd- ing constantly was higher than 25 percent, and its staff frequently bemoaned this issue as they eagerly awaited the pledged construction of additional state facilities.22
Undoubtedly overcrowding, which aff ected most institutions around the country during the Depression era, encouraged higher sterilization rates in the 1930s and 1940s but does not fully account for them. Instead,
figure 8. Numbers of patients in various diagnostic categories in California state institutions, including the fi ve most common diagnoses in all nine institutions, 1935–44. Source: Prepared from Eugenic Sterilization Data Set, California Department of State Hospitals, Sacramento, by author and researcher Kate O’Connor.
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“I Like to Keep My Body Whole” | 119
these rates generally correlated with the attitudes of superintendents and refl ected the milieus they fostered in the totalizing institutions they over- saw. For example, beginning with the passage of the inaugural law in 1909, superintendents at Patton were outspoken advocates of reproduc- tive surgery for both therapeutic and eugenic purposes, and this two- pronged approach helped make that institution the most aggressive ster- ilizer of all. In 1916, Patton superintendent Dr. John A. Reily wrote in response to a survey sponsored by the California Department of Chari- ties and Corrections that the aim of sterilization was to improve “the standard of the human race,” adding that the occasional denial of the pleasures of parenthood was a “small consideration as compared with the vast benefi ts accruing to society in the prevention of the propagation of the unfi t.”23 Ten years later, Dr. G. M. Webster echoed his predecessor: “We are trying, in so far as possible, to sterilize every male and female who enters the hospital during active sexual life,” not only to relieve the patient’s “present mental condition” and avert future attacks, but also to limit “as far as possible the birth of the unfi t into the world.”24
Similar although more muted patterns were at play at Stockton, where Dr. Fred P. Clark was superintendent from 1906 to 1929. Clark championed sterilization for its eugenic and therapeutic value, contend- ing that vasectomy could result in the mental and physical improvement of male patients.25 In 1924, the year Hector Rivas was sterilized at Stockton, Clark applauded the “law permitting the sterilization of the insane” as “one of the best things that has been done to prevent the unfi t from reproducing their kind.”26 Dr. Margaret Smyth, who became superintendent upon Clark’s death in 1929, continued this trend during her seventeen-year tenure at Stockton. As one of a handful of superin- tendents who traveled in eugenic circles, networking and delivering lec- tures, she received positive feedback about the priorities she promoted at Stockton.27 In 1938 Smyth wrote glowingly about California’s sterili- zation program, affi rming that the state’s laws were being applied “with- out racial or political implications and with a minimum of diffi culty.”28 The counterexample to Stockton and Patton is Agnews, where Dr. Leon- ard Stocking was much more cautious: performing very few steriliza- tions, chiefl y because he did not “think direct benefi t to the patient is to be expected unless it may be in cases where the mental trouble follows and recurs with pregnancy or childbirth.”29 Stocking’s reluctance is evi- dent in the offi cial statistics, which show comparatively fewer opera- tions performed at Agnews during Stocking’s superintendence and their twofold increase after his retirement.30
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120 | “I Like to Keep My Body Whole”
The zeal for the “surgical solution” at Patton and Stockton helped ensure that California’s mental hospitals performed more total steriliza- tions (approximately twelve thousand) than its feebleminded homes (approximately eight thousand) over the course of the twentieth cen- tury. In absolute terms, there were more operations in mental hospitals because they housed an average of fi ve times as many patients as the feebleminded homes. For example, in 1940, California’s mental hospi- tals held 22,953, compared to 4,076 in Sonoma and Pacifi c Colony combined.31 Given this, it is all the more striking that the two feeble- minded homes, Sonoma and Pacifi c Colony, carried out eight thousand operations in the twentieth century. These numbers can be attributed to the ardent impulse to prevent people with intellectual disabilities from procreating, a motive exemplifi ed by Fred O. Butler, who served as Son- oma’s superintendent from 1918 to 1949.32 Over these three decades he proudly oversaw approximately four thousand surgeries, one thousand of which he purportedly did himself.33 In line with California eugenicists who strove to expand the purview of sterilization, Butler was convinced that combating the menace of mental defi ciency required reaching beyond state institutions. He made strides toward that goal by turning Sonoma into something of a revolving operating room. Working with juvenile courts and reformers in Northern California, he tried to ensure that teenage girls identifi ed as unruly, promiscuous, and mentally defec- tive by caseworkers and county offi cials were transferred temporarily to Sonoma for salpingectomy. Paul Popenoe took note of this in 1926 dur- ing a site visit conducted for the Pasadena-based Human Betterment Foundation: “It appears that something like 25% of the girls who have been sterilized were sent up here solely” for surgery. “They are kept only a few months—long enough to operate and install a little discipline in them; and then returned home.”34 According to Butler, “sterilization only” cases made up 21 percent of Sonoma’s load, and it was routine for persons categorized as “retardates” (possessing an IQ of 80 or below) to be surgically fi xed and released in under a month’s time.35
Butler’s concern about women and girls categorized as social prob- lems is borne out by the numbers. From 1909 to 1950, for example, 55 percent of those sterilized at Sonoma were women.36 Moreover, Sonoma and its sister institution Pacifi c Colony were instrumental to two over- lapping longitudinal trends related to gender and diagnosis. At the outset of the state’s sterilization program, more men than women were steri- lized. To some extent, this refl ected the relative safety and simplicity of vasectomy, which involves small incisions to sever the vas deferens. For
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“I Like to Keep My Body Whole” | 121
example, at all institutions from 1909 to 1934, 5,267 men as compared to 4,843 women underwent the procedure: that is, men made up 52 per- cent of those sterilized and women 48 percent. By the 1940s, in part because of advances in speed and safety of surgical techniques for salp- ingectomy (which entails removal of the Fallopian tube), female steriliza- tions began to outpace those of men by what would become a growing margin. For example, from 1934 to 1960, 4,939 women were sterilized as compared to 4,085 men: that is, women now made up 55 percent of those sterilized.37 Nationwide, by the 1930s female rates of sterilization were surpassing male rates. However, the comparatively early start of California’s sterilization program meant that women would not substan- tially outpace men in annual or aggregate numbers until the 1940s.
This gendered transition mapped onto rising rates of sterilization in the feebleminded homes starting in the 1930s. Initially, the majority of opera- tions occurred in mental hospitals, aff ecting more men than women. How- ever, this pattern started to level off in the 1930s and soon began a minor reversal. Preliminary analysis of sterilization data from Pacifi c Colony, matched with individual-level census data from the 1940 US Census, dem- onstrates the disproportionate sterilization of women, who had a 20 per- cent greater risk of reproductive surgery when compared to men. Young people also were more likely to be sterilized; individuals under eighteen years of age had 3.3 times the risk of being sterilized as compared to those over eighteen. Finally, patients with Spanish surnames had 2.4 times the risk of being sterilized as compared to non-Spanish-surnamed patients. Our analysis also shows that those with middle-level IQs (morons) were more likely to be sterilized than those in the lower ranges (idiots and imbe- ciles). In multiple regression models, female gender, Spanish surname, and age younger than eighteen each remained associated with a higher likeli- hood of sterilization, so that the group most likely to be sterilized would be Spanish-surnamed women under age eighteen.38 These fi ndings from Pacifi c Colony underscore the racial and gender biases of sterilization, as well as the anxieties about “morons,” who preoccupied eugenicists pre- cisely because they could “pass” and function in society while still threat- ening future generations with their deleterious heredity.39
racism and resistance: trends among mexican-origin patients
Spanish-surnamed individuals constituted an elevated proportion of sterilized patients at both feebleminded homes and mental hospitals,
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particularly at the four most active facilities. Figure 9 illustrates percent- ages of sterilized patients who had a Spanish surname. The highest per- centages of Spanish-surnamed patients could be found at Pacifi c Colony, where 29 percent of those sterilized were Spanish-surnamed, followed by Sonoma with 21 percent, Patton with 14 percent, and Agnews with 13 percent. For all institutions the average percentage of sterilized patients who had a Spanish surname was 16 percent. In and of itself, this fi gure emphasizes the extent to which Mexican-origin persons, who made up the majority of Spanish-surnamed patients, were overrepresented, given that between 1910 and 1940 they never made up more than 6.5 percent of the state population according to census fi gures.40
Across institutions, Mexican-origin sterilized patients, both male and female, tended to be younger than the overall population. For example, the mean age of non-Spanish-surnamed sterilized patients in all institu- tions from 1935 to 1944 was twenty-six (the median was twenty-fi ve), whereas the mean for sterilized Spanish-surnamed patients was twenty- three (the median was nineteen). This pattern was particularly pro- nounced at the feebleminded homes, such as Pacifi c Colony, where the mean age of sterilized Spanish-surnamed patients was eighteen (the median was seventeen). Refl ective of this pattern was seventeen-year- old Dolores Chávez, who was committed to Pacifi c Colony in 1941. Chávez had been a ward of the Ventura Juvenile Court and was classi- fi ed as a middle moron with an IQ of 56.41 Her father, deported years earlier to Mexico, was deceased, as was her mother. At some point, she had been placed in the care of a female guardian, perhaps an extended family member, also of Mexican origin. Chávez was tagged as a truant and a “behavior problem,” and her home was disparaged as unfi t. Figure 10 is the sterilization recommendation for this girl. In the 1920s and early 1930s, sterilization recommendations were processed as let- ters, sometimes accompanied by additional communications and modi- fi ed consent forms. In 1936 the Department of Institutions adopted the “787” form, which streamlined the process. Staff could simply type onto the form, fi lling in the sections on personal, family, and clinical history, and checking a box under “Legal Provisions” that included phrasing from the state’s sterilization law. As with many Mexican-ori- gin families, Chávez’s next of kin, in this case her guardian, refused consent. Exercising the legal prerogative to make the fi nal determina- tion, Pacifi c Colony’s superintendent proceeded to authorize the opera- tion on the grounds of Chávez’s purported mental defi ciency, and two weeks later she was sterilized.42
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“I Like to Keep My Body Whole” | 123
In contrast to several other states, California’s law off ered next to no room for appeal or objection. This, however, did not deter hundreds of Mexican-origin families, who resisted the sterilization of their children more intensely than any other group.43 In 1937, for example, the mother of Carlos Vásquez “refused two letters of consent” that Sonoma had sent to her home. Seeking to overcome this hindrance, Butler dispatched a letter to the director of the Department of Institutions in which he described Vásquez as a “run-away and a menace to society” who had been remanded to the court for petty and grand theft. Butler impugned the mother, labeling the boy’s parentage “a low grade Mexican type” and requesting permission to proceed with the operation, which was carried out the following year.44
Many parents declined consent in written correspondence. However they also lobbied offi cials who had been involved in their child’s com- mitment. In 1931, Butler recommended the vasectomy of Juan Romero, who had arrived to Sonoma from the Preston School of Industry, so that he would never “reproduce his kind, for we know from experience that individuals of his mentality should never bear off -spring, as they are usually defective in some manner.”45 One of Mr. Romero’s three sons, Javier, had already been sterilized, and in the same communica- tion Butler reminded him that Sonoma was still awaiting approval for
figure 9. Percentage of sterilized patients with a Spanish surname in each California state institution, demonstrating higher proportions of Spanish-surnamed patients in Sonoma, Patton, and Pacifi c Colony, 1935–44. Source: Prepared from Eugenic Sterilization Data Set, California Department of State Hospitals, Sacramento, by author and researcher Kate O’Connor.
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figure 10. Sterilization recommendation made in 1941 for a seventeen-year-old Mexican-origin girl at Pacifi c Colony who was a ward of the Juvenile Court of Ventura and was classifi ed with an IQ of 56 (middle moron grade). Source: Eugenic Sterilization Data Set, California Department of State Hospitals, Sacramento, used in accordance with the California Committee for the Protection of Human Subjects under 12–04–0166.
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“I Like to Keep My Body Whole” | 125
his third son, Pablo. Butler asserted that having three boys in one family who ended up in correctional facilities was evidence of “a hereditary thread” and that any grandchildren born of these boys would certainly be defective.46 Attempting to reverse this planned course of action, Mr. Romero went to talk to the health offi cer at the San Francisco Detention Hospital who had initiated his son’s institutional odyssey. According to the health offi cer, Mr. Romero was “violently opposed” to sterilization and rebuff ed the classifi cation of his son as feebleminded. Like Carlos Vásquez’s mother, Romero’s father was belittled, described as “an igno- rant, unintelligent Spanish man.” Authorities found it “impossible to convince him of the value of the operation for sterilization either for his son’s protection or for that of society.”47 Six months after this letter exchange Butler convened a conference on this case and decided that the presence of three defectives in one family and the thirteen burglaries attributed to Romero warranted his sterilization.48
In addition to challenging authorities that endorsed sterilization, Mex- ican-origin families sought intervention from community allies. In 1936, Celia Ramírez was recommended for sterilization at Pacifi c Colony. She had been classed as a high moron with an IQ of 68 and had a long case history that involved repeated running away and institutional escapes. Ramírez’s record suggest that she was gang-raped at age nine by fi ve men, including her uncle. Despite clinical detection of venereal disease, her account of this sexual violence was deemed to be “without foundations” by juvenile authorities. Ramírez’s protracted and pained trajectory involved various stints in the court and in homes including Pacifi c Colony. Both separately and together her father and mother “opposed sterilization on religious grounds.” They contacted the Mexican Consulate in Los Angeles, which in turn wrote to Sacramento “verifying the parents’ objec- tions to sterilization and stating that the Consul had taken the liberty of informing the mother that such operation would not take place without her consent.”49 It is possible the Mexican’s consul’s actions stalled Ramí- rez’s sterilization, as there is no record of her name in the lists of patients sterilized at Pacifi c Colony in 1936 and succeeding years.
The Catholic Church also played a role in protesting sterilization. In 1942, the father of Ignacio Domínguez, a fi fteen-year-old boy diagnosed with a borderline IQ of 75, responded negatively to Butler’s request for sterilization through the intermediary of his priest. Domínguez was under the watch of the Santa Barbara Police Department’s Probation Offi ce because he had been found intoxicated in a local pool hall, had been party to a knife fi ght, and had been “involved with a local gang of
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126 | “I Like to Keep My Body Whole”
marauding Mexicans.”50 According to Butler, Domínguez’s parents were divorced, feebleminded, and unable to care for their many children, several of whom were at a local reformatory. Disregarding the priest’s objections to Domínguez’s sterilization, Butler requested permission from Sacramento, which was granted, and this boy was sterilized the following year.51
Most dramatically, Mexican-origin families took to the courts, fi ling what appear to be the only constitutional challenges to California’s ster- ilization law.52 In 1930, sixteen-year-old Concepción Ruíz, through her guardian, sued in district court for $150,000 damages for the salpingec- tomy performed “against her wishes and in spite of protest” at Sonoma the previous year. Her attorneys argued that Ruíz’s Fourteenth Amend- ment rights to due process had been violated.53 There is no indication that Ruíz won her suit or that any legal precedent was set. Nine years later Sara Rosas García, a widow with nine children, fi led a Writ of Pro- hibition in the second appellate district to prevent the Pacifi c Colony superintendent from sterilizing her eldest daughter, Andrea. Represented by David C. Marcus, a Jewish American lawyer with ties to the Mexican Consulate and the NAACP (National Association for the Advancement of Colored People), García put forth a compelling criticism of the pro- posed sterilization as an infringement on the equal protection clause of the Fourteenth Amendment and on due process given that there was no mechanism for patient appeal. Marcus averred that the surgery would be performed against the “wishes and desires” of García’s daughter and that the law gave “no remedy or method of redress” for the “irreparable damage” she would suff er. Although García’s writ was denied in a 2 to 1 decision, Judge J. White, who was sympathetic to Marcus’s argument, excoriated the existing law in a terse dissent. White wrote that the grant- ing “of such power should be accompanied by requirements of notice and hearing at which the patient might be aff orded an opportunity to defend against the proposed operation. To clothe legislative agencies with this plenary power, withholding as it does any opportunity for a hearing or any opportunity for recourse to the courts, to my mind par- takes of the essence of slavery and outrages constitutional guaranties.”54 Despite this legal contest, records indicate that Garcia’s daughter was sterilized at Pacifi c Colony in 1941.55
Mexican-origin parents were not the only ones who fought steriliza- tion. In 1937, the Italian father of a sixteen-year-old girl housed at Son- oma refused consent. His daughter had been committed because she
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“I Like to Keep My Body Whole” | 127
had stolen from friends and neighbors and “once from an oil or service station.” Yet this girl with a registered IQ of 75, or borderline grade, had “very good scholastic standing.” Thus Butler saw her as a prime candidate for house parole where “she might receive further schooling on the outside.” Butler wrote to Sacramento asking that this girl be “sterilized over and above the father’s objections” so that she could be released and “receive further schooling on the outside.”56 Butler’s peti- tion was granted, and the salpingectomy performed in 1938.57
Parental resistance to sterilization was a persistent feature of Califor- nia’s sterilization regime. By far, this pattern was most pronounced among Mexican-origin families, who exhibited an unwillingness to abide by the strictures of institutionalization for religious, moral, and cultural reasons. This pattern of pushback comprised more than several hundred solitary episodes of refusal and can be interpreted as a hitherto obscured dimen- sion of mid-twentieth-century ethnic and civil rights mobilization around family dignity and bodily autonomy.58 The strident rejection by so many Mexican-origin families of the assumptions and justifi cations of the state’s sterilization regime underlines the heightened racial hostility that perme- ated eugenics in California. Although all patients were labeled as mentally defi cient or insane, only Mexican-origin parents were so consistently derided as “low grade,” or “inferior stock” in formulations that con- demned both their biological and social capacity to parent. Mexican-ori- gin parents were struggling against an inimical system that sought to dis- articulate families, many of which were already coping with the strain of seasonal migration and poverty. The stakes were high as parents sought to make an impossible choice between familial separation through long- term institutionalization or the prospect of reproductive surgery foreclos- ing the possibility of future generations.
the hard and soft edges of consent
The majority of patients and families did not object to sterilization but signed on the line consenting to reproductive surgery. Even though the law did not require consent, superintendents nevertheless put a great eff ort into obtaining signatures from the patient and from parents, spouses, and guardians. This practice speaks more to offi cials’ concerns about liability and professional standards than to a compelling interest in the agency of patients. Because of its asymmetries, the microdynamic of consent off ers a window through which to examine the nuances of
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128 | “I Like to Keep My Body Whole”
acceptance, acquiescence, and refusal among institutionalized patients and their families.
Some patients signed recommendation forms themselves. Thus far, we have identifi ed sixty-seven instances of self-consent in the 1935 to 1944 period. One such self-consenter was a twenty-fi ve-year-old Canadian man who voluntarily committed himself to Stockton in 1935 for dementia praecox, hebephrenic type, and then of his own avail agreed to steriliza- tion.59 Figure 11 is the Sterilization Recommendation for this young man. The reasons why his signature appears on the form cannot be deciphered satisfactorily even with sensitized, subaltern readings of sterilization forms as administrative documents that contained and elided human subjectiv- ity to construct a diagnosis. We can speculate that, given the dual-purpose approach to sterilization embraced by superintendents at Stockton, this man might have accepted surgery as an intervention aimed to quell his reported sexual perversions and pathologized same-sex desires.60
More often than the patient her- or himself, a parent or spouse off ered her or his signature. In 1939 Rhonda Johnson, a white twenty- six-year-old mother of three, arrived at Patton. According to her fi le, Rhonda qualifi ed for salpingectomy under the law on three counts: she was classifi ed as dementia praecox, catatonic type; she tested positive for gonorrhea; and she was ranked as an imbecile with an IQ of 46. The clinical notes indicated that Johnson “got drunk, left home,” and “asso- ciated with other men.” Her husband provided written consent for the operation just three days after her commitment, and one month later she was sterilized.61 Bertha González’s mother approved her steriliza- tion. González, a nineteen-year-old Mexican American woman, was placed in Pacifi c Colony in 1950.62 She had a third-grade education and had taken some “special development classes.” Forms indicate that she was married and had a one-year-old child. González’s IQ score was 35, in the imbecile range, and her overall diagnosis was “mental defi ciency- familial type.” The brief family history suggests what González had suff ered. Her father was a violent alcoholic who had been jailed for ninety days for attacking her. Apparently she was “beyond control of her mother” and her three siblings were “none too bright.”63 Against the backdrop of these compounded troubles, her mother endorsed ster- ilization, which took place about one month after being recommended.64
These operations occurred during the height of medical paternalism in the United States, when parents and patients relied heavily on the expertise and recommendations of physicians. It is likely that many family consenters, lacking alternative possibilities for care or treatment,
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figure 11. Sterilization recommendation made in 1935 for a man of Canadian origin at Stockton State Hospital identifi ed as a sexual delinquent who “has had perverse sex experiences since he was 8 years of age.” Source: Eugenic Sterilization Data Set, California Department of State Hospitals, Sacramento, used in accordance with the California Committee for the Protection of Human Subjects under 12–04–0166.
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130 | “I Like to Keep My Body Whole”
were doing what they thought was best and most prudent for their dependents and loved ones. Indeed, many parents were eager to have their children with disabilities committed to state homes because they could not manage fi nancially or emotionally and they wished to devote more attention to their “normal” children. In March 1952, a father who worked as a pilot fl ying between San Diego and Oakland airports wrote to Governor Warren, pleading that Pacifi c Colony accept their older boy, fi ve-year-old Thomas, who was “mentally and physically under developed since birth” and in need of “constant medical care” that neither he nor his wife could provide.65 Pacifi c Colony responded to his impassioned plea, informing him that his son was “number four- teen on the urgent list of San Diego children awaiting admission to the Nursery B Cottage.” Offi cials sympathized with his situation, stating that “at the present time we have over 2800 such patients awaiting admission and every eff ort is being made to meet this end” and alerting him that additional state homes were slated for construction. We do not know if his son ever was admitted to Pacifi c Colony.66
From today’s vantage point, the consent process followed in Califor- nia would not pass ethical or legal muster. It lacked core elements of bona fi de informed consent. First, the diagnoses assigned by the institutions themselves, which classifi ed patients with low mental grade or insanity of some sort, would have disqualifi ed patients from having the necessary capacity to understand the information provided about the operation and its consequences or to make an informed decision based on that information. Second, although California authorities painted the picture of a voluntary consent process, by defi nition voluntariness—a core tenet of informed consent—cannot be conditional. From the 1920s to the 1950s, sterilization was a precondition of release and was held over the heads of patients and their families. Third, superintendents relied heavily on a system of surrogate decision making, whereby a designated family member or guardian was assumed to be acting in the best interest of the child or patient judged incompetent of possessing autonomous judgment. Not only do doubts arise about whose autonomy is actuated in this model, but eugenic sterilization was predicated on a formula in which the best interest of society superseded that of the individual in the name of human improvement. Thus California’s sterilization system was based on implicit and explicit conditional and coercive features that severely restricted the autonomy and options of patients and their kin.67
The contingency of sterilization is exemplifi ed by the case of a father who wanted his adopted son released but was not willing to acquiesce
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“I Like to Keep My Body Whole” | 131
to sterilization for religious reasons. This father wrote to the director of mental hygiene in 1947, explaining that his son was in Pacifi c Colony because he was a truant who would not attend school, not because he had ever gotten in any serious trouble. His fi le shows that the boy, diag- nosed with an IQ of 68, was sent there from the Los Angeles Superior Court, whose evaluation generally concurred with the father’s: the boy “was a problem in his home and in school although he had not actually become a delinquent.”68 A veteran, the father remarked, “I fought in World War II and I wonder if that’s the sort of thing I fought for.”69 In its correspondence, the Department of Mental Hygiene reminded the father that the “law now authorizes sterilization with or without con- sent of the patient or responsible relatives.” However, he also was reas- sured that his son’s case would follow “a defi nite procedure which cul- minates in the case being reviewed in headquarters.”70 Records indicate that the father’s petitions resulted in a half-victory: this boy’s steriliza- tion was postponed, but without the surgery he remained in Pacifi c Colony while his father awaited his return.
The vacuity of the consent process comes into stark relief in instances of surrogate decision making where parents or guardians with limited lit- eracy signed with an “X” on the instruction of institutional staff . In 1944, a thirteen-year-old Spanish-surnamed girl was committed to Pacifi c Col- ony for “mental defi ciency” and was placed in the “high imbecile grade,” with an IQ of 43. This girl had been sexually abused by her stepfather; the family was described as having “low moral background” and a “low standard of living.” At the courthouse in San Bernardino, an X was placed on the consent line of a makeshift sterilization form, and “Grandmother’s mark” was written by one of the witnesses in cursive.71 In another case, an X was off ered by or for the mother of a twenty-six-year-old Italian Amer- ican woman with a tested borderline IQ of 75 who was committed to Sonoma in 1935. On the margins of the index card–sized consent form are the words “I don’t know how to write but I should make a cross showing my signature,” a phrase that probably was read to her by the Sonoma offi cial with whom the mother interacted.72 Two problematic elements converged in surrogate signatures: the limited ability of the consenting family member to understand the surgery and its consequences, especially since little to no explanation was provided, and the assumption that the patients, because of IQ scores and other prejudicially derived characteris- tics, did not possess the capacity to comprehend or decide.
In the late 1940s, fi ssure lines appeared in the pillars of the state’s sterilization program, partially in response to changes implemented by
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132 | “I Like to Keep My Body Whole”
Dr. Dora Shaw Heff ner, who in 1943 became the head of the Department of Institutions under Governor Earl Warren. Like her predecessors, Hef- fner countenanced sterilization, but, seeking a more scientifi cally informed and democratic approach to institutional care, she created some latitude for patient communication and appeal. Starting in the mid-1940s, at least at Patton, patients slated for sterilization began to receive typeset memos, printed in English and Spanish, clarifying that the director of the Depart- ment of Institutions had authorized sterilization; if the patient wished to object, she or he needed to send a letter to Heff ner within the next ten days. The ward physician and attendants would furnish paper and pen to patients who wished to pursue this option.73 The memo clarifi ed that the operation did not aff ect sex function but was solely for the purpose of ending the ability to procreate. The microfi lm reels contain approxi- mately fi fty such written appeals from patients at Patton. The penman- ship and grammar of these letters vary, but they all convey strong objec- tions to reproductive surgery. In 1947, a twenty-seven-year-old mother of two, diagnosed with dementia praecox, hebephrenic type, expressed her disagreement with her husband’s consent: “I do object to this strenu- ously, kindly permit me to explain my reasons against it.” She explained that she and her husband were unhappy, “sexually and otherwise,” and that her in-laws had committed her to Patton. She thought her husband had approved sterilization because although he “evidently still loves me and is hurt,” he nonetheless was naturally “seeking a kind of revenge.” She believed she could remarry and might be happy again. She concluded, “My religion also causes me to object to sterilization. I have no venereal disease and there is no insanity in my family’s background and I am young enough to remarry and have a normal, happy life with children.”74 In spite of clearly articulating her opposition, Heff ner endorsed the steri- lization that she underwent two weeks after writing this letter.75
A perfunctory yet very poignant letter was penned by Thomas Rog- ers, a pseudonym for the clergyman introduced at the beginning of this chapter whose wife had approved his vasectomy. She probably did not realize that her husband would take advantage of a newly available avenue of appeal. But on March 11, 1947, Rogers sat down to write a letter to Heff ner in capital block print.76 His letter is shown in Figure 12. It succinctly states, “Inasmuch as I am religiously opposed to steriliza- tion, I am submitting this as a protest against any such action.”77
Unlike the petition of the young mother discussed above, Rogers’s peti- tion appears to have succeeded. It was taken seriously enough to prompt a reply from Heff ner’s medical deputy director. Writing to Patton’s
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“I Like to Keep My Body Whole” | 133
figure 12. Letter written in 1947 by an inmate at Patton State Hospital who opposed his sterilization on religious grounds. Source: Eugenic Sterilization Data Set, California Department of State Hospitals, Sacramento, used in accordance with the California Committee for the Protection of Human Subjects under 12–04–0166.
superintendent, he noted that the patient was a clergyman who disagreed on “religious grounds.” This offi cial gave the superintendent permission to perform Rogers’s operation without any further communication with Sacramento. However, he asked that it be deferred, in hopes that Rogers, once his mental state had improved, would be “amenable to reason on this subject” and would acquiesce to the surgery.78
A similar outcome occurred with Karen Wright, the mother of two young children, diagnosed with dementia praecox, simple type, who hailed from Washington State. In a 1946 missive to Heff ner she pleaded: “I like to keep my body whole. I feel insulted by the whole thing,” adding, “I don’t think that I am insane either.”79 Referring to this letter, and to
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134 | “I Like to Keep My Body Whole”
information gleaned from her case fi le, Heff ner cautioned Patton’s super- intendent, “It would seem from her letter that a sterilization at this time would cause a psychic trauma.” Heff ner added that since the patient was divorced, “Nothing would be lost by deferring this sterilization to a more appropriate time.”80 Heff ner clarifi ed that sterilization and discharge should be revisited when this patient’s mental attitude had improved.
A few currents merged to allow for a reprieve for these two patients at Patton. In the case of Rogers, as an educated white man and clergy- man, the tenor of the correspondence suggests that he was treated with some respect and as a person eventually capable of coming to reason to consent to sterilization. In the case of Wright, emergent theories of men- tal illness, which encompassed psychoanalytic understandings of trauma, worked in her favor, as did her status as a divorcée unlikely to have any children in the near future. As new somatic therapies, such as insulin coma and convulsive therapy, and antipsychotic drugs such as chlorpromazine were introduced in Patton and the other mental hospi- tals, sterilization gradually was being abandoned as a viable therapy for mental illness, a transition that benefi ted Wright.81
It was not only white middle-class patients at Patton who managed to stall their own sterilizations. In 1950, the family of a twenty-one-year- old African American woman, Gladys Marshall, originally from Glen- dora, Mississippi, wrote to Pacifi c Colony. Marshall had been commit- ted three years earlier, sent from San Diego County, which had “expressed fear that she would produce feebleminded children.” Although she was briefl y married, Marshall’s two children apparently were born out of wedlock, and her IQ, as tested at Pacifi c Colony, was 42 (imbecile) (it had tested at 55 in San Diego). Marshall’s mother wanted her daughter released but without reproductive surgery, which Pacifi c Colony staff strongly recommended for Marshall on the grounds that she was “alco- holic, incorrigible, mentally defi cient; interested in men.” The staff felt that “releasing supervision of the girl without sterilization would not be justifi ed.” Without consent to sterilization, Marshall’s parents were not able to bring her home on furlough. The parents emphatically did not want their daughter in Pacifi c Colony, but they were unwilling to agree to sterilization as a quid pro quo for release. Seeking assistance, Mar- shall’s mother contacted the NAACP, who in turn retained an attorney to represent the family. Faced with this legal action, Pacifi c Colony’s superintendent, George Tarjan, backed down, stating, “The operation cannot be performed because of lack of consent.”82 It appears that the family won the day, as Marshall’s name does not appear in the lists of
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“I Like to Keep My Body Whole” | 135
those sterilized at Pacifi c Colony in those years. This concession, how- ever, meant that Marshall was not released from Pacifi c Colony.
Rumblings of change were under way starting in the late 1940s, inside state institutions and in the broader arena of mental health. In 1949, the conclusions of the “Report on the Governor’s Conference on Mental Health” suggested that the state’s mental hygiene system needed to be transformed from a model of custodial care to one of treatment, from an investment in bricks and mortar buildings to trained personnel, and from rural asylums to more urban institutions located near medical schools and research centers.83 These shifts presaged revisions to the state’s steri- lization laws in the early 1950s, when successful senate (1951) and assembly (1953) bills deleted any references to syphilis (long since under- stood as bacterial rather than hereditary in etiology) and sexual perver- sion; removed references to “the feebleminded,” “idiots,” and “fools,” terms seen as archaic; and instated patient and next-of-kin notifi cation as well as channels for legal appeal at the county court level.84 The Roman Catholic bishops of California, who opposed the existing law in its entirety, and the Department of Mental Hygiene, now striving to mod- ernize the nomenclature for people classifi ed as mentally ill and retarded, backed this update.85 Approved by Governor Warren, these legislative amendments refl ected his administration’s commitment to revamping California’s mental health and public health programs.86
The revisions had an immediate impact, turning the sterilization rec- ommendation process from a formality into a more demanding exercise. This change is captured in the numbers. From 255 operations in 1951, the number dropped to 51 in 1952, and by the mid-1950s it hovered around 20, even as three new hospitals and homes opened.87 For exam- ple, at Sonoma, only 4 operations were performed in fi scal year 1952– 53 and only 1 was performed in 1953–54. The superintendent at the time, Butler’s successor, noted the “conspicuous drop” in the number of surgeries, which he attributed to factors including the revamped law.88
At the same time as the sterilization law was rewritten, psychiatry was moving into the mainstream, and the mix of patients in mental hospitals such as Patton and Stockton started to encompass people with nonpsychotic and less severe conditions such as psychoneuroses or per- sonality trait disturbances. In 1952, the American Psychiatric Associa- tion issued the fi rst edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-I), which both standardized psychiatric nosol- ogy and incorporated psychodynamic and psychoanalytic theories.89 Heff ner’s concern about the “psychic trauma” that might befall Karen
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136 | “I Like to Keep My Body Whole”
Wright, the mother institutionalized at Patton who wanted to keep her “body whole,” is indicative of this emerging trend.
Mental health attitudes toward what was now referred to as mental retardation, and no longer feeblemindedness, were undergoing an anal- ogous metamorphosis. As a Sonoma physician explained in 1956, men- tal retardation was “as much a social and psychological problem as it is a medical one.”90 In a shift propelled in part by a generation of middle- class parents skeptical of doctors’ assumptions that their children required institutionalization, mental retardation ceased to be viewed as a hereditary stigma that must be eradicated and instead began to be understood as a condition that required thoughtful conversation among experts and families. The founding of the National Association of Retarded Children in 1950 signaled this shift, as did the publication of best-selling memoirs by well-known authors such as Pearl Buck and Dale Evans Rogers about the value and joy of their children with intel- lectual disabilities.91 Most prominently, in 1962 Eunice Shriver, Presi- dent John F. Kennedy’s sister, published “Hope for Retarded Children” in the Saturday Evening Post. Frankly discussing her sister Rosemary’s diagnosis of mental retardation, Eunice Shriver wrote, “Like diabetes, deafness, polio or any other misfortune, mental retardation can happen in any family. It has happened in the families of the poor and the rich, of governors, senators, Nobel prizewinners, doctors, lawyers, writers, men of genius, presidents of corporations—the President of the United States.”92
In the 1960s and 1970s, the rejection of labels of retarded or insane was hastened by muckrakers who exposed the abysmal conditions and overcrowding at state institutions. Increasingly, Americans were chal- lenging the farce of public custodial “care” and questioning the infl ex- ible demarcation between normal and abnormal, abled and disabled. Many Americans were shocked to learn that people with physical and intellectual disabilities had served as subjects in myriad medical experi- ments, including an infamous case in which hundreds of children at the Willowbrook State School in Staten Island, New York, were deliber- ately infected with hepatitis.93
The glaring absence of either institutional oversight or legal recourse for patients from 1909 to the late 1940s helps explain California’s com- paratively high sterilization rates. During these decades superintendents acted with great impunity, aided by a geography of isolated institutions and legal statutes that aff orded remarkable protection. In this scenario
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“I Like to Keep My Body Whole” | 137
institutional peculiarities thrived, and California’s sterilization program unfolded unevenly across the state’s nine institutions. There were clear diff erences among the mental hospitals and the feebleminded homes as well as among superintendents depending on their beliefs about the therapeutic, eugenic, or punitive purpose and value of reproductive sur- gery. Nevertheless, one preponderant pattern was an unforgiving racial antagonism toward Spanish-surnamed, primarily Mexican-origin, patients and their families, which was expressed both in ethnic derision and in disproportionate rates of sterilization. This racialized dynamic set the stage for the resistance of Mexican-origin patients and families inside and outside the walls of the institutions.
With the benefi t of the digitized archive of sterilization documents, a picture begins to coalesce—of institutional paternalism, the pretense of a consent process, and multiple instances of speaking back to compulsory sterilization. Ultimately, the acts of Reverend Thomas Rogers, who wrote a short letter expressing his objection to sterilization, Sara Rosas Garcia, who appeared before the second appellate court, the parents of Celia Ramírez, who sought the Mexican consul’s intervention, and the family of Gladys Marshall, who retained an attorney through the NAACP, served as pressure points on a system that faced more organized assaults in subsequent years. Indeed, this quieter and largely forgotten resistance adumbrated the activism of the 1960s and 1970s, when the antipsychia- try, feminist, and gay and lesbian rights movements rejected the paternal- ism of midcentury medicine and institutions; the disability movement expanded that critique to upend assumptions about the physical and intellectual limitations of people deemed “retarded”; and the Chicana/o movement, aligned with ethnic and racial justice struggles, upbraided the stereotypes of inferiority, criminality, and delinquency that were staple ingredients of midcentury eugenic racism.
In 1979, California’s sterilization law was unanimously repealed by a generation of lawmakers astonished that the Golden State still had such a statute on the books. And by 1986, the reproductive control of earlier decades had become anathema; the law now stipulated that peo- ple with disabilities could be sterilized only at the request of a conserva- tor or guardian after a court process and that “the right to choice over procreation is fundamental and may not be denied to any individual on the basis of disability. Persons with developmental disabilities should be provided with services to enable them to live more independent lives, including assistance and training that might obviate the need for sterili- zation.”94
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138 | “I Like to Keep My Body Whole”
Despite these noble intentions, the sterilization of vulnerable popula- tions in state institutions did not end in California with the erosion of the eugenics era. Starting in the 1980s, the overlapping trends of dein- stitutionalization and skyrocketing incarceration led to a process of transinstitutionalization, whereby the same kinds of people deemed “social problems” and “menaces” to society, especially those convicted of minor off enses or with mental health problems, who in the 1930s might have been committed to Patton or Sonoma, were incarcerated in San Quentin or Valley State Prison. At the outset of the twenty-fi rst century, a generalized crisis in California’s mismanaged prison system made possible yet another episode of reproductive injustice in state institutions.
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