COLUMN ONE
Forced Sterilization Once Seen as Path to a Better World
Decades of files on mental patients reveal how a foundation of noted
leaders hoped to influence the fate of the human race.
By Mike Anton
Times Staff Writer
July 16, 2003
In a basement at Caltech, 59 gray boxes contain thousands of documents
that reveal in detail how an influential group of California men once hoped
to help direct the fate of the human race.
Within the brittle files is the story of the state's long and largely forgotten
effort to sterilize mental patients. Memos show how California civic leaders
helped popularize eugenics around the world, including Nazi Germany. Case
histories offer a glimpse of the more than 20,000 people who were, by law,
sterilized in state hospitals from 1909 through the 1960s in anticipation
of curing an array of social ills — from poverty and promiscuity to overcrowded
institutions.
"One of the giggling dangerous type — a delinquent sexually, morally. Forged
checks, remained away from home nights," reads the case file of a 16-year-old
girl who was sent to the Sonoma State Home, sterilized and released.
The archives of the Human Betterment Foundation, a private, Pasadena-based
think tank that promoted sterilization from 1926 to 1942, have been at Caltech
for six decades. They were kept in a warehouse until 1968. Only since 1995
has most of the collection been open to researchers.
"California is an enormous story in the history of eugenics," said Paul
Lombardo, a professor at the University of Virginia's Center for Biomedical
Ethics. "What makes California special is the work of the Human Betterment
Foundation, how it shaped public policy, and the links between major players
in the private sector and state officials who carried out the work."
When Lombardo lectured in March to a state Senate committee on California's
aggressive sterilization policy, lawmakers were stunned. Most had never heard
of this. Within hours, Gov. Gray Davis issued an apology.
Today another hearing on the state's program is scheduled in Sacramento,
at which a historian, directors of state departments and mental health advocates
will probably raise the issue of whether the state should try to find and
compensate survivors of sterilization.
"Many have cried a great deal," said Robert Edgerton, a psychiatric anthropologist
and director of UCLA's Center for Culture and Health, who interviewed dozens
of former mental patients in the early 1960s for a state-sponsored study
of sterilization.
Some still do. They are among the 14 of his subjects who are still alive.
To illustrate the fact that no feebleminded girl is safe at large unsterilized
... one might cite the case of a Los Angeles girl 20 years old, with the
mind of a three-year-old child. She was also humpbacked and so ugly that
it was supposed that she would never be molested, so her parents ... used
to leave her alone in the house sometimes. On one such occasion she was raped
by the iceman, and gave birth to an illegitimate child. Following this she
was sent to Sonoma to be sterilized ...
— patient summary from the files of the Human Betterment Foundation
In 1909, California became the third state to legalize the sterilization
of the feebleminded and insane. Eventually, more than 30 states with such
laws would sterilize about 60,000 — a third of them in California, which
repealed its law in 1979. Working hand in hand with state officials, the
Human Betterment Foundation served as spokesman and primary scorekeeper for
the eugenics movement, collecting data on sterilizations nationwide.
Ezra S. Gosney, the Pasadena financier who started the foundation, was
well-regarded for his work in philanthropy and education reform. In 1926,
at the age of 71, he quietly began funding studies on how sterilization could
combat problems caused by excessive breeding of the "unfit."
At the time, eugenic sterilization was in the mainstream of science and
politics, soon to be upheld by the U.S. Supreme Court and embraced by many
social progressives, from Planned Parenthood founder Margaret Sanger to economist
John Maynard Keynes. Many doctors at the time thought sterilization had a
therapeutic effect on mental patients.
Gosney was about to become the movement's chief public relations agent.
"Any common man will tell you that a herd of common, long-horn Texas or
Mexican cattle can be converted to a high-grade Hereford or white-faced herd
in three or four generations," states a memo with Gosney's initials contained
in the Caltech files. "Man falls under the same laws of heredity. The only
difference is that we have mixed the breeds and failed to teach our children
to ... select their mates."
The foundation's members included a who's who of California: David Starr
Jordan, Stanford University's first president; Los Angeles Times publisher
Harry Chandler; Nobel Prize-winning physicist and Caltech head Robert A.
Millikan; USC President Rufus B. von KleinSmid; and Lewis M. Terman, a Stanford
psychologist who developed the IQ test.
To spearhead his work, Gosney hired Paul Popenoe, an energetic, self-trained
biologist who studied the genetics of dates before turning to humans, and
who was also a writer with a knack for translating dense material for the
common man.
When Popenoe visited the state's mental hospitals, he found administrators
eager to open their patient files to him. He described two cases to Gosney
that would not be published in the foundation's upbeat reports.
"I found one case, which they didn't know about, where they had sterilized
the same man twice, two years apart," Popenoe wrote Gosney from Stockton
state hospital. "He was an unintelligent Italian, and I suppose he didn't
know enough to tell them that he had been through the mill before, and they
missed the fact in their own records."
One hospital superintendent told him of a convention of the Assn. of Railway
Surgeons held at the Mendocino state hospital at which the association's
president was invited to sterilize two women as a "special honor."
"Both women died in agony a few days later," Popenoe wrote Gosney. "Autopsy
showed that instead of tying the Fallopian tubes, the surgeon had tied up
the ureters, so they both died of kidney poisoning from being unable to urinate."
Popenoe compiled stacks of handwritten charts that correlated the background
of thousands of patients sterilized in the 1920s using dozens of measuring
sticks — from IQ, birth rank, number of siblings and whether forceps were
used at birth, to the marital status, occupation and "moral rating" of the
parents.
He found that men and women were targeted in roughly equal numbers. The
average age: 30. Mean IQ: 60. The operation was generally done within a few
months of commitment.
A foreign-born patient was far more likely to be sterilized than a native-born
patient, Popenoe found. Black patients were more likely to be sterilized
than whites; this wasn't a surprise, he wrote, because "studies show that
the rate of mental disease among Negroes is high."
Those sterilized routinely came from large families with histories of mental
illness who were reproducing feebleminded children at a rate "more than half
again as great as that of the stock which sends its sons and daughters to
Berkeley," he wrote. They were three times as likely to have come from a
broken home; half had fathers who were laborers.
In a 1935 memo to The Times' Chandler, the foundation estimated sterilization
saved the state more than $1 million a year by removing patients from overcrowded
hospitals. That year, The Times began a weekly column championing strong
sterilization laws that ran for six years.
They were among the sermons that were intended to draw the public to the
cause.
"In modern civilizations, where the weak and helpless are protected so
carefully, it is not possible to depend on Nature to solve this problem of
the survival of the unfit," Popenoe wrote in one report. "Sterilization was
seen to be not a punishment but a protection, alike to the afflicted and
their families, to society, and to posterity.
"The man who breaks down mentally and requires hospitalization is a sick
man. In most instances his wage-earning capacity is impaired for the rest
of his life. Multiplication of his family may be as unfair to him as it is
to his family." For women, the strain of pregnancy "is sufficient to cause
a nervous breakdown .... Here, sterilization is a psychological protection."
A quarter of "first admissions" to state hospitals for the insane and subsequently
discharged were sterilized, Popenoe found. Those sent to the Sonoma State
Home in Eldridge — many of them girls as young as 11 who were committed because
of their alleged promiscuity — faced a different policy. "No one is allowed
to go out of this institution, even for a short vacation, unless sterilized,"
Popenoe wrote.
The Human Betterment Foundation not only promoted the sterilization of
the mentally ill, but it also advocated voluntary sterilization of the blind
and disabled at public expense, as well as people with cancer, heart and
kidney disease and tuberculosis.The number of people who should be sterilized
"are numbered not in the thousands, not in the hundreds of thousands, but
in the millions," Popenoe wrote.
When Gosney died in 1942, the foundation was known worldwide. Hundreds
of thousands of its studies, pamphlets and books were distributed to policymakers,
schools and libraries. Its work informed a wide audience, from government
officials developing their own sterilization programs to high school students
writing term papers.
"You were so kind to send ... new information about the sterilization particulars
in California," Dr. Fritz Lenz, one of Nazi Germany's leading eugenicists,
wrote Gosney in 1937. "These practical experiences are also very valuable
for us in Germany. For this I thank you."
In a 1934 article for the Journal of Heredity, Popenoe dismissed suspicions
that the Nazis were motivated by dreams of racial purity. He lauded Hitler
as a visionary, quoted from "Mein Kampf" and concluded that Germany's effort
was in "accord with the best thought of eugenicists in all civilized countries."
The Germans returned the compliment. When Sacramento banker and Human Betterment
Foundation board member Charles M. Goethe visited Germany in the mid-1930s,
leaders in the Nazi sterilization movement praised the writings
of Gosney and Popenoe.
"You will be interested to know that your work has played a powerful part
in shaping the opinion of the group of intellectuals who are behind Hitler
in this epoch-making program," Goethe wrote Gosney. "I want you, my dear
friend, to carry this thought with you for the rest of your life, that you
have really jolted into action a great government of 60,000,000 people."
Boy from very good family ... committed to Sonoma. Family claimed that
feeblemindedness was not inherited and fought sterilization. Allowed to go
home on parole. Within a few months the family learned that a very low-grade
Mexican girl was pregnant and that this boy was the father.... Family insisted
that he marry girl, even though it disgraced them and broke their hearts.
— patient summary from the files of the Human Betterment Foundation
The Caltech archive contains 16 boxes of patient case histories that will
remain closed until 2005. But hundreds of unnamed records offer sketchy profiles
of patients and the motives of doctors who operated on them.
Female, 20. Parents not married. Mother drank constantly before conception
and during pregnancy. Child was neglected and abused. Consent for operation
given by stepfather. Patient's sexual condition: Passionate. Lived for a
time with a man to whom she was not married. Hard to control where men are
involved. Might easily become a prostitute.
Female, 20. Mother of low mentality. Mother's mother also feebleminded.
Patient uncontrolled around boys. After operation: One of the few girls with
whom sterilization may have done more harm than good, in making her feel
free from restraint.
Male, 20. Masturbator. Up to this time mother and stepfather have been
able to care for this boy by keeping him closely at home. Now they are afraid
that he will do harm to some of the little girls in the neighborhood.
Mothers, fathers, uncles, stepfathers, sisters and husbands are listed
as those providing consent for the operations. Many other forms state that
there were "no responsible relatives" to give consent; they were either dead,
overseas or insane themselves.
The Human Betterment Foundation recognized that loopholes in California's
sterilization law opened doctors and the whole program to the threat of lawsuits
and negative publicity over the issue of consent.
Margaret Lee Griffin posed such a threat. She was a 24-year-old married
mother of three who was living with another man when she was sent to the
Sonoma State Home for sterilization after social workers accused her of neglecting
her children.
Griffin escaped in 1940 with her lover's help. "We will try to apprehend
Margaret and arrest the parties who stole her," said Dr. Fred O. Butler,
the hospital's superintendent, in a letter to the foundation.
Griffin was captured and brought back to Sonoma. But weeks later, Butler
changed his mind and let Griffin go — unsterilized. "There had been so much
newspaper notoriety regarding this case," he wrote the foundation, that "we
felt under the circumstances we were not justified in forcing it as it might
have some deleterious effect on the whole sterilization program."
Today, scholars believe consent for many of California's sterilizations
were obtained through coercion. It was something promoters knew at the time
and kept hidden.
"Dr. Butler has always had a strong weapon to use in getting consents for
sterilization by telling the relatives that the patient could not leave without
sterilization," Popenoe wrote to John Randolph Haynes, a nationally known
social reformer and one of Los Angeles' most powerful civic leaders. The
letter is part of Haynes' papers, archived at UCLA.
Haynes applauded Butler's efficiency and believed other state hospital
superintendents could increase the number of sterilizations by following
his example. "It is my opinion," he wrote Popenoe, "that no woman of child-bearing
age and no man capable of propagation should be discharged ... without sterilization."
He offered to help set up a $100,000 defense fund for doctors who were sued
by patients.
Gosney didn't like the idea, saying it "might only serve as an incentive"
to lawyers. Instead, the foundation maintained in its studies that consent
wasn't an issue and that sterilization was embraced by patients and their
families.
The foundation sent questionnaires to 821 sterilized former patients in
1926 asking how they were doing. The 173 letters they got back formed the
basis of a report that concluded the overwhelming majority were satisfied
with their new lives.
Only a handful of those letters survive.
"I do not believe I have been benefited mentally by the operation; perhaps
my 'pride' still resents the thought," one man wrote. "I did not and do not
quite understand the motive or 'purpose' for compulsory operation.... Hope
you can realize my viewpoint."
"Doctor, if you write my son do not mention the sterilization operation
to him as he does not know it was performed," wrote another patient's mother.
"I think such operations is just the finest thing there is for people that
not mentally or physically healthy: not only for them, but for all those
women who are bearing unwanted and uncared for children," one woman reported.
"It was all a mistake," wrote a man who had been sterilized at Stockton
state hospital. "I would rather not be sterilized as I do not think there
is the slightest danger of myself being responsible for any weak or feeble-minded
children, and I shall ever bemoan the fact that I shall never have a son
to bear my name, to take my place and to be a prop in my old age.
"My brother is at present a patient at Stockton.... He does not intend
to ever marry and does not wish to be operated on and as his brother I hope
you will please see to it that he is not."
Sterilization in the United States continued until the early 1970s. Its
demise had begun during World War II, and the number of operations slowed
in the 1950s. Scientific advances discredited the link between heredity and
mental illness. New techniques for treating the mentally ill took hold. And
the Nazi abuses drove sterilization promoters underground.
As Gosney wrote to a colleague in 1940: "We have little in this country
to consider in [terms of] racial integrity. Germany is pushing that. We should
steer clear of it lest we should be misunderstood."
Popenoe eventually abandoned sterilization, turning his attention to marriage
and family counseling, which he had advocated since the 1920s. In the 1950s,
he became one of America's best-known marriage counselors — a pop psychology
guru with best-selling books, a syndicated newspaper column, articles in
Ladies' Home Journal and appearances on Art Linkletter's "House Party" television
show.
What had been done in the name of human progress was all but forgotten.
UCLA's Robert Edgerton was a young researcher working for a state hospital
in Pomona when he and a colleague interviewed 50 former mental patients.
Their 1961 study tested the still popular assumption — propagated by the
Human Betterment Foundation decades before — that sterilized patients accepted
their operations as beneficial.
Edgerton found that only a fifth of those interviewed approved of the operation,
and most of them were unmarried men who felt freed sexually.
Nearly all of the women were devastated. Many were abandoned by their families.
Those who married generally didn't tell their husbands what had been done
to them.
"They said they were going to remove my appendix," one woman told Edgerton.
"I still don't know why they did that surgery to me. The sterilization wasn't
for punishment, was it? Was it because there was something wrong with my
mind?"
Said another: "I love kids. Sometimes now when I baby-sit, I hold the baby
up to myself and I cry and I think to myself, 'Why was I ever sterilized?'
"
Edgerton attended the funeral of one of his subjects a few months ago.
He had an IQ of 52 and couldn't read or write. Yet he worked, accumulated
a fair amount of money and had plenty of girlfriends. He also was bisexual.
Edgerton won't divulge the man's name, or those of the 14 other sterilization
survivors he has kept in contact with for four decades as part of a long-term
study of life after institutionalization.
All are older than 70. One woman attempted suicide. One is an active member
of a church and delivers food to the needy. Another was married to man who
dominated her every move for 20 years. After he died, Edgerton said, "she
took off like a rocket," went to school, got a driver's license and joined
a bridge and Scrabble club.
Her new friends don't know her secret.
"Of all the things they endured in the state institutions, what has stuck
the longest and most painfully is their sterilization," Edgerton said of
his subjects. "This scar that they carry is just a symbol of that."
In 1999, Edgerton interviewed dozens of former mental patients as part
of a class-action suit over a Canadian sterilization program. The government
of Alberta, which sterilized mental patients from 1928 to 1972, eventually
settled and agreed to pay $55 million.
That same year, the Swedish government agreed to pay $21,250 to each person
it sterilized from 1941 to 1975.
"What could we do for those people who are still alive?" asked state Sen.
Dede Alpert (D-San Diego), whose committee earlier this year renewed interest
in California's effort to sterilize its way to a better society. "What should
we do beyond ... issuing an apology?"