State-sanctioned eugenics and the Mississippi Appendectomy

Written by: Becca Williams, SBT Copywriter

The cover art for this post is a 2019 piece titled "Fannie Lou Hamer", by artist Michael C. Gibson.

This week, we’re going to continue with the theme of state sanctioned violence against Black women by talking about Mississippi Appendectomies, a term used to describe the hysterectomies and tubal ligations performed in the South in the early- to mid-19th century.  These procedures were funded for and insisted upon by state and federal entities and were often performed without the patient’s informed consent, under a certain amount of coercion, under the auspices of performing a different procedure, or on a patient younger than 18.  Forced sterilization programs, also known as eugenics programs, are deeply ingrained in the fabric and history of our country.  While state eugenics programs have been dismantled, varying forms of eugenics exist today.  We’ll get into this history, the ways in which these programs affected Black communities, and how eugenics and its modern-day counterparts are inextricably linked to capitalism. 

This conversation runs deeper than the time and space allotted here and involves discussions on current approaches to reproductive health and contraception, welfare reform, and criminal justice - all topics that warrant much further learning.  We have long been a country where Whiteness dictates who has the right to decide how and when to have children, and under what circumstances that choice happens for them. 

Once again, I did not know much about this before writing this blog and am pretty constantly reminded of the lengths White Supremacy will go to protect itself from its own reflection.  

The word “eugenics” comes from the Greek term “eugenes”, meaning, essentially, “well-born”.  The term was coined for scientific use by Francis Galton, Charles Darwin’s cousin in the late 1800’s.  American biologist Charles Davenport put Galton’s eugenics theory to practice.  Both Galton and Davenport believed that ‘selective breeding” could transform the US population by eliminating the reproduction of certain groups that they believed were passing along undesirable genetic traits, namely poor, institutionalized, and immigrant communities.  In 1910 Davenport founded the Eugenics Records Office (ERO), which tracked hereditary information on families, particularly those entering the country.  The ERO began a nationwide education program on eugenics and as the video linked above notes, in 1920, as new immigrants were arriving in the US, Davenport wrote a letter to a friend that stated: “Can we build a wall high enough around this country to keep out these cheaper races?”  The similarities between that perspective and Trump’s are chilling.

(Eugenics Records Office, 1920's, Long Island New York)

The eugenics movement began going in multiple directions and iterations, embedding itself in society and in the mindset of many. Let's talk about Planned Parenthood founder Margaret Sanger, a devout eugenicist.  One of the most fascinating aspects of writing these blogs and emails is witnessing the ways in which Whiteness infiltrates how information about these topics is conveyed – both in my own writing and in the writing of others.  I touched on this in last week’s blog when I wrote about how some of the most atrocious aspects of the forced reproduction of enslaved Black women were dismissed in articles because there wasn’t enough “evidence”.  Similarly, a lot of people feel the need to defend Margaret Sanger – largely because of her Whiteness and because of the overall impact that Planned Parenthood currently has.  This article writes, “Historians contest a longstanding myth that Sanger thought non-white people should be prevented from procreating, but they agree that Sanger supported eugenics, a theory that ‘undesirable’ populations could be reduced or eliminated by controlling their breeding.”  This sounds like someone saying “I reject you telling me that you went to the grocery store, but I agree that you went to a large building with aisles of food for sale.” 

Sanger took her birth control trials all the way to Puerto Rico, where groups of brown and Black Puerto Rican women trialed contraceptive pills that were at the time quite dangerous.  Those same women were then were denied access to those methods once the pills were refined.  Further, Sanger’s projects in Southern Black communities whereby she attempted to build relationships between Black women and Black doctors - and where she also led contraceptive trials - actually led to an increase in Black women seeing White doctors for their reproductive care, which only further rooted the deeply racist misconceptions held about Black women and reproductive health.  Yet, this is called “outreach” by Planned Parenthood, in an effort to hold themselves accountable for her eugenicist approach.  I’m spending so much time on this because it’s important for us to understand how entrenched in eugenics some of our most well-known and, depending on your politics, beloved institutions are.  For me, this points to another reason for well-meaning liberal White women like myself to take a step back and begin to see history for what it really is and what it really meant to communities of people who don’t look like me. 

Back to Charles Davenport. His projects began receiving funding and beginning in 1907 eugenics laws began taking hold, eventually reaching 31 states and remaining in effect until 1978.  Eugenics laws authorize sterilization of those deemed “socially inadequate.”  The Model Eugenics Sterilization Law, published in 1914 sanctioned involuntarily sterilizing people who are “feeble-minded, insane, criminalistic, epileptic, inebriate, diseased, blind, deaf, deformed, and dependent” and whose reproduction was viewed as a “menace to society”.  These laws were upheld in the Supreme Court in the 1927 case of Buck v. Bell.  From the inception of these laws until they were dismantled, there were around 70,000 known involuntary sterilizations (although this number is later contested) that took place in the US, with 20,000 of those taking place in California and predominantly impacting the Latinx and Asian- American Pacific Islander communities. Native American women were involuntarily sterilized at much higher rates as well – this article details much of the medical abuse they faced. These numbers don’t include the one in three Puerto Rican women that survived involuntary sterilization in a program that flourished in the years after Sanger’s and her associate’s contraceptive experiments. 

(A 1935 map of state eugenics laws)

As you can see there is a dearth of information about this topic, and it winds its way to our discussion of Mississippi appendectomies.  The practice of involuntary sterilization changed after World War II when the general public saw how eugenics led to horrific violence and the decimation of the Jewish population in Europe.  I don’t know how many of those same people understood that Hitler was inspired by the US eugenics model; he even wrote a thank you letter to a famous eugenicist in the US.  It was also around this time that science was beginning to catch up and demonstrated that genetics was much more complicated than the mediocre White men with enough power to create and enact laws would have us believe.  

What came from this shift, however, wasn’t an end to eugenics – just a different iteration of it.  Instead of focusing on the involuntary sterilization of folx who were institutionalized, either for mental illness or because they were involved in a criminal justice process (many of these sterilization survivors were people of color), state-run eugenics programs began to target the social and domestic sphere.  This became a concerted campaign against minority women who were seen as being dependent on the government, irresponsible, and taking resources away from White communities. 

North Carolina’s eugenics program, for example, forcibly sterilized more folx after WWII than before.  From 1929 to 1974, North Carolina sterilized close to 7,600 men and women, most of them Black; 70% of these sterilizations happened after the war – again these numbers will later be contested.   A 2010 research study that focused on this era of North Carolina sterilizations discovered that sterilization rates paralleled the size of the population receiving government assistance only when that population was Black.  The author uses the term “genocide” to describe this trend.  

These state eugenics programs were “federally funded welfare state” programs, meaning they were often linked to the provision of welfare benefits to lower income families.  The fear of and hatred toward folx receiving government assistance was highly racialized, including the racist stereotype of the “welfare queen”, which led to presidential initiatives – from Reagan to Clinton – to slash welfare programming, predominantly impacting communities of color.  Why am I talking about this?  Black women were routinely threatened with the withholding of welfare benefits from their families or even the withholding of their own children, lest they undergo sterilization.

(Page from a North Carolina 1950's brochure speaking to the benefits of sterilization. You can see the whole brochure here.) 

As desegregation became prominent in the 1950s, sterilization rates for Black women rose.  This is no coincidence.  White Supremacy felt itself losing its grasp of a small portion of its control and backlash ensued as a way to enforce racial hierarchy.  As last week pointed out, enslaved Black women were forced to reproduce as a means for enslavers to gain more profit.  Now that Black folx could no longer directly produce capital for White folx through enslavement, White folx devised a state sanctioned way to limit their existence all together. 

There were other forms of coercion as well.  In the late 1960’s, 14-year-old Elaine Riddick was forcibly sterilized while giving birth.  Her pregnancy was the result of rape.  The North Carolina Eugenics Board considered her “promiscuous” and “unable to get along with others” – both viable justifications at the time for sterilizing a child survivor.  The consent form for the surgery was signed by Elaine’s grandmother with an “x” – Elaine’s grandmother could not read, and it is unclear if she understood the nature of the procedure. Similarly, the 1973 case of Relf v. Weinberger details the forced sterilizations of Mary Alice Relf, 14, and her sister Minnie, 12, after their mother who could neither read nor write, signed a consent form. The Southern Poverty Law Center filed a lawsuit on behalf of the Relf sisters and in the course of the lawsuit it was discovered that between 100,00 and 150,000 poor people were sterilized annually in these programs.  Coercion is difficult to ascertain as welfare benefits were often brought into this, doctors falsified paperwork, and until this lawsuit, informed consent was not practiced. 

Forced sterilizations of Black women in the South became so widespread that they came to be known as Mississippi Appendectomies.  Many articles that I read didn’t attribute the naming of this term to any one individual, but some attribute this phrase to none other than civil rights activist Fannie Lou Hamer.   Hamer was born in Mississippi in1917 and spent the first part of her life as a sharecropper.  She underwent surgery in 1961 to have a uterine tumor removed and awoke to discover that the doctor performed a hysterectomy without her consent.  The next year, she joined the Student Nonviolent Coordinating Committee and the Southern Christian Leadership Conference and began to organize to register Black Mississippians to vote - an arduous process that often resulted in violence, and sometimes death, at the hands of White folx. Hamer later spoke about her experience with forced sterilization in front of a crowd in Washington, D.C., and conducted her own research in her home county, Sunflower County, Mississippi, discovering that 60% of the Black women in that county had a similar experience.  There is so much to learn about Hamer, and I encourage you to take some time to read about her.

(A 1977 poster advertising for a rally in San Francisco)

So where are we today?  Federally funded eugenics programs were dismantled by the late 1970s, however their legacy continues.  Some states began reparations programs for survivors of forced sterilizations:  North Carolina has paid $35,000 each to 220 survivors, and Virginia agreed to give $35,000 each.  This amounts to a tepid attempt at a symbolic apology, as there are thousands more survivors, this is decades late, and while there is no way to gauge the worth of what is lost in a forced sterilization, these numbers are absolutely too low.  Horrifically, there are stories of judges offering sterilizations to folx in the jail system as a way to reduce their sentencing.  We continue debates about offering cash benefits to folx receiving welfare in exchange for undergoing sterilization.  A few years back, a Black nurse whistle blew about forced sterilizations occurring at Irwin County Detention Center in Ocilla, Georgia.  

Don’t worry, we’ll keep this discussion going. In May, we’ll talk more about how the reproductive rights movement grew out of the eugenics movement, as well as how much of the White feminist discussion about reproductive rights stems from eugenics principles of population decrease. 

Additional Resources:

I encourage you to listen to this podcast interview Harriet Washington.  She is a medical ethicist who wrote the book “Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present". 

There is an album of Fannie Lou Hamer’s music, titled The Songs My Mother Taught Me.  Please take a listen.

Lastly, this book details a lot of the atrocities I spoke about above.