Abstract
In Fixing the Poor: Eugenic Sterilization and Child Welfare in the Twentieth Century, Molly Ladd-Taylor provides a social history of Minnesota’s sterilization program from the late nineteenth century to the late 1960s. In doing so, she shifts scholarly attention away from discourse analysis in which eugenics occupies center stage to a state-centered approach. The drama of eugenicists, with their dire warnings of race suicide propelled by the imagined rampant propagation of the feebleminded, fostered an environment ripe for the denial of human rights. However, Ladd-Taylor argues that the implementation of sterilization programs was primarily shaped by the institutional design of states, the intricacies of routine administrative policy, and pragmatic efforts to reduce the cost of dependency regardless of eugenic indications. Indeed, rather than a dramatic shift in beliefs or practices, she argues sterilization policy is instead best explained through “a mundane and all-too-modern tale of fiscal politics, troubled families, and deeply felt cultural attitudes about disability, welfare dependency, sexuality, and gender” (p. 2). Through this approach, Ladd-Taylor illuminates the workings of sterilization as one tool within a broad set of miserly welfare policies controlled at local and state levels aimed at “fixing” the poor.
Fixing the Poor is organized chronologically, and each chapter provides considerable historical data to sort through the impact of eugenic versus fiscal and administrative factors shaping sterilization. Ladd-Taylor begins the history in the late nineteenth century with the bureaucratic foundations that facilitated the passage and implementation of Minnesota’s sterilization law. The state’s Children’s Bureau and its Department of the Feeble-Minded shared an institutional commitment to reducing the cost and negative consequences of the “three Ds”—“defective, dependent, and delinquent classes.” The 1917 Children’s Code created a bifurcated welfare system in which dependent and even delinquent children benefited from policies that shifted care away from institutional solutions toward the community. In contrast, as part and parcel of protecting innocent children, “defective” children were subjected to unprecedented state power to impose guardianship and compulsory institutionalization. As chapter 2 documents, the increased administrative capacity of the state and the changing nature of the courts provided an opportunity for local officials to use state institutions for the feebleminded as a means to rid local communities of troublesome or “defective” individuals and shift potential local expenditures to the state level. Thus, due to the expanded state power combined with the pragmatic and often biased assessment of local judges and county child welfare boards (not necessarily due to eugenic reasoning), the number of residents at the Faribault School for the Feebleminded quickly grew beyond capacity.
In 1925, Minnesota passed its sterilization law. While eugenicists influenced the debate over sterilization, Ladd-Taylor deftly documents that prominent eugenicists did not succeed in passing their preferred bill; rather, the state Board of Control (created by the 1917 Children’s Code) promoted a narrower bill that applied only to the feebleminded and insane under guardianship, and this bill passed. In chapters 3 and 4, Ladd-Taylor’s state-centered argument reaches its peak as she analyzes the processes by which people were labeled feebleminded, placed under guardianship, and sterilized. She notes, “Most scholars writing about feeblemindedness have analyzed it as a cultural discourse and (pseudo)scientific diagnosis. But feeblemindedness was also a legal and administrative category by which persons deemed to be incompetent for citizenship were made to surrender their political and civil rights in exchange for the state’s ‘protection’” (p. 85). Local probate judges without medical or eugenic expertise determined feeblemindedness and institutionalization, in often relatively arbitrary fashion, sometimes based on eugenic data but primarily based on evidence of delinquency and dependence. Decisions about sterilization also focused on pragmatic social and economic concerns, often based on assessments of who could be best paroled from the institution. Parole required employability, marriageability, and housing—in other words, some sense that one would not constitute a public menace or be dependent upon release. In addition, program administrators prioritized pragmatic factors including the physical ability to withstand surgery, the availability of community supervision, and legal consent from relatives to the operation. These criteria were applied in gendered and racialized ways. Ladd-Taylor asserts that for the Board of Control, “sterilization was primarily an administrative means of reducing hospital overcrowding” (p. 129), reserving institutionalization for those who were defined as the least deserving and restoring back to the community those who, without additional children and with supervision, could function.
During the Depression, institutionalization and sterilization served as key components of Minnesota’s public welfare system. As local economies collapsed and capacity to serve those in need declined, local officials found great appeal in the cost-shifting strategy of institutionalization and the hope of reducing economic burdens by preventing procreation among the “defective” poor. As with the prior era, the growth of institutionalization and sterilization was shaped by party politics, bureaucratic reorganization, and administrative legal opinions (p. 162), more so than rhetoric about eugenics.
The 1940s and 1950s ushered a new push for human rights and critiques of eugenics, institutionalization, and sterilization; however, economic arguments continued to shape ideas about rights and services. Indeed, Ladd-Taylor argues that reforms “reflected new ideas about poverty and welfare as much as the disapproval of eugenics” (p. 176). Parents of children with “mental retardation” used their middle-class status to present themselves as respectable, tax-paying citizens who deserved humane treatment of their loved ones, in contrast with the undeserving poor. Critics cast sterilization as rooted in the inhumane pseudoscience of eugenics. Yet, by 1960, the reasons for institutionalization and sterilization had remained largely consistent over time. Institutionalization was still largely based on sexual delinquency and economic dependency, while Minnesota’s sterilization program continued to target persons institutionalized for mental retardation based on an assessment of their suitability for parole including heredity, a woman’s ability to provide adequate care for children, and a man’s ability to maintain self-sufficiency for himself and family.
In the 1960s, new welfare initiatives including public education and expanded aid to the poor (e.g., social security) made institutionalization and sterilization less necessary and institutionalization even seemed costly in comparison to community services. Reformers heralded this shift as a victory for progress, but the antipathy for the “defective, dependent, and delinquent” classes remained. “It is a cruel irony that the important legal and symbolic gains for people with disabilities coincided with the increasingly punishing approach to welfare dependency and sexual delinquency” (p. 224). Child welfare and criminal justice systems continue to serve many of the same functions of institutionalization and sterilization—reducing the birth rate of and separating children from disreputable families, segregating and controlling troublesome populations, and shifting the cost of social services away from local economies to the state and federal government, often in racialized and gendered ways. Although the heyday of blatantly eugenic rhetoric has largely passed, the welfare system continues to pathologize the poor as incompetent and undeserving, assume the need to limit their family size, and deny people the services and supports that would lead to fulfilling lives.
Ladd-Taylor’s work makes several valuable contributions. As should be clear from the above summary, Ladd-Taylor offers a richly detailed account of the ways in which the practical, bureaucratic, and administrative functioning of welfare shaped Minnesota’s sterilization program. This institutional approach is in line with Deborah Stone’s 1984 classic work, The Disabled State, but bureaucracy is not academically “sexy,” and few works have taken up Stone’s call to document its significant impact. Ladd-Taylor's work is also keenly historically and geographically situated and shows how the specificity of institutional structure and the people in given roles shaped the course of sterilization. Thus, each state has a unique history, not easily predicted by broad national trends or rhetoric. Ladd-Taylor documents the frequent shifts in rhetoric and policy in sorting the undeserving and deserving poor yet also shows that each shift left some vulnerable population in the undeserving category, bereft of adequate services, and deemed unworthy of family support. Ladd-Taylor also documents the blurry boundary between compulsion and choice. Minnesota prided itself on having a “voluntary” sterilization program that required consent by family members, yet the options for family members were scarce. Indeed, some poor women with very limited access to birth control may have subjected themselves to the label of feeblemindedness and institutional commitment—a very frightening proposition—in order to gain access to sterilization. There seems little comfort in the illusion of choice. Ladd-Taylor shows time and time again how locally administered, highly variable, yet consistently miserly social welfare programs presented the poor themselves as at the heart of the problem of poverty, which could only be “fixed” through a range of more or less humane policies distributed on the basis of perceived deservingness. Thus, even when liberal reformers achieved increases in aid and shifted services toward the community, attempts to radically address the structural, root causes of poverty were hampered by the decentralized welfare system, stigma on dependency, and local stinginess. In doing so, Ladd-Taylor connects the history of sterilization to the broader history of welfare, resisting the common practice of conceptualizing disability policy as distinct from and unrelated to other forms of social policy. Finally, Ladd-Taylor attends to the nuances of intersectionality and documents the ways in which race, class, gender, and disability intertwined with pragmatic concerns through time.
The primary weakness, which is a relatively minor one, is that in prioritizing economic and practical explanations of sterilization over eugenics ones, Ladd-Taylor at times seems to give short shrift to the role of eugenics. For example, readers learn that the eugenics society did not succeed in passing their broader sterilization law, but very little about what else the eugenics society did accomplish. For a reader with little exposure to the broader literature on sterilization, the lack of attention to the role of eugenics may underestimate its overall impact. For those well versed in the sterilization literature, versions of several chapters have been published already, and therefore, the primary argument has previously been well established.
That said, in Fixing the Poor, Ladd-Taylor presents a model for sociologically informed historical analysis and significantly contributes to the already rich scholarship on sterilization. It will be of great interest to a broad range of scholars—including historians, sociologists, disability studies scholars, and ethicists. In particular, it is of great value for those interested in the histories of welfare, eugenics, and sterilization and/or the intersections of disability, race, gender, and class in policy and the family.