Promoting involuntary sterilization: early hints of problems in the 1930s

Please note that this post is from 2017. Evaluate with care and in light of later events.

In 1937, William M. Kantor published an interview with an early pioneer in sterilization (especially of men), Dr. Harry Sharp, in the Journal of Heredity.[1] Kantor had, according to documents in the archives of California’s Human Betterment Foundation (California was a pioneer in eugenic sterilization), interviewed Dr. Sharp in 1935 about his role as a physician and surgeon at Jeffersonville, a penal institution in Indiana. The article, “Beginnings of Sterilization in America,” is notable as much for what was not included as for what was.[2]

The Journal of Heredity

As of 2016, the Journal of Heredity is published by Oxford Journals on behalf of the American Genetic Association, and now covers “organismal genetics across a wide range of disciplines and taxa.” According to the Oxford Journals page about the publication, “Virtually every major figure in the field has contributed to the journal,” which “[o]ver the last 100 years … has established and maintained a tradition of scholarly excellence in the publication of genetics research.”

As of 1919, the Journal of Heredity—formerly known as the American Breeders’ Magazine—billed itself as “[a] monthly publication devoted to Plant Breeding, Animal Breeding and Eugenics.”[3] The January edition of 1919 included the following articles:

• “Chimeras in Corn Hybrids”;
• “Better American Families,” by Wilhelmine E. Key of the Eugenics Record Office;
• “New Everbearing Strawberries”;
• “Testing New Foods,” by “Agricultural Explorer” David Fairchild of the U.S. Department of Agriculture;
• “The Fighting Abilities of Different Races,” notably published just at the end of WWI; and
• “Race Mixture in Hawaii,” by Vaughan MacCaughey (“What is likely to appear is the gradual growth of the new stock, fitting itself for leadership in the minor business and clerical activities of the islands.”)[4]

In the 1919 volumes, under the heading “What Genetics Is,” the editors write that the “object of the science of genetics” is to gain “[a]n exact determination of the laws of heredity.”

The knowledge so gained finds its application in methods for the improvement of cultivated plants and domesticated animals and, most important of all, in the improvement of the human race through the science of eugenics, which was defined by its founder, Francis Galton, as “the study of agencies under social control that may improve or impair the racial qualities of future generations,” either physically or mentally.”[5]

As of 1937, when Kantor’s article appeared, the front matter of the journal no longer contained references to eugenics or Galton, but eugenics still appeared favorably in various articles, as evidenced by, for example, book reviews about American versus German eugenics, and of course Kantor’s favorable history of sterilization in America.[6]

Dr. Sharp and turn-of-the-century sterilization

Dr. Harry C. Sharp was a logical choice for Kantor to use as the core of his article. More than thirty years earlier, Dr. Sharp himself had published an article on sterilization and eugenics in the New York Medical Journal, in which he had argued for the benefits of sterilization and explained his early use of the procedure. Without offering much in the way of supporting evidence, Dr. Sharp wrote:

[P]ractically all other animal kind protect themselves, or are protected, by putting to death those weaklings that are unable to weather the storm, and others that appear peculiar are castrated by their sires, and none but the perfectly healthy are left to reproduce their kind. … It is altogether probable that we, through our spirit of humanity, our broad ideas of liberty and individual right, have gone too far in this direction [of giving way for all to marry that will, too much liberty and indulgence in tolerating all sorts] for the good of the entire race.[7]

But despite the harsh rhetoric, and more in keeping with his role as a physician, Dr. Sharp believed castration unjustifiable, “for the method employed to render these unfortunates sterile should not in itself be a punishment to the individual—it must not result in a deformity, neither must it interfere with his enjoyment of life.”[8]

According to Dr. Sharp’s 1902 article, after performing vasectomies in forty-two patients, “whose ages range from seventeen to twenty-five,” he now believed that it “does not impair the sexual power,” but that patients instead demonstrated marked improvements in both mental and physical functioning:

[T]hey improve mentally and physically, in that they increase in flesh, feel that they are stronger, sleep better, their memory improves, the will becomes stronger, and that while prior to the operation they made no advance in school, their advance is now fairly satisfactory.[9]

In short, sterilization benefits both patient and society to such an extent that Dr. Sharp argues that doctors should advocate for legislation that would give “those in charge of State institutions the authority to render every male sterile who passes its portals, whether it be almshouse, insane asylum, institute for the feeble minded, reformatory, or prison.”[10] (A skeptical modern reader might be inclined to ask if, given these vast reported improvements, perhaps all but a few men ought to be sterilized for their own good and the good of society?)

Published versus unpublished accounts of an interview with Dr. Sharp

In the record of an interview recorded in the E. S. Gosney Papers and Records of the Human Betterment Foundation and dated 1935, Dr. Sharp says he performed some five hundred sterilization operations—presumably carried out on male penal inmates—before a 1907 Indiana law explicitly authorized them.[11]

In the 1935 archival version of the interview, Dr Sharp explains, “Operations were performed on the personal request of the individual, with written consent, prior to the law of 1907, with the exception of one case.”[12] Notably, Kantor’s article, published in 1937 but clearly drawing on the same interview as the 1935 Gosney archival material, instead reads: “Operations at Jeffersonville were performed on the personal request of the individual, with written consent, prior to the law of 1907.”[13] Kantor makes no mention of the “exception,” suggesting that scientific publications like the Journal of Heredity were beginning to recognize the potential issues of patient consent and possibly even discriminatory treatment based on race.

An exceptional case expunged from print

The exceptional “one case” referred to by Dr. Sharp—but left out of Kantor’s article in The Journal of Heredity—was a vasectomy carried out by Dr. Sharp on “a syphilitic Negro.” Dr. Sharp is quite up-front about his actions, explaining that “while operating for chancre, the vas was exposed, and I performed a vasectomy without his knowledge or consent.” He added, “I thought it was a shame for this diseased Negro to go on freely propagating his kind.” A year later, when asked by Dr. Sharp in a follow-up interview, “the Negro” made it clear “he never knew what had happened to him.” Dr. Sharp checked that he “had felt no ill effects, whatever,” and then “let the matter drop” without ever informing him of the operation or its effects.[14]

Another notable case appears in the Gosney version of Dr. Sharp’s interview but not in Kantor’s published article: a salpingecomy (the tying of the Fallopian tubes) he performed on a twelve-year old epileptic after her family appealed to him for help (presumably her family consented to his operating on the child, although there is no indication that anyone considered the wishes of the girl herself). Dr. Sharp notes that she did not suffer from any seizures while he monitored her for two years after the operation—he is very careful to allow that this result might be “merely coincidental” to the operation—though he also adds, perhaps more out of wishful thinking than actual belief, that “it is possible that there was some connection” between her sterilization before puberty and the cessation of her epileptic seizures.[15]

Consent before and after Indiana’s 1907 sterilization law

Both the Gosney document and Kantor’s published article contrast the state of affairs at Jeffersonville before and after the passage of the 1907 Indiana law authorization sterilization on the recommendation of an expert panel (and with no mention of any need for patient consent), stating, “Previous to the passage of the law, all patients gave their consent in writing, but not after the law was passed.”[16]

In both Kantor’s published article and in the Gosney document, Dr. Sharp speaks favorably of one other specific case that today we would consider a violation of informed consent: a vasectomy performed on an inmate—Kantor’s published article calls him a “boy from Missouri”—who “complained of excessive masturbation, and insisted on castration.”[17]

Dr. Sharp, who “did not feel justified in performing that mutilation,” instead “convinced the patient that he would receive all the benefits that should be expected” and performed a vasectomy instead, telling the inmate it “had all the effects of castration, as far as getting away from masturbation.”[18] In the Gosney document, a parenthetical note reads: “perhaps I misrepresented to him.”[19] Kantor’s published version preserves Dr. Sharp’s potential doubt, but excuses it: “Perhaps I misrepresented the facts to him; but we did not know so much about sexual science in those days.”[20]

When, after six months, the young inmate complained again about “excessive masturbation,” Dr. Sharp says he gave him another “treatment,” telling the young man he would perform an actual castration if he did not notice improvements.[21] But this time it worked, according to Dr. Sharp: “He reported later that he had stopped masturbating, felt very little desire to do so, his mind was better, and he was making better progress in school.”[22]

Sterilization is good for the patient

Although the words vary slightly between versions, both interviews show that Dr. Sharp was clearly pleased by this outcome: “Here was a condition that would not mutilate or impair health, and yet improve the nervous system.”[23]

In Kantor’s published version, but oddly not in the Gosney document, Kantor says that Dr. Sharp noted, “Other inmates began to request that they have the advantage of the same operation.”[24] The Kantor version, also adds expert endorsement of the procedure and its potential improvements, as well as a kind of after-the-fact approval by patients: “this method of preventing procreation is so infinitely superior to all other proposed—that it is endorsed by the persons subjected to it,” including “three physicians,” all of whom “assured me that they have a decided lessening of muscular and nervous fatigue.”[25]

Sterilization is in the public interest, too

Both the 1935 Gosney and the 1937 Journal of Heredity versions of Dr. Sharp’s interview strongly imply that vasectomies are in the interests of both the public and of the patients themselves, a position Dr. Sharp also strongly argued for in his earlier 1902 article.

Kantor’s 1937 article goes further than the Gosney document does by adding additional expert opinions beyond Dr. Sharp, like those of Dr. A. J. Ochsner, another early proponent of vasectomies, who makes an argument that sterilizations are in the public good: “This method would protect the community at large without harming the criminal. The same treatment could reasonably be suggested for chronic inebriates, imbeciles, perverts, and paupers.”[26]

Such arguments fit well into the use of the government’s “police power” to infringe on individual liberties in the name of public health, as in Buck v. Bell (1927) and Jacobson v. Massachusetts (1905).