 It's my great pleasure to introduce our speaker today. Dr. Alexandra Ministerne is the Carol Smith Rosenberg Collegiate Professor in the Department of American Culture at the University of Michigan. She holds professorships in a number of departments, including history, women's studies, and obstetrics and gynecology. She founded and co-directs the Sterilization and Social Justice Lab, an interdisciplinary multi-institutional research team that is reconstructing and analyzing the history of eugenics and sterilization in four US states, Michigan, North Carolina, Iowa, and California. Her research has focused on the history of genetics, eugenics, society, and justice, both in the United States and in Latin America. Through these topics, she has explored the dynamics of gender, sexuality, race, ethnicity, disability, social difference, and reproductive politics. These explorations have been made with the belief that historical research and analysis can provide important coordinates for understanding and navigating contemporary dilemmas in health, especially with respect to racial inequities and reproductive injustice. She is the author of the prize-winning book, Eugenic Nation, Faults and Frontiers of Better Breeding in Latin America, and her latest book, Proud Boys and the White Ethno-State, applies the lenses of historical analysis, feminist studies, and critical race studies to deconstructing the core ideas of the alt-right and white nationalism. I'm thrilled that as part of this lecture series, we were able to get Dr. Stern to give this talk today because as we have seen over the last several years, the issue she's interested in are timely and very appropriate to our modern culture. And it's always wonderful to have a friend and colleague from the University of Michigan join us. So I'm gonna go on mute and let our speaker take it. Thank you. Thank you so much. I'll go ahead and share my slides. I really appreciate that lovely introduction. And as someone, you know, as University of Chicago is my alma mater, I did my PhD in history there, finishing around the year 2000. So I remember when I arrived and speaking of weather, I arrived in Chicago in September of 1993, and I thought it was the most glorious place ever, fall, the trees, everything, little did I know, three months later, you know, I would need to buy boots and a jacket. You know, I'd come from California. I learned what winter really was. So, but very fond memories and I like to get back to Chicago when I can. So let me. So what I'm gonna be talking with you today, I'm going to be sharing with you some of the research and kind of the trajectory of research that we have been doing at the sterilization and social justice lab and conclude with reflections on legacies. What kinds of legacies do we see in terms of eugenics today? How can we assess them? What might we do about them? And I would love to hear your thoughts and comments about them. With that in mind, my, the title of my talk today is wrestling with the legacies of eugenics and medicine and society. Thank you, Mindy, for the invitation. Thank you, Dr. Mark Siegler for letting me crash the party, so to speak. I know this is your lecture series, so I really appreciate it. Alaina for arranging the logistics and all of you for being here on this snowy day. So I'm going to start my talk by taking you back to what is now 15 years ago to Sacramento, the capital of the state of California. I published the book that Mindy mentioned Eugenic Nation, Faults and Frontiers of Better Breeding in Modern America in 2005. And that book was really one of the first monographs to look more comprehensively at the eugenics movement in California, having been a real epicenter of eugenics in the nation and really in the world. And I wrote that book looking at different facets of hereditarian thinking, including education, intersections between eugenics and the early environmental movement in a range of other themes. I can tell you more about that book and its arguments if you're interested, but after I published that book, I was left frustrated by the fact that I still knew so little about the state that sterilized more than one third of people sterilized under eugenic laws in the 20th century. California sterilized more than 20,000 people in about 10 different institutions. I'll show you that in a minute. And I didn't know much about what happened behind the walls of those institutions. What demographic patterns were at play in terms of who was sterilized? How did that change over time? So there was this big question mark for me hanging over this history that I delved into pretty much in depth. And one of the reasons why I couldn't answer those questions was because I didn't have the archival material. I had spent a lot of time in archives up and down the state, including the California state archives. And I decided that in order to try to track down more material related to the history of sterilization, I was going to go directly to the California Department of State Hospitals, which had kind of, it had merged several different previous departments together, but was the holder of records related to kind of past administrative histories, as well as some institutions. So I walked into the main offices of the Department of Mental Health in 2007. And I was very fortunate because I met up with the staff person who wanted to be helpful. And they directed me to literally a file cabinet like the one you see in the image here and said, we have microfilm reels in this file cabinet. Why don't you just look through them and see what you find? Which for a story is always fun when they say just look through it and see what you might come up with. And so it was all microfilm reels in the little boxes. And I started taking them out of the boxes and using just a desk lamp to try to figure out what was on them. And there were all kinds of materials on there. But after a few drawers, I found one reel that when I held it up to the light said the word sterilization recommendation. And soon I figured out that there were 19 microfilm reels that contained sterilization recommendations and accompanying documents from the period 1919 to 1952. Ultimately encompassing more than 20,000 sterilization procedures in the state of California in the 20th century. So this obviously was very exciting and overwhelming because it was such a large amount of data and it was in a form that was hard to access and hard to organize. I knew then that I would be able to pick up where I left off in the first edition of Eugenic Nation to really go more deeply into patterns and stories of eugenic sterilization in California. What you see on the slide here now is the second edition of the book which includes some of this new material and an additional chapter that discusses sterilization histories as well as postcards which were very common at the time sent from people who idealized these institutions or were visiting them from three of the different state institutions where these procedures took place in California. So you can see the Sonoma State home and two of the others. So let's do a quick stop here to discuss what was eugenics. And I suspect with this group I don't need to go into great depth nor do I have time to go into great depth but the kind of the quickest version is that eugenics which is taken from the Greek to Greek terms meaning to be well-born is a term that was coined by Sir Francis Galton in 1883 and was building on both theories of selection and evolution as well as the rise of classical genetics. Mendelian genetics and even some aspects of the kind of the now discredited Lamarckian style of genetics or heredity and inheritance. Eugenics for elites across the world by the early 20th century had become from their perspective was a science that could be applied to solve social problems. It was the idea of efficiency, science and improvement through hereditarian frameworks. And eugenicists, you have to go back into the time period in which they were coming to prominence were very much in the US, white male Protestant elites who not surprisingly wanted to build and maintain a country that reflected their own image. And they spent a lot of time dividing categorizing populations between those that were deemed fit and unfit. From their perspective, they were fit and they thought more white middle class and upper class people should be having babies and unfit people, those classified as unfit were deluding and damaging for the term we would use, recognize today the gene pool. They were basically contaminating the biological makeup of the US population and pulling it down into degeneration. In order to determine how to address this problem that they've received, they spent a lot of time classifying, categorizing, on figuring out ways to control and control populations and policies that could be implemented to do so. Eugenics had was multi-pronged in terms of the types of measures, ideas and popular interventions that were supported. And eugenics sterilization obviously fits into that. Now, some historians of eugenics like to divide eugenics into the positive and the negative poles that can be useful, we'll complicate that in a minute, but just to explain what that means, positive eugenics has generally referred to those types of measures and initiatives that were meant to increase the reproduction of the quote unquote fit. So you all probably have heard of the fitter family contest that the American eugenics society sponsored. The better babies contest that were all the rage and county fairs and local fairs across the country in the early 20th century, as well as marriage counseling and advice about mate selection. These types of eugenics certificates or these metals that were given saying ye have a goodly heritage were really hallmarks of the positive side of eugenics. And I put that in quotes kind of the positive or productive side of eugenics in the early 20th century. On the other kind of side of the spectrum was negative eugenics. And you may be most people are aware of negative eugenics because they know what was taken to its most horrific conclusion in Nazi Germany where the focus was on controlling the reproduction of the unfit or even the existence of the unfit. So those deemed kind of life not worthy of living. I mean, you've heard these types of phrases. And on the negative eugenics, this was a slide that I'm showing you that was put together by Harry Loughlin who was the superintendent of the eugenics records office which was kind of the premier research and training ground for eugenicists in the US in the 20th century. He was the superintendent from 1910 till 1939 when the funding was revoked by the Carnegie Foundation because Loughlin was too much of an unrepentant racist. I can tell you more about that if you're interested. The reason I show you this slide is because it captures this kind of spectrum from the quote unquote positive to the negative eugenics with the positive being the eugenic education and the better babies contest kind of marriage, restrictive marriage and so on. And then the negative side obviously going all the way to eugenic sterilization as well as euthanasia. So in the United States, I mean, many people are still surprised to learn that 32 of what was then 48 states passed eugenic sterilization laws between 1907 and 1937. The first state to pass a law was Indiana in 1907 followed by Washington state and California in 1909. The last state to pass a law was Georgia in 1937. Sometimes these laws were overturned by Supreme courts because they were deemed to constitute cruel and unusual punishment or to violate the equal protection clause of the 14th amendment. But then the eugenicists who wanted to make sure that they were on the books went back and revised the laws so that they could skirt in, kind of in the framework of public health and protection of society from disease and other ailments. So you can see on this map, it just imagined Georgia's included there, all of the states, the ones that have the diagonal the diagonal lines had sterilization laws on the books. And I can, another interesting question is why did some states not? And that is an intriguing question that's important to think about as a kind of counterfactual to this history. So if 32 states pass these laws, it's interesting to go back and look at what was contained in these laws. And one of the things that we learned right away when we look at them is that these laws did not target specific racial or religious groups. The language they used was first and foremost, the language of disability. So it was a disability framework, particularly what we might think of today as intellectual disabilities that were targeted because the unfit were seen as being feeble minded, insane, defective, and you can look at the language across these different states. What you see over and over again is this catch-all term of feeble minded, which was very popular in the early 20th century and actually was a larger category that encompassed other categories that were seen at the time as measurable and scientific, such as idiocy, moron, and imbecile. And those were actually tied to results of IQ tests that would be given to people who often would be institutionalized and then in the institution they would be subjected to sterilization. So it's really important to remember that this disability thread, this disability injustice thread, let's say, or disability bias, runs all the way through what we might see as a longer history of eugenics that can take us even to the contemporary moment. But just going back to the sterilization laws, this is the language that was used and it played out differently state by state. So I already mentioned before that California surpassed all other states with more than 20,000 surgical sterilizations. You can see they were followed by Virginia, North Carolina, and then Michigan coming in fourth place. There's a reason that you don't see Illinois on there because this is a state that did not pass a sterilization law but instead focused on eugenic segregation in institutions. So it's kind of an interesting counterpoint to these other states. Zoning in on California, I already showed you the postcards. Those postcards came from three of these different institutions where these 20,000 procedures took place. And you can see these institutions kind of span from the South land, the Southern part of the state, all the way up to Northern forest of Mendocino. So back to the file cabinet and the microfilm reels that I found. So what they contained was more than 20,000 of these types of forms plus 30,000 other accompanying documents, surgical consent forms, letters, documents from the institutions themselves and so on. So I just wanna stop here for a moment and look at these records because these are the records that we have been that started off the whole adventure and journey that has been, that is what we've been doing at the sterilization and social justice lab. So these are forms. Now, when they started sterilization in California, it was more ad hoc. It was a superintendent would write a letter to the director of what was then the state department of institutions, explaining why even though a parent opposed it, he supported sterilization of an individual because their IQ was below 70. Or that's just an example that happened numerous times and then would get approval from the, from the department of institutions in Sacramento. Over time though, as sterilizations increased and this became more routinized, this form was invented. So by the mid 1930s, all of the institutions had these forms and you can look at these forms and you can see what they say on the top is recommendation and approval for vasectomy or salpingectomy for the purpose of sterilization. It has the person's name, which we've redacted in this case for IRB reasons. It has the institution and it has a bunch of other information, you know, what we would call demographic information as well as texts that was taken directly from the state law around the rationale for why someone should be sterilized. And if you see on one of them, the second box that's checked on one of these forms is feeble mindedness in any of its various grades, specify grade IQ of 72 borderline. So this would be like considered a person who was considered a borderline moron and based on that was recommended for sterilization. In one instance, written consent was not given in another case it was and so on. So these were the documents that we have been using to reconstruct this history. Here is a close up of what was included on that form and taken directly from a revision to the 1909 law which clarified a few things in, this is actually the 1913 law, but it shows you this is what unfitness looked like in the eyes of eugenicists and those carrying out these procedures in the early to mid 20th century. So I found these microfilm reels and all of this amazing data. And I knew that it would not be possible to simply input this into an Excel spreadsheet that we needed more high powered tools and programs to be able to capture this data and to make sense of this. And I'm fortunate to be at a university very much like your institution that has experts across different fields and departments. And I connected with two colleagues who have worked on, have worked in this area of an epidemiology and demography in the School of Public Health as well as several other colleagues. And we began to work on how are we going to input all this data that we have found that I found in this forms to create basically a data set to understand both the demographic patterns and to begin to do some qualitative analysis of that. Over time, we started with California and I'll tell you more about that in a minute but over time we have expanded to now we have five, we have five states that should not say five and we have five states that we're looking at. We actually have five institutions in terms of universities that are involved in this and we now have more than 30 lab members. And with luck, we have been fortunate and we've worked hard to get NEH, National Endowment for the Humanities and NIH funding through the National Human Genome Research Institute. So we spent a lot of time creating the data set. So this is where, as I'm trained as a historian, as you know, I just told you I got my PhD at the University of Chicago. I could have never imagined that basically 10 years after receiving my PhD I would be working with epidemiologists to design a data capture instrument to capture all of the data from these records that I just showed to you before. But nonetheless, that was the way to do it and that was what we needed to leverage. So we began working with RedCap which some of you are probably familiar with which is a HIPAA compliant data capture system to pull in all the information from these 20,000 forms. Ultimately our instrument has room for 212 different variables, many of which were pre-populated so that we would maintain as much precision as possible. And so that took over almost three years. First we thought, oh, we'll do it in six months. It took a long time to do all of the data capture and the data entry. Along the way, we found very interesting and compelling personal stories of resistance related to eugenic sterilization in California. One of them being a mother who contested the constitutionality of California sterilization law in 1939 and she sued the state. She did lose her lawsuit, but it raised some awareness of the issue and laid the groundwork for further resistance. We also found in the records that just as I was saying before that the routinization of sterilization resulted in the bureaucratization of the forms, it also resulted in changed language of the forms. So if you go back to the earlier period, like in 1934, you saw that what superintendents were doing is they were actually crossing off the part of the form that said who is now an inmate to who is to be an inmate, which meant that individuals who were often like picked up by the juvenile courts and like young Mexican women who were labeled as promiscuous would be pulled into like the LA juvenile division. They would be determined that, they didn't have a based on their understanding a kind of stable family structure. They would be given an IQ test, maybe get that borderline score of 72 that you saw before and would be remanded to an institution based on all that information. Well, over time, what they began to do was they began to basically build the sterilization procedure into the commitment itself and to also make sterilization a prerequisite for release from the institution. So you can see how it begins to become very coercive. So the language changed over time. Another really interesting element of this, and this I think is important for thinking about issues around reproductive rights today and where sterilization fits into this to go back to this historical period when women had very limited access to birth control and contraception, including sterilization. As you well know, the ACOG rule of 120 was around until the 1970s. So there we have found that about 5% of inmates and institutions actually committed themselves to institutions or found their way to places like Sonoma for the purposes of sterilization because it was the only way as low income people they could get access to that form of permanent birth control. So we worked with RedCap. We finally entered all the data. And one of the first analyses that our team decided to do was what is the first really rigorous statistical estimate of living sterilization survivors in a state. Our team, and I didn't do this part, I work with our demographers, they know how to use life tables. They use life tables and they used our records to determine the likely number of living sterilization survivors of those 20,000 as of 2017. So when this paper first came out in AJPH, we estimated there were about 840 living survivors of the sterilization program. Sadly, that number has now diminished by about 100 people per year. We now estimate it's a little under 400. In this paper, we made a case, and this goes right into kind of thinking about the bioethics. We made a case that this was a wrong that merited some type of reparations and some type of redress, ideally in the form of a compensation program in a form of some type of recognition through historical markers or plaques and so on. So this was both an article that presented our findings and our analysis and made a case for redress based on a number of factors and engaging with literature on other forms of reparations and redress. Our second paper continued the theme of doing statistical analysis. And what we did is our team, we had the data set from California. We used individual census level data from all of these 10 different institutions reconstructing their populations and the demographic makeup of their populations from 1910 to 1940 and then, well, 1920 to 1940 and then interpolated that over time to take us to 1945 to demonstrate that based on the actual institutional populations, people with Spanish surnames were disproportionately sterilized. And this is something that I had seen in my kind of qualitative review, but we're now able to actually show it with this analysis. And kind of you can read this slide here, but one of the most striking findings was that female Latinas were 59% more likely to be sterilized than non-Latina females. So this is where you see how the disability framework, which is about unfitness becomes, it merges with the anti-Mexican racism in California at the time, such that the sterilization program disproportionately affected was mainly Mexican origin women and men as well. So we have our team has grown and our project has grown over time. I think Mindy said we had four states, now we actually have five. We're teaming up with a philosopher and a bioethicist at the University of Utah, who has acquired a de-identified data from the state. So we now have four states and more than 35,000 records that we're looking at to, and we have this geographical diversity of states as well as demographic differences across the states. These are just some fun descriptive statistics. We love to spend time making charts and graphs and descriptive statistics to show patterns over time. This shows you that California sterilization, much of it happened before 1950, but then if you look at North Carolina, sorry, this all doesn't quite show up on the screen. I'm not sure why, but you see that in the red North Carolina sterilizations actually rise in the 50s and 60s. And that is in conjunction with increasing sterilization of black women who are identified both as likely to have defective children, but also seen as unfit for parenthood. So that's another shift that we see over time. So the lab is busy doing all kinds of research and projects. We are looking into questions of consent. We have a researcher who's using in vivo to look at 400 cases where consent was refused to understand what was a play there. We have a researcher who has been looking at Asian nativity patients in California and there's a paper that's been as a revise and resubmit. I'm working with one of our researchers on a really, I think important piece of research that shows that there was collaboration between the war relocation authority, which moved over 100,000 Japanese and Japanese Americans into the incarceration camps. There was collaboration between that authority and the California mental institutions and that about 40 Japanese Americans were sent either, were sent back and forth between the incarceration camps and the institutions and were sterilized as part of that process. So that's something that has not been shown before. We're also doing a similar survivor estimate as we did for California, for the state of Iowa. And then finally, one of the kind of, I think most powerful aspects of our mixed methods research is that we are working on cross-state demographic comparisons. So in other words, we have enough commensurable data from the five states that we're going to be able to show over time, gender patterns, age patterns, diagnostic patterns and patterns related to race, ethnicity and nationality. And then in addition, I am working with a colleague who's a digital humanist to build a digital archive called Eugenic States of Contextual Archive that will include big data, interfaces, stories and a range of other materials. It's really meant for like a kind of an eighth grade through early college level audience. And we're going to be doing a soft launch of that in this coming spring, actually. So I could tell you a lot more about how these sterilization laws came to an end. They started to be repealed in the 1970s and 80s, although some of them were not repealed to even about 10 years ago, like Washington State and Mississippi. But there's these questions, well, what are the legacies of the history of Eugenics and particularly around kind of thinking about the history of forest or involuntary sterilization? Well, one is that several states, now three states have actually launched programs to compensate sterilization survivors or victims of these state sterilization programs. The first was North Carolina, their program was in effect for several years. And you can see one of the flyers that they distributed to try to locate people as part of their outreach. Virginia was the second state to do so. Their program was smaller and both of those programs have ended, but our research has informed recent efforts in California and the recent launch of the California's program for forest or involuntary sterilization, which is working with the Victims Compensation Board in California. So it's a particular point of pride for me that in the actual bill that was passed, Assembly Bill 1107 in California, it includes in the bill that the Victims Compensation Board shall consult the Sterilization and Social Justice Lab so that we can look in our massive database, we can look for people and we can find the records if they exist. And I can report to you that we actually had our first verified case as of yesterday. We get like triple encrypted emails from the Victims Compensation Board that you have to download all these things and passwords and then we are able to look at the request and if we find the materials, we send them back to them and those individuals will receive up to $25,000 and in addition, we'll be working with them on plaques and other memorials. So that is obviously a way in which the legacy of eugenics continues to play out and we will see if other states pass compensation programs, follow the leads of North Carolina, Virginia and California which states that are pretty different politically in terms of their climates and kind of there where they stand on the kind of red-blue spectrum. It's interesting that those three states have been the ones. Obviously they sterilized at high rates but that doesn't mean others couldn't as well. Another place in which we see legacies playing out and particularly a reckoning with the way in which eugenics shape science and medicine and how that legacy is often colliding with and contradicting efforts at institutions like ours to become more inclusive, to become more racially and ethnically diverse and to be more representative of kind of the increasingly diverse U.S. population as a whole is the fact that place names and honorifics have been challenged and in some instances and many instances removed or renamed. So I've done a significant amount of work looking at this whole issue of place names. Why were things named after certain eugenicists? When did that happen? And how is that potentially being challenged or overturned? So we can just look across the past five years and see that buildings, statues, parks, even rivers that were named after eugenicists such as David Star Jordan or Galton himself have been unnamed, have been renamed, have been kind of reassessed in light of what we, of kind of DEI related initiatives and justice initiatives. In addition, awards and fellowships have been renamed. So I spent some time consulting with the foundation for the Society of Maternal Fetal Medicine that has had a fellowship named after obstetrician who was based in Los Angeles for many years and appears to have been himself a population control advocate who supported eugenic sterilization in a county hospital. And his name was removed from the fellowship even as the Society has continued to recognize some of the positive things that he did in the field. And then professorships and organizations themselves have been renamed. And so you can look across our, you can look anywhere across our academic landscape whether it's higher education and academic medicine and see that this question of renaming and what is our on a master landscape? What does it mean to us? What does it represent? Is happening on a daily, practically on a daily basis. I was involved in an effort in this regard at the University of Michigan. So some of you may know that C.C. Little or probably this is like lots of trivia was president of the University of Michigan from 1926 to 1929. He was ousted not so much because he was a eugenicist but because they didn't like his heavy handed kind of presidential administrative tactics. In any case, during the time he was president of the University of Michigan, he worked closely with John Harvey Kellogg who ran the Race Betterment Foundation which was one of the premier eugenics organizations in the country. And in fact, he used university letterhead to send all these invitations to eugenic bigwigs and others to get them to come to the 1928 conference which was held in Battle Creek. Because of all of this and because of the way in which he infused education and various biases around kind of ability and race and so on, his name was removed from the science building before the university made its kind of official decision to do so, students took it into their own hands and you could see they plastered that up on the building. Now, sadly the building, this is one of the problems. The building, it was unnamed, it has not yet been renamed, it's just called the science building, very bland. And we risk with this that C.C. Little's history and role as a eugenicist at the institution will be lost. So whenever a name is removed, I always think it's important to provide a way to put that history into context so we don't forget the history as part of the removal. And then finally, I'm just gonna wrap up by raising this provocative question about our current moment, which is, I have talked about kind of this longer thread of kind of disability bias and questions of whose life is worth living and quality of life. And the way that that has played into prioritizations and understandings of kind of death, life and disease in our COVID era. So we know that the CDC director got in some hot water because of something, one of the quotes that she made, and you see it there, which was about the fact it was encouraging. I mean, some people, you can give her more the benefit of the doubt. You can also read this and say, well, she finds it encouraging that people with at least four comorbidities are the ones who are dying, which is not that encouraging to the people with four comorbidities who are dying as you might imagine. So one of the questions that, I've been thinking about and grappling with and I would love to hear your thoughts on is how much can implicit and explicit ideas of worth health and disability explain contemporary health inequalities. And would it be too radical to consider eugenic legacies, a fitness and unfitness to be a kind of social determinant of health that has historical baggage? How has quality of life changed? I mean, we have an interesting dynamic where we've had the ADA around since 1990 and I think more awareness of the need, the legal requirement and the need for disability accommodations and support. At the same time, I think we would all agree there's still a lot of lack of awareness around disability issues and discrimination against people with a range of different disabilities. And so that then kind of leads us to the question like, is there maybe a more passive or more active aspect of the US response to COVID that has been eugenic in terms of valuing some lives over other lives? So I think that is my last slide. With that, I will stop happy to answer questions about the lab, about my provocative final slides, about the compensation programs. And I think I'll stop sharing my screen so we can all see each other. There we go. That was an incredibly powerful lecture and one that's gonna give us food for thought for a long time, but I'm gonna open the question and answer to Peggy Mason. Thanks so much. I don't think we need to go to COVID. I would like your reaction to the idea that eugenics is live and well, it's simply called prenatal testing. And so we're eliminating, we're eliminating or preventing people from passing on deaf genes, passing on down syndrome, passing on many other conditions which are arguably good lives to lead. Yeah. So I mean, and I would just push it a little bit farther when Tom Rosenbaum, who you may or may not know was our provost and I have a lot of admiration for Tom, but when he said he was taking down the Millican name, he said, Millican who was involved with the Human Betterment Foundation should have known at a time when science knew, when the science was available. To me, this is so superficial because in fact, it's not a matter of science, it's a matter of values. Eugenics is a matter of values how you exercise that, how you pull it off is a matter of science, but the desire to breed better people and not breed so-called worse people is a value. And so there was no science, there's morality, there's philosophy to tell you that this is good or bad, but there's no science to tell you whether that's a value that society wants to share or not. And in fact, society is in the university, including Caltech are clearly exercising their opinion that prenatal testing is a good thing to do, that it does not fit under this rubric that personally I think it fits under. Yeah, well, thank you for that comment. I have a lot of thoughts about it. So in my second book called Telling Jeans, the Story of Genetic Counseling in America, I cover the eugenic back history of the rise of the field of genetic counseling and spend a chapter discussing the fraud area of prenatal testing and really the fact that prenatal testing particularly since we have seen the rise of so-called non-invasive prenatal tests, which are not really tests, they're kind of just, what do you call them? They're not, they don't give you, they're not diagnostic, they're like probabilistic, but in any case though- They're actually money-making. New York Times revealed they're basically money-making. And they're often inaccurate when it comes to the- Exactly. So I mean, that gets to another point I want to point out. I wanna discuss in a second. However, I mean, I do think that prenatal testing is we can view prenatal tests along as part of this longer trajectory of eugenics and basically implicit assumptions, pressures, decisions about who, whose life is worth living and who's not. And the kinds where this gets complicated, even more complicated though, is where you have kind of prenatal testing and prenatal care caught up with complicated issues around reproductive rights and autonomy and access to medical knowledge and information in the kind of prenatal and prenatal period. So that's a whole fraught area where if you're looking at kind of disability issues around prenatal testing and the kind of contemporary manifestations, like that is a thorny, thorny area that is important to figure out. Like if you support disability justice and reproductive justice and you're thinking about prenatal tests, how do you connect those dots there? Like where do you stand? And maybe you have some helpful thoughts in that regard. I would say that one thing that has still not been given sufficient attention is that if we look at what I've been discussing, which is really where kind of let's just say the big bad state came in and was forcibly sterilizing people based on state laws. So this is the state as eugenic actor. This is like these 32 states in the US, this is Nazi Germany, this is Sweden, this is British Columbia and Alberta and these different states or provinces that implemented eugenics laws. Well, those laws kind of come off the books by the 70s and 80s. And we do have a shift to kind of the rise of bioethics and a move towards more consent. And even around sterilizations, you see changes in terms of some safeguards that are put in place with regard to waiting periods and bilingual forms and no sterilizations of minors and things like that. So that happens, which is basically those are good developments overall, but then by the 90s, what we began to see is the massive commercialization of everything related to genetic testing in genomics, whether it's recreational ancestry testing or whether it's so now it's not the state of California, it's these companies that are producing these products that they are trying to market to healthcare providers. And they are the companies that are often because like let's say the National Society of Genetic Counseling, they have their annual meeting each year, they don't necessarily have the resources that big, powerful MD organizations have to say, okay, no junkets, no sponsorship, I won't even take a pin from you. If they're going to have their meeting and actually like be able to have any exhibits or whatever, they generally take money from these different genetic companies who are developing these tests. So that's a real, to me, that's an, so how do we think about eugenics, coercion subtle or maybe more kind of overt in the context of what some have called like liberal eugenics or market eugenics or things like that. So that is an important long-duree question as we say in history over time to kind of track that. But anyway, in general, I agree with you. And that's why I wrote the second book on genetic counseling to really try to, it's critical and sympathetic to genetic counselors who are often really just trying to do their job and provide helpful information to people. They came into the field, especially when it was first launched, without knowledge of all this baggage. Like why does the word non-directiveness exist in genetic counseling? Well, because they were trying to define themselves against eugenics and a lot of them weren't even aware of that back history, especially by the second or third generation. So now you have some genetic counseling programs that are putting disability justice like front and center, but it's an incredibly fractious relationship because the products they're often trying to interpret or talk to their clients about are ones that have implicit values, as you mentioned, about who is normal and who is abnormal. Okay, there's a lot more to say, like you got into it, there's a deep well of things to talk about, but I will stop and take another question or comment. Luke, you can take it away. Hey, thank you. Over to you again from North Carolina. So we talked a lot about one of the reparations program that was in place. So thank you for your work. One thing I've noticed is that it's harder to be sterilized now than it was before largely because there are all these safeguards in place that patients enter pregnancy, maybe we enter care like 32, 34 weeks and not be able to get sterilization itself. So how do you respond to the pendulums for being too far of the way where access to permittalization has become an issue? Well, that's actually a very lively topic of debate among OBGYNs in terms of, if we look at some of the restrictions, let's say, we can call them safeguards, we can call them restrictions, we can call them filters that were put in place starting in the 1980s and 1990s, particularly around sterilizations that have any type of federal funding like Medicaid funding attached to them. Those are what I mentioned before in terms of the most relevant is a waiting period. The next is no sterilization of minors, often like strict scrutiny, like let's say there's a sterilization, a potential, the parents and there have been cases like this, parents would like to sterilize their 14 year old daughter with severe developmental disabilities because they're concerned about her, what they perceive to be her inability to kind of control her own boundaries and the fact that she could be subjected to kind of a sexual assault or end up pregnant or something like that. Those are cases that will then come before like hospital IRB boards or other clinical ethics committees and things like that and are very, very tough decisions to make about what is in the best interest of the child and would do the parents actually, should the parents be able to speak for the child? Like what those are kind of things you see in the clinical domain. But in any case, I would say back to the debate, so you have a number of let's, like feminist healthcare practitioners, they're both groups to find themselves as feminist clinicians. One group says, we need to keep these safeguards because we still see things like we saw in California in the first decade of the 21st century where women were sterilized and unauthorized procedures in prisons. We still see what happened in Irwin, Georgia where women who were detained in a ICE facility were subjected to sterilizations and other unwanted gynecological procedures. And there are other instances where these pop up. And so, and especially in our contested environment now around reproductive rights, that's absolutely necessary. Then you have another on the other side also, feminist healthcare practitioners who say, no, we need to get rid of these safeguards or restrictions because they are basically totally paternalistic. If a woman wants to have a tubal ligation, she should be able to have a tubal ligation. If she wants it tomorrow, she can have it tomorrow. Why does she have to wait several weeks or a month before the procedure is actually done? So I don't know if I, you know, that's not my area as a historian to really come down with an opinion. What I have done is I have observed this. I guess if I were to come down with an, you know on one side of it, I would kind of lean on kind of more the let's keep the safeguards in place because we haven't proven that we're doing better yet side of things. So yeah, I hope that covers some of what your questions were but it, those can, you know these kind of debates continue. Aralyn, you have something to say. Hi there, thanks so much for your talk, Dr. Stern. I have a question that was inspired a bit by Dr. Mason's question but takes us in a slightly different direction. I wondered if you thought at all about the legacy of eugenics and the sort of rise of online dating and the way in which choice and sort of the construction of choice or the sort of determination of the available, the choices that are available to someone. If any of that kind of resonates with your work if you've thought a bit about like sort of pop culture trends like online dating. Well, I mean, and kind of similar to that is the rise of kind of online, you know sperm, you know, fertility clinics and kind of sperm and kind of egg donation. And, you know, what you see there is the commodification of reproductive and genetic material into, you know, little sellable nuggets. So that when, you know, couples go and look on, you know, there are many of these fertility sites you can basically look through a catalog of sperm donors and, you know, they, the criteria are like, we can, you could see them, you know, just through the lens of eugenics. It's about height, it's about eye color, it's about skin color, it's about, you know, if you pay for the more deluxe version you're gonna find out, you know, how well they did on the SAT or the GRE, you know, what kind of a profession they have if they have artistic abilities, if they're athletic and so on and so forth. So, you know, is this that different than the trade book that Charles Davenport and the Eugenics Records Office developed in the early 20th century? No, but it is not part of a state coercive practice. It's actually part of a, you know, a kind of a market, it's the marketplace. It's kind of a eugenicized marketplace. In terms of actual dating, I haven't thought that much about, you know, kind of apps, but I would say the commodification, you know, people are looking for a whole range of things. They're looking for hookups, they're looking for long-term relationships, they're looking for relationships that may or may not involve any sort, you know, reproduction or thoughts of creating a family or anything like that, but I would say the commodification element and the reductionism that is involved and the fact that, you know, it's often very visually driven and so there are kind of visual assumptions about obviously what is aesthetically pleasing and what is not and all of that. So yeah, I think there's a connection, you know, this is one of the interesting things when you're studying eugenics is that you can, I can locate eugenics in very specific historical moments and practices and policies at the same time when you talk about the eugenic impulse and eugenic ideas, you can, if you begin to look, you can see them in many different places where decisions about kind of mating and reproduction are happening. There's a couple of interesting things here on the chat. I just wanna bring up, let me just scroll back a little bit. Clara said, looking at the history of eugenics in America, were you able to discover any connections between attendance, residence, school such as indigenous children or minors and involuntary sterilization? In Canada, indigenous people were disproportionately affected by eugenics based on laws in Canada. And I'm wondering if the same populations were affected in the United States. I think that's a great question. First, I want to, and I was kind of looking for it quickly but I can't talk and look for something and on Google at the same time, I just can. Too much bandwidth. There's a historian of disability eugenics named Michael Rimbus who wrote a book called, I think it's called Defining Deviance and it's focused on Illinois. And it's really interesting because he chose that state because it didn't have a sterilization program yet it had a fairly developed eugenics program. Part of it driven like a motor of it was everything that was going on in the juvenile court system in Chicago, as well as those progressive leaders who were interested in kind of classifying, categorizing and making determinations about fitness. And one of the points that he makes is that if you look at eugenic approaches, I've talked a lot about eugenic sterilization but often the first entry point to that involved eugenic segregation. So in other words, moving the unfit, the unassimilated, the uncivilized, whatever would be after that prefix to a holding area containing them in some way, shape or form. Often that involved disrupting and breaking up families which obviously affected the possibility of those families to continue into the future and to, it was an assault against them. If you were to take it to the most extreme reading, you could say that what happened with the boarding schools in Canada and Australia and also what happened in the US with boarding schools was a form of kind of cultural and or native genocide because it was all about breaking up those communities and ending the possibility of their futures. So I see a lot of similarities between these impulses to, label, to relocate, to contain and to control the reproduction of particular populations either based on long-term confinement or on sterilization itself. And it's interesting, I wanna go back to a point I made about the way in which sterilization worked in California as well as some of the other states is that, but the state, the institution that sterilized more than any other in California was the called the Sonoma State Home. It was an Eldridge, California. Basically it was just decommissioned a few years ago. It had been a long, sort of morphed into being kind of a group home in the 1970s. But in any case, in that institution and another institution that was set up for morons, which was the specific directive in the California state legislature, in order for the inmates slash patients to lead the institution, they had to be sterilized. So if they, and the idea was that and often they would focus on those who would have a chance of parole or those who were seen as borderline. They were people who could go off and be, have jobs, often menial jobs, like women post-institution would be sent to be domestic somewhere. They would be servants, or they would go with a long lost aunt and kind of work for her at her bakery or something like that. And then the men were often sent to kind of menial jobs they would work in an auto shop or they would join a janitorial crew or something like that. But before they could be released, the institution required that they be sterilized. And so it hung over them, like the sword, damocles or whatever, basically they had to make that decision if they wanted to leave. And in fact, I spoke with a survivor who was at Sonoma who said, they told him that, he would have to do hard labor basically in the Sonoma unless he was sterilized and the only way he'd ever get out and be reunited with his family was to have the procedure done. So I think I got a little bit off the question, but yes, I mean, I think we have to go back and look at the connections between these different types of popular, these different types of institutions be they mental institutions, asylums, boarding schools and so on and they have a lot in common. And we can tell they have a lot in common because the way in which their legacies are playing out today have similar resonances. September, you said that you had a lot of interesting things in the chat. Did you wanna say something or you just wanna share those with the group? I'm open to whatever you like. I just wanna point out that when we're teaching, since I do a lot of film based teaching and writing is that there are some things that are in the lexicon that are there. One of them is Nomas Babies, which is a film that was done a few years ago about the forced sterilization of Hispanic women at LA County Hospital and basically during my time in my lifetime. And then another one is to look at the fact that, I was almost 12 years old before black and white people were allowed to marry in every state. So the relationship between miscegenation and abortion and sterilization is something that in the communities of black and Hispanic people that I grew up in was always being talked about. They are trying to make it so we aren't enough people to vote. So the Hispanic sisters and brothers were like, okay, we're not going for that. But African-Americans population has decreased over the last century and a half to something like between 12 and 13% from what it was at the beginning of the 19th century. So I think that using film to help students and residents really look at these things as could be helpful to make people understand it's still going on. So and understand the resistance to abortion, the resistance to small families in different communities. That's kind of off. No, I mean, I think, and there's another documentary called Belly of the Beast. I don't know if you've seen that one, September, but that one is about the sterilizations at the California women's prisons. And how one attorney, kind of, social justice attorney found out about them and then how she advocated. And I actually worked with her on the, well, because I've been involved in the coalition that worked hard to get this compensation bill passed in California. But I agree. And speaking of the USCLA County, it was there that kill again Edward Killigan was the lead OBGYN. And in fact, the subcommittee of the society from maternal field of medicine, that decided to remove his name, told me that they were really struck by, and they watched that documentary, how basically unapologetic he was. Like he refused to even see that there had been any racism or any bias involved in what they were doing. He just rejected that outright and said he had been basically a good doctor following good practice and they didn't buy it. So yeah, I think that those tools, there's another one called State of Eugenics, which is about the passage of the law in North Carolina. And all of those are really great to teach with and learn from, because you hear the voices of survivors too. And they tell their stories, which is so powerful. Oh, and I wanted to say something about your point about anti-miscegenation laws. So those, I mean, anti-miscegenation laws go back to the 17th century in the US. They get a huge boost with the Eugenics movement, such that, and here is like the kind of exemplary case in point, if you look at Virginia in 1924, what did they do in that year? They passed two major laws. One was the Racial Integrity Act, which basically was another anti-miscegenation law and was not overturned until 1967 with loving versus Virginia, which you're all probably aware of that case. And that same year, they passed the Eugenics Sterilization Act. So they were kind of interwoven with one another in the way in which disability and race were connected in terms of how white supremacists, we can look back at them today, and we're defining who was fit and who was not fit to be part of society. Absolutely. And you know, the other component of this is that Charles Galton was actually a cousin of Charles Darwin. So Galton went that way and Darwin had another, Darwin had a different philosophy about how things came up. It's worth looking back further, right? So the idea of miscegenation was brought up by Dalton. It was created by Dalton. That means that you were different before as a species, and then you've put these, they shouldn't be mixing basically. Well, there's a really interesting scholar named Reina Hogarth. I don't know if she's coming to speak to this group. She's in Illinois as well at Urbana-Champaign. And she, I saw her present her research, which looks at kind of this longer history of eugenics and the way in which kind of anti-black racism in medicine and science, particularly going back to the era of slavery, and then what happens immediately kind of in reconstruction and with kind of the backlash. And then she is able to show the connections between racism and medicine in like the 18th and 19th century, how that fuels eugenics and the particular forms that it takes in the United States. So it seems like a really important, that longer history that you're talking about. Oh, good. So she's the speaker. We're in sync here. So I think her talk will then connect in ways to my talk and you'll learn a lot from her interesting work. Yeah, I just wanna end with one question and give you a little downtime for the next session is just one quick question about address the issue of criminality or when sterilization was used in criminals because a couple of questions about that. And I'm also curious. I know you had it as one of the things in your slides, but I wanna just see if you have any more to say about that. Yeah, so it's interesting when you go back to the 1907 Indiana law, which as I mentioned was the first one passed, that really was due in large part to the aptly named Dr. Harry Sharp, who was based at the Jeffersonville Reformatory in Southern Indiana. And that reformatory basically housed pretty offenders and minor criminals and criminality itself was all caught up with biases of the time. I've looked through the ledgers of who was there and who we identified for sterilization. One of the most common terms that was used was sodomite. So obviously it's about policing same-sex sexuality and ideas about masculinity and all of that. So one of the things that he and others came to recognize when they helped write the first law in Indiana in 1907 was that any law that explicitly targeted criminals could be challenged in the courts because it would be seen as cruel and unusual punishment and could be interpreted as such. And in fact, Indiana's first law, despite their awareness of it, was overturned by the Indiana Supreme Court. Then they came back by the 1920s with the new law that was all about, and this is where we have to think about the language around public health and the language around public health protection. It was a couch much more in the kind of the language around the common good, around protecting the public health, around ensuring kind of hereditary fitness for the benefit of all, like all this kind of language. And you found in several other states in the teens and 20s that their sterilization laws were also overturned because they included prisons as one of the institutions where sterilizations could be authorized. So we see that play out in the 20s and 30s. And in fact, in California, they were very clever because in 1909, they realized that they would face that kind of scrutiny around criminals or those in prisons. And so they didn't include prisons as the institutions where the law could be enforced, although the Human Benefit Foundation was very happy that there was a superintendent at San Quentin who was doing sterilizations, not to mention like strange hormonal experiments on the men that were there. So that is nevertheless, it was not uncommon that people who were institutionalized would be labeled in some way as criminalistic, although eugenicists were careful to kind of steer clear of the prisons because they knew that could be kind of a legal minefield. So I hope that answers your question. I think it does. And I think we're gonna thank you and give you about a little bit of downtime to get some water or just stretch before the 130 session. And on behalf of the McLean Center, I wanna thank you, that was a superb talk and so interesting and stimulating. I think everybody really enjoyed it. So many, many thanks, we really appreciate it. Well, thank you. And I'll see a subset of you back in 15 minutes on the other link, which I'll have to find. Thank you. Okay.