Birth Control and the Eugenists (Part 2 of 2)
by Linda Gordon
Linda Gordon has been active in the socialist-feminist movement. She is an editor of Radical America and is presently teaching history at U. Mass. Boston. In addition to her book on the history of the birth control movement, she is the author of America’s Working Women (1976).
This article is part two of a two-part article. Part one appeared in the last issue of Science for the People. It is a revised and abridged excerpt from Woman’s Body, Woman’s Right: A Social History of Birth Control in America (Viking Press, 1976).
As the birth control clinic movement mushroomed around the country, conflict raged about how and by whom the clinics should be controlled. Margaret Sanger still resisted relinquishing personal control of her New York clinic to the medical profession. No doubt part of her resistance came from a desire to control things herself, especially since she had lost control of the American Birth Control League (ABCL) and its publication the Birth Control Review by 1929.
But part of her resistance, too, came from disagreement with the doctors’ insistence on requiring medical indications for the prescription of contraceptive devices. Her Clinical Research Bureau had consistently stretched the definition of appropriate indications; and if an appropriate medical problem that justified contraception could not be found, a patient was often referred to private doctors whose prescriptions would be less dangerous. Sanger was willing to avoid an open challenge to the law on the question of indications, but she was not willing to allow close medical supervision to deprive physically healthy women of access to contraception.
In her struggle against the doctors, Sanger found another professional group to support her — the eugenists. Though easily as conservative as the doctors in terms of the feminist or sexual freedom implications of birth control, they were solidly in Sanger’s camp on the issue of indications. They could not be content with a medical interpretation of contraception, i.e. that its function was to prevent pathologies in mothers. The eugenists sought the kind of impact birth control might have when disseminated on a mass basis; they wanted to improve the quality of the whole population, not just protect the health of women. They also felt a certain amount of professional rivalry with the physicians.
Eugenists had been among the earliest of the non-radicals to support birth control, and some of them had spoken out for it publicly even before the War. They perceived the doctors as joining the cause after it was safe, and then attempting to wrest power from the movement’s originators. Though politically conservative, their intensity of commitment to selective breeding allowed them to accept Sanger’s militant rhetoric and her willingness to challenge and stretch the law. At the same time the eugenists had a great influence not only on Sanger but on the whole birth control movement.
Eugenics attitudes had attracted reformers of all varieties for nearly a century. Lacking a correct genetics, 19th-century eugenics consisted largely of utopian speculation based on the assumption that acquired characteristics could be inherited. This assumption meant that there was no necessary opposition between environmentalism and heredity. The scientific discrediting of the theory of the inheritance of acquired characteristics changed the political implications of eugenics, and more narrow applications of it became dominant.
The new eugenics, “selective breeding,” was rigidly elitist, intended to reproduce the entire American population in the image of those who dominated it politically and economically. The “new” eugenics was not a reform program but a justification for the status quo. Its essential argument—that the “unfit,” the criminal, and the pauper were the products of congenital formations—suited the desire of its upper-class supporters to justify their privileged positions in society.
As eugenics enthusiasts developed specific political and social proposals for action, they established organizations to spread the gospel and do legislative lobbying. The first of these was the Eugenics Section of the American Breeders Association, set up in 1910; in 1913 human breeding became the main focus of the Association, which changed its name to the American Genetic Association. Several other organizations were established in the next decade.
In no academic field was the coalition between corporate capital and scholars developed more fully than in eugenics. By the 1920s eugenics was a required course in many American universities. The development of eugenics as a scholarly field represented the capitulation of university scholars to a fad, allowing their skills to become a commodity for sale to the highest bidder. The backers of eugenics research and writing included the wealthiest families of the country. The Eugenics Record Office was established by Mrs. E. H. Harriman. The Station for Experimental Evolution was funded by Andrew Carnegie. Henry Fairfield Osborn, a gentleman scholar and founder of the New York Museum of Natural History, was a main financial backer of the eugenics societies; in the late 1920s Frederick Osborn, nephew of Henry Fairfield, assumed leadership in the cause and financed a research program for the Eugenics Research Association.
Despite the direct influence of big business on eugenics, the cause carried with it some of its historic aura of radicalism for many years, an aura which sometimes disguised its fundamentally conservative content. For example, eugenists identified themselves as crusaders for reform, and argued their case with apocalyptic warnings (e.g. “race suicide,” “menace to civilization”) and utopian promises (“a world of supermen”). They advocated techniques, such as sterilization and marriage licensing, which were often repulsive to traditional and religious people. Equally important, many radicals remained interested in eugenics programs. Socialists, feminists, and sex-radicals continued to use eugenics ideas. Mainly outside academic and scientific circles, these followers of a traditional “popular eugenics” continued to offer analyses and proposals that assumed the inheritance of acquired characteristics well into the 1920s. They endorsed programs to lessen suffering through the prevention of birth defects; they included demands for prenatal medical care for women under the aegis of eugenics.
After the First World War, academic eugenists consistently avoided all except strictly hereditarian interpretations of eugenics. In clinging to their hereditarian assumptions, they stood in opposition to the tradition of social reform in America. Eugenists justified social and economic inequalities as biological; their journals featured articles about “aristogenic” families, as if the existence of several noted gentlemen in the same family proved the superiority of their genes. Their definitions of what was socially worthy naturally used their own professional and upper-class standards of success. The professional bias can be seen particularly clearly in their emphasis on intelligence. Standard eugenics concepts of inferiority, such as “degeneracy,” consistently equated lack of intelligence with viciousness and intelligence with goodness. “Among the 1000 leading American men of science,” eugenist Paul Popenoe wrote, “there is not one son of a day laborer. It takes 48,000 unskilled laborers to produce one man distinguished enough to get in Who’s Who, while the same number of Congregational ministers produces 6000 persons eminent enough to be included….”
Aristogenic stock was missing not only from the working class as a whole, but also from non-Yankees in particular. Here is a typical explanation of the problem from a standard eugenics textbook first published in 1916:
From the rate at which immigrants are increasing it is obvious that our very life-blood is at stake. For our own protection we must face the question of what types or races should be ruled out… many students of heredity feel that there is great hazard in the mongrelizing of distinctly unrelated races …. However, it is certain that under existing social conditions in our own country only the most worthless and vicious of the white race will tend in any considerable numbers to mate with the negro and the result cannot but mean deterioration on the whole for either race ….
Consider the following — typical — passage from Revolt Against Civilization: The Menace of the Under Man by Lothrop Stoddard, one of the most widely respected eugenists:
But what about the inferior? Hitherto we have not analyzed their attitude. We have seen that they are incapable of either creating or furthering civilization, and are thus a negative hindrance to progress. But the inferiors are not mere negative factors in civilized life; they are also positive — in an inverse destructive sense. The inferior elements are, instinctively or consciously, the enemies of civilization. And they are its enemies, not by chance but because they are more or less uncivilizable.
The eugenics movement strongly supported immigration restrictions and contributed to the development of racist fears and hatreds among many Americans. In 1928, the Committee on Selective Immigration of the American Eugenics Society recommended that future immigration be restricted to white people. The movement also supported the enactment of antimiscegenation laws throughout the South, and Southern racists used the respectability of eugenics to further the development of segregation.
The feminist content of birth control practice and propaganda was especially obnoxious to the eugenists. They feared the growing “independence” of women. Eugenists were frequently involved in propaganda for the protection of the family, and in anti-divorce campaigning. The most common eugenics position was virulently anti-feminist, viewing women primarily as breeders. One typical eugenist wrote in 1917: “in my view, women exist primarily for racial ends. The tendency to exempt the more refined of them from the pains and anxieties of child-bearing and motherhood, although arising out of a very attractive feeling of consideration for the weaker individuals of the race, is not, admirable as it seems, in essence a moral one.”
While most eugenists were opposed to birth control, some were not, and all saw that they had certain common interests with the birth controllers. Some believed that while sterilization would be necessary in extreme cases, birth control could be taught to and practiced by the masses. Especially the younger eugenists and the demographer-sociologists (demography was not at this time a distinct discipline) were convinced that the trend toward smaller families was irrevocable, and the only thing to do to counteract its dysgenic tendency was to make it universal. Finally, they shared with birth controllers an interest in sex education and freedom of speech on sexual issues.
If these factors contributed to closing the gap between eugenists and birth controllers, the attitudes of the birth controllers contributed even more. While eugenists by and large opposed birth control, birth controllers did not make the reverse judgement.
Feminist birth controllers tended to accept racist and ethnocentric attitudes. Southern feminists used the fear of the black vote as an argument for suffrage, and were supported by the national woman suffrage organizations in doing so. Birth control reformers were not attracted to eugenics because they were racists; rather, they had interests in common with eugenists and had no strong tradition of anti-racism on which to base a critique of eugenics. As did most middle-class reformers, the feminists also had a reservoir of anti-working-class attitudes. The American feminist movement had its own traditions of elitism, in the style of Elizabeth Cady Stanton’s proposal for suffrage for the educated. Many feminists had been active in the temperance movement, and saw immigrants and working-class men as drunken undesirables. Anti-Catholicism particularly had been an undercurrent in the women’s rights movement for decades, stimulated by Catholic opposition to prohibition and women’s rights.
Sanger, too, had always argued the “racial” values of birth control, but as time progressed she gave less attention to feminist arguments and more to eugenical ones. “More children from the fit, less from the unfit—that is the chief issue of birth control,” she wrote in 1919. In Woman and the New Race, published in 1920, she put together statistics about immigrants, their high birth rates, and low literacy rates in a manner certain to stimulate racist fears. In The Pivot of Civilization, published in 1922, she urged applying stockbreeding techniques to society in order to avoid giving aid to “good-for-nothings” at the expense of the “good.” She warned that the masses of the illiterate and “degenerate” might well destroy “our way of life.” She developed favorite eugenical sub-themes as well, such as the cost to the society of supporting the “unfit” in public institutions, and the waste of funds on charities that merely put bandaids on sores rather than curing diseases. Society is divided into three demographic groups, she argued: the wealthy who already practiced birth control; the intelligent and responsible who wanted birth control; and the reckless and irresponsible, including “the pauper element dependent entirely upon the normal and fit members of society.”
She shifted her imagery about such social divisions, for later in the 1920s she cited a “Princeton University authority” who had classified the U.S. population as 20 million intellectual, 25 million mediocre, 45 million subnormal, and 15 million feeble-minded. The racism and virulence of her eugenical rhetoric grew most extreme in the early 1930s. In 1932 she recommended the sterilization or segregation by sex of “the whole dysgenic population.” She complained that the government, which was so correctly concerned with the quality of immigrants, lacked concern for the quality of its native-born.
Eugenics soon became a consistant, even a dominant, theme at birth control conferences. In 1921 at the organizational conference of the American Birth Control League there were many eugenics speakers and exhibits. In 1922 Sanger went to London for the Fifth International Neo-Malthusian and Birth Control Conference as its only female honored guest. Yet not a single panel was devoted to birth control as a woman’s right nor did Sanger raise this point of view. In 1925 Sanger brought the Sixth International Conference to New York under the sponsorship of the ABCL. Not a single session was chaired by a woman: about one out of ten speakers was a woman. Four of the total of eleven sessions focused specifically on eugenics, none on women’s problems.
Meanwhile the propaganda of the ABCL was becoming more focused on eugenics at the expense of women’s rights. The introductory brochure used during the 1920s lists the first point of “What This Organization Does To Inform the Public” as publishing and distributing literature and conducting lectures “on the disgenic (sic) effects of careless breeding.” The program of the ABCL included a sterilization demand and called for “racial progress.”
The Birth Control Review, the ABCL publication, reflected eugenics influence from its inception in 1917. While eugenists of the older, radical tradition dominated in its first years, it also printed without editorial comment a eugenical anti-birth-control argument, virtually a “race suicide” argument, in its very first volume. By 1920 the Review published openly racist articles. In 1923 the Review editorialized in favor of immigration restriction on a racial basis. In the same year the Review published a study on “The Cost to the State of the Socially Unfit.” In 1920 Havelock Ellis favorably reviewed Lothrop Stoddard’s The Rising Tide of Color Against White World-Supremacy. Stoddard was at this time on the Board of Directors of the American Birth Control League. So was C.C. Little, another openly racist eugenist. President of the Third Race Betterment Conference, he justified birth control as an antidote to the “melting pot,” a means of preserving the purity of “Yankee stock.”
The Decline of a People’s Birth Control Movement
It is important to understand correctly the birth controllers’ conversion to eugenics and their desertion of feminism. They did not disavow their earlier feminism so much as find it not useful because of the more general change in the country’s political climate. Had they had deeper feminist or anti-racist convictions, they might have found eugenic ideas more uncomfortable.
But feeling no discomfort, they found such ideas useful. They could get from the eugenists a support that they never got from the Left. The men who dominated the socialist movement did not perceive birth control as fundamental to their own interests, and their theory categorized it as a reform peripheral to the struggle of the working class. Eugenists, on the other hand, once they caught on to the idea of urging birth control upon the poor rather than condemning it among the rich, were prepared to offer active and powerful support.
Nevertheless, the professionalization of the birth control movement was identical with its takeover by men. Although women remained the majority of the membership of the large birth control organizations, the officers and the clinic directors more and more frequently became men. By 1940 Margaret Sanger had been “kicked upstairs” to become an “honorary chairman.” Men came to occupy the positions of President, General Director, and all the five Vice-Presidents. Two of them were noted eugenists and authors of explicitly racist tracts — anti-immigrant and anti-black. The only remaining woman on the board was Mrs. Mary Woodard Reinhardt, Secretary. The men, however, did not all agree; the doctors wanted to preserve narrow medical justifications for prescribing contraceptives, while eugenists and many lay birth controllers wanted to use contraception to ameliorate social, psychologic, and economic problems as well. Beyond this, eugenists were eager to use birth control clinics to collect data on family patterns, birth control use, changing attitudes, sexual behavior, and genetic history. The eugenists were there in the forefront of the social sciences. Many eugenists (e.g. Lewis Terman and Edward Thorndike) were leaders in the development of improved quantitative and statistical techniques in the social sciences. The foundations generously funded such statistical studies. Eugenists feared and opposed medical supervision of clinics because it threatened to interfere with their data collection.
Most birth control clinics appreciated the eugenists’ support for making contraceptives available in the absence of pathologic indications. The clinics also gave in to eugenists’ research interests. Many clinics conducted inquiries into the hereditary histories of their patients, and presumably advised the women as to whether or not they should have children. In 1925, responding to suggestions from her eugenist supporters, Sanger reformed her clinical records to show the nationality, heredity, religion, occupation, and even trade union background of patients. A review of the work of 70 birth control clinics in Britain and the U.S., published in 1930, proudly demonstrated that they reached a disproportionately large number of working-class women, and claimed a eugenic effect from doing so.
The birth controllers also influenced the eugenists, of course. As Sanger described the relationships:
… eugenics without birth control seemed to me a house built upon sands. It could not stand against the furious winds of economic pressure which had buffeted into partial or total helplessness a tremendous proportion of the human race. The eugenists wanted to shift the birth control emphasis from less children for the poor to more children for the rich. We went back of that and sought first to stop the multiplication of the unfit.
Thus in one paragraph is condensed the transformation of birth control politics: the poor, “buffeted into partial or total helplessness” by economic pressure, are re-christened the unfit.
The clinics encountered difficulties in teaching working-class women to use birth control properly. Some thought such women were unteachable. Sanger and several other birth control leaders agreed. They particularly had trouble with “the affectionate, unreflecting type known to housing experts, who, though living in one room with several children, will keep a St. Bernard dog.” For these women, sterilization was recommended. Another area in which the snobbery of the birth control workers was manifest was in their attitude toward working-class men. They projected an image of these husbands as uncontrolled, uncontrollable, sex-hungry, violent sexual aggressors, with no regard or respect for their wives, who would never agree to contraception. Certainly the reasons such men might have for hostility to birth control clinics were not taken seriously.
But medical supervision of the clinics had created similar problems in reaching the poor with birth control, and Sanger and other clinic partisans ultimately saw more usefulness in the propaganda of eugenics than in the more reserved, “soft sell” style of doctors. Furthermore, the eugenists could not exercise the kind of direct control over clinics that the doctors could, lacking institutions such as hospitals or medical academies, and were thus willing to share control with birth controllers like Sanger. If Sanger and her colleagues ultimately chose to work with the eugenists, it was because it seemed to them their only realisitic option. They would greatly have preferred cooperative working relationships with both groups; and perhaps, had this been possible, they might have retained more direct power in their own hands by playing off the two groups of professionals against each other. As it was, the ideological disagreements, and, even more, the jurisdictional rivalry of the two professions prevented this.
Ultimately, the rivalry held back the clinic movement. Although contraception became widespread in the 1930s, most middle-class people continued to get their help from private doctors. Working-class people, on the other hand, often did not get it at all. Many studies have shown that poor people have more excess fertility — in terms of their own preferences — than more prosperous people. It is equally clear that poor people have little access to birth control services. This last is, of course, part of the general inadequacy and unequal distribution of medical care in the United States. Poverty generally tends to limit the use of medical facilities to the treatment of emergencies and acute or painful conditions, and minimize access to preventive health services. While the right to birth control is not a medical issue, the actual delivery of most contraceptives must be done in medical situations. The movement for birth control clinics was thus in itself a break with the private capitalist medical system in the U.S. and its failure was a part of the general failure of American medicine.
Physicians’ attitudes toward the birth control movement — their demand for exclusive control and restrictive distribution — represented a microcosm of the general attitude taken by the medical profession. The attitude of many doctors toward their private patients continued, well into the mid-20th century, to parallel that of many elite 19th-century doctors; for while they opposed the “promiscuous,” “indiscriminate” dissemination of contraception, they did not question their own discrimination and even thought it important that private doctors should be able to make exceptions to the policies they supported as general rules. Well-to-do women were able to secure diaphragms without medical indications from doctors who may themselves have opposed making it possible for clinics to use the same principles. The discretionary right of the individual doctor was a privilege as cherished by the profession as that of privacy — and the latter, of course, protected the former.
In the 1930s eugenics rapidly declined as a mass movement. Nazi eugenic policies tarnished the image of the movement, and scientific criticisms stripped away much of the academic respectability that had clothed eugenical racism. On the other hand, the success of birth control also contributed to the decline of eugenics.
Birth control had become a movement that could do much of the eugenists’ work for them. Henry Pratt Fairchild, former President of the American Eugenics Society, told the annual meeting of the Birth Control Federation (successor to the ABCL) in 1940:
One of the outstanding features of the present conference is the practically universal acceptance of the fact that these two great movements (eugenics and birth control) have now come to such a thorough understanding and have drawn so close together as to be almost indistinguishable
Birth control emerged as a movement in the 1910s among radicals, especially feminists, who sought basic social change in sexual and class relations. By the end of the 1930s birth control was no longer a popular movement but had become a staff organization of experts lobbying for reforms in behalf of a larger constituency. This transformation was accomplished by the large scale entrance of professionals into the birth control cause.
The organization that today dominates birth control in the U.S., the Planned Parenthood Federation, originated in 1942 out of a merger of birth control groups. It represents the culmination of the tendencies which the professionals introduced in the 1920s and 1930s: removing the focus of birth control education from women’s rights to family stability, social unity, and population control. For example, Planned Parenthood continued the efforts of the original birth controllers in promoting sex-education, but its content was subtly changed. Planned Parenthood spokespeople avoided the connotation that women might wish to remain childless, affirming motherhood as the main source of women’s fulfillment, and arguing merely for the economic and health benefits of small families. They offered a male-centered sex education which perpetuated many existing myths about female sexuality, such as the vaginal orgasm and dangers of promiscuity.
Planned Parenthood long clung to a policy of offering birth control services only to married women. That policy in practice supported the double standard, the view that unmarried women who “went all the way” had to “take their chances.” Choosing not to challenge conventional norms about women’s roles in society—full-time wifehood and motherhood as primary — Planned Parenthood therefore had to argue for birth control in terms of health and population control primarily.
And these two themes, as we have seen, were interpreted to the public under the influence of doctors and eugenists. The “experts” defined good social policy for the public. They held up small families as a model for all people, regardless of their economic and psychological needs, and without relating family size to the overall quality of life. The planned parenthood population control merger of the 1950s reflected the experts’ sense of their responsibility for offering the small family as a solution for poverty all over the world, with increasing insensitivity to the personal and cultural preferences of other people.
None of these criticisms should obscure the fact that the availability of efficient birth control provided the basis for a radical change in women’s possibilities. Lack of control over pregnancy (except through avoiding marriage, which was not an economic or social possibility for most women) and the great burdens of child-raising had perhaps represented the single most important factor in women’s inequality.
Placing reproduction under individual control has the potential of making any opportunity available to men open to women also. But the vast majority of women never won these advantages. It is precisely because the liberating potential of birth control for women was so great that the failure of the birth control movement thus far to reach its potential seems regrettable, and is worth analyzing.
Part of the problem lies in the inadequate quantity of birth control services available. But many women do not take advantage of birth control techniques available to them: their problem is social and economic, not merely technologic. For women to desire limiting their pregnancies and to be able to take the responsibility for contraception, they must have a new way of looking at what women should be, a new image of femininity and a new set of actual possibilities that do not require sexual passivity, maternalness, domesticity, self-sacrifice, and the absence of ambition. It was this new sense of womanhood that the birth controllers of the early 20th century were after. Margaret Sanger believed in 1916 that birth control was revolutionary because it could provide the technologic basis for women to control not only their pregnancies, but their destinies.
Historically, the technology of birth control did not lead, but followed, the social demand for it. Today too women have tended to use contraception to the extent that they have other activities which they find preferable to child-raising. The birth control movement was once part of an overall feminist movement, struggling for more opportunities for women in many areas simultaneously, and championing total self-determination for women. Lacking that overall movement, birth control has become a part of the technologic revolution, attempting to create social reform through a single invention, without the process of liberation that is entailed in a movement of people struggling for their own interests.
Because birth control became removed from a larger social movement, it lost the political content that identified it with the struggle for human liberation. Indeed, one of the problems birth control advocates face today is that many associate birth control with the opposite of liberation — with elitist and racist policies leading even to genocide. There is truth in that belief. Population controllers have used coercion and trickery to impose birth control, often in the form of permanent sterilization, upon Third World peoples such as Puerto Ricans and Indians. Many poor people associate birth control with feminism and disapprove of both. They have experienced feminism as the struggle of privileged women for equality with the men of their privileged classes. It is true that the feminist movement primarily reflected the needs of privileged women in the past; it is also true that the discrimination such women faced, within the birth control movement, for example, paralleled that directed against working-class people. The birth control professionals felt confident that they knew how to arrange the social advancement of less privileged groups, and offered contraception as the general solution. In fact for women and all poor people birth control represents a major step forward only when it is combined with campaigns for equality on many fronts.
The struggle for birth control today offers opportunities for those concerned with the welfare of women and of the poor — for those concerned with social equality in general — to change its previously elitist direction. The history of the birth control movement suggests that it is possible to make of it a popular cause that reaches people of all classes if its basic principle is self-determination through increasing the real choices that people have. Legalized abortion that remains out of the price range of most women does not, for example, represent real self-determination. Offering women contraceptives without thorough, female-centered sex education does not represent self-determination. Offering women inadequately tested pills, and testing those pills on poor and non-white women as has been the custom of the drug companies, does not represent self-determination nor is it likely to make poor people favorably inclined toward birth control as a reform. Similarly, it makes no sense to offer advice or contraceptives without adequate general medical care, or to offer it through disrespectful and condescending doctors. Birth control ought to be one of the central demands of a socialist program of medical care that emphasizes preventive health, health education and sexual equality; a program that must provide the best medical care to working-class and poor people at little or no cost.