The Ultimate Betrayal
It has been 40 years since Elaine Riddick heard the words, but she still remembers them like yesterday: "The doctor told me I had been butchered."
In 1968, at just 14 years old, Elaine became one of the thousands of victims of North Carolina's forced sterilization program. Quietly and efficiently operating from 1929 until 1974, the program's purpose was to weed out the "unfit" of society by stopping them from reproducing.
Elaine is sitting in a quiet apartment high above the noise of Atlanta traffic. A well-dressed, poised and dignified African-American woman in her mid-50s, it is difficult to imagine her as the young girl that she describes.
As a teenager in tiny Winfall, N.C., Elaine had already known poverty and violence. She had witnessed her father cutting her mother's throat from ear to ear in an alcohol-induced rage. She remembers frequently missing school. When she did show up, she was dirty and unkempt. She sometimes stole food from other children's lunches because she was always hungry. At just 13 years old, she was raped and impregnated by a neighbor's brother who was in his 20s. Elaine remembers that he threatened to kill her if she told anybody.
Elaine was 14 when she gave birth to what was to be her only child, a son, in 1968 at Chowan Hospital in Edenton. She doesn't remember much about her hospital visit, but she was told that she almost died and had to stay in the hospital a week longer than her son.
For the next few years, Elaine says she remembers having frequent stomach pain and hemorrhaging so severe that at 16 she was admitted to a hospital. The doctor gave her little information, but she remembers he remarked that she'd been "butchered."
However, Elaine didn't know what that meant until, at 19, she went to a doctor again. By then she was married and she and her husband wanted to start a family. After talking with the doctor and one of her sisters, she finally realized that she had been sterilized right after her son's birth five years before.
Like Elaine, tens of thousands of people across the country were victims of eugenic sterilizations. But North Carolina was something of an anomaly. Most of the states with eugenic sterilization programs dismantled them after World War II when the horrors of the Holocaust were uncovered. North Carolina, however, ramped up its program in the postwar years, increasingly targeting poor black women during the '50s and '60s.
By the program's end in 1974, North Carolina ranked third among the states for number of eugenic sterilizations performed—at least 7,600 over 45 years. It was also the only state in which social workers were empowered to start the sterilization petitioning process. The Eugenics Board of North Carolina—comprised of five bureaucrats who met monthly in Raleigh—approved 90 percent of the sterilization petitions, often deciding cases within 15 minutes and without interviewing the individual to be sterilized. More than 70 percent of the victims were sterilized for "feeblemindedness," a vague term open to the board's interpretation—from supposedly possessing a low IQ to being "promiscuous," "rebellious" or even "untidy."
According to the petition filed with the board for Elaine in 1967, she needed to be sterilized because of her "inability to control herself and her promiscuity." The petition adds that there are "community reports of her 'running around' and out late at night unchaperoned." It concludes that Elaine can "never function in any way as a parent." Her diagnosis: "feebleminded."
Elaine had obtained her medical records after consulting with the ACLU, who worked with her to file a lawsuit against the state for $1 million in damages on the grounds that her constitutional rights had been violated—which she lost. She underwent a reversal procedure that didn't work. And she tried to save a marriage with a man who called her "barren" and "a waste."
"He said I should have died," she remembers. At 27, she finally divorced him and decided to go back to school. She got an associate's degree, even though she had never completed high school. "They never asked to see my transcript," she says.
But even a college degree could not erase the stigma she felt from her sterilization and years of verbal and physical abuse. She married another man in Georgia and suffered more abuse. Elaine blamed herself for both abusive husbands because she wasn't able to give them children. And, she says, she internalized the "feebleminded" label placed on her by the state, believing "I was too dumb and stupid."
Elaine continued to suffer from pain and bleeding, and finally underwent a full hysterectomy. For years she took anti-depression medication and says she was always hiding, hurting and crying: "I would never smile."
She avoided her family and people from her past. "I felt like they knew about me," she says. "I had 'sterilization' written all over my forehead and back."
And she felt betrayed by her government.
While the program in later years most often targeted poor black women, it didn't begin that way. Early on, the program focused on people in mental hospitals and training schools, which admitted those believed to have developmental disabilities or psychiatric disorders.
"It's something that you never forget," says Agnes, a white elderly woman who lives in Raleigh. (She wishes to remain anonymous because no one else knows about her sterilization.) Although her hair is white and her voice fragile, she appears much younger than her 82 years. She sits at her kitchen table in her well-maintained home, and her eyes begin to tear as the memories from 60 years ago begin to surface.
In 1949 she was 21 years old, married and had just given birth to her second child, who was born with cerebral palsy. She knew that something was wrong but couldn't pinpoint it. She felt angry and depressed all the time. She wouldn't eat. She cursed at her husband and her doctor, faulting him for her newborn's problems. At one point she attempted to jump out the window of their home.
What might be recognized as postpartum depression today was deemed a "mental breakdown." Agnes was sent to Dorothea Dix State Hospital in Raleigh, where she remained for eight months. "It seemed like 50 years to me," says Agnes, adding she "wasn't the best patient."
She received more than 25 electrical shock treatments during her hospital stay. It's been more than 60 years, but Agnes still shudders as she recalls being strapped to a table with a mouth guard in place and feeling the electricity course through her body. Then she would be taken back to her ward, tied down with sheets to her hospital bed and covered with ice chips. She also remembers being sent to solitary confinement for weeks at a time as punishment for "bad behavior."
While at the hospital, Agnes complained of a recurring pain in her side, which the doctors suspected could be appendicitis. She says she clearly remembers hearing them discuss their plans,
"It wasn't their choice," she says. "That should have been my choice."
Agnes did not consent to the procedure, nor did her husband. In fact, he wasn't even aware she'd had surgery until the following day when she told him about it. The sterilization greatly saddened both Agnes and her husband, who died about eight years ago. They were young and planned to have more children. For years, Agnes had a secret hope to become pregnant despite her sterilization. She would sometimes look longingly at someone else's baby. "I felt like, if this was my baby I would just be so thrilled."
Elaine and Agnes, though separated by generation and race, and now by hundreds of miles, are connected by history: they are both survivors of North Carolina's eugenic sterilization program. There are two bills in the Legislature that, if passed, would help make amends for North Carolina's eugenic past. One would provide a one-time cash payment of $20,000 to each of the estimated 2,800 victims expected to still be alive, as long as they come forward themselves and can be verified to have been part of the program. (State Rep. Larry Womble initially proposed $50,000, but the most recent House bill reduced the amount.) The other bill addresses health and counseling benefits for victims as well as ethics training for government employees and a directive for the state's K–12 schools to teach about North Carolina's eugenics program as part of its state history curriculum. No other state has made this type of effort. Yet, considering the uniqueness of the state's sterilization program, the extra effort seems warranted.
To be fair, most North Carolinians knew little or nothing about the state's forced sterilization program at the time it was happening. Few sterilization victims spoke up about what happened to them, and the records of the Eugenics Board were closed to the public. However, in the late 1990s, Dr. Johanna Schoen, a professor of women's history at the University of Iowa and a graduate of UNC-Chapel Hill, was researching the history of birth control, sterilization and abortion when she was granted access to the board's previously sealed records.
Recognizing that the stories of thousands of victims desperately needed to be told, she shared her research with a team of reporters at the Winston-Salem Journal, who combined Schoen's research with their own investigative reporting and published a five-part series in the winter of 2002–2003 titled "Against Their Will." The series detailed the flagrant abuses that occurred during the program's tenure. For example, more than 2,000 of the victims were ages 18 and younger. A 10-year-old boy was castrated. The board sometimes backdated approval for procedures that had already been performed. Young girls were sterilized for perceived promiscuity or rebelliousness. Welfare recipients were sometimes threatened with loss of benefits if they did not agree to sterilization.
Not surprisingly, the Journal's series was shortly followed by a formal apology from then-governor Mike Easley for the state eugenic sterilization program. Easley appointed a blue-ribbon committee to study compensation for program survivors, and that committee developed several recommendations—everything from increasing public awareness to providing outreach services to survivors through monetary as well as health and education benefits. In 2003, it seemed that North Carolina was well on its way to making some sort of amends for a regrettable chapter of its history. However, because of staff changes at the Department of Health and Human Services and lack of resources, most of the recommendations were left to collect dust for several years.
When State Rep. Womble (D-Forsyth) received a phone call from the Winston-Salem Journal in 2002 asking if he knew about the state's eugenic history, he said he didn't. Once he learned the details, he was flabbergasted and angry that such a program had ever taken place and vowed to do something about it. "It's been a long battle," says Womble. "First we had to take the law off the books."
That's right. The sterilization law remained on the books until 2003, although the Eugenics Board was disbanded in 1974. After the law was finally removed, thanks mainly to Womble's efforts, the state developed a traveling museum exhibit describing the program. A historical roadside marker recognizes the program's victims. It was unveiled in downtown Raleigh last year. And, most recently, Charmaine Fuller Cooper of Durham was appointed executive director of the new N.C. Justice for Victims of Sterilization Foundation, which will examine options for restitution for the survivors and collaborate with other state agencies in carrying them out (see sidebar story).
After seven years of promises, though, the sterilization victims have yet to see any tangible benefits, and some of them are starting to lose hope they ever will.
Among the many regrettable aspects of the state's eugenic program, perhaps the most unforgivable is what happened to children in state training and reform schools. Willis Lynch, now in his mid-70s and living in Littleton, was just a child when he was sterilized during his time at a state training school in the late 1940s. He was the third of seven children being raised by a single white mother on welfare. Although they were desperately poor, Willis fondly remembers how his mother once pulled together enough money to buy him a guitar. He taught himself how to play.
But when Willis was 12, the pressure of taking care of seven children on her own became too much for his mother. Willis was sent to Caswell Training Center in Kinston, and a few of his siblings were sent to other institutions. He remembers learning that he needed some kind of medical procedure.
His mother was probably told so by authorities. A 1935 report from the Eugenics Board states,
Willis didn't know what the operation was for or why he needed it, but he complied. He says he remembers lying on the operating table as a nurse prepared him for the procedure. She asked him about his music. Fourteen-year-old Willis was singing her a song as she slipped the anesthesia mask over his face.
No one ever explained to Willis what had happened to him, but eventually he figured it out on his own. Later in life, he married a woman who already had two children, but Willis says he would have very much liked to have his own biological children. He went on with his life, and music remains his passion. He plays and sings Hank Williams-style songs every Friday night at a local country jamboree. But he says his sterility was always something in the back of his mind.
Willis assumed he was sterilized because people thought he was "mean" and "they didn't want my kids running around." He was able to obtain his medical records from Kinston and learned that the doctors had tried but failed to get his mother sterilized as well. It represents a chapter of his life he'd rather forget. "But you can't forget things like that."
It's not only victims from that period who remember the program with horror. Robin Peacock, now in her early 80s and living in Raleigh, was a social worker in the area of child welfare services in the 1960s and early 1970s. She says that during those years she didn't understand the purpose and rationale given for the state eugenics program. "At one point my concern turned to rage when working with a young couple who had come to the agency to apply to adopt an infant. At that time, we looked into causes of sterility. In talking with the wife, she confessed that in her early teens she had been sent to one of the state's training schools for juvenile delinquents. While there, and without her knowledge, she had been sterilized. The memory of that painful conversation has remained with me over 40 years." Hundreds of children who passed through the doors of state training schools ended up sterilized. Caswell Training Center had the most, with nearly 600 sterilizations. The State Home and Industrial School for Girls was second, with 300 sterilizations. It was assumed that these North Carolina children would grow up to be unfit parents, so they were sterilized before they ever had the chance.
As a man, Willis is an exception to the rule of forced sterilizations. For the most part, men and boys were a small percentage of the victims of sterilization. Eighty-four percent of the sterilization victims overall were women. And by the 1960s, nearly all of the sterilization victims were female. Women bore the brunt of the sterilization law, even though it was readily acknowledged that a tubal ligation for females was a more invasive surgical procedure requiring significant downtime for women than was a vasectomy for males, especially before the advent of laparoscopic surgery.
Eugenic sterilizations for women were secured and performed at a remarkably rapid pace, at a time when women in the general population had an extremely difficult time accessing birth control, sterilization and abortion. Most hospitals followed the "120 formula." In order to be considered for elective sterilization, you multiplied the woman's age by the number of children she had, and the number had to reach or exceed 120. So if a woman was 30 years old and had four children, for instance, she might be allowed to have a tubal ligation. Even then, she would often need the endorsement of two doctors plus a psychiatrist to obtain the procedure. There were also policies in place requiring both doctor and spousal permission for a woman to use birth control.
In Schoen's book Choice & Coercion, she writes about parents who would sometimes petition the board for sterilizations of their daughters because they feared a pregnancy would ruin their family's reputation. In one especially troubling case, a father sought sterilization for his 14-year-old daughter and admitted he had incestuous feelings for her. An examination revealed that the girl had had intercourse. The petition was approved. We do not know what became of this young girl—first betrayed and possibly abused by her own father, then betrayed and abused by the state.
Schoen's book also notes cases when women themselves actively sought eugenic sterilization and sometimes were successful, other times not. Shirley was a white woman in her 30s who had suffered from mental illness for years, had been in and out of psychiatric hospitals and had given up three children for adoption and could not care for the fourth. She actively sought eugenic sterilization in 1966 to relieve her constant fear of pregnancy. Her husband, however, objected to the procedure, thinking he might want to have more children in the future and hoping Shirley might be cured of "not wanting more children." So the board turned down Shirley's petition. They deferred to the male head of the household as the person best capable of making the decision.
If the eugenic sterilization program in practice was discriminatory based on a person's gender, class or race, it was especially so for those individuals who stood at the intersection of all three. Never an attractive program, by the early 1950s eugenics in North Carolina managed to take an even uglier turn. Noninstitutional procedures rapidly increased. With social workers empowered to petition the board for sterilization of their cases, black women from welfare families were increasingly targeted for the procedure.
Nial Cox Ramirez, a 64-year-old black woman now living in Union City, Ga., was one of them. In 1964, 18-year-old Nial became pregnant. She was from a poor family, and she recalls a white woman with a briefcase ("the Devil from hell") frequently visiting the family's home and telling the girl she needed to agree to sterilization or her entire family would lose its welfare benefits.
She agreed to the procedure following the birth of her daughter but tearfully pleaded with the doctor to spare her—to not sterilize her and to just say that he had. The doctor told her he had no choice. Perhaps to make her feel better or to relieve his own guilty conscience, he told Nial that the procedure was temporary and she could get it undone later on. "He told me a bald-faced lie. He knew it was permanent."
Nial's daughter, Debra Chesson of Riverdale, Ga., is still angry and heartbroken about what happened to her mother in North Carolina more than four decades before. In a letter dated Nov. 18, 2008, to Rep. Womble, she writes:
Being young, African-American, unwed and pregnant was apparently enough evidence to classify Nial as "feebleminded," but the lynchpin was that she resided in a home that drew a welfare check and received visits from a social worker. Presumably, there were girls and boys from wealthy and middle-class white as well as black families who could have also been characterized as "feebleminded." But they are largely absent from the group that ended up sterilized. Many North Carolinians who might have otherwise ended up under the doctor's knife didn't—for the simple reason that their families had money and clout.
The eugenics program of North Carolina was part of a much larger pattern of sterilization abuse across the South. A class action lawsuit filed in federal court from Alabama in 1973 revealed that an estimated 100,000 to 150,000 poor women in the United States had been sterilized annually under federally funded programs. Nearly half of these women were black, numbers far exceeding the percentage of African-American women in the general population. This number of sterilizations equals the rate reached by the Nazi sterilization program in the 1930s.
Mary English, a black woman now in her late 50s from Fayetteville, was married with three children when she started having health problems at age 22. Her doctor suggested she participate in a "program" in which she would undergo a procedure and not have to worry about birth control anymore. He told her the procedure was easily reversible should she decide to have more children in the future. According to Mary, the doctor had her sign a blank piece of paper authorizing the procedure. A few years later, when she went back to get the procedure reversed, she was informed that it was, in fact, permanent. "He got me and all my friends," she says of the doctor's blank-paper program.
Unfortunately, Mary's name does not match with any of the records from the Eugenics Board stored in the state historical archives. Her doctor was apparently "going rogue" and operating outside the appropriate legal channels for eugenic sterilizations. Mary will not qualify for compensation when and if it is ever paid. We have no way of knowing how many others may have been coerced or otherwise misled into sterilization outside of the state's legal program. Mary is still trying to figure out how to obtain some measure of justice.
In the 1930s and '40s, African-Americans represented 23 percent of North Carolina sterilizations. That grew to 59 percent between 1958 and 1960 and finally to 64 percent between 1964 and 1966. Dr. Roberts says the policies surrounding women and reproduction, especially African-American women, have been shaped by a long-standing mythology.
This myth, she says, was developed during the time of slavery in the South and was used as a way of legitimizing her rape and exploitation as a breeder to perpetuate slavery.
The Jezebel character later morphed into the "Welfare Queen," the black woman who deviously has babies to get a fatter check. "These myths helped legitimize white oppression and perpetuate racial inequality," Roberts says. "When you think about it, these forced sterilizations were very violent, brutal assaults on these women's bodies. The mythology helped to justify their assault because it was being done not only for the 'good' of society but for the 'good' of the victim as well."
Dr. Roberts points out that it's interesting to note what was happening historically while black women made up an increasingly larger percentage of eugenic sterilizations. The civil rights movement, desegregation in the South and inclusion of African-Americans as Aid to Dependent Children (ADC) recipients greatly heightened racial tensions and fears among whites in the South.
Sadly, more than half of the forced sterilization victims have already died, without ever receiving any kind of acknowledgement that what happened to them was wrong. But for the estimated 2,800 individuals still expected to be alive today, there is still a chance to do what's right. Sharing their stories, acknowledging the past and trying to learn something from it is a start. The $20,000 compensation being considered for survivors is not a hefty sum when you think about what the trade-off has been. Still, it is something, and it should be paid while the survivors are still surviving.
In the letter from Nial's daughter, she writes about how her mother is on a fixed income now and struggles to pay her medical bills.
At 82 years old, Agnes is not sure she'll live to see when or if the proposed compensation is paid. She appreciates the efforts being made in North Carolina to reconcile its eugenic past by acknowledging what she and thousands of others in our state went through.
Elaine, Agnes, Willis and Nial wonder why the American values of equal protection and individual liberty did not apply to them, and there are no simple answers to give them. They were caught within an ideological framework that said it's acceptable to toss aside ethics and trample over the most basic of human rights if someone is perceived to not meet certain social expectations.
Now in her mid-50s, Elaine Riddick is one of the younger survivors of North Carolina's eugenic sterilization program. From her apartment on the 32nd floor of an Atlanta skyrise, she has a beautiful view of the entire city. She says she has been able to obtain some measure of peace, which she attributes to her faith in God and finally letting go of the self-blame that she carried for years. Her adult son, Tony Riddick, whom she describes as "brilliant," still lives in Winfall and owns his own computer electronics company.
Elaine has a loving boyfriend who, she says, takes good care of her and has a positive relationship with her son and siblings. Still, sometimes the cruelties from her past come back to haunt her.