The history of coerced sterilization in North America remains a topic of enduring interest for at least two reasons. First, the operation was an illiberal assault on citizens’ autonomy and control of their bodies. Second, the history of coerced sterilization is at once both narrow and broad. It is narrow in that it is in part the history of a small subset of the overall population: people with developmental disabilities. It is broad in that their personal histories intersected with and were intertwined with some of the largest and most defining trends of the twentieth century: public health, demographic decline, institutionalization, privately supported policy research and lobbying, and social engineering based on the application of “scientific” findings to public policy.

Many protagonists of coerced sterilization viewed it through a public-health perspective: an attack on threats to a nation’s or race’s health from within (through better breeding and sterilization) was the counterpart to an attack on these threats from without (through sanitation and medication). The elimination of disease and premature death could only be accomplished with the elimination of heritable feeblemindedness. Sanitation and sterilization, as it were, went hand in hand. Similarly, concerns about racial health and degeneration fed into anti-immigration sentiment and fears about dysgenic and ecological doom. Those who held these fears made no sharp distinctions between individual, racial, and environmental vigor and decay. It is not a coincidence that racist eugenicists founded some of the earliest environmental organizations on the West Coast.