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British statistician Francis Galton gave rise to eugenics in 1883 based on his belief that the human race could be improved through the use of selective breeding by discouraging procreation among people, frequently from lower economic strata, deemed “inferior.” Progressive reformers in the West soon applied Galton’s ideas by instituting policies labeling people “feebleminded” based on flawed IQ tests and targeting them for sterilization in the name of “human betterment.” And in their landmark 1927 ruling in Buck v. Bell, United States Supreme Court justices permitted the compulsory sterilization of people deemed to be “socially inadequate” and “feebleminded.” The Buck ruling emboldened eugenicists across thirty-two states to sterilize more than 60,000 Americans.

Revelations about similar horrors of forced sterilizations during the Holocaust by the Nazis, who drew inspiration from the American eugenics movement, prompted numerous state governments to shutter their own programs. But some states, like North Carolina and Utah, doubled down and sterilized more people after 1945 than they had before.

Utah alone sterilized at least 830 men and women, while more populous states like California and North Carolina oversaw the sterilization of nearly 30,000 people. But what the Beehive State lacked in raw numbers, it made up for with unrivaled enthusiasm.

“In the 1940s, [Utah] was going gangbusters,” Tabery reported. “I mean they were just sterilizing more people per capita than any other state.”

Whereas many states like California ramped down their sterilization programs in the 1940s and 1950s, Utah and North Carolina found ways to keep it going decades later, and I think that’s why it ends up having such a lasting impact. . . . It was quite aggressive for the size of the state.

The Utah State Training School, the central arbiter of eugenics in the state, sterilized people with intellectual disabilities for fifty years until 1974. The sterilization of people with disabilities without their consent remains legal in Utah under section 26B-6-806 of the Utah Health and Human Services Code. In fact, the National Women’s Law Center reported that as many as thirty-one states and Washington, DC, allow for the forced sterilization of people with disabilities.

What drove the eugenics era in the United States was not merely the desire to cull the population of genetic “impurities.” Eugenicists used pseudoscience to legitimize entrenched racist, patriarchal, and classist attitudes to demonize and control the country’s most marginalized groups, including prisoners, people of color, the poor and working class, and people with disabilities.

Among the most outspoken champions of eugenics were robber barons like industrialist Andrew Carnegie and financier John D. Rockefeller Jr. Their capital fueled eugenics research that helped convince state and local officials of the need to prevent poor and working-class people from reproducing lest their children and their children’s children continue to be a financial burden on the state and the wealthy. Speaking about the perpetuation of “feeblemindedness” passed down to Carrie Buck from her mother and later to her young daughter, Supreme Court justice Oliver Wendell Holmes clarified the concerns of the country’s elite when he infamously decried that “three generations of imbeciles are enough.”

In the Jim Crow South, compulsory sterilization was frequently deployed along racial and class lines, particularly against black women with the aim to not only stifle dissent but also to thin the welfare rolls. Rarely were survivors in a position to fight back. A notable exception was Fannie Lou Hamer, whose forced sterilization, a procedure common enough that it was dubbed the “Mississippi appendectomy,” galvanized her to join the civil rights movement.

“Immigrants of an undesirable type,” specifically those from Mexico, were at increased risk for sterilization at the height of eugenics in California. Even today, Latina women are sometimes forced to undergo sterilizations and other medical procedures without their consent. In 2020, whistleblower Dawn Wooten alleged that women at the Irwin County Detention Center in Georgia were subjected to an alarming rate of hysterectomies, among other human rights abuses.

Yet efforts over the last forty years to expose the past and present permutations of American eugenics and to secure justice for survivors have not met with the same level of institutional and philanthropic support that was marshaled around increasing the number of sterilizations in the United States. While the sum total of people sterilized against their will far outstrips that of living survivors who have received compensation, some advocates remain determined to tip the scales.

Tabery felt compelled to take action after learning more about his home state’s eugenics program. An important step toward reckoning with forced sterilizations in Utah, Tabery posited, would be to estimate the number of living survivors in order to underscore that one of the state’s darkest chapters continues to reverberate today.

He and other researchers, many of them based in Utah, drew inspiration from their counterparts in California, whose 2017 article published by the American Journal of Public Health estimated that 831 survivors might still be alive. The peer-reviewed data analysis informed the campaign that eventually secured compensation in that state in 2021.

Analyzing data collected from the Utah State Developmental Center as well as a master’s thesis documenting every case of sterilization in Utah before 1932, Tabery and the research team concluded that among the 830 men, women, and children sterilized by the state, as many as fifty-four survivors — thirty-six women and eighteen men, at an average age of seventy-eight — could still be alive today. Their findings appeared in the journal the Lancet Regional Health — Americas in February 2023. (Their latest estimate is forty-eight survivors total — thirty-two women and sixteen men — at an average age of seventy-nine.)

The researchers’ report also revealed important aspects about the scope of Utah’s eugenics program in addition to demographic data about the individuals targeted for sterilization.

The eugenics programs in California and North Carolina were carried out largely on the basis of race, gender, and class animus. For example, poor black women receiving welfare benefits were disproportionately targeted for sterilization in the final years of North Carolina’s eugenics program.

Not so in Utah, argued Jennifer Rust in her master’s thesis, “Propagating Perfection: Eugenic Sterilization at the Utah State Training School, 1935–1974.” Utah sterilization survivors were overwhelmingly white and disabled; women held only a slim majority over men. Children were not spared the procedure, and at least one child under the age of ten was operated upon.

Utah’s eugenics program is notable for its focus on sterilizing people with disabilities. Nearly two-thirds of the 7,600 men, women, and children sterilized in North Carolina were never institutionalized, according to reports by the Winston-Salem Journal. Utah, on the other hand, almost exclusively targeted people with intellectual disabilities at a single institution: the Utah State Training School.

“Even though [Utah] wasn’t obviously targeting people of color, it was obviously targeting people with disabilities,” said Tabery. “I think a lot of it, in hindsight, is what we would call ableism.” Further evidence that ableism was a primary motivator is provided by the maneuvering of legislators in the 1960s and ’70s to continue sterilizing people with disabilities long after the science of genetics had disproved the rationale for the procedure. “The passing of decades saw an ideological shift in eugenics as the justification for sterilization evolved from preventing the birth of disabled individuals to protecting the unborn child from disabled parents,” Rust wrote in her master’s thesis.

Rust also illuminates the ways the Mormon church paved the road for the eugenics movement in Utah. “Before Gregor Mendel began his pea plant experiments or Charles Darwin published On the Origin of Species, Brigham Young colonized a vast basin, initially necessitating plural marriage to bring forth a perfect human race in his present-day Zion,” she wrote:

The predominant religion [in Utah], Mormonism, held that God commanded marriage to provide as many virtuous bodies as possible so that spirits may continue their eternal progression. Even as polygamy was outlawed, this theology supported and exerted the social control necessary to segregate and sterilize those found unworthy to procreate.

Reformers like Amy Lyman and other founders of the Utah State Training School wedded their anxiety over the propagation of genetic impurities with their Mormon beliefs that “only the ‘fittest’ in the community should be allowed to reproduce.” And school superintendents and trustees openly broadcast their hopes for sterilization as a tool to make people with disabilities “fit” to return to the general population.

Shortly after the publication of the Lancet article, the Utah Department of Health and Human Services (DHHS) issued an apology addressing the more than fifty estimated living survivors of the state’s sterilization program.

The letter was notable for several reasons. First, Utah DHHS oversees the Utah State Training School, now called the Utah State Developmental Center, in American Fork where the vast majority of the state-sanctioned sterilizations were carried out. Second, the department’s historic admission of wrongdoing went a step beyond a mere apology by also pleading that it wanted to issue personal statements to survivors, declaring, “We are in the process of trying to identify any individuals still living who underwent these procedures.”

Tabery called the DHHS missive “heartfelt,” contrasting it with the political boilerplate common in similar public statements from other state officials. Moreover, he thought the apology signaled a willingness to collaborate with his team and maybe even result in an official governmental response that could be parlayed into a program to compensate survivors. But the Utah DHHS instead opted to identify individuals on its own, according to emails shared with Jacobin, and did not accept Tabery’s offers for assistance in locating survivors.

The DHHS used the same data from the Utah State Developmental Center and the Utah State Hospital that Tabery had relied on. Operating under the rationale that living sterilization survivors would likely receive Medicaid benefits, DHHS officials took the names and dates of birth of the potentially living individuals and cross-referenced them with historic and current Medicaid claims. Next they cross-referenced the Utah State Developmental Center’s dataset with state death records, Katie England, public information officer with the Utah Office of Public Affairs and Education, told Jacobin in an email in August 2024.

The Utah DHHS confirmed the deaths of five sterilization survivors, but its search failed to identify any living individuals. Notably, there were living survivors as recently as 2020 because the staff member at the Developmental Center who compiled the data for the research team listed people as alive in the dataset, Tabery told Jacobin.

When pressed about whether they anticipated working alongside legislators or community members to identify survivors of the state’s shuttered eugenics program, Utah DHHS officials shut the door on the possibility. “We are not planning to conduct any additional searches in this matter,” England told Jacobin.

Unaware that the DHHS had closed a potential avenue for collaboration but not content to wait for state officials to take the lead, advocates like Tabery started drafting their own plan to secure financial compensation for survivors.

When Tabery set out to formulate a bill to compensate survivors of Utah’s eugenics program, he again turned to North Carolina for inspiration. Under the proposed legislation, a draft of which was shared exclusively with Jacobin, Utah survivors would receive $30,000 in the order that their cases are verified. Like North Carolina’s own Eugenics Asexualization and Sterilization Compensation Program, the Utah bill calls for the state to establish a sterilization compensation commission to review applications, mobilize outreach, and distribute the funds to survivors.

The proposal points out that the $400,000 necessary to compensate roughly fifty-four survivors is a modest request compared to the seven-digit figures allocated by the North Carolina and California legislatures.

Whether these overtures will be enough to sway hard-line conservative lawmakers in Utah is unclear. North Carolina Democratic state congressmember Larry Womble faced a similarly difficult challenge as the primary champion of sterilization compensation, an issue so polarizing and so off of everyone else’s radar that it seemed to be a political moonshot. Womble’s sterilization compensation bill languished for years in the General Assembly in Raleigh under the control of conservative members of the Democratic Party. The campaign received a boost after Democratic governor Bev Perdue established a special task force in 2011 tasked with making recommendations about how survivors should be compensated.

Ultimately, the North Carolina compensation bill became law only after Republican legislators, having gained majority control of the House and Senate for the first time in one hundred years in 2010, threw their support behind the cause alongside their Democratic colleagues.

As shocking as it may be to see fiscally conservative Republican lawmakers earmark government funds to right past wrongs, the reasons become clearer when viewed as a rare opportunity to rack up publicity points for joining hands with Democrats while at the same time using the past to advance hard-right GOP initiatives in the present. Press materials reframed eugenics as the inevitable outcome of “Big Government” and blurred the distinction between forced sterilization and the debate over the “sanctity of life” by slamming Margaret Sanger, who in addition to supporting forced sterilization also championed abortion and founded Planned Parenthood.

North Carolina Republicans included the sterilization compensation bill into the general budget, which also included cuts to publicly funded social programs like disability benefits and a refusal to expand Medicaid under the Affordable Care Act. The irony that lawmakers would compensate people who were sterilized in an effort to ensure their progeny would not “burden” the state welfare system, while simultaneously passing laws depriving contemporary poor and working-class North Carolinians of social support, led one critic to liken the Republican budget to a “new eugenics.”

In Utah, the political calculus may be different, but it appears no less daunting. The Republican Party currently maintains a tight grip over the political agenda in the state, enjoying a supermajority in the legislature and reigning over the governor’s mansion. To break through Utah’s solid red wall, Tabery shaped the bill to appeal not only to the empathy of compassionate conservative lawmakers but also ideologues who could be swayed to come on board out of a desire to protect individual civil liberties. The issue of forcibly sterilizing vulnerable populations could also resonate as a moral issue with other power brokers in the state, like religious leaders within the Church of Jesus Christ of Latter-Day Saints.

Eugenics is an issue that many would prefer to stay in the past. The Utah proposal carefully distinguishes compensation from reparations and restitution, recognizing that conservative lawmakers cry foul at any suggestion they might bear responsibility for past wrongs. The proposed bill attempts to sidestep these concerns by stipulating that only survivors and not family members or descendants would be eligible for compensation. But perhaps the most difficult task confronting compensation supporters is pressuring Utah legislators to allocate the required funding.

“I think when it comes to compensation, the challenge here is our state is very fiscally responsible and getting funding for things can certainly be an uphill battle,” said Nate Crippes, public affairs supervising attorney with the Disability Law Center. “We have a very long waiting list for people to get into services here, and community-based services [is] something we fight for funding every year,” Crippes lamented. “Adding to the list of things the disability community would want the state to fund is going to present a challenge.”

In 2014, North Carolina became the first state to compensate sterilization survivors when government officials mailed $20,000 checks to more than two hundred people. Dr Paul Lombardo, a lawyer and historian at Georgia State University and author of Three Generations, No Imbeciles: Eugenics, the Supreme Court and Buck v. Bell, credits the North Carolina exception with combining several key factors: academic scholarship, hard-hitting investigative reporting, bipartisan legislative support, and survivors willing to come forward and tell their story, be it in the courtroom or in the public square.

Every successful compensation effort is different, but most campaigns share some variation of these elements. It remains unclear whether compensation could pass in Utah without these elements and, if not, whether other modes of public pressure such as a grassroots campaign led by the disability community could be mobilized in time to overcome opposition within the halls of the Utah State Legislature.

Tabery and others have already provided the academic research that could inform such a campaign. Their findings captured media attention, but it was a flash in the pan compared to more sustained and expansive coverage such as the Winston-Salem Journal’s investigative series that kept North Carolina’s eugenics program in the public eye.

One of the reasons why compensation advocates in Utah are finding it difficult to keep the issue in the press is that no survivors have come forward to tell their own stories. Advocacy by North Carolina eugenics survivors like Elaine Riddick and Nial Cox Ramirez brought history to life and galvanized public sympathy.

“[Elaine Riddick] was able to tell her own story,” Lombardo recalled. “Many people with disabilities are not in the position to do that. We don’t have the kind of face and voices [in Utah] that you have in a few cases in other states.”

No living sterilization survivor in Utah has so far contacted Tabery or stepped forward to talk to the media about their own experiences. Nor have any elected officials, so far, proved willing to take up the cause and sponsor the compensation bill. The silence from survivors could make it more difficult to capture media attention and increase public support for compensation. The lack of public outcry makes it easier for elected officials to run down the clock until there are few or no survivors to compensate.

Grassroots advocates in California avoided this fate by recognizing the common oppression suffered by survivors of the state’s shuttered eugenics program and the targeted sterilization of female prisoners, particularly black women as well as immigrant women from Latin America and Asia.

“I think part of why [compensation] ultimately did pass [in California] was that it ended up becoming a coalition and not just being about eugenics survivors, but also about survivors of sterilization in California state prisons,” said Dr Nicole Novak, an assistant research scientist at the University of Iowa and codirector of the Sterilization and Social Justice Lab. “So there were two classes of survivors included, and the second class did include people who were telling their story.”

As nascent campaigns to reckon with the legacy of forced sterilization emerge, survivors continue to age. Consequently, the number of people who are alive to receive compensation shrinks with each passing day, month, and year.

A measly eleven survivors among 8,000 were ultimately compensated by Virginia. The North Carolina Industrial Commission certified significantly more survivors — 220 — but that figure still pales against the 7,600 people the state allowed to be forcibly sterilized. Compensation advocates in Utah face a similarly disappointing outcome in the absence of a seismic shift in political attitudes in Salt Lake City, pressure from grassroots protest, or heightened scrutiny from the media.

Utah has an opportunity to learn from past oversights and to make amends for forcibly sterilizing more than 800 of its residents, but time is running out.

“This could always happen again, and the biases that drove this before are still out there,” said Tabery. The connections to broader disability injustices, punitive regard for poor Americans requiring welfare assistance, and ongoing attacks on women’s bodily autonomy are glaring.

For his part, Tabery has vowed to stay in the fight despite the odds of securing justice for survivors within their lifetimes.

“We’re going to keep talking about [Utah’s eugenics program], and the compensation legislation will be one aspect of that,” Tabery said. “It’s going to be a drum that I keep beating, but you’re right, with each passing year, the number of people you might hope to find is going to go down.”