2021 AAHM – Madness in Michigan

Link to Presentation’s PowerPoint

Good morning, everyone. Before we begin, for anyone who would find it helpful, the text version of today’s talk is already available on my website, kateeoconnor.com/talks. I have also dropped a link in the chat.

Today, I am going to present a small portion of my ongoing dissertation research on Michigan’s eugenic sterilization program, which existed from the early through mid 20th century. I will be presenting data from the sterilization files from one of Michigan’s state mental hospitals, the Kalamazoo State Hospital. I argue that these records largely reflect the overall patterns of eugenic sterilization in Michigan’s mental health hospitals and that they reflect racial and economic anxieties present among Michiganders during the early through mid 20th century.

Brief History of Kalamazoo State Hospital 

The Kalamazoo State Hospital opened on August 29, 1859 as the Michigan Asylum for the Insane and is still in operation today. It was purposefully built in a rural area so as to separate the “insane” from the general public. Based on both necessity and because it was believed to be a form of therapy, Kalamazoo functioned as a largely self-sufficient town called a farm colony with its own farm, garage, laundry, water tower and other amenities.

Like most mental hospitals, Kalamazoo was overcrowded for most of its history. For example, in 1927, the hospital’s capacity was 1800 patients but they were housing 2400. One of the proposed methods of reducing the overcrowding was to sterilize and parole the less critical cases. 

Brief History of Sterilization in Michigan 

         In 1897, Michigan had been the first state to propose a eugenic sterilization law. The author of the bill, Representative W. R. Edgar, who was also a physician, believed he could pass the bill when he proposed it in the House. However, opponents, who Edgar called “sentimentalists” claimed the bill would be used to “unsex” political opponents and it quickly lost steam and was abandoned.

A reworked bill was passed in 1913, making Michigan the seventh state to enact a eugenic sterilization law. This law was only applicable to inmates in state institutions whose stay was being subsidized by taxpayers. Only one person was sterilized under the 1913 law before it was challenged in court. The Michigan State Supreme Court found it to be unconstitutional as it was only applicable to patients in institutions, thus violating the Fourteenth Amendment’s equal protection clause. A new law passed in 1923 was essentially the 1913 law expanded to include individuals outside of institutions.

Once the Supreme Court of the United States declared eugenic sterilizations legal in Buck v. Bell, sterilizations in Michigan and the United States increased substantially. Michigan passed its final sterilization law entitled “An Act to Prevent the Procreation of Feeble-minded, Insane and Epileptic Persons, Moral Degenerates, and Sexual Perverts” in 1929. The law instructed the courts, superintendents, and other welfare and medical professionals to apply these labels as liberally as possible in order to prevent the procreation and increase of individuals who are or may become “a menace to society or wards of the state.” 

While studies of eugenic sterilizations have taken place in states such as California, North Carolina, Iowa, Virginia, and Minnesota, Michigan has remained largely understudied despite being the 4th most prolific sterilization state. The public statistics that are occasionally listed about Michigan’s eugenic sterilization program, as listed in this slide, come from the Human Betterment Foundation’s records which show that 3,786 people were sterilized in Michigan’s state hospitals, homes for the feebleminded, and other public institutions. The Foundation’s records show that 74% of those sterilized were women and that 76% of patients were listed as feebleminded. 

Unlike most other states, Michigan did not have a central authorizing body for sterilizations. Instead, sterilizations were ordered by the County Probate Judge and conducted at the discretion of the superintendent or other medical heads of individual institutions. The vast majority of these county ordered sterilization records have been destroyed as have most medical records. The approximately 1,000 sterilization records that survive have done so because they were sent to the State Board of Welfare for authorization and thus were preserved as administrative files. 

Methodology and Results 

      The data I’m presenting today comes from the 212 Kalamazoo sterilization files that are housed at the Michigan State Archives. In Michigan, unlike in many other states, all patient mental health files are protected indefinitely by HIPAA and other privacy laws. This is important as due to the relatively small number of cases and Michigan’s strict privacy laws, you’ll notice that some of the data that I present later needed to be combined in order to remain unidentifiable. 

Records differed by hospital and there was no standardized form across the hospitals like there were in many other states. However, the records all contained varying degrees of the same type of information, which included family background, personal background, and the economic condition of both the individual and family. The section on mental trouble was usually the shortest.

        Once analyzed, Kalamazoo revealed patterns that were both different and similar to the overall sterilization statistics within Michigan. The patients sterilized at Kalamazoo were disproportionately women, with 54.2% of sterilized patients being women and 45.8% being men. This is significantly different from the overall sex distribution statistics given by Human Betterment Foundation, for reasons I can discuss later in the Q&A if anyone is interested.

The most common diagnoses were Dementia Praecox (35.4%), Feebleminded or mentally deficient (21.7%), and Psychosis (14.6%). Many patients had multiple diagnoses and many others had no diagnosis. The diagnosis appears to have been largely irrelevant when deciding who to sterilize. 

The sterilizations by year follow the same general pattern as Michigan overall. While the sterilization law went into effect in 1923, patients at Kalamazoo did not appear to face sterilization until Dr. Roy Morter, a strong supporter of eugenic sterilization, was appointed as the Medical Superintendent in 1930. If you’ll notice on the graph, there is a significant dip in sterilizations by 1937 and a gap after 1938. Dr. Mortar lamented in a letter to the Human Betterment Foundation that this was “because of the growing reluctance on the part of the Judges of Probate to issue the legal order.”

Finally, the ethnic analysis. For these statistics, patients were coded by the primary race or ethnicity as indicated in the family or personal history section of their sterilization file. If the patient had a father of one ethnicity and a mother of another, the patient was coded as the father’s ethnicity. In the cases where no race was indicated or simply listed as “mixed race”, the patient was coded for ethnicity by their surname. For married women, their maiden surname was used. 

The results are as shown on this slide. Those with English, German, and Dutch heritage were the most prevalent, reflecting Michigan’s long history of immigration from these countries. Very few of these patients’ files indicated that they, their parents, or their grandparents were immigrants. This is reflective of the 1930 census which showed that approximately 90% of whites in western Michigan counties, where Kalamazoo pulled patients from, had native-born parents. Only approximately 10% of native-born whites in Western Michigan had at least one parent who was an immigrant. 

In total, there were very few Black and Native American, or Indians as they are labeled on the chart, patients who were sterilized in Kalamazoo. This is likely because Black migrants moved to the industrial centers in eastern Michigan and Native Americans largely resided in northern Michigan. 

The Irish and Scottish had been longtime immigrants to Michigan but they generally stuck close to Detroit on the eastern side of the state. The Irish in this dataset were almost equally likely to have immigrants as non-immigrant parents or grandparents while individuals of Scottish descent were more likely to have lived in the US for several generations. Slavic individuals who were largely Polish, and Italians were the most likely to have recent familial immigration. 

Overall, the number of whites with immigrant parents in this dataset was higher than the general population of west Michigan. In general, patients of ethnic backgrounds other than English, German, and Dutch were far more likely to have their homes and families discussed negatively with frequent mentions of too many children and generally poor familial stock. Those of English, German, and Dutch descent were more likely to have personal or moral failures. 

 I must stress that these are relatively small numbers and more research needs to be done to determine the extent of immigrant bias among Michigan’s eugenicists. However, given that the vast majority of western Michigan residents came from native-born parents and grandparents of Germanic, English, and Dutch heritage, the fact that nearly one quarter of the patients sterilized were identified as something other than these ethnicities demands that further research be conducted.

Qualitative Evidence

The proof of racial and economic anxieties runs far beyond this descriptive statistics. On this slide, you’ll find the family history section of one patient. This particular record is worth reading in full because it does an excellent job of demonstrating the eugenic ideology that is present in nearly all of these patients’ files.

Family History: Of Mixed racial descent (note – this is referring to mixed ethnic descent. This person was white and had primarily an English background). A study of approximately 100 members of the family through the past four generations reveals an amazing extent of mental deficiency, delinquency, crime and public dependency. The patient has been married three times and had legitimate children as well as illegitimate children, several of whom are mentally deficient. The patient’s maternal grandfather is insane, as was his father before him and the latter’s brother. In the entire network there are many divorces, separations, remarriages, as well as cohabitation without legal sanction.

In the personal history section, it focuses not on his perceived mental illness but rather on his social and moral failings. He is described as a petty thief who has had children with multiple feebleminded women. Further he, “has always lived in submarginal economic conditions.”

Finally, at the end of his record it briefly describes his mental troubles – including being unable to work. He was tentatively diagnosed with Psychosis with Mental Deficiency.

  The language of this patient’s file is reflected repeatedly throughout Kalamazoo’s sterilization files. The family history section nearly always contained the racial heritage of the patient and both the family history and the personal history section focused not on the patient’s mental state but on their contributions to society and the gene pool. 

Eugenics in Context, Situating Michigan

Finally, I want to situate this small study in the larger context of American eugenics. Researchers such as Alex Stern, Nicole Novak, and Natalie Lira, have demonstrated a significant over-representation of Mexican-Americans and other Latinx populations in California’s sterilization records. Johanna Schoen has demonstrated that North Carolina, on the other hand, disproportionately targeted Black women. All eugenic scholars have demonstrated the over-representation of poor individuals and families, regardless of race or ethnicity.

Western Michigan had a xenophobic bias that largely targeted Southern and Eastern European migrants. After the immigration restrictions of the 1920s, the Windsor/Detroit border became a major site of illegal immigration. Unlike the Pacific Northwest and along the US/Mexico border, illegal migrants coming through Detroit were usually much more difficult to differentiate based solely on physical appearance than other targeted racial and ethnic groups. As immigration historian Ashley Johnson Bavery has demonstrated, it was much easier for Southern and Eastern European migrants to “pass” for the northern and western Europeans who were welcomed into the country, than it was for migrants coming from outside of Europe. In fact, many smugglers provided would-be illegal migrants with American and Western European clothing and basic English skills in order to increase their chances of crossing into the United States undetected.

This anxiety is reflected in newspaper headlines, such as this one from the Detroit Free Press that says “Ellis Island problems Moved to Detroit Border” along with a quote from the story by an Assistant US District attorney that says “We have been faced with new problems and have discovered new and astounding facts about the social and economic situation [of migrants]. For instance, a survey in 1927, six years after the passage of the 1921 Immigration Act showed more than 111,300 aliens confined in penal institutions, insane asylums, and hospitals. All in all, better than 70 per cent of the inmates of all penal institutions are either aliens or one generation removed.” 

While these very high statistics have not been reflected in the data I presented today, I hope that the similar underlying economic and racial anxiety has been.  

Thank you. 

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