While researching America’s secret history of Eugenics I discovered that of all the states, my home state of North Carolina ranked third for the number of people compulsorily sterilized. The State of North Carolina officially closed down its Eugenics Board in 1977. After the passage of the sterilization law in 1929, sterilization began at comparatively low rate; it was not until about 1938 that the forced sterilizations began to increase. The total number of victims sterilized in from 1929-1973 was well over 7,600. African-Americans represented 39% of those at first, but by the late 1960’s blacks made up 60% of those sterilized (even though they were only a quarter of the population). Although women represented approximately 85% of those, by the late 60s the sterilization of men was virtually halted and women made up 99% of all sterilized victims. After WWII, sterilizations accelerated and peaked in the two years between 1950 and 1952, with 704 sterilizations. This makes North Carolina unique in that respect, because most other states began to cease performing the operations. After 1960, the sterilization rate began to slow and continued to decrease from a rate of about 250 a year in 1963 to 6 per year in 1973. From 1950-1963 there were an average of about 300 sterilizations per year. In the peak years there were about 7 sterilizations for every 100,000 residents per year. 
According to the North Carolina History Project:
The Eugenics Board of North Carolina practiced negative eugenics (discouraging reproduction by persons having genetic defects or presumed to have inheritable and undesirable traits). The Eugenics Board approved applications for four types of sterilization: vasectomy and castration for men and salpingectomy, and ovariectomy for women.
The very first sterilization law was passed in 1919 but it was never used, because many feared that the law was unconstitutional. Then in 1929, The North Carolina General Assembly passed its true sterilization law stating, “the governing body or responsible head of any penal or charitable institution supported wholly or in part by the State of North Carolina, or any sub-division thereof, is hereby authorized and directed to have the necessary operation for asexualization or sterilization performed upon any mentally defective or feeble-minded inmate of patient thereof” The original sterilization law of 1929 stated, the groups targeted for sterilization were the “mentally ill, the retarded, and the epileptic”, the law also stated that the purpose of sterilization was to protect “impaired” people from parenthood. The North Carolina General Assembly authorized the governing body (or executive head) of any penal, and/or charitable public institution to order the sterilization of any patient or inmate when it was deemed to be in the best interest of the individual or the public. In addition, each county’s board of commissioners were also authorized to order sterilizations of any mentally defective or feeble-minded resident upon receiving a petition from the individual's next of kin or legal guardian. In 1933, North Carolina enacted the sterilization law that remained for the rest of the eugenics movement there. This law provided for “notice, hearing, and the right to appeal”.
In 1933, under the new law, the General Assembly created the Eugenics Board of North Carolina to review all orders for sterilization. This centralized board included five members: the commissioner of the Board of Charities and Public Welfare, the secretary of the State Board of Health, the chief medical officer of a state institution for the feeble-minded or insane, the chief medical officer of the State Hospital at Raleigh, and the attorney general. Orders for sterilization had to be signed by at least three members of the board and returned to the prosecutor. In the hearings of patients or inmates in a public institution, the head of that institution was the prosecutor in presenting the case to the Eugenics Board. In hearings of individuals who were non-institutionalized, the county superintendent of welfare or another authorized county official acted as the prosecutor. However, in both hearings, the prosecutor provided the board with a medical history signed by a physician familiar with the individual’s case. Mentally competent individuals, at their own expense, could select their own physician for consultation or for an operation. The petition for the hearing was sent to the individual being ordered or to their next of kin or legal guardian. In the situation where this person could not represent or defend themselves at the hearing, the next of kin, guardian, or county solicitor stepped in to represent them. A decision by the board could be appealed by the individual or in his or her behalf to the county superior court and further appealed to the state's Supreme Court. A successful appeal precluded any further petition for the sterilization for one year unless specifically requested by the individual, or by his or her guardian or next of kin.
From the beginning to the end of the Eugenics movement in North Carolina, women comprised six out of seven sterilizations. They were labeled as either “promiscuous, lazy, or unfit”, or more commonly, as “sexually uncontrollable”. Overall, women made up 84.8% of sterilizations. However, more interesting is that the sterilization of men virtually halted in the 1960s, with only 2 sterilizations in 1964, and 254 sterilizations of women. Therefore, after 1960, women accounted for 99% of sterilizations. African-American women in particular were assumed to have uncontrollable sexual behavior, and due to the racial stereotypes in the south in general, black women became a large target for controlled reproduction through sterilization. Social class played a major role in who was targeted, as women on welfare were overrepresented. The poor were not only targeted for their “social ills” but also because they were easier to sterilize. They would often be denied released from institutions until they either voluntarily agreed or a family member agreed to have them sterilized. One of the major proponents of compulsory sterilization was “Feeder Institutions”, where sterilizations were performed. Chief among them was The Bowman Gray School of Medicine (where my Aunt graduated from) which housed a program for eugenic sterilizations starting in 1948 aimed at the eugenic improvement of the population of Forsyth County (where I was born in 1977). The program consisted of a systematic approach that would eliminate certain “genetically unfit strains from the local population”. It expanded the program throughout North Carolina as the school received more philanthropic support for its “research” of genetic ideas. The school is now part of the Wake Forest University Baptist Medical Center-one of the most respected academic medical centers in the country and responsible for the deaths of both my grandmother and mother. It is difficult for me to separate personal feelings from the politics of the matter, although school officials condemn the Eugenics movement there is no mention of the program or the eugenic sterilizations preformed their on the center’s website.
One leading factor attributing to the acceleration after WWII was the race issue. According to data up until the 1960s, more whites were sterilized than blacks. From 1929 to 1940, whites comprised almost four-fifths of the sterilizations. It was during the 1960s, that social workers were given the authority to recommend sterilizations, and the number of sterilizations among African-Americans increased dramatically. When the state gave social workers the authority to submit petitions for sterilization, the Eugenics Board of North Carolina which had initially targeted those who were deemed mentally ill expanded its program to include the general population. The compulsory sterilizations of non-institutionalized victims rose from 23% between 1937 and 1951 to 76% between 1952 and 1966. It was during the 1950s, that some whites had become anxious about supporting blacks through welfare. The heads of welfare departments agreed on the value of sterilization for reducing welfare and Aid for Dependent Children (ADC) payments for African-Americans. They believed that blacks accounted for the majority of illegitimate births that were therefore “subsidized” by the ADC. The state would also threaten to remove the welfare benefits of someone who would not submit to the operation. The fears about the rising cost of the ADC program was the major factor in leading to the shift in race of those who were targeted for sterilization. As the attention shifted away from the structural causes of poverty and crime to placing the blame for poverty and social unrest on African-Americans so the sterilization of African-Americans was easy. The percentage of blacks sterilized rose from 23% in the 1930s and 1940s to 59% between 1958-60 and finally to 64% between 1964 and 1966.
While the sterilization program was only whispered about in African-American communities, any evidence that race played a part in those who were sterilized was not made public, therefore, the eugenics board was allowed to proceed with few hurdle. African-Americans who opposed the sterilizations were of one of two types: there were those who knew about the racial bias and those who did not. Those who knew about the racial bias involved with sterilization tried to push for their equal rights. However, African-Americans that demanded to be heard were ruled out of order by the white-controlled legislature. Many college students were also in opposition to the sterilizations, and in 1960, students from N.C. A&T State University (a primarily black college in Winston-Salem) began a sit-in movement against the states attitude toward race relations. However, this failed to gain any recognition by the state to make any changes in the program. At Shaw University (in Raleigh) from 1968 to 1972, student activists tried to educate African-Americans about the threat of sterilization, because of government stonewalling they lacked any specific details on the issue, and therefore gained very little momentum as well. As the civil-rights movement began to grow across the country the board received more and more petitions to halt the practice. IT would seem the ultimate undoing came not from public pressure however, but from doctors who began to refuse to perform the operations, mainly due to growing opposition from outside the state. Medical practitioners frowned upon the practice and under the Executive Organization Act of 1971; the Eugenics Board of North Carolina was transferred to the newly created Department of Human Resources (DHR). Although the board retained its statutory powers and actions regarding sterilization proceedings, the board's managerial and executive authority was vested in the secretary of the DHR, a cabinet-level officer appointed by the governor. Under the Executive Organization Act of 1973, the Eugenics Board became the Eugenics Commission. The five members of the commission were to be appointed by the governor were; the director of the Division of Social and Rehabilitative Services of the DHR, the director of Health Services, the chief medical officer of a state institution for the feeble-minded or insane, the chief medical officer of the DHR in the area of mental health services, and the attorney general. In 1974 the General Assembly transferred the responsibility for any sterilization to the judicial system. In 1977 the General Assembly formally abolished the Eugenics Commission.
It was not until 2003, however, that the sterilization law was voted to be overturned by the North Carolina Senate, and a law was signed by then Governor Mike Easley to officially put an end to forced sterilizations in North Carolina. North Carolina is trying to amend for its past, making it one of the only states to do so thus far. Governor Easley soon after, issued a public apology stating, “To the victims and families of this regrettable episode in North Carolina's past, I extend my sincere apologies and want to assure them that we will not forget what they have endured".
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