Content warning: coercive sterilization, institutional violence, medical violence, racism
Mississippi Appendectomy - A phrase made popular by Civil Rights leader Fannie Lou Hamer referring to involuntary sterilization procedures. Beginning during the heyday of the American eugenics movement (1920s and 1930s), poor black women were made subject to hysterectomies or tubal ligations against their will and without their knowledge. The practice was considered particularly frequent in the Deep South, although coercive sterilization practices took place in many areas of the country and also affected other women of color, women with physical disabilities whom physicians judged to be “unfit to reproduce,” and poor white women as well.
“She went into the doctor for a cold and came out with a Mississippi appendectomy.”
Number of Victims
The eugenics project in Mississippi resulted in a total of 683 sterilizations. Of these sterilizations, 160 were performed on males, while 523 were performed on females. Through 1944 women made up seventy three percent of the total individuals sterilized in Mississippi (Cahn, p. 160). Individuals considered mentally ill made up approximately nine tenths of the sterilization victims; those deemed “mentally deficient” made up close to one tenth of the sterilized victims. A small percentage did not fall into either category. Mississippi ranks number eighteen, when ranking the states by total number of sterilizations.
Period during which sterilizations occurred
Sterilizations took place in Mississippi between the early 1930s and 1963.
Temporal pattern of sterilizations and rate of sterilization
After the passing of Mississippi’s sterilization law in 1928, the number of sterilizations remained very small until the mid 1930s. In the second half of the 1930s sterilizations were performed at a much higher rate, followed by the war and post-war years’ decline in operations (Paul, p. 399). It seems that the last sterilization in Mississippi was performed in 1963. The rate of sterilization per 100,000 residents was about three per year during the peak years of 1938 to 1941.
Passage of laws
Mississippi passed a sterilization law in 1928 that was very similar to Virginia’s sterilization law. The sterilization statute passed in Mississippi right before the onset of the Great Depression. Consequently “the state did not even have the money to distribute printed copies of the law” (Larson, p. 121). The first sterilizations were performed in the early 1930s. Mississippi was the twenty-sixth state to pass a sterilization law.
Groups identified in the law
In the sterilization law that Mississippi adopted and passed, the following groups are identified: “persons who are afflicted with hereditary forms of insanity that are recurrent, idiocy, imbecility, feeble-mindedness or epilepsy” (Landman, p. 91).
Process of the law
The superintendent of one of Mississippi’s institutions for the mentally ill or disabled could recommend to the board of the institution that an inmate be sterilized. Notice would be given to the inmate and a hearing had to be held within 30 days after notice. The inmate, legal guardian, or counsel could be present at the hearing, seeking to dispute the charges and dissuade the board from a recommendation for sterilization (Landman, p. 91). Appeal of an order for sterilization all the way to the state Supreme Court was allowed (Paul, p. 399). The law was compulsory, although an early report stated that it was carried out only on a “voluntary” basis (Paul, p. 399).
The procedural safeguards of the Mississippi sterilization law caused H. H. Ramsey, superintendent of the Mississippi School and Colony for the Feebleminded, “to proceed cautiously under [the law’s] provisions and sterilize only such cases as consent from parents or guardians can be secured” (Larson, p. 121). The necessity of family consent to perform sterilizations frustrated those interested in sterilizing as many patients as possible as later superintendents “[stressed] the importance of a simplified Sterilization Law”—wanting the freedom to sterilize whomever they pleased.
In Mississippi commitment procedures began with application to chancery courts. Judges were allowed to give jurisdictions to clerk of court in many cases. The feeble minded person in question or his or her family was allowed to demand a trial by jury if necessary (Noll, Feeble-minded, p. 34).
Unlike most states in the United States “Mississippi[…]showed little faith in medical judgments, instead relying on a jury to determine the necessity of commitment” (Noll, Feeble-minded, p. 33). Mental deficiency verification was not required by any medical doctor in order to commit the feeble-minded to an institution in Mississippi. Patients of these institutions would often never see a physician before being admitted; many would not leave without first being sterilized.
Precipitating factors and processes
Mississippi had in common with other states in the Deep South certain conditions that mitigated against the adoption of eugenic policies: concerns for the integrity of the family, the reliance on the family (instead of state agencies) to provide for the welfare of individuals, little concern for immigration, religion’s universalistic views, and the relatively weak impact of progressivism (see, for example, Alabama on this web site).
Eugenic sterilization in Mississippi came on the heels of progressive reform efforts, specifically, the eugenic surveys of the “feeble-minded” carried out by the National Committee for Mental Hygiene in the 1910s (see Larson, 61-71; Noll, Feebleminded, pp. 16-17). The discovery of a putative social problem consequently led to the establishment of segregated but under-funded facilities for the mentally disabled, who would subsequently not be released back into the community without sterilization.
The Southern Sociological Congress, also known as the SSC, was organized in 1912 and “provided a regional forum for much of [the] urban-based [social] reform movement[s]” (Noll, Feeble-minded, p. 13). The SSC was established with the goal of “tackl[ing] the South’s social problems, ‘admittedly more difficult than those in other sections of the Nation’” (Noll, Feeble-minded, p. 13). The SSC provided a forum via which many eugenic ideas were expostulated. “[The] SSC operated as a clearinghouse for reform thought” during a time in which most reforms involved institutionalizing and sterilizing as many second-rate citizens as possible in order to eradicate social problems like extreme poverty and feeble-mindedness (Noll, Feeble-minded, p. 13).
Many state governments, even those with passed sterilization laws, documented as many sterilizations as they could as therapeutic so to avoid the safe guards of the Mississippi sterilization laws. “State governments […] misrepresented the number of mandated sterilizations they performed by labeling a significant number of them ‘therapeutic’ rather than ‘eugenic’” (Cahn, p. 173.) Many physicians who supported eugenic sterilization would use “the event of childbirth or nongynecological surgeries, like appendectomies, to perform a tubal ligation” and “these operations had become so common in Mississippi that they were nicknamed ‘Mississippi appendectomies’” (Cahn, p. 174).
Groups targeted and victimized
In Mississippi, those targeted for sterilization were the same as elsewhere in the Deep South: those considered unfit to produce, particularly those with mental illnesses and mental disabilities.
Women were particularly targeted in the typical eugenic fashion in Mississippi. Haines described to the Mississippi Mental Hygiene Commission an “imbecile white woman […] who has more children than she can count, both white and black” as a perfect example of why Mississippi needed houses for the mentally retarded so that sterilizations could be performed (Larson, p. 61).
In Mississippi, the higher likelihood of a legal challenge and compliance of family members at institutions for the mentally ill meant that many sterilizations were carried out on such patients, especially in the late 1930s. In the 1940s, most victims of sterilization policies were mentally disabled. The rate and number of eugenic sterilizations dropped at the institutions for the mentally ill because of a shortage of physicians.
Other restrictions placed on those identified in the law or with disabilities in general
Mississippi followed a regional trend, in that with the exception of miscegenation, “southern states traditionally imposed fewer restrictions on marriage than did northern states” (Larson, p. 98). Marriage contracts of “Idiots” or “lunatics” were invalidated on the basis of the argument that a lack of legal capacity prevented them from executing such contracts (Larson, p. 98).