Throughout the Progressive Era, enthusiasm for eugenics was growing. Eugenicists believed that by eliminating hereditary defects, the general population would strengthen. Prior to Harry Hamilton Laughlin publishing Eugenical Sterilization in the United States in 1922, compulsory sterilization laws were easily challenged. In Laughlin’s book, he included the Model Eugenical Sterilization Law, which he thought could be a guide for sterilization laws going forward. Laughlin claimed that compulsory sterilization would eliminate “the most worthless one-tenth of our present population” in two generations. 

In 1924, Virginia enacted the Virginia Eugenical Sterilization Act, which allowed the sterilization of a patient in an institution if the institution’s board was able to find them as having hereditary insanity or intellectual disability. The Act’s proponents wanted the law to be upheld under judicial review and created a list of women they thought they could use as a test case. One of the women chosen was Carrie Buck. Carrie was a teenager living with her foster mother when her adoptive cousin raped and impregnated her. Carrie’s foster mother decided to commit Carrie to the State Colony for Epileptics and Feeble-Minded when she found out about Carrie’s pregnancy. The state viewed Ms. Buck as a moral delinquent, and when she gave birth to her daughter Vivian, she was forced to relinquish her to the foster care system. 

Eugenics proponents thought Carrie was a good test case because there was evidence that both her mother and her newborn daughter were “feebleminded.” A Binet-Simon I.Q. test given to Carrie and her birth mother showed their mental ages as nine and less than eight, respectively. However, a Red Cross social worker noted that she could not find any defects in Carrie’s daughter Vivian. Nonetheless, the institution’s board and Dr. Bell recommended the state sterilize Carrie, cutting her fallopian tubes. Irving Whitehead, a sterilization supporter, represented Carrie. However, Whitehead argued that sterilization violated the Fourteenth Amendment’s Due Process Clause, which said that no state shall deprive “life, liberty or property without due process of law.” The Court had to decide if the Virginia law forcing Buck’s sterilization violated her Fourteenth Amendment rights. 


In an 8-1 decision, the Supreme Court upheld Virginia’s sterilization law. The Court decided that since sterilization only occurred after months of observation and an institutional board hearing, the practice was constitutional. Justice Oliver Wendell Holmes, a eugenics enthusiast, wrote for the Court. Holmes stated that society’s welfare would be promoted by sterilizing Carrie Buck since she could likely have another child with a mental impairment. Holmes went on to say that since the country asks men to potentially lose their lives in battle, other citizens should be willing to suffer “lesser sacrifices.” He brazenly stated that the country must prevent being “swamped with incompetence,” and that “three generations of imbeciles are enough.”

The decision set a precedent that state laws mandating sterilization of institution patients were considered a reasonable use of police power under the law. The Court also agreed that these mental impairments were hereditary. 


Justice Pierce Butler dissented, thinking that personal liberty was at stake, and the state’s justification was not sufficient. However, he offered no written opinion. 


Later investigations found that both Carrie and Vivian were not mentally disabled, but it was too late. Carrie was sterilized, and Vivian died under her foster mother's care at age eight. Carrie spoke publicly in 1983, stating how her sister was also sterilized when doctors claimed they were treating her for appendicitis. Carrie’s sister, Doris Buck, did not learn of her own sterilization until years later. 

However, in 1942, the Court decided Skinner v. Oklahoma ex rel Williamson. Jack Skinner was a chicken thief that the state of Oklahoma sought to sterilize. However, the Supreme Court decided differently in this case, stating that reproduction is one of the basic rights of man. Therefore, sterilization violated the Equal Protection Clause of the Fourteenth Amendment. The Court also noted that being a chicken thief was not identified as an inheritable trait. While the decision did not overturn Buck v. Bell, it marked a shift in public attitudes towards eugenics. Eugenics came to be associated with the Nazi party, which committed mass genocide against the Jewish people and others in the Holocaust while claiming to promote the Aryan race.

The Buck v Bell case was a landmark decision for the eugenics movement. Another eight thousand three hundred people in the state of Virginia and sixty-thousand people nationwide were involuntarily sterilized until the practice and eugenics as a whole fell out of favor in the 1970s. While the Virginia Act was repealed in 1974, Buck v. Bell has surprisingly never been overruled.

Think Further

  1. Can states require sterilization of its citizens? What if the citizens are proven to be mentally unstable or longtime criminals? 
  2. Why do you think this decision has never been overturned? Is it important that it is overturned? 
  3. What has changed since 1927 in our understanding of intellectual disabilities, mental disorders, and trauma? 


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Learn More

  1. Gillman, Howard. American Constitutionalism, Second Edition. Volume II Rights and Liberties. [Virtual Source Bookshelf].
  2. Antonios, Nathalie, Raup, Christina, “Buck v. Bell (1927)”. Embryo Project Encyclopedia (2012-01-01). ISSN: 1940-5030
  3. “Buck v. Bell.” Oyez,