Public historian Elizabeth Catte is known for artful and forceful correctives. 

Her first book, What You Are Getting Wrong About Appalachia, was a no-holds-barred rebuttal to J.D. Vance's grifty bestseller Hillbilly Elegy, in which she highlights Appalachia's overlooked radical and multiracial labor history. She presents Vance's memoir as the latest in a long line of eugenicist poverty porn that whitewashes the region for a white bourgeois readership. 

Like its predecessor, Catte's latest book, Pure America: Eugenics and the Making of Modern Virginia, offers interventions with national implications. At its center lies Western State Hospital in Staunton, Virginia, which conducted more than 1,000 forced sterilizations between 1927 and 1974. 

The hospital has since been converted into an upscale hotel and condo complex. Western State's flip from "carceral" to "cozy" conceals the forced labor of the people institutionalized and sterilized at the hospital; patients constructed the very campus that imprisoned them. Three thousand people remain buried anonymously in its unkempt graveyard, the unspoken annals of a multimillion dollar complex. "After all, asylums were places of forgetting, were they not?" Catte inquires, suggesting this history is hidden by design. "At least that was the hope." 

See also: A Black kingdom in postbellum Appalachia

With Western State as its hub, Pure America explores many spokes of Virginia's eugenic history, from "urban renewal" discourse that legitimized the razing of a Black neighborhood in Charlottesville, to the forced removal of "mountain people" to make way for Shenandoah National Park, to the disenfranchisement of Native tribes that only secured federal recognition three years ago. 

Catte telescopes out from the American South to prove that U.S. eugenic policies were not the fruit of progressives who succumbed to scientism's prejudices, but rather that they were the keystone of an explicitly white supremacist agenda—one that strove to preserve white dominance through "purity." From Western State's glossy reincarnation to mass incarceration, for-profit health care, and deadly immigration policies, those markers and effects of eugenics remain. 

What follows is a conversation between Scalawag and Catte about her research. and the relevancy of this work today—in the law, our culture, and our communities. This conversation has been edited for length and clarity.

Scalawag: Eugenics is "everywhere and nowhere," you write, subject to the tension between the where and what of history. So, to start off: What is eugenics, and where do we find it? 

Catte: Eugenics is the practice of engineering human reproduction for the benefit of society—understanding that, in the early 20th century context I write about, "for the benefit of society" largely means white society. More than a scientific philosophy, eugenics in this era took on the characteristics of a social movement and diffused out of the academy and laboratory into law, policy, and even everyday life for millions. 

Eugenics can be positive or negative, active or passive. That is, sometimes the goal is to add people to the population, and other times it is to remove them. The means can be direct, like sterilization, or more indirect, like limiting access to health care for certain people. My focus in Pure America is on negative eugenics and Virginia's system for controlling the lives of "unfit" people—who, at this time, are primarily poor, Black, Native, or presumed mixed-race, or disabled people. 

See also: The media's extractive telling of Appalachia

Eugenics is a tricky subject in terms of separating past from present, and that's where the "everywhere and nowhere" tension I describe comes from. The logic of eugenics still exists in the belief that some people are born destined to drain society of resources, and that the state should be conservative in helping them survive. At the same time, historical eugenics is a subject that is well-researched, but not often well-remembered by the public. Institutions and communities are reluctant to claim that past as part of their legacies. 

For example, I live in a small community in Virginia, which is home to [Western State]. One of our most famous former citizens is a physician named Joseph DeJarnette, a long-serving director of that hospital and one of the most vocal advocates for eugenics in Virginia. But his legacy is largely invisible today, particularly to people without deep community roots. The former hospital campus is now a luxury development that, through historic preservation, tells the story of an earlier era. There are no markers or memorials, no books in the library that speak to this local past. There is a small collection of papers related to the hospital at the local historical society, but to actually understand them, you must read them alongside administrative records held at an archive two hours away. 

That's why, in writing Pure America, I focus on the houses that eugenics built—and sometimes they are literal houses. It was my aim to show that far from existing in a remote past, eugenics and the logic of eugenics helped create institutions and assets and landscapes that are still utilized and profited from in the present. 

See also: The Departed and Dismissed of Richmond

Scalawag: You connect eugenics in your own backyard to historical attempts to maintain a segregated, white supremacist order in Virginia. Charlottesville's Carrie Buck, a poor white woman, was sterilized against her will at a state-run institution after the U.S. Supreme Court's Buck v. Bell ruling in 1927. That decision legalized forced sterilization across the country, further legitimizing Virginia's efforts to avoid a "corrupted" white bloodline by way of national policy.  What explains Virginia's particular significance to eugenics through courts and other systems? 

Catte: I write about Virginia because I live here, because this past is physically close to me—not because Virginia is the most significant example of the eugenic mindset. Many states had marriage restrictions for disabled people, followed by compulsory sterilization laws—and certain organizations, like the Indian Health Service and the Puerto Rican Relief Organization, helped facilitate eugenic sterilization and spread eugenic ideas. That said, Virginia does have interesting distinctions. The notorious Supreme Court case Buck v. Bell originates here, like you mentioned, and this meant that advocates of eugenics in Virginia worked closely with leaders of the national movement, employed at centers like the Eugenics Record Office in New York. Historian Gregory Dorr has also written extensively about the unique degree to which universities here—particularly the University of Virginia—embraced eugenic teaching.

Virginia also coupled its 1924 sterilization law with the harsh Racial Integrity Act, which was intended to enforce a standard of racial purity for white people and outlaw interracial marriage. One effect of this law was that it made life incredibly difficult for people presumed to be mixed-race, and at this time state bureaucrats regarded all Native peoples as mixed-race, using eugenic ideas to justify their beliefs. Virginia altered the vital records of Native peoples, racially-recomposing them as "colored"—to an extent so great that six Virginia tribes were unable to achieve federal recognition until 2018, and only then by an act of special legislation.

See also: Appalachian Whiteness—A History that Never Existed

It's striking how fully Virginia integrated eugenic beliefs into a wide array of aims—from advancing the reputations of its universities, to recuperating the state's image in the critical decades after the failure of Reconstruction, and even in localized matters like zoning. Virginia really milked eugenics as a way to rehabilitate older worldviews about the biological inferiority of Black people, for example, or the naturally subordinate position of women. Eugenics allowed these beliefs to appear rational and modern, a sign of a state advancing toward the future, and meant Virginia could keep a foot in both the Old South and the new—which was a tremendous advantage to white elites at this time. 

Scalawag: And the Buck v. Bell legal precedent remains! How does this affect us today—locally, nationally?

Catte: I want to quote law professor Jasmine E. Harris here on the endurance of Buck v. Bell: "… Buck v. Bell remains relevant, not because it gave a green light to involuntarily sterilization but, rather, because it used the highest court in the nation and the power of its laws to broadcast a lasting message to those with disfavored bodies and minds that their societal value lies not in their lives but their deaths." 

I think this is a powerful way to understand why it matters that the precedent Buck set remains, even as states repealed their compulsory sterilization laws. It is doubtful many people think about Buck v. Bell when disabled people are denied life saving treatment, or when Black men with mental illness are killed by the police, and yet those situations persist because the United States still upholds the message that Harris cited.

Scalawag: You conclude in Pure America that the future eugenicists strove to build did come to fruition. More than the underpinnings of Western State's transformation into condos and a luxury hotel, eugenics also plays out as a privatized health care system beyond the reach of poor people. "Survival of the fittest" discourse is one way it survives, used callously to dismiss COVID-19 victims and casualties of Texas' deregulated infrastructure. If our eugenic past elucidates our present, then what kind of accountability can we expect moving forward? How can we confront contemporary eugenics?

Catte: We very obviously need a system of health care in the United States that isn't predicated on rationing access to services that people need to survive. Currently, we have a market system of governance, and the eugenic implications of that system are vast. We have tied health care to employment, meaning that we must earn the right to take care of our bodies and minds by first putting them to work in suitable ways, or accept inferior access if we are unable to do that. We have a system that allows people to die of preventable disease, that demands wellness is contingent on our ability to pay for it, that profits from medical racism, and that sustains itself through Byzantine roadblocks intended to prevent even people eligible for services from using them. 

We also need to fix federal intervention laws and policies that make life difficult for disabled people in cruel and unnecessary ways. One fix would be ceasing to use a spouse's income to determine eligibility for Supplemental Security Income and Medicaid. Many disabled people cite this reality as a reason they cannot marry and feel it produces outcomes reminiscent of early 20th century eugenic marriage restrictions. Another fix would be repealing employment laws that make it legal to pay disabled workers a subminimum wage. Disabled workers are workers, not the beneficiaries of a charitable arrangement, but attitudes persist that frame their labor in those terms.

Scalawag: What do you hope comes out of Pure America

Catte: I have one very specific hope, and that is to see the cemeteries associated with state hospitals in Virginia receive further protections from the state. More broadly, I think the state could be investing more resources in preserving and protecting sites associated with the history of disability, but I personally have a special interest in hospital cemeteries. People who read Pure America will learn about the hospital cemetery in Staunton where patients were buried anonymously, which is now on private property that is part of the luxury development I mentioned. It feels like a hopeless case in terms of intervening to reverse neglect. But the former Lynchburg Colony, which I also write about and which eventually became the Central Virginia Training Center, only closed in 2020, and there is a large cemetery on the grounds there as well. I hope the state is more thoughtful about what becomes of the site and how it will ensure the people buried on the grounds have a dignified place of rest. 

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Adam Willems writes and reports on religion, technology, and incarceration from Seattle, Washington. Their work can be found in The Appeal, The Baffler, Real Life, and elsewhere. Adam also writes Divine Innovation, a newsletter on spirituality and technology. Follow them @functionaladam.