Institutionalization and Sexual Control: How Disabled People Were Segregated

For over a century, thousands of disabled people in the United States were locked away-not just to be cared for, but to be controlled. Their bodies were monitored, their relationships banned, and their ability to have children taken away without consent. This wasn’t the work of a few rogue doctors or isolated institutions. It was state policy, backed by laws, courts, and medical authority, rooted in the belief that some lives were not meant to continue.

The Birth of Institutional Control

The first major institution for disabled people in the U.S. opened in Boston in 1848, founded by Samuel Gridley Howe. It was called the Experimental School for Teaching and Training Idiotic Children. The name alone tells you how it saw its residents: not as people, but as problems to be fixed. By the 1950s, over half a million people with intellectual and developmental disabilities were living in similar facilities across the country. These weren’t hospitals or schools. They were warehouses with locked doors, barred windows, and no privacy. People shared showers, slept in rows of beds, and were never alone. The design wasn’t accidental. It was meant to prevent intimacy, to crush any chance of sexual expression.

Marriage, Sex, and the Law

In 1896, Connecticut passed the first law in the U.S. that made it illegal for people with disabilities to marry or have sex. Violators faced up to three years in prison. This wasn’t an outlier. By the 1940s, at least 32 states had similar laws. They targeted people labeled as "epileptic," "feeble-minded," or "morally deficient." The logic was simple: if disabled people couldn’t reproduce, society wouldn’t be "contaminated." The language of these laws didn’t mention rape, consent, or human rights. It talked about "heredity" and "social purity." Women with disabilities were seen as dangerous temptresses. Men were viewed as predators. Neither view was about actual behavior-it was about fear. Fear that disabled people might want the same things everyone else did: love, touch, pleasure, family. And so, their sexuality was treated like a disease to be quarantined.

Forced Sterilization: The Medical Endorsement of Erasure

In 1907, Indiana became the first state to legalize forced sterilization of disabled people in institutions. By 1931, 30 states had followed. The procedure was often done without consent. Some people were told they were getting appendectomies. Others were pressured with threats: refuse the surgery, and you’ll stay locked up forever. The most infamous case was Buck v. Bell a 1927 U.S. Supreme Court case that upheld the forced sterilization of Carrie Buck, a young woman institutionalized after becoming pregnant following what was likely rape. The court’s ruling, written by Justice Oliver Wendell Holmes Jr., declared, "Three generations of imbeciles are enough." Over 65,000 people were sterilized under these laws before they were mostly abandoned in the 1970s.

Most of the victims were women. Tubal ligations were common. Men received vasectomies. The surgeries were often done in institutional infirmaries, with no anesthesia, no witnesses, and no record of consent. The doctors didn’t see themselves as criminals. They saw themselves as scientists saving society from "degeneracy." The Walter E. Fernald State School in Massachusetts, once a model institution, kept detailed records of sterilizations. Those records stopped abruptly in 1973. By then, many residents had been there for decades, their lives erased one procedure at a time.

The Role of Eugenics

Eugenics wasn’t a fringe belief. It was taught in universities, supported by philanthropists like the Rockefellers, and promoted by politicians. The movement claimed to improve the human race by preventing "undesirable" people from reproducing. Disabled people were at the top of that list. So were poor people, immigrants, and Black people. The same logic that justified sterilization also justified segregation. If you couldn’t control your sexuality, you couldn’t be trusted in society.

The Virginia State Colony for Epileptics and Feebleminded, where Carrie Buck was held, was a factory of sterilizations. Its superintendent, Albert Priddy, openly called it a "safety measure." He didn’t care if the women were raped. He didn’t care if they wanted to be mothers. He only cared about stopping their genes from spreading.

Survivors and Silence

Few spoke up. Those who did were ignored. Institutions punished residents for showing affection. Holding hands could mean isolation. Kissing could mean being strapped down. One survivor recalled being locked in a closet for weeks after she was caught hugging a fellow resident. Another said she was told, "You’re not like other girls. You don’t get to have a boyfriend." The stigma didn’t end when they left. Many were labeled "dangerous" or "unfit" even after release. Some were sent to prisons instead of community homes. Others were told they were "too broken" to date, to marry, to have children. Internalized shame became as powerful as the locks on the doors.

Deinstitutionalization: A Half-Empty Promise

The 1950s brought new drugs and growing outrage. Families began demanding change. The deinstitutionalization movement pushed to close the big facilities. By the 1970s, many were shuttered. But the promise of freedom came with no support. No housing. No counseling. No help finding jobs or relationships.

Instead of integration, many people ended up in smaller, just-as-controlling settings. Group homes with rigid rules. Day programs that monitored their every move. Some were still denied access to sex education-except for lessons on avoiding pregnancy. The message didn’t change: your body is not your own.

The Legacy Lives On

As of 2023, around 140,000 people with intellectual and developmental disabilities still live in large institutions in the U.S. The 1999 Olmstead decision said they had a right to live in the community. But funding, bureaucracy, and old attitudes kept them locked in.

Forced sterilization was officially banned in most states, but surrogate decision-making still allows guardians to consent to sterilization on behalf of disabled people. In some cases, it’s still done without court review. The same logic that justified Buck v. Bell still whispers in the halls of courts and clinics.

Virginia apologized in 2001. North Carolina paid $50,000 to each living survivor of forced sterilization-about 200 people. But what do you pay someone for a childhood stolen? For a womb taken? For a lifetime of being told they were less than human?

Sexual Autonomy as a Human Right

The United Nations Convention on the Rights of Persons with Disabilities, adopted in 2006, clearly states: disabled people have the right to the same sexual education, relationships, and reproductive choices as anyone else. But in practice, that right is still denied.

Today’s disability justice movement is pushing back. Activists are demanding real sex education-not just warnings about pregnancy, but lessons on consent, pleasure, and boundaries. They’re fighting for access to contraception without coercion. They’re telling the world: disabled people aren’t asexual. They aren’t predators. They aren’t burdens. They are people who want to love, to be loved, to choose.

The institutions are gone, but the mindset lingers. The belief that some bodies are too dangerous, too broken, too different to be trusted with their own desires. That belief is what kept people locked away. And it’s what still holds them back.