Connors Jackman on Dyck and Lux, 'Challenging Choices: Canada's Population Control in the 1970s (Volume 55) (McGill-Queen's Associated Medical Services Studies in the History of Medicine, Health, and Society)'

Author: 
Erika Dyck, Maureen K. Lux
Reviewer: 
Michael Connors Jackman

Erika Dyck, Maureen K. Lux. Challenging Choices: Canada's Population Control in the 1970s (Volume 55) (McGill-Queen's Associated Medical Services Studies in the History of Medicine, Health, and Society). Montreal: McGill-Queen's University Press, 2020. 240 pp. $34.95 (paper), ISBN 978-0-228-00375-5

Reviewed by Michael Connors Jackman (University of Vienna) Published on H-Socialisms (November, 2021) Commissioned by Gary Roth (Rutgers University - Newark)

Printable Version: https://www.h-net.org/reviews/showpdf.php?id=56443

Population Control in Canada

In an effort to deal with its aging population and the effects of its infamous one-child policy, China, the world’s most populous country, will now allow couples to have three children.[1] India, the world’s second-largest country, has recently called for a two-child limit to deal with its increasing numbers.[2] Meanwhile, just as countries such as Northern Ireland and Argentina overturned long-standing laws criminalizing abortion, parts of the United States have begun to roll back abortion laws previously instated to give women control over reproduction. Such changes herald neither an uncontested shift towards liberalization in reproductive health policy nor the rise of a unified conservatism, but rather, they underscore a pervasive and enduring concern with the regulation of reproduction on a global scale. According to the United Nations, by the year 2044, the world population will have reached ten billion.[3] What this means for the environment, the survival of nonhuman species, access to healthcare, the distribution of wealth, and forms of prevailing inequality has yet to be seen, but whatever the risks or potential benefits a more densely populated planet may bring, it is highly likely that discussions concerned with population growth and its management will become more intensely politicized in the years to come.

It is within ongoing debates over the historical development of public and private interventions aimed at the biopolitical regulation of specific marginalized groups that Erika Dyck and Maureen Lux frame their critical intervention. In their accessible and sober examination of the rocky terrain of reproductive politics in Canada through the 1970s, the authors put forward a nuanced critique of widely accepted views of the period as one of progressive politics and personal freedom. By unpacking the myriad ways in which state and nonstate actors pursued moral campaigns through the harnessing of rhetoric of progress and emancipation, they isolate the persistence of various eugenic legacies through periods of social reform in the mid-twentieth century. The supposed disappearance of eugenics and eugenics-informed rationale from Canada in the postwar period is shown to be a myth of progress through which the institutional and ideological forms that enabled and sustained eugenics in the name of population control were largely rebranded and modified in the 1960s and 1970s, operating across the political spectrum and sometimes in tandem with struggles for women’s rights.

Taking four case studies as objects of analysis, the authors consider how particular capitalist, colonial, and patriarchal imperatives have guided state-sanctioned and civil society efforts to manage reproduction in various Indigenous and settler communities. Their examination centers on key campaigns and government initiatives ostensibly concerned with regulating population growth that were directed at Indigenous women, people with intellectual and physical disabilities, men, and teenage girls. What unite the groups are not only the ways in which they were similarly managed by the state but how attitudes about reproduction drew on a common language of choice tied to notions of social progress, humanitarianism, and feminist emancipation. The analysis of interrelated regulatory policies demonstrates that the banishment of eugenics as an ideology in the postwar period was largely a reform of language that served to mask the persistence of previous attempts to control and/or eliminate disenfranchised groups at the margins of Canadian society.

The book deliberately aims to move away from “dichotomous categories, and the historical divisions between illegal contraception and legal contraception marked by the formal laws, and instead highlight examples that cut across these rather more basic categories” (p. 15). A focus on legality, while important in tracing how the criminal justice system and reproductive justice are entwined, can easily overlook dimensions of state governance beyond state actors and the ways in which official law and policy can lag behind norms and stand apart from common practice in society. As the authors note, before the Amendments to the Criminal Code of Canada in 1969, the legal situation and the social realities surrounding contraception were paradoxical. Contraception was illegal, which meant that requesting it “connoted a degree of criminal behaviour,” while at the same time, legal and medical officials were given license to perform coercive sterilizations believed to protect society at large (p. 60). As became clear in the aftermath, the 1969 Amendments did not liberate women or give them control over their reproductive capacity as anticipated. Rather, they granted the medical establishment greater decision-making power, thereby tightening the state’s grip on women and curtailing personal freedom. On the whole, Dyck and Lux’s text succeeds in challenging histories of population control that impart a unity of perspective and belief to particular social groups. Fractures within supposedly unified social groups indicate how multiple perspectives form and circulate as segments of groups face distinctive issues and how individuals who belong to the same group can hold widely diverging perspectives on contraception.

Significant sections of the book deal with forms of colonialization and the exploitation of Indigenous women through both coercion and the denial of necessary medical services. As contemporary scholars of colonial history have demonstrated, the range of state interventions and programs aimed at the displacement, regulation, and extermination of Indigenous peoples that were orchestrated and overseen by various levels of government in Canada is extensive. Indigenous women in particular have been the targets of complex and overlapping programs administered at federal, territorial, and provincial levels, with Canadian medical officials playing the roles of gatekeepers, deciding when, where, and how they received forms of contraception. Fear of the flourishing of Indigenous communities was incited through warnings of overpopulation, where the danger and management of overcrowding in the Global South, namely India, became both a touchstone for eugenic justification and a model for its prevention in Canada. Dyck and Lux provide a detailed overview and engagement with existing work on colonial violence and the curtailing of Indigenous community survival, yet their reflections also disrupt overarching views of Indigenous women as possessing a singular subjectivity. Pointing to the existence of multiple and sometimes contradictory subject positions in the historical record, they portray Indigenous women not only as victims of coercion but as active agents seeking control over their individual bodies. Through the 1970s, some Indigenous women took issue with the view presented in popular media that sterilizations were taking place without consent. In December of 1976, a group of five women in Nunavut addressed the federal health minister on access to sterilization, arguing that media reports were contributing to broad judgements of issues on moral rather than medical grounds. In their view, there were women who wanted sterilizations and the concerns of women in need were not being heard. As Dyck and Lux note, the false assumption of uniform pronatalism masks the complexity of relationships between Indigenous women and health authorities. Their discussion challenges the common framing of processes of victimization as a simple relation between active perpetrators of violence, on the one hand, and passive victims on the other. The government’s genocidal efforts in forcibly sterilizing Indigenous women require continued examination and, as recent media reports on residential schools and the transformation of colonial legacies in public culture have shown, the complexities of colonization and its effects have yet to be fully apprehended. That work, as Dyck and Lux’s critique demonstrates, must be carried out with an awareness of the complexity of women’s views on state violence and in avoiding the tendency to treat Indigenous women as an internally homogeneous group.

Reflections on the governmental regulation of people with disabilities provide an equally nuanced analysis of the entanglement of notions of freedom and control, critically assessing the ways in which the pairing of coercion and freedom can obscure their contradictory relationship. The paternalism of the Canadian state in the 1970s took many forms, where decision making concerning reproduction remained in the hands of medical officials, and in the case of people with intellectual disabilities, it was often a power struggle between the state and parents in seeking the right to make decisions affecting their (adult) children. Dyck and Lux provide an insightful discussion of the life and work of Donald Zarfas, a psychiatrist practicing in Hamilton, Ontario, who advocated for deinstitutionalization, the sterilization of people with mental, intellectual, and physical disabilities, and the need for sexual freedom for such people. In Zarfas’s view, sterilization was an ideal option for people with disabilities, as it would allow them greater autonomy as sexually active adults outside institutional settings. This additionally meant that they would not become a burden on parents or the state by having children for whom others would be responsible, nor would they run the risk of passing on congenital disabilities. His twofold eugenic justification for sterilization was thus tied to a liberal logic of freedom and personal autonomy insofar as he believed that sexual expression was a key aspect of adult personhood. What Zarfas’s logic reveals is not only the way psychiatrists and medical officials were the complicit handmaidens of eugenics, but how coercion and freedom constituted interrelated parts of a humanitarian view which held that sterilization was emancipatory, as it would allow women to “live freely and safely, without fear of becoming pregnant.” The authors identify within the strange discussion of independence “an extension of rights-based logic to a group lacking the same rights and services that would allow for such a free choice in the first place” (p. 107). In place of self-determination, which would allow women to make their own decisions about their bodies, Zarfas put forward a view of protection as justification for the advancement of campaigns aimed at preventing procreation.

Turning their attention to a familiar feminist concern with abortion and questions of access, Dyck and Lux consider the positioning of teenagers within various debates over contraception and population control through the 1970s. Access to abortion is not the central focus of their book, and the authors’ analysis is not concerned with pro- and anti-choice debates themselves, but rather the role of the state and media in the propagation of paternalism in how questions of reproduction were addressed. A key development that shaped whether and how women could safely access abortion was the creation of therapeutic abortion committees (TACs) made up of three doctors tasked with deciding whether the continuation of a pregnancy could negatively impact a woman’s physical or mental health. Feminists criticized the infantilization of women through such bureaucracy, highlighting the need for women in decision-making processes and demanding that women be given control over what happened to their own bodies. Dyck and Lux acknowledge the validity of such criticism, yet also consider the disjunctive aspects of popular rhetoric, which largely failed to address the experiences of those who were economically and legally dependent on family and the state. Feminist activism, in their view, did not deal with the problematic case of teenage girls, whose lack of legal rights and financial means to access medications and other forms of birth control made them an awkward fit as examples of female autonomy. The analysis of their representation and demonization is helpful, for it highlights the Canadian state’s uneven distribution of reproductive rights and its paternalistic framing of choice as well as the limits of the rhetoric of choice in encompassing the range of complications involved in calls for freedom. In contrast to the other case studies that foreground sterilization and eugenics, the plight of teenage girls shows how state control operated through the denial of basic services to teenagers, owing in part to the fact that some of the concerned were considered children. The text carefully maps, on the one hand, how feminists largely ignored the concerns of teenage girls, and on the other, the ways in which the Canadian state framed teen pregnancy as an economic and moral issue connected to population control. In their analysis of Nova Scotian teenage girls’ own perspectives on their positioning as they reflected on experiences of abortion and pregnancy, the authors note that some of the women reproduced the rhetoric of paternalism in their argumentation, using it to gain access to abortion. As one teenager explained, her age and lack of life experience were legitimate reasons for not carrying a pregnancy to term. When asked by a committee why she had requested an abortion, she responded “Well, what do you mean, what are my reasons? Look at me, I’m just a kid” (p. 148). In explaining why she should not be asked to carry a child to term, she highlighted a paradox of being physically capable of creating a child but unprepared to raise a child. To some, perhaps to certain feminists at the time, this is an inconvenient justification because it does not fit with a clear narrative of empowerment, centering the individual woman in control of her own affairs. In this case, it is in adopting—and to some extent extending—the paternalism of the Canadian government’s management of the affairs of “problem” groups that the girl was able to gain control of the situation. The example contrasts with the previous situation involving people with disabilities, in which coercion was coupled with infantilization yet was seen as a liberating force that would produce greater personal freedom. In assessing how teenage pregnancy was framed as a social, economic, and moral issue, it is less clear what infantilization and the relinquishing of autonomy might have meant. What of cases in which those seeking medical treatment are legally and socially children? If pregnant teenagers were and are not recognized as adults, it is unclear how to describe the management of their lives and bodies, what forms of protection ought to be extended, and how other parties might be involved in making decisions on their behalf. With this in mind, paternalism as a shorthand for the denial of autonomy might need to be unpacked for what it suggests about diverse relationships of dominance, regulation, and control.

Where paternalism runs throughout the management of social groups identified as problematic, the case of vasectomy and men—a group that includes fathers—provides an interesting counterpoint and highlights the ways in which different constellations of gender and race relate to eugenic logics grounded in economics. Dyck and Lux’s examination of the development of vasectomy as a preferred method of birth control provides a much-needed analysis of the regulation of men’s bodies through governmental programs. Their reflections on the life of manufacturer and birth control advocate Alfred Kaufman shed light on the entanglement of hardline eugenics and the framing of choice for men seeking to limit the size of their families. Kaufman is named as an enthusiastic eugenicist who advocated surgical sterilization for Inuit men and his working-class factory workers. To understand how he went about marketing sterilization and the success of uptake within certain communities, the specificities of choice as an aspect of social and historical context are significant. The shifting terrain of public opinion on men’s roles and responsibilities concerning reproduction in the postwar period suggest the redoubling of a gendered double standard in how decisions about reproduction were regarded. A consequence of this shift relates to how men’s reproductive choices were less directly dictated by coercive and interventionist medical authorities. Through the 1970s and 1980s vasectomy became the preferred form of contraception for couples, due in part to its relative simplicity as an operation compared to tubal ligation and also to its promotion in the media both as a responsible decision for men who did not want to have (more) children and as an attractive option for heterosexual couples wanting to enjoy uninhibited sex. This stands in contrast to news stories on women seeking abortion and tubal ligation, who were commonly regarded as failing to contribute to society. In this way, women were not only coerced into accepting sterilization while men were permitted to access surgeries of their own volition; they also faced moral scrutiny and condemnation for their decisions. Class is, however, important in understanding whether and how men accepted or rejected vasectomy. As the authors point out, particular strata of society were more likely to seek vasectomies: generally, “white, well-educated professionals, middle- and upper-class fathers with means, doing their part for the economy. Vasectomy did not imperil this particular group’s claims to hegemonic masculinity” (pp. 114–115). Since the 1970s, working-class men have persisted as holdouts, which has made tubal ligation the preferred option in economically disadvantaged northern regions, whereas those in the wealthier south have more frequently opted for vasectomy.

An attentiveness to how particular attitudes came into being and either endured or died out makes Challenging Choices: Canada's Population Control in the 1970s an intelligent and carefully researched contribution to contemporary debates on the machinations of the biopolitical regulation of gender, sexuality, race, age, and disability in Canada. In addition to complicating and expanding on the existing studies of state control and gendered aspects of colonization, Dyck and Lux also offer a revisioning of how historical narratives need to be reassessed for the untimeliness. The authors successfully show how the Amendments of 1969 were a way of catching up with attitudes toward contraception and a range of issues related to sex. They also go to great lengths to show how early twentieth-century enthusiasm for eugenics was rebranded rather than abandoned in the postwar period. When referring to other periods, however, shifts in legislation and policy, such as the introduction of the Charter, are cited as examples not of the state catching up to social attitudes but as productive forces that brought about particular kinds of progressive social change. Indeed, the effects of legal reform concerning contraception at the end of the 1960s are carefully detailed, but in their attempt to complicate historical accounts of the 1970s, the authors choose a framing that suggests a neat closure of the decade, and one wonders whether the same complexity of untimeliness might be similarly applied in thinking about what the 1970s introduced and foreshadowed about the political landscape of the 1980s and thereafter.

In dealing principally with the period between the decriminalization of particular forms of birth control and the implementation of the Charter, Dyck and Lux provide a critique of state regulation at specific historical moments, yet their book nonetheless speaks to our contemporary global context in which political stakeholders on an international level collaborate to reignite panic over the world’s population, the dwindling numbers of some groups, and the spiraling headcount of others. The book makes a significant contribution to current studies on governmentality, the construction and regulation of disadvantaged social groups, and forms of governance that transform explicit forms of social control into implicit ones. Working at the intersection of multiple fields of critical inquiry, the authors approach the subject matter with an awareness of debates about ongoing forms of colonial rule and how intersecting categories frame experiences of inequality and state violence. Scholars and students across disciplines will find Challenging Choice to be an illuminating discussion of the complexities of governmental and social control and the ongoing challenges that Canada faces in reckoning with its past.

Notes

[1]. Sui-Lee Wee, “China Says It Will Allow Couples to Have 3 Children, Up From 2,” New York Times, May 31, 2021, https://www.nytimes.com/2021/05/31/world/asia/china-three-child-policy.html.

[2]. Gerry Shih, “In India, a Debate over Population Control Turns Explosive,” Washington Post, August 29, 2021, https://www.washingtonpost.com/world/2021/08/29/india-population-hindus-muslims.

[3]. “World Population Prospects 2019,” United Nations, Department of Economic and Social Affairs, accessed September 20, 2021, https://population.un.org/wpp/Graphs/Probabilistic/POP/TOT/900.

Citation: Michael Connors Jackman. Review of Dyck, Erika; Lux, Maureen K., Challenging Choices: Canada's Population Control in the 1970s (Volume 55) (McGill-Queen's Associated Medical Services Studies in the History of Medicine, Health, and Society). H-Socialisms, H-Net Reviews. November, 2021. URL: https://www.h-net.org/reviews/showrev.php?id=56443

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