Project Prevention, formerly called Children Requiring a Caring Kommunity (C.R.A.C.K.) is an American organization that “offers cash incentives to women and men addicted to drugs and/or alcohol to use long-term or permanent birth control” (“Our Mission,” n.d.). Founded in 1997, Project Prevention has paid over 5300 people for submitting to long-term medical birth control or surgical sterilization. The organization is a 501 (C) 3 registered charity, meaning it operates entirely on donations, and it holds tax-exemption status. In 2010, Project Prevention expanded to the United Kingdom, where popular opinion and medical organizations criticized sterilization procedures. At the present, the organization continues to fund clients in the UK, although only for obtaining long-term birth control. Both on their website and in media coverage, Project Prevention consistently denies any connection to historical eugenic practices in North America, including compulsory sterilization programs. Against compulsory sterilization programs, Project Prevention positions itself as offering the choice of long-term or permanent birth control. Yet by accounting for the shift towards a neoliberal political context, we can identify the eugenic logic at the heart of Project Prevention.

Eugenics and Economic Logic
Historical compulsory sterilization programs in North America were eugenic. Paul Lombardo (2010) explains that the most prevalent historical argument in support of sterilization programs is rooted in economics. The common economic arguments suggest that sterilization is “a means to reducing social costs and the community burden passed by the unfit progeny of unfit citizens” (xiv). The social cost and community burden of unfit citizens, to use Lombardo’s language, are quantified through dollar amounts in this type of argument. But there is an important assumption made apparent in this argument that is common to negative eugenic practice: it is the unfit citizen who causes the community to endure undue expenses. That is, undesirable traits are understood not as products of structural inequalities and social normativities, but instead as characteristics of the individual.

In their self-description, Project Prevention uses economic arguments to support their claim. Just as with historical compulsory sterilization programs, this argument recognizes large-scale problems like drug addiction and alcoholism as individual rather than social problems. They identify “addicts/alcoholics” as a social problem, and the organization “seeks to reduce the burden of this social problem on taxpayers” (“Objectives,” n.d.). Moreover, the organization explicitly states that long-term and permanent birth control are the most cost effective means to reducing the effect of these individuals on the community. They explain:

“Project Prevention does not have the resources to combat the national problems of poverty, housing, nutrition, education, and rehabilitation services. Those resources we do have are spent to PREVENT a problem for $300 rather than paying millions after it happens in cost to care for a potentially damaged child.”

Beyond the inflated monetary expense of alternatively embodied children, this rhetoric raises an important question: rather than thinking about the negative impact of the individual on the community, what are the negative impacts of the broader social context on individuals, particularly those that fall outside of norms like white, middle class, heterosexual, and able-bodied?

Gendering of Sterilization and Reproductive Rights
Let's briefly recognize that gender, too, is a norm that is central to questions of birth control, sterilization, and reproduction. Project Prevention offers long-term and permanent birth control of many forms to both men and women, including Norplant, implanon, tubal ligation, and vasectomies.

Yet throughout history, women have been made primarily responsible for reproduction. The connections between reproducing and femininity are extensive and intensive. As Alison Bashford and Phillipa Levine (2010) explain, “since eugenics was always concerned with reproductive sex, it was also always about gender” (8). This is certainly reflected in Project Preventions actions: around 97% of their clients are women (“Statistics,” April 2015). This is one clear example of how, although Project Prevention describes itself as offering a choice to an entire population, its interventions into reproductive rights are impacted by social norms.

Project Prevention as a Eugenic Project
In the epilogue to The Oxford Handbook of the History of Eugenics (2010), Alison Bashford explains that “historians always write about the beginning of eugenics because they can: Galton coined the term “eugenics” in 1883. Identifying an end to eugenics is another story altogether” (539). Simply put, eugenics didn't disappear or end when compulsory sterilization programs across North America were halted. As Nancy Ordover (2003) argues, “the premise that people with disabilities should, and could, be expunged/excised/eliminated by “controlled evolution” remains largely intact” (206-207).

We should note that over the course of eugenics, unfit individuals can be identified through a variety of shifting, undesirable characteristics, and rather than focusing on disability, Project Prevention targets the undesirability of addiction. The primary difference between Project Prevention and compulsory sterilization programs seems to be that clients elect medical intervention. Yet as we've seen, this freedom to choose is impacted by one's identity, particularly for those marked by marginalized identity categories.

Neoliberalism and the rhetoric of choice
There are many ways to think critically about the assumption that contemporary organizations like Project Prevention are choice-based. Lene Koch (2004) argues that despite the language of “informed consent favoring individual and voluntary decision-making,” we need to remember that “cultural pressures and informal forms of coercion, such as social expectation or economic considerations, shape individual choices” (316). What’s more, these cultural pressures and informal forms of coercion are not equally applied across populations. Marginalized populations experience these pressures and forms of coercion much more acutely. Nancy Ordover explains the correlation between marginality and differential access to choice when she reminds us that “choice” is not a static or immovable construct. It is bound by race and class” (xxvii) and other stratified identity markers. In a neoliberal political context, the language of choice—and the assumption that every person has equal access to it—works to obfuscate the lived reality of these social categories. It suggests a false equality. It evades structural inequalities, as it “emphasizes individual solutions (e.g. fewer children for welfare recipients) to systemic problems (a lopsided distribution of resources, institutionalized racism, ableism, and so on)” (Ordover, 129).

Conclusion
The rhetoric of choice is a central operating principle of eugenic logic in the 21st century, and Project Prevention clearly demonstrates how alive and well such modes of thought are in contemporary North America.

-Samantha Balzer

• Bashford, A., & Levine, P. (Eds.). (2010). The Oxford Handbook of the History of Eugenics. New York and London: Oxford University Press.

• Koch, L. (2004). The meaning of eugenics: Reflections on the government of genetic knowledge in the past and the present. Science in Context, 17(3), 315-331.

• Lombardo, P. (2010). Three generations, no imbeciles: Eugenics, the Supreme Court, and Buck v. Bell. Baltimore: Johns Hopkins University Press.

• Objectives. (n.d.). Retrieved from http://www.projectprevention.org/objectives/

• Ordover, N. (2003). American eugenics: Race, queer anatomy, and the science of nationalism. Minneapolis, MN: University of Minnesota Press.

• Our Mission. (n.d.). Retrieved from http://www.projectprevention.org

• Statistics. (April 2015). Retrieved from http://www.projectprevention.org/statistics/