In 1917, the American Plan became law, authorizing doctors and the police to indefinitely imprison women assumed to be sex workers, sexually loose, or infected with STIs. This law was on the books until the 1960s and 70s, but practically no one has heard of it.
For much of the 20th century in America, a little-known but widespread government program locked people up without trials simply for having sexually transmitted infections—and then forced them to undergo dangerous, poisonous “treatments.”
If they were women, that is.
Take, for example, the nearly two dozen women rounded up by authorities on a single day in Sacramento, California in 1919. Margaret Hennessey was one of them, apprehended while walking with her sister to the meat market. It was Tuesday, February 25, a clear winter morning with a gentle wind and temperatures rising to the 40s or 50s. Hennessey—who lived in Richmond, California with her husband, H.J., a Standard Oil foreman—had been staying in town, recovering from influenza at the home of her sister, known from press reports only as Mrs. M. Bradich. As the two women walked to the market, they were approached by an Officer Ryan and other members of Sacramento’s “morals squad”—a unit formed that very morning, tasked with cleansing the city of vice and immorality. The police told the two lone women they were under arrest as “suspicious characters.”
Mrs. Hennessey tried to explain who she was and what she was doing in Sacramento. She offered to show the officers identification. She told the officers her 6-year-old son was attending school in a local convent, and if they arrested her, someone would have to care for him. The officers, Hennessey later told the press, “paid no heed, but took my sister and I to the hospital.” The morals squad delivered Hennessey and Bradich to the “Canary Cottage,” as the city’s isolation hospital was known. There, a doctor probed and prodded the two women’s genitalia, examining them for sexually transmitted infections (STIs). “At the hospital I was forced to submit to an examination just as if I was one of the most degraded women in the world. I want to say I have never been so humiliated in my life,” Mrs. Hennessey told the local newspaper. “My reputation means something to me and I am going to defend it.”
Margaret Hennessey’s experience was far from unusual. She had been detained under a program she likely had never heard of: the “American Plan.” From the 1910s through the 1950s, and in some places into the 1960s and 1970s, tens of thousands—perhaps hundreds of thousands—of American women were detained and forcibly examined for STIs. The program was modeled after similar ones in Europe, under which authorities stalked “suspicious” women, arresting, testing and imprisoning them.
If the women tested positive, U.S. officials locked them away in penal institutions with no due process. While many records of the program have since been lost or destroyed, women’s forced internment could range from a few days to many months. Inside these institutions, records show, the women were often injected with mercury and forced to ingest arsenic-based drugs, the most common treatments for syphilis in the early part of the century. If they misbehaved, or if they failed to show “proper” ladylike deference, these women could be beaten, doused with cold water, thrown into solitary confinement—or even sterilized.
Blamed for infecting the troops
The American Plan began during World War I, as the result of a federal push to prevent soldiers and sailors from contracting STIs. In 1917, federal officials were horrified to learn that a huge percentage of men in the military (some erroneously estimated one in three) were infected with syphilis or gonorrhea. Suddenly these diseases presented not just a health threat—but a national security threat as well. So officials passed a federal law that outlawed sex work within a five-mile “moral zone” of every military training camp in the country. When they learned that most infected soldiers and sailors actually contracted their STIs back in their hometowns, they worked to expand this prohibition to cover the entire nation. And when they discovered that most of the women who supposedly infected the men weren’t professional prostitutes, they expanded the program even further.
So, beginning in 1918, federal officials began pushing every state in the nation to pass a “model law,” which enabled officials to forcibly examine any person “reasonably suspected” of having an STI. Under this statute, those who tested positive for an STI could be held in detention for as long as it took to render him or her noninfectious. (On paper, the law was gender-neutral; in practice, it almost exclusively focused on regulating women and their bodies.)
The Plan enjoyed complicity, if not outright support, in high places. New York Mayor Fiorello La Guardia gave speeches lauding the Plan; then-California Governor Earl Warren personally spearheaded its enforcement in his state. In 1918, the attorney general personally sent a letter to every U.S. attorney in the country, assuring them this law was constitutional; he also sent a letter to every U.S. district judge, urging them not to interfere with its enforcement. During World War II, the American Civil Liberties Union not only failed to oppose the Plan; its founder, Roger Baldwin, sent a memorandum encouraging its local branches to cooperate with officials enforcing it.
Governors and state legislatures responded to the federal government’s “model law” with enthusiasm. STIs were a hated epidemic, and sex workers, often incorrectly blamed for spreading most STIs, served as popular scapegoats. By 1921, every state in the union, as well as hundreds of municipalities, had one of these statutes on their books. Cities and states enforced these laws, off and on, for the next half-century.
The Sacramento sweep
One such city was Sacramento. Margaret Hennessey and her sister were not the only women arrested that day in 1919; Officer Ryan and the rest of the morals squad had had a busy morning. According to city police records, at about 9:25 a.m., they had arrested a Mrs. M. Sodfreid on “reasonable suspicion” of having an STI. Forty minutes later, they had arrested another woman, Lena Roserene, on the same charge. Then followed identical arrests of women recorded only as Mrs. J.S. Smith, Mrs. Butterworth and Mrs. R. Nichols. Hennessey and Bradich were Ryan’s fifth and sixth STI arrests of the morning. It was a sweep. In all, the morals squad arrested 22 women on February 25, all for the crime of suspicion of STIs. But because Margaret Hennessey alone of these women gave a statement to the newspapers, it is her story that exemplifies the rest.
The STI examinations showed that neither Hennessey nor Bradich had an STI, and officers released them at about 8:00 pm, with orders to appear for court the next morning. At 9:30 a.m., Hennessey stormed into court—ready, she declared to the Sacramento Bee, to “defend myself,” but “I would have no chance.” She was informed the charges had been dismissed. Nonetheless, the arrest left a mark. “I dare not venture on the streets,” she told the Bee later that day, “for fear I will be arrested again.”
In fact, of the 22 women arrested for suspicion of STIs, 16 were released later that day, including Hennessey and Bradich. Six were held overnight, not allowed to speak with or contact anyone. In the end, only one of the 22 women tested positive for STIs. “In other words,” the Bee reported, “out of twenty-two suspects subjected to an examination, the police were justified in arresting but one woman.”
Women could be detained for almost any reason
Actually, the police were justified in none of these arrests. It is clear to modern observers that the American Plan was a stunningly sexist program, and one that made no sense from a public-health perspective. Nearly every person examined and locked up under these laws was a woman. And the vague standard of “reasonable suspicion” enabled officials to pretty much detain any woman they wanted. Records exist in archives that document women being detained and examined for sitting at a restaurant alone; for changing jobs; for being with a man; for walking down a street in a way a male official found suspicious; and, often, for no reason at all.
Many women were also detained if they refused to have sex with police or health officers, contemporaneous exposés reveal. In the late 1940s, San Francisco police officers sometimes threatened to have women “vagged”—vaginally examined—if they didn’t accede to sexual demands. Women of color and immigrant women, in particular, were targeted—and subjected to a higher degree of abuse once they were locked up.
Enforcement of the American Plan ended by the 1970s, amid the rise of the Civil Rights Movement, the women’s lib movement and the sex-workers-rights movement. It had lasted in many places for half a century; but today, half a century later, few people have ever heard of it. Even fewer are aware that the American Plan laws—the ones passed in the late 1910s, enabling officials to examine people merely “reasonably suspected” of having STIs—are still on the books, in some form, in every state in the nation. Some of these laws have been altered or amended, and some have been absorbed into broader public-health statutes, but each state still has the power to examine “reasonably suspected” people and isolate the infected ones, if health officials deem such isolation necessary.
For much of the 20th century, the United States government locked women in concentration camps. “Concentration camp” — that isn’t my phrase; it was written by a woman named Billie Smith, in a lawsuit she filed against the government.
Smith’s travails began on the evening of June 13, 1942. A thunderstorm and fierce winds had swept through Little Rock, Ark., just hours before. That night, 33-year-old Billie Smith was arrested in her hotel room for violating two sections of a Little Rock ordinance that prohibited prostitution and “immorality.” Smith quickly pleaded guilty; to get out of jail, all she had to do was pay a fine of $10. Yet after she paid the fine, Little Rock’s health officer informed Smith that he was going to force her to undergo a medical examination. He suspected she had a sexually transmitted infection. The health officer took vials of Smith’s blood for a syphilis test, and closely examined her vagina for signs of gonorrhea. While the health officer awaited the results of the blood test, Smith waited behind bars, in the Pulaski County jail.
After a day, the test results were back: Smith had syphilis; what’s more, the health officer said she had gonorrhea, too. He ordered that she be quarantined in a detention hospital in Hot Springs, Ark.
Smith, who had already paid her fine, thought this was ludicrously unfair. So on June 16, she filed suit, demanding that the Pulaski County sheriff release her at once. She insisted that the ordinance that enabled her imprisonment was unconstitutional. In a highly significant turn of phrase, she further asserted that, simply because she had an infection, she was about to be locked away in a “concentration camp.”
Billie Smith was not alone. Indeed, for much of the 20th century, tens, probably hundreds, of thousands of American women were detained and subjected to invasive examinations, usually conducted by male physicians, for sexually transmitted infections (STIs). These women were imprisoned in jails, “detention houses” or “reformatories” — often without due process — and there treated with painful and ineffective remedies, such as injections of mercury. They were locked in buildings that often had barbed wire, armed guards or both. Some of these imprisoned women were beaten or otherwise abused; some were sterilized.
These women were incarcerated as part of a government campaign known as the “American Plan.” Initially conceived during World War I as a federal project to protect soldiers from STIs and prostitutes — who were believed to nearly always carry STIs — it later expanded to reach into American communities at large, with state and municipal governments encouraged to pass their own parallel laws. Eventually, the Plan became one of the largest and longest-lasting mass quarantines in American history.
Under the American Plan, government officials were empowered to scour the streets looking for any woman whom they “reasonably suspected” of carrying an STI. These officials detained countless “suspected” women, examined them without their consent, and locked up those who tested positive — as well as a number who didn’t, but who were deemed sufficiently “immoral” or “promiscuous.” The Plan operated more or less continuously in many places during the 1910s, 1920s, 1930s and 1940s. During World War II, it was reinvigorated on a national level, though local officials had never truly ceased to round up and lock up women for having STIs or being suspected of prostitution. In some places, officials continued to enforce the Plan as late as the 1970s, and laws originally passed under the Plan were referred to in the 1980s and 1990s to justify the proposed quarantine of another group of individuals with a stigmatized infection: HIV/AIDS. Each of these laws remains on the books, in some form, to this day.
As for Billie Smith, she remained behind bars for four days. Then, on the afternoon of Saturday, June 20, she had her day in court. Following a hearing, Judge Guy Fulk ruled that Little Rock’s ordinance was void, describing it as “dictatorial.” But when the Arkansas Supreme Court heard the city’s appeal, it overruled Judge Fulk, declaring that Smith’s status as infected “affects the public health so intimately and so insidiously, that consideration of delicacy and privacy may not be permitted to thwart measures necessary to avert the public peril.” The court overturned Judge Fulk’s invalidation of the ordinance and ordered the Pulaski County sheriff to immediately remand Smith to “isolation and quarantine.”
Yet when the Little Rock authorities went looking for Smith, she was nowhere to be found. Smith had vanished.
Rather than face the chance of reincarceration and forced STI treatment, Billie Smith had fled. It was another month before Smith was captured in a Memphis hotel and fined $127 for several crimes, including prostitution. Smith was sent to what the Arkansas Gazette called an “isolation unit” for STI treatment. It wasn’t until the end of 1942 that she was returned to the Pulaski County jail, and then finally to the detention facility in Hot Springs — the institution she had called a “concentration camp” months before.
That still wasn’t the end of Billie Smith’s saga. After just a few days in the Hot Springs facility, Smith and another woman attempted to escape, and, after this, the Hot Springs authorities refused to take them back. Smith remained behind bars for a few more weeks, but she successfully avoided spending her sentence in Hot Springs.
Hundreds of women locked up under the American Plan did just what Smith did: attempted to escape from the detention facilities in which they were held. At least one woman jumped out a window to her death; another woman leapt from a moving train to try to avoid incarceration. Others would riot and destroy their sites of incarceration; many would burn these buildings to the ground. Still others would go on hunger strikes or use the press to call attention to the conditions under which they suffered.
The case of Billie Smith illustrates the ongoing resistance of women incarcerated under the American Plan. She attempted to defy the Arkansas authorities in almost every conceivable way: by suing them, by fleeing the state, and then by trying to break out of her detention hospital.
To me, the case of Billie Smith also exemplifies something more: the importance of using individuals’ own words when attempting to tell their stories.
Billie Smith used the phrase “concentration camp.” Later, as I was piecing together her story, several people counseled me not to use that phrase — it was too politically charged, too associated with the Holocaust and other genocides. It would distract from the story I was trying to tell.
Yet this was the phrase Smith had chosen. And it was not one she’d chosen at random. At the time, the phrase appeared regularly in American newspapers to refer to what was happening in Europe, and was also widely used to refer to the internment of Japanese-Americans on the West Coast. Smith’s invocation of the phrase “concentration camp” — literally the only record we have of her own voice — reveals a notable degree of worldliness. It also suggests that women being held against their will under the auspices of the Plan connected themselves to a larger pattern of resistance against governmental violence and disdain.
Furthermore, Smith was not alone. A month after the Arkansas Supreme Court issued its ruling in her case, and weeks before she was tracked down in Memphis, the Associated Press ran a story about “concentration camps for diseased prostitutes presumably after they have been apprehended through infecting soldiers.” One wonders if the fleeing Smith glimpsed this article in a newsstand somewhere.
Smith’s story tells us something about how we remember the past, and whose words we read or hear when trying to learn more about it. When those of us who have not lived through the traumas of the past do not ground our stories in the voices and words of those who did, we risk infecting those stories with our own contemporary, privileged biases and assumptions. It is inevitable that a writer shapes the story she tells, but that shaping is a matter of degree, and making extensive use of the voices of historical actors means that a writer’s story is more reflective of her subject’s story.
When historians or journalists write about people, they must strive to use their writing to give voice to those people. A historian writing about slavery must use the surviving words of enslaved people; a journalist covering refugees must allow herself to become a mechanism through which refugees can have their truths heard.
For anyone writing Billie Smith’s story not to use her pair of surviving words would allow her captors — who tried to marginalize and “fix” her — to win. It would be a victory for those throughout history who have tried to silence others. It would not just be incomplete. It would not just be inaccurate. It would be erasure.