MAHA's American eugenics

It’s hardly news that the current administration and its allies include any number of wild-eyed extremists. But when it comes to the harm they’re actually doing, what’s happening in the realm of public health is as consequential as any part of the destruction being unleashed at home and around the globe. And a key theme of that sabotage of successful public health efforts is the embrace of a new kind of eugenics, one with deep links to past models.

A lot of comparisons get made to Nazi rhetoric on this front. And there are certainly parallels. Pseudoscientific language about demonized groups like immigrants is used to unleash massive state violence.

But for this post, I want to focus on eugenical developments here in the U.S. and less on Nazi connections. As many of you know, the United States had a broad and deep eugenics movement that predated The Third Reich. And England had its own as well. So today I want to look at how deeply invested Trump and his allies currently are in retrograde homegrown ideas gussied up as new and common-sense thinking, when they’re anything but that.

 MAHA madness

Along with Stephen Miller, whose obvious support of eugenics shows up almost daily, we have RFK Jr., whose role as Secretary of Health and Human Services makes his actions likewise extraordinarily consequential. For Kennedy to be in charge of administering federal public health efforts is a disaster, and nearly every part of that disaster ties into backward-looking ideas that have been discredited for decades—or even centuries.

Kennedy has claimed not to know many people died from COVID, when the toll has clearly been established at well over a million. He and his staff have worked to suppress evidence of the extraordinary efficacy of Covid vaccines and other vaccines with even longer track records.

He’s suggested that “it’s very, very difficult for measles to kill a healthy person,” which is not true. But even if it somehow were, more than a third of the U.S. population lives with at least one major chronic condition. Writing off a third of the country is unacceptable.

RFK Jr. also seems to reject the two most significant ideas behind global and U.S. public health successes across this country’s entire history: vaccines and the germ theory of disease. He seems to have embraced the idea that there is some inherent fitness to the volk in their natural state underpinning public health—with a disturbing implicit suggestion that those who die are reasonably fated to do so because of some defect.

All these ideas are bound up with eugenics through the ideas of purity culture and genetic superiority. Purity culture suggests that things that don’t occur naturally are inherently corrupting, making any number of medical interventions suspect. And warped ideas about genetics are used to try to make a case that only genes reliably predict social and physical outcomes, and even human value. These are two areas in which Trump and RFK Jr.’s Venn diagrams on public health overlap—to the degree that either has enough coherence to intersect at all.

The birth of public health

Public health emerged as a field in the nineteenth century. In time, it became commonly accepted that government should have a role in protecting the public health, and that it ought to have authority to impose at least some rules toward that end. Examples include clean water, clean air, and hygienic standards.

I’ve mentioned before that modern concentration camps—the styles of camp that emerged after the invention and mass production of automatic weapons and barbed wire—were a technological shift and exacerbation of prior tactics. But they were also very much a product of this nineteenth-century public health movement. The idea of quarantine for some contagious diseases, key to arresting the spread of many illnesses, itself became a motivating idea behind holding targeted groups in detention “for the good of the nation.”

There’s a whole wartime element, too, involving national security, that usually goes hand in hand with the public health argument for concentration camps. But the more insidious concept that's extremely effective at activating those vulnerable to authoritarian rhetoric is that a certain group of people are unclean physically or psychologically, and that this fundamentally foul condition is capable of corrupting or damaging those they see as the virtuous foundation of the nation. This effect can happen through association, but the rhetoric of bloodlines is often used, too.

Buck v. Bell

I did my first reporting on U.S. history and eugenics back in 2007, before I’d ever started researching concentration camps. Back then, I wrote about Carrie Buck, who was institutionalized and sterilized in Virginia a century ago for being “feeble-minded.” In 1927, the U.S. Supreme Court upheld her sterilization, with Justice Oliver Wendell Holmes Jr. claiming that “three generations of imbeciles is enough.”

Back then, I spent several days with Paul Lombardo, traveling to sites in Virginia from Carrie Buck’s life, exploring how we as a country do and don’t remember this history. He had just written a book on her, and was the person who originally found Buck’s report cards at her old elementary school, showing that the accusations against her were dishonest—not that having a cognitive disability would have legitimized the treatment of her in any way.

I was reporting a feature story back then, but we’ve stayed in touch during the almost two decades since. Lombardo is currently an emeritus professor at Georgia State University, and is an expert on both bioethics and related law.

This week, I reached out to him to ask about the current administration’s approach to public health and the degree to which it echoes the past. Here’s his reply. I’m going to include the whole statement here, because he really has been a crucial voice in this field for several decades, and doesn’t say any of this lightly.

Lombardo on the U.S. and eugenics today

“I have been studying eugenics since 1980. During that time I have heard the term ‘eugenics’ used to critique new technologies or condemn racist practices or highlight discriminatory policies toward people with disabilities, because the activities being criticized might be motivated by the same toxic bigotry we associate with history of eugenics. Sometimes I thought the analogy was apt; sometimes not.

“But for the first time in my memory government officials, people in this administration from the top down, invoke the language—sometimes in nearly exact quotation—used in the early 20th century to advocate eugenic policies. They recycle century old eugenic talking points to stoke fears of immigrants “poisoning the blood” of America, and blaming crime, ill health, poverty and other social problems on ‘bad genes’ that generate high taxes. They repeatedly attack opponents, particularly people of color, as ‘low IQ.’ They argue that the U.S. is ‘under-babied’ and use pronatalist talking points to oppose abortion, just as the eugenicists shouted ‘race suicide’ when they talked about abortion, or blamed women for choosing higher education over teen motherhood. They rail against spending taxes on public health interventions because it would save the ‘wrong people’ like children with autism who they falsely claim ‘will never pay taxes.’

“It is possible to overuse the word “eugenics.” But what we are being told to believe from
government today is not merely ‘like eugenics’ or ‘comparable to eugenics.’ When an official echoes with precision the same arguments that were used successfully to weave eugenic reasoning into the fabric of American life and law for decades, it is eugenics.”

DOGE as eugenics

I would argue that the MAHA movement is a highly visible part of the administration’s eugenics, but it’s far from the only part. Though it appears some DOGE staffers thought the US Agency for International Development was all about abortion, the agency was responsible for delivering lifesaving treatments that addressed maternal health and HIV, food insufficiency, and more. Just days ago, we learned that the CDC will end most technical support for PEPFAR by September 30 of this year, which—combined with prior USAID cuts—will be devastating for millions, including hundreds of thousands of children worldwide. In addition, hundreds of thousands of human beings have already died as a result of DOGE cuts to USAID.

These massive cuts to global public health reject the long-held understanding that not only is such humanitarian funding smart government policy for global powers to embrace, but it also has domestic benefits in terms of suppressing the spread of contagious disease, as well as saving lives worldwide.

Fertility rates

One of the ways eugenics plays out in the larger public conversation—among Trump allies and oligarchs alike—is in the obsession with birth rates. In this warped, black-mirror version of public health, the government doesn’t have obligations to the larger public. Instead, the public has obligations to the power-holders in a given society. One obligation is producing children.

Most fertility-focused types seem to be concerned about two groups. There’s an acknowledgement that a large background servant class is necessary in a broader sense. But the more common topic of conversation is the prioritization of reproduction that would sustain a white ruling class (or a dominant-culture class, in other countries).

In the heyday of U.S. eugenics a century ago, this obsession with reproduction took two forms. In one, the “Fitter Families” movement, those seen as physically or genetically superior were encouraged to reproduce. Simultaneously in a majority of states, the government assumed the power of sterilizing whole categories of humans who had been deemed deadweights on society: poor people deemed unproductive, the blind, the deaf, those declared “feeble-minded” (an elastic and often-abused category), and more. The forced sterilization movement echoed past more openly genocidal impulses in American society by turning away from murder itself and giving a more clinical and scientific veneer to population control.

Historically, the paranoia over producing children that obsesses some eugenics-focused regimes has also led to the persecution of LGBTQ+ communities. When the state’s goal is to promote reproduction, taken to extremes, that policy can reinforce second-class status or even punishment for those who choose not to have children or whose queerness is interpreted as a fundamental rejection of traditional gender roles and parental duties.

Purity culture

The natural affinity of MAHA culture’s obsession with purity can be seen in its relentless discussion of eating healthy, avoiding processed foods, and viewing vaccines as dangerous or polluting the body.

But in the end, there seems to be little actual interest in public health on this front. Red meat is pushed as if it were medicine, though it’s actually been linked to diseases severely afflicting the US population, a population which is already consuming tremendous amounts of beef.

The MAHA movement also has vague ideas around the dangers of ultra-processed food, which it talks about but often fails to follow through on in any consistent way. The use of drugs like antidepressants for medical reasons is seen as suspect by the administration, but Kennedy has skated on his own use of recreational drugs, and even acts as if his past gives him some kind of expertise in medical matters.

Disease as weakness

In an eugenical framework, illness in “undesirable” populations is seen inevitable and a sign of a given group’s weakness or degeneracy. This has implicit parallels in the worldview that allows the massive cuts to USAID.

Disease is sometimes encouraged indirectly. In immigration detention, we see outbreaks and horrific medical conditions. Public health is clearly not the goal in these camps. Vaccines are not administered, and medical staff have gone unpaid for more than half a year, because this approach falls under the heading of negative eugenics—the subtraction of the “undesirable” population via negligence, sterilization, or more active measures.

Eugenics today is the public-facing, more-acceptable view of genocidal goals created by filtering them through medical language and pseudoscientific theories.

RFK Jr. and his associates encourage people to be skeptical of a pharmaceutical industry that has sometimes put profit over the needs of sick people. But rather than hold Big Pharma to account or press for more widespread access to vetted medicines, Kennedy undermines best medical practices. He promotes dubious remedies under the guise of fostering wellness, and undercuts both independent scientific research and the scientific method.

An endless grift

Taken together, these are some of the eugenic ideas behind the current hijacking of U.S. health policy. But in the end, there’s an important difference. This twenty-first-century version of public health is grifting all the way down. Anti-vaxx movements, purity culture, and paranoia over the presence of immigrants and the existence of queer folks are merely the powerful triggers used to activate Trump’s base. By creating a public force against effective public health and delegitimizing real experts, they make it possible to redirect resources in a crony system that relies on patronage and brings them more power.

And it turns out that purity culture has its limits. When convenient, Trump and his allies have backtracked on the use of pesticides, as well as mercury levels in the atmosphere.

A century ago, there was at least a little naivete involved with some proponents of eugenics. You saw progressive types and scientific leaders who took up the cause of population control, superior genes, and sterilization. They did so in part because of underlying bigotries, ableist mythologies, and a sense of entitlement in which they believed they could arbitrarily use science to reshape society, even at tremendous costs to specific communities.

But we all absolutely know where this kind of eugenic thinking can lead now—not only in a Nazi setting, but right here in the US, with forced sterilizations, institutionalizations, and the denial of rights to whole groups. So to embrace this same thinking a century later is doubly depraved.

My sense is that the MAHA movement is part of a political coalition-building attempt to bring MAHA and MAGA together. The fusion may well be an effort to combine two constituencies, allowing a corrupt political cult to persist even after Trump dies. Despite the eugenics link between them, I think actually achieving that fusion will be difficult—and the administration seems to agree, at least for now. We’ve recently seen the expulsion of some of MAHA’s best-known characters, acknowledging the unpopular nature of many of these policies in the face of November elections.

 What you can do

We can remember our history. And we can see what they’re up to—which is lining their pockets. Yet what the administration is doing is already taking a real toll on the public, due to vaccine programs they’ve targeted, and on other medical care by extension. Just look at the Vitamin K shots that have been the default care for newborns, to help prevent brain hemorrhages. In this fraught atmosphere around vaccines that RFK Jr. and Trump (among others) have fostered, parents are rejecting even this vitamin shot, leading to fatalities.

What specific actions can you take? Shore up vaccine efforts in your community. Do health education outreach in schools and at libraries. Work with your church or your workplace to organize free clinics. State policies can have a huge effect, even when the federal government is undermining them. Talk to your state legislators.

And remember that eugenics extends to more than just medical care. See where the polluters are are in your community and who’s bearing the burden of toxic health conditions. Take names and monitor what you can, bringing it to light and establish a record of events.

The federal government has played such a huge role in public health in my lifetime. There’s no way that smaller efforts to sabotage clean air, clean water, access to vaccines, and more can replace that vast apparatus of protection. But shoring up your community and raising awareness can make it easier to reestablish—and even expand—public health efforts in the future, when we usher in leadership that rejects an evil, discredited eugenic worldview and understands the value of public health at home and abroad.

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