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Because of the threat of the "moral menace," persons with mild to moderate disabilities who lived in the community were now labeled morons and viewed with suspicion. Many of these individuals were placed in institutions that were already filled to capacity and had long waiting lists. Consequently, superintendents began paroling higher-functioning inmates to make room for new intakes. Since the superintendents promoted the idea of persons with disabilities as moral menaces, who could potentially ruin the human species, these individuals were sterilized before being released.

The first sterilization procedure performed on inmates, around the turn of the century, was castration. This procedure was usually done on "low-grade imbeciles" who displayed "obscene habits" in the institution. Vasectomies were performed on men and tubal ligations on women.

Buck v. Bell, a sterilization case concerning a woman who was labeled as "feebleminded," reached the United States Supreme Court in 1927. A family tree showed that the girl was the third generation of people with limited intelligence. The Chief Justice, Oliver Wendell Holmes, " declared that three generations of imbeciles are enough!" and he approved the sterilization procedure. Later studies proved that the woman was not feebleminded, and that her family tree had been concocted. However, sterilizations were still permitted because of the belief that mental retardation was hereditary.

While forced sterilizations were performed at many institutions, the eugenics movement lost its scientific backing. An increasing knowledge and better understanding of the causes of disabilities cast doubt on Goddard's conclusions. The eugenics movement, however, resulted in tens of thousands of forced sterilizations due to misguided fears about people with disabilities and as a method of social control.