Sex Disabil DOI 10.1007/s11195-016-9434-z ORIGINAL PAPER
Sexual Admissions: An Intersectional Analysis of Certifications and Residency at Willowbrook State School (1950–1985) Darryl B. Hill1
Springer Science+Business Media New York 2016
Abstract Willowbrook State School has a significant place in the history of disability rights movement in the United States, from being one of the largest long-term care facilities for children and adults with disabilities during the 1950s–1970s, to the public and contentious legal battle to shut it down due to atrocities. Yet, historical scholarship has yet to fully account for what happened there. In long-term care facilities, sexuality is typically observed, controlled, and exploited, but at Willowbrook, sexuality was also a reason for admission. What role did sex play in resident’s admission and residency? This archival analysis of resident records selected admissions where sexuality played a factor, and then examined the influence of gender, family, race, class, and most importantly, ability, on the certification of the youth and their stay at Willowbrook. The findings show that race played a significant role in the lives of youth placed at Willowbrook, as did their impoverished and troubled family backgrounds, and their ability (often indexed by IQ). A narrative analysis of resident stories identified five main admission narratives: the youth were placed at Willowbrook because they were sexually promiscuous or ‘‘perverted,’’ truant, unruly, or attending remedial education classes, the parents were unable to care for the youth, the youth was delinquent, or the youth was sexually vulnerable. Extensive evidence from case files in support of these themes supported an intersectional analysis of admissions to Willowbrook as ability, sexuality, race, class, and gender interact in sometimes simple and predictable—and other times complex and surprising—ways. Keywords United States Mental retardation Learning disability Institutionalization Intersectionality Sexuality
& Darryl B. Hill
[email protected] 1
Department of Psychology, College of Staten Island, City University of New York, 2800 Victory Blvd., Staten Island, NY 10314, USA
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Willowbrook State School, Staten Island, New York, was home to thousands of children and adults from 1950 to 1985. It was a long-term care facility for children and adults with cognitive and physical disabilities that was eventually closed after a long and highly-public legal battle over the atrocious living conditions. There have been many stories told about it, the most widely-known is that it was home to more than 6000 residents, making it one of America’s largest and most infamous schools for disabled children and adolescents, eventually ‘‘ground zero’’ for the U.S. disability rights movement, a ‘‘total institution’’ that dehumanized its residents [12]. Once the locus of death and atrocities, the reformation of Willowbrook is now the standard for disability rights [22] due to laws designed to prevent Willowbrook. While the above works have looked at the legal case against Willowbrook, or a sociological analysis of the institution, many questions about this significant place remain. This paper tells one story of how residents arrived and what happened during their residency at Willowbrook. Specifically, how did children and youth get there? Historians suggest that medical and legal processes, conditions in the family, and the macrosocial conditions of their admission—ability, gender, sexuality, class, and race—are the most promising contributing factors, and this was substantiated by the following archival analysis of Willowbrook resident case files. The sexual experiences of people with intellectual and physical disabilities has long been a topic of interest, as historians have written about sex in institutions, and social scientists continue to document it (e.g., [20]). Sexual health care for persons with intellectual disability has often failed to meet individuals’ needs, either by ignoring the importance of pleasure in people with disabilities lives’ [27], or letting their negative attitudes towards sex among people with disabilities create a climate hostile to sexual intimacy [1, 29]. Whether in the community or institutions, care givers are concerned about sexual behavior, and may even note it in medical charts. Yet this sex takes place in a context of misinformation and ignorance (about hygiene, pregnancy, and sexually transmitted infections), where care takers try to regulate and control sex, and fail, exposing their wards to sexual abuse and exploitation [23]. This is all despite the fact that people with disabilities consider it a right to be given the education, privacy, space, and opportunity to engage in sex [16]. This analysis of admissions to Willowbrook is also partly grounded in feminist disability and intersectionality theories. It is a ‘‘scholarly retrieval’’ of women’s history, seeking to reimagine gendered stories at Willowbrook and reveal how gender is a system of oppression and violence, how gender interacts with race, sexuality, class, and ability, and how the material environment of Willowbrook shaped resident’s bodies [2, 11, 13, 19]. Intersectionality has been useful as a framework for understanding violence against women of color with disabilities [4], and has shown how women more than men, and non-White women more than non-White men, experience more disability [31], or more broadly, how sexual experiences of people with disabilities are shaped by gender, sex, the body, and disability [7]. The intersectional analysis that follows shows how gender, ability, sexuality, class, age, race, and other factors work together in a matrix of multiple systems of oppression [3, 5] against Willowbrook residents during their admission and stay. Admission to Willowbrook usually depended on a mental health certification, which involved an assessment of the youth’s mental and physical health. In the 1950’s in New York, it almost always was done by a psychiatrist consulting for the court, though earlier it was medical doctors that controlled this process. There were many varieties of this process, but in New York during this period, it was simple: parents—sometimes representatives from the state—would sign a petition before a judge, the youth may or may not be examined or tested by a psychiatrist,
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and then the child is held. Willowbrook was not a psychiatric facility, yet admission to state schools were dependent on psychiatry, medicine, and law. Moreover, mental health certifications were common to a wide range of institutions, not just psychiatric facilities. Psychiatrist’s role in admissions to state schools had historical roots in the basic mission of psychiatry: to separate the sane from the insane and to control and regulate social behavior [9]. Over the twentieth century, psychiatrists sought to define mental illness and health, and in the process determine who should be held apart from society, either for the protection of the individual or community. Similar to what was happening with disability, often inspired by eugenic philosophy, this process was dominated by the strong association between ‘‘moral degeneracy’’ (i.e., sexual perversion) and mental disability e.g., [8, 28, 30, 32] especially during the twentieth century [6, 15, 17, 25], and especially for women [14, 18, 21, 26] and visible minorities [22]. The historical study of how gender, race, and sexuality influenced civil commitment procedures and considerations of mental ‘‘defect or illness’’ in other periods and places is extremely helpful to frame this analysis. Wright [33] claimed to do the first study of certification during the period when the medical profession was just becoming involved. He noted that the purpose of certification was, as Foucault [9] suggested, a way of separating the sane from the insane, but the process revealed more about how British culture viewed insanity. He reviewed over 400 certificates of insanity for children admitted to the National Asylum for Idiots in Earlswood (UK) in the mid to late 1800s. He found the spaces on the certification forms for ‘‘indications’’ (reasons for the certifications) were very small, seemingly mandating very short descriptions. There were no checklists for symptoms, and equal space was given for family members to testify to their insanity. Family members focused on the social skills of the child, violent tendencies, or the inability of the youth to care for themselves, while doctors often characterized the children as ‘‘idiots’’ and described some of their reasons such as ‘‘peculiarity of manner’’ and ‘‘inability to speak,’’ characteristics many Willowbrook residents showed. Wright argued that in this way, insanity was constructed in the interaction between lay family members and opinions from medical doctors with no formal training on insanity or mental disease. Thus, civil commitment procedures were problematic from the start. Some have suggested that the interaction of gender (a psychological sense of masculinity or femininity; the cultural conditions of sex) and sexuality (expressions of sexual desire) work against women’s institutionalization. Walmsley [30], in an analysis of the ‘‘Mental Deficiency Act’’ of 1913 in the United Kingdom, argued that sexuality was one of many factors that determined whether a woman would be institutionalized for ‘‘mental deficiency.’’ Walmsley cited Tredgold’s (1908) definitive textbook that asserted abnormally fertile feebleminded women gave birth to defective children, spread venereal disease, and were prone to poverty and drunkenness. Thus, young mentally deficient women, for fear of rising birth rates, were specifically targeted for institutionalization. Walmsley looked at cases between 1916 and 1918 in Bedfordshire (UK). She found most males were detained because of unlawful behavior; however 11 of the 15 women detained were described as ‘‘displaying inappropriate sexual behaviour [sic]’’ [30]. In two case studies, she documented how these young women were characterized as engaging in ‘‘immoral’’ relationships and lacked ‘‘moral control,’’ evidence that they were mentally defective. It wasn’t only gender and sexuality that led to these women’s incarceration: poverty, unemployability, and low family social status, also shaped their fates, stories familiar to residents at Willowbrook. An early paper by MacPherson [17] on cases presented to the Hartford, Connecticut juvenile court linked ability, gender, sexuality, and race as co-factors in the incarceration
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of ‘‘juvenile delinquents,’’ although similarities to Willowbrook are apparent. While most of the cases were boys, the proportion of females rose as cognitive capacity diminished: females represented 14 % of the ‘‘normal’’ cases, yet they represented 23 % of the ‘‘feebleminded’’ cases. She further classified the cases by their reason for being in court as either for ‘‘theft’’ or being ‘‘incorrigible.’’ Using her data, 74 % of the girls (compared with 43 % of the boys) were in court because they were incorrigible (i.e., sexual offenders, runaways, those guilty of mischief, or ‘‘unmanageable’’). Contrasting greatly with modern day statistics, 29 of the 49 cases (or 57 %) referred to the court for sex offenses were girls. For those youth with IQs 70 or less, girls accounted for 2/3 s (66 %) of the sex offenses. MacPherson explained that these youth ‘‘fall into the clutches or under the influence of vicious adults by whom they are exploited. They are the more or less willing accessories to perverted sex practices. They easily become initiated into such rites and continue in them’’ (p. 49). Race, or at least nationality, was also an issue in this juvenile court. MacPherson [17] reported that the majority of the ‘‘mentally defective’’ cases had one or both foreignborn parents; 17 % were ‘‘colored.’’ These early studies documented how sexuality and gender work in concert in the construction of legal commitment and deviance. In a further study, closer to Willowbrook in time and place, Stowell [25] reviewed a few case studies of youth detained in a ‘‘training school’’ in Maryland. These cases were notable for their consideration of sexual issues. For example, one 14-year-old boy was committed to a state school because he was ‘‘assaultive to the weaker sex’’ (p. 256) during the attempted rape of a four-year-old girl. Another case involved a 13-year-old girl, with an IQ of 70, who sexually assaulted her caretakers, ‘‘was promiscuous’’ (p. 257), treated for sexually transmitted diseases, eventually became pregnant, and then ‘‘bigamously’’ married a gangster. Similarly, Malzberg [18] reviewed how children ended up at state schools in upstate New York: after being diagnosed in child guidance clinics, teachers and social workers would determine if the child was ‘‘mentally retarded,’’ and if the child was old enough, they were admitted directly to state schools. Malzberg reviewed a year’s worth of cases, over 4500, for the fiscal year of 1950. Of those cases that were considered ‘‘mentally defective or retarded,’’ 40 % were female. Unlike the results of MacPherson [17], gender didn’t appear to influence the classification of cognitive abilities. Most of the females (83 %) had no diagnosis other than ‘‘mentally defective.’’ The secondary diagnoses for the remaining females were for conduct or behavioral disorders, a pattern consistent with the boys in the sample. Typical of an upstate New York sample, most were White, and conclusions about race or ethnicity were not possible.
‘‘Sexual Admissions’’ at State Schools Recent scholarship has broadened the connections on how and why residents ended up at state schools. D’Antonio [6], writing about the Massachusetts Walter E. Fernald State School, claimed administrators, inspired by eugenicist aims, travelled the state testing children, and if parents didn’t agree to placement of the child in a state school, they ‘‘often lost custody of a son or daughter in court’’ (p. 12) as the state would hold certification hearings. Hornick [15], in a history of Belchertown State School in Western Massachusetts agreed. D’Antonio hinted that school officials misused IQ testing and used ambiguities in testing and classification to incarcerate children and adults who were not actually cognitively impaired citing a 1949 study in which 8 % of all Massachusetts state school
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admissions had normal range intelligence. The idea that initial IQ estimates for certifications were often bogus was substantiated by the remarkable gains many residents made: for one resident of Fernald State, his IQ jumped 10 % in 18 months (p. 71). These claims were dubious given the therapeutic success of these institutions. Rothman and Rothman [22], commenting on admission IQs at Willowbrook, observed IQs were political: ‘‘the point of the exercise was to establish eligibility for federal support; any [IQ] number would do, provided it was below 65’’ (p. 39). An IQ of 70 or higher was considered borderline, the person ‘‘educable,’’ and not suitable for institutionalization. D’Antonio’s and Hornick’s scholarship also reinforces the importance of gender, sexuality, class, and race during residency at state schools. Historians tell us that psychologists in the day, such as Goddard, proposed that ‘‘feeblemindedness’’ was associated with social vices such as crime, poverty, prostitution, delinquency, and drunkenness (e.g., [28]). ‘‘Wayward’’ women, in particular, were believed to be vulnerable to pregnancy, and perhaps even morally and intellectually deficient. By the early 1900s, there were many such places in New York, and they were accepting everyone from poor people, ‘‘juvenile delinquents,’’ and people suffering from epilepsy. A crucial idea in these institutions was ‘‘sexual quarantine’’ [6], because it was believed, at the time, that ‘‘generally speaking, feebleminded women are potential prostitutes and feebleminded men are potential sex offenders’’ (p. 13). Because they presumed so many ‘‘morally loose’’ young men and women were living together, they often segregated the genders. At Letchworth Village in upstate New York, they actually lived on either sides of a creek. Failing this, staff stopped sex, and castration limited pregnancies. State schools segregated residents from society, from their sexual partners through institutional gender segregation, and sterilized residents, like those in Belchertown and residents in state schools in more than 30 states. Yet, despite the sexual quarantine, sex was rampant. D’Antonio documented a wide range of activity. As early as 1922, Fernald State School administrators, trying to stop an on-going practice, issued a memo reminding their women employees ‘‘not to make love to the boys in their charge’’ (p. 107). Still, there were many notable instances of staff using residents for their own sexual needs. Attendants would be joined by ‘‘big shot’’ residents, who together would exploit other residents for sexual favors (e.g., D’Antonio, p. 58; see also [15]). Sometimes the residents would gratefully enjoy the extra attention, the gifts and privileges, yet it also led to trouble: As Jimmy explained it, in the months before his parole from Fernald he had begun a sexual relationship with a female attendant. Their affair continued after his release, and she soon became pregnant…State officials had threatened to return him to the school if he didn’t sign an agreement ending the relationship and giving up his claim to the child. He signed, but had regretted it every day since [6]. It is clear from these books on state schools, that the residents also had sex with each other [6, 15]. There were ‘‘night crawlers,’’ ‘‘After the lights were turned off, they would get into a younger or smaller boy’s bed, threaten him into silence, and then teach him to engage in mutual masturbation and oral sex’’ (p. 108). Like in prisons, the weaker boy would become a ‘‘pet,’’ and ‘‘During the day, the younger boy would receive favors and protection. At night, he would perform sexually’’ (p. 108). Even though many engaged in homosexuality, male residents would re-assert their heterosexuality by sneaking out and peeking in the female showers, or flirting with girls at dances, even meeting girls for furtive sexual encounters in tunnels between buildings or other secluded places, even though this behavior was rigorously restricted and punished. At Belchertown dances, for example, only their fingertips could touch [15].
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Others also support the contention that sexuality and gender were key factors in state school life. Starogiannis and Hill [24] and Goode et al. [12] analyzed archival records and oral histories of people who worked and lived at Willowbrook. Although newspaper accounts early in the 1950s and 1960s celebrated the institution and its’ good work healing sick children, there was a sense that something very wrong was going on at Willowbrook. Even by 1950’s it was clear: amongst other serious deficiencies, there was a ‘‘sex problem’’ at Willowbrook. Nudity was rampant due to residents’ stress and a lack of clothing. Even though all the residents were wards of the state, so could not consent to sex legally, both same-sex and opposite-sex sexual activity was common. Sexual assault at Willowbrook was mentioned several times in the papers, and raped girls became pregnant. Young women were particularly vulnerable to sexual assault. The institution tried to segregate the residents by gender, but this did little to stop sex. Goode et al. [12] emphasized the importance of sex to residents: in a ‘‘total institution’’ like Willowbrook, that tried to control every aspect of life, it was one of the few available ways to have a human experience, a subversion of institutional control. Sexual activity then, became more than sex, it was a way to subvert institutional control and regain one’s humanity through intimacy. Scholarship on state schools, therefore, does point to the importance of sexuality during internment, but little is known about how it influenced the admission process. According to Goode et al. [12], a 1961 document on state institutions published by the New York State Association for Mental Health explained the two ways to be admitted to Willowbrook State School. Under voluntary admission, a person simply presented themselves to the institution for a 60 day examination. Involuntary admission followed a judge-ordered 60 day involuntary commitment usually with supporting evidence from a physician or psychologist. Most residents of Willowbrook State School were admitted using a legal process beginning with a parent or guardian swearing before a judge, along with evidence from a physician or psychologist, that the child was a ‘‘mental defective’’ (Forms 190 or 131-D, Department of Mental Hygiene, New York State) and this allowed the state 60 days to hold and examine the child. This is the most simple and straightforward answer to how youth arrived at Willowbrook: someone thought they belonged there, and testified to a judge, and the child was placed at Willowbrook. Yet there is probably a more sophisticated answer to how people ended up at Willowbrook, and what factors specifically were involved and how they worked together. The connection of all of this to race has been hinted at, with D’Antonio’s (and many others) claims about eugenicist ideologies governing assistance to people with disabilities. So given its past association with eugenics, the connections between institutions for people with disability and race or ethnicity in America is obvious. Some might argue that into the latter half of the twentieth century, explicit eugenics ideology was not at work in institutions like Willowbrook. The connection to race wasn’t at Fernald or Belchertown. There were just a handful of Black residents, and a report cited by D’Antonio explained that there were few Black children at Fernald because there were lower expectations for ‘‘negro’’ children, so they stayed in the community. Yet with a complicit past, and in the context of unsettled race relations in America in the 1960s, race was likely to have had an effect on Willowbrook. Some estimated that Willowbrook was 66 % White even though most New York institutions were 84 % White (i.e., [22], p. 25); the following findings put these characterizations into question. Another way race influenced Willowbrook was among the staff: almost all professional staff were White, while the attendants were mostly Black or Hispanic, and there were charges of racism amongst the staff [12].
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Race and ethnicity were likely factors in admissions at Willowbrook. Recent Spanishspeaking immigrants or those children in poor schools, likely experienced language problems, and these problems contributed to low test scores in school, led to placement in remedial classes, and ultimately their language problems meant low IQ scores. Children of recent immigrants from Puerto Rico, and elsewhere, no doubt faced challenges with language. More importantly, broader cultural expectations likely played a role in Willowbrook resident lives. A mother with strong ties to Hispanic culture, in the 1950s and 1960s America, might consider her young daughter’s counterculture clothing, sexual experimentation, staying out late with boys, or even recreational drug use as evidence of moral degeneracy. Similarly, a Black father in the Bronx might consider his son’s homosexual behavior, or his daughter’s promiscuity, as quite literally crazy, clear signs of mental illness, typical of the views of the day. And these considerations would interact with economic class in mid-twentieth century New York. Poor White parents, both working a low-paying jobs, might not have the resources to supervise a more challenging child who skips school, and giving up, might feel relief that the child is now being cared for, educated, and protected by the state. It was common during this time to view state institutions with hope and respect, especially for those who had little to pay for private care.
Summary The above discourse suggests that ability, race, gender, class, and sexuality interacted in the lives of Willowbrook residents, yet it is unclear to what extent, and exactly how they worked together to shape the experiences of residents. Based on the preceding review, it seems reasonable to predict that a ‘‘eugenic’’ ideology prevailed in early civil commitment procedures and practices, an ideology that dominated modern institutions for people with disabilities and psychiatric concerns. Moreover, the historical scholarship on these processes suggest that the admission process for Willowbrook residents was likely initiated by the courts or parents, and was dependent on perceived ability, as residents should evidence some concerns about their physical or cognitive abilities (like low IQ), and this would be evident in all cases. Race should impact admission simply as a co-factor with immigration status, fluency in English, poverty, and cultural beliefs. A resident’s gender would clearly influence their admission and stay: women would be more likely to be residents, mostly because of their gender-incongruent sexual behavior, especially for those who were racial or ethnic minorities. Also, gender would place more girls at risk of sexual assault at Willowbrook. Sexuality was likely the reason for some males and females to find their way to Willowbrook: for the girls, it would be sexual promiscuity or vulnerability; for the boys, it would be sexual immorality and predatory behavior, or for a few, homosexuality. Perhaps obviously, most children placed at Willowbrook would likely be from distressed families of limited economic means.
Method This archival study was based data drawn from the resident records of Willowbrook State School held at the New York State Archives in Albany, New York. As stated by Article 33.13 of the New York State Mental Hygiene Law, these are protected case files, accessible only by qualified researchers with a reasonable justification to access the records. The
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author presented his qualifications to the Archives, sought permission from the Willowbrook Class Community Advisory Board, and had the proposal for this study approved by the Institutional Review Boards for New York State and his home institution. The New York State archives have held the resident records since 1997 (some were transferred also in 2003). There are approximately 246 cubic feet of documents in this archive. They include some of the resident records from 1950 to 1985. The catalogue at the Archive describes the contents as containing documents on the: Patient’s admission, treatment, therapy, and education. Case files typically contain admission phase sheets, records of visitors and correspondents; ward admission records, legal admission records, psychiatrist’s psychological reports, Willowbrook school reports, physical examination information, progress notes by doctors, social service notes by case social worker, laboratory testing results (routinely for syphilis, hepatitis, shigellosis), consultation requests for surgery signed by doctor, prescription records, nurse notes, dental and weight chars, medication records, clothing lists, and correspondence from other institutions. Complete records contained even more information such as photos of the residents, correspondence with the families, fingerprint cards, basically any documentation related to a resident. Some files were very large, some were very small, depending on how long the resident stayed at Willowbrook. If they were transferred to another institution, their files travelled with them, and the file usually only contained a discharge summary. If they were discharged from Willowbrook, their record was usually complete. Even though the archive contains more information than is conceivable for any researcher to process, as with most archives, there was a great deal of missing information. For instance, most of those people known to have lived at Willowbrook, culled from various sources like media reports, public events, or bloggers, did not have files in the archive. The series of those residents who died at Willowbrook was the most incomplete with only those whose last name started with an A to F. The rest are missing. There were rumors of a fire and a flood which damaged or destroyed many files. This seems credible as several of the files reviewed had been obviously burned along the edges. In some cases, the records for transferred cases had only the admission template sheet and a copy of the certification petition. A few times a file was marked ‘‘1 of 4 folders,’’ but only one folder existed. Every other file box would have an ‘‘out’’ folder marker at a point where a file had been. Someone in the Staten Island Developmental Disabilities office had signed out the file (most recent date was 2003) on a short term loan but never returned it. All of this ‘‘incompleteness’’ of clinical records, should be considered also in the context of the nature of clinical records of large institutions, how they do not reveal the truth of an institution’s practices, records are institutional discourses tied to social systems, indexical accounts of reality [10]. No uniquely identifying information about each resident was recorded. Each case was assigned arbitrary initials for identification and any personal information was changed to protect the identity of the resident. This review used purposive and incremental sampling procedures. Due to the enormous amount of information, the researcher sampled every file in every 10th box in the archive. Files for infants and young children (admitted and discharged before 5 years of age) were not reviewed; similarly, those who arrived at the institution as adults (18 or over) were not reviewed. Moreover, since the focus of this study was on gender, sexuality, and race, if there was no mention of any details in the file on these issues, the case was excluded. In practice, sexuality was the most restrictive inclusion criteria. Occasionally, details in one
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file would reference another resident who might have promising information in their file, so these additional referral files were also consulted for corroboration. Files for transferred residents were examined, but they often had very little information, in many cases only the admission sheet and the certification papers. The remainder of their file followed them to their new institution. Using a template to collect relevant features of each file, the following variables were noted: gender, race, ethnicity, date of birth, date of admission, date of discharge, condition at admission, condition at discharge, socio-economic status, any evidence of issues directly related to sexuality, race, class, or gender.
Results In all, 761 cases were reviewed. Fifty-nine percent (n = 449) were residents who had transferred to another institution, and since their main file went with them, there was only limited information. Those who were admitted and discharged before 5 years of age and those who died before 5 years of age were excluded. After these exclusions, 266 cases were considered valid. Of these, sexuality played a major role in their admission or stay for 77 cases (29 %). The analysis that follows is based on this subset of 77 cases.
Age The average age of the cases at admission was 12.8, ranging from 3 to 18 years. The average age at discharge was 20.8 (or 21) years; the average stay was 90 months. This meant that very few cases were admitted and discharged immediately after the 60 days examination period. Indeed, it was the case that regardless of when they arrived to Willowbrook, youth usually stayed just beyond their twenty-first birthday.
Gender Most of the cases were female, with only 23 males included in the 77 total cases. That is, 2/3 of the cases in this sample were female. There is no medical artifact for this, no statistics that women are more likely to be physically or intellectually disabled, so this means that young women were disproportionately placed at Willowbrook. Since the sample was selected if ‘‘sexuality’’ figured prominently in the admission of the youth, and given the role of gender in the history of eugenics and patriarchy, it was expected that women would be held in such institutions more than men.
Race Just under a third of this sample was White (31 %). There was a similar proportion of Hispanic (31 %), along with Black (26 %) and mixed race (7 %) residents. The forms even recorded 5 % as ‘‘Hebrew.’’ Given that New York City at the time was still a White majority, and Rothman and Rothman [22] reported a White majority overall at Willowbrook, the higher proportion of non-White residents (69 %) in this sample suggests that non-White residents were more likely to be placed at Willowbrook for sexual reasons. And it shows the city’s Black and Hispanic poor had few other choices when raising a child that wasn’t able to live independently or without supervision. As noted earlier, linguistic problems, sometimes like those of recent immigrants, simply not knowing how to speak
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English, or not knowing basic facts about American culture, was also a risk factor for being at Willowbrook, as was being placed in remedial classes or testing poorly on an IQ test.
Family Situation (Class) Class was hypothesized to have an impact on the residents’ lives. The archival records recorded details on the family life of 45 newly admitted residents. The main source for this data was the background report prepared by a social worker called the Anamnesis report, almost always included in the patient file. These reports were often based on interviews and home visits with the parents, and reported on the general living conditions of the parents as well as the family home and finances. It seems obvious that the situation at home had a big role in the child coming to the attention of authorities and their placement at Willowbrook. It was clear that economic distress played a significant role in almost all of these families. From these reports, it was apparent that many children were described as living in impoverished circumstances. Perhaps typical of New York, many shared their one and twobedroom apartments in Midtown, the Bronx, Harlem with as many as 10 other family members, paying low rents from their low salaries. One report documented how a 12 yearold Black girl was sharing a 3 bedroom apartment with her 9 brothers and sisters where the rent was $17.25 a month. She came to the attention of the authorities because she was accused of selling sex for a dollar. In all, 8 reports documented the Black and Hispanic neighborhoods the youths came from variously as an ‘‘overcrowded area of East Harlem,’’ a ‘‘lower east side slum,’’ ‘‘the Bronx in a high crime area,’’ and ‘‘East 108th Street in the Puerto Rican slum of Harlem.’’ Most of the Willowbrook residents reviewed for this study were from working class backgrounds or lower. For example, JB a Black male 14-year-old lived with his mother, five siblings, and four grandchildren in a six room apartment in Harlem. His deceased alcoholic father was a WWI veteran and left a small pension; his mother did domestic work and laundry. His brother had a criminal record, and his two sisters both had children out of wedlock. His mother often showed up to the youth house drunk. One daughter claimed she had been sexually assaulted by the father, and both the mother and father had been hospitalized for mental health problems. Six of these cases were born to parents from Puerto Rico, and they struggled, as many immigrants do, with language and succeeding in a new country. AC, a 15-year-old Hispanic male had it pretty good overall. He lived with his mother and three siblings in a tworoom apartment in midtown Manhattan. Even though his father was still in Puerto Rico and his mother was completely illiterate, his mother worked in a factory for $32 a week, almost the highest salary of any of the parents of Willowbrook youths in this sample. Only two residents (4 %) had been living with both natural parents at the time of their placement. Thus, the majority had some disruptions to their nuclear family: six were simply the children of single parents (e.g., mother missing, father in navy). In three cases, the mother was living with a step-father figure and her children were removed from her because of neglect. Three children had deceased parents. Four children had siblings also removed from their parents and institutionalized. In five families, the mother was institutionalized and the father was absent. In one case, both parents were institutionalized. In four cases, the child had been living with extended family or foster parents at the time of placement at Willowbrook. In two families, the father was abusive or alcoholic. Three of the cases had been institutionalized since infancy: for example, HE, a ‘‘Hebrew male’’ had
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been in a shelter since age 2—he was born with syphilis to his prostitute mother and jailed father.
IQ (Ability) One of the key indicators of cognitive ability to the psychologists at Willowbrook was IQ. It was noted on most charts at admission and discharge, both in terms of whole numbers and categories (e.g., ‘‘moron’’); so there is IQ data on almost all residents (96 %) in this study, except for those few where it was not recorded or the file documents were missing or damaged. It was also crucial to certification procedures, usually mentioned in the commitment petition, and was usually low enough to justify incarceration. Those with IQs above 70 or with ‘‘borderline’’ IQs were considered educable, and not placed at Willowbrook in most circumstances. Of course, though, in practice, IQ estimates ranged, varying greatly depending on if a standardized test was used, what test was used (whether it was culture-fair or not), who did the testing, and when the testing was done. In some files, a number for IQ appears on the forms and reports, but there is no evidence that any psychologist conducted any objective test of IQ, so the judge must have estimated the IQ. For many of these youth, especially recent immigrants or the children of immigrants, or children attending poor inner-city schools, the main problem with intelligence testing was that it was a poor estimate of their IQs due to their poor English-language skills or basic knowledge of American culture. Indeed, by the 1970s, psychological reports on two mixed race children suggested that their English language skills impaired any estimate of their IQ, a sensitivity that had been completely absent from two decades of reports previously. One simple demonstration that this was happening was evident in the files: after testing, some psychologists at Willowbrook would get a hand-writing sample from the child, and many were written in Spanish, suggesting that the child couldn’t write in English. The IQ tests they used were conducted entirely in English. So in these cases, any IQ would be a severe under-estimate. Resident IQ categories at admission and at discharge are listed in Table 1. Any cases along the diagonal of this table had no or minimal change in their IQ across their stay at Willowbrook. The cases indicated above the diagonal improved in their IQ; those below the diagonal became more impaired across their stay. Thus, according to official reports, 19 youths improved at Willowbrook; and only four suffered losses in cognitive ability across their stay. It seems reasonable to expect an increase in IQ at discharge, and there are charitable and less generous explanations. If IQ estimates were bogus, then we would observe youths placed at Willowbrook with low IQs, and then after time, closer to their impending release, Table 1 IQ at admission and discharge IQ at admission
IQ at discharge ‘‘Idiot’’
‘‘Imbecile’’
‘‘Moron’’
‘‘Borderline’’
‘‘Not mentally defective’’
‘‘Idiot’’
5
0
0
0
‘‘Imbecile’’
1
14
3
1
0 0
‘‘Moron’’
0
1
30
11
2
‘‘Borderline’’
0
0
2
0
2
‘‘Not mentally defective’’
0
0
0
0
3
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the child would be tested again, and would show gains in IQ. For example, a White 13-year-old boy RD made remarkable progress at Willowbrook. Upon admission, he was considered an ‘‘imbecile’’ (IQ below 25), and then the form at the front of his file has this IQ crossed out and replaced with 32, then that is crossed out and 38 is listed, and finally, replaced by 48, effectively doubling his cognitive capacity over a few years. Less dramatically, many ‘‘morons’’ became borderline: the most charitable explanation was offered by one psychologist, noting that ME, a 12-year-old White female, had initially tested at 52, but now her IQ was 67, concluded that ‘‘She seems to have made positive gains from the warmth and consistency of the institution in which she currently resides.’’ Even though it seemed necessary to suggest the child had low IQ for them to be placed at Willowbrook, several youth didn’t even meet this criteria, yet ended up at Willowbrook. Indeed, at least 3 youth had their IQs assessed upon admission and the tests suggested that they were ‘‘not mentally defective.’’ For example, WB, a Black 18-year-old female, admitted because she was doing poorly all of a sudden in her school classes, was assessed with an IQ of 83; she stayed at Willowbrook for 6 weeks. Goode et al. [12] documented cases of young women who obviously had no disability, but were kept at Willowbrook and used as cleaners for the doctors’ and nurses’ quarters.
Sexual Charting Since all the cases in this paper were selected for some element of sexuality significant in their admission or stay at Willowbrook, sexuality represents the main theme and reason for this subset of Willowbrook admissions. As noted earlier, sexuality was a big concern for those working at schools like Willowbrook. At these institutions, sexuality was observed, controlled, exploited, all true at Willowbrook, and sexuality was also a significant factor in many admissions to, and stays at, Willowbrook. Sometimes the observations about sexuality served the purpose of normalizing the children, even encouraging heterosexual romances between the residents, making them appear more normal. Sexuality was important to the proper functioning of the institutions or the treatment of the cases, and this was evident in that they often noted when it wasn’t a concern for the person. Sexually active or not, nurses’ progress notes commented on sexual behavior. All of the cases in this report mentioned sexuality in some manner, and for eight (10 %) of the cases, there wasn’t much to go on, at least while they were at Willowbrook. For example, CC, a mixed-race female who came to Willowbrook at 9 years of age with IQ assessed at 66, left Willowbrook 20 years late at age 29, and during these 20 years, there was not a single note on her file about sexual behavior, masturbation, or even contact with boys. This is despite the fact that one of the main reasons her mother signed her into Willowbrook was because she was masturbating excessively and ‘‘allowing boys considerable familiarity with her,’’ and ‘‘going off for walks with strange men.’’ The nurses were probably interested in watching for sexual behavior so as to police it, but also as an indication of how mature the resident was and where they were in their physical development, and any needs associated with a post-pubertal resident. Of course this was a dynamic theme because although a youngster might not be interested in sex at 10, at 15, they might be. For example, in 1962, a progress report on JB, a White 15-yearold female, stated she had no interest in sex. Eighteen months later, in 1964, JB was described in the nursing notes under the heading ‘‘Needs Supervision,’’ and described as ‘‘showing more than normal interest in the opposite sex.’’ In some cases, even sexual offenders placed at Willowbrook avoided sexual charting. For instance, JC, a Black male aged 13, was sent to Willowbrook because he was accused
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of sexually assaulting a younger boy, and he was assessed with an IQ of 49. JC claimed it was another boy who was bullying him and forced him to do it, and he really just faked the assault. A judge certified him to Willowbrook, where he spent the next 4 years, and during this time, there was not a single incident of sexual behavior noted on his record. He did well upon release, suggesting that perhaps he was telling the truth about the incident, and probably didn’t need to spend his adolescence at Willowbrook. The resident records also contained reports of doctors, nurses, psychologists, and psychiatrists that characterized the residents in sexual terms, mostly in the form of comments on their sexual maturity or attractiveness. There were 20 instances of this coded for 15 residents (19 %). The cases coded this way were all female (no males received such comments in the charts), and this was regardless of ability and race. The clinical descriptions of residents in reports often contained personal judgements about the physical attractiveness, appearance, or body of the resident. At first, it seemed innocent, such as comments that girls seemed older than they were. A nursing report described AA, a 13-year-old Hispanic girl as ‘‘a pretty, dark haired girl well-built girl with brown eyes and hair, who takes good care of her appearance.’’ In this case, it might be that the worker was simply trying to convey a sense that AA was able to care for herself and took pride in her appearance, indicators of someone functioning at a good level. But then, several reports on this resident noted this, and a doctor’s report in 1964 observed: ‘‘She has a nice hair-do, nails painted and also her toenails.’’ Willowbrook girls were repeatedly described in this manner. CC, a 14-year-old Hispanic girl was described as a ‘‘well developed good looking girl.’’ A doctor’s examination of JA, a 15-year-old Black girl described her as ‘‘physically well developed’’ and ‘‘wears heavy makeup but is very attractive.’’ Perhaps the doctor felt he should comment on this since she was accused of becoming pregnant after having sex with a man. It was 1954, after all, and perhaps less accepting morals on premarital sex prevailed. A similar report in 1956 once again chastised the resident for excessive make-up. MD, a 14-year-old Hispanic female, was described this way: ‘‘She is a very attractive girl, has her hair up in curlers because she expects to go to the movies in the evening. Has an excessive amount of lipstick on.’’ An 18-year-old Black female had been admitted because her mother feared that she would get pregnant with her 19-year-old boyfriend since they recently had sex. The Family Services report summarized her case: After about a year ago, her appearance became quite seductive as she commenced to wear heavy makeup, extreme hairdos, and exaggerated ‘beatnik clothes’ very short tight skirts, etc. As far as we know there was (as yet) no overt behavior to match this appearance. While the majority of these comments were made about Black and Hispanic girls, three White girls were also characterized in a sexual manner in reports. In 1961, ME, a 14-yearold White female, was described this way ‘‘She wears exaggerated hair-dos, excessive amounts of make-up, very tight and short skirts; in short, she likes to make a show of herself, especially in the presence of males,’’ and ‘‘She loves attention and is quite interested in the opposite sex.’’ Willowbrook staff also charted about resident masturbation. This is one theme where more men were mentioned than most others: 8 of the 14 mentions of masturbation were about males, and since there were only 23 males, it represented an issue for approximately a third of the men, but only 11 % of the women. Race and other factors were associated with the tendency to note masturbation in the charts. Mostly, comments in the chart about masturbation seemed irrelevant to the management of the resident, but in some cases it
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seemed pertinent such as the young girl in 1950 referred to Willowbrook because she masturbated ‘‘excessively,’’ or the young man who masturbated fondling his large breasts (which he thought were female), or the 9-year-old Black boy who masturbated during the certification examination. And the institution was not hesitant to respond and control masturbation. ED was a 19-year-old mixed race female who ‘‘played with feces and masturbated’’ became autistic and withdrawn, and was treated with Niamide [an antidepressant], then two treatments of ECT, and the ‘‘patient was slightly more relaxed and stopped soiling and masturbating.’’ JC, a White male aged 17 was admitted in 1959, with an IQ of 31 because his mother felt he ‘‘needed training’’ at Willowbrook. For a year there were no notes on sexuality, and then in the summer of 1960, the progress notes focused on his masturbation and untidiness. It seemed as if that was the focus of his care. In 1961, each progress summary addressed how much he masturbated. In 1967, the doctor noted in his file that the ‘‘Patient has a habit of masturbating, therefore he is on Thorazine 50 mgs BID which controls him to a certain extent.’’ They kept him on it through to 1971 when the progress notes summarized: ‘‘He has a habit of masturbating. He is receiving Thorazine 25 mgs BID which keeps him under control.’’ He was discharged in 1979. The stigma of sexuality in institutions and the willingness of doctors to prescribe Thorazine (as an inappropriate method to control masturbation) speak volumes about life at Willowbrook. Despite expectations to the contrary, no one was placed at Willowbrook primarily because they had been accused of homosexual relations, yet for three boys, it was mentioned repeatedly in their court documents and Willowbrook assessment notes. These boys were Black, mixed race, and Hispanic. Thus, no White males were placed at Willowbrook with a history of homosexuality, and no females were suspected of homosexuality before their placement at Willowbrook. While at Willowbrook, there is substantial evidence of homosexual behavior, mostly with other residents, and it was all documented in detail in the resident’s file, such as who was the active and passive partner, who their partners were, and how often they were observed having sex and where, and the punishments delivered. This is not to say that Willowbrook residents were solely homosexual. Willowbrook residents, like in many institutions, were, for the most part, gender segregated—girls slept in separate buildings than the boys, and this was done with the hope that it would prevent sex, or at least pregnancies. It is debatable whether gender segregation helped the pregnancy problem at Willowbrook, but it didn’t end sex. As has been found in previous studies of Willowbrook: residents had sex with each other, staff had sex with residents, and even members of the community were caught having sex with residents, most of which was nonconsensual sex [12, 24]. With almost half of the residents in this study being placed at Willowbrook because of sexual vulnerability or promiscuity, the goal of protecting sexually vulnerable youth by placing them at Willowbrook was perverse. Sex with staff and community members has been well-documented in the news accounts of Willowbrook [24], but little has been said about sex between the residents. The manner and thoroughness of Willowbrook staff when it came to documenting and controlling sex, all described in resident files, was surprising. For instance, the staff at Willowbrook actively noted any residents’ sexual behavior, especially homosexual contact. Sixteen of the cases (21 %) had notations documenting their homosexual activities during their stay at Willowbrook. Homosexual activity existed across all races and genders. Moreover, even those residents who were documented to have heterosexual desires, also engaged in homosexual relationships, perhaps typical because of their unusual living and social conditions. At least four residents had the staff confused as they debated whether the resident was ‘‘gay or straight’’ across the years in the progress notes. And at least two
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parents complained about Willowbrook ‘‘perverting’’ their children by making them gay; one even was quoted saying this in the local newspaper. Further evidence of the failure of gender segregation is that resident records were filled with comments about resident heterosexual activities. Three times, in young girls’ files, progress notes read: ‘‘Shows more than a normal interest’’ in the opposite sex. Was it possible that none of the boys showed more than a normal interest in sex? The girls were probably a concern because of pregnancy. Even the notation, ‘‘shows a normal interest in boys,’’ had a tone of concern, that even normal interest was perhaps too much. It all suggested that part of the assessment of normality for the residents included sexual maturation and interest, and when this wasn’t there, it was a problem because it suggested abnormality, and when it was there, it was a problem because of the consequences. In all, six of the female’s stories, from all different races, spoke to heterosexual relationships despite being gender segregated. The idea that sex happened at Willowbrook at all is a testament to the notion that residents often resisted and subverted the institutional controls placed on them [12]. A Black girl aged 12 hung around the dining room and the community store hoping to meet the boys who frequented these places. Other stories described elsewhere also fit this narrative: JF arrived at Willowbrook testing pregnant, and while at Willowbrook had a tryst with a boy through a locked door. Some girls like LD, a White 18-year-old female escaped, took the ferry to Coney Island to have fun with boys; or escaped to the nearby Willowbrook woods to have sex with another resident. RA, a mixed race girl, was found with three male residents in the swimming pool: the staff accused her of sex, a medical examination including a vaginal smear revealed no evidence of sexual activity, and she denied it all, but something could have happened. And a few girls were caught in the catwalks between the buildings meeting boys. In 1958, 14-year-old Black SD and four other girls sneaked into a dance and were all put on Thorazine as punishment; later, she was caught kissing and hugging a boy in the catwalks.
Who Brought the Petition? In the cases where a petition (the certification) was on file, most certifications were brought by the child’s mother (n = 19, 25 %), and this was especially so for the Hispanic and Black youth. No Black fathers were involved in any certification, and only two of 8 Hispanic fathers were involved. White fathers were almost as likely to certify (n = 7) as White mothers (n = 5). In a few cases, it was the guardian or an older sibling that brought the petition. Other than parents, 12 cases were brought to Willowbrook by hospital (e.g., the lay superintendent at Bellevue Hospital) or court (e.g., Manhattan Children’s Court) officials. In one case, a Hispanic mother didn’t want to have her 14-year-old son certified, and complained to the judge, but the judge placed him at Willowbrook anyway (as discussed later).
Admission Narratives The main research question is what brought these children to Willowbrook, or more directly, what were the conditions of their admission? The main source for this was the petition, as well as the social worker and psychologist reports. Some admissions reflected multiple conditions and reasons, and so the narratives that follow usually contained multiple narrative elements. Each case was coded for how well they represented each of
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Sex Disabil Table 2 Type of admission narrative
Narrative
n (%)
Sexual promiscuity or perversion
36 (47)
Truant, unruly, or ‘‘CRMD’’ classes
31 (40)
Parents ‘‘unable to care’’
24 (31)
Delinquency
19 (25)
Sexual vulnerability
13 (17)
the main reasons for admission, and then a micro-narrative analysis was conducted to determine exactly what was happening within each admission narrative. Table 2 represents the frequency of these main narratives.
Sexual Promiscuity or Perversion ‘‘Sexual promiscuity’’ and ‘‘sexual perversion’’ were main justifications for certification in 36 (47 %) of the cases. Yet, in fact, Form 131-D used to certify Willowbrook residents listed sex twice as possible factors. Item 12 on the form read: Please underscore following traits of character or tendencies present: Obedient, unruly, indolent, industrious, considerate, sensitive, affectionate, cruel, adaptable, emotionally unstable, sexually promiscuous, sexually perverted, inadequate, thievish, untruthful, manually dexterous, clean, untidy, enuretic. Most judges would circle or underline the appropriate characteristics. Young teen females who were pregnant or involved in a pregnancy scare, were always certified this way, as explained in a later section. And young teen males caught in homosexual encounters were also certified using ‘‘sexual pervert,’’ also addressed in a later section. Those who were designated ‘‘sexually perverted’’ on the certification form had engaged in a range of behaviors. A Hispanic female ‘‘attempted to make love to the family dog.’’ A White male aged 42 repeatedly exposed himself in public to a 15-year-old Hispanic female and a 9-year-old Black male. RC, a Hispanic male aged 19 was considered a sexual pervert because he touched the breasts a 15-year-old girl. He was assessed as having an IQ of 45 and very limited English and Spanish. He was sitting on his porch at home, and the young girl walked by taunting him, and he called her a ‘‘mother fuck’’ and pushed her touching her breasts. ‘‘He told her that anytime he wanted to feel her up he could do so and no one would stop him.’’ He was charged with impairing the morals of a 15-year-old girl. It appeared locking him up in Willowbrook cured him of his perversion, for he was never involved in any sexual activity or violence, and after a year and 7 months of loading trucks in the laundry, he was released back to his family home where he helped his mother run the house. Sexual promiscuity was also listed on the petition form, but it seemed to mean different things, depending on gender of the youth. For four young males, it meant that either the authorities or the family feared that the boys would be sexual predators. In one case, DA, a mixed-race male 19 years old, was accused of sexually assaulting his younger sister. The reports on one case, a White male 13 years of age, put together the rationale behind this kind of justification. He came to the attention of the authorities because he pulled a false fire alarm. The physician examining him for the certification commented that ‘‘sexual difficulty is feared for the future’’ and that he had a ‘‘very low IQ 37, cannot look after self.
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Requires constant supervision. Is beyond reasonable care from the family. Is maturing sexually.’’ The main concern was raised by his father who ‘‘fears that R is now achieving sexual maturity and will become dangerous sexually to small children,’’ reflecting the belief that R had little moral control. Placement at Willowbrook might be a bad idea given all the vulnerable young children at Willowbrook that he could attack, but it all ended without incident: he lived at Willowbrook from 1955 to 1971, when he was transferred to another institution in California, nearer his family. The only sexual notation on his chart over 16 years: he masturbated occasionally. The meaning of a ‘‘sexual admission’’ depended on historical context. For girls in the 1950s in New York City, sexual promiscuity meant ‘‘running around,’’ going out late at night, socializing with males. Certainly, BB, the Black 12-year-old who was having sex for 50 cents to a dollar in Harlem in 1955 was classified this way. So was NF, the Black girl accused of playing with White boys in a park. This was a gendered justification for certification: none of the men, but 13 women in the sample, were characterized as sexually promiscuous. For teen girls in the 1950s in Brooklyn and the Bronx, staying out late and socializing with boys was dangerous behavior, and several were sent to Willowbrook. Many stories were similar to MD’s experience. In 1956, MD, a 14-year-old Hispanic girl was certified by her father because he was concerned that she was using profanity, dressing sexy, and going to dance clubs. The incident that sent her to Willowbrook was not promiscuity but rape. During one of her late nights, she went to the Palladium dance club with another 16-year-old girl, where they met two men in their 20 s. The Youth House report described what happened next: They went back to one of the men’s apartment, the men slapped her, she tried to leave, they locked the door, and then both had intercourse with her over a few hours. This was the first time she had had sex. The girl and one of the men left, and she had intercourse again with the other guy. Then he gave her a quarter for carfare. Her version portrays it as rape: ‘‘They both raped me. I tried to fight them but they beat and forced me. When I got loose I went home…’’ The psychologists’ report explained: As might be expected in view of her age and etc., sex is a source of conflict and difficulty for her. Sexual delinquency may be entered into not because her own sex drives are so strong, but as a means of satisfying her desire for attention and as a means of satisfying her own needs for a strong person on whom she can lean. Her admission diagnosis was moron with an IQ of 65; her discharge IQ was 75. She was discharged to her family on by September as ‘‘not mentally defective.’’ The story of VD, a 15-year-old Hispanic girl, showed that even in the 1950 s, there was resistance to the idea that promiscuity was a justification for placement at Willowbrook. VD was admitted with an IQ of 58 (done with a Spanish interpreter) for promiscuity because in the past year, she had twice left home to live with a male sexual interest for several weeks. The petition, initiated by the First Deputy Commissioner of the Department of Welfare stated that: ‘‘The mother does not really regard her developing promiscuity as wrong and therefore does not effectively curb it or her excessive truancy.’’ This case is fascinating because her mother eventually secured the help of a lawyer and demanded her daughter’s release. She threatened legal action against Dr. Berman, the Director of the School, and a judge released a Writ of Habeas Corpus, ordering Willowbrook to release her. The order basically said that the mother claimed ‘‘Her said daughter is not a mental defective and that her commitment and confinement as herein stated are without reason or justice and without your petitioner’s consent and against her wishes and protest, including
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the wishes of my daughter.’’ ‘‘On information and belief, that the proceedings leading up to and including the commitment and confinement as aforesaid were irregular, illegal, in the same were based on false and misleading statements,’’ VD was discharged a year and four months after her admission. Fear of pregnancy and promiscuity were sometimes overblown. MA, a 13-year-old female was brought to the U.S. from Puerto Rico by her foster parents, attended CRMD (‘‘Children with Retarded Mental Development’’) classes, and was certified by her foster parents for sexual promiscuity and having sex, because ‘‘M is fast becoming interested in the opposite sex and the mother is fearful of her safety and also of her becoming pregnant.’’ Her limited English meant her IQ was assessed at 34. Her medical examination revealed that she had not yet had sex: her hymen was found to be intact. But sometimes fears about the sexual promiscuity were real. A Black 13-year-old was described as ‘‘very flirty and interested in boys,’’ and: When sex topics are discussed with her, she admits frankly that she had several sexual intercourses [sic] with different men and she enjoys that very much. During the last one she spent a night with an unknown fellow. She used to go to hotels and houses with them. She missed her period for the last two months and during the examination it shows a probability that the patient is in the second month of pregnancy. It turned out that she was not pregnant, and after a few years at Willowbrook, she graduated from school, but was transferred to Rockland State Hospital because of repeated suicide attempts. These cases illustrate a basic injustice: women were incarcerated, while the men involved often went free.
Truant, Unruly, or in CRMD Classes Perhaps the biggest surprise reading the resident records was how being truant or unruly in school, or even just simply being in a non-graded CRMD class was enough for the police to take the child to court and have them certified to Willowbrook. It was never the sole reason though; there would have to be other reasons such as more serious delinquency, parents unable to care, or concerns about sexuality. In all, 31 cases (40 %) reported such issues as justification for certification of the new Willowbrook resident. For example, JB, a Hispanic 11-year-old boy, had been attending his CRMD classes, was a good student, and his mother had opposed placement at Willowbrook, but the judge certified him anyway, even without evidence of a low IQ. There seemed to be no particular pattern to the way school problems interacted with social factors such as race. Both Black and Hispanic boys and girls alike had school problems. Only White females avoided accusations of truancy and behavior problems in school, yet Black and Hispanic girls, and White boys, were often incarcerated because of it. It could be that American society’s expectations for young women’s behavior controlled the girls’ behavior, and the stereotypes of non-Whites as more ‘‘unrestrained’’ might, according to the self-fulfilling nature of stereotypes, lead to more unregulated behaviors and acting out.
Parents Unable to Care, Control, or Provide Supervision Form 131-D of the Department of Mental Hygiene, the petition, was the main source for why the child was placed at Willowbrook. One of the most common reasons for
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certification to Willowbrook was that the parents claimed, or were judged to be, unable to provide proper care for their child. This theme was prevalent in the admission of 24 of the 77 cases (31 %) reviewed in this study. Gender was the most prominent factor for this reason: only four of these cases were male, making ‘‘parents unable to care, control, or provide supervision’’ the main reason young women were admitted to Willowbrook. These were often older girls, mostly in their teens, who obviously had either low value to their parents, or their value was outweighed by the cost of care. The petition would sometimes be specific, and other background reports on the family from social workers expanded on these reasons variously. Parents were unable to care if the child was from a broken home and lacked necessary supervision, but also because the single father or mother worked and was not at home during the day, and then the child would get into trouble while unsupervised. In a few cases, the parents were judged unable to provide for the child because of their own health issues or because of a pattern of neglect. Perhaps the most common claim was that the parents could not control the child, the child was unmanageable and required constant supervision.
Delinquency Reviewing the case files, it became clear that many youth were admitted to Willowbrook because they had been apprehended for a crime by the police, usually truancy, minor theft, or breaking and entering, and then while in court, certified to a psychiatric ward in a hospital, and eventually transferred to Willowbrook because of some history of ‘‘slow learning.’’ In some cases, their petition would simply state a history of delinquency and truancy, and this seemed sufficient evidence for their placement at Willowbrook. In this sense, part of Willowbrook’s role in New York was as a holding place for delinquent youth from CRMD classes. This was the case in 19 (25 %) of the files we reviewed. Gender wasn’t very predictive of delinquency: 8 were girls; 11 were boys. But only one boy, and not a single girl, was White; all the rest were Black or Hispanic. It does not seem impossible that with cognitive limitations, like those without ability concerns, might get into trouble from time to time. The father of JD, a 13-year-old boy, thought that even though his son had been arrested multiple times for theft, his son was not delinquent, rather ‘‘The boy was not a bad sort but that he was unable to use good judgment and became involved with bad company.’’ Youth with a delinquent past did poorly at Willowbrook and often posed a management problem to already over-burdened care givers, and since delinquent youth were often not severely limited in their abilities, they would come to dominate the wards. For example, AC, a 15-year-old Hispanic male was admitted after being caught breaking into an apartment, and when he refused to return to school, he was placed at Willowbrook. At Willowbrook, the daily nursing reports documented that he was a constant management problem, abusive to other children, refusing to cooperate. He was ‘‘fresh’’ with nurses and doctors and was described as a ‘‘wise guy.’’ He was constantly sent to detention or seclusion for fighting, even helping another ward mate get out of his restraint sheet. No one liked him, and a nurse, invoking the common understanding that residents usually segregated themselves by race, wrote: ‘‘He is resented by the White and the colored also the Puerto Rican population of this ward.’’ Another Hispanic boy came to Willowbrook at age 8, was described on his certification papers as delinquent and uncontrollable for stealing and attacking other children. When he was a teen at Willowbrook, he became a ‘‘big shot’’ on his ward, stealing from other children and bossing them around. After reaching 18, he was released, and there was a follow-up note that he had been arrested for purse-snatching.
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Girls were also admitted for delinquency, but most were not appropriate referrals to Willowbrook, as having a disability, learning or otherwise, wasn’t a requirement for admission to Willowbrook [12]. SD, a Black girl aged 14, came to Willowbrook because she and another girl robbed a third girl, demanded her wallet and a bag of potato chips, and she had previously stolen a wallet from a teacher. She was frequently described as a good looking girl, clean and tidy in her appearance. Her five siblings lived in a 2 bedroom apartment in Brooklyn for $25 a month rent. At Willowbrook, she was described as enjoying music, movies, was somewhat mischievous and bossy, attended occupational therapy, and went to school. She eventually got into trouble with the ‘‘Spanish speaking girls,’’ used vulgar language, and started stealing cigarettes from staff and clothing from other girls. Then, she began a series of escapes. She was described as having trouble adjusting to the institution, and just before her 18th birthday, she was released. After a follow-up visit in 1959, the psychiatrist recorded that she ‘‘does not give the impression of her having any serious degree of mental deficiency.’’ Another girl, Hispanic and aged 13, was admitted because she was truant and disobedient. Shortly after admission and a visit from her mother, a nurse observed that ‘‘Pt [Patient] cries a lot after visit, broods that a lot of girls did things that was real bad and they have gone home. Claims that attendants tell Dr. to keep you here so you can work for State.’’ This was a good strategy: within 3 months, she was placed on convalescent status, meaning that she had recovered, and 6 months later, she had a job at a factory, and was ‘‘an attractive looking girl, well dressed, and in good contact. Has friends, reads, rides a bicycle, goes to parties.’’ The file of one young woman was a rare instance in which race played an explicit role in her placement at Willowbrook. NF, a 12-year-old Black female, was admitted primarily due to violent behavior, some of it sexual assault. She was being raised in foster homes, but had been bullying younger children, taking her clothes off in a bus, parading up and down the aisle, pulling down the pants of a boy, and forcing a young White boy to have sex with her. She was arrested ‘‘for loitering in a park with White boys.’’ This case wasn’t just about inter-racial sex, it was also about tensions between White and Black New Yorkers in the 1960 s. Her foster mother, in her defense, says ‘‘Nothing is wrong with N and she has been unjustly accused of certain wrong doings because the child is Negro.’’ The social worker writing the report states that the foster mother has ‘‘prejudiced N against White people and this fact may be one cause for N’s vindictiveness towards people of the White race.’’
Sexual Vulnerability Fears of a child’s maturing sense of sexuality because of pregnancy or assault, drove parents to petition for placement at Willowbrook in 13 (17 %) of the cases. None of the cases that relied on sexual vulnerability as reasoning for certification were males, and there seemed to be no other pattern among race, ability, or age to account for these justifications, so young women judged to be developmentally disabled, regardless of race, age, were commonly portrayed as victims, or potential victims, of sexual assault, and thus posed real dangers of pregnancy and sexually transmitted diseases. It should be noted that sometimes there was confusion on behalf of the petitioners when applying sexuality to their justification for certification. Two parents certified their children emphasizing ‘‘sexual promiscuity’’ to the judge, suggesting that their children were out seeking sexual relationships, but what they really meant was that their children were sexually vulnerable because they didn’t know right from wrong, had become sexually mature and interested in sex, and were easily misled or bribed into sexual activity. Parents
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feared sexual assault and pregnancy, and felt that placement at Willowbrook would protect their children. Several cases represented these themes, and there wasn’t much variety among them, and they seemed to take on a formula. For instance, CA, a 14-year-old Hispanic girl was assessed with an IQ of 48. Her court certificate stated that she had been staying out all night, and showed ‘‘poor judgment in social areas due to impoverished home situation,’’ thus ‘‘placement might be necessary to protect this girl from more serious problems.’’ It concluded: ‘‘Parents are simple, working people who feel their responsibility as parents is to work for the support of the children, send them to school and protect them by not allowing them to go out alone or with friends,’’ and ‘‘Mother has requested placement as the easiest way out, so that her daughter may be protected while she continues to work and help with the family expenses.’’ Later on, after at Willowbrook for some time, her case Anamnesis clarified: she was an ordinary girl from Puerto Rico who spoke little English, went out with her cousin and had sex, was tested for pregnancy and it was negative, and the father was incensed that the offender who had sex with his daughter was free. In some of these stories, the problem wasn’t necessarily all the sex offenders preying on vulnerable girls, but that the girls themselves were not to be trusted with their sexuality. In one case, JB, a White 15-year-old girl was living at Willowbrook and the administration became very nervous about her developing sexuality, that she seemed focused on sexual talk, so much so that the director Dr. Jack Hammond wrote a worker about it, warning him that JB might not be able to control herself sexually. Part of the reason for not trusting girls like JB is because, as was often stated, she didn’t know right from wrong and could be easily misled. It is also difficult in these stories to discern just how vulnerable these youth were simply because of their ability and sexual maturity. Sometimes it seems as if their stories would be common, and not a justification for incarceration for years in an institution. This was the case for JF, a mixed-race girl aged 14, whose mother stated on her petition: ‘‘Child is in CRMD. Has become involved in sexual acts’’ and ‘‘does not seem to know right from wrong.’’ Much about her case was typical. She was adopted to a White mother and Puerto Rican father, but her parents were separated and she lived with her mother in a five room apartment in Harlem. Her mother made $45 a week working at a clothing factory. Her IQ was variously reported as 57 and 62. Even after petitioning a judge, her mother was ambivalent about JF’s placement at Willowbrook as her situation didn’t seem ‘‘that serious.’’ It appeared that JF had been having sex, drinking beer, ‘‘and occasionally attends whiskey parties.’’ JF was described as an ‘‘attractive child, who smiles readily and relates well,’’ and ‘‘She is able to hold a conversation freely and to give an account of her personal data. She is clean and tidy in her personal appearance. Appears well mannered.’’ During her psychological examination, she was asked to provide a writing sample, and she wrote: ‘‘I want to go home soon.’’ Sadly, she’d stay for over 4 years. The nursing reports were obsessed with her periods after admission, and she tested positive on a pregnancy urine test a month after admission. Then she had her period. She was even denied home visits because of her ‘‘history of sexual promiscuity.’’ After being at Willowbrook for over a year, in the fall of 1957, she was caught having a date with a boy from Building 8 in Building 23. They had arranged a meeting, and he entered the building through the sewing room in the basement, climbed to the second floor and they exchanged kisses through the opening of the door window. A few months later, she was one of a group of girls caught at the senior dance without permission, and this drew a round of Thorazine injections. By June of 1958, she graduated from academic classes, and asked to be placed in the sewing room. In the fall, she went home on
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a visit, did well, and was placed on convalescence leave. She got engaged on Christmas Eve 1959, but in the spring she broke off the engagement because she discovered that her boyfriend was already married. She was discharged the following July. PD’s admission narrative was mostly about sexual vulnerability, but also a combination of a few other themes already addressed: she had a severely disrupted family life, was often characterized as ‘‘very attractive,’’ ‘‘attractively dressed, good looking girl,’’ and ‘‘a pretty charming picture’’; her IQ changed from 64 to 75 over the course of her stay; and although her behavior would concern most parents, ultimately—like for many—it seemed as if she never really needed to be at Willowbrook. Her case illustrated another dimension to life for Willowbrook residents: sometimes they bounced back and forth between home and Willowbrook, during escapes or furloughs, coordinated with the cycles of their family dysfunction. PD arrived at Willowbrook in 1956, a White 13-year-old female. She had been a ward of the state because her mother was institutionalized for mental illness and her father was not around. In one of her foster homes, she was accused of being over-affectionate, going on dates with boys, attending ‘‘unsupervised night beach parties.’’ She accused her foster father of ‘‘bothering her.’’ Six months after being admitted, in the summer of 1957, she was released to her uncle, only to return her back to Willowbrook barely six weeks later because of financial problems, only to be released again to her mother freshly discharged from the hospital. During this period, she tried several escapes, hung out with men at an outdoor movie near Meiers Corner in Staten Island, or escaped to her aunt and uncles’, only to return back to Willowbrook and a new round of Thorazine injections. In the fall of 1957, she escaped several times to be with a boy in the Bronx only to be brought back by the police several hours later. After being released to her mother again, she returned in August of 1959: her mother was ill again, and the aunt and uncle invoked sexual vulnerability: ‘‘She has been keeping late hours, will not obey, argues constantly, is running around with boys, and the Uncle fears that she may become pregnant.’’ By the spring of 1960, she escaped again, and ended up living with a 24-year-old man for a month until he was arrested on having sex with her (PD stated that she gave consent and was not pressured). She went back and forth two more times, and then in April 1961, living at home, she was talking about marriage and her father, fearing she would become pregnant, dropped her off at Willowbrook. PD was asked about the boy she had planned to marry and she said ‘‘Oh, that’s all over. I did not bother with him after I saw him with another girl. I went out to dances but only together with other youths and if you ask me about sex relations, I didn’t have any.’’ She went on a family visit leave in the spring of 1962 as an 18-year-old, and never returned to Willowbrook. Thirteen of the cases (17 %) documented previous sexual assault against the children as a justification for their placement at Willowbrook. The reasoning seemed to be this: since they had already been sexually assaulted, they were at risk for further assault. Once again, not a single male was coded in this category; this happened with girls of all ages, abilities, and race. CC, a White female aged 16, of Italian background, was placed at Willowbrook after being sexually assaulted by a fellow student in her CRMD class in PS 142. Further investigation suggested she had also been assaulted by her cousin. She stated that when the boy did ‘‘bad things’’ to her she promptly told the other girls in school. This pattern of incarcerating the victim of sexual assault for her own protection was observed in all the cases, despite the fact that Willowbrook provided little protection for them. Moreover, the boys and men who raped these girls were rarely incarcerated or convicted of crimes. MD, ME, and MF, all under 17, already described above, were all raped. EB, a 15 year old Hispanic girl had been sexually assaulted, and when confronted, the boy applied for a marriage, which was denied. In some cases, like IC, Black, and ME,
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White, both 12 years old, or NA, a Hispanic 14-year-old, all were placed at Willowbrook because their father or mother’s boyfriend was sexually abusing them. Another obvious sign of sexual vulnerability among youth was the tendency for young women to get pregnant. As was the case most of the time, fears about pregnancy were just that: fears amounting to nothing, and the girls were admitted to Willowbrook, only to discover later that they would have their periods, such as what happened with JA as described above, but also SB, a Black 13-year-old, and MF, a Hispanic 16-year-old. Two adolescent women had already been pregnant before arriving at Willowbrook, and this fact was used against both in the certification hearings. MC, a 16-year-old Hispanic girl was ‘‘admitted to Bellevue Psychiatric Hospital from City Magistrates’ Court because of two illegal pregnancies without insight into the seriousness of this problem.’’ Four months into her third pregnancy, in September 1962, she stayed at Willowbrook for 3 days, and walked out of the institution after lunch and never came back. She ended up having a boy and planned to get married with the father. PD’s (who was Black and age 14) mother, summarized her situation on the petition this way: ‘‘My daughter is mentally retarded and attended the ungraded class until she became pregnant. Had a baby 2 weeks ago,’’ ‘‘But I do not know who the father is. I will take care of the baby and wish to place PD in Willowbrook State School.’’ Two young women in this file review arrived at Willowbrook pregnant. And three got pregnant and gave birth at Willowbrook. EB mentioned above, gave birth to a girl in 1954, which was given to her grandmother, and by November of that year, EB had fled to Puerto Rico with her boyfriend to get married. AC, a White female arrived at age 12 in 1959. At age 25, October 25th, 1972, while still at Willowbrook, she gave birth to a boy. KE, about who we know very little, arrived at age 10, eventually gave birth to a child in 1973, gave the child to the state. Five years later, she married the father, another client at the Staten Island Development Center. In a reversal of what one might expect, JC, an Italian male, living at Willowbrook since age 3, impregnated a staff member. He left his family of six, living in a two room apartment in the Bronx (rent was $30) because JC had cerebral palsy, was ‘‘retarded,’’ and required constant care. His IQ was constantly increasing: at admission, it was 27. By age six, it was 51, then at 11, it was 62, and 5 years later, 71, and a few years later, 73. Whatever his IQ, he was characterized in the progress notes as wanting to ‘‘have a normal social life with a ‘normal’ girl but has been unable to find one.’’ The social worker observed that he had dated one of the attendants, but ended it because she wanted to have intercourse with him, and he will only go out with ‘‘nice girls.’’ Eventually, as a young adult, he left Willowbrook, got an apartment of his own and worked at Willowbrook in food services, enrolled in Staten Island College for classes, and he found a girlfriend, a married woman who worked at Willowbrook. She got pregnant, but had an abortion, and then when her divorce was finalized, in the spring of 1978, they were married at Borough Hall.
Discussion Evidence from medical and legal records presented in this paper supported an intersectional approach: ability, gender, sexuality, class, and race interacted in residents’ ‘‘sexual’’ admissions. This make sense because of the long history of entanglement among these macrosocial factors and conceptions of ability. Taking a narrative approach, there were five
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main types of admission stories in this sample. The most common story was admission centered on the sexual promiscuity or perversion of the resident. Second most common were admissions primarily related to the fact that the youth was truant, unruly, and attending CMRD classes. The police would pick them up for being truant, and because they were in a CMRD class, the courts would place them at Willowbrook. The third most common reason for admission to Willowbrook was that the parents were unable to care for the resident. Delinquency was also a factor in a quarter of the admissions. Lastly, some residents were admitted to Willowbrook because their guardians felt they were vulnerable to sexual assault or pregnancy. Willowbrook clearly failed to protect its residents from both, and in fact, housed these sexually vulnerable youth with youth who had been accused of sexual assaults. Within the narratives were several instances in which the key macrosocial factors interacted together with ability. Class was a key factor for admission to Willowbrook in this study. Almost all residents came from family situations that showed evidence of economic or familial crisis. Social worker reports commonly associated poverty with race, and many of the poorest residents were indeed from the Puerto Rican and Black slums of Harlem, Brooklyn, and the Bronx. Gender was a significant factor in resident admissions, if but for one reason: most of the cases in this study about sexuality and ability were female. Most of the residents who arrived because their parents were unable to care for them were female. This may be because of the increased perceived vulnerability of young females, or because there were higher expectations placed on young women. Girls were exposed to scrutiny and judgements about their physical appearance, and were often characterized in a sexual manner by staff. We know a good deal about female residents and their heterosexual relationships at Willowbrook because when they were caught with boys, there were punishments, orders for medication, pregnancy and disease tests, and sometimes a round of Thorazine injections. We also know about the boys’ homosexual encounters, which were also thoroughly documented. Lastly, gender defined what ‘‘sexual promiscuity’’ on the certification petition meant. For boys, it meant they were sexual predators and the courts feared for the public’s safety; for girls, it meant that the girls were sexually active and the court feared for their safety. Sexual vulnerability was also a gendered term: no male was placed at Willowbrook over fears that he was vulnerable to sexual assault, yet it was mentioned in 17 % of the cases, all female. Perhaps these were reasonable fears since many women residents were victims of sexual assault, impregnated at Willowbrook, and were from all different races, ages, and abilities. In general, the findings above suggest that sexuality was a profound factor in the disempowerment of teens with disabilities at Willowbrook. Some suggest eugenics was to blame for past atrocities against non-White people with developmental disabilities. It’s not clear whether eugenic ideology was to blame for what was observed at Willowbrook, but race was a central macrosocial factor in this study. Most of the residents examined were not White. Whether that finding generalizes beyond this sample, is unknown, but based on other recent reports (e.g., [12]), we can assume that Whites were in the minority, both as residents and staff at Willowbrook, while most doctors were White. The fact that Blacks and Hispanics were in the majority probably reflected the reality that from the 1950’s to the 1970’s, New York’s Black and Hispanic families often had few choices when faced with a child who needed more care than they could provide. Moreover, the children of these families, residents of Willowbrook, were often non-English-speaking immigrants or lacked a strong education from poor inner-city schools, and thus tested poor on intelligence tests that were biased against them because of their foreign cultural backgrounds. The IQ tests were often suspect anyway, as explained
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earlier, since incarceration at the inhospitable Willowbrook often ‘‘increased’’ resident IQs gradually up to a discharge diagnosis of ‘‘not mentally defective.’’ Of course, this was improbable, since Willowbrook had a broad negative impact on most [12]. What is more likely is that doctors used bogus IQs to incarcerate Black and Hispanic youth, and when it became difficult to keep them there, raised the IQs and discharged them. As noted above, race interacted with the other variables, not just ability. For instance, it was observed that the certifications of Black and Hispanic youth were almost always brought by the mother, not the father, while White fathers were just as likely to bring a petition against their child as their mothers. In terms of reasons for admission, all but one of the boys and all the girls who were admitted for ‘‘delinquency’’ were Black or Hispanic. Only non-White boys had homosexuality in their past. Only White females avoided being admitted for truancy. All these observations could be parts of broader patterns. This feminist intersectional analysis established the value of exploring multiple social identities across an institution like Willowbrook, highlighting the notion that one institution can mean so many different things to people depending on their various identity positions. It also establishes that the very nature of disability is multifaceted, given the multiple realities and perspectives involved, and socially constructed amongst all involved. Institutions, like Willowbrook, are erected on similar divergent interests, and as such there are many Willowbrooks, not just one. Thus, trying to tell a story about lives that happened in the past can be a tricky thing, even if it is in the recent past, and involves hundreds of boxes of information. As a result, there were some specific limitations to this study. This study was based on a selective sample, in which every case selected had something to do with sexuality. Therefore, this is only one story about an institution that had many stories, and certainly there are other stories to be told about admissions to Willowbrook. For instance, although sexuality was a theme in 29 % of the valid files reviewed, there were other more common stories. In reviewing the files, one common, yet very short story was this: a young child with some form of serious disability was placed at Willowbrook, and before they were five, they were dead from some sort of affliction. It’s a simple and tragic story, and there are others yet to be told. Along with the sample limitations, this was an archival study based on a partially complete record. Resident files were missing from the archive, the files themselves were often incomplete, and it is reasonable to assume that whatever was recorded in the resident’s file was only a fraction of what happened to them at Willowbrook. Now that this study has shown some of what was happening at Willowbrook, hopefully, future researchers will address the weaknesses in this study with further explorations of Willowbrook and other similar institutions. There has been some attempt to document the experiences of people who lived and worked at Willowbrook, in their own words, a meaningful account of life at Willowbrook, but they are incomplete (e.g., [12]). Perhaps a full accounting of what happened at Willowbrook State School remains to be written—and never can be written—because not everybody who lived or worked at Willowbrook can share their experiences. Acknowledgments The author would like to thank Helen Nieves for research assistance and David Goode for comments on an earlier draft. This study received support from the Larry J. Hackman Research Residency Fellowship and the Professional Staff Congress-City University of New York. A shorter version of this paper was presented at the American Psychological Association in 2015.
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