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We can blame war for a lot of things; among them is America’s decision to lock up women suspected of being sex workers, and to do so indefinitely while forcing dangerous medical treatments on them.

World War I poster from the National Museum of Health. Under Creative Commons license from Flickr.

In Part 1 of this post, I set the scene for the development of the American Plan, explaining why STIs were such a big deal, how various governments attempted to regulate prostitution starting in the 19th century, and how the American Social Hygiene Association – ASHA – came onto the scene.

The U.S. officially joined World War I in April of 1917. Almost immediately, ASHA officials helped form and began to cooperate with the CTCA (Commission on Camp Training Activities). The guy in charge of making a lot of these connections, Raymond Fosdick, was a reformer who spent weeks checking out various red light districts across the country in order to make recommendations on how best to contain the flow of sex workers into military-adjacent towns.

The point of the CTCA was not only to provide soldiers with wholesome amusements to distract them from the lascivious sort, but also to enforce “moral zones” outside the camps: limiting the sale of alcohol and making sure no sex workers could set up shop. A number of resolutions were passed at federal, state, and local levels, all with the same goal of controlling the spread of STIs by shutting down brothels and jailing prostitutes. An early version of the FBI got in on the action; so did female reformers, under the auspices of the Committee on Protective Work for Girls (CPWG), a branch of the CTCA that locked up women and girls not in jails, but in detention homes where they were to be taught how to be properly feminine through forced domestic labor.

Both the jails and the detention homes were racially segregated, and both were unlawful in that women suspected of prostitution could, without a warrant or proof, be indefinitely detained, forcibly medically examined, and forcibly treated with mercury injections, sometimes tempered with arsenic. Medical officials were aware that, eve when used cautiously, arsenic-based treatments could “cause convulsions, liver damage (resulting in jaundice), dermatitis, abdominal pain, vomiting, and necrosis at the site of injection” (Stern 95), while mercury would loosen teeth while making the patient horrendously ill.

While the language of the federal, state, and city resolutions was usually gender-neutral, the impact was not. To take an example from the California State Board of Health, which met later in 1917 to discuss their implementation of the American Plan, Scott Stern summarizes their laws as such:

At the time, prostitution was defined as a crime of which only women could be guilty. Male prostitutes were often harassed and arrested, but this was for cross-dressing, sodomy, crimes against nature, or the like; they could not be charged with prostitution, per se. Furthermore, men patronizing prostitutes were not guilty of prostitution either, so they were not automatic STI suspects in the same way accused prostitutes were (35).

Indeed, as Stern recounts, a lawyer who heard about California’s laws exclaimed: “Why, a woman or girl could be kept in prison under that regulation for years without trial!” (35)

And that is exactly what happened.

All over the country, old hospitals were turned into detention centers. Women prison’s became overcrowded. Dormitories were taken over for this purpose, and bars were put on the windows. Women across the U.S. – and in Puerto Rico – were imprisoned by the tens if not hundreds of thousands. We don’t have exact numbers because many of the records were destroyed.

Nina McCall (1900-1957) had grown up in Michigan and was imprisoned in 1918 under suspicion of having a venereal disease. After being taken in by the police, she was vaginally examined by a man she did not know (and prior to this, she had probably been a virgin). She was declared to be “slightly infected” with gonorrhea, and forced to live in a dormitory, all the while undergoing hard labor and mercury injections that loosened her teeth, made her hair fall out, and made her generally ill. When she was finally released, months later, a nurse involved in her treatment stalked and harassed her until she consented to more mercury shots.

She sued them all – the doctor, a matron at the dormitory, and the stalker-ish nurse – and hence we have court records detailing her travails. Unfortunately, she lost her case. But her bravery gives us a window into how the American Plan impacted people’s lives at the time.

We have records of other women rebelling, too. Some rioted in prisons, some escaped, some burned those buildings to the ground. Impoverished women, immigrants, and women of color were disproportionately impacted by the American Plan and the racism and xenophobia of those in charge of implementing it. This is why, even examining a phenomenon that is sexist through and through, it’s important to take an intersectional perspective and look at the cruel impact on women whose identities were not white.

After World War I ended, funding for implementing the American Plan began to evaporate. The laws remained on the books, but without as much money attached. And, as is the case today, following the money leads to a better understanding of the motivation to lock people up. As Stern observes, “the Plan was inextricably linked to capitalism. Cities locked up women in part to make money” (173). Private anti-vice groups, staffed in part by businessmen who thought nearby brothels would hurt their businesses, helped fund private prisons. One strategy for wooing lucrative military bases was to aggressively enforce the Plan, and in fact this worked as a type of business blackmail as well: “When, late in 1917, officials in Seattle refused to lock up infected women with sufficient vigor, the military placed the city ‘off limits’ for the soldiers from Camp Lewis–presenting what one historian called a ‘grave threat to the local economy'” (173).

The American Plan continued to be enforced on the local level up through the 1930s where it was profitable to do so, while its influence waned in other places. It would see an uptick when World War II started, and then it would not fully wind down until the 1960s-70s.

In the final installment of this post, I will delve into the sexist implications of the American Plan, its lasting effects on American policies and people, and its tie-ins with other breaches of medical ethics, from the Tuskegee syphilis experiment to forced sterilizations and HIV/AIDS.



Scott Stern. The Trials of Nina McCall: Sex, Surveillance, and the Decades-Long Government Plan to Imprison “Promiscuous” Women. Boston: Beacon Press, 2018.

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Jeana Jorgensen

FOXY FOLKORIST Studied folklore under Alan Dundes at the University of California, Berkeley, and went on to earn her PhD in folklore from Indiana University. She researches gender and sexuality in fairy...