Healthy, happy, rational: reflections on genetic counselling in the GDR.

The development of genetic counselling in the German Democratic Republic (GDR) was closely connected to a well-established system of prenatal care and a process that placed reproductive decisions in the hands of women. It was embedded in the pronatalist reproductive policy of the GDR and a narrative of medical and (socialist) humanistic progress. As in other countries at that time, it promoted the goal of avoiding the birth of children with disabilities and was hence based on ableist premises. In this paper, I focus on communicative aspects of genetic counselling, as it was established in the 1970s and 1980s in university and district clinics. Thus, on the one hand I explore the communication of genetic counselling to the public; and on the other, I study the communication processes in genetic counselling centres themselves. In contrast to the USA, where the 'genetic counsellor' became established as a professional identity in the 1970s, there was no distinct profession of 'genetic counsellor' in the GDR. Instead, counselling was practised by physicians or biologists with a special interest in human genetics. This resulted in a strong emphasis in these clinical encounters on diagnosis and technical solutions, as well as an educational impetus. I propose that an important goal of genetic counselling in the GDR was to generate a sense of 'rationality' in prospective parents. To achieve this, those advocating and giving counselling explicitly sought to distance this practice from the eugenic ideas of the past, and to dispel superstitious ideas of heredity and religious ideas of fate. In addition, they attempted to alleviate emotions such as fear and guilt. It was in that context that counselling physicians and biologists provided interpretations of genetic findings, risk figures and disease values. I show how different interests and experiences shaped these and how risk evaluations structured counsellor-counsellee communication.

Die Humangenetische Beratung in der DDR.

In recent years, the history of human genetic counseling has increasingly become the subject of research in the history of medicine and science. In this article, I examine the establishment and design of human genetic counselling in the GDR from the 1960s until the fall of the Berlin Wall in 1989, based on archive material and medical literature of the time. The initiative for the establishment of a genetic counselling service in the GDR originated in the 1960s and can be traced back to scientists with different political backgrounds who were concerned with human genetic problems. In the 1970s and 80s, a nationwide network of human genetic counseling centers was established. They were located at either university institutions or district hospitals. Despite the centralized control, there was a considerable difference between the individual districts. Both biologists and doctors practiced genetic counselling in the GDR. With their focus on single individuals or families and their rejection of any kind of coercion, human geneticists set themselves apart from the eugenic practices of the Nazi era. Nevertheless, they did not completely ignore population-genetic objectives, as was the case in the FRG. Human genetic counseling in the GDR did not differ from other, even non-socialist, states in its objectives, namely to prevent the birth of handicapped children and to promote the birth of healthy children. This intent was not prescribed by the state, but it reflected a social attitude that equated disability with suffering.

["Well, it's not our fault that God made us so small". Opposition and self-will in women who suffered enforced sterilization]. / "Dass uns der liebe Herrgott hat so klein bleiben lassen, nun dafür können wir ja schliesslich nichts"--Widerspruch und Eigen-Sinn zwangssterilisierter Frauen.

Coercive sterilizations committed during the "Third Reich" were seen as a means of creating a Volksgemeinschaft (people's community) based on racial purity and hereditary health. While the physicians and attorneys who executed those actions emphasized the victims' sacrifice for the Volksgemeinschaft and stressed the benefits to the persons concerned and their families, the victims tried to escape the sterilization program. The "view from below" offers the possibility to observe victims as active agents who expressed their self-will in various ways: through escape, verbal protest and by refusing to be branded "inferior". In their attempts to reject the stigma of "inferiority", the victims often clung to the prevailing genetic ideas. The present article wants to highlight the also existing cracks inside eugenic thinking and shows, moreover, that other body concepts and ideas of illness existed, as the importance of eugenic thinking and the primacy of the Volksgemeinschaft were also called into question at the time.