Atwood's Hand Maiden's Tale is not a dark vision of the future--it is an all too accurate description of our past.
Arresting, involuntarily testing, imprisoning and torturing women because men don't approve of their sexuality was the explicit policy of the US for most of the 20th Century. Under the now largely forgotten "American Plan", women were detained on mere suspicion of being infected--and the official position was that prmiscuity was by definition reasonable suspicion of infection--is something one would hope was rare. But as Stern metiulously demonstrates, this was, in fact, the policy of the US government for the ENTIRE period of 1918 through at least 1945...and in some states and cities, continuing as late as the 1970's. All under the guise of fighting Sexually Transmitted Infections (STI's).
While the stated purpose was to combat the spread of disease, it is beyond dispute that the actual purpose of this policy was to police the sexuality of women. While the law was written without reference to either gender, in enforcing the law, women were imprisoned at rates about 1,000 times more frequently than men. And to be clear, I am using the word "women" loosely--females as young as 13 were caught up in the maw of this horror.
From the early 1900's on, public officials were struggling to figure out how to respond to prostitution, but there was little agreement, and little government funding (although the Rockefeller Fund "generously" supported these early efforts). Then came WWI, and the massive mobilization of troops in the US. An astoundingly high number of those reporting for duty tested positive for STI's. Rather than focus on the men's behavior, public officials focused on rising rates of prostitution near newly built army bases as the source of the problem initially ignoring the fact that men who arrived in camp already infected could not possibly have caught the disease from area prostitutes. Quikly, the army corrected this mistake, and the so called American Plan was born--sending out "investigators" nationwide to locate and observe women who appeared to be promiscuous (including 13 year olds who were raped by adult men), forcing them to undergo testing (using procedures which yielded as many false positives as accurate results), imprisoning those who tested "positive" and forcing them to undergo painful, ineffective treatments (injections of arsenic and other poisons was the accepted treatment protocol of the day--treatment which might kill the patient, but had no impact on the disease).
To the surprise of absolutely no one, the American Plan targeted women almost exclusively, specifically working class women in non-traditional jobs (retail sales was the largest category of employment for victims), and disproportionately targeted Black women.
Stern centers his story around Nina McCall, a white woman from a small town in Michigan who was observed in the company of a soldier. On this non-existent "evidence" she was forced on threat of arrest to report to the local Board of Health doctor, who in a five minute "test" found that she was a "little infected." when Nina protested that she had never been sexually active, the doctor lied, and told her that was not necessary to become infected. Off she was sent to an institution misleadingly labelled a "Treatment Center" where she was kept under lock and key for weeks, while being forced to undergo painful, useless treatments.
Stern chose Nina as the center of his history of the American Plan because she sued, and the transcript of her trial survives. This allows him to center the voice of someone directly impacted (albeit, a white woman, and thus not typical of the victims of the Plan), rather than center the bureaucrats that carried out the plan. Admirable as that intent is, the historical record regarding Nina's life is extremely thin--as one would expect from a working class person at this period. This forces Stern to fill in gaps with a huge number of "she must have" or "she may have" or "it is possible that she." It also means that while Stern comes back to Nina's story off and on throughout the book, most of the time her voice is absent, as Stern falls back on the more traditional tools of the historian--official documents. This clearly detracts from the narrative.
But inthe end, this book should make you livid. The way women were routinely abused, deprived of their liberty, and literally tortured, under the guise of protecting public health, is both appalling, and all too familiar. I continually thought about Kate Mann's brilliant book, Down Girl, as I read this history. Misogyny is not new; it is hard wired into this country's history.