When Public Health Becomes Punishment: A Review of Women of a Promiscuous Nature by Donna Everhart

 

Donna Everhart | Historical Fiction | 362 pages | Published January 27, 2026

Rating: ★★★★☆

There are historical novels that transport us to another era, and there are those that expose how comfortably the injustices of the past can disguise themselves in the language of the public good. Donna Everhart’s Women of a Promiscuous Nature belongs firmly in the second category. Set in 1940s North Carolina, the novel draws upon the long-obscured history of the American Plan, a government program through which women suspected of sexual “immorality” or venereal disease could be detained, examined, treated, and confined—often without meaningful evidence or due process.

Everhart transforms this history into a disturbing story about institutional power, bodily autonomy, moral judgment, and women’s resistance. The result is not merely a novel about an abusive system. It is an examination of the conditions that allow such a system to present itself as reasonable, scientific, and even benevolent.

The Dangerous Elasticity of “Promiscuity”

At the center of the novel is twenty-four-year-old Ruth Foster, a diner employee whose ordinary life is abruptly upended when a sheriff stops her on the way to work. He demands that she submit to medical testing, invoking public decency and the prevention of sexual disease. Ruth has never had a sexual relationship, but her innocence offers no protection. By the end of the day, she has been confined at the State Industrial Farm Colony for Women.

The speed with which Ruth loses control over her body and future is one of the premise’s most unsettling features. She has not been convicted of a crime. She has not been afforded an opportunity to challenge the allegation against her. Suspicion is treated as evidence, and compliance is demanded before she can understand what she is being accused of.

The term “promiscuous” proves frighteningly elastic. It can encompass prostitution, but it can also mean being unmarried, attractive, poor, independent, outspoken, seen speaking with a soldier, or simply disliked by someone willing to make an accusation. One woman is confined after eating alone in a restaurant; another is punished for operating a business without a husband. Still others arrive because they have been abused, abandoned, or deemed socially inconvenient.

This is where Everhart’s premise acquires much of its force. The women are not incarcerated solely for what they have done. They are incarcerated for failing to conform to a prescribed model of respectable femininity. “Promiscuity” becomes less a definable behavior than an accusation used to police women whose lives make others uncomfortable.

The novel’s subject is therefore broader than sexual morality. It concerns the danger of administrative categories that appear objective but are vague enough to absorb prejudice. Once a label is placed in an official record, it can acquire the authority of fact—regardless of the evidence behind it.

Public Health Without Consent or Justice

From a public health perspective, Women of a Promiscuous Nature raises an essential question: What happens when the stated goal of disease prevention becomes detached from consent, proportionality, equity, and human rights?

Preventing sexually transmitted infections is a legitimate public health objective. Everhart’s story, however, illustrates how quickly that objective can be corrupted when enforcement is directed almost exclusively at a politically vulnerable population. Rather than addressing transmission through education, voluntary testing, access to treatment, or shared responsibility, the system identifies women as both the source of disease and the appropriate site of punishment.

Men’s behavior largely escapes equivalent scrutiny. Women, meanwhile, are expected to bear the moral and medical burden for an entire society. The result is not neutral disease control but gendered social regulation.

The novel also highlights the relationship between health inequity and institutional power. Women with money, family influence, or social standing are better positioned to resist coercive authority. Poor women, unmarried women, women who work outside the home, survivors of violence, and those with mental illness are easier to classify as suspicious and more difficult to defend.

This is a cautionary example of why public health cannot be evaluated solely by its declared intention. A program may claim to protect the population and still operate unjustly. Ethical public health requires evidence, transparency, proportionality, procedural safeguards, and respect for the dignity of the people affected. Without those protections, prevention can become surveillance, treatment can become coercion, and health policy can become punishment.

The novel is especially timely because it asks readers to examine the reassuring vocabulary institutions use: health, safety, rehabilitation, training, and decency. None of these words is inherently sinister. Yet each can conceal harm when those subject to policy have little ability to refuse, appeal, or even ask for an explanation.

Dorothy Baker and the Bureaucracy of Moral Certainty

The Colony’s superintendent, Dorothy Baker, is the novel’s most psychologically and politically significant character. She is not presented simply as a stock villain who recognizes her cruelty and delights in it. Instead, she believes she is reforming “degenerate” women and returning them to society as respectable citizens.

That conviction makes her more disturbing.

Systems of oppression rarely depend entirely upon obviously malicious people. They are often sustained by conscientious officials who mistake obedience for virtue, ideology for evidence, and institutional procedure for moral legitimacy. Dorothy’s rule book gives prejudice the appearance of order. Solitary confinement, grueling labor, invasive treatment, and other punishments become administrative responses rather than acts of violence.

This distinction matters. If cruelty is committed only by monsters, readers can distance themselves from it. But if cruelty can be administered by people convinced of their own righteousness, the novel’s challenge becomes harder to dismiss. Everhart asks us to consider how easily moral certainty can suppress compassion—and how bureaucracy can make personal responsibility seem abstract.

From an analytic perspective, Dorothy represents the danger of a closed system. She begins with a predetermined conclusion—that the incarcerated women are morally defective—and interprets every response as confirmation. Submission proves they need discipline. Anger proves they are unstable. Resistance proves they are incorrigible. Even silence can be construed as deceit.

Such a system cannot correct itself because it has eliminated the possibility of disconfirming evidence. Its assumptions are protected by circular reasoning, while those most capable of exposing its failures are dismissed as unreliable precisely because the institution has labeled them deviant.

Women as Individuals, Not Symbols

Ruth’s story provides the reader’s point of entry, but the novel’s wider emotional and ethical scope lies in the community of women around her. Josephine, Maude, Frances, Opal, and Stella arrive with different histories and vulnerabilities. Their alleged “sins” reveal how the same institution can capture women through multiple pathways: independence, grief, mental illness, domestic abuse, sexual violence, poverty, or the refusal to remain invisible.

Stella’s situation is particularly devastating. At fifteen, she has already survived assault, yet the system treats her victimization as evidence against her. Her confinement demonstrates one of the novel’s bleakest truths: institutions that claim to protect vulnerable people may instead punish them for the harm done to them.

As a mother, I find that aspect of the story especially difficult to contemplate. It is painful enough to imagine a young person experiencing violence; it is more terrible still to imagine adults in authority responding by removing her liberty and teaching her to regard herself as the problem. Motherhood sharpens the question running beneath the novel: Who is believed, who is protected, and what happens when the institutions entrusted with care become sources of harm?

As a woman in midlife, I also read these characters with an awareness of how women’s choices are judged differently across time and circumstance. Behaviors that may now appear unremarkable—working independently, eating alone, speaking openly, choosing not to marry—could once be interpreted as evidence of moral disorder. Yet the deeper warning is not that society used to judge women unfairly and has since moved beyond that tendency. It is that the vocabulary of judgment changes more readily than the impulse to control.

North Carolina is more than a backdrop. Its social hierarchies, expectations of female respectability, economic inequalities, and deference to local authority create the conditions in which the Colony can function. The setting grounds the story in a recognizable social world rather than an abstract dystopia.

More Disturbing Than Dystopia

The publisher’s comparison to Girl, Interrupted and The Handmaid’s Tale is understandable. Like Girl, Interrupted, Everhart’s novel examines women confined within an institution that interprets their identities through medicalized categories. Like The Handmaid’s Tale, it centers the regulation of women’s bodies and the political power of supposedly moral authorities.

Yet Women of a Promiscuous Nature derives its greatest power from the fact that its underlying system was not speculative. The American Plan belongs to American history. The women at the heart of this story are fictional, but the mechanisms used against them reflect a real convergence of medical authority, law enforcement, gender prejudice, and government power.

That historical foundation gives the novel a burden as well as an advantage. Fiction based on overlooked injustice must balance narrative momentum with historical explanation. Too much exposition can flatten characters into educational instruments; too little context can leave readers unable to distinguish documented practice from invention. The story is strongest when the history emerges through what the women experience: intake, classification, labor, discipline, medical authority, and the gradual realization that compliance does not necessarily produce justice.

The thriller elements and emphasis on resistance make the book accessible, though they may also create a tension familiar to historical fiction. The demands of a propulsive plot can simplify systemic injustice into a conflict between identifiable heroes and villains. The history itself is more uncomfortable. It implicates not only cruel individuals but laws, medical personnel, law enforcement officers, social conventions, and ordinary citizens willing to report women whose behavior they disliked. No single antagonist can carry all of that responsibility.

A Story for the Present

Calling a historical novel “timely” can become an empty compliment, but the description is justified here. Women of a Promiscuous Nature speaks to continuing debates about bodily autonomy, government authority, unequal enforcement, medical consent, and the use of public-welfare language to rationalize restrictions on individual liberty.

Its warning is not that governments should never act in response to public health threats. Rather, it is that urgency does not eliminate the need for ethics. Public trust is not created by demanding obedience; it is earned through fairness, transparency, consistency, and accountability. Policies that stigmatize selected groups may produce compliance in the short term, but they also generate fear, concealment, resentment, and lasting mistrust.

My professional instincts lead me to ask of any intervention: What evidence supports it? Who defined the problem? Who benefits? Who bears the burden? What assumptions are embedded in the policy? What protections exist against error or abuse? And, perhaps most importantly, what happens to a person who says no?

Everhart’s novel suggests that those questions are not academic luxuries. They are safeguards.

Final Assessment

Women of a Promiscuous Nature is a compassionate and unsettling work of historical fiction about women caught in a system that converts suspicion into guilt and prejudice into policy. Its most important achievement is the recovery of a largely neglected chapter of American history through the lives of women who might otherwise have survived only as diagnoses, case numbers, or institutional records.

The book should appeal to readers of feminist historical fiction, Southern fiction, institutional dramas, and novels concerned with medical ethics and social justice. It would also make a strong book-club selection because it invites discussion beyond the fate of its characters: Can an institution be benevolent when participation is coerced? What responsibility do professionals bear when harmful policies are legal? How does social class determine whose behavior is considered eccentric and whose is deemed dangerous? What does meaningful resistance look like when every response is interpreted as proof of guilt?

This is not comfortable reading, nor should it be. It is the kind of novel that leaves a cup of coffee cooling unnoticed beside you—not because the past feels remote, but because it does not.

Coffee pairing: A strong, dark roast with a bittersweet finish—something bracing enough for a story about injustice, but warm enough to accompany its hard-won solidarity.