In each aspect of the overall narrative, Only the Beautiful engages in a scathing critique of the implementation of eugenics, different versions of which were embraced by the Nazi regime and in the United States. Broadly speaking, eugenics is defined as the intentional manipulation of the human gene pool in order to create a predetermined population based upon arbitrary standards. During World War II, for example, the Nazi regime enacted the “Aktion T4” program in Austria, which forcibly removed certain citizens who were deemed unfit for living a normal life. Such individuals were forcibly euthanized in order to remove their genes from the population. Designed as part of Hitler’s plot to create a so-called “master race,” Aktion T4 was active throughout World War II and resulted in the murders of hundreds of thousands of people.

However, eugenics practices were not limited to the depravities of the Nazi regime, for just as Rosie’s experience is designed to illustrate, American psychiatric institutions once engaged in a form of eugenics themselves by forcibly sterilizing patients that they deemed to be unsuitable parents. Rosie experiences this ideology firsthand when she is forced to undergo such a procedure after the birth of her daughter.