Just to hit this one more time as directly as I possibly can:

> The core difference is some things which are reprehensible when backed by state violence are fine when chosen individually or encouraged by social pressures.

No. It is both reprehensible for the state to tell people they're too sicky or unintelligent to procreate and for society to pressure people not to procreate based on society's assessment of how sickly or unintelligent they are.

We can set aside all the prior examples of when people have previously believed this, or tried to implement this in various ways, all of which were reprehensible. Even if this was day 0 and we were starting fresh, the idea of society pressuring the sickly or unintelligent not to procreate would be reprehensible.