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Her legal father was Alice Roosevelt's husband, Speaker of the House Nicholas Longworth; her biological father, however, was Senator William Borah, as biographers Carol Felsenthal and Betty Boyd Caroli, and TIME journalist Rebecca Winters Keegan all report. In fact, Alice proposed the name Deborah for her daughter but her husband would not agree, thinking it looked too much like "de Borah", so Alice reluctantly chose Paulina for her daughter's name. Nicholas Longworth died when Paulina was six, and she had a distant, strained relationship with her mother. Paulina made her social debut in Cincinnati, her father’s hometown. She briefly attended Vassar College.
Carol Felsenthal's biography of Alice Roosevelt Longworth portrayed Paulina as an awkward, unattractive child who grew into an "immensely shy woman with a severe stutter." Historians agree that Paulina was ignored, stifled, and belittled by her overbearing mother, who desired for Paulina to become an extroverted society woman like herself. Instead, in her adult years, Paulina suffered from depression and alcoholism, and endured institutionalizations and shock therapy treatments following several suicide attempts.
Despite family tensions, Paulina was often invited to the White House by Eleanor Roosevelt to play with her cousins. Sisty and Buzzie Dall were near Paulina's age and they played often. Eleanor Roosevelt often looked after Paulina at the White House when her mother, Alice was out of town and Eleanor Roosevelt also made sure to include Paulina in dinner party invitations to the White House.
In 1944, while helping her mother campaign against their distant cousin Franklin Delano Roosevelt, Paulina met Alexander McCormick Sturm, known as "Sandy," an artist and recent Yale graduate from a prominent family. They married on August 26, 1944, when Paulina was nineteen. Paulina's marriage to Sturm further strained the mother-daughter relationship. Alice Longworth desired for Paulina to complete her college education before marrying, something she herself had missed out on.
The Sturms had a daughter, Joanna Mercedes Alessandra Sturm, (born July, 1946). By most accounts, Paulina, unlike her own mother, was a doting and attentive mother to Joanna. Sandy Sturm died of hepatitis in 1951. Widowhood plunged Paulina deeper into depression and drug dependency, and she sought spiritual guidance, converting to Catholicism. In 1952, she joined Dorothy Day's Chrystie Street hospitality house on New York's Lower East Side. She also volunteered at several Washington, D.C. hospitals.
In early 1957, Paulina died of an overdose of sleeping pills. Though the autopsy noted her death as accidental, the Washington Post reported that Paulina committed suicide (at her mother's request the newspaper later printed a retraction). Though she had attempted suicide before, Alice Roosevelt Longworth did not agree with the suicide view, citing Paulina's subsequent conversion to Catholicism, which forbids suicide and her Catholic burial, indicating that the Church did not consider her death a suicide. Vice President Richard Nixon was a pallbearer at her funeral.
In Paulina's will, her mother Alice Roosevelt Longworth was left custody of Joanna, whom she raised and with whom she was very close. Upon Paulina's death, her mother’s cousin Eleanor Roosevelt sent condolences and the two women mended their broken relationship.
Paulina Longworth Sturm is buried in Rock Creek Cemetery in Washington.