Tag Archives: ob/gyn

Pathologizing Women’s Sexuality: Then and Now

15 Jul

Pathologizing and medicalizing women’s sexuality is nothing new. Here is a brief timeline of just some of the appalling highlights throughout human history of how women have been treated regarding sex:

Here is a great article from the New York Times on the pathologizing of women’s sex drives in modern times. To briefly cover how women’s sexuality has been pathologized throughout the ages, see below:

1. Actually, low female desire is ‘normal.’ Women have been made to feel that having a low libido means something is wrong with them. Currently women with chronic low libido are pathologized as having a type of female sexual dysfunction called hypoactive sexual desire disorder (HSDD). The trouble is, many of the researchers who have come up its nebulous definition have financial ties to pharmaceutical companies.”

2. Freud himself pathologized women’s sexuality to the point of literal “hysteria.” He popularized the idea that a sexually interested woman was not only unhealthy, she was mentally ill and wishing she was really a man with a penis. Though he certainly wasn’t the first person to present these ideas. “In his early theories, Freud simply extended his views of male sexuality to women, viewing women as simply men without penises (Cohler & Galatzer-Levy, 2008). His male perspective of sexuality is understandable, but nonetheless problematic, as it marginalizes female sexuality. Female sexuality, according to early Freudian theory, is exactly the same as male sexuality up until the phallic stage of psychosexual development; since women don’t have a penis, however, they experience penis envy. He also fell prey to the general sexism of the time, writing that in men alone is “the sexual life…accessible to investigation, whereas in the woman it is veiled in impenetrable darkness, partly in consequence of cultural stunting and partly on account of the conventional reticence and dishonesty of women” (Freud, 1905). Dismissing women and their sexuality in such a way seems troublesome not only because he treated many female patients, but because his theories are still so prevalent today, continuing to influence psychologists and sexologists alike (Jayne, 1984).”

3. Victorian ideas about women and sex were particularly appalling. The vibrator was invented by doctors in Victorian England for a stunningly awful reason. During these times, doctors believed that women became unhinged and unhappy due to either having a uterus that was unattached to anything in their body and “roving around” inducing so-called “hysteria,” or they needed either a REMOVAL OF the clitoris (clitorectomy) or stimulation of it. Yes, doctors had well-to-do women in Victorian England visit their offices for the doctor to “perform a treatment” of manual stimulation of their clitoris to induce orgasm. This treatment became popular and therefore the vibrator was invented to save doctors from incessant hand cramps. As hilarious and ridiculous as it sounds, it is but one example of devastating erasure of women’s sexual agency and identity. This is one of the most egregious examples of pathologizing women’s sexuality to the point of extreme violation of their bodies. 

4. The clitorectomy was also popular around this time. From an excellent article on the history of clitorectomies and vibrators: “In a series of papers, Baker-Brown argued that the professional manipulation of the clitoris to induce paroxysms was no cure for hysteria. In his view, it only made the problem worse by feeding the patient’s lust for gratification. The only effective solution, he insisted, was a permanent one: the surgical removal of the clitoral glans. As Martha Coventry wrote in a famous article for Ms., Baker-Brown promised that after a clitoridectomy, “intractable women became happy wives; rebellious teenage girls settled back into the bosom of their families; and married women formerly averse to sexual duties became pregnant.”

Happily, Baker-Brown was soon discredited by his fellow gynecologists, many of whom objected to his habit of performing clitoridectomies on women without their consent. Unfortunately, the surgical procedure he popularized survived his fall from grace. Baker-Brown may have fallen out of favor with his British colleagues, but his ideas found a more enduring footing on the other side of the Atlantic. As early as 1866, American doctors began performing clitoridectomies to stop hysteria, nymphomania, and above all, masturbation. As Coventry discovered, medical textbooks continued to recommend clitoral excisions as late as 1937, and some doctors continued to perform the procedure for at least a decade after that. (Coventry interviewed a Michigan woman who underwent a clitoridectomy in 1944, at age 12: “…as she sat on the exam table, an attendant clamped an ether-soaked rag over her mouth from behind. When she woke up, her clitoris was gone. ‘They tried to keep me from masturbating,’ she said. Then, after a pause, added, ‘Didn’t work.'”)

5. None of this is anything new. During colonial times in Europe: “Although ordinary women could never aspire to [political or religious positions in the public sphere] they had other powers unique to their sex: Women were disorderly, sexual, and lustyÉ With woman’s intellect at the mercy of her lower nature, she would be prone to the evil powers of witchcraft. Her very sensual and deceptive power, in fact, dictated the necessity of her subordination within marriage” (Evans, 22-23).

The medical perspective was limited in that males dominated this profession. “Even diagrams of female anatomy in medical books are limited to male eyes only. Plans to instruct midwives in anatomy were thwarted. Physicians were reluctant to give their patients too much knowledge”(Porter, 86). Women during this period really had nowhere to turn to obtain helpful knowledge about their bodies and/or sexuality in a world dominated by men.

6. Going back further, in ancient Greece and Rome, “women’s sexuality was something to be controlled. To Aristotle, women’s bodies were passive receptacles for men to deposit their seed, what Sophocles called a “field to plow.” Since the key function of women was to produce children, Athenians thought it was pointless to educate them or allow them to participate in public life.” Further, “Rome’s highest priestesses were known as the Vestal Virgins. They were “vestal” because they served the goddess Vesta, and “virgins” in that their untouched bodies were seen as essential to the safety of Roman society. No one else in Rome was expected to stay a virgin, but a single sexual detour by a Vestal was thought to bring pestilence, losses in war and divine displeasure. On several occasions, when no one could figure out why some calamity had befallen Rome, Vestals were accused of no longer being virgins. For that crime, they were buried alive in a tiny room and covered up without a trace.”

7. Back to Victorian times:  “nearly all official measures against venereal disease were directed exclusively against women. In the 19th century, many European governments legalized prostitution, but only to the extent of subjecting real or suspected prostitutes to punishing medical inspections, often called “instrument rapes,” which probably resulted in the transmission of a variety of harmful infections. One French woman described the process in detail:

It is awful work; the attitude they push us into first is so disgusting and so painful, and then those monstrous instruments—often they use several. They seem to tear the passage open first with their hands, and examine us, and then they thrust in instruments, and they pull them out and push them in, and they turn and twist them about; and if you cry out they stifle you….”

8. In modern times, women’s sexual agency is not only pathologized, but women’s lives are at risk throughout the world for exploring their sexuality or deviating from cultural norms. In some countries, honor killings are practiced if a woman’s mere sexual reputation is under threat. Similarly, “crimes of passion” are rampant throughout the world as jealous men attack and murder women for the act or idea of being sexual with another man.

So little wonder that even in modern times, the idea of women having satisfying sex lives according to their own desires is threatening to the fabric of society, since it is built on patriarchal ideals of controlling women’s bodies and sex. Little wonder, then, that politicians are trying to prevent access to reproductive resources such as contraception, emergency birth control, and abortion. Little wonder that young girls don’t receive very much sex education or information about their own sexual pleasure. Little wonder that we can see someone be disemboweled in the movies, but a woman’s face during an orgasm is not allowed to be in even an R-rated movie. Little wonder that the worst thing you can call a woman is a “slut,” especially if she is sexually liberated, yet the worst thing you can call a man is a “woman,” “girl,” or “pussy.” 

This is the legacy upon which our current sexual health conversation is built. I don’t trust pharmaceutical companies to be concerned with women’s health. They are more concerned about making money. Women are going to be pathologized for not wanting sex and for wanting it “too much.” A pill is probably not the answer to this much more complex social issue that reverberates sexism into the interpersonal and sexual-emotional issues in relationships.

Specula from 1847 (U.S. National Library of Medicine)

For more on the systemic violation of women’s sexuality and bodies, review the invention of the speculum by the father of gynecology, who performed “instrument rape” on slave women in early America. That was then, this is now, you say? Yes, and nowadays OB-GYN’s get their license by performing vaginal exams on nonconsenting women who are under anaesthesia for other operations in teaching hospitals. See this article for the testimonies of several doctors who refused to participate and who loudly question the ethics of this practice. The practice is so commonplace for OB-GYN departments of teaching hospitals that in 2003 the residency doctor of Johns Hopkins said, ““I don’t think any of us even think about it. It’s just so standard as to how you train medical students.”

In consequence, there is no precedent set to earn women’s trust regarding their sexual health. It is wise to be suspicious of any product or service that is directed at our sexuality, especially coming from the medical establishment. We like to take a pill for the easy way out. But that may very well cause more trouble than it solves, especially if the root of the issue lay ignored in the context of emotionally unsatisfying relationships that are based on patriarchal norms.

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