DAVENPORT LECTURE: HOW GENDER CHANGED THE

HISTORY OF MEDICINE
I BEGIN WITH A RIDDLE THAT MADE THE

ROUNDS AT SOCIAL GATHERINGS IN THE 1960’S. NOW

OBSOLETE, IT TESTIFIES TO THE DYNAMISM OF SOCIAL

CHANGE IN THE LAST 35 YEARS. THE SCENE IS A

TERRIBLE AUTOMOBILE ACCIDENT INVOLVING A FATHER

& SON. ONLY THE BOY IS ALIVE—HE IS RUSHED TO THE

HOSPITAL IN CRITICAL CONDITION. THE SPECIALIST ON

CALL HURRIES INTO THE OPERATING ROOM, GLANCES

DOWN AT THE PATIENT, AND, WITH A LOOK OF HORROR,

CRIES OUT, “MY GOD! I CAN’T OPERATE ON THIS CHILD,

HE IS MY SON!” “HOW COULD THIS BE?” THE RIDDLER

ASKS. GROUPS OF PERFECTLY INTELLIGENT INDIVIDUALS

WERE STUMPED. HOW COULD THE DOCTOR BE THE BOY’S

PARENT WHEN THE FATHER WAS KILLED IN THE CAR CRASH? IN

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THE MID-1960’S, THE RIDDLE WAS WILDLY SUCCESSFUL

BECAUSE NOBODY THOUGHT TO GUESS THAT THE

NEUROSURGEON WAS A WOMAN! THE SOCIAL AND POLITICAL

UPHEAVALS OF THAT PERIOD WHICH RESULTED IN MORE

RACIAL AND GENDER INCLUSIVENESS IN AMERICAN SOCIETY

HAVE RENDERED THE RIDDLE MEANINGLY. AT THE SAME

HISTORICAL MOMENT, A REVOLUTION OF SORTS ALSO TOOK

PLACE IN THE HISTORICAL PROFESSION; UNTIL THAT TIME

HISTORIANS HAD FOCUSED THEIR ATTENTION PRIMARILY ON

THE ACHIEVEMENTS OF GREAT WHITE MEN: THEY STUDIED

WAR, POLITICS, AND BROAD INTELLECTUAL AND SOCIO-

ECONOMIC CHANGE.

TODAY I WANT TO REFLECT ON THE CONSEQUENCES OF

TWO SIGNIFICANT ASPECTS OF THAT CHANGE. THE FIRST WAS

THE INSISTENCE THAT WOMEN, NOT JUST MEN, BE CONCEIVED

AS HISTORICAL ACTORS; THE SECOND, CHANGES IN HISTORIANS

UNDERSTANDING OF THE DEVELOPMENT AND PRACTICE OF

MEDICINE OVER TIME. INDEED, THE “INVENTION” OF WOMEN’S

HISTORY AND THE REORIENTATION OF MEDICAL HISTORY WERE

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CLOSELY INTERTWINED FROM THE OUTSET. FOR THE

DISCIPLINE OF MEDICAL HISTORY, THIS MEANT CASTING ASIDE

THE PHYSICIAN-IDENTIFIED TRIUMPHALIST SUCCESS STORIES

ABOUT MODERN WESTERN MEDICAL SCIENCE THAT, SINCE THE

19TH CENTURY, HAD ENCOMPASSED THE BULK OF HISTORICAL

WRITING ON MEDICINE. FOR WOMEN’S HISTORY, THE PROJECT

WAS EVEN MORE TRANSFORMATIVE: A NEW AREA OF INQUIRY

DEVOTED EXPLICITLY TO WOMEN HAD TO BE ENVISIONED, AND

NEW THEORETICAL CONCEPTS—MOST NOTABLY THINKING

WITH GENDER AS A CATEGORY OF ANALYSIS—NEEDED

CONSTRUCTING.1

The feminist movement in the US and the contemporary politics of

women’s health care helped to animate this new historical orientation toward

finding the women. Feminist “consciousness raising” groups complained that

women lacked knowledge of their own bodies. How did thEIR ignorance

come about? Ordinary young women sought more control, not just over their

sexuality, but over other stages of the female life course: pregnancy,

childbirth, breastfeeding, birth control, abortion, and menopause.2

 4
THE ADVENT OF SOCIAL HISTORY AND CULTURAL
HISTORY ENGINEERED A REVOLUTION IN HISTORICAL
THINKING. I WOULD ARGUE THAT WHAT WE CALL THE
“CULTURE WARS”—ARE PARTIALLY A RESULT OF THE
COMPETING UNDERSTANDINGS OF AMERICAN HISTORY
THAT THESE NEW APPROACHES INTRODUCED. THIS
MORNING I WANT TO FOCUS ON TWO SIGNIFICANT
ASPECTS OF THIS INTELLECTUAL REVOLUTION: THE
FIRST, NEW CONCEPTUALIZATIONS OF WOMEN AS
HISTORICAL ACTORS; THE SECOND, NEW HISTORICAL
UNDERSTANDINGS OF THE THEORY AND PRACTICE OF
MEDICINE. I HOPE TO SHOW THAT THE “INVENTION” OF
WOMEN’S HISTORY AND THE REORIENTATION OF
MEDICAL HISTORY TOWARD NEW MODES OF INQUIRY
WERE CLOSELY INTERTWINED FROM THE OUTSET. FOR
THE DISCIPLINE OF MEDICAL HISTORY, THIS MEANT
CASTING ASIDE A PREVAILING BODY OF WORK: NAMELY,
THE PHYSICIAN-AUTHORED, TRIUMPHALIST SUCCESS
STORIES ABOUT MODERN MEDICAL SCIENCE THAT HAD,
SINCE THE MIDDLE OF THE 19TH CENTURY, ENCOMPASSED
THE BULK OF HISTORICAL WRITING ON MEDICINE, AND
SERVED PRIMARILY TO REINFORCE THE STATUS AND
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POWER OF THE MEDICAL PROFESSION. FOR WOMEN’S
HISTORY, THE PROJECT WAS EVEN MORE
TRANSFORMATIVE: VIRTUALLY A NEW AREA OF INQUIRY
FOCUSING EXPLICITLY ON WOMEN HAD TO BE OPENED
UP, ALMOST FROM SCRATCH.3
Today I want to reflect on the consequences of two significant aspects

of that change. The first was the insistence that women, not just men, be

conceived as historical actors; the second, changes in historians

understanding of the development and practice of medicine over time. Indeed,

the “invention” of women’s history and the reorientation of medical history

were closely intertwined from the outset. For the discipline of medical history,

this meant casting aside the physician-identified triumphalist success stories

about modern Western medical science that, since the 19th century, had

encompassed the bulk of historical writing on medicine. For women’s history,

the project was even more transformative: a new area of inquiry devoted

explicitly to women had to be envisioned, and new theoretical concepts—

most notably thinking with gender as a category of analysis—needed

constructing.4

The feminist movement in the US and the contemporary politics of

women’s health care helped to animate this new historical orientation toward
 6
finding the women. Feminist “consciousness raising” groups complained that

women lacked knowledge of their own bodies. How did this ignorance come

about? Ordinary young women sought more control, not just over their

sexuality, but over other stages of the female life course: pregnancy,

childbirth, breastfeeding, birth control, abortion, and menopause.5

THIS POINT IS AN IMPORTANT ONE. ALONG WITH THE

EMERGENCE OF FEMINISM, THE CONTEMPORARY
POLITICS OF WOMEN’S HEALTH CARE HELPED TO
ANIMATE THIS NEW ORIENTATION TOWARD FINDING THE
WOMEN. A RECURRING COMPLAINT OF FEMINIST
“CONSCIOUSNESS RAISING” GROUPS WAS WOMEN’S LACK
OF KNOWLEDGE OF THEIR OWN BODIES. WHY AND HOW
DID THIS IGNORANCE COME ABOUT? ESPECIALLY
RANKLING WAS THE RESPONSE OF PHYSICIANS TO
WOMEN PATIENTS WHO SOUGHT MORE INFORMATION.
THE CONSCIOUSLY-CRAFTED BEHAVIORS OF MALE
MEDICAL PROFESSIONALISM-- DOCTORS ADDRESSED
PATIENTS BY THEIR FIRST NAMES, OCCASIONALLY SPOKE
TO HUSBANDS AS IF THEIR WIVES WERE NOT IN THE
ROOM, AND RARELY TOOK THE TIME TO EXPLAIN
MEDICAL PROCEDURES—WERE EXPERIENCED BY MANY
 7
FEMALE PATIENTS AS CONDESCENDING AND
PATERNALISTIC.6 YOUNG WOMEN SOUGHT MORE
KNOWLEDGE AND CONTROL, NOT JUST OVER THEIR
SEXUALITY, BUT OVER OTHER STAGES OF THE FEMALE
LIFE COURSE: PREGNANCY, CHILDBIRTH,
BREASTFEEDING, BIRTH CONTROL, ABORTION, AND
MENOPAUSE.7
THIS WOMEN’S HEALTH MOVEMENT BLAMED THE
RESISTANCE OF DOCTORS TO SHARED MEDICAL
KNOWLEDGE ON MALE SUPREMACY AND LOOKED TO
HISTORY TO EXPLAIN HOW KNOWLEDGE OF THE BODY
BECAME INCREASINGLY THE PURVIEW OF POWERFUL
PROFESSIONALS. WHILE THEY DENOUNCED
CONVENTIONAL DOCTOR-PATIENT RELATIONSHIPS,
THEIR FAULTFINDING CONVERGED WITH TWO OTHER
NON-FEMINIST CRUSADES THAT ALSO CRITICIZED
PHYSICIANS’ TREATMENT OF WOMEN. THE FIRST, THE
NATURAL CHILDBIRTH MOVEMENT, ARGUED THAT
PARTURITION WAS OVER-MEDICALIZED. THE SECOND,
LA LECHE LEAGUE, BEGAN AS AN ORGANIZATION OF
CATHOLIC MOTHERS WHO CHALLENGED “MODERN
TECHNOLOGICAL MEDICINE” ON BEHALF OF WOMEN
 8
8
WHO WISHED TO BREAST FEED THEIR BABIES.
TOGETHER, THESE SEVERAL STRANDS OF WOMEN’S
RANK AND FILE ACTIVISM SUCCESSFULLY RESISTED THE
HEGEMONY OF THE MEDICAL PROFESSION OVER
CRUCIAL LIFE CYCLE EVENTS, AND EVENTUALLY
BROUGHT ABOUT DRAMATIC SHIFTS IN WOMEN’S
HEALTH CARE AND SELF KNOWLEDGE. THEY NOT ONLY
INFLUENCED THE KINDS OF QUESTIONS WOMEN’S
HISTORIANS WOULD BEGIN TO ASK ABOUT THE PAST,
BUT UTILIZED INTELLECTUAL CHANGES OCCURRING IN
WOMEN’S HISTORY TO ALTER THE DAILY TASK OF
DOCTORING FOR ALL PATIENTS, EVEN MEN.
FINDING THE WOMEN
NOW, LET ME SAY SOMETHING ABOUT THE
DEVELOPMENT OF WOMEN’S HISTORY AND THE
DISCOVERY THAT WOMEN PHYSICIANS ENTERED THE
MEDICAL PROFESSION IN SIGNIFICANT NUMBERS THE
MID-19TH CENTURY, NOT THE 20TH. WE UNDERSTOOD FROM
THE OUTSET THAT ASSESSMENTS OF WOMEN’S
HISTORICAL SIGNIFICANCE WOULD REQUIRE NEW
MODELS OF CONCEPTUAL ANALYSIS THAT DID NOT
REPRODUCE THE DEFAULT QUESTIONS SCHOLARS USED
 9
9
TO ASK ABOUT MEN. TAKING WOMEN SERIOUSLY
MEANT RETHINKING WHAT KIND OF EVIDENCE WAS
DEEMED IMPORTANT AND HIGHLIGHTING DOMESTIC
SPACES—THE FAMILY, THE BEDROOM, THE NURSERY—.
IN FOCUSING ON PRIVATE LIFE AND THE FAMILY,
WOMEN’S HISTORIANS TURNED FIRST TO THE 19TH
CENTURY. THEY HELPED TO SHOW THAT THE
EMERGENCE OF INDUSTRIAL CAPITALISM IN THAT
PERIOD CATALYZED NEW NOTIONS OF FAMILY LIFE AND
REORDERED PUBLIC AND PRIVATE SPACE.10 THE
“DOMESTIC FAMILY”—THE MODEL OF MIDDLE CLASS
FAMILY LIFE THAT AROSE-- EXAGGERATED SEXUAL
DIFFERENCES AND INSCRIBED THEM ON THE BODY IN
NEW WAYS. PHYSICIANS AND MEDICAL SCIENTISTS
PARTICIPATED IN THIS CRUCIAL SHIFT BY RETHINKING
PRIOR UNDERSTANDINGS OF “NATURE” AND
AUTHORIZING THIS NEW KNOWLEDGE ABOUT MALE AND
FEMALE BODIES IN THE NAME OF SCIENCE. PREMODERN
SCIENCE HAD ASSUMED THAT MEN’S AND WOMEN’S
BODIES WERE SIMILAR, WITH MEN’S GENITALIA
PROTRUDING OUTSIDE THE BODY WHILE WOMEN’S WERE
HIDDEN WITHIN. THIS ONE BODY MODEL GRADUALLY
 10
GAVE WAY TO A RADICAL DIMORPHISM IN WHICH
MALE AND FEMALE BODIES WERE VIEWED AS
INCOMMENSURATE.
MEDICAL TREATISES SUPPORTING THE NOVEL
THEORIES OF DIFFERENCE GENERALLY FOCUSED
ATTENTION ON THE PECULIARITIES OF THEFEMALE
BODY.11 KEY PHYSIOLOGICAL CRISES OF THE FEMALE
LIFE CYCLE WERE DESCRIBED IN FLORID PROSE,
EMPHASIZING THE MORBIDITY OF MENSTRUATION,
CHILDBIRTH AND MENOPAUSE, AND DETAILING
WOMEN’S INCAPACITATING DISCOMFORT,
VULNERABILITY TO DEPRESSION, IRRATIONALITY, AND
MOOD SWINGS. “MANY A YOUNG LIFE IS BATTERED AND
FOREVER CRIPPLED IN THE BREAKERS OF PUBERTY;”
OBSERVED ONE OFT-QUOTED TEXT. “IF IT CROSSES
THESE UNHARMED AND IS NOT DASHED TO PIECES ON
THE ROCK OF CHILDBIRTH, IT MAY STILL GROUND ON
THE EVER-RECURRING SHADOWS OF MENSTRUATION,
AND LASTLY, UPON THE FINAL BAR OF THE MENOPAUSE
ERE PROTECTION IS FOUND IN THE UNRUFFLED
WATERS OF THE HARBOR BEYOND THE REACH OF
SEXUAL STORMS.”12 NOTING THE FRAILTY OF WOMEN’S
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NERVOUS SYSTEMS, DOCTORS ADVISED THEM TO
EMBRACE DOMESTICITY AND REFRAIN FROM HIGHER
EDUCATION AND OTHER ACTIVITIES TOO CLOSELY
ASSOCIATED WITH THE MALE SPHERE, THEREBY
SANCTIONING NEW CULTURAL UNDERSTANDINGS OF
THE STARK DIVERGENCE BETWEEN PUBLIC AND PRIVATE
LIFE .13
SCIENTIFIC “TRUTHS” THAT LEGITIMATED
DIFFERENCE GAVE RISE TO A REIGNING IDEOLOGY –THE
IDEOLOGY OF DOMESTICITY—THAT SHAPED
INSTITUTIONS AND SOCIAL RELATIONS. NEWLY-
CONSTRUCTED VICTORIAN IMAGES OF WOMEN AS
MORALLY SUPERIOR, NURTURING, NATURALLY
MATERNAL, HOME-LOVING, AND SEXUALLY AND
SOCIALLY VIRTUOUS SERVED TO PRESERVE
TRADITIONAL COMMUNALLY-ORIENTED MORAL VALUES
IN THE WAKE OF THE MASSIVE DISRUPTIONS OF AN
INDUSTRIALIZING ECONOMY. THESE IMAGES OF
FEMININITY CONTRASTED STARKLY WITH
REPRESENTATIONS OF MEN AS INNATELY COMPETITIVE,
AGGRESSIVE, AMBITIOUS, AND MORALLY SUSPECT--
CHARACTER TRAITS ACTUALLY CELEBRATED IN MID-19TH
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CENTURY, THE DOG-EAT-DOG, CAPITALIST WORLD.
ONLY 50 YEARS EARLIER, TRADITIONAL
ENLIGHTENMENT THINKING HAD CONSIDERED
VIRTUE A MASCULINE TRAIT. DISCUSSING THE
OBLIGATIONS OF CITIZENSHIP, THE FOUNDING FATHERS
HAD EMPHASIZED THE IMPORTANCE OF MEN’S
DISINTERESTEDNESS, CIVIC BENEVOLENCE, SELF-
SACRIFICE FOR THE COMMON GOOD. THESE QUALITIES
WERE DEEMED ESSENTIAL TO THE SUCCESSFUL
STEWARDSHIP OF SOCIETY AND POLITICS.
BY 1850, HOWEVER, THE CULTURAL MEANINGS OF
VIRTUE HAD CHANGED. NO LONGER ASSOCIATED WITH
MEN IN THE PUBLIC SPHERE, VIRTUE WAS INSTEAD
LINKED WITH IDEALIZED FEMALE ATTRIBUTES AND
PRESUMABLY FOUND WITHIN THE PRIVATE REALM OF
THE FAMILY. THESE NEW PRESUPPOSITIONS ABOUT
FEMALE VIRTUE, WHICH LINKED ETHICAL AND
EMPATHIC BEHAVIOR TO WOMEN THROUGH THEIR REAL
OR POTENTIAL MOTHERHOOD, IMAGINED THEM AS
IMMUNE TO THE SELF-INTEREST AND COMPETITION
DEEMED INTEGRAL TO VICTORIAN NOTIONS OF
ECONOMIC SUCCESS. THEIR SUPERIOR MORALITY, IN
 13
FACT, COMMITTED THEM TO PROTECTING THE FAMILY
FROM THE IMMORAL DICTATES OF “THE MARKET.” THIS
“IDEOLOGY” OF FAMILY LIFE SO DOMINATED THE
VICTORIAN IMAGINARY THAT A MAJORITY ASPIRED TO
IT, INCLUDING FREE BLACKS AND WORKING CLASS
WHITES. AND, IN SPITE OF CERTAIN MODERNIZATIONS
AND MODIFICATIONS, THE DOMESTIC FAMILY ENDURES
EVEN TODAY AS A STRIKINGLY POTENT SET OF CORE
ASSUMPTIONS, DESPITE THE INABILITY OF VAST
NUMBERS OF TWO-PARENT BREADWINNER AMERICAN
FAMILIES TO LIVE BY ITS DICTATES.
IRONICALLY, THESE SHIFTING BOUNDARIES
BETWEEN PUBLIC AND PRIVATE BEGAN TO ERODE
ALMOST AS SOON AS THEY COULD BE CONSTRUCTED.
DOMESTICITY WAS AN IDEOLOGICAL CONSTRUCT AND A
SET OF CULTURAL ASPIRATIONS, BUTTRESSED BY
MEDICAL THEORY, BUT NEVER A DESCRIPTION OF
REALITY. THE ASSUMED DIFFERENCE BETWEEN THE
SEXES PERFORMED CRUCIAL IDEOLOGICAL WORK THAT,
IT WAS HOPED, WOULD INSURE
SOCIAL STABILITY. IT ORDERED HIERARCHIES AND
SOCIAL ROLES. BUT WORKING CLASS WIVES AND
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FAMILIES OF COLOR COULD NOT EASILY ADHERE TO
THEM. EVEN WOMEN OF THE EDUCATED MIDDLE CLASS
UTILIZED THEIR OWN UNDERSTANDINGS OF FEMALE
DIFFERENCE TO JUSTIFY THEIR ENTRANCE INTO THE
PUBLIC SPHERE. IN ORDER TO PROTECT THE FAMILY,
THEY ARGUED, WOMEN NEEDED TO PERFORM A WIDE
RANGE OF SOCIAL TASKS THAT HISTORIANS HAVE
SUBSEQUENTLY CALLED “QUASI-POLITICAL.”
HERE ENTERED THE WOMAN PHYSICIAN. IN MY OWN
WORK, I FOUND THAT WOMEN DOCTORS WERE
ENERGETIC CULTURE BUILDERS AND ACTIVELY TOOK
PART IN THESE SOCIAL CHANGES.14 THEIR REFORMIST
STANCE WAS INITIALLY PREMISED ON AN ACCEPTANCE
OF THE NOTION OF FEMALE DIFFERENCE. HOWEVER,
EVEN AS EARLY WOMEN PHYSICIANS UTILIZED
VICTORIAN SEPARATE-SPHERE IDEOLOGY TO CLAIM
THAT THEY COULD OCCUPY “POSITIONS IN MEDICINE
THAT MEN CANNOT FULLY OCCUPY,” AND EXERCISE “AN
INFLUENCE WHICH MEN CANNOT WIELD AT ALL,” THEY
BRIDGED THOSE SPHERES BY BECOMING WHAT THEY
CALLED A “CONNECTING LINK” BETWEEN SCIENCE AND
THE EVERYDAY LIFE OF THE FAMILY.15
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THE IDEA OF EDUCATING WOMEN IN MEDICINE
ACTUALLY EMERGED OUT OF A PRE-CIVIL WAR MIDDLE
CLASS PREOCCUPATION WITH HEALTH AND FITNESS
THAT ACCOMPANIED THE CHANGES IN FAMILY LIFE AND
SOCIAL RELATIONS UNDER EARLY CAPITALISM.
WOMEN’S RESPONSIBILITY FOR FAMILY HEALTH BECAME
A SIGNIFICANT PART OF THEIR NEWLY RECONSTITUTED
DOMESTIC ROLES.16 THE STORY OF WOMEN’S HEALTH
REFORM ENCOMPASSED LAY ACTIVISM IN THE FORM OF
LECTURING, WRITING, AND SEEKING OUT ALTERNATIVE
FORMS OF MEDICAL PRACTICE. MOTHERS WERE
ENCOURAGED TO MASTER SCIENTIFIC KNOWLEDGE
ABOUT THE BODY, ANATOMY, HEALTH, AND DISEASE.
EVENTUALLY FEMALE HEALTH REFORMERS WOULD
CLAIM THEIR RIGHT TO ATTEND MEDICAL SCHOOL.
WHEN MEN’S INSTITUTIONS PROVED SLOW TO ADMIT
THEM, THEY FOUNDED THEIR OWN MEDICAL COLLEGES.
AND, BECAUSE WOMEN PHYSICIANS WERE SERIOUS
REFORMERS, SEVERAL OF THESE SCHOOLS ADMITTED
BLACK WOMEN AND TRAINED WOMEN TO TREAT THE
POOR.17 BY 1880, ROUGHLY 200 WOMEN HAD RECEIVED
MEDICAL DEGREES, AND ONLY 20 YEARS LATER THEY
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NUMBERED A LITTLE UNDER 5% OF THE PROFESSION
UNTIL THE EARLY 1950’S. HOW WOMEN DOCTORS
MANAGED THE PERSONAL, PROFESSIONAL, AND SOCIAL
CONFLICTS THAT AROSE OUT OF THOSE EFFORTS AND
HOW THEY CONSTANTLY PUSHED AT THE BOUNDARIES
OF SOCIETY’S NARROW CONSTRUCTION OF WOMANHOOD
HAS BEEN A MAJOR THEME OF MY OWN RESEARCH.
I’VE JUST OUTLINED VERY BRIEFLY SOME OF THE
CONTRIBUTIONS THAT WOMEN’S HISTORIANS MADE TO
RECLAIMING THE HISTORY OF WOMEN. ASSESSING
WOMEN PAST HELPED TO INSURE THAT WOMEN’S
CONTRIBUTIONS AND ACCOMPLISHMENTS WOULD NO
LONGER BE “HIDDEN FROM HISTORY.” BUT TO
UNDERSTAND HOW SCHOLARSHIP ON WOMEN CHANGED
THE HISTORY OF MEDICINE, I WANT TO TURN NOW TO AN
EXPLORATION OF HOW WE USED THE ANALYTICAL TOOL
OF “GENDER.” I WILL FIRST EXPLAIN HOW THE TERM IS
UNDERSTOOD BY HISTORIANS, AND THEN GIVE SOME
EXAMPLES OF HOW GENDER ANALYSIS REVOLUTIONIZED
OUR THINKING ABOUT THE PAST.
THE TERM “GENDER” IS NOW COMMONLY USED AS A
SYNONYM FOR THE WORD “SEX.” “WHAT GENDER IS
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YOUR BABY?” FOR EXAMPLE THAT IS UNFORTUNATE,
BECAUSE WE’VE LOST A USEFUL LINGUISTIC TOOL.
“GENDER” WAS FIRST USED BY PSYCHIATRISTS IN THE
1960’S TO DISTINGUISH THE BIOLOGICALLY SEXED BODY
FROM SOCIALLY ASCRIBED BEHAVIORS THAT WERE
CATEGORIZED AS “MASCULINE” AND “FEMININE.”18
FEMINIST SCHOLARS IN THE 1970’S BEGAN TO SHOW
THAT “GENDER” WAS A SIGNIFICANT FEATURE OF ALL
CULTURAL AND SOCIAL SYSTEMS, AND THAT THE
SPECIFIC GENDER CHARACTERISTICS OF MASCULINITY
AND FEMININITY DIFFERED ACROSS TIME AND
CULTURES. HISTORIANS BEGAN TO FOCUS ON HOW
GENDER ASSUMPTIONS MANIFESTED THEMSELVES IN
THE ORGANIZATION OF INSTITUTIONS, PUBLIC AND
PRIVATE PRACTICES, POLITICS, INTELLECTUAL AND
ARTISTIC EXPRESSION, AND MORAL VALUES.19 HERE THE
CONTRIBUTIONS OF THE INTERDISCIPLINARY FIELD OF
GENDER AND SCIENCE STUDIES WAS CRUCIAL IN
CHALLENGING SOME OF THE 20TH CENTURY’S MOST
BASIC INTELLECTUAL SUPPOSITIONS—IN PARTICULAR,
POST-ENLIGHTENMENT CONCEPTS OF OBJECTIVITY AND
THE IDENTIFICATION OF RATIONALITY WITH THE MALE
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INTELLECT. THEY DID THIS BY DEMONSTRATING IN A
VARIETY OF HISTORICAL CONTEXTS, HOW PROFOUNDLY
THE NOTION OF OBJECTIVITY WAS GENDERED MALE
AND HOW SUCH THINKING WAS USED, SOMETIMES
CONSCIOUSLY AND SOMETIMES INADVERTENTLY, TO
SUSTAIN THE TRUTH-CLAIMS OF SCIENCE.20 MOUNTING
CRITICAL PERSPECTIVES FROM THE SOCIAL, BIOLOGICAL,
AND PHYSICAL SCIENCES, RESEARCHERS INVESTIGATED
THE EMERGENCE OF SCIENTIFIC IDEAS AND
INSTITUTIONS OVER TIME, CROSS-EXAMINING THE
HISTORICAL RECORD TO LEARN HOW NOTIONS OF
MALE/FEMALE DIFFERENCES SHAPED SCIENTIFIC
KNOWLEDGE AND VICE VERSA.
THEY FOUND ENLIGHTENMENT SCIENCE TO BE
RIDDLED WITH MASCULINE VALUES THAT
AUTHORITATIVELY REINSCRIBED LONG-HELD
RELIGIOUS AND PRE-MODERN UNDERSTANDINGS OF SEX
DIFFERENCES. CASE STUDIES THAT DEMONSTRATED
SCIENCE’S EMBEDDEDNESS IN CULTURAL AND
POLITICAL PRACTICE LED FEMINIST SCHOLARS TO
ADVANCE NEW MODES OF THINKING, NEW RESEARCH
PROTOCOLS, AND CONTROVERSIAL UNDERSTANDINGS OF
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THE DECIDEDLY UNOBJECTIVE AFFILIATION BETWEEN
THE SCIENTIST AND THE OBJECT OF HIS/HER
INVESTIGATION.
THEY ARGUED THAT GENDERED FOUNDATIONALIST
ASSUMPTIONS ABOUT THE BODY—ESPECIALLY
CHARACTERIZING “MIND” AS MALE, THE “BODY” AS
FEMALE---STRUCTURED POWER RELATIONSHIPS OF
VARIOUS KINDS. LOOKING AT THE PROCESS OF
PROFESSIONALIZATION, THEY CHARTED HOW THESE
PRESUMPTIONS CONSTITUTED SOCIAL RELATIONS
WITHIN THE MEDICAL AND SCIENTIFIC WORLD FROM THE
18TH CENTURY ON. UTILIZING THESE INSIGHTS, WOMEN’S
HISTORIANS MOVED RAPIDLY BEYOND A FOCUS ON THE
VARIED AND COMPLEX LANDSCAPE OF WOMEN’S
EXPERIENCE TO THE MORE CHALLENGING TASK OF
MAKING GENDER INTELLIGIBLE AS A CULTURAL SYSTEM
OF REPRESENTATION, ONE THAT GAVE MEANING NOT
ONLY TO BIOLOGY, BUT ACTUALLY STRUCTURED
SOCIETY IN ALL ITS COMPLEX MANIFESTATIONS
THROUGH SEXUAL DIFFERENCE.
MY OWN WORK ON WOMEN PHYSICIANS USED
GENDER ANALYSIS IN VARIOUS WAYS. THOUGH
 20
WOMEN PHYSICIANS DID NOT INVENT THE IDEOLOGY
OF SEPARATE SPHERES, THEY HELPED TO SHAPE IT,
AND USED IT TO ACHIEVE THEIR OWN ENDS.
FOR EXAMPLE, 19TH CENTURY WOMEN PHYSICIANS
OFTEN BELIEVED THAT THEY TREATED THEIR
PATIENTS DIFFERENTLY FROM MEN, AND SOME
HISTORIANS TOOK THEIR STATEMENTS AT FACE
VALUE. WERE THEY RIGHT TO DO SO? MY OWN
RESEARCH FOUND THAT DIFFERENCES IN THE
MECHANICS OF OBSTETRICAL PRACTICE—THE USE
OF FORCEPS AND HEROIC DRUGS-- WERE
NEGLIGIBLE. BUT I DID DISCOVER SUBTLE, BUT
MEANINGFUL VARIATIONS IN PHYSICIAN-PATIENT
INTERACTION THAT MAY HAVE MADE THE
EXPERIENCE OF BEING TREATED BY A WOMAN
DOCTOR A MORE POSITIVE ONE FOR THE PATIENT.
(TIME STUDIES SUGGEST THESE DIFFERENCES STILL
EXIST TODAY) WOMEN DOCTORS MADE ROUNDS
MORE OFTEN THAN THE MEN, AND PRESCRIBED
MILD, SUPPORTIVE THERAPIES. THEY CONCERNED
THEMSELVES WITH THEIR PATIENTS’ SOCIAL
SITUATIONS. MANY AN UNMARRIED MOTHER WAS
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SETTLED IN A JOB AFTER SHE LEFT THE HOSPITAL,
AND COUNTLESS POOR PATIENTS WERE KEPT LONG
AFTER THEIR RECOVERY UNTIL PROPER HOUSING
COULD BE FOUND FOR THEM. BY THE PROGRESSIVE
ERA, THEIR VISION OF THEMSELVES AS ATTENTIVE
TO THE WHOLE PATIENT TRANSLATED ITSELF INTO A
STRONGER FOCUS ON PREVENTIVE MEDICINE AND
ENTHUSIASTIC PARTICIPATION IN PUBLIC HEALTH
POLICY. YET WOMEN PHYSICIANS’ CLAIMS THAT
THEY WERE LESS INTERVENTIONIST
THERAPEUTICALLY WAS A MISPERCEPTION,
INFLUENCED BY THE PREVAILING 19TH CENTURY
CULTURAL RHETORIC THAT ASSUMED THE
EXISTENCE OF SIGNIFICANT, BIOLOGICALLY BASED
SEXUAL DIFFERENCES.
ON THE OTHER HAND, WOMEN PHYSICIANS ALSO
STOOD READY TO CHALLENGE MALE COLLEAGUES’
DEFAULT ASSUMPTIONS REGARDING PREVAILING
THEORIES OF FEMALE BIOLOGY THAT GOVERNED THE
TREATMENT OF WOMEN’S HEALTH AND DISEASE. THEY
MOUNTED A CAMPAIGN TO DISCREDIT NOTIONS OF
INHERENT FEMALE FRAILTY. OFTEN, THEY GAINED THIS
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KNOWLEDGE EXPERIENTIALLY, BY PAYING ATTENTION
TO THEIR OWN BODIES AND TO THOSE OF THEIR
PATIENTS. THEY ALSO BUTTRESSED AN ALTERNATIVE
PARADIGM OF FEMALE HEALTH WITH STATISTICAL
SURVEYS AND CLINICAL CASE STUDIES, SUGGESTING
HOW WELL THEY UNDERSTOOD THE ABSOLUTE
NECESSITY OF SPEAKING IN THE LANGUAGE OF SCIENCE.
GRADUALLY WOMEN PHYSICIANS HELPED WEAN
VICTORIAN CULTURE AWAY FROM A FOCUS ON THE
INCAPACITATING NATURE OF THE FEMALE
REPRODUCTIVE SYSTEM, SOFTENING IF NOT DISLODGING
THE SOCIAL IMPLICATIONS OF THE RADICAL
DIMORPHISM EMBEDDED IN 19TH CENTURY
UNDERSTANDINGS OF SEX DIFFERENCES.

THERE ARE SOME INTERESTING IRONIES TO BE

NOTED HERE. U.S. WOMEN PHYSICIANS CARVED OUT A
PLACE FOR THEMSELVES IN THE LAST THIRD OF THE 19TH
CENTURY AT A TIME WHEN ORTHODOX MEDICINE WAS IN
CRISIS BECAUSE THE INTELLECTUAL UNDERPINNINGS OF
HEROIC TREATMENT WERE BEING UNDERMINED.
MEDICAL AUTHORITY HAD BEEN SHAPED BY A
TRADITIONAL SYSTEM OF BELIEF. THERAPY AT MID-
 23
CENTURY LACKED A CONCEPT OF SPECIFIC ETIOLOGY,
IT WAS DESIGNED TO TREAT THE WHOLE PATIENT, AND
TOOK PLACE IN THE HOME. UNABLE TO CURE MOST
DISEASES, MALE PROFESSIONAL IDENTITY AT MID-
CENTURY EMPHASIZED THE SACRED NATURE OF TIES
WITH PATIENTS. RITUALIZED ENACTMENTS OF
SUCCESSFUL TREATMENT TESTIFIED TO THE
CHARACTER, MORAL SENSITIVITY, AND THERAPEUTIC
ACUMEN OF THE PRACTITIONER.21 THIS PREVAILING
MODEL OF CARE PROVED QUITE VULNERABLE TO THE
ARGUMENTS OF ASPIRING WOMEN DOCTORS THAT THEIR
“NATURAL” POWERS OF EMPATHY WOULD LEAD THEM
TO PRACTICE A MILDER, MORE “SYMPATHETIC” FORM OF
CARING THAN MEN.

BUT BY THE LAST THIRD OF THE CENTURY, A

YOUNGER GENERATION OF RESEARCH ORIENTED
MEDICAL PRACTITIONERS FOUND THAT THE GERM
THEORY AND ITS PARADIGM OF EXPERIMENTAL
MEDICINE IN THE LABORATORY OFFERED A WAY OUT OF
THE DOLDRUMS OF THERAPEUTIC STAGNATION.
RESEARCHERS BEGAN TO ISOLATE PATHOGENIC
BACTERIA FOR SEVERAL EPIDEMIC DISEASES. THEY
 24
FASHIONED A NEW IDEOLOGY OF CURE, CONSISTING OF
SPECIFIC ETIOLOGY, INCREASING SPECIALIZATION
WITHIN MEDICAL PRACTICE, AND A WILLINGNESS TO
RESORT TO EVIDENCE PRODUCED IN THE LABORATORY.
WHILE OLDER PRACTITIONERS TRAINED BEFORE MID-
CENTURY CONTINUED TO EMPHASIZE THE IMPORTANCE
OF CLINICAL OBSERVATION AND INDIVIDUAL
DIFFERENCES IN TREATMENT, THOSE ENTHRALLED WITH
EXPERIMENTAL SCIENCE ADOPTED REDUCTIONIST AND
UNIVERSALISTIC CRITERIA IN DIAGNOSIS AND CURE.
INCREASINGLY, DOCTORING FOCUSED LESS ON THE
PATIENT AND MORE ON THE PHYSIOLOGICAL PROCESS
UNDER INVESTIGATION. IN ADDITION, LABORATORY
SCIENCE, ALONG WITH BACTERIOLOGY, AND SURGERY,
RAPIDLY BECAME IDENTIFIED AS A MASCULINE
FRONTIER. AS CARE MOVED INTO THE HOSPITAL, THE
PROFESSIONALIZATION OF NURSING SPEEDED UP THE
SPLITTING OFF OF CARE FROM CURE, REINFORCING THE
FIRST AS FEMININE AND THE LATTER AS MASCULINE.
NEW GENERATIONS OF WOMEN PHYSICIANS SOON
DISCOVERED THAT THE RHETORIC OF THEIR
FOREMOTHERS, WHICH EMPHASIZED WOMEN’S
 25
DIFFERENCE, WAS OUTMODED AND INEFFECTIVE AS A
JUSTIFICATION FOR WOMEN’S MEDICAL PRACTICE.
OLDER MODELS OF FEMALE PROFESSIONALISM BASED
ON DIFFERENCE WERE ABANDONED, BUT MODERN
MEDICAL PROFESSIONALIZATION WOULD CONTINUE TO
IDENTIFY THE NEW MEDICAL SCIENCE WITH MEN.
ALONG WITH STRUCTURAL, SOCIAL, AND ECONOMIC
FACTORS, THIS POWERFUL IDEATIONAL SHIFT SLOWED
THE PROGRESS OF 20TH CENTURY WOMEN PHYSICIANS.22

HAVING CITED SOME EXAMPLES OF HOW

HISTORIANS LEARNED TO THINK WITH GENDER, I WANT
TO TURN NOW TO SOME OF THE SCHOLARSHIP
ACCOMPLISHED IN THE LAST DECADE, WHICH HAS
CONTINUED TO EXPAND GENDER AND MEDICINE
HISTORIOGRAPHY IN SIGNIFICANT WAYS. AS EARLY AS
THE 1950’S, HISTORIANS HAD BEGUN TO EXPLORE THE
ROLE OF SCIENCE IN THE PRODUCTION OF RACIAL
DIFFERENCES. PROLIFERATING IN THE 1970’S AND 1980’S,
WORK ON “RACE SCIENCE” UNDERSCORED ITS CRUCIAL
ROLE IN SUSTAINING EUROPEAN AND AMERICAN
IMPERIALISMS, LEGITIMATING AMERICAN SLAVERY, AND
AUTHORIZING EUGENICAL THEORIES THAT BUTTRESSED
 26
THE SYSTEMATIC DISCRIMINATORY REGIMES THAT
TOOK PLACE AFTER EMANCIPATION. AT FIRST, WORK
ON RACE AND WORK ON GENDER RAN ON PARALLEL
TRACKS, BUT IN THE LAST DECADE, RACE AND GENDER
ANALYSIS HAVE CONVERGED. WE HAVE LEARNED HOW
AND WHY AN IDEOLOGY OF RACIAL DIFFERENCE WAS
PRODUCED PRIMARILY THROUGH SCIENTIFIC
REPRESENTATIONS AND MEDICAL INTERVENTIONS UPON
WOMEN’S BODIES. PARTICULARLY IN EFFORTS TO
CONTROL SEXUALITY, REPRODUCTION, AND FAMILY
LIFE, THE SCIENTIFIC CONSTRUCTION OF RACIAL
DIFFERENCE HAS ALWAYS CONTRASTED THE BODIES OF
DOMESTICIZED, RESPECTABLY “PURE” WHITE WOMEN
WITH THE ALLEGEDLY “TROPICAL,” PRIMITIVE,
DISEASED, OVERSEXED, AND COLONIZED BODIES OF
WOMEN OF COLOR. MEDICAL DISCOURSE—DEVELOPED
PRIMARILY BY TROPICAL MEDICINE, EUGENICS,
GENETICS, PSYCHIATRY AND PSYCHOLOGY HAS
PROVIDED MUCH OF THE AUTHORITATIVE LANGUAGE
USED TO UNDERSCORE THESE DISTINCTIONS.23
ON THE OTHER HAND, NEW SCHOLARSHIP ON THE
MEDICAL CULTURE OF THE ANTE-BELLUM PLANTATION
 27
SOUTH, ILLUMINATES THE DEGREE TO WHICH MEDICAL
PRACTICE WAS LODGED IN THE SOCIAL RELATIONS OF
SLAVERY ON THE GROUND, RATHER THAN IN THE
DICTATES OF PROFESSIONALISM OR THE IMPERATIVES OF
WESTERN MEDICAL SCIENCE. SCIENCE IN THIS REGION
SERVED A PROSLAVERY IDEOLOGY THROUGH ITS
CONTRIBUTIONS TO “KNOWLEDGE” ABOUT BLACK
INFERIORITY. BUT IRONICALLY, IN TERMS OF HOW
MEDICAL CARE WAS ORGANIZED ON SOUTHERN
PLANTATIONS, CARING AND CURING WAS PERFORMED
ON BOTH SIDES—BY SLAVEOWNERS AND THEIR
CONTRACTED PHYSICIANS, AND BY SLAVES. JUST AS THE
19TH CENTURY NORTH ENDURED COMPETING MEDICAL
SYSTEMS AND COMPETITION BETWEEN REGULAR AND
SECTARIAN PRACTITIONERS, THE SOUTHERN HEALING
REGIME ENCOMPASSED AFRICAN AMERICAN DOCTORING
TRADITIONS AS WELL AS WHITE PLANTERS’ INCREASING
COMMITMENT TO WESTERN MEDICAL “SCIENCE.”
MOREOVER, SEX/GENDER SYSTEMS PLAYED A KEY ROLE
IN THIS COMPLEX HEALING REGIME. BONDSWOMEN, AS
MOTHERS, LABORERS AND HEALERS, DREW FROM A
WIDE RANGE OF AFRICAN TRADITION AND COMPETED
 28
WITH WHITE PHYSICIANS FOR THE PRIVILEGES OF
MEDICAL AUTHORITY, DECENTERING THE ROLE OF
DOCTORS.
IN ADDITION TO WORK ON RACE, SCHOLARSHIP ON THE
HISTORY OF THE BODY HAS HELPED DISRUPT MANY OF
OUR CULTURE’S COMMON-SENSE ASSUMPTIONS. THE
NOTION THAT THE BODY HAS A HISTORY MIGHT WELL
RAISE SOME EYEBROWS IN THIS ROOM. ALTHOUGH WE
MAY AGREE THAT GENDER IS A CULTURAL CONSTRUCT
THAT DIFFERS FROM SOCIETY TO SOCIETY, MANY OF US
RESIST SEEING THE BODY AS SOMETHING OTHER THAN A
MATERIAL, BIOLOGICAL SUBSTRATE THAT CONFORMS TO
CERTAIN UNIVERSAL PHYSIOLOGICAL LAWS. THE WORK
OF GENDER AND MEDICINE HISTORIANS IN THE LAST
DECADE AND A HALF, HOWEVER, POWERFULLY
CHALLENGES THIS VIEW.
WE’VE SPOKEN ABOUT THE EMERGENCE IN EUROPEAN
SCIENCE OF A TWO BODY MODEL OF SEX DIFFERENCES
AT THE END OF THE 18TH CENTURY. OTHER STUDIES HAVE
FOUND ENORMOUS DIVERGENCES IN HOW PEOPLE HAVE
EXPERIENCED THEIR BODIES’ ROLE AND FUNCTION
ACROSS TIME. TAKEN TOGETHER, THIS WORK CALLS
 29
INTO QUESTION WHETHER OURS OR ANY OTHER
CULTURE’S KNOWN “FACTS” ABOUT THE BIOLOGICAL
BODY MUST LEAD OF NECESSITY TO ANY PARTICULAR
OR “OBVIOUS” SOCIAL THEORY REGARDING
DIFFERENCES BETWEEN THE SEXES. INDEED, MANY
BIOLOGISTS WILLINGLY ADMIT THAT CURRENT
SCIENTIFIC KNOWLEDGE INDICATES THAT OUR BODIES
ARE TOO COMPLEX TO PROVIDE CLEAR-CUT ANSWERS TO
QUESTIONS ABOUT SEX DIFFERENCE. IN ADDITION, EVEN
SEX IS NOT PURELY A PHYSICAL CATEGORY. THE BODILY
SIGNALS AND FUNCTIONS WE DEFINE AS MALE AND
FEMALE ARE ALREADY DERIVED FROM PRIOR NOTIONS
ABOUT GENDER THAT WE HAVE INHERITED FROM THE
PAST. FOR EXAMPLE: WHY SHOULD THE PRESENCE OF
TESTES AND A Y CHROMOSOME IN A WOMAN WHO HAS
LIVED AND EXPERIENCED HERSELF AS A FEMALE ALL
HER LIFE BE GROUNDS FOR CALLING HER A MAN?
DOCTORS WHO MAKE SEX ASSIGNMENT DECISIONS AT
BIRTH HAVE BASED THEM SOLELY ON COMMON
CULTURAL ASSUMPTIONS ABOUT GENDER ROLES. DOES
THIS BABY HAVE THE REPRODUCTIVE APPARATUS TO
HAVE A CHILD? A CHILD BORN WITH TWO X
 30
CHROMOSOMES, OVIDUCTS, OVARIES AND A UTERUS,
BUT ALSO A PENIS AND SCROTUM ON THE OUTSIDE, IS
ASSIGNED TO BE A GIRL BECAUSE OF THE POTENTIAL TO
GIVE BIRTH. IS THIS PENIS LARGE ENOUGH TO
PENETRATE A WOMAN? IF NOT, IS IT NOT BETTER TO LOP
IT OFF?, AND SO ON.24
THE WORK OF GENDER AND MEDICINE HISTORIANS
HAVE HELPED TO SHOW THAT IMPROVING OUR
UNDERSTANDING OF ANATOMY, PHYSIOLOGY, AND
ENDOCRINOLOGY DOES NOT NECESSARILY PREVENT
MEDICAL SCIENTISTS AND PRACTITIONERS FROM
“CREATING TRUTHS” ABOUT SEXUALITY DERIVED NOT
FROM SCIENCE, BUT FROM CULTURE. IN COMPLICATED
WAYS OUR BODIES, IN TURN, INCORPORATE AND
CONFIRM THESE TRUTHS. THIS IS A RECIPROCAL
PROCESS.
YOU MIGHT ASK WHAT THESE DISTINCTLY SOCIAL
DILEMMAS HAVE TO DO WITH PHYSICIANS AND
MEDICAL SCIENTISTS? I SUPPOSE THE FIRST THING TO
SAY IS THAT DOCTORS MAY WISH TO APPROACH
CURRENT SCIENTIFIC “TRUTHS” WITH A LARGE DOSE OF
HUMILITY. WORDS SUCH AS “NORMATIVE” AND
 31
“TRANSGRESSIVE” ARE ALWAYS HISTORICALLY AND
CULTURALLY RELATIVE. THEY ARE PARTICULARLY
UNSTABLE IN OUR CURRENT SOCIETY, AND THE FACT
THAT THEY ARE INVOKED CONSTANTLY IN
CONJUNCTION WITH THE HIGHLY CHARGED NOTION OF
“MORAL VALUES” IS A SURE SIGN OF THE HARDENING
OF IDEOLOGICAL POSITIONS THAT ARE DEEPLY
THREATENED BY THE UNCERTAINTY THAT HAS
ACCOMPANIED SCHOLARSHIP IN MEDICAL HISTORY,
ESPECIALLY IN ITS UTILIZATION OF GENDER, RACE, AND
CLASS AS CATEGORIES OF HISTORICAL ANALYSIS.
SECOND, THE LITERATURE ON GENDER AND MEDICINE,
FROM HISTORICAL ACCOUNTS OF SOUTHERN
PLANTATION MEDICAL SYSTEMS, TO THE HISTORY OF
GYNECOLOGICAL SURGERY, STUDIES OF CARING,
ACCOUNTS OF THE DEVELOPMENT OF TREATMENTS FOR
BREAST CANCER, RECENT WORK ON DOCTORS’
“DISCOVERY” OF AND SUBSEQUENT SCIENTIFIC
CLASSIFICATION OF “HERMAPHRODITISM” AND
“HOMOSEXUALITY” AS DEVIANT, TO THE LATEST
HISTORICAL SCHOLARSHIP ON TRANSSEXUALITY-- ALL
REMIND US THAT WESTERN MEDICINE IS ONLY ONE KIND
 32
OF MEDICAL SYSTEM. EVEN WITHIN THAT SYSTEM,
MEDICAL OUTSIDERS—PATIENTS, MEDICAL CONSUMERS,
LAY CARETAKERS, SLAVES, AND RACIALLY AND/OR
SEXUALLY MARGINALIZED PRACTITIONERS--
CONTRIBUTED TO THE MEDICAL PARADIGM AND TO THE
CIRCULATION OF SPECIFIC NOTIONS OF BODY AND SELF
IN NON-SCIENTIFIC TEXTS.
INDEED, CURRENT WORK ON THE HISTORY OF THE
BODY WARNS US TO BEWARE OF ENFORCING IN THE
SOCIAL REALM THE RIGID DIMORPHISM EMBEDDED IN
OUR CULTURALLY PREVAILING, TWO-BODY MODEL OF
SEX DIFFERENCES. HOW TO BETTER CONCEPTUALIZE THE
BIOLOGICAL SIGNIFICANCE OF SEX AND RACE
DIFFERENCES, HOWEVER, IS CRUCIALLY IMPORTANT TO
MEDICAL RESEARCHERS AS WELL AS PATIENTS.
HISTORICAL WORK ON THE TREATMENT OF FEMALE
DISEASES AND, MORE RECENTLY, THE MEDICAL
TREATMENT OF PERSONS OF COLOR, HAS RAISED A
NUMBER OF CAVEATS THAT WOULD GREATLY BENEFIT
FROM THOUGHTFUL EXCHANGES AMONG MEDICAL
SCIENTISTS, FEMINISTS, AND RACIAL CULTURAL
THEORISTS. IRONICALLY, WHILE THE 19TH CENTURY
 33
FEMALE BODY WAS REPRESENTED AS DISEASED AND
SICKLY, THE COMMITMENT OF 20TH-CENTURY MEDICAL
RESEARCHERS TO “VALUE FREE” AND “OBJECTIVE”
INVESTIGATION HAS RESULTED IN THE NEGLECT OF
FEMALE MORBIDITY AND MORTALITY ALTOGETHER,
WHICH IS ONLY NOW BEING CORRECTED. THE FEMALE
BODY HAS BEEN A CASUALTY OF SCIENCE’S NEED TO
STRIP AWAY DIFFERENCES AND FIND COMMON
ELEMENTS THAT COULD ALLOW SUCCESSIVE CASES TO
BE BOUND TOGETHER WITHOUT COMPLICATED
CONTAMINANTS LIKE THE FEMALE REPRODUCTIVE
SYSTEM. THIS DICTATED A WOEFUL NEGLECT OF HOW
DISEASE MANIFESTS ITSELF IN WOMEN AND BLACKS.
UNTIL RECENTLY, FOR EXAMPLE, BASIC SCIENCE
AND CLINICAL TRIALS ON HEART DISEASE USED ONLY
MEN, BECAUSE FROM THE 1950’S ON, CULTURAL WISDOM
EMPHASIZED THAT HEART DISEASE PRESENTED
PRIMARILY IN MALES, DESPITE THE FACT THAT IT HAS
BEEN THE LEADING CAUSE OF DEATH IN OLDER WOMEN
FOR SOME TIME, WITH BLACK WOMEN MORE LIKELY TO
DIE OF IT THAN WHITE WOMEN. SIMILARLY, THOUGH
AIDS HAS INCREASED MORE RAPIDLY IN HETEROSEXUAL
 34
WOMEN THAN IN ANY OTHER GROUP IN THE U.S. SINCE
THE LATE 1980’S, THE CDC WAS SLOW TO ENACT A CASE
DEFINITION OF THE DISEASE THAT INCLUDED
GYNECOLOGICAL AND OTHER SYMPTOMS PECULIAR TO
WOMEN. INDICATIONS COMMONLY PRESENTING IN
WOMEN WERE VALIDATED ONLY IN 1993, TWO DECADES
AFTER AIDS WAS DISCOVERED AND IN SPITE OF THE
KNOWLEDGE THAT IT HAD BEEN FOR AT LEAST THAT
LONG THE LEADING CAUSE OF DEATH FOR WOMEN IN
SUB-SAHARAN AFRICA (A FACT INDICATING HOW
GENDER AND RACE BIAS WORK TOGETHER). IN THE
EARLY 1990’S, THE AVERAGE LIFE EXPECTANCY OF MEN
DIAGNOSED AS HIV POSITIVE WAS 30 MONTHS: FOR
WOMEN IT WAS ONLY 15 WEEKS.
WHAT KIND OF LESSONS DO THESE EXAMPLES HOLD
FOR MEDICAL SCIENTISTS AND PRACTITIONERS? FIRST,
THEY SUGGEST HOW NEW AND FRAGILE IS OUR ABILITY
AS A CULTURE TO UNDERSTAND EXACTLY HOW GENDER,
RACE, AND CLASS PERSPECTIVES FUNDAMENTALLY
SHAPE ECONOMIC, SOCIAL AND POLITICAL HIERARCHIES
IN OUR SOCIETY. SECOND, THEY PUSH US TO ASK HOW
SHOULD SAMENESS AND DIFFERENCE BE HANDLED? ONE
 35
LESSON MIGHT BE TO AVOID THE BINARY THINKING SO
FUNDAMENTAL TO THE 19TH AND 20TH CENTURY WORLD.
HOW IMPORTANT REALLY AS A CAUSE OF PRESENT
SOCIAL ILLS-- FROM POVERTY, HOMELESSNESS, AND
DRUG ABUSE, TO THE DECREASING RESOURCES FOR
EDUCATION, CHILD CARE, AND PREVENTIVE HEALTH-- IS
THE “DECLINE IN TRADITIONAL FAMILY VALUES”-- A SET
OF BELIEFS LINKED TO THE ENDURING LEGACY OF A 19TH
CENTURY IDEOLOGY OF SEPARATE SPHERES? OR DO
THESE COLLECTIVE SOCIAL CHALLENGES DERIVE,
RATHER, FROM OUR INABILITY TO THINK OURSELVES
OUT OF A SET OF ASSUMPTIONS ABOUT GENDER AND
RACE THAT MYSTIFY RATHER THAN CLARIFY CURRENT
DILEMMAS? TO THE DEGREE THAT SUCH WORK
REQUIRES NEW UNDERSTANDINGS OF BIOLOGY AND
MEDICAL SCIENCE, DOCTORS WILL BE IMPLICATED,
WHETHER THEY CONSCIOUSLY CHOOSE TO BE OR NOT.
FOR THIS REASON, I WANT TO UNDERSCORE THE VALUE
OF HISTORICAL PERSPECTIVES TO MEDICAL
PRACTICE. IF GENDER HISTORY HAS HELPED TO PROVE
ANYTHING, IT IS THAT SEXUALITY AND RACE ARE
POWERFUL AND
 36
DYNAMIC SOCIAL CONSTRUCTIONS, AND THAT
BIOLOGY AS IT EMERGED IN THE 19TH- CENTURY HAS
BEEN INEXTRICABLY BOUND UP WITH POLICING THE
BOUNDARIES OF SEXUAL, RACIAL AND NATIONAL
POLITICS. HISTORICAL SCHOLARSHIP ON GENDER AND
MEDICINE CAN OFFER INSIGHTS INTO HOW MEDICAL
SCIENCE MIGHT CONTRIBUTE TO EFFECTIVE SOCIAL AND
POLITICAL CHANGE, BY LEADING THE WAY TO A
REALIZATION THAT A TRULY EQUALITARIAN SOCIETY
IS ONE THAT IS CAPABLE OF BOTH RECOGNIZING AS
WELL AS RESPECTING DIFFERENCE.
1
That work gathered steam in the 1960’s. (See footnotes to S_R’s article and cite. Note Mary Beard, Eleanor Flexner,
attempts to recuperate past writings on women and women’s historians in the profession but this was something new.
2
Morgen, 3-15.
3
That work gathered steam in the 1960’s. (See footnotes to S_R’s article and cite. Note Mary Beard, Eleanor Flexner,
attempts to recuperate past writings on women and women’s historians in the profession but this was something new.
4
That work gathered steam in the 1960’s. (See footnotes to S_R’s article and cite. Note Mary Beard, Eleanor Flexner,
attempts to recuperate past writings on women and women’s historians in the profession but this was something new.
5
Morgen, 3-15.
6
Quote is from the Boston Women’s Health Book Collective, 1973,1. Quoted in Sandra Morgen, Into Our Own Hands: The
Women’s Health Movement in the United States, 1969-1990. New Brunswick: Rutgers University Press, 2002, 4. See also
Jule DeJager Ward, La Leche League: At the Crossroads of Medicine, Feminism, and Religion. Chapel Hill: University of
North Carolina Press, 2000, 1.
7
Morgen, 3-15.
8
Ibid.
9
Cite articles cited in CSR article and Lerner Mention Blake and Shryock too. On the broader historiographical front, even
social history, dedicated to the history of the marginalized, was not at first able to solve the dilemma of how to recuperate a
past that gave women an active voice. One might add that only a few male historians at the time tried to do so. Most social
historians privileged class relations, while some of the early work that studied women’s participation in the abolitionist,
suffrage, and moral reform movements, as important as they were in demonstrating that 19th-century women took part,
proved conceptually inadequate. This summary is taken from several of Gerda Lerner’s earliest articulations of the agenda
and goals of the new women’s history. They are collected in her first book of essays, The Majority Finds its Past: Placing
Women in History. New York: Oxford University Press, 1979. They are still worth reading. Those especially helpful to me
were “New Approaches to the Study of Women in American History,” originally published in the Journal of Social History
in 1979, “Placing Women in History: Definitions and Challenges,” which appeared in Feminist Studies in 1975, and “The
Challenge of Women’s History,” given first as a lecture in 1977.
10
Craig Calhoun’s introduction to Habermas and the Public Sphere is extremely helpful in analyzing the convergence of
scholarly questions around the development of the public and private spheres. In addition, the essays in that volume by
Nancy Fraser, Mary Ryan, and Geoff Eley demonstrate the ways in which gender was undertheorized in this early work and
how women’s history contributed to more sophisticated understandings of this crucial social transformation. See Habermas
and the Public Sphere, Cambridge, MA, MIT Press, 1994.
11
Elizabeth Fee, “The Sexual Politics of Victorian Social Anthropology,” in Clio’s Consciousness Raised, 86-102. The
modern, standardized, scientific text did not appear till the end of the 19th century, and was a new cultural genre. See Nancy
Stepan and Sander Gilman, “Appropriating the Idioms of Science: The Rejection of Scientific Racism,” in Dominick La
Capra, ed. The Bounds of Race. Ithaca: Cornell University Press, 1999, 72-103, 79.
12
From George J. Engelmann, “The American Girl To-day. The Influence of Modern Education on Functional
Development,” Transactions of the American Gynecological Society 25(1900): 9-10. Cited in Carroll Smith-Rosenberg,
“Puberty to Menopause: The Cycle of Femininity in Nineteenth-Century America,” Feminist Studies 1(Winter-Spring
1973): 58-72, 60.
13
Carroll Smith-Rosenberg, “Puberty to Menopause: The Cycle of Femininity in Nineteenth-Century America,” Feminist
Studies 1(Winter-Spring 1973): 58-72, 60. Ann Douglas Wood, “The Fashionable Diseases,” McClaren, 39.
14
“The Hysterical Woman: Sex Roles and Role Conflict in Nineteenth-Century America,” Social Research 39 (Winter
1972):652-658. See when Nazi women question came up and cite. Note your women physicians who supported
conservative constructions of women’s bodies.
15
See Elizabeth Blackwell, “On the Education of Women Physicians,” Blackwell MSS, Library of congress; Regina Markell
Morantz, “The “Connecting Link”: The Case for the Woman Doctor in 19th Century America,” in Judith Leaviett and
Ronald Numbers, eds. Sickness and Health in America: Readings in the History of Medicine and Public Health. Madison:
University of Wisconsin Press, 1978, 117-128.
16
Linda Gordon, ”Voluntary Motherhood: The Beginnings of Feminist Birth Control Ideas in the United States,” Feminist
Studies, 1(Winter-Spring 1973): 5-22; Angus McLaren,” The Early Birth Control Movement: An Example of Medical Self-
Help,” in John Woodward and David Richards, eds. Health Care and Popular Medicine in Nineteenth-Century England,
89-105. On medical self-movements see Guenter Risse, Ronald Numbers, and Judith Leavitt, Medicine Without Doctors:
Home Health Care in American History. New York: Science History Publications, 1977; Regina Markell Morantz,
“Nineteenth Century Health Reform and Women: A Program of Self-Help,” in Medicine Without Doctors,73-94; Michelle
Mitchell, Righteous Propagation: African Americans and the Politics of Racial Destiny after Reconstruction. Chapel Hill,
University of North Carolina Press, 2004. (other stuff to cite if ever publish)
17
,Regina Markell Morantz, “Making Women Modern: Middle-Class Women and Health Reform in 19th-Century America,”
Journal of Social History, 10(June 1977): 490-507.
18
Cite Meyerowitz and Fausto-Sterling Sexing the Body, 3 mention Money and M’s other person
19
See Gayle Rubin, “The Traffic in Women: Notes on the Political Economy of Sex,” in Rayna Rapp, ed. New York:
Monthly Review Press, 1975, 157-210, where she introduced the concept of the “sex/gender system” to feminist scholars.
20
It is perhaps difficult to overemphasize the extraordinary excitement generated by this new field or how vast was this
scholarship, produced in a relatively short period of time. In citing only the work most influential to my own thinking, the
list that follows is necessarily idiosyncratic: Ethel Tobach, ed. Genes and Gender I. New York, Gordian Press, 1978, and
Ruth Hubbard and Marian Lowe,eds., Genes and Gender II. New York: Gordian Press, 1979; Carolyn Merchant, The Death
of Nature: Women, Ecology and the Scientific Revolution. New York: Harper and Row, 1980; Carol MacCormack and
Marilyn Strathern, eds. Nature, Culture, and Gender. Cambridge: Cambridge University Press, 1980; Donna Harraway,
“Animal Sociology and a Natural Economy of the Body Politic, Part I: A Political Physiology of Dominance,” and “Part II:
The Past is the Contested Zone,“ Signs 4(Autumn 1978): 21-36, 37-60; Evelyn Fox Keller, “Feminism and Science,” Signs
7(Spring 1982):589-602; Hilary Rose, “Hand, Brain, and Heart: A Feminist Epistemology for the Natural Sciences,” Signs
9(Autumn, 1983):73-89. In addition to these just cited, Signs published a number of important articles in gender and science
studies in this decade, including essays by Susan Bordo, Stephanie A. Shields, Inez Smith Reid (on gender and race), and
Sandra Harding, and others that were eventually collected in a very helpful volume (with a bibliography at the back) edited
by Sandra Harding and Jean F. O’Barr and published under the title Sex and Scientific Inquiry. Chicago: University of
Chicago Press, 1987. See also Carol MacMillan, Women, Reason, and Nature. Princeton, N.J., Princeton University Press,
1982. See also Marion Lowe and Ruth Hubbard, Woman’s Nature. Oxford: Pergamon Press, 1983; Ruth Bleier, Science &
Gender: A Critique of Biology and its Theories on Women. Oxford: Pergamon Press, 1984; Genevieve Lloyd, The Man of
Reason: “Male” and “Female” in Western Philosophy. Minneapolis: University of Minnesota Press, 1984; Susan Rubin
Suleiman, ed., The Female Body in Western Culture: Contemporary Perspectives. Cambridge, MA: Harvard University
Press, 1985, (especially the section on “Illness); Evelyn Fox Keller, Reflections on Gender and Science. New Haven: Yale
University Press, 1985; Sandra Harding, The Science Question in Feminism. Ithaca: Cornell University Press, 1986; Mary
Field Belenky, et. al. Women’s Ways of Knowing. New York: Basic Books, 1986; L. J. Jordanova, ed. Languages of
Nature: Critical Essays on Science and Literature. New Brunswick: Rutgers University Press, 1986; Ruth Bleier, ed.
Feminist Approaches to Science. Oxford: Pergamon Press, 1986; “Feminism & Science I,” and “Feminism & Science II” in
Hypatia: A Journal of Feminist Philosophy, 2(Fall 1987) and 3(Spring 1988); Emily Martin, The Woman in the Body: A
Cultural Analysis of Reproduction. Boston: Beacon Press, 1987; Pnina Abir-Am and Dorinda Outram, eds. Uneasy Careers
and Intimate Lives: Women in Science, 1789-1979. New Brunswick, N.J.: Rutgers University Press, 1987;Sue V. Rosser,
ed., Feminism Within the Science & Health Care Professions: Overcoming Resistance. Oxford: Pergamon Press, 1988;
Alison M. Jaggar and Susan R. Bordo, Gender/Body/Knowledge: Feminist Reconstructions of Being and Knowing. New
Brunswick: Rutgers University Press, 1989; Mary Jacobus, Evelyn Fox Keller, and Sally Shuttleworth, eds. Body/Politics:
Women and the Discourses of Science. New York: Routlege, 1990.
21
Charles Rosenberg, ”The Therapeutic Revolution: Medicine, Meaning and Social Change in Nineteenth-Century
America,” in Morris J. Vogel and Charles Rosenberg, eds. The Therapeutic Revolution: Essays in the Social History of
American Medicine. Philadelphia: University of Pennsylvania Press, 1979.
22
Regina Markell Morantz and Sue Zschoche, ”Professionalism, Feminism, and Gender Roles: A Comparative Study of
nineteenth-Century Medical Therapeutics,” Journal of American History 67(December 1980):568-88 In this article we
compared male and female physicians’ treatment of obstetrical patients at a male-run and a female-run Boston hospital,
finding a rough parity among all practitioners, regardless of sex. However we also found evidence that physicians’ social
attitudes were somewhat gendered and influenced their treatment as well. In the years between 1873 and 1899, male
physicians began to embrace a more modern, technocratic approach to their patients, while women physicians, believing
their own self-description as nurturing, actually did concern themselves more visibly with the non-medical needs of
patients. We called this a more traditional, holistic approach to patient care. See also a more fully developed version of this
argument in Regina Morantz-Sanchez, “Feminist Theory and Historical Practice: Rereading Elizabeth Blackwell,” History
and Theory, Bieheft 31(1992):51-69, as well as Sympathy and Science and Conduct?
23
See Alexandra Stern, Eugenic Nation: Faults and Frontiers of Better Breeding in Modern America. Berkeley: University
of California Press, 2004; Wendy Kline, Building a Better Race; Gender, Sexuality and Eugenics from the Turn of the
Century to the Baby Boom. Berkeley, University of California Press, 2002, Johanna Schoen, Choice & Coercion: Birth
Control, Sterilization, and Abortion in Public Health and Welfare, Chapel Hill: University of South Carolina Press, 2005,
and Michelle Mitchell, Righteous Propagation, above.
24
Cite Fausto-Sterling, Laqueuer, Duden