Thread by @DrAnneHanley

Today is the start of #SHW2020! Each day this week, I'll be tweeting about Britain's long, tempestuous and ever-so-slightly bonkers love–hate relationship with its #sexualhealth.

Darlings, brace yourselves. 💋 #SHW20

We begin with the Victorians, who, contrary to popular belief, were obsessed with sex. In the C19, the only known #STIs were syphilis and gonorrhoea. Diagnosis depended on observable symptoms (no blood tests/smears). Effective treatments were non-existent. Image: @ExploreWellcome

In 1864 the British government introduced the Contagious Diseases Acts, intended to protect the armed forces through 'regulation' of 'common prostitutes'. The Acts gave police almost-unlimited discretionary powers to arrest any woman they thought might be soliciting. Image: HCPP

If arrested, you were taken before a magistrate to prove you weren’t a ‘common prostitute’. You also had to submit to a genital examination (no smears/blood tests, remember) in which a male doctor (no women doctors yet) used a sort-of-sterile speculum. Image: @ExploreWellcome

William Acton, MD and hardcore advocate of the CD Acts, once boasted that he could perform 58 such examinations thoroughly 🤣 in just over an hour… #histSTM #histsex

wellcomelibrary.org/item/b21309802

If a doctor like Acton thought you might have VD, you could be sent to a Lock Hospital and forcibly treated for up to 9 months. Treatment for #syphilis was mercury. For #gonorrhoea, it was urethral irrigation. Women were also unethically experimented on. Image: @ExploreWellcome

Many working-class women were prosecuted under the CD Acts because policemen *thought* they looked suspicious. As a working-class woman, your version of events was nearly worthless. If you were poor, you were vulnerable. Image: Wiki Commons #histsex #histSTM

The Acts were eventually repealed in 1886 after heavy campaigning by The Ladies’ National Association for the Repeal of the CD Acts, led by Josephine Butler and incl. supporters like Florence #Nightingale. They were vilified for talking publicly about VD. Image: Wiki Commons

But that was only in Britain. There were numerous colonial versions of these Acts that remained in operation for many decades, the assumption being that colonised people's sexuality needed to be regulated and surveilled for the protection of the #Empire and its white colonists.

Good morning, everyone, and welcome to Day 2 of #SHW2020.

Today is all about VD, #eugenics and hereditary degeneration. Not the most cheerful of #sexualhealth histories, but definitely one of the weirdest. Image: @ExploreWellcome #histSTM #histsex #SHW20

'Eugenics' (from Greek meaning ‘well-born’) was coined in 1883 by Francis #Galton to describe the betterment of the race through scientific interventions and social controls. But if heritable traits could improve racial health, so too could they weaken it.

https://twitter.com/DrAnneHanley/status/1229014216281133058

Key among eugenicists’ preoccupations was the idea that the British race was ‘degenerating’ because ‘unfit’ people were allowed to reproduce. And a key marker of this unfitness was venereal disease. Image: @ExploreWellcome
#histSTM #histsex #SHW2020 #STIs

With the advent of bacteriology, the Victorians recognised that #gonorrhoea could be transmitted from mothers to newborns. This could cause ophthalmia neonatorum, which, if untreated, resulted in blindness. Image: @ExploreWellcome

But gonorrhoea can also cause #infertility. Today, we would talk about pelvic inflammatory disease. For the Victorians, it fed larger anxieties over population decline (esp. falling middle-class birthrates during the final decades of the C19). #histsex
nhs.uk/conditions/pel…

If gonorrhoea reduced the *quantity* of a population, then syphilis was thought to undermine its *quality*. #histSTM #histsex #sexualhealth #SHW2020

The Victorians recognised that #syphilis—termed the hereditary disease *par excellence*—was transmissible to #children. ‘Congenital’ syphilis could lead to a variety of serious health complications and developmental problems. #histSTM #histsex #sexualhealth

Indeed, fear of congenital #syphilis was so potent, that it became a common trope of popular Victorian literature, such as #Ibsen's "Ghosts".
theguardian.com/stage/video/20…

And remained a scare tactic for #publichealth campaigns well into the twentieth century. #sexualhealth #STIs #histSTM

https://twitter.com/ExploreWellcome/status/1303310339640090626?s=20

So, for eugenicists, the transmission of VD was tantamount to ‘race suicide’. We can see this in Dr Arabella Kenealy’s outrageous, melodramatic letter to the British Medical Journal in 1895. #eugenics #sexualhealth #histSTM
ncbi.nlm.nih.gov/pmc/articles/P…

Good morning! On Day 3 of #SHW2020 we're picking up where we left off—Kenealy's letter to the BMJ. Part melodrama, part case note, it had all the ingredients of a cracking New Woman novel. #histsex #SexualHealthWeek punch.photoshelter.com/image/I0000uLQ…

The term ’New Woman’ was coined in 1894 by Sarah Grand, who was herself a eugenicist. Image: @britishlibrary

The ‘NW’ became popular shorthand for a new type of independent, educated woman, who rode bicycles 😱 and held mirrors up to the sexual hypocrisies and double standards of late-Victorian society. Image: @PunchCartoons #histsex #SHW20
bl.uk/romantics-and-…

Through radical essays and best-selling novels like Grand’s The Heavenly Twins, the New Woman movement helped to radically redefine the narrative of #sexualhealth. #histsex

[SPOILER] Grand’s heroine Edith marries a syphilitic reprobate, gets infected, gives birth to their congenitally syphilitic child and then dies. At no point in this horrific spiral did her husband or her doctor feel the need to tell her that she had VD. #STIs #syphilis #histSTM

And in case you thought this was just absurd fiction, here’s part of the *actual* testimony given in 1914 by Armand Routh (Consulting Obstetric Physician to Charing Cross Hospital) before the Royal Commission on Venereal Disease. #histSTM #histsex #sexualhealth #SHW2020

In New Woman stories, the villains were no longer ‘common prostitutes’ preying on unsuspecting men. Rather, the villains were well-heeled cads, protected by society while exploiting working-class women and infecting their own wives and children. Image: Wiki Commons #histsex

For NW writers, these men were the cause of ‘racial degeneration’. Women and their benighted children were sacrificed to male lust and VD. If only they’d been properly educated. If only society were interested more in a potential husband’s #sexualhealth than his social status.

Outraged by this injustice (and at not being invited to testify before the Commission), suffragette Christabel Pankhurst wrote The Great Scourge, arguing that the cure for this 'evil' was 'Votes for Women and Chastity for Men'. ✊🏽✊🏾✊🏿 Image: Wiki Commons
wellcomecollection.org/works/sshusq9a…

It's Day 4 of #SHW2020! Today, we're covering two of the biggest, sexiest things to happen to British #sexualhealth in the twentieth century: The Royal Commission on Venereal Disease and the interwar VD Service. #histSTM #histsex #STIs #SexualHealthWeek

Est. in 1913, the Commission's mandate was to determine the prevalence and impact of VD in the UK and identify ways to reduce it. Importantly, the Commission made clear that 'no return to the policy or provisions of the Contagious Diseases Acts' was to be considered. #histSTM

The Commission ran for 3 years, heard testimony from almost 90 witnesses and collected thousands of pages of evidence. And although some witnesses were keen to maintain the status quo, the Commission made a series of radical recommendations. #sexualhealth

https://twitter.com/DrAnneHanley/status/1306194887176585217?s=20

Foremost among them was the establishment of a service that would be universal and free at the point of use.

Sound familiar? #universalhealthcare #histSTM

Before the VD Service, access to #sexualhealth care depended on your wealth (and, if you were a woman, your husband's beneficence). If poor, your options were quacks or inadequate care from the Poor Law and the few hospitals that actually treated VD. Image: @ExploreWellcome

Such #inequality is difficult to sustain in a socialised service, where doctors aren't subject to market pressures or coercion from patients’ fee-paying relatives. The VD Service was flawed, but it offered confidential, reliable and free #sexualhealth care to everyone. #histSTM

But unsurprisingly, VD carried a LOT of cultural baggage. The CD Acts were still in living memory. So, with the National Council for Combatting VD (later renamed the British Social Hygiene Council), the Ministry of Health launched an aggressive #sexualhealth campaign... #histSTM

...capitalising on the fabulous new silver screen! Throughout the 1920s and 30s, the NCCVD commissioned numerous health-ed. films. Melodramatic and unsubtle, they had a big impact on the numbers of people seeking care and reassurance from the VD Service. #histSTM #publichealth

Good morning! On Day 5 of #SHW2020, we're looking at #sexualhealth during the Second World War and, then, under the #NHS. Image: Wiki Commons #histSTM #histsex #WW2 #STIs #SexualHelathWeek

In 1942, @MassObsArchive surveyed residents in several London boroughs about a public-health advertisement that had recently appeared in the @DailyMirror. The advert—‘Ten plain facts about VD’—was part of the Ministry of Health’s largest-ever #sexualhealth campaign. Image: @alamy

.@MassObsArchive hoped to understand how people felt about the public airing of a subject that, despite heavy campaigning by the British Social Hygiene Council, was still very taboo. As one outraged man from Wandsworth fumed, ‘A bloody fine game—syphilis on your breakfast table’.

But a lot of people interviewed by @MassObsArchive felt that the campaign hadn't gone far enough... #histSTM #histsex #sexualhealth #WW2

There was also a wild collection of #publichealth posters—like "The easy girlfriend" (1943)—highlighting the dangers of VD. But these posters relied heavily on fear as a deterrent. Image: @ExploreWellcome #histSTM #histsex #sexualhealth #SHW2020

They also fell back on the tired old stereotypes of predatory female sexuality. See any similarities between "The easy girlfriend" and this 1912 painting by Richard Tennant Cooper? Image: @ExploreWellcome #histsex #histSTM #syphilis #STIs

In the C20, Britain eschewed #sexualhealth regulations ... except during crises. Similar to 'Regulation 40D' in #WW1, 'Regulation 33B' in #WW2 allowed for forcible confinement/treatment of people thought to have VD. 33B applied to men+women, but was enforced mostly against women.

This period also saw the introduction of #penicillin. 🥳 But it wasn't the 'magic bullet' that many had hoped. Almost immediately, health authorities started talking about the dangers of #AntibioticResistance. Image: @ExploreWellcome #histSTM #STIs #bacteria #bacterialinfection

In 1948, VD Service was absorbed into the newly est. #NHS. By this time, venereology had become a coherent specialism. Although still derided as ‘pox doctoring’, it had come a LONG way from the old days when association with VD treatment could seriously damage your med. career.

But, like other #NHS provisions, #sexualhealth services were patchy. Moreover, with the introduction of #penicillin and declining infection rates after #WW2, some Local Authorities diverted resources away from their VD clinics, or closed them entirely. #bigmistake #histSTM #STIs

Hello. On Day 6 of #SHW2020, we're looking at how politicians, civil servants, health authorities and the popular press all used #sexualhealth to push a nationalist, anti-immigration agenda in postwar Britain. #racism #histSTM #histsex #STIs #SexualHealthWeek

In 1948, the British Nationality Act conferred British citizenship on all Commonwealth subjects.

Hundreds of thousands of 'New Commonwealth' migrants made use of the Act. Many came from the Caribbean, helping to ease severe labour shortages following #WW2. Today, they are known as the #Windrush Generation. bl.uk/windrush/theme…

Almost immediately, there were calls to introduce (non-white) #immigration controls. But wanting to maintain the appearance of being not #racist, politicians, civil servants and health authorities went looking for expedient non-racial excuses.

A popular trope was that migrants were 'importing' #syphilis and #gonorrhoea. Despite much searching, however, the Ministry of Health could find no evidence to support this. On the contrary, data showed that migrants were contracting VD *after* arriving in Britain. #sexualhealth

This didn't stop wild claims about migrants bringing VD and burdening the #NHS. Venereologists resorted to racial stereotypes, insisting that migrants' "basic philosophy" encouraged "promiscuity and therefore high VD rates" #eugenics #sexualhealth #histSTM
ncbi.nlm.nih.gov/pmc/articles/P…

#Eugenics didn't disappear with the #Nazis. Fictions of racial difference were recycled to assuage / play on Britain’s postwar insecurities about imperial decline, social change and its increasingly marginal role in international Cold War politics #histSTM
historyworkshop.org.uk/lies-damned-li…

VD became a popular way to reinforce those fictions. Health workers and journalists claimed disingenuously that migrants were responsible for infection spikes in the 1950s and 60s. But overlooked that #sexualhealth services were also being systematically dismantled. #histSTM

They overlooked the socioeconomic factors (e.g. what we now call institutional #racism) that undermined migrants' #sexualhealth outcomes. And they cherry-picked health data to double-down on racial stereotypes and create a picture of a looming heath crisis caused by #immigration.

As we've seen in recent years, the calculated misuse of #sexualhealth figures remains popular among those with an anti-immigrant agenda.
theguardian.com/politics/2015/…

Institutional #racism continues to undermine Black British (and wider #BAME) #sexualhealth outcomes, as evidenced in the @HouseofCommons 2019 Report on Sexual Health. #STIs #SexualHealthWeek #HealthInequalities houseofcommons.shorthandstories.com/health-and-soc…

It's the final day of #SHW2020! Today, we're looking at one of the most devastating moments in #sexualhistory history in Britain and globally—the emergence of #HIV/AIDS. Image: @ExploreWellcome #histSTM #histsex

No history of #sexualhealth is complete without reflecting on the impact of #HIV. There's a wealth of #histSTM scholarship on HIV/AIDS by experts like @sexhistorian @RAMcKay and @engelmal81 (to name a few!) to which I cannot begin to do justice.

Today in Britain, #HIV is a manageable condition. We've come a long way since it first emerged in the 1980s and was feared as a "death sentence". Particularly resonant for Australians like me was this campaign. Similar gruesome imagery was used in Britain.
theconversation.com/the-grim-reape…

And as we see in the work of historians like @GeorgeSevers10, AIDS activists were instrumental in helping to change public perceptions of #HIV/AIDS as well as attitudes towards those infected. Image: @ExploreWellcome @ACTUP_LDN #sexualhealth #activism #histSTM

Key to positive sexual-health experiences is, as @sexhistorian shows, comprehensive sex education. But parents, school governors and the government have not always been on board with this, esp. when it comes to #LGBTQ inclusivity and #HIV/#STIs. #histsex
wellcomecollection.org/articles/WxZnZ…