Full citation:Chauncey, George, Jr. 1982. “From Inversion to Homosexuality: Medicine and the Changing Conceptualization of Female Deviance” in Salmagundi 58-59 (fall 1982-winter 1983).
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This article focuses on the end of the 19th century as the era when a medical model of homosexuality replaced a religious/moral model, creating the conditions for the idea of belonging to a sexual minority. Starting with the first publication of a medical paper on “sexual inversion” in Germany in 1870, the next few decades saw increasing interest from medical professionals in the topic. However Chauncey argues that a direct connection between medical publications on the topic ad the rise of self-conscious identities is far from established, or that homosexuals accepted the medical model uncritically. In particular, that view—that sexology invented homosexual identity—ignores preexisting evidence for subcultures and concepts of identity, even when documented in the medical literature itself. The author notes other issues that complicate this connection, such as the restricted social class that most medical studies were drawn from. He recommends non-medical and more personal records, such as diaries and letters, as a field that would provide balance.
Rather, Chauncey suggests, medical literature in America (the article’s focus) could be understood as a response to social change around sexuality at the turn of the century, rather than a driver of it. Medical literature initially conceived of “sexual inversion” as a broad and diffuse category of behavior that deviated from normative sexual and gender roles. Only later, several decades into the development of sexology, was homosexual desire distinguished in this literature as a distinct concept, rather than being considered a simple consequence of an underlying gender identity.
Further, sexology did not develop in a social vacuum. The challenges that the women’s movement made to normative gender roles and the increasing awareness of urban gay male culture are among the factors causing social anxiety that medical sexology claimed to explain and manage. A parallel is drawn between the rise of the idea of “social Darwinism” and challenges to racism and colonialism. One of the implicit purposes of sexology was to justify male supremacy as biologically determined. And this helps explain some of the differences in how the field treated male and female homosexuality.
The heart of this article is a review of 85 medical publications in the USA between 1880 and 1930, discussing how they reflected and responded to changes in society.
The medicalization of sexuality can find roots in pseudo-scientific theories that shaped the Victorian era about male sexual agency and female sexual passivity. Within this framework even women who expressed active sexual desire within a heterosexual marriage were seen as suspect. This lesbianism was inherently deviant as it required at least one of the female partners to experience and express active sexual desire. Active desire was a masculine trait, therefore a woman expressing sexual desire for a woman was behaving in a masculine fashion. [Note: This idea dates far earlier than the Victorian era, of course.] As a consequence of this pre-existing framing, sexological literature described the sexuality of lesbians as a sort of pseudo-male aggressiveness. A corollary was that just as male sexuality was understood to be aggressive and uncontrolled (the onus was on women to “control” men either by being virtuous and untouchable, or by being prostitutes and unconditionally available), lesbian desire was assumed to be uncontrollable and thus required professional treatment to suppress it.
Nineteenth-century gender roles went beyond what happened in bed, therefore the required “feminine passivity” extended to social roles and interactions, and “inversion” was assumed to apply to all manner of behavioral interactions and personal presentation. This could be identified even in childhood by a preference for play associated with a different gender. A 1921 article asserted that female “inverts” could be identified by wearing male-coded garments like tailored suits (even those that included a skirt), certain hair styles, an aversion to corsets, by drinking, smoking, whistling, and being “very independent in her ways.” (Similar assertions were made about identifying male inverts.) In this all-encompassing view of gender identity, researchers could be contradictory. Havelock Ellis, while claiming that transvestism was separate from homosexuality, nonetheless claimed that lesbians typically had some degree of “masculinity” in their clothing, alongside “…brusque, energetic movements…direct speech…masculine straightforwardness and sense of honor…” alongside “a dislike and sometimes incapacity for needlework and other domestic occupations.” [Note: It’s hard not to connect these opinions with the classic “not like other girls” traits of supposedly progressive literary heroines, who habitually reject corsets and despise needlework. Gender essentialism comes in many forms.]
Early versions of the “inversion” theory of homosexuality meant that the object of desire was less relevant than gender presentation. A “masculine” woman was an invert even if happily married to a man (who then would be assumed to be effeminate to some degree, or else he wouldn’t be attracted to her). But by 1900 this had shifted to distinguish homosexuality more clearly from gender presentation, as in Freud’s language about “sexual object.” But this shift was more solidly and earlier applied to men than women and became part of arguments for tolerance and acceptance of male homosexuals, while the same was not argued for lesbians. Even as men were allowed to be “manly” and yet desire men, women were still being characterized as generally “masculine” if they desired women.
Early sexological literature functionally ignored the femme partner of women identified as “inverts,” treating them as passive objects who simply accepted the attentions of their partner, much in the same way that the wives of “female husbands” had been viewed over the previous couple of centuries. Toward the end of the period under consideration, these femme partners were increasingly viewed as actively choosing to engage in lesbian partnerships, rather than being hapless “victims” of the aggressive sexuality of the “actively inverted woman.” But the underlying assumption supported the idea that a femme partner could be “saved” by the intervention of a Real Man.
It can be easy to see how this assumed gender-role-binary works to reinforce itself by ignoring or shoehorning likely counterexamples. If lesbians are always inherently masculine, then a femme-femme couple will be overlooked by those trying to identify lesbians. A quote in the article from Havelock Ellis notes, “we are accustomed to a much greater familiarity and intimacy between women than between men, and we are less apt to suspect the existence of any abnormal passion.” [Note: And if both partners participate in female masculinity—whether in dress, or in behavior—it was common to assign one partner as the more masculine, based in minor differences in occupation or personal habits. This can be seen even before the application of sexological frameworks when partners in Boston Marriages are analyzed to determine “which was the husband and which the wife.”]
Once the shift from “gender inversion” to “sexual object” became established in the first decade of the 20th century, and “passive lesbians” became a topic of greater interest, the medical establishment turned their attention to pathologizing intimate same-sex friendships in single-sex institutions such as schools, convents, and gender-segregated work environments. Now that these relationships were a topic of study, surprise! researchers found that partners might alternate the “husband/wife” roles, or even claim “that they did not think of it in that way.” (Quoted from a 1929 study.) Such relationships had, of course, existed previously, but had been outside the scope of study due to not overtly challenging gendered behavioral norms.
The medical approach to homosexuality shifted in parallel with general medical trends. Where doctors in the 1880s had ascribed inversion and other “nervous disorders” to a physical cause with physical symptoms that could be treated, and argued that homosexuality was pathological rather than criminal, as the 1890s progressed, the “somatic cause” of nervous disorders was increasingly ascribed to congenital defects, which could be managed but not cured. An extreme version of the congenital theory was to classify inverts as biological hermaphrodites, with “structural cellular elements of the opposite sex.” This helps explain the undue interest doctors took in recording the genital anatomy and menstrual habits of patients being examined for lesbianism. This physiological approach faded early in the 20th century but lingered in a form of “psychic hermaphroditism”—the “male soul in a female body” explanation (initially raised as early as the 1860s by Karl Ulrichs). As eugenics became a popular theory, homosexuality was frame as part of a general “degeneration” of civilization to a less evolved state. [Note: Of course, eugenics and theories of degeneration applied to many other social anxieties, such as non-Anglo immigration.] Early proponents of gay acceptance in the 1910s countered this with arguments from Classical civilizations, which of course focused only on male-male relations.
Class issues infiltrated the medical literature in how patients from different social strata were differentially diagnosed: middle-class patients being identified as suffering from illness, while working-class patients were written off as immoral. Lesbianism was claimed to be rife among domestic servants (who might teach it to the children of their employers) and especially among prostitutes where it was assumed to go hand-in-hand with general criminality.
The congenital theory of homosexuality promulgated by Havelock Ellis and others was in the ascendent around 1900, but began to be challenged by Freud and his followers who saw it as an acquired condition due to interactions of family dynamics. (Though many professionals worked with a mixture of the two approaches.)
The article most to a conclusion with a consideration of why gender/sexuality became a topic of medical interest at the specific time when it did, and why the focus shifted in the ways it did. The author focuses strongly on the lesbian angle (in addition to the increasing visibility of gay male subcultures), in the context of challenges to Victorian sex/gender stereotypes and the “resexualization” of women at the beginning of the 20th century. The women’s movement in the late 19th century challenged social and political limitations placed on women (and were achieving a certain amount of success in that field). Declining marriage and birth rates among the white middle class and the intrusion of women into previously male-only fields, created what some identified as a “masculinity crisis” in the decades around 1900. There was a perception that women were having undue influence on society and in the workplace. Within all of this, the identification of women’s challenge to assumed norms as a “disease” enabled authorities to undermine and stigmatize it, rather than having to address the challenge on its merits. Not only were the women who challenged gender restrictions themselves “diseased” but their dismissal of domestic and material duties produced another generation of degenerates. Within this framework, gay men, rather than joining the crusade against the New Women, were rejecting their own masculinity and contributing to the degeneration of society. And to a limited but meaningful extent, the women were “winning.” Meaningful female employment increased. Campaigns for suffrage and prohibition were successful. [Note: Whatever one might think about the advisability or lasting impact of Prohibition, it was a symbol of female political power.] Women were once again recognized publicly as sexual beings. And professional attachment to the idea that gender roles were natural and inherent began to weaken. Within this context, shifting professional concern from “inversion” to “homosexuality” allowed a backing off from the unstoppable aspects of these changes while narrowing the scope of persecution to more marginalized groups. Women could be actively sexual, even outside marriage, but only heterosexually. The homosocial bonding that had supported suffrage and other aspects of the women’s movement could be stigmatized, weakening political momentum. Homosociality was replaced by a greater acceptance of mixed-sex socializing, including “dating culture” and the promotion of marriage as a woman’s primary social context.
Thus, Chauncey concludes, while the shifting medical discourse from 1880 to 1930 did not drive these social changes, it provides a fertile field for studying them in all their intertwined complexity.
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