“Intolerable Lesbian Lovers:” Medicine’s Control of Deviant Sexuality and Gender Norms

Hannah Boggess is a [2018] Gender, Women’s, and Sexuality Studies and History double major. Outside of schoolwork, she enjoys playing with every dog she sees, watching The West Wing, and being a feminist killjoy.

Compulsory heterosexuality, a term popularized by Adrienne Rich in the 1980s, is the overwhelming, hegemonic, enforced belief that all people are assumed—and required—to be heterosexual. It is enforced largely by patriarchal power structures but can be seen in many ways: through advertising, mass media, microaggressions, pop culture, and general cultural understandings. Consequently, anyone who diverts from heterosexuality (especially women) are seen as a threat to the established hierarchy of gender. This can be seen throughout history as well as today—think about the ways in which women are “slut shamed” for asserting their sexuality or the assumption that a lesbian woman simply “hasn’t met the right man yet.” Though today, heterosexuality is enforced primarily through cultural norms, historically, the medical community was in charge of regulating gender norms and women’s sexuality. The medical community used its scientific authority in the first half of the 20th century to prescribe heterosexuality as a way to control gender relations; doctors specifically identified lesbian women as a threat to cisgender, heterosexual norms and consequently attempted to control their sexuality.

Even before sexuality explicitly became a part of medicine, it was still regulated and researched. In the late 1800’s, women’s sexualities were subject to taxonomies and definitions through advice manuals circulated by doctors. These articles and the beliefs they purported created a medical context for relationships and defined “normal” marital health and sexual desire. (In this context, “normal” meant cisgender, heterosexual, submissive, compliant, stay-at-home wife and mother.) Their recommendations included normal social relationships with a potential to turn deviant; for example, the articles encouraged female friendships, but not “polluted” friends who would engage in sexual activities together. [1] Women could have “romantic friends” with whom they were intimate in private, they could be eccentric but pass for cisgender and heterosexual, but they could not be what one advice manual called “intolerable lesbian lovers.” [2] The doctors also identified threats: an unmarried woman, a professional woman, or a woman who chose another woman as her sexual or romantic partner. These recommendations can be understood as a way to control gender relations. In the late 1800s, the feminist movement was beginning to gain ground, and people were seeing a “new woman”—one who had ambitions outside of being a heterosexual wife and mother. This threatened every social norm—economic, cultural, political—in a way that necessitated a response from the white, heterosexual, cisgender men in power. In order to remind women how they were meant to act, medical professionals began to take on the cultural work of regulating gender norms. In pathologizing lesbian women, doctors consequently created a dichotomy between the “normal” and “deviant” population, therefore encouraging and requiring everyone to fall under the “normal” category.

In the 1880’s, sexual inversion became a common term to describe homosexual people. A person could “invert” their gender identity and consequently choose sexual partners of the same gender. [3] In 1907, with the coining of “sexology,” one’s sexual life became fair game for doctors to analyze and pathologize. [4] Sexology’s primary interest was to categorize and catalog the known variety of sexual desires and behaviors. Initially, this included various kinds of treatments—specifically, hormone therapy was popular in the early 1900’s, which was when a doctor would inject a lesbian woman with estrogen, the female sex hormone, in order to reverse their sexual “inversion.” [5] The conflation of sexuality and gender is evident here: doctors believed that in shifting a lesbian woman’s gender further to the side of femininity, they could counteract her deviant sexual desires. However, when this therapy was shown time and time again to do nothing in encouraging a lesbian woman to “become” heterosexual, doctors turned to new methods.

In the early 1900’s, medical opinions and practices towards lesbian women were a means of establishing control and regulating gender roles. For example, the medical journal American Medicine wrote that someone could identify a lesbian if she only had an orgasm while on top during sex, cut her hair, had a masculinity complex, and wore jackets. [6] These traits are obviously completely separate from one’s sexuality, but doctors’ prescription of norms to all behavior (sexuality, gender performance, and lifestyle choices) was how they understood lesbianism at this time. Being a lesbian was something that was assumed to be evident in all aspects of life.

Doctors explicitly connected being a lesbian to a number of lifestyles and identities, specifically, masturbation, nymphomania, feeling superior to men, and being a suffragist. Female masturbation was a significant fear among doctors; it was widely considered sexual filth and the first step towards homosexuality. Echoing the advice manuals of the 1850’s, medical journals warned against female masturbation because girls would be coerced into mutual masturbation with older women, who were nymphomaniacs, and they would then be compelled into homosexuality. [7] Doctors claimed that only female masturbators were leaders of social justice movements such as suffrage, spinsters, and misandrists. An article in American Medicine in 1916 claimed that suffragettes were repressed homosexuals because “rarely, if ever, do women whose libido is satisfied take any interest in the suffragist movement.” [8]

In creating this dichotomy between normalcy (heterosexual, sexually satisfied, passive, politically uninvolved woman) and obscenity (lesbian, nymphomaniac, angry, jealous, suffragette), doctors further isolated and pathologized lesbian women. The American public, and specifically white heterosexual men, feared so deeply that women were becoming sexually independent and politically active that they condemned homosexuality as a means to resist change in the gender hierarchy. Sexology, especially the study of lesbian women, was “about constructing a model of sexuality which purported to be objective and scientific but in fact promoted the interests of men in a sexually [read gender] divided society.” [9] Medical professionals attempted (and perhaps succeeded) in claiming control over lesbian women under the guise of science, but their ultimate goal was to preserve heterosexuality, which also preserved and encouraged other systems of white male power, such as the patriarchy and capitalism.

Later, in the 1930’s and 40’s, medical opinion was focused on how to find homosexuals, and they searched for a common trait through a battery of tests and scales that were ultimately about gender performance, not sexual behavior. [10] Doctors emphasized the importance of physical appearance and body type in identifying lesbian women, pointing to factors as inconsequential as lesbian women’s age of first menstrual cycle, body proportions, and pitch of voice. [11] The American Journal of Psychiatry published an article in 1935 that decisively claimed that “the lesbian” is characterized by firm muscle, excessive hair on her back and chest, a masculine distribution of pubic hair, a small uterus, and an over- or under-developed labia and clitoris. [12] Again, similarly to their earlier fixations on lifestyle and habits, doctors identified irrelevant physical characteristics in an attempt to find a root cause for homosexuality and therefore justification for its pathologization.

One example of the extremes to which doctors went to identify the reason for lesbian women’s existence is seen in the 1930’s study on lesbian women’s physiological attributes. This research project, funded by Helen Reitman and the Committee for the Study of Sex Variants, enlisted psychiatrists, gynecologists, obstetricians, pathologists, radiologists, neurologists, clinical psychologists, endocrinologists, and a host of other medical professionals to look at “sex variants” and subsequently diagnose their homosexuality. [13] Lesbianism was seen as a problem for medicine to solve for the good of society, and so these doctors took it upon themselves to learn about the physical makeup of the homosexual. The research was explicit in its aims: it was not for the purpose of knowledge, rather, it was “to assist doctors in identifying and treating” gay patients. [14] Doctors also wanted to keep homosexuality from “spreading” through the general population, and as such, they “had the duty and capacity to play a crucial role in ensuring the mental (and moral) health of the community.” [15] The final results of the research included a family tree, psychiatric evaluation, first person narrative about one’s personal history, gynecological examination results, assessment of skull, chest, and pelvic x-rays, a rating of femininity on a 1-10 scale, and a Freudian psychoanalytic review. [16]

Despite this barrage of tests, doctors were unable to understand certain factors about lesbians—essentially, why they didn’t all act and look the same. Prior to this study, doctors assumed that lesbians had inverted their proper gender role, and their sexual desire for women was a consequence of their masculine traits. As the study went on, however, certain findings (i.e. feminine lesbians, sexual passivity of masculine women) were confounding to the doctors, and they used elaborate searches to prove the origin of homosexuality in these women. [17] In their search for a source, male doctors asserted their ability to understand and diagnose sexuality and apply that diagnosis to women’s lived. However, the research they did—though it may have been rooted in problematic beliefs—was novel in that the lesbian women were actually speaking for themselves. In allowing for self-representation, the doctors were faced with factors that complicated their understandings of gender representation and sexuality.

In the first half of the twentieth century, doctors used a variety of methods—linking lesbianism and deviant social practices, performing tests on lesbian women, and identifying irrelevant physical characteristics—in an effort to “prove” who was a lesbian. However, these diagnoses and treatments were simply a way for (male, heterosexual) doctors to establish their authority over (lesbian, female) patients, and largely, for the cisgender, heterosexual, capitalist patriarchy to assert their control over those who threatened their power. Doctors’ efforts to control lesbianism were ultimately about the regulating of gender norms and power structures, not deviant sexuality.


[1] Marylynne Diggs, “Romantic Friends or a Different Race of Creatures? The Representation of Lesbian Pathology in Nineteenth-Century America” Feminist Studies 21, no. 2 (1995): 325.

[2] Ibid, 323.

[3] Ibid, 330.

[4] Celia Roberts, “Medicine and the Making of a Sexual Body” in Handbook of the New Sexuality Studies ed. Nancy Fisher, Chet Meeks, and Steven Seidman (New York, NY: Routledge, 2006): 90.

[5] Ibid, 90.

[6] Karin Martin, “Gender and Sexuality: A Medical Opinion on Homosexuality, 1900-1950” Gender and Society 7, no. 3 (1993): 251.

[7] Ibid, 259.

[8] Ibid, 250.

[9] Ibid, 251.

[10] Ibid, 248.

[11] Ibid, 253.

[12] Ibid, 253.

[13] Jennifer Terry, “Lesbians Under the Medical Gaze: Scientists Search for Remarkable Differences” The Journal of Sex Research 27, no. 3 (1990): 318.

[14] Ibid, 318.

[15] Ibid, 319.

[16] Ibid, 323.

[17] Ibid, 321.

For Further Reading:

Jennifer Terry, “Lesbians Under the Medical Gaze: Scientists Search for Remarkable Differences” The Journal of Sex Research 27, no. 3 (1990): 317-339.

Karin Martin, “Gender and Sexuality: A Medical Opinion on Homosexuality, 1900-1950” Gender and Society 7, no. 3 (1993): 246-260.

Celia Roberts, “Medicine and the Making of a Sexual Body” in Handbook of the New Sexuality Studies ed. Nancy Fisher, Chet Meeks, and Steven Seidman (New York, NY: Routledge, 2006): 88-97.