The Walking Wounded
The cosmetic surgery industry is expanding by manipulating ideas of health and sickness. There is a clear historical precedent for what the surgeons are doing. “Healthy” and “diseased,” as Susan Sontag points out in Illness as Metaphor, are often subjective judgments that society makes for its own purposes. Women have long been defined as sick as a means of subjecting them to social control. What the modern Surgical Age is doing to women is an overt reenactment of what nineteenth-century medicine did to make well women sick and active women passive. The surgical industry has taken over for its own profit motives the ancient medical attitude, which harks back to classical Greece but reached its high point in the Victorian female cult of invalidism, which defines normal, healthy female physiology, drives, and desires as pathological. “In the traditions of Western thought,” write Deirdre English and Barbara Ehrenreich in Complaints and Disorders: The Sexual Politics of Sickness, “man represents wholeness, strength and health. Woman is a ‘misbegotten man,’ weak and incomplete.” Historian Jules Michelet refers to women as “the walking wounded.”The relation of doctors to women has been less than straightforward for most of their history. Healing and tending the sick were primarily female skills until the Enlightenment; women’s medical effectiveness was one catalyst for the witch burnings that swept Europe from the fourteenth to the eighteenth centuries. But the ascent of science and the exclusion of women healers from the childbed are connected, and the professionalization of medicine in the nineteenth century deliberately barred women from their traditional healing role.The Surgical Age took over from the institutionalization of female “mental illness,” which had in turn overtaken the institutionalization of nineteenth-century hysteria, each phase of medical coercion consistently finding new ways to determine that what is female is sick. As English and Ehrenreich put it: “Medicine’s prime contribution to sexist ideology has been to describe women as sick, and as potentially sickening to men.” The “vital lie” that equates femaleness with disease has benefited doctors in each of these three phases of medical history, guaranteeing them “sick” and profitable patients wherever middle-class women can be found. The old edifice of medical coercion of women, temporarily weakened when women entered medical schools in significant numbers, has gained reinforcements from the beauty doctors of the Surgical Age.The parallels between the two systems are remarkable. Both arose to answer the need for an ideology that could debilitate and discredit middle-class women whose education, leisure, and freedom from material constraints might lead them too far into a dangerous emancipation and participation in public life. From 1848 until the enfranchisement of Western women in the first decades of the twentieth century was a time of feminist agitation of unsurpassed intensity, and the “Woman Question” was a continuing social crisis: in backlash, a new ideal of the “separate sphere” of total domesticity arose. That ideal came, like the beauty myth in a parallel backlash against women’s advancement, with its socially useful price: the cult of female invalidism, initiated by “a constriction in the field of vision which led doctors to focus, with obsessive concern, on women as organs of reproduction…a distortion of perception which, by placing primary emphasis on the sexual organs, enabled men to view women as a creature apart.” Showalter also notes thatduring the decades from 1870 to 1910, middle-class women were beginning to organize in behalf of higher education, entrance to the professions, and political rights. Simultaneously, the female nervous disorders of anorexia nervosa, hysteria, and neurasthenia became epidemic; and the Darwinian “nerve specialist” arose to dictate proper feminine behavior outside the asylum as well as in…and to oppose women’s efforts to change the conditions of their lives.The Victorian woman became her ovaries, as today’s woman has become her “beauty.” Her reproductive value, as the “aesthetic” value of her face and body today, “came to be seen as a sacred trust, one that she must constantly guard in the interest of her race.”Where Victorian doctors helped support a culture that needed to view women through ovarian determinism, modern cosmetic surgeons do the same for society by creating a system of beauty determinism. In the last century, notes Showalter, “women were the primary patients in surgical clinics, water-cure establishments, and rest-cure homes; they flocked to the new specialists in the ‘female illnesses’ of hysteria and neurasthenia, as well as marginal therapies, i.e., ‘mesmeric healing,’” just as women are the primary patients of “beauty therapies” in the current backlash. These attitudes, in both ideologies, allow doctors to act as a vanguard in imposing upon women what society needs from them.
Both the Victorian and the modern medical systems reclassify aspects of healthy femaleness into grotesque abnormality. Victorian medicine “treated pregnancy and menopause as diseases, menstruation as a chronic disorder, childbirth as a surgical event.” A menstruating woman was treated with purgatives, forced medicines, hip baths, and leeches. The regulation of menstruation was pursued obsessively, just as the regulation of women’s fat is today: “The proper establishment of the menstrual function was viewed as essential to female mental health, not only for the adolescent years but for the woman’s entire life-span. Menarche was”—as the weight gain of puberty is now considered to be—“the first stage of mortal danger.” Maintaining reproduction, like the maintenance of “beauty,” was seen as the all-important female function threatened by the woman’s moral laxness and mental chaos: Just as they do today, doctors then helped the Victorian woman maintain her “stability in the face of almost overwhelming physical odds,” and enforced in her “those qualities of self-government and industriousness that would help a woman resist the stresses of her body and the weakness of her female nature.”With the advent of the Victorian women’s doctor, the earlier religious rationale for calling women morally sick was changed into a biomedical one. That in turn has changed into an “aesthetic” one, bringing us full circle. Our rationale is even more subjective than the “vital lie” of the Victorians. While their medical terminology had at least to gesture at “objectivity,” today’s aesthetic judgments about who is sick and who is well are as impossible to prove, as easy to manipulate, as a belief about the stain on a woman’s soul. And the modern reclassification makes more money: A woman who thought she was sick with femaleness couldn’t buy an ultimate cure for her gender. But a woman who thinks she is sick with female ugliness is now being persuaded that she can.The nineteenth-century version of medical coercion looks quaint to us: How could women have been made to believe that menstruation, masturbation, pregnancy, and menopause were diseases? But as modern women are being asked to believe that parts of our normal, healthy bodies are diseased, we have entered a new phase of medical coercion that is so horrific that no one wants to look at it at all.The reclassification of well and beautiful women as sick and ugly women is taking place without hindrance. Since the nineteenth century, society has tacitly supported efforts of the medical profession to confine women’s lives through versions of this reclassification. Since it is socially necessary work, now as in the last century, fewer reality checks apply to this than are applied to medical practices in general; the media is tolerant or supportive; and the main functionaries, whose work benefits the social order, are unusually highly compensated.The purpose of the Victorian cult of female invalidism was social control. It too was a double symbol, like “beauty”: Subjectively, women invalids exerted through it the little power they had, escaped onerous sexual demands and dangerous childbirth, and received attention from responsive doctors. But for the establishment, it was a political solution as useful as the Iron Maiden. As French writer Catherine Clément puts it: “Hysteria [was] tolerated because in fact it has no power to effect cultural change; it is much safer for the patriarchal order to encourage and allow discontented women to express their wrongs through psychosomatic illness than to have them agitating for economic and legal rights.” Social pressure demanded that leisured, educated, middle-class women preempt trouble by being sick, and the enforced hypochondria felt to the sufferer like real illness. For similar reasons today, social pressure requires that women preempt the implications of our recent claim to our bodies by feeling ugly, and that forcibly lowered self-esteem looks to the sufferer like real “ugliness.”The surgeons are taking the feminist redefinition of health as beauty and perverting it into a notion of “beauty” as health; and, thus, of whatever they are selling as health: hunger as health, pain and bloodshed as health. Anguish and illness have been “beauty” before: In the nineteenth century, the tubercular woman—with her glittering eyes, pearly skin, and fevered lips—was the ideal. Gender and Stress describes the media’s idealization of anorexics; the iconography of the Victorians idealized “beautiful” hysterics fainting in front of male doctors, asylum doctors dwelt lasciviously on the wasted bodies of anorexics in their care, and later psychiatric handbooks ask doctors to admire the “calm and beautiful face” of the anesthetized woman who has undergone electroshock therapy. Like current coverage by women’s journalism of the surgical ideal, Victorian journalism aimed at women waxed lyrical on the sentimental attractiveness of feminine debility, invalidism, and death.A century ago, normal female activity, especially the kind that would lead women into power, was classified as ugly and sick. If a woman read too much, her uterus would “atrophy.” If she kept on reading, her reproductive system would collapse and, according to the medical commentary of the day, “we should have before us a repulsive and useless hybrid.” Menopause was depicted as a terminal blow, “the death of the woman in the woman”: “The end of a woman’s reproductive life was as profound a mental upheaval as the beginning,” producing, like the modern waning of “beauty,” “a distinct shock to the brain.” Then as now, though with a different rationalization, menopause was represented as causing the feeling that “the world…is turned upside down, that everything is changed, or that some very dreadful but undefined calamity has happened or is about to happen.”Participation in modernity, education, and employment was portrayed as making Victorian women ill: “warm apartments, coal-fires, gas-lights, late hours, rich food,” turned them into invalids, as today, as the skin cream copy puts it, “central heating, air pollution, fluorescent lights, etc.” make us “ugly.” Victorians protested women’s higher education by fervidly imagining the damage it would do to their reproductive organs; Friedrich Engels claimed that “protracted work frequently causes deformities of the pelvis,” and it was taken for granted that “the education of women would sterilize them” and make them sexually unattractive: “When a woman displays scientific interest, then there is something out of order in her sexuality.” The Victorians insisted that freedom from the “separate sphere” impaired womanhood, just as we are asked to believe that freedom from the beauty myth impairs beauty.Vital lies are resilient. Contraception, for example, is defined by the medical profession, depending on the social mood, as making women ill or “beautiful”: Victorian doctors claimed that any contraception caused “galloping cancer, sterility and nymphomania in women;…the practice was likely to produce mania leading to suicide.” Until the 1920s, it was considered “distinctly dangerous to health,” sterility and “mental degeneration in subsequent offspring” being among its supposed effects.+“The myth of female frailty, and the very real cult of female hypochondria that seemed to support the myth, played directly into the financial interests of the medical profession,” according to Ehrenreich and English. In the nineteenth century, competition in the medical profession rose. Doctors were frantic to ensure a reliable patient pool of wealthy women, a “client caste,” who could be convinced of the need for regular house calls and lengthy convalescences. Suffragists saw through to the real impetus behind women’s invalidism—the doctor’s interests and the unnatural conditions that confined women’s lives. Mary Livermore, a suffragist, protested “the monstrous assumption that woman is a natural invalid,” and denounced “the unclean army of ‘gynecologists’” who “seem desirous to convince women that they possess but one set of organs—and that these are always diseased.” Dr. Mary Putnam Jacobi traced women’s ill health directly to “their new function as lucrative patients.” As Ehrenreich and English put it: “As a businessman, the doctor had a direct interest in a social role for women that required them to be sick.”+Western sexual surgery is not new. Normal female sexuality was a disease in the nineteenth century, just as normal breasts are operable today. The role of the nineteenth-century gynecologist was the “detection, judgment and punishment” of sexual disease and “social crime.” Pelvic surgery became widespread as a “social reflex,” since “orgasm was disease and cure was its destruction.”Victorian clitoridectomy made women behave. “Patients are cured…the moral sense of the patient is elevated…she becomes tractable, orderly, industrious and cleanly.” Modern surgeons claim they make women feel better, and that, no doubt, is true; Victorian middle-class women had so internalized the idea of their sexuality as diseased that the gynecologists were “answering their prayers.” Says a face-lift patient of Dr. Thomas Rees’s, “The relief was enormous.” One of Victorian Dr. Cushing’s patients, relieved by the scalpel of the “temptation” to masturbate, wrote, “A window has been opened in heaven [for me].” “It’s changed my life,” says a rhinoplasty patient of Dr. Thomas Rees’s: “As simple as that.”Victorian medical opinion varied on whether female castration worked in returning women to their “normal” role. A Dr. Warner conceded, as do modern surgeons, that the results were probably psychological, not physical. A Dr. Symington-Brown conceded that, but insisted that the operation was still valid because it worked by “shock effect.” The Surgical Age likewise reinforces women’s submissiveness to the beauty myth with the unspoken background fear: If she is not careful, she will need an operation.+The modern sexual surgeons display their work with pride; Fay Weldon’s The Life and Loves of a She-Devil reproduces a current fantasy of the completely reconstructed woman shown off to fellow surgeons at a cocktail party. Victorian doctors boasted of the numbers of ovariotomies they had performed and displayed ovaries arranged on silver platters to admiring audiences at meetings of the American Gynecological Society.The removal of the ovaries was developed in 1872. The next year, it was recommended for “non-ovarian conditions,” especially masturbation, so that by 1906 about 150,000 American women were without ovaries. “Non-ovarian conditions” was a social judgment aimed to prevent the “unfit” from breeding and polluting the body politic. “The ‘unfit’ included…any women who had been corrupted by masturbation, contraception and abortion…from the 1890s until the Second World War, mentally ill women were ‘castrated.’”
I was somewhat disappointed with Hysteria (Tanya Wexler, 2011). The movie has feminist themes, it has a feminist character (Maggie Gyllenhaal as Charlotte Dalrymple), yet I can't say the movie itself is feminist. Yes, I'm going to be one of those complaining about how this movie is not subversive enough. While it's true Hollywood (as an institution) still has an issue with the representation of a woman's sexual desire and pleasure, Hysteria barely challenges that idea. It also barely scrapes the surface of the deeply institutionalized misogyny that created the fiction that was/is hysteria. But you know, this is a romantic comedy, so the light approach was to be expected. In all fairness, Hysteria is the most women-friendly romantic comedy I've seen - and that in itself is a major accomplishment.