Across the twentieth century Britain experienced several radical transformations of its sexual-health policies and services. These developments brought huge benefits and helped to break down the stigma and inequalities that had impeded access to care. Yet fundamental challenges remain, and history has much to teach us as we face those challenges. Understanding the historical impact of clinical practices, social conditions, cultural attitudes and policy interventions enables us to recognise long-term trends and patterns. And it makes us better equipped to tackle persistent and emerging sexual-health challenges today.
Today, sexual health is defined as the ability to lead a pleasurable and safe sex life and is recognised as a vital component of overall health and wellbeing. Historically, its definition was much narrower. In clinical practice, it meant combating syphilis and gonorrhoea—the principle ‘venereal diseases’ preoccupying health authorities. In the public imagination, it meant remaining morally and eugenically ‘fit’ to ensure the future health of the race and nation. Gradually, sexual health ballooned, becoming its own clinical field and encompassing a variety of other, newly identified diseases like chlamydia as well as diverse provisions for women’s health, maternal welfare and family planning.
Key to these changes was Britain's state-funded sexual-health service. At the end of the First World War, Britain created the Venereal Disease Service, which was universally available and free at the point of use. Integrated into the NHS after 1948, it was a vital part of Britain's shift towards socialised medicine. Millions of patients passed through its nationwide network of clinics. It was among the most important pieces of health infrastructure in Britain in the twentieth century, changing the way that people thought about, talked about and experienced sexual health. The Venereal Disease Service was intended to help overcome the enormous inequalities and stigma that had defined sexual healthcare for the Victorians and Edwardians. Certainly, it went a long way towards correcting a variety of social injustices and endemic health challenges.
But in practice, within sexual-health clinics and wider society, prejudice and stigma persisted. Women and the working classes continued to be viewed as 'vectors' of contagion, in need of management and surveillance. Structural violence faced by LGBTQ+ communities within healthcare continued to undermine wellbeing and health outcomes. Institutional racism continued to impact the sexual-health experiences of minoritised communities. And many of these problems persist.
These are among the many important issues that the project explores. In mapping the complex interplay of personal, social, cultural and political factors that shaped people’s health experiences, the project aims to fill major gaps in scholarly and public understandings of Britain’s historical sexual health.
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