Listen this affair
In their quest to regulate medicine, British doctors from the mid-Victorian period banded together with anti-vice activists to suppress discussions around sex, reproduction, and sexual health, aiming at what they considered “obscene quackery.” This collaboration ended up crafting a censorship system that limited what these doctors could share about sexual health too.
Scholar Sarah Bull explains how the 1868 case Regina v. Hicklin set a precedent for controlling medical information that lasted into the twentieth century.
Though Hicklin was about a supposedly obscene religious pamphlet, the obscenity test outlined in the ruling could be used wherever censors wanted. Justice Cockburn described this test as assessing whether the material could “deprave and corrupt those whose minds are open to such immoral influences, and into whose hands a publication of this sort may fall.” Bull points out that the intentions and qualifications of the creators were deemed irrelevant.
Following Hicklin, any content that included sexual details could be prosecuted in Britain and eventually other English-speaking nations like the United States.
Before Hicklin, British doctors had been fighting against public anatomy exhibits, alternative healing methods, unlicensed practitioners, and the chaotic trade of medical literature. There was a boom in affordable publications about pregnancy, contraception, sexual anatomy, venereal diseases, and sexual dysfunction aimed at middle-class readers in the 1840s. By the 1860s, even working-class folks could easily access these writings, either through discreet mail orders or on the street. Sellers of these materials also often marketed profitable patent medicines and offered personal consultations.
But who decided what was too risqué or immoral when it came to sexual health info?
Some publications, particularly those from publishers on Holywell Street in London, were straightforward erotica or “proto-pornographic” material. (Holywell Street was more known for its French letters than fine literature.) This gave rise to the “anti-quackery” campaign led by The Lancet, which blurred the lines between quackery and obscenity. Organizations like the Society for the Suppression of Vice, focused on “protecting” the public—especially vulnerable groups like women and children—from “immoral literature,” found a partner in the medical community.
But again, who really got to decide what sexual health info was inappropriate? For many, it was always a gray area. Before Hicklin, as Bull notes, “the line between respectable and supposedly obscene print promotion was very hazy.” After Hicklin, “even renowned medical authors became wary of discussing sexual topics.” Actual prosecutions were uncommon since doctors and publishers learned to self-censor.
Bull observes, “The increase in disclaimers regarding the necessity of mentioning sex in medical texts during the last third of the nineteenth century indicates that fears of prosecution also affected choices in writing, editing, and distribution,” as authors and publishers felt pressured to predict and address potential criticisms of their work.
A notable example of authorities taking action against a medical text as obscene is the 1897 case involving Havelock Ellis’s Sexual Inversion. This study was one of the first to look sympathetically at what would later be recognized as homosexuality. Ellis, an English doctor and social reformer, initially wrote the book in German and published it in Germany. However, the English translation he did with John Addington Symonds caused a stir when a bookseller selling it was prosecuted after selling a copy to an undercover cop. The rest of Ellis’s groundbreaking Studies in the Psychology of Sex were ultimately published in the United States but were only available to medical professionals until 1935, when Random House picked up the rights following a New York court ruling that declared James Joyce’s Ulysses wasn’t obscene. This ruling opened the door for wider distribution of Studies in the Psychology of Sex beyond just the medical field.
