Abstract

The nineteenth-century medical attitude to normal female sexuality was cruel, with gynaecologists and psychiatrists leading the way designing operations for the cure of the serious contemporary disorders of masturbation and nymphomania. The gynaecologist, Isaac Baker Brown (1811-1873), and the distinguished endocrinologist, Charles Brown-Séquard (1817-1894) advocated clitoridectomy to prevent the progression to masturbatory melancholia, paralysis, blindness and even death. Even after the public disgrace of Baker Brown in 1866-7, the operation remained respectable and widely used in other parts of Europe. This medical contempt for normal female sexual development was reflected in public and literary attitudes. Or perhaps it led and encouraged public opinion. There is virtually no novel or opera in the last half of the 19th century where the heroine with “a past” survives to the end. H G Well's Ann Veronica and Richard Strauss's Der Rosenkavalier, both of which appeared in 1909, break the mould and are important milestones. In the last 50 years new research into the sociology, psychology and physiology of sexuality has provided an understanding of decreased libido and inadequate sexual response in the form of Female Sexual Disorder (FSD) or Hypoactive Sexual Desire Disorder (HSDD). This is now regarded as a disorder worthy of treatment, either by various forms of counseling or by the use of hormones, particularly estrogens and testosterone.

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