History

Authored by Henry Strick van Linschoten

As opposed to the Internet, antibiotics, nuclear war and air-planes, we can be very certain that as long back as evolutionary history goes, our ancestors will have engaged in sexual activity for us to be alive now. Without sexual activity, nobody reading this would be here. This gives sexuality, and the experience of it, a depth and longevity that few other human activities, other than motoric activity, brain activity and the basic emotions, have. Sexuality plays a key part in the vast field of cultural history, in fact in the history of civilisation, part of which is unavailable for lack of recorded sources Its history is so extensive that it is impossible in this module to do more than making a very limited and biased selection. This short summary will almost completely restrict itself to Western culture. Participants of this module are encouraged to add comments about other perspectives.

For significant periods Hindu and Buddhist cultures in Asia were investigating and reflecting on sexuality, gave it positive attention, considered that pleasure was an important reason for sex, and wrote about it. The Kama Sutra of Vatsyayana (1961), composed or completed around 300 BC, is a major example. Buddhism originated around the 5th century BC, and especially in the later form of certain streams or schools in Tantra Buddhism, starting around the 7th century, was sex-positive, and incorporated sexuality in its rituals and education.

In Western civilisation, a fair bit is known about sexual activity in ancient Greece, e.g. sex of men with men, men with boys, and a tolerance for sex with younger boys, which today would be labelled as paedophilia. Spanking is documented as a practice in Greece, in the Roman Republic, and in Etruscan culture.

Christian influences

Christianity early on had a negative view of sexuality, though it probably reached its most condemnatory phase only in the Middle Ages. The Bible contains many prohibitions and limitations about sexual activity; it forbids adultery and other practices, including being negative about coitus interruptus. Neoplatonism and Gnosticism, with their dualistic preference of the soul over the body, of spirit over matter, and the official ideas of the influential Saint Augustine, contributed to the further development of sex-negative attitudes in Christian churches. It is not appropriate to devote too much space to it, but overall the doctrinal positions of Christianity, as well as the practices of many priests and other senior church representatives, have been and continue to be damaging in the formation of sexuality, in sex education, and in decisions about Western laws concerning sexuality and sexual practices. It is important for therapists to be fully aware of this connection, as it will be regularly apparent in psychotherapy clients we work with.

Marriage

Over the long period from around 400 to 1800, marriage moved from a private matter to a solidly public one, with first churches, then church and state more and more involved – until in various forms they became the arbiter over most of the rules surrounding marriage, with an extensive influence on sexuality, and on what was regarded as legitimate and what was not. This was paralleled by a generally growing power over the most minute detail of sexual activity, more and more becoming policed by church and state, at least in theory. Over that period the growing attempts of the new institutions of organized church and state to regulate individual personal and sexual behaviour, was matched by the knowledge and experience that whatever was legislated could be subverted and evaded too, thus leading to the generalised difficulty of obtaining truthful information about sexual behaviour by asking people – however much surrounded by formal assurances and safeguards of confidentiality. This also stimulated the growth of the practice of underground, illicit sexual activity, and of what is often disparagingly described as hypocrisy. As Christian ideology became adopted by rulers, a split began whereby sexuality as lived and privately enjoyed differed from what was publicly performed and sanctioned.

Masturbation

One of the major lightning conductors in the early Enlightenment in Western Europe was masturbation. The first tentative pamphlet against masturbation (initially more often referred to with the quasi-biblical term of onania or onanism) appeared in 1712 in England. It was an enormous success with church and state authorities, conservatives, and patriarchal institutions, and the idea that masturbation was unhealthy, dangerous, corrupt, wrong and deviant continued to grow and become more and more “orthodox” until it peaked – perhaps in the early 20th century. Nowadays it is widely recognised that there is nothing wrong about masturbation, that (almost) everyone masturbates – though not necessarily consciously, and not necessarily having the name of masturbation or any other name for it. Throughout the 250 years in which masturbation was seen as a major danger to health, physical and mental, this was stated and restated by the foremost “scientific” and academic authorities of the day, and statements were made, without any evidence, about its immense dangers. It is one of several examples in this brief historical round-up of the widespread phenomenon in sexuality that morality, or simply arbitrary exercise of power, is disguised and lied about by rationalisations and justifications involving claims of consequences that are not only false, but in many cases actively harmful.

In the case of masturbation, the claim that it was harmful, and caused a range of otherwise incurable and untreatable diseases and disorders, was used to justify treatments and preventive regimes that were downright damaging, but also could often be used partly to justify controlling people, especially women. The dangers of masturbation were used to extol the virtues of marriage, to stigmatise the single state, as an additional argument for homophobia and criminalising homosexuality, as an argument to condone marital rape, and generally to strengthen patriarchal control over sexual behaviour. It also excused the idea that in “difficult cases” the resort to genital mutilation and clitoridectomy was justified by the “need” for it, i.e. for preventing “worse”. Driel (2012) gives an excellent historical overview, including the connections with clitoridectomy, infibulation and circumcision. These were all regularly practised in the USA, Britain, France and Germany in the decades around 1900, to reduce or eliminate masturbation, and to supposedly cure a range of mental disorders.

A selection of major sexologists from 1800 to 2000

Isaac Baker Brown (1811-1873) was an English gynaecologist and obstetrical surgeon who performed clitoridectomies on women to cure them of epilepsy and hysteria (Sheehan, 1997). He practised in London and was invited to the USA to lecture on the success of his treatment. Probably partly due to his reputation and persuasiveness, clitoral surgery was a widespread practice in the USA, peaking from 1880 to 1920 and then slowly declining (Rodriguez, 2014).

Moving to the general history of sexology, following is a list of some of the most prominent names in the past two centuries.

Heinrich Kaan (1816-1893), a medical doctor, was the first publisher of a book under the title of Psychopathia Sexualis. It was published in 1844, in Latin. This would have been read by most people born after him in the 19th century in this field – but of course only by people who could read Latin. His book was a clear example where he directly shifted theological words such as deviance and perversion to the field of sexual and psychiatric medicine, which was largely followed by his medical successors until very recently – part of the process of medicalising sexual health issues.

Krafft-Ebing (1840-1902) with his Psychopathia Sexualis of 1886 was the most prominent and well-known psychiatric expert on sexual disorders and influenced several generations after him – although of course on key issues they could and did disagree with him. Krafft-Ebing wrote in the 7^th edition (1894): “With opportunity for the natural satisfaction of the sexual instinct, every expression of it that does not correspond with the purpose of nature, – i.e.,propagation, – must be regarded as perverse.”

Sigmund Freud (1856-1939) was the founder of psychoanalysis. In the formative period of his ideas about psychotherapy, the 1890s, he was in active correspondence about sexuality. He published his Three Essays on the Theory of Sexuality in 1905. It soon became a best-seller in professional circles. It is one of the two main books he wrote that he continued to update during his lifetime, and through 1925 it went through six editions.

Shortly before his death, Freud wrote a short summary for his followers of what he regarded as the fundamental tenets of psychoanalysis (An outline of psychoanalysis). He devoted one complete chapter to sexuality, which shows that he considered thinking about and working with sexuality as a fundamental part of psychotherapy.

Havelock Ellis (1859-1939) was the best-known British expert in sexology of the 19th century. His main works are Sexual Inversion of 1896 (first published in German), and after that the continuously updated Studies in the Psychology of Sex (from 1897). Ellis was a proponent of eugenics, and an active and senior member of the Eugenics Society. He was very interested in gender identity and trans people. He shared Freud’s idea of the existence and importance of infantile sexuality. Ellis lived in an open marriage.

Magnus Hirschfeld (1868-1935) was one of the major, perhaps the major, founders of sexology in Germany. He was an early gay rights activist and an important early writer on trans issues.

Alfred Kinsey (1894-1956) was perhaps the most influential sexologist of the 20th century. His two reports (Kinsey 1948; 1953), based on large numbers of one on one interviews supported by special provisions to protect the anonymity of the people interviewed by him and his team, had an enormous influence in the USA and worldwide. The first report in 1948 about male sexuality, and the second in 1953 about female sexuality, both contained startling revelations about actual sexual practices and activities in the USA. They remain readable. There is a lot to find about sexuality by reading these two reports, one of his biographies (Jones, 1997; Gathorne-Hardy, 1998), or watching the 2004 semi-documentary / biographical drama film about him under the title of Kinsey.

Wilhelm Reich (1897-1957) was one of the first generation of psychoanalysts. He had to leave Germany when the Nazis came to power, and later migrated to the USA. He was the pioneer of body psychotherapy and was very interested in sexuality as an integral part of the person, and essential for physical and mental health. He emphasised attention to the body, to orgasms and to sexuality as an integral part of all longer-term psychotherapy. His major work was Character Analysis (Reich, 1972)

Denis de Rougemont (1906-1985), in 1939, published L’Amour et l’Occident, translated as Passion and Society or Love in the Western World, in which he argues, using his extensive historical knowledge and psychological as well as sociological reasoning, that passionate romantic love is culturally constructed, and damaging to successful committed relationships.

William Masters (1915-2001) & Virginia Johnson (1925-2013) made major contributions in the practice of joint couple-focused therapy designed to improve problems in their sexual relationship. They developed and practised a form of short-term intensive therapy in which the couple was taken through a series of guided exercises, and the use of two therapists of the same gender as the couple for the therapy. They believed that their method could work successfully with a surrogate partner being made available to a single person without an existing (sexual) relationship, and tried to work with gay, bisexual as well as heterosexual couples – but problems with financing and funding, and ethical issues meant that they mostly had to work with heterosexual couples in established relationships. Their books (1966; 1970) are still useful and readable, and so is their biography (Maier, 2009). The 2013/2016 fictionalised TV series is loosely based on their work.

Virginia Johnson (1925-2013) was a gifted sexologist in her own right, and a fully equal partner of Masters. Given how closely and for how long they worked together, it is unlikely that it will ever be fully clear what their relative contributions were.

The French philosopher Michel Foucault (1926-1984) wrote contributions to his long (3-volume) and influential History of Sexuality (Foucault, 1976-1984, with more posthumously available material published in a fourth volume) throughout most of his life. He was an observer and critic of modernity. Many attempted to co-opt him as a post-structuralist, a postmodernist or social constructionist, but he refused most labels. He went very deeply into the historical and sociological origins of sexuality, and its interaction with power and politics. He is a major influence on most parts of modern social science.

Shere Hite (b. 1942) is a writer, sex educator and feminist. In 1976 she published an influential report about female sexuality, the Hite report, based on a more qualitative and interactive model of personal interviewing, which came up with a number of new viewpoints and observations. The influence of different forms of feminism, as well as of queer theory (Barker, 2016), on sexological thinking has been substantial, but is not easy to trace in detail.

Coming back to the history of ideas and topics in sexology, apart from the already mentioned changes in attitudes to masturbation, and to the acceptability of genital mutilation and surgery, it may be worth reminding of a few more areas in which massive changes of societal opinion have taken place.

Homosexuality

Homosexuality is still criminalised in perhaps half the world. It was criminalised in England and Wales from 1886 till 1967, and for a long time thereafter significant discrimination and civil rights restrictions remained. It may be easy to believe that this battle has been largely won; but homosexuality remains subject to criminal sanctions in many countries, and the memory of the great British mathematician and computer scientist Alan Turing being given the choice between imprisonment and chemical castration in 1954, leading to his suicide, is still vivid; he is the one person who is very well-known – countless others suffered the same treatment and are forgotten. Turing’s major biography is Hodges (1983).

Marriage, monogamy and “promiscuity”

Directly and indirectly, the short indications given above about history have illustrated the major societal disapproval, legal and criminal sanctions exercised against people caught in adultery, premarital or extramarital sexual activity, or for what is labelled as “promiscuity”. This is far from gone and continues to be a problem for all who believe that monogamy is not the only way to structure relationships, or who want to have sex with a frequency or in relationship forms that are not usual or conventional.

Gender identity

Finally, there are the major issues of the treatment of gender identity, and changes in gender identity or gender-related body appearance that are needed for people to feel that their identity as they experience it themselves is respected and accepted in public. Much is moving, but equally much has not changed yet. People continue to be killed all around the world only for being trans. Financing of hormone treatment and of body modification is frequently still uncertain. Persecution and discrimination continue. And the mental health issues and suicidality of trans people are scandalously higher than those of cis people or of those without any changes or variation in their gender identity.

Variations in sex characteristics

Non-consensual body modification and mutilation continues of the large numbers of people who have one of the many forms of “intersex” variation. From inside the “intersex” community there is a growing preference for the use of VSC, standing for Variations in Sex Characteristics, instead of intersex. “Differences in Sex Development” is also used, and much preferred to the medicalising and pathologising terminology of “Disorders of Sex Development”. Apart from the naming, it is important to know that in the UK for example it is likely that there are more people with VSC than trans people who want to have body modifications. There is far too little awareness of what happens with people with VSC, and far too few spaces where they can speak up about their differences without drawing any adverse attention – let alone about getting their rights honoured and respected.

All the above examples are important especially if as a therapist you already consider that these changes are now “completed” and you have no problems with them. In other parts of the variations and differences that will be discussed in this module, almost certainly there will be issues on which as a person you have countertransference reactions when they would come up in your practice. And quite a few of them can involve and lead to legal issues, or practical ones like problems with the reactions from family, including parents or children, or issues related to a client’s work or profession. Even if in some cases as a therapist you feel challenged, or simply out of your depth, the above examples may make you think how much has changed historically, even in recent history, and hence that more may be relative, historically and culturally determined, and socially constructed, than has already changed.

References

Barker, M.-J., & Scheele, J. (2016). Queer: A graphic history. London: Icon Books.

Foucault, M. (1978). The history of sexuality: An introduction (Vol. 1; R. Hurley, Trans.). New York: Random House.

Foucault, M. (1985). The history of sexuality: The use of pleasure (Vol. 2; R. Hurley, Trans.). New York: Random House.

Foucault, M. (1986). The history of sexuality: The care of the self (Vol. 3; R. Hurley, Trans.). New York: Random House.

Gathorne-Hardy, J. (1998). Sex the measure of all things: A life of Alfred C. Kinsey. London: Chatto & Windus.

Hite, S. (1976). The Hite report: A nationwide study of female sexuality. New York: Seven Stories Press.

Hodges, A. (1983). Alan Turing: The enigma. London: Vintage.

Jones, J. H. (1997). Alfred C. Kinsey: A life. New York: W W Norton.

Kinsey, A. C., Pomeroy, W. B., & Martin, C. E. (1948). Sexual behavior in the human male. Philadelphia, PA: W B Saunders.

Kinsey, A. C., Pomeroy, W. B., Martin, C. E., & Gebhard, P. H. (1953). Sexual behavior in the human female. Philadelphia, PA: W B Saunders.

Krafft-Ebing, R. von. (1894). Psychopathia Sexualis, with especial reference to contrary sexual instinct: A medico-legal study (7th ed.; C. G. Chaddock, Trans.). London: Forgotten Books.

Maier, T. (2009). Masters of sex: The life and times of William Masters and Virginia Johnson, the couple who taught America how to love. New York: Basic Books.

Masters, W. H., & Johnson, V. E. (1966). Human sexual response. New York: Ishi Press.

Masters, W. H., & Johnson, V. E. (1970). Human sexual inadequacy. New York: Ishi Press.

Reich, W. (1972). Character analysis (3rd ed.; V. R. Carfagno, Trans.). New York: Farrar, Straus; Giroux. (Original work published 1945)

Rodriguez, S. B. (2014). Female circumcision and clitoridectomy in the United States : A history of a medical treatment. Rochester, NY: University of Rochester Press.

Sheehan, E. A. (1997). Victorian clitoridectomy: Isaac Baker Brown and his harmless operative procedure. In R. N. Lancaster & M. Di Leonardo (Eds.), The gender/sexuality reader: Culture, history, political economy (pp. 325–334). London: Routledge.

Strachey, J. (Ed.). (1953). An outline of psycho-analysis. In S. Freud, The standard edition of the complete psychological works of Sigmund Freud: Vol. XXIII (pp. 139–207). London: The Hogarth Press. (Original work published 1940)

Strachey, J. (Ed.). (1953). Three essays on the theory of sexuality. In S. Freud, The standard edition of the complete psychological works of Sigmund Freud: Vol. VII (pp. 123–245). London: The Hogarth Press. (Original work published 1925)

van Driel, M. (2012). With the hand: A cultural history of masturbation (P. Vincent, Trans.). London: Reaktion Books.

Vatsyayana. (1961). The Kama Sutra (S. C. Upadhyaya, Trans.). London: Watkins.