Women’s right to reason… (Part 3)

12 March 2018.

Part 1 of this 3-part blog post discussed the way in which medical theories tend to be highly reflective of their particular cultural, and historical context. In part 2, we looked at the history of women’s rights movements, and how they evolved in parallel with the birth of modern democracy in Europe; prompting debates about the ‘rationality’ of women, as a means to justify their continued lack of legal rights, in supposedly fairer and more representative societies. The final part of this International Women’s Day special blog describes how the myth of the ‘irrational female’ thus became medicalised

Hysteria meets hypochondria…

When Thomas Sydenham reclassified ‘hysteria’ as a nervous, rather than a physical (uterine), disorder, in the late 17th Century, he also expressed his belief that it could affect men, too [1]. He dodged criticism by calling ‘male hysteria’ by a different (non-womb-related) name; ‘hypochondriasis‘ [1].  The ‘hypochondria’ is actually the name of a specific part of the human body [2], near to the diaphragm in the upper abdomen. Critically, this anatomical area includes the spleen- the organ thought to be the cause of melancholia [3]. Partly as a result of this pairing, (but also because other hysterical symptoms were beginning to be redefined as separate illnesses e.g. iron deficiency anaemia), ‘female hysteria’ began to be more closely associated with mental health, especially anxiety or depression

A hypochondriac surrounded by doleful spectres. Coloured etching by T. Rowlandson after J. Dunthorne, 1788. Wellcome; http://catalogue.wellcomelibrary.org/record=b1176006

Then, in 1822, French physician Jean Pierre Falret stated that ‘false beliefs about an impaired state of health‘ were characteristic of hypochondriasis [4]. This signalled a gradual transformation of the male version of hysteria into what we might now call health anxiety. Simultaneously, ‘female hysteria’ became increasingly defined as a mental health disorder, stigmatised, and associated with malingering, or ‘imagined’ illness… {Much like many female-prevalent conditions continue to be ‘disbelieved’, today e.g. abdominal pain [5],  Irritable Bowel Syndrome [6], Chronic Fatigue Syndrome/ ME or Fibromyalgia [7]}. This is what Jean Pierre’s (rather unsympathetic) psychiatrist son, Jules Falret, had to say about hysterical patients [8];

Medicine, morality, and ‘hysteria’ as a political tool…

You may have spotted a few veiled references to sexuality and other (shocking!) ‘unladylike‘ behaviours in the above quote. This is no coincidence, Jules Falret is voicing the same fear of female agency (i.e. the right to self-determination), that so distressed his post-revolution fore-fathers. Only, in his case, he is attributing ‘improper’ female behaviour (i.e. anything that does not fit with the prescribed social role as an obedient wife and mother) to a female-prevalent medical condition (albeit one that he simultaneously implies is faked).

Whilst this position makes no logical sense, it still effectively undermines the actions of any woman who dares to resist her designated role in life, by claiming she is irrational and/ or immoral, either through physical/ mental illness, or her ‘innately’ poor moral character, and diagnosing such behaviour as ‘hysteria’. This meant that a pre-existing  tool of oppression e.g. the locking up of political activists in ‘mental institutions’ (as happened to some working class Leveller women in 1649), could still be justified as a necessary medical intervention, even in a supposedly more egalitarian society.

This association between the women’s rights movement, and the myth of the ‘irrational female’ can clearly be seen in anti-suffrage propaganda. Female sexuality, morality, and rationality is undermined by the notion that suffragists (people who demanded the right to vote for women) were ‘hysterical’ (i.e. mentally ill, irrational, immoral, sexually unattractive, and ‘bad’ wives and mothers);

The tendency to make moral judgements on ‘inappropriate’ social behaviour, and describe it in medical terms (i.e. as symptoms) in order to justify political inequalities, continued into the 20th Century and beyond…

For example, in 1931, Dr Robert Frank first formally described Premenstrual Tension (PMT- the precursor to what we now call Premenstrual Syndrome, PMS). Take a look at the ‘complaints’ column, below. In several cases, the symptom is actually a value judgement on improper, or undesired, female behaviour, and highly reminiscent of Jules Falret’s version of ‘hysteria’, e.g. “husband to be pitied”, “unbearable, shrew”, “almost crazy”, or “impossible to live with”. Similarly, we see societal expectations of the proper (healthy/ moral) role of women (i.e. as wives and mothers) reflected in the inclusion of apparently ‘diagnostically significant’ data regarding marital status and parity, the condition of having borne children (as well as known miscarriages, labelled as ‘abortions’, in this case) [9];

Cases of Premenstrual Tension [9], p 1055
21st Century hysteria…

It is interesting to note that ‘hysteria’ no longer really exists as a culturally relevant medical condition (it stopped being listed in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders from 1980, onward). However, the medicalised myth of the ‘irrational female’ persists…

  1. Medical disbelief/ presumed hypochondria; female-prevalent chronic ill-health symptoms are more likely to be disbelieved by family members, or clinicians [5-7].
  2. Over-diagnosis of anxiety and depression in female patients; research has shown that patients presenting with exactly the same symptoms are diagnosed and treated differently depending on their gender, women are more likely to be diagnosed with depression, and are also more likely to be prescribed antidepressants [10].
  3. The cultural/ clinical portrayal of PMS; menstrual cycle-related symptoms are frequently presented as being mainly mood-based, exaggerated, or as a type of mental health disorder [9]- despite the obvious hormonal origins of cyclical issues, and more common physical symptoms e.g. period pain, abdominal pain, upset digestion, or fatigue [11].
  4. An assumption that ‘all women’ are biologically the same; there is a tendency to extrapolate (extend to a larger population) the symptoms, or experiences of a minority of female patients to ‘all women’. For example, because a minority of menstruating people experience such severe period pain that they are unable to work, there have been calls for ‘menstrual leave’ for ‘all women’… Even though, not all women menstruate, sick leave already covers severe period pain, and only a minority of menstruating people experience this problem (see this blog post for even more reasons why ‘menstrual leave’ is a bad idea for gender equality and menstrual health). It’s almost as if the female body itself (especially the womb and the menstrual cycle) is classed as a type of illness.

So, in this celebratory year (100 years of the right to vote for all men, and land owning women over the age of 30) please take note of the on-going legacy of anti-suffrage propaganda…

Listen to any justifications made for gender inequality e.g. why there are more men than women in parliament, in leadership or senior management positions, or why women earn less than men for the same work- you’ll be amazed how often female biology, anatomy, hormones, rationality, and the ‘natural’ social role of female humans as wives and mothers (only), comes up!

This isn’t an unimportant issue, gender inequality has real life impacts on many individuals and families. For instance, in England, it wasn’t until 1991 that rape within marriage became a crime- before then it was deemed legally impossible for a husband to rape his wife, since through the marriage contract, he had rights over her body.

On a more positive note, it’s also good to reflect on how far we’ve come since the 1600’s when brave women and men first campaigned for women’s right to have a political voice. Here’s some rather lovely footage from the first time women were allowed to vote in France (suffrage was granted in 1944- during World War II )- (I find it very moving!)…


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