Sexual surgery in late-nineteenth-century America.

This article describes how the tendency of post-Civil War medicine accorded with general social tendencies. Doctors' attitudes toward women reflected their anxiety about female emancipation and changing sex roles. The specialty of gynecology emerged in significant part as a reaction to female emancipation. The strong surgical emphasis in American gynecology practice has continued. The operations, clitoridectomy and female castration, were intended to reimpose the traditional sexual order (the term "castration" and "female circumcision" implied women had become men). The paper goes on to describe the beginnings of psychosomatic medicine, the circularity of gynecologists' treatment of women, and the effects of this treatment. The operations were in part the expression of a symbiotic relation between doctor and patient. Because they expressed widespread and deep-seated beliefs, they were difficult to challenge.