Lesbians in Medical Dictionaries

This chapter compares the dearth of entries for f/f sexuality in general dictionaries in the 1750-1850 period with the wealth of discussion on those topics in medical dictionaries. The appearance of medical dictionaries as a genre aligned with an explosion of vernacular publishing in the health field in the 16-17th centuries. These were aimed not only at non-specialists, but at health workers outside the academic elite—people who didn’t have access to Latin literature. The publishing establishment operated as gatekeepers in terms of what material got published and how it was presented. Certain material was not considered appropriate for a female audience, even health workers such as midwives, and manuals aimed at the household market clearly understood their audience to primarily be women. Thus there was a concern to exclude material considered inappropriate for women to read. Within this context, the medicalization of sexuality began to emerge as a site of social control.

Non-normative sexuality could be seen as either a cause or a consequence of health problems. For example, the condition known as “malthacos” listed in a medical dictionary of 1745 is described as being associated with “molles” and “tribades” and discussed both as a congenital defect and an acquired vice, but is classed as a disease. In common with general dictionaries, the discussion of such words in medical texts either assume the reader knows what “molles” and “tribades” mean or leave it to guesswork for the reader to figure it out. The classical sources from which the medical dictionaries harvested “malthacos” saw it as a transgender condition—men taking the role of women, and women that of men—rather than homosexuality in the modern sense. But even this specificity is lost in the vague description of the medical dictionaries.

In contrast to general dictionaries, medical dictionaries had a particular fascination for f/f sex and especially with how it was performed. Given phallocentric assumptions, this focus centered around penetration and the use of the clitoris as a penis analogue. A particular interest was the relationship between anatomy and sexuality—how transgressive sex could change the body, and how aberrant anatomy could drive a person to participate in transgressive sex. The discussion touches on venereal diseases and intersex anatomy, but returns to the clitoris as its main example.

Discourse around the clitoris focused on it being an analogue to the penis, both in shape and function (with regard to pleasure). Variation in size of the clitoris was recognized by medical authorities and was use to reanalyze the theories of prior eras about “hermaphrodite” (intersex) bodies in order to fit them into a gender binary. But the more a clitoris fell outside what was considered the norm, the more it was treated as a medical condition to be addressed by prevention or correction. “Abuse” of the clitoris for pleasure—whether solo or with another woman—was thought to cause it to enlarge. But, in turn, the prevailing opinion was that a woman with a clitoris large enough to engage in penetration would be drawn to f/f sex. These beliefs appear at least from the 16th century on, although explicit terms for the women involved only begin to appear in medical dictionaries around the 1720s.

In addition to concerns about a variant clitoris causing/enabling f/f sex, medical texts alleged that it might interfere with m/f sex. For this, surgical removal was suggested lest it “hinder the enjoyment.” Given that the erotic sensitivity of the clitoris and labia were recognized in medical literature from at least the 17th century, the “enjoyment” being referenced was clearly that of the male partner. It isn’t clear to what extent this surgical approach was actually practiced in England. As with many topics, discussion in the medical dictionaries typically displaced the practice into foreign regions (Egypt and Arabia), and some texts specifically note that English women rarely have the anatomy that would require it. Another displacement intersects with anti-Catholic sentiment in connecting clitoral enlargement with f/f sexual activity in convents.

These general themes come together in a 1719 medical dictionary to explicitly attribute clitoral enlargement to engaging in f/f sex. A 1722 edition of the same work is the first of this genre to include a headword relating to f/f sex: “confricatrices” glossed as “lustful women who have learned to titillate one another with their clitoris.” The authors asserts the word was in common use (though probably mostly in Latin). A 1663 medical text had included it as a Latin word and glossed it with “rubster” (which presumably means that the word rubster was familiar to its readers).

A central theme in sex writing in the 17-18th centuries is that “sex” is defined by phallic penetration. Therefore, to the extent that authors discuss “sex between women” they are concerned only with practices that include penetration. [Note: I want to emphasize here that this doesn’t mean that women weren’t engaging in non-penetrative erotic activities, simply that those activities weren’t going to be discussed by medical authorities.] However discussions of “confricatrices” sometimes discuss their activity in mutual terms, not distinguishing an active/passive contrast. Other authors view such acts as asymmetrical and driven by the deviant anatomy of one woman, whose partner simply benefits by avoiding the risk of pregnancy. The possibility of either partner being inspired by an active desire for a female partner is not considered.

Although some historians of sexuality assert that the “macroclitoral” woman ceased to be of interest after the mid 18th century (based on the dismissal of erotic desire as a factor) Turton notes that medical texts of the later 18th century continue to repeat the motifs that enlargement of the clitoris is both caused by and results in erotic stimulation, with regular reference to “the tribades…of the ancients” or fricatrices, with reference to a preference for female partners.

This conjunction of motifs continues to appear in medical manuals of the 19th century, although there is a shift to emphasis on enlargement as a result of stimulation, thus making it a behavioral issue rather than an anatomical one. In addition to blurring distinctions between masturbation and f/f sex in connection with clitoral enlargement, some texts (e.g., one of 1791) mention the use of a dildo (using Greek “olisbos” and Latin “coriaceus”) as a source of sex-related ailments of women.

Anne Lister gives us a useful practical contrast to these professional assertions. She writes that she doubts that classical tribades all used dildos and she herself refused to use one (interestingly, she associates it with “sapphic” practices, suggesting that she had some clear distinction in mind with respect to her own practices). Explorations of her own body, inspired by medical texts discussing the clitoris, indicate that her own was not of notable size. Her comments on this exploration also suggest that the dictionary editors who worried about women “getting ideas” from explicit texts were not entirely wrong!

(There is a brief discussion of some additional vocabulary related to m/m sex, but I’m not entirely ignoring m/m topics, they simply aren’t the focus on this chapter.)

While earlier medical dictionaries had converted Greek and Latin terms into English forms (in parallel with practices in general dictionaries which sometimes created new English vocabulary from Greek/Latin words), the Victorian era saw a preference for retaining the original Greek and Latin words, and coinages from them, as a sort of “international scientific vocabulary.” The cross-cultural exchange of medical writing in the 19th century resulted in the establishment and spread of a common vocabulary for sexual topics, sometimes altering previous understandings of the meaning. As an example, some terms that in classical sources had referred to same-sex topics specifically were reinterpreted as referring either to homosexuality or masturbation with no distinction made. These medical definitions of sexual vocabulary were then projected back onto the classical texts in which they occurred, changing the context in which those takes were understood. Thus all words for participants in f/f sex were defined as meaning “tribade” and tribade was defined as a woman with an enlarged clitoris who takes an active role in sex with another woman. [Note: I have seen histories of sexuality that appear to accept these 19th century redefinitions as reflecting actual usage in other eras, especially in terms of concluding that “tribade” has always universally meant “a woman with a penetrative clitoris” from classical times onward. I view this with skepticism, especially given the semantic origins of the word.]

Medical theories of the effects of homosexuality on the body were invoked by legal bodies in respect to men suspected of sodomy, in contrast to the primarily medical (and moral) focus of concerns about women.

The author notes that this persistent and increasing medical discourse around homosexuality in the 18-19th centuries rather undermines the idea that sexology represented a dramatic shift in the late 19th century. He connects this observation with Traub’s “cycles of salience” in which concepts recur periodically in different forms across the centuries. The focus of sexology on psychological rather than physical models was the most distinguishing feature of the late 19th century. [Note: But even sexological theories about homosexuality placed a strong emphasis on somatic markers of orientation – the mannish woman, the effeminate man.]

The chapter concludes with a discussion of the physicality and materiality of dictionaries themselves – how they were printed, their size and scope, cost and distribution, and the resulting effects on accessibility to various potential readerships.