Catching venereal disease is different from catching a cold. It's nastier, more intimate, raises suspicions, and makes you wonder why you were so stupid not to have safe sex, or why you had sex at all. Not surprisingly, the loaded meaning of VD has haunted European society for ages. Who infected whom was not simply a medical but also - at least for the past 150 years - a political question. An oversimplified but nevertheless true answer to this question has been, until fairly recently, that women infect men. The roots of this view are found in 19th-century approaches to combating VD by controlling prostitution, most often through a system of licensed brothels and compulsory medical checkups and treatment. "Syphilis" (or what was diagnosed as such) was seen as a gendered sickness, transmitted by "loose" women from the lower classes whose civil liberties were trampled by lock-up hospitals, police control and forced examinations, all in order to protect male sexual needs.
The regulation of prostitution has been intensively studied by historians; increasingly, too, there have been studies that look beyond the "standard" British history focusing on Josephine Butler's famous crusade against the Contagious Diseases Acts. Ida Blom contributes to this debate, and to the history of VD, by tracing the development of anti-VD policies in three Scandinavian countries - Sweden, Denmark and Norway - including the HIV/Aids crises of the late 20th century. She shows how, by and large and to different degrees, the three countries represent a Scandinavian Sonderweg (special case) compared on the one hand with the traditional liberal approaches that emerged in the UK following the repeal of the Contagious Diseases Acts and on the other hand with the controlling, coercive strategies of Germany. She argues that VD legislation foreshadowed and mirrored the three main categories of (emerging) welfare states - liberal, conservative-corporate and social democrat. In the Scandinavian social democracies, the welfare state was your friend, downgrading social hierarchies, whereas in Germany it upheld gender and social differences, and had to be obeyed by its citizens. This had an impact on issues such as prevention, free and/or compulsory treatment, "contact tracing" and the social groups targeted in the fight against contagion.
Increasingly, legislation in Scandinavia was formulated in gender-neutral and universal terms, respecting what Blom calls "the morality of citizenship", the idea that the state conferred the same rights and duties on all citizens. Obviously, medicine and sexual morality were always intertwined and a gendered morality prevailed even if legislation was put in neutral terms. In the mid-20th century, for example, "deviant" young girls were targeted. However, new policies emerged at the same time as curative medicine, offering successful treatment with antibiotics, helped to pave the way for a change from the late 1940s onwards. Ultimately, all five countries would witness an end to the long tradition of seeing women as the principal transmitters of VD - but it took more than a century. At the same time, HIV/Aids was seen as transmitted primarily by gay men.
Medicine, Morality and Political Culture is as complex as the title suggests. How could it be otherwise? Blom's study stretches over a long historical period, involves five countries, traces the history of legislation, attempts to incorporate the impact of women's organisations, and deals with changing medical views on sexual morality and with particular forms of welfare state policies. Aren't there too many variables here? How do they relate to each other? Reading this book initially gives you the feeling that you have not quite understood the main argument, which is problematic, and all the more so as some periods and some legislative processes are highlighted while others are not. Nevertheless, the finding that it is possible to view VD policies through the lens of an emerging welfare state is very useful as an academic contribution to an ongoing historical debate.
Medicine, Morality and Political Culture: Legislation on Venereal Disease in Five Northern European Countries, c.1870-1995
By Ida Blom Nordic Academic Press. 192pp, £26.95. ISBN 9789185509737. Published 1 March 2012