Women in Gynecology Textbooks

The Scully and Bart piece published in 1973 analyses 27 gynecology texts written from 1943 to 1972 by looking at the viewpoint presented. The scholars conclude that the literature remains oriented towards maintaining the male-dominated, traditional views of sexuality despite the revolutionary findings of Kinsey, Masters and Johnson (Scully and Bart, 1048). Overall, ideas of the centrality of motherhood in women's lives persists, while men as defined by their active sexual responses and desires.

The authors note that "one's perspectives are constrained by one's place in the social structure and thus gynecologists may not adequately represent the interests of the group they are supposed to attend and advocate" (Scully and Bart, 1045). An overwhelming majority of male practitioners would mean that the field lacks a female perspective on what is a female health issue.  Considering that 40 years ago, when this article was published, over 90% of gynecologists were male, it is not hard to imagine that their academic writings on the subject reflected their male perspectives and portrayed female sexuality in a way that maintained traditional sex-role stereotypes (Scully and Bart, 1045). 

MOTHERHOOD
Gynecology texts from 1943 to 1972 revolve around the idea that women as "anatomically destined to reproduce, nurture" (Scully and Bart, 1045). One text refers to the experience of motherhood as an "urge" (Scully and Bart, 1046). This biological explanation is used to define the role of females in a very strict way which does not allow for possible deviant behaviors and attitudes. In the medical literature, the natural inclination for motherhood is balanced by sexual pleasure, considered "entirely secondary or even absent" (Scully and Bart, 1046). In other words, the automatic, biological female response is seeking motherhood, while sexual response is not important or present as women as frigid.

FRIGIDITY
The texts dating from this period assume that women are "almost universally generally frigid" (Scully and Bart, 1046). Their role in sexual health is defined as constricted to motherhood, while men are defined as active and pursuing their sexual drives. This was done, in the case of women, by reporting that the vagina was the main erogenous zone, even after Kinsey debunked the myth of vaginal orgasms (Scully and Bart, 1047). The vagina was considered the "mature response", while the role of the clitoris was greatly diminished and linked to immaturity and frigidity (Scully and Bart, 1047). This generalized female sexual unresponsiveness, the passivity, was for some authors part of the core of the female personality (Scully and Bart, 1048). The construction of the myth of female frigidity was in opposition to the active male sex, who had an insatiable appetite for intercourse (Scully and Bart, 1046).

MALE SEXUAL DRIVE
These texts in a woman-oriented field claimed that women are biologically designed to keep their husbands happy, they are to at the control of their male counterparts (Scully and Bart, 1045). Sexually, women are frigid, unable to perceive or care about pleasure, but men have a much greater appetite and capacity for intercourse. So, their sexual contacts already have a paradoxical nature, however they were greatly encouraged. Gynecologists were told to suggest that patients, unresponsive in nature, should deceive their partners by using innocent simulation (Scully and Bart, 1046). Faking sexual interest or an orgasm was part of making your husband happy. 

"The frequency of intercourse depends entirely upon the male sex drive ... The bride should be advised to allow her husband's sex drive to set their pace and she should attempt to gear hers satisfactorily to his."(Scully and Bart, 1048).

This was advice given to young women in 1970, a time was less than 30% of women had premarital sex (CDC, 1991). Men were described in the literature as wanting to dominate and subjugate women(Scully and Bart, 1048). It means that the submissive behavior was natural, but for women it was also learned behavior, as a means of social control. The norm was that women had to adapt to the male response their husbands exhibited or else there was a "real [medical] problem" (Scully and Bart, 1048).

INTENTIONAL SELECTIVITY
The article notes the rigidity in textbooks along the studied decades. After Kinsey, Masters and Johnson made their discoveries in human sexuality, most textbooks cherry-picked the data to present their points of view. Result? Most books included some details pertaining to male sexuality, but failed to include any of the discoveries on female sexuality such as the myth of the vaginal orgasm or the existence of female multiple orgasms (Scully and Bart, 1047). This level of selectivity of results leads the authors to characterize the general tone of gynecology literature as having a male bias (Scully and Bart, 1048). The evidence does indeed point to severe opposition to change in mentalities concerning human sexuality. Women's sexuality is barely researched and discussed, although the lack of knowledge can be detrimental for public health. 

FOREVER MALE FIELD?
The article dates back from 1973 and we are seeing changes. While almost two thirds of ob-gyn doctors are male, the majority of those training are women.The increased supply of female doctors can benefit research and policy making by bringing a new perspective and patients can feel like their doctors can empathize with them. However, the current demand for ob-gyn doctors is skewed towards the female applicants, their male counterparts feel unwelcome in a job market that is searching for female doctors.  http://www.nytimes.com/2001/02/07/us/women-s-health-is-no-longer-a-man-s-world.html


RELATION TO ORGASMS
The literature has changed from the 1970s, but many of these deeply embedded beliefs have carried over to this generation, some have turned into other forms of controlling and underplaying female sexuality. Female orgasms are not discussed, are considered nonexistent, unimportant. The problem with medical literature that is not accurate is that is reinforces gendered social behaviors and attitudes, instead of objective results. Beliefs and stereotypes are heavily used used in social interactions, thus it is no surprise that these are some of the most popular ideas in regards to female orgasms we currently hold seem to stem back from a few generations ago  http://www.everydayhealth.com/sexual-health-pictures/dr-laura-berman-top-10-female-orgasm-myths.aspx#01



Reference:
Scully, Diana, and Pauline Bart. "A Funny Thing Happened on the Way to the Orifice: Women in Gynecology Textbooks." In American Journal of Sociology, 1045-1050. Jan. 1973 ed. Vol. 78. University of Chicago Press.
The Centers for Disease Control and Prevention, 

Current Trends Premarital Sexual Experience Among Adolescent Women -- United States, 1970-1988. 1991

 http://www.cdc.gov/mmwr/preview/mmwrhtml/00001869.htm