To put it very briefly, Medicine, the Penal System and Sexual Crimes in England, 1919-1960s is about the history of the idea that there is something ‘wrong’ with sex offenders that can be cured. It focuses on the mid-twentieth century, when (in England, at least) there was an opportunity for doctors interested in mental or sexual disorders to attempt to rehabilitate some of those guilty of sexual crimes. This started with psychotherapy, but evolved into group therapy, psychoanalysis, hormone injections, and more. Treatments were sometimes carried out inside prisons, and sometimes as an alternative to prison sentences, as was the case most famously for Alan Turing. These approaches were connected to shifts in the legal and penal systems and a greater interest in individualised rehabilitation, as well as the development of sexology and psychiatry.
NOTCHES: In a few sentences, what is your book about? Why will people want to read your book?
Weston: I’m hoping that the book will offer a different perspective on medical interventions around ‘sexual deviance’. We’re starting to learn more about the experiences of lesbians and particularly gay men who were studied and treated by doctors in the recent past, and about sexual violence and how crimes like rape and child abuse have been perceived. I wanted to look at all types of sexual crime, however that was defined, to see how different offences and offenders were theorised and treated. I hope that the book helps to show why sexual crimes were singled out as signs of sickness, how medical explanations and cures were adopted, and why therapeutic or pathological models of sexual crime did not see quite the same success in England as was the case elsewhere.
NOTCHES: This book is clearly about the history of sex and sexuality, but what other themes does it speak to?
Weston: It’s also a history of crime and punishment: it looks at the role of the legal system, attitudes towards offenders and rehabilitation more broadly, and changes in sentencing practices that both reflected and encouraged medical ideas and interventions.
It also addresses the evolution of the psy-professions, the limitations of medicine within the judicial system in the England, and the role of prison doctors in particular.
And lastly, it touches on ideas about crime and responsibility and culpability, which come to a head in debates over the insanity defence in cases of sadistic sexual violence. When does difference become disease, and does this affect whether people are responsible for their actions?
NOTCHES: How did you research the book? (What sources did you use, were there any especially exciting discoveries, or any particular challenges, etc.?)
Weston: One of the major challenges was that copies of medical evidence used in criminal proceedings, and records of treatment attempted on sexual offenders, is extremely patchy. Where records exist, some are closed because they contain medical information about persons who may still be alive, and others are closed because they might identify victims of sexual crime. Even when it came to what could have been simple statistics about how many people were directed to receive treatment as part of their sentence, it turned out that this kind of information hadn’t been collected consistently. I had to piece information together from a wider variety of places than I’d initially expected. I also have to acknowledge that the story might change, as the archives become more accessible with the passage of time!
Parts of the research were also, to be honest, fairly upsetting. A lot of the material I used, such as newspaper reports or research into ‘the psychotherapeutic approach to crime’, was one step removed from crimes and treatments themselves, but police and prosecution records were sometimes hard to read.
Some police files delivered the unexpected. Perhaps the most startling moment was when I was sifting through a file about the theft of schoolgirls’ underwear from washing lines. The underwear would be returned through the letterbox, stained and with obscene notes attached. I’m grateful – I think! – to whichever investigator or archivist carefully tucked those obscene notes into the file, even if it’s not the sort of language I’m used to seeing in the National Archives.
NOTCHES: Whose stories or what topics were left out of your book and why?
Weston: I would have loved to find out more about the kinds of medical arguments that were actually put forward in mitigation, to argue for reduced sentences or even an acquittal, and to have had a fuller picture of how often these were accepted. There’s a chapter in the book on medical evidence in court, but gaps in the archives meant that it had to be fairly broad-brush and speculative. I think there’s still more to be said there.
I was also particularly intrigued by a collection of interviews with sexual offenders, first published in 1969, in which the interviewees reflected upon their experiences with medicine and the law. Some had wanted treatment but been refused, while others had been sent to group therapy, given hormone injections and tranquillisers, and even undergone lengthy and expensive psychoanalysis. They also had very different views of their doctors’ theories and efforts, and their own offences.
These interviews were absolutely fascinating, but they were the only first-hand accounts I could find from this perspective – except for some memoirs by gay men who had run-ins with the law. I would have liked to know more about whether medical interpretations of sexual crime were accepted or rejected by offenders themselves, and whether treatments – which were rarely seen as successful from the clinician’s perspective – did feel like cures.
NOTCHES: Your book is published, what next?
Weston: I’ve been lucky enough to have had two great research positions since finishing the research for this book. I’m currently researching the history of mental capacity. This picks up on some of the ideas around responsibility that I began to consider in the book, but considers them in a non-criminal context: namely, when adults are deemed unable to make their own decisions, usually because of mental illness, learning disability, or dementia. How has this changed, and what does it say about our ideas of free will, autonomy, rights, and the role of the state?
Before that, I worked on the project ‘Prisoners, Medical Care and Entitlement to Health in England and Ireland, 1850-2000’, where I focused on HIV and AIDS in prisons. There’s a lot of exciting work going on right now on the history of HIV and AIDS, so watch this space for more on that!
Janet Weston is a Wellcome Trust Research Fellow at the Centre for History in Public Health, at the London School of Hygiene & Tropical Medicine. She has recently worked on a history of HIV and AIDS in prisons and co-convened the London AIDS Histories and Cultures Festival. Her current project is a history of the medico-legal concept of mental capacity.
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