Morphology and Meaning

The authority by which the sexologist could interpret his female subject's sexuality was nearly unbounded. Dickinson combined case history material with information obtained in gynecological examinations. The results of his investigations, as presented in the text, provided little dignity and showed no respect for these patients. Throughout the case studies, psychologized assumptions about women, understood in terms of a libidinal economic theory, were mapped onto the study subjects' bodies. In this another case, Dickinson decoded pathology in a girl's body and actively enforced the conventions of health that conveniently mirrored his vision of sexual propriety.52

During the course of treating an upper-class seventeen-year-old girl, Dickinson was shocked to uncover what he thought were sexual aberrations. He examined this girl's genitalia and found "evidence" that she was not a virgin, although she protested otherwise. The findings of his examination in case 372, the first case in the series, were described as follows.53

The vulva indicates the most extreme autoerotic or homosexual practice. The vagina has huge folds, very unusual in a young girl, and is enormous; the anterior wall is whitish, leathery but rugose. The meatus gapes. The vulva shows big glands on a flushed, shiny surface, great veins above the clitoris, old smegma and little prepuce; it immediately appears very erotic, flushing to a quick purple without mucous secretion, very thin pelvic floor, no levator action, nearly admits the hand, four fingers two joints. This is an exhausted vulva. The hymen has no nick and is insensitive. The patient has never douched, never been examined or treated by a doctor, the possible alternative causes of such enlargement of the hymen.54

The depiction of this girl's genitalia was used to demonstrate that physical signs could point to sexual deviance specifically, homosexuality and autoeroticism. It was assumed in this diagnosis that a chaste girl's genitalia would be different; the chaste girl was seen as the normal girl. The patient's genitalia was described in Dickinson's discussion to reflect her perceived sexual activity. He believed in a strong connection between psychic life and what he called the "physiology of the pelvic zone."55 Words such as "flushed," "erotic," and "exhausted" which he applied to her genitals mirrored Dickinson's attempts to construct her as sexually precocious. Drawing upon what Ellis had theorized earlier, Dickinson believed that women had a level of sexual energy that was comparable to men, but it was harder for women to express and control it. This formulation made women more prone to disease, particularly nervous disorders.56 For Dickinson, the mismanagement of her limited sexual energy was seen as leading to pathology (i.e. the exhausted vulva). Furthermore, her genitals were depicted as unclean by Dickinson's language. Phrases such "old smegma" and that "she has never douched" stressed the impurity and pathology of the study subject. She was not only represented as being precocious because of her non-heterosexual activity, but she was dirty.57

This view of her being unclean led to the connection between sexual deviance and pathology which drew on the medical mythos of contamination equaling disease58 . Since the shape of her vulva did not coincide with her story and no other medical intervention which could be alternatively read as male penetration occurred, she was rendered a liar who concealed her sexual pathology because of shame. Dickinson implied that by wasting her sexual energy engaging in autoerotic and homosexual practices, she was harming herself. The "harm" of her pleasure supposedly led her to require gynecological treatment. In Dickinson's mind, sexual misconduct was translated into sexual mismanagement. The apparent over expenditure of sexual energy was what Dickinson cited as leading to disease. 59

Dickinson constructed this girl's genitalia in a peculiar fashion. He compared her vagina, clitoris, hymen, and labia to those of other girls. Noticing the difference between them, he assumed sexual pathology. Dickinson not only constructed a definitive normal limit to the shape of her genitalia but turned them into an object of scientific inquiry. The contours of female genitalia were fetishized under Dickinson's scopaphillic gaze. Female genitals were either virginal or, as he put it, "erotic." The unbroken hymen became a prized symbol of pure girlhood and potential heterosexuality. The enlarged vagina represented pathological desires in the form of autoeroticism and homosexuality. Genital size signified erotic intensity and sexual pathology. By looking and touching the girl's vulva, Dickinson produced a narrative of her sex life which disputed her own recollection of it. Dickinson's aesthetic judgments decided the "sexual truth" which for him was written on her body.

Dickinson turned this girl's body into an object of pathos, and he went further. He wanted to punish her for her sexual improprieties. Dickinson deliberately hurt her during the gynecological procedure she came to have him complete. Dickinson did not apparently have any qualms about printing this statement in the published version of the case study. Dickinson "hurt her purposely" to teach her a lesson. Somehow his abusive act was acceptable enough to the medical community to be put into print. 60

After the painful procedure, the girl returned to Dickinson for further treatment during an engagement she secretly agreed to with a young lawyer. She asked, "Why do I have to come again?". Dickinson replied, "Because of the catarrh61 of the womb and you have that because you are doing something you deny you do?". Dickinson wrote, "no erotic behavior, but some face flushing" during this tense verbal exchange.62 Dickinson yet again connected sexual deviance and illness but this time in the form of cervicitis. He blamed this girl for her illness and the sex life he perceived she had. The symbols of his description had changed, however. The erotic vulva had now become the flushed face. Dickinson implied a transfer of shame from one part of the body to the other. For him, the shame could be read by his trained eye observing her body; she did not need to say a word.63 Dickinson commented at the end of case 372, "happily married with normal response in coitus and no nick of hymen or fourchette in labors."64 Apparently, Dickinson believed her marriage caused an improvement in the shape of her genitals. A return to heterosexual sex was equated with a return to health and somehow Dickinson saw it signified on her body.

Dickinson played three roles in this particular case study: gynecologist, sexologist, and disciplinarian. He used his socially sanctioned ability to observe the female body as a tool to disrupt its pleasures. Dickinson would not merely look, touch, or draw what he saw. He would deploy his findings into a theory that would employ education as a means to ending sexual deviance. This would necessarily promote marital sexuality. As shown in the above case study, sometimes he would not take the time to educate his patient. Dickinson could simply enforce his scientific morality by hurting her.

Much of this anatomical diagnosis was linked to Dickinson's much earlier research in female genital morphology. In his 1902 article "Hypertrophies of the Labia Minora and Their Significance," Dickinson connected the shape of the labia minora and majora with sexual activity, particularly autoeroticism. The enlarged genitals he located in these women's bodies exhibited their autoeroticism. Dickinson connected autoeroticism with pelvic diseases such as cervicitis. It was in this early work that Dickinson first attempted to read behavior into the female body.65

In the final analysis, Dickinson could not definitely demonstrate a cause or cure for homosexuality in these women. He favored a theory of bisexuality. Through development, a person would be socialized into a heterosexual lifestyle. Homosexuality was conceived as the failure of proper developmental socialization.66 These failures are linked to both the family and the individual. "The youthful life of these patients often contains early and critical brooding and adverse judgments about the parental relationship and marriage, the father relatively lacking and the mother's position unstable."67 According to Dickinson, those who later have homosexual relationships come from unhappy and unstable homes. In a sense, he believed these patients were rejecting the family structure which further complicated attempts to heterosexualize them. During critical periods the transition from bisexuality to heterosexuality was apparently not made in his research subjects. In Dickinson's estimation, this lead to a period of homosexuality in these women that ended in marriage.68

Despite the fact that he claimed to be unable to come up with a detailed curative regimen for homosexuality, Dickinson was developing a preventive remedy. The last case in the series on homosexuality, 1137, of this volume discussed a form of social manipulation which was mentioned as an example of the progress of Dickinson's theory.69 The case study explored a mother's concern for the normalcy of her daughter. The mother came to Dickinson because she was suspicious of the relationship of her daughter and a college friend. They were quite close friends, but there was no evidence of sexual relations. In response to the mother's concerns, Dickinson advised her to, "raise no questions and do nothing directly. . . have the other girl at the house weekends and with the chance to live like sisters they will become so. Meanwhile consider her daughter's chances to meet men, have rest and social life and try to make opportunity. Later when this situation is not acute, take up the question of marriage."70 Dickinson wanted the mother to conspire to normalize her daughter's sexuality. He wanted her to discretely engineer social situations which would push her daughter into a heterosexual lifestyle. Dickinson believed this would allow her daughter to enter the world of marriage and family, to lead a "normal" life.

Dickinson believed it was his position as a physician specialized in treating the "diseases of women" to regulate many aspects of his patient's lives to promote health. The case of the concerned mother and her daughter was not an aberration in his work. Dickinson favored the redirecting personality through education. He went further. Food intake, sleep, exercise, amusement, and vocation were parts of his patient's lives he wanted to regulate. He linked social and personal behaviors to health in a way that was analogous to this case. To what extent he was able to effectively supervise such diverse behaviors is difficult to answer. Regardless, Dickinson's will to do so was problematic.71

The implications of this study to his construction of homosexuality, and necessarily heterosexuality as well, were great. Heterosexuality became something that needed to be promoted and protected. Heterosexuality was paradoxically constructed as fragile even though it was designated as healthy and natural by Dickinson. He believed heterosexualization was a precarious series of developmental steps that could be disrupted at any time. This was especially true, in his opinion, for women. Dickinson wanted experts to intervene to help prevent people from straying from the heterosexual path and correct deviance if it was discovered. All that was not heterosexual was projected onto the homosexual. Yet, an important absence persisted in his understanding of homosexuality as Dickinson noted to himself in 1933, "Why does this sexual manifestation cure itself sometimes but not always?"72 He saw that sometimes women married after experiencing same-sex love, but others did not. This was a question he would try to resolve in his next major study of homosexuality. It was a question he could never completely unravel.

The Committee for the Study of Sex Variants was established by Dickinson in 1935 to further his investigation into homosexuality. He had to work outside of the Committee for Maternal Health because of opposition to further study in this area by the executive secretary, Louise Stevens Bryant. The study relied upon the help of people within the New York City's gay culture particularly a "Miss Jan Gay”73 . Gay contacted Dickinson in the hopes that he would be receptive to helping the homosexual community. They eventually collaborated and she brought him the case studies he used in the study. The gay researchers involved in the project hoped that their participation would lead to a sympathetic reading of gay life, but that did not occur. This study turned out to have a strong commitment to a medical model of homosexuality which did far more to condemn gay life than it did to improve its cultural understanding and acceptance.74 After the publication of the two-volume Sex Variants monograph, the committee, which was founded only six years prior, ceased its operations.75

Dickinson's contribution to Sex Variants took a much more clinical vision of same-sex desire which extended his work in The Single Woman. It was in Sex Variants that Dickinson articulated a more definitive interpretation of homosexuality which was rooted in physiology. Anatomical observation clearly became more important than patient interviews when compared with the studies he undertook in The Single Woman. Patient speech was even more sparse and under closer scrutiny in this collection of case studies. Most of the information he presented came accompanied by anatomical observations and diagrams which connected homosexuality with biological abnormality. These diagrams and the misrepresentation of the lives of the subjects in the case studies made them appear to be diseased and, at times, morally depraved.76

Dickinson began his appendix to Sex Variants entitled "Gynecology of Homosexuality" by noting what was new in his investigation of female sexuality. "Among the characters which render this sex-study unique, the physical examinations - general, local, roentgenographic 77 - stand out next to the impressive detail of the record."78 Dickinson's case studies combined the doctor's analysis of the patients' self-reporting of their sexual histories with a medical examination. Dickinson examined global aspects of these women's health as well as the interstices of their genitalia. He sought a correlation between same-sex desire and a multiple of factors, all of which were within the parlance of disease. What followed in the text were case studies written in the first-third person split narration style which included detailed drawings of these women's erogenous zones (see figure 1 and 2).79 This was the data he used to persuade his audience that there was a connection between abnormal genital morphology and homosexuality. He cautioned the reader to remember, "that this is the voice of a rather intelligent group defending its point of view."80 Before the study subjects were allowed to speak, Dickinson already had questioned the veracity of their stories.


--Figure 1: Comparison of homosexual vulva to norm


--Figure 2: The range of female genital size and shape

Throughout the studies he presented homosexuality as being mimetic of heterosexuality. His discussions of sexual practices between women made them seem to be necessarily fraught with complications, difficulties, and the need for phallic implements. He could not conceive of a non-phallic sexuality which could achieve any real satisfaction. He described heterosexual intercourse as "facile" and natural, but sex between women presented "anatomical difficulties." The difficulty for Dickinson was the lack of the insertion of an erect penis. This heterosexist notion deigned the legitimacy of noninsertive sexuality to be as pleasurable as
phallic penetration.81 Yet, he could not deny that these women experienced pleasure and reported that most of these women achieved orgasm with their female partners.82 He could make no clear pronouncement on this subject. In his discussion, Dickinson succeeded only in making sex between women seem problematic.(see figure 3, 4, and 5)


--Figure 3: Depiction of the "anatomical ease" of heterosexual sex


--Figure 4: Depiction of the "difficulties" of sex between women


--Figure 5: Dickinson sees that sex between women requires phallic implements


The case of Myrtle K., whom he called a "negress," revealed much about how Dickinson read behavior through the body. It was also a case that explored a supposed physical mimicry of different-sex intercourse between women. Dickinson described her genitals as being abnormally large with her "pelvis of a moderately masculine type." As with other cases in the study, the female doctor who examined her caused her genitals to become "erotic." When Dickinson examined her, this did not occur. He found this response to be a common trait among female homosexuals. However, the discussion of genital morphology was the central focus of the case study.

Dickinson wrote concerning Myrtle K., "The vulva is of a very unusual length, 11 cm; the corrugated labia minora protrude a little through the thick labia majora, spreading 3.5 cm. when laid apart, but 6.5 cm on a very slight stretch, and with the blackness of deep pigment so often found in the negro.83" The darkness of her genitals was linked with their size and erectility; conceived by Dickinson as a product of both heredity and deviant sexual practices. Dickinson had previous noted that hypertrophy of the vulva was more common in darker-skinned women than lighter-skinned.84 This allowed him to imply that women of color were more prone to sexual deviance. This case was representative of the intersection of race and sexual ideology. Homosexuality was linked with scientific discourses concerning race that were particularly prevalent during Dickinson's lifetime.85 Racial theory, with its obsessive concern with the racially "mixed" body, allowed for a way to articulate homosexuality. The language was extended to include another supposedly pathological mixing, that of femininity and masculinity.86

"My clitoris is two inches long," she claims, "and enlarged, it's three inches, and the thickness of a little finger. It's grown half an inch in the last year." She is able, she declares, to "insert the clitoris in that vagina" and produce orgasms in other women in a most desired fashion.87

This was the first text in the first person printed in the case study and it set the tone for the medical reader. This woman was viewed as dominant and therefore was masculinized. Her sexuality was represented as all pervasive; the words she spoke through Dickinson in the case study were meant only to support that "fact." He connected a perceived black sexual power with pathology. The clitoris was constructed as phallic substitute while at the same time the possibilities of insertive sex between women were called into question by Dickinson. The emotional mimetics of different-sex desire were translated into physical reality in Dickinson's presentation (see figure 6).


--Figure 6: Investigation in the possibilities of clitoral projection

Dickinson chose to excerpt this from her interview, "No man in the world could rouse me. I loathe the idea of anything going inside me, even a douche."88 This example as nearly all excerpted speech. was meant to show how pathological she was; Myrtle K. was betraying her femininity. Ellis' vision of sexual inversion lingered in this case as in the others. The masculinization of this woman continued. She was represented as psychic hermaphrodite with genitals of a virile nature. Beyond that, the fact that she denied any form of vaginal insertion made her seem "non-female" to Dickinson. Dickinson saw the female body as a sexual space that needed to be open to insertion for sexual pleasure to occur. He believed the female body should be passive. Only male sexuality was insertive in his sexual theory; female sexuality could not be. Myrtle K. denied this formulation and therefore abdicated her femininity in the eyes of the sexologist.

There was a separation being made in this case like the others in the study. Myrtle K. deviated from traditional gender roles. She was seen in direct opposition to the heterosexual woman. Her penetrative sexuality showed her "taking the male part"; this act could only be understood by Dickinson in terms of deviance and pathology. The fact of her gender made this extremely problematic for Dickinson. She did more than transgress gender boundaries; she assumed a "male" subject position in her sexual relations. She therefore came to embody sexual pathology and the disruptive effects it could have on traditional ideas of gender, power, and pleasure. Dickinson "other-ized" her to pathologize her sexual practices and deny her disruptive power. Her resistance to societal norms was read simply as a manifestation of disease; here, deviance became pathology. The anxieties caused by Myrtle K.'s difference were projected on to her as deviant affliction.89

Dickinson had devised a way to mark the "otherness" of female homosexuals. He designated their genitals as the locus of their difference. He made them recognizable, but only by experts. This allowed homosexual women to be set apart from heterosexual women. Dickinson was not alone in trying to demarcate the "homosexual" body as distinct and other. Sommerville has noted that, like the science of race, sexological discourse attempted to demarcate specific types of bodies.

Methodologies and iconographies of comparative anatomy attempted to locate discrete physiological markers of difference by which to classify and separate types of human beings. Sexologists drew upon these techniques to try to position the "homosexual" body as anatomically distinguishable from the "normal" body.90

The distinction between these two types of bodies allowed for the medical marginalization of those who enjoyed same-sex eroticism. This specification of individuals involved the projection of anxieties about female power and sexual autonomy as was clearly shown in the case of Myrtle K. Those labeled "homosexual" became living signifiers of sexual pathology in Dickinson's work. They constructed the boundaries of normal sexuality right before the eyes of the medical reader.

The findings of this study were two-fold. First, Dickinson detailed a supposedly high frequency of responsive erotic feeling during gynecological examination in most of the subjects. He claimed this was especially true when a woman gave the examination. Dickinson also demonstrated that the external genitals of these women are large and exhibited special hypertrophies of various parts linked to their nonheterosexual erotic practices. He claimed only masturbation and sex between women could cause this change in genital morphology. Dickinson was shocked to find that these sexual practices did not coincide with gynecological difficulties in his subjects. He believed that more research was needed.91 He concluded, "Thus, while no definite local findings could be classified as peculiar to homosexual practices, there are indications on examination which fully warrant inquiry concerning genital excitations and preferences by homosexual or autoerotic technique."92

Although Dickinson felt he needed to continue studying the connection between the erotic response in the examination room and homosexuality or autoeroticism, he still had made a connection, however preliminary, between large genitals and deviant sexual practices. He thought this could be useful to marital counselors or psychiatrists. He wanted such "experts" to compare "the patient's statement of her experience with the findings on inspection of the generative tract."93 There were two types of evidence for Dickinson, verbal and anatomical. The anatomical evidence obtained through the physical exam was always privileged when compared to the personal statements given by the patient. The expert's act was about ordering bodies, not uncovering lives.

This connection between genital shape and sexual activity created a new observational position for Dickinson. He could view the female body and understand its sexual history with little regard for the patient's own recounting. He created an objective way to read the female erogenous zones and discover the markings of sexual activity that was pathological and/or deviant. This constituted a new phrenology of the female body, a way to read behavior into the shape of the body.94 By looking at the body in this way, Dickinson thought its sexual past and its sexual future could both be simultaneously predicted. Using this clinical criteria, he could read sexual deviance in his patients without even exchanging a word with them. In writing sexual transgression on the body, Dickinson created a particular epistemology of female sexuality. The female subject became divorced from her body. Her body became the vessel of sexual knowledge that only the medical expert could read. She need not speak because her body spoke for her. What was seen on the body's surface could even contradict what women said about their own lives.

Dickinson wrote about homosexuality to find ways to eliminate it. The key to this elimination was recognition. He created a way to identify eroticism between women. By making morphological distinctions between "types" of women, Dickinson designated the genitals as the site of identification. The female genitalia came to represent the origin of objective sexual truth in Dickinson's work. They revealed both pathology and health. They became sex's witness. This represented an important extension of sexological theory. Dickinson translated Ellis' sexual inversion which was primarily internalized into something observable that existed at the body's surface. This allowed the female body and its sex to be connected by a reading of genitals which could apparently produce medical, psychological, and historical knowledge.

The reflection of genital morphology on to same-sex desire mirrored Dickinson's attempts to eliminate love between women. He thought his findings could be applicable to preventing homosexuality in certain cases. He wanted to deploy the knowledge he acquired to redirect desire. Dickinson sought to make sure women were normalized into a heterosexual lifestyle. Dickinson believed that marriage could prevent homosexuality. He also thought that it had the potential to preclude sexual activity between women after the wedding.95 To ensure that marriage could prevent same-sex eroticism, Dickinson thought the management of sexual pain was a critical point for medical intervention.

The complaint of pain during coitus is the typical instance of such a need. Another is the finding of an infantile vulva in woman otherwise well developed; another, muscular resistance in the athletic woman. These are well worth premarital discovery, as is shown in more than one example in this series, where timely self-stretching of the inadequate opening could have prevented the association of pain with the approach by a male. Such distress in coitus or failure to provide for orgasm, tend - once desire has been awakened - to drive desire toward a woman.96

This was a very simplistic vision of desire; the simple association of the pain of intercourse with a man would cause a woman to find a female lover. This did not take into account any other aspects of sexuality or the desire for a partner. It was either pain or pleasure. Dickinson did not notice that pain could be a part of "normal" sexuality. This reductionistic stance allowed Dickinson a simple preventive prophylactic for homosexuality. He would tell the woman to stretch her vaginal opening to more easily allow the painless penetration of a man. Painless intercourse with men would ensure the development of proper marital sexuality.

The blame for sex between women was also placed on men. Men who could not provide for orgasm in their female partner were held responsible by Dickinson. Without pleasure from heterosexual intercourse, Dickinson thought, women would necessarily turn to homosexual sex. His vision of female sexuality as flexible and to a certain extent unpredictable, stood as a rationale for medical intervention into women's lives. It also accorded sexual behavior a totalizing power to determine identity. The "nebulous" quality of female sexuality also necessitated the proper sexual training of men. Men needed to perform properly in the bedroom in order for women to enjoy marital sexuality.

Dickinson's formulation of desire and its relationship to the body made sexuality something that needed to be managed. The dissemination of medical information and the deployment of medical techniques by experts was all that could ensure the proper sexual behavior in Dickinson's work. Both men and women needed to be properly instructed by their physicians to safeguard them from deviant desires. If that did not accomplish Dickinson's normative goals, then he believed doctors should directly intervene.