“Now, we see, as in a speculum, darkly”

By 1920, Dickinson had turned fully to research. He left his gynecological practice and lived on the investments he had accumulated over the years. His large office-home in Brooklyn was exchanged for a smaller apartment in Manhattan. Dickinson had gained eminence as a surgeon but felt that the perfection of surgical techniques was not as rewarding as sex research. Although he lacked training in the basic sciences, his intellectual curiosity led him to devote the rest of his life to a more serious "study of womankind."50 Dickinson saw the female body as centrally important to the maintenance of social stability. By understanding more about this body - its pleasures, its diseases, and its supposed reproductive proclivities - he thought he could understand the root of American social problems. His focus became centered on how sociological problems related to and stemmed from women. He would instruct other gynecologists to follow in his footsteps.51

Dickinson was influenced by many important figures who spoke about women's relationship to social strife and cultural redemption. Contributing to an article about Havelock Ellis for his eightieth birthday on January 11, 1939, Dickinson showed the great admiration he had for him. Dickinson ended his essay with this sentence "The noble head of Havelock Ellis is a fitting leader in the line of the prophets of the promised land, a line which includes powerful figures like Malthus and Galton and Drysdale, Forel and Mensinga, Reuter and Hardy and Briffault , and the priestesses of the time to come Margaret Sanger and Marie Stopes and Aletta Jacobs."52 These theorists and activists represented the intellectual world that Dickinson aspired to be a part of. A world where the scientific management of heredity, reproduction, and "races" were the keys to saving a civilization that was constructed as being in serious decay, was described by these authors. Dickinson wanted to do his part to help American civilization and drew upon the ideologies of men such as Galton, Malthus, and Briffault. The "priestess of the time to come" were applying these ideologies through the birth control movement to women's bodies, but for not necessarily the same conservative end. Despite the prominence of all these figures he situated Havelock Ellis above them as their leader. Ellis' work touched upon much of these theorists' life's work.53

Ellis was the most fundamental influence on Dickinson's research into sexuality. He represented for Dickinson the culmination of a long stream of thought about sexuality and race's connection to the development of Western civilization. Feminist scholar, Margaret Jackson sees Ellis' sexological perspective as the codification of male sexual power which relied on two main themes. The first being that normal heterosexual sex is based on a power relationship which is biologically determined; masculine domination and female submission are natural and necessary to sexual satisfaction. The second assumption was that all forms of abnormal sex are extensions of the normal and even violent and dangerous forms of sex are rooted in "innocent and instinctive" impulses.54 She argues that sexology disrupted and undermined feminist challenges to male power by articulating a false ideology of sexual liberation.55 The specter of Ellis' phallogocentric sexology would haunt Dickinson's work, but without Ellis it seems impossible for Dickinson to have emerged as an American sexologist. Ellis' sexological paradigm was what Dickinson articulated in the American context. The limits of love and sex for these sexologists were unconsciously already prescribed by their observational standpoint.

Robert Dickinson had risen to the top of his profession but he had since retired from his private practice by the second decade of our century. In his inaugural address as the president of the American Gynecological Society in May 1920, Dickinson unveiled a bold new plan for American Gynecology. This address was paradigmatic of Dickinson's scientific inquiry into the lives and bodies of women. He began his address with a discussion of the state of American gynecology. The analysis and readjustment which medicine had been undergoing made Dickinson feel that it was of the utmost importance for gynecology to reorganize itself. He wanted gynecology to continue to progress and reform or he believed it would become antiquated and absorbed into other medical specialties.

Further studies into the various departments of medicine are imminent. It is for us to decide whether we shall lead or be led in such surveys. Now, we see, as in a speculum, darkly. It is for us to say how we wish to be seen in the future.56 (bold mine)

Dickinson spoke here of a lack of clarity and direction in the gynecological profession. He believed that there were reasons that made gynecology a distinct speciality. Gynecology had been quite successful with dealing with obstetric complications and the "diseases of women" in Dickinson's opinion. More importantly, he believed that gynecology's past and present ability to obtain knowledge about the pathology of women's anatomy and physiology was reason alone for gynecology's independence. Dickinson challenged his audience to continue research on a much grander scale than ever before. He wanted to both sharpen and extend the focus of gynecology.

Dickinson endeavored to reformulate the structure of the American Gynecological Society's organization and extend its scope. This was in the interest of facilitating research and promoting professional cohesion. The professional language of gynecology was to be reformed. As Dickinson explained to his audience, "a standard nomenclature should be a matter of agreement on the part of authoritative organizations.57" Gynecology must have its own distinct medical language in order to continue to be a distinct medical speciality in Dickinson's view. Through discursive systematization, gynecology would be able to progress more rapidly, operate more efficiently, and continue to possess its own exclusive forms of knowledge about women and their bodies. Dickinson did not want gynecology to lose its authority.

Since research was a necessary part of Dickinson reform program, he wanted the result of their studies to be shared between members of the American Gynecological Society. To facilitate the exchange of professional opinions, he wanted a new official journal to be established. Dickinson defined this journal as, "an example of the type of concrete and visible activity on the part of the Society."58 The journal would serve as a repository for new gynecological knowledge. More importantly, the journal would show the medical community and other professionals the necessity of a gynecological perspective, given the new findings it would contain. Like other scientific organizations, gynecology would have an academic journal.

In his address Dickinson also pointed to some new directions for gynecological research. He stressed that there were new realms for gynecology to encompass and offer assistance. Dickinson laid out a program to tackle what he called "sociologic" problems such as marital instability or preventing the birth of "degenerates". Such problems were not traditionally part of the gynecological sphere, but presumably by their connection with women's health Dickinson felt confident that other gynecologists would begin to explore them. According to Dickinson, gynecology had lacked the appropriate concern for these issues in the past.59

The Society's interest in sociologic problems, to judge from recent volumes of the Transactions, does not evince itself to the extent of half a dozen papers in a dozen years. These are of limited range, dealing chiefly with venereal diseases and prenatal care.60

The narrow focus of his contemporaries must change and there was much to uncover as Dickinson saw it. He believed that gynecology could be useful in more ways than just ensuring proper fetal growth, maternal nutrition, and protection from infection. These activities were certainly important for Dickinson; yet he saw that through proper medical intervention, at the earliest of stages, the gynecologist could be involved in the prevention of illness.

Dickinson drew upon eugenic theory to support his claim that gynecology could serve a preventive capacity. He presented a classic negative eugenic viewpoint in regard to sterilization of "diseased" women.

From among the strictly technical social problems that are in our hands, a few instances may be given. Is there a simple method of preventing propagation among women who are idiots, epileptic, hopelessly insane or incurably criminal?61

Dickinson was steering gynecology to participate in the eugenic project of stopping degeneracy. He claimed these eugenic concerns were only technical and, subsequently, were well within the reach of the intervention of medical science. The dehumanizing language he used, such as the words "technical" and "propagation", turned women who are not healthy in the eugenic sense into objects of scientific knowledge who needed to be policed by gynecologists for the greater social good. "Unfit" women were seen as without the necessary subjectivity to recognize the dangers they posed to society. His perspective was that such women needed to be taken under the care of their gynecologists to prevent social harm.

The "sociologic" problems Dickinson wanted to address were eugenic concerns that he felt the gynecological establishment was ignoring. These were areas into which he wanted gynecology to expand its jurisdiction. The most radical form of preventive medicine, sterilization, should become standard gynecological practice as Dickinson assessed the situation. Dickinson was sponsoring the genocidal elimination of those with the "potential" to be idiots, epileptics, insane or criminals by the members of his association. He assumed a constitutional basis for social deviancy. This belief in a constitutional basis for behavior positioned Dickinson to propose a means of social progress through medical management.

At the opposite pole from sterilization, with its enormous potentialities of betterment of the race, is artificial impregnation. Dublin proposes to open the abdomen after a few months of sterile married life, and Boston and Brooklyn do so without trial of this simpler means. This procedure is an excellent instance of the need of collective experimentation, since no man is likely to have a large experience.62

Dickinson was clearly charging gynecology to embrace notions of race hygiene. In the spirit of negative eugenics, sterilization was a tool he felt could be used to reduce socially unwanted pregnancies. There were other methods to improve the race as well. Artificial impregnation had much promise as a tool of implementing positive eugenics. Dickinson wanted gynecologists to direct their studies to "opening up" women's bodies to see how fertility can be improved upon. Through this experimentation on women, Dickinson thought his Society would be able to ensure the fertility of the fit, while sterilizing those who are not of the proper extraction. Dickinson believed the objective gynecological eye can purify the race through a collective medicoscientific intervention into women's reproductive organs. According to Dickinson gynecology should not only prevent degeneracy, but they must help those who were healthy and without a suspect family history to understand their obligation to reproduce.63

Presumably working together under Dickinson, American gynecologists could devise new ways of preventing the further degeneration of the race and possibly improve the stock. He promised societal progress by way of the application of eugenics through the speculum and the surgical knife. It is clear that Dickinson has combined the medical interests of gynecology with the goals of the eugenic movement. Using the new science of eugenics, he would resituate gynecology as an important and necessarily independent branch of medicine.

In order to accomplish this, Dickinson saw the need for further study. Sexuality and birth control were the two principal problems that Dickinson thought gynecologists needed to investigate.

Another of the distasteful subjects we naturally shirk is contraception. What serious study has ever been made bearing upon the harm or harmlessness of the variety of procedures, or concerning the failure or effectiveness of each? Who has or can acquire any considerable body of evidence on these matters but ourselves? What, indeed, is normal sex life? What constitutes excess or what is the penalty for repression in the married? Do we still have to hark back to Luther for an answer? It will take a few professional lifetimes of accredited histories to gather evidence to submit, but some time a start must be made.64

Dickinson believed the time was at hand for gynecologists to embrace subjects that had not been addressed previously. Gynecology must understand all aspects of the sexual life to accomplish his goals. Dickinson wanted gynecology to open the mythical bedroom door to understand the multiplicity of behaviors and normalize them to conform with some external, idealized medico-moral criteria. With this knowledge, Dickinson and the members of the Society would prescribe a proper sexual behavior that was healthy and contraception that worked. Needless pregnancy and senseless repression were solvable problems with the proper data, given the proper understanding of sexuality. Sexuality could apparently be liberated from "Luther," but only as far as what the data showed was "normal". What his form of sexual liberation entailed was left unanalyzed in his speech. Repression may be costly for Dickinson but licentiousness could be even more dangerous for him. Therefore, more study was needed in order for Dickinson and American gynecology to fully understand what fell into the contested category of a normal sex life.

By invoking Martin Luther, Dickinson was seemingly distancing himself from ideas of sexual repression. By moving away from silence concerning sexual issues, Dickinson was moving away from the still recent Victorian past. He was casting himself as a sexual pioneer in a supposedly more enlightened age.65 This had another important effect. By representing himself as allowing all sexual possibilities to come under medical scrutiny, he conjured unbiased objectivity. This apparent progressive openness towards sex was by no means the entirety of his particular medical project. The word "normal" still haunted his speech and limited the possibilities of both objectivity and liberation.

This new understanding of sexuality that Dickinson wanted to bring about was to be used for sex education as well as to inform medical praxis. He stated to his audience, "parts of sex instruction belong to us, and we may well be chief counselors in the determination of the details of the curriculum." Dickinson wanted gynecology to be an authority in matters of sex education concerning women since women were, in a sense, his province. This instruction would involve the gynecologist speaking directly to the patient and also demonstrating techniques. He used the metaphor of masturbation to make his point. Sex instruction he said, "applies to the prevention of vulvar irritation and watchfulness lest the normal degree of autoeroticism go beyond bounds ." Watchful observation was necessary to prevent pathology for Dickinson. The limits of sex would be defined by gynecological research and enforced through the gynecological consultation. Dickinson turned speaking about sex into a preventive medicine.66

Dickinson's vision of sex instruction was based in the embedded structure of power within the medical relationship. The doctor was conceived as both healer and teacher. The woman was constructed as the object of knowledge and source of pathology. Dickinson's rhetoric was indicative of a disparity in power relationships. In the service of his particular scientific perspective, Dickinson relegated women little of any real subjectivity. Women were constantly spoken about in his work but only in terms he and other specialists had already defined. Yet, women were presumably the source of knowledge that the gynecologist drew upon. Dickinson's perspective on gynecology revealed the complicated relationship between women and gynecologist.

Dickinson's articulation of eugenic theory made visible the centrality of women's bodies within that particular discourse. Women were the cause of race degeneration by their inappropriate couplings. Women were also the necessary source of racial regeneration. Therefore, the control of women was necessary for any eugenic act. Women's reproductive power was too important for eugenicists to leave unpoliced. In a sense, sexology served as a form of applied eugenics through its power to regulate sexual acts.

The connection between sexology and eugenics, which Dickinson's work exemplified, revealed sexology's inability to escape its own coercive power. Dickinson sought to liberate women from sexual unhappiness and the burdens of unwanted pregnancy. Yet, his discourse permitted only a further surveillance of their bodies and proscriptions of their pleasures. Of course, this surveillance was conceived by him as "for their own good". Yet, it only (re)presented the sexual restrictions placed on women in a scientific form. Dickinson's articulation of sexological theory did not seek to overturn the sources of power which restrict female pleasure. It, in essence, only strengthened them.

The rise of the medical industry, the spread of sexology, and the growth of eugenic ideology were all intrinsically linked in a particular historical moment. Dickinson's medical foray into sexuality was a production of the particular historical moment from which these discourses emanated. Dickinson brought sexology to American gynecology and connected the research projects of the two. His work represents the multiplication and intensification of medical discourse concerning sex. This "incitement to discourse", as Foucault would call it, leads in Dickinson's work to the pathologization of women and the redefinition of gender roles in terms of male power (knowledge) and female subservience (ignorance). Dickinson's pathologization of femininity was new in the sense that new aspects of women's lives were coming under the gynecological gaze. More than ever before, the interstices of women's sexuality were now available to the gynecologist for the purposes of research. The knowledge obtained, through both verbal confession and physical observation, would be used to regulate women's sexual activity and control their desires.

Dickinson would continue this process of obtaining knowledge about women and using it to delineate their sexuality throughout his career. He defined himself as "a gynecologist who studied the body as an exposition of the mind questioned the pelvic organs for documentary evidence of emotional experience and accumulated records about the sex life of woman in relation to health and personality."67 The body, seen as the essential source of behavior, was always connected with the mind in his work. Directing medical vision toward female genitals was an important analytical tool for Dickinson; it allowed the body to stand testament for behavior in a striking fashion. He positioned himself as a neutral observer of physical fact merely looking at the body. The dubious connection between the pelvic organs, the case history, and understanding sexuality will be explored in the next chapter.