Richard Smith: The BMA and homosexuality

Richard SmithI was once responsible for Family Doctor Publications, which were a series of booklets owned by the BMA, had titles like You and Your Bowels, and sold in huge numbers in the 1950s because they were almost the only information on health available to the public. I was much amused that in the 50s the BMA agreed that the booklets could include advertising for cigarettes and alcohol, but under no circumstances could they advertise contraceptives. And at about the same time thousands of copies of one booklet had to be pulped because it seemed to accept the possibility of sex before marriage. Now I’ve learnt more about the prudishness and “severe, restrictive morality” of the BMA.

I’ve learnt more by reading Richard Davenport-Hines’s highly informative and readable book  An English Affair: Sex, Class and Power in the Age of Profumo. There must be readers of this blog who won’t know about the Profumo Affair, but it sent an earthquake through Britain in 1963 when John Profumo, a cabinet minister, was exposed as having had an affair with Christine Keeler, who was also supposed to be the mistress of a Soviet spy. Profumo later lied to Parliament and contributed to the downfall of the government. It was an orgy of sex, smut, class, drugs and politics, a wonderful time for Britain’s many scandal sheets.

It’s also one of the reasons that Philip Larkin, that most English of poets, identified 1963 as the year that sexual intercourse began:

Sexual intercourse began
In nineteen sixty-three
(which was rather late for me) –
Between the end of the “Chatterley” ban
And the Beatles’ first LP.

Before 1963, wrote Larkin, there had been “A shame that started at sixteen
And spread to everything.” Davenport-Hine’s book is in many ways an extended, evidence based, prose elaboration of Larkin’s lines. Britain in the 50s (and most of the 60s, because, as everybody knows, the 60s didn’t really begin until the 70s) was an intensely conservative, restrictive, and hypocritical society, where women were subjugated and homosexuals never mentioned. (The word homosexual was not used on the BBC until 1955, when it was used on Woman’s Hour; the BBC recognised that women could cope but men couldn’t.)

The BMA was a bulwark of that suffocating, self-righteous society, as its evidence to the Wolfenden committee on homosexuality and prostitution. When referring to sex the BMA always used the word “indulgence” and never pleasure. It was clear too that sex was some sort of national duty: “The proper use of sex, the primary purpose of which is creative, is related to the individual’s responsibility to himself and the nation.” The state has a rightful place in the bedroom.

“At the present time” wrote the BMA in 1957, “doctors observe their patients in an environment favourable to sexual indulgence, and surrounded by irresponsibility, selfishness, and a preoccupation with immediate materialistic satisfaction. There is also no lack of stimulation to sexual appetite. Suggestive advertisements abound on the street hoardings and in the Underground; provocative articles and illustrations appear in the daily and, especially, the Sunday newspapers; magazines, cheap novels with lurid covers frequently provide suggestive reading matter; and the erotic nature of many films and stage shows is but thinly veiled.”

You can imagine the author of these moralising sentences panting over the suggestive advertisements, cheap novels, and erotic films. The BMA thought that its job was not to prevent and treat disease, but to uphold moral values.

The BMA was also happy to ignore science and evidence when it launched into explanations of what at the time was perceived as “an epidemic of homosexuality.” “Many men see in homosexual practices as a way of satisfying their sexual desires without running the risks of sequelae of heterosexual intercourse. They believe, for example, that there is no danger of contracting venereal disease in homosexual activity. Other men adopt homosexual practices as a substitute for extramarital heterosexual intercourse because there is no fear of causing pregnancy or emotional complications as in the life of a woman.” The idea that “women” equals “emotional complications” was a very 50s idea.

It was unsurprising, thought the BMA, that the public would be hostile to homosexuals because of the propensity of its practitioners in “positions of authority to give preferential treatment to homosexuals or to require homosexual subjection as an expedient for promotion. The existence of practising homosexuals in the Church, Parliament, Civil Service, Armed Forces, Press, radio, stage and other institutions constitutes a special problem.” Medicine is conspicuously absent from that list. God (heterosexual, of course, even though capable of insemination without intercourse) forbid that the BMA would have homosexuals in its membership.

The BMA found sexual acts between men “repulsive” and that “homosexuals congregating blatantly in public houses, streets, and restaurants are an outrage to public decency. Effeminate men wearing make-up and using scent are objectionable to everybody.” Born in 1952 I was infused with this kind of thinking and didn’t use a deodorant until I was 45 for fear of what people might think. My father, born in 1922, didn’t like me to buy half a pint rather than a pint of beer in case I be thought homosexual.

Having made its position clear, the BMA concluded that “if degenerate sodomists” persist then “it would be in the public interest to deal with them in the same way as mentally deranged offenders.” In other words, commit them to state lunatic asylums.

In fact the Wolfenden report recommended the decriminalising of sex between consenting male adults. It was another decade, however, before it happened.

After reading all this I’m left with three thoughts.

Firstly, I remember motions in the late 80s at the annual meeting of the BMA condemning the BMJ for taking advertisements for the Gay and Lesbian Medical Association. Many of those supporting the motion would have qualified in the 30s and 40s, when gay doctors were unthinkable.

My second thought is related in that the BMA’s views in the 50s help me understand the visceral objection that many, mostly older, people feel to gay marriage.

But my most important thought is to wonder what similar rubbish the BMA might produce in 2013 in the week that it holds its annual whingefest in Edinburgh.

Richard Smith was the editor of the BMJ until 2004 and is director of the United Health Group’s chronic disease initiative.