Medicalisation as marginalisation: queer heritage and class oppression in the RCP collections.
On 22-23 October 2024, Katie Birkwood (Rare Books and Special Collections Librarian) and Felix Lancashire (Assistant Archivist) from the RCP Archives, Heritage Library and Museum Services team attended the Queer Heritage and Collections Network Symposium. We heard presentations from many organisations about the fantastic work being done around the country to better integrate queer (LGBTQ+) history into the wider work of the heritage sector. We will work to implement the lessons learned into how we collect, interpret, and present the RCP’s history.
For our presentation, we asked the question, ‘What is the point of queer heritage?’ We had previously delivered events, for example as part of LGBT History Month, where we had highlighted the stories of queer doctors and patients found among our collections. However, we were interested in exploring how we might use our collections to move beyond showcasing queer lives of the past, to helping liberate queer people in the present. Queer people, in particular trans people, still face oppression today in terms of unequal access to healthcare, housing, education, employment, and public services. Examining the stories told in our collections more closely allowed us to see how queer oppression stems from the oppression of women and the wider working class. The road to complete and lasting queer liberation therefore lies in the liberation of the working class as a whole.
Among the most captivating and unique objects in the RCP’s collections are our anatomical tables. These consist of large wooden slabs with the nervous and circulatory systems from human cadavers pasted onto them in the shape of the bodies they once powered. The tables were made around the 1650s in the Republic of Venice, as teaching tools at the University of Padua. The dissection of bodies for medical education was not limited to Padua – the RCP itself continued to acquire bodies for its lectures into the 19th century. Our archives include a small number of warrants for the removal of corpses from workhouses, hospitals, and asylums across London, that include the names of people whose bodies were taken without their consent: William Fisher (c.1798-1875), Ann Sullivan (c.1800-1875), Sophia Benny (c.1857-1876), George Henry Flexon (1845-1877), William Waters (c.1849-1878), Eliza Allender (c.1808-1878). Representing a range of ages and genders, what these individuals shared was that they came from the most vulnerable groups in society, people whose families could not afford to pay for a funeral, or who had lost or been rejected by their families. We do not know the names of the four people whose bodies were used to make the Padua tables, but they too would have represented the poorest in society. They may have been immigrants who travelled to Venice in search of a better life; they may have been homeless; they may have been prisoners; they may have been hospital patients who died in poverty and whose bodies the state therefore claimed for itself. Today, queer people worldwide disproportionately face homelessness and criminalisation, and the same was true in the 17th century. The bodies available for dissection would therefore have included a disproportionate number of queer people, as well as other systemically oppressed groups, for example global majority people and neurodivergent people.
Four of the six anatomical tables held at the RCP (X19 - X22)
The man who most likely created the tables was John Finch (1626-1682), an English physician working as an anatomy professor in Italy, whose prowess with the dissecting blade earned him a reputation as ‘a lynx with a knife.’ Finch was from an influential family; his father had been an MP and Speaker or the House of Commons. Finch’s role in Italy was not just medical, but diplomatic, as he served as English Consul to Padua and went on to become the Ambassador to the Ottoman Empire. His lifelong partner was Thomas Baines (c.1622-1680), also a physician, with whom he apparently enjoyed a relatively out relationship. Charles II intervened to ensure Finch and Baines were able to live together in Constantinople (Istanbul); they were later buried side-by-side in the Chapel of Christ’s College, Cambridge, where they had met as students, with a memorial inscription describing them as ‘two of the most loving friends, whose hearts and souls were one.’
John Finch and Thomas Baines, portraits by Carlo Dolci, courtesy of Fitzwilliam Museum, Cambridge
We have previously celebrated Finch and Baines as an example of a relatively liberated 17th century queer relationship. However, by ignoring their class position, we failed to see that their story does not represent anything progressive in terms of the systemic oppression of queer people. Their wealth and social status afforded them protection that was not available to the queer (and other working class) people who passed through the prisons and workhouses and whose bodies ultimately met with Finch’s dissecting knife.
When Finch became a fellow of the RCP in 1661, the College had been in existence for 143 years. It was founded to police the practice of medicine; in its earliest days the RCP had the power not only to licence doctors but also to fine and imprison those practising without its permission. Our records from this time include the names of those being examined as well as those being prosecuted – these names represent people of a range of genders, nationalities, and backgrounds reflecting the mix of people earning a living through medicine in early 16th century London. If wealthy, university-educated doctors wanted to secure a lucrative monopoly on medical practice, they needed the power of the state behind them. Of course it was doctors such as these who were closest to the state; our founding president Thomas Linacre (c.1460-1524) was the personal physician to Henry VIII. In 1511, a medical reform law was passed barring women from practising medicine and introducing mandatory licencing for the first time. Seven years later, the RCP was founded to enforce the new status quo. To receive a licence from the College, a candidate had to be a man, and he had to be able to afford not only an Oxbridge education but also the RCP’s examination fees. Like today, immigrants were divided into ‘good’ and ‘bad’; wealthy immigrants whose interests aligned with the status quo were welcomed, while poorer immigrants trying to make a living were criminalised. Examples in our records include John Mercadie, described on 2 May 1555 as ‘a Frenchman and cheating carpenter’ and given an unspecified punishment; similarly Margaret Kennix, described on 19 December 1581 as ‘an ignorant foreign woman.’ On 15 February 1594, Raphael Thorius from Holland ‘confessed to practising medicine for the last three years but only among French people and foreigners’; the RCP fined him £3 s6 d8 – they had no problem with the discrimination, but they wanted their cut. Social inequalities did not begin in 1511, but before then a doctor could in theory be anyone. With the founding of the RCP in 1518, the barriers to entry for anyone who wasn’t a wealthy, male English national were heavily fortified.
A key barrier was gender-based: women were barred from practising. If a state is going to determine ‘rights’ based on gender (right to own property, practise medicine etc), then the state needs to define its terms. This leads to the enforcement of heteronormative, gender-binary, monogamous norms that do not reflect how human beings lived for tens of thousands of years before private property and class-based societies. A legally enforced patriarchy clearly disadvantages women, and also disadvantages anyone who deviates from the heteronormative template. This is why all forms of queerphobia have their roots in misogyny, and misogyny has its roots in private property. We know of one recorded example of a woman doctor permitted to practise by the RCP in the 16th century. Alice Leevers was friends with Elizabeth I, and the Lord Chancellor sent a letter to the College requesting that the rules be bent in her case. The RCP grumbled about Leevers, but ultimately it could safely overlook her gender and Finch’s sexuality because these were not individuals who represented a threat to the status quo; indeed, they owed their privileges to it. For the same reason, gay MPs could vote through the homophobic legislation, Section 28, in the 1980s. Rules are for the masses, not those in or close to power.
Having established the RCP on the basis of an artificial gender binary, the medical establishment assumed the role of arbitrator of gender and sexuality on behalf of the state. Our archives include a set of notes made in 1830 by a doctor named John Lavies, relating to a 17-year-old young woman who might today describe herself as intersex, and whom Lavies describes as ‘hermaphrodite.’ The information we have doesn’t include her name, and we can only piece together fragments of her biography from Lavies’ notes. She was raised as female and worked as a household servant in a female-gendered role. There is no evidence she identified as any gender other than female, despite the document’s use of male pronouns. Reading between Lavies’ euphemistic lines, it seems that she was fired from her job after having a sexual encounter with a man and being outed as intersex. Lavies is not interested in whether this encounter was consensual or not, or in offering any actual medical or psychological care; he is fixated only on describing her genitals: ‘there was much difficulty in obtaining permission to examine the parts, indeed he shed tears and hid his face.’ Here we have a young woman losing her job for being intersex, but unlike Finch or Leevers, she is powerless in the face of that discrimination because of her class position.
Twopenny news pamphlet report of the trial of Fanny and Stella, 42461-6
Exclusion from the formal economy is what still today disproportionately drives queer people into informal work, such as sex work. In 1871, RCP fellow, Alfred Swaine Taylor (1806-1880), involved himself in the trial of Fanny and Stella, whose legal names were Frederick William Park and Thomas Ernest Boulton, two individuals accused of soliciting for sex and committing ‘the abominable crime of buggery.’ A factor in the media’s sensationalising of the case was the defendants’ cross-dressing. Reports at the time described them condescendingly as ‘the would-be ladies’, and stated they would ‘disguise themselves as women and frequent places of public resort so disguised, and thereby openly and scandalously outrage public decency and corrupt public morals.’ Taylor was a determined advocate for the establishment of forensic medicine – which in his day was known as medical jurisprudence – as a tool within the criminal legal system. He wrote what became the standard textbook on the subject, providing doctors, as dutiful servants of the state, with all the know-how they needed to police the bodies of the working class. This included detecting ‘evidence’ of ‘unnatural offences’ such as anal sex, as well as the strict regulation of women’s bodies in matters such as pregnancy, ‘concealed birth’, abortion, ‘legitimacy’ of children, and paternity. The health of women is not the concern here; the enforcement and exploitation of their reproductive labour, and the preservation of systems of property ownership and inheritance are what’s at stake. Taylor makes clear that harm to individuals is not his priority, when he dismisses the very concept of anal rape: ‘Unless the person is in a state of insensibility, it is not possible to conceive that [the act of anal sex] should be perpetrated on an adult of either sex against his or her will.’ Harm to social norms, the ‘corrupting of public morals’ that ‘the would-be ladies’ were accused of, is what must be prevented. Happily, Fanny and Stella were acquitted by the jury in their trial, but the state, aided by the medical establishment, continues to attack gender non-conforming people to this day.
The erosion of already-inadequate healthcare for trans people taking place today, such as the banning of puberty blockers for children with gender dysphoria (but not for any other group of patients), not only serves the age-old function of enforcing heteronormative power structures, but the ‘culture war’ it helps fuel also creates a distraction from the failures of the system to meet the needs of the working class as a whole. The use of fearmongering and funding cuts throughout the AIDS pandemic by governments of all colours has served the same functions. While individual physicians rose to the challenge of HIV/AIDS from the start, the RCP as an organisation, to judge by its council minutes, was very slow to show any interest. The first mention is in June 1987, three years after the identification of the human immunodeficiency virus, and almost six years after the first case of AIDS was described in Britain. No great strategy had been brewing all that time – the minutes simply state that information on AIDS should not be included in higher medical training (the College would instead provide one-week courses for district AIDS officers). However, the RCP did push back on at least one government move. In 1993, the Department of Health asked for the College’s views on a draft letter to be sent to patients informing them that they had been in contact with an HIV-positive healthcare worker, and urging them to get tested. The RCP advised against the policy, pointing out that it would not only be a breach of confidentiality for the individual healthcare workers, but that there had never been a single recorded case anywhere in the world of someone contracting HIV from a healthcare worker in a clinical setting.
In 2023, the prevalence of HIV globally was 9.2% higher in trans people, and 7.7% higher in men who have sex with men, than in the general population. It was also higher in sex workers, young women and girls in eastern and southern Africa, and people in prisons. In 2025, homosexuality is illegal in 65 countries. In Britain, 47% of queer people have experienced some form of homelessness. 60% of trans people experience harassment at work; they also face unequal access to healthcare, education, and other public services. Queer heritage activities organised by cultural institutions can provide recognition of the struggles faced by queer people today and in the past, but can they ever be put into the service of truly breaking the systems that cause these material inequalities?
If we as heritage and information professionals want our work to be in any way liberational, we must:
- Recognise that the oppression and liberation of queer people cannot be disentangled from the oppression and liberation of the working class as a whole; that oppression is systemic, and that liberation can only be achieved through system change
- Make every effort to reject the false narrative of linear progress. Societies do not magically become ‘more tolerant’ over time; change is hard won through collective struggle, but without fundamental systemic change, these wins are concessionary as far as the ruling class are concerned, and can be rolled back at any time
- Challenge the institutions and sectors we are part of to improve their practices in terms of recruitment, accessibility, transparency, empowering workers and service-users, and speaking truth to power
- Improve how we collect, interpret, and provide access to material, with the aim of creating collections and services that are not memorials to the past but powerbases of knowledge for those working to build a better future
With oppression and violence against the working class – particularly trans people, women, migrants, and indigenous populations – ramping up around the world, and the rolling back of concessionary democratic norms, there is a need to take a stand, not for a return to the status quo, but for true and lasting liberation. Those of us whose business is history need to decide which side of history we’re on.
Felix Lancashire, Assistant Archivist
Katie Birkwood, Rare Books and Special Collections Librarian