In this day and age, we are so lucky to have our National Health Service. It’s often criticised, and whilst it undoubtedly isn’t perfect, it manages to look after the whole population in a wide number of ways. Let’s just have a think about this, how many reasons are there for someone to use the NHS for medical help? Firstly, you have the primary care physicians, e.g. GPs, who are the people you approach initially when you think there’s something wrong. Studies show that the top five reasons to visit a GP are:
- 1.Being concerned about a cough/cold/other minor illness.
- 2.Being worried about a lump or growth.
- 3.Concerns about a child.
- 4.Needing mental health support.
- 5.A suspected damaged limb, e.g. breaks, strains, etc.
As the media is always telling us, patients these days are far too quick to attend A&E because they have to wait for a GP appointment. They see it as a way to jump the queue and access medical care more quickly, which is an absolute pain for the doctors and nurses. Obviously there are always people who are so acutely unwell that they need to go to emergency care, but more often than not you’ll see waiting times at your local A&E often extending into multiple hours. And those who are not there for an accident or an emergency push the waiting times up for those who genuinely need urgent care. That said, 100 years ago it would be unimaginable to walk into a local health centre and have all sorts of investigative tests done. Mainly because people still had to pay for medical care at that point, but also because most of them didn’t exist. So, what did sexual health provisions look like 100 years ago, compared to today? To kick things off let’s have a look at what the two main issues of the day were.
Venereal disease. Another way of describing this is STIs/STDs. So, chlamydia, herpes, syphilis, HIV, etc. Not all of them could be diagnosed back then and treatment for things like these was notoriously difficult. Plus, there was almost always a stigma attached to admitting that you had one of these, especially for women, because it was tantamount to saying that you were sexually promiscuous. Which, in an age of chaste sexual behaviour, virgin wedding nights and monogamy, would see women as social outcasts if they admitted to any of these. So the problems were dual fold: getting the people to ask for the treatment, and then being able to give them an effective treatment. And if people didn’t think they could be treated, then lots of them thought – hey, what’s the point of going then?
Unwanted pregnancy. Now, the repercussions of this were enormous. Having a child out of wedlock was seen as a sin and very few people would thrive socially if they admitted to a pregnancy when they weren’t married. Hence, very few did. But that doesn’t mean that the problem wasn’t rife. Simply having sex before marrying your betrothed could put you in a difficult situation, which is why so many weddings were rushed and why so many women mysteriously gave birth two months early. There were also sexual assaults, and married gentleman having sex with domestic maids was something that was rife back then, so you can imagine the number of unwanted pregnancies that sprang up through the upper classes. Solutions back then included dismissal of the maid, but supporting them and their child financially. Which was all very well, but the chances of marrying someone else when you had an illegitimate child were vanishingly small, which is why so many women lied and claimed to be widows. Quite unbelievably, instances of Irish Catholic girls being cast out from society for having babies without being married, being sent away to an ‘unmarried mother’s home’ was endemic. Even worse was that once the child was born, it was only allowed to stay with the mother until a suitable adoptive family was found, one that could bring the child up with no shame. Imagine the emotional repercussions of that. Contraception was almost non-existent, there were condoms - not always readily available - but no Pill, no implants, no coils, nothing we take for granted today.
Bearing all of this in mind, as we slid into the 20th century, it’s fair to say that an overhaul of the sexual health system was badly needed. But how could this be effected? And what did they need to do? It was not an easy matter to deal with, considering the absolute private nature of sexuality back then. But, as was proved, it wasn’t impossible, and so our modern day sexual health system entered its embryonic stage…..(continued in Part 2.)
