The Dark History Of The Speculum

Illustration by Evey Joan

The Western world has a long history of experimentation and 'exploration' at the expense of people from the​ southern hemisphere, an expense which is typically borne out by women of colour. Women’s bodies have long been used as a commodity; for labour, reproduction and the sexual satisfaction of others. This is particularly true for women of colour, especially black women. The bodies of women of colour are othered, hypersexualised and stripped of agency in a way that perpetuates dangerous myths; from black people being immune to pain, to Native American women having an insatiable sexual appetite or Latina women being ‘fiery’ in bed.

These stereotypes are deliberate. They dehumanise women of colour and encourage abuse - often as a means to an end - by racists such as James Marion Sims. Known widely as the ‘father of gynaecology’, Sims was a white doctor who lived from 1813 to 1883, accredited with inventing the ​vaginal speculum​ and a surgical technique to repair ​vesicovaginal fistulas. It is hard to understate the significance of these inventions. Vesicovaginal fistulas are commonly caused during complications from childbirth, which essentially tears a hole between the bladder or rectum and the vagina, allowing urine or faeces to enter. Aside from the obvious pain and health implications of this, women with fistulas were typically ostracised from communities, and left to deal with infections and incontinence at a time when it was considered indecent and shameful for doctors to conduct vaginal examinations. The speculum revolutionised gynaecology: it allows doctors to directly see inside the vagina to the cervix, helping to diagnose a number of medical conditions. Today, it is most commonly recognised by women who undergo smear tests, which help to detect STDs and check for cancer by sampling cells from the cervix.

But at what cost?

Sims first got the idea for the speculum by forcing a black, enslaved woman to be his ‘patient’, and inserting the handle of a spoon into her vagina to see what would happen. He then escalated this experimentation by keeping enslaved women at the back of his private hospital in Alabama and performing surgical procedures on them whilst he treated white women at the front section of the hospital. Operating under the assumption that black women could not feel pain, he did not provide anaesthesia to the women at the receiving end of his surgeries, and some women were allegedly operated on up to 30 times. Sims’s own written accounts appear to question his belief that black people did not experience pain the way that white people did, as he recorded the agony of each patient. Yet he never offered the anaesthesia he would offer his white patients. There are claims (including from Sims himself) that black women were happy to participate in order to relieve their own vaginal discomfort, but the stories of these women were never recorded, and I find it hard to believe that enslaved women would have had the option of refusing. Given that Sims also operated on the heads of enslaved black children - believing that their skulls grew around their brains too quickly - I also find it hard to believe he considered the safety and wellbeing of any of his black patients.

There are monuments celebrating the success of Sims across the US, including a painting - now removed - at the university of Alabama that shows Sims and other white men standing over a half-clothed black patient. Activists who campaign for the removal of monuments or their rebranding into tributes to the women he experimented on have faced backlash from Confederates who argue this would be an erasure of history and the retrospective punishment of a man who was simply a product of his profoundly racist time.

These views gloss over the sacrifices of those women who were victimised due to their gender, class status - and most fundamentally - the colour of their skin. They repeatedly ignore the historical appropriation of black women’s bodies for the benefit of the rest of society. Women such as Henrietta Lacks, whose cancerous tumour was sampled from her cervix for research without her knowledge or consent. Those cells are now known as the ‘HeLa’ line of cells, transforming medical research as they were used to test how effective cancer treatment methods were.

As long as black bodies are commodified so consistently and violently – as they still are today – the full horror of this dehumanising practice will never be acknowledged for its horror and its barbarism; racism in its purest form. Western societies owe much of our common medical knowledge to black men and women which we have yet to admit, and every woman who has ever had a vaginal exam has the lives of enslaved women to acknowledge. I would say thank as well but it feels disingenuous to thank women who were forced into experiments and tortured because of a society of systematic racism. We have a duty to recognise the significance of Sims’s work, but not through his glorification or praise. Instead, it falls on us – the beneficiaries of their sacrifices - to listen and learn from the black voices bringing these atrocities to the public consciousness, and we must be willing to diversify institutions of power, even if it requires giving up some of our own seats at the table.

Written by Monika Radojevic