The global proliferation of radical gynaecological surgeries: A history of the present

Abstract

This paper asks questions about the resilience of radical gynaecological surgeries, such as hysterectomy and ovariectomy, from the moment of their widespread use in Western European and American practices of the late nineteenth century, to their renewed increase in the Indian subcontinent and Africa into our own time.

Race, class, caste, disability, sterilisation and hysterectomy

“…Hysterectomy has been a difficult practice to explain as a historical phenomenon because vastly different motives have underpinned it in diverse contexts. In the 1890s, it was embraced as an experimental procedure that could be used to advance surgical technique, to generate higher income for clinicians, and in the view that women who received it may also be treated with the new ovarian extracts about which French, German and Swiss researchers were becoming so excited ( Moore et al 2021 ). From the 1920s onwards throughout the West, it has been commonly used in the sterilisation of women and girls with disabilities and as a routine surgery for older women in the justification of their treatment with pharmaceutical hormone replacement.…”

“…2020 ; Walker and Rogers 2017 ). Throughout its modern history, hysterectomy has served the interests of surgical technical advancement, clinician profits, state sterilisation programmes, and the minimisation of state health expenditure on the treatment of uterine and cervical cancer, rather than best serving the interests of diverse women’s ageing health and well-being ( Moore et al 2021 ; Moore 2022 ; Frampton 2018 ). This is not to say that hysterectomy is always medically unnecessary.…”

“…As one of many surgical procedures for the treatment of severe uterine pathologies, conducted with the informed consent of the patient and with adequate aftercare, it may be a legitimate therapy. But its ubiquity throughout the long twentieth century (1890–2022) has also coincided with mass sterilisation programmes around the world, which have disproportionately impacted black, indigenous, lower-class and lower-caste women, as well as women and girls with disabilities ( Moore et al 2021 ; Theobald 2019 ; Lawrence 2000 ; Amy and Rowlands 2018 ; Ladd-Taylor 2014 ); and a growing movement of patient-centred clinicians and researchers in current gynaecology has criticised the ongoing rampant overuse of hysterectomy for conditions that are treatable in other ways ( Stewart, Missmer, and Rocca 2021 ). The current paper considers this critical perspective in light of the global inequalities of women’s healthcare in relation to bodies classified differently according to class, caste, race and disability.…”

The French Invention of Menopause and the Medicalisation of Women's Ageing

“…65 Mercado,Gynaeciorum,vol. 1,[2][3] Felix Platter, Quaestionum medicarum paradoxarum et endoxarum, juxta partes medidnae dis positarum centuria posthuma (Basel: Impensis Ludovici Regis, 1625), 107. 67 Ibid.,109.…”

“…43 Ibid., Nicholas Chambon de Montaux, Maladies chroniques à la cessation des règles (Paris: Dugour et Durand, 1798). 45 Ibid.,[1][2][3] Chambon de Montaux, Des maladies des femmes, vol. 2, 184-485.…”