The story of the "sexual revolution" in Bolshevik Russia has had many tellers. In this fine book, Dan Healey adds new dimensions to the narrative by exploring the medicalization of sexual disorder during the 1920s and 1930s. He provides the first historical examination of Soviet forensic medicine's entanglement in matters [End Page 157] concerning sexual maturity, violence, and identity, exposes a range of scientific practices surrounding human sexuality, and offers glimpses of ordinary people who had to navigate the medico-legal terrain being mapped out by the experts.
Perhaps most exemplary of this new landscape was the Soviets' approach to sex crimes. The 1922 RSFSR Criminal Code established a biological rather than chronological threshold for "sexual citizenship." Hailed by some as a progressive measure, the "sexual maturity" standard led to the reinforcement of traditional assumptions about gender and cultural development. Healey deftly uses archival case studies to demonstrate the theoretical as well as practical consequences of this radical approach. A lack of definition undermined the experts' desire for disciplinary uniformity and authority in the courtroom while the overwhelming emphasis on biology fetishized the female body (particularly the hymen) at the expense of sexuality's psychological dimensions. Healey also demonstrates the negative implications for women, who were doubted in the absence of unambiguous physiological signs, made to undergo multiple exams, and further reified as "baby-making machines" (p. 60) who lacked agency and sexual desire.
Healey's nuanced attention to everyday practices and negotiations is one of the book's strong points. For example, he detects the growth of a "crude medical consciousness" (p. 166) among members of the public. Peasant families requested examinations of their daughters to protect the young women's reputation in the community, while hermaphrodites sought out physicians to help them resolve both physical and psychological dilemmas. There is also evidence of accused rapists and their families enlisting medical language and expertise as a way to avoid prison. While Healey is rightfully circumspect about how much we can extrapolate from a limited number of examples, his research suggests that laypeople were active participants in the process of medicalization. His book reinforces the need for Soviet historians to mine the sources for a medical history "from below."
Overall, the book calls into question the transformative character of the sexual revolution. It joins a growing list of studies that reject the sharp juxtaposition of the 1920s and the Stalinist 1930s. Healey convincingly argues that the essentialist attitude of the Stalin era toward human sexuality was not simply the product of Bolshevik prudery and dictatorial proclivities. Rather, it was also the result of medical professionals, whose rhetoric of scientific objectivity masked a morally conservative vision of the modern social order.
Healey nevertheless identifies genuine elements of progressivism in Soviet practices, most notably surrounding hermaphrodites. Physicians increasingly rejected the prevailing infatuation with the gonads as the sole determinant of sex and therapy. Partly thanks to a more relaxed attitude toward homosexuality during the 1920s, they instead prioritized the individual's social role when assigning sex. Healey sees this work as anticipating the psychological approach that would appear decades later in the West, a rather intriguing fact given the collectivist rather than individualistic sensibilities of the Soviet regime.
Medical historians will find much of interest in this book, and a short review cannot do it justice. Healey is well versed in the literature and applies an explicitly comparative approach to highlight both the common and distinctive features [End Page 158] of Soviet medicine's approach to sexuality. He unpacks the sources to reveal the degree to which Soviet experts achieved their professional goals and were complicit in reinforcing traditional norms. Thus, when it comes to sexual citizenship in Soviet Russia, we see both the limits of medicine and its limiting powers.