What Adolescents Ought to Know: Sexual Health Texts in Early Twentieth-Century America

Chapter 1: French Origins of International Sexual Health Communication with Adolescents

[ 19 ] Chapter 1 O French Origins of International Sexual Health Communication with Adolescents The first questions which were posed were relative to youth. Ought one enlighten students in the higher classes at teaching centers? Ought one enlighten soldiers, sailors, young people of the working classes? Alfred Fournier presented the first response on these questions. —justin sicard de plauzoles At the age of seventy, French physician Alfred Fournier turned, in the words of one colleague, his “prudent pen” to adolescents’ risk for sexually transmitted infection.1 The preeminent syphilologist of his generation , Fournier had become convinced that the secrecy and shame surrounding syphilis were conditions that allowed it to flourish.2 It followed that communicating broadly, rather than only with other physicians , was essential to disease prevention. For years he had challenged cultural and professional norms that left the general public, particularly young people, ignorant and consequentially vulnerable to the longterm and even fatal consequences of sexually transmitted infection. His profound commitment, described as crusading by some contemporaries , culminated in his founding of a national association to serve this aim. This French anti–venereal disease society quickly grew to more than 300 members, and Fournier expected others to do the same sort of organizing whether they lived elsewhere in Europe or in the United States. His most renowned act, though, was the creation of the short treatise Pour nos fils, quand ils auront 18 ans: quelques conseils d’un médecin , first published in 1901. In For Our Sons, When They Turn 18: Some Advice from a Doctor, Fournier named the three known venereal diseases , depicted their consequences, and called upon young men to regard sexual experience as the reward of marriage rather than the prerogative of masculinity. Eventually this fifty-page booklet would find a [ 20 ] chapter one broad readership and spark the creation of other health texts. Its existence , however, was possible only after the social and scientific developments of the recent past. Around the middle of the nineteenth century, forces that would render germ theory a convincing explanation for illness coalesced, and individuals committed themselves to organizing for all sorts of social reform. Abolition, suffrage, and workers’ rights were among the popular causes of the nineteenth century, while child welfare and eugenics would prevail in the next. Medicine and movements for the betterment of the human condition met, resulting in professional conferences that shared knowledge in hopes of preventing disease and human suffering. Significantly, these efforts were also intended to protect commercial interests and national vitality. First came meetings like the International Sanitary Conference of 1851, which focused on controlling the spread of cholera. This initial international collaboration was a novel endeavor whose recorded outcomes and disease containment strategies were shared only among participants.3 From this first meeting in Paris, others would follow, directing attention to health threats whose significance was indicated by emergent scientific and technological developments. Before the end of the century, sexually transmitted infection became the object of this sort of international scrutiny and communication. The First International Congress of Dermatology and Syphiligraphy, held in Paris in 1889, was followed by two conferences dedicated to the prevention of syphilis and venereal disease in Brussels in 1899 and 1902.4 Unlike the more limited 1851 meeting, the later international conferences hosted delegates from a diversity of nations. In addition to nearby European neighbors, physicians from Brazil, Denmark, the Congo, Iran, and Japan attended.5 At these meetings, physicians sought to repair the breach identified by writers like Dr. Homer Bostwick, who in 1848 claimed that European governments were considering how to respond to syphilis, while England and the United States left their citizens to suffer.6 Half a century after Bostwick suggested that American doctors ought to emulate their European colleagues, the parties did meet to consider the common problem of preventing venereal disease, and the working group publicized its conclusions.7 The gradual recognition that ignorance of repro- french origins of international sexual health communication [ 21 ] ductive health and its converse, venereal disease, were inherently dangerous in an era before effective cures led physicians, authors, and editors to present new audiences with medical facts. In 1902, doctors at the second Brussels conference created an education committee “which, inspired by existing brochures, shall serve as a means of instruction for the world in general.”8 This declaration transmitted Fournier’s warnings to young men in other countries and resounded in later works like...