The Dictatorship of Sex: Lifestyle Advice for the Soviet Masses (review)

Frances Lee Bernstein's main argument in The Dictatorship of Sex is that the Soviet doctors who claimed to be providing "sexual enlightenment" in the years 1917–1933 chose a sexless model of sex, one which dealt almost exclusively with sexual deviancy, rather than sexual pleasure. Moreover, the doctors' chosen focus on medical professionalization and the elimination of competing discourses ultimately contributed to the ultimate demise of their discipline. Understandably, the medical writers wanted to curb the quacks and salacious independent authors who sought to titillate audiences without providing genuine medical care. Yet in the end their invocation of state aid in their quest for dominance left them vulnerable themselves and ultimately presaged their own demise as the authorities declared the end of the sex question (at the same time as the end of the woman question, the Jewish question and a variety of other so-called "sore" problems).

In six informative chapters Fran Bernstein considers topics ranging from the medical authorities responsibility for sex education, medical definitions of sex difference, the diagnosis of "nervousness," images of sexual health, the sexual issues of young people, and procreative sexual relations (abortion, eugenics, and so on). This is primarily an institutional and intellectual history, one concerned with analyzing medical and popular texts in light of both their messages and their silences. Bernstein's discussion of the absence of a positive discussion of female sexuality is particularly striking and, in the magnificent chapter on visual propaganda, shockingly graphic.

The challenge of writing this kind of history of ideas is that it remains rather understated. At one point in Bernstein's narrative the Commissar of Health. Nikolai Semashko takes to task those who write about sexuality without having established medical credentials. He accuses them of being "cobblers trying to bake pies." Yet Bernstein herself does not give the whole story, telling only Semashko's criticism, but not providing a full analysis of those whom Semashko is criticizing. Perhaps the sources are not available, but I would have loved to hear more about real debates within the medical community, as well as between and among the medical and political authorities. Bernstein's doctors argue a bit among themselves about the glandular nature of sex and gender, but on the whole she does not indicate whether the medical profession had its critics who sought alternative interpretations.

Bernstein focuses principally on the "medicalization of sexuality," a perfectly legitimate pursuit, yet she underestimates the problem that in principally examining medical texts, she has of necessity principally found medical descriptions of sexuality. Had she looked at Communist Party texts she would have concluded that sexuality was principally a moral affair. Had she looked at sociological research she would have found particular forms of pronatalism. Studies of Russian proverbs and/or the language of the camps would have provided an entirely different kind of sexual "lifestyle advice."

The book is a bit haunted by the ghost of what Bernstein did not find, and what, it appears, she especially hoped to find: namely, any positive reference to sexual experience and sexual pleasure. She correctly concludes that the doctors chose deliberately to stay out of the bedroom, venturing only to treat and write about those who were experiencing sexual difficulties. This she attributes primarily to Soviet (and pre-Soviet) reticence on sexual matters, which I think is correct. But it is also, once again, a consequence of Bernstein's choice of focus. Russian doctors in both the pre-revolutionary and the revolutionary periods primarily treated people who complained of being sick. The Hippocratic Oath nowhere enjoined them to enhance the pleasures of their patients.

This is an excellent book for scholars interested in the ins and outs of the medicalization of sexuality. It contributes as well to debates in the Soviet field about the origins of Stalinism and the role of professionals in allowing, even abetting, the rise of a political climate that discouraged debate and heterodoxy.