Unwell Women by Elinor Cleghorn review – battle for the female body

The shocking mistreatment of women by the medical establishment is laid bare in a compelling social history

During the recent anxieties about the AstraZeneca Covid vaccine and its possible link to blood clots, many women felt obliged to point out, on social media and in the press, that the risk of fatal thrombosis was significantly higher from using hormonal contraception, and yet this continues to be prescribed to millions of women without anything like the level of concern or scrutiny that the vaccine has received. The potential danger of a medication that only affects women is less of a headline-grabber, it seems. In fact, when the pill was first licensed in the US in 1960 it contained more than three times the levels of synthetic hormones than the modern version, and the side-effects - including fatal pulmonary embolisms and thrombosis - were deliberately downplayed. It took a sustained grassroots campaign by women's groups to bring the issue to the attention of a congressional hearing in 1970. From the beginning, the pill was couched as a way for women to take control of their bodies and fertility," writes cultural historian Elinor Cleghorn in her debut book, Unwell Women. But this also means that the costs - physical and mental - remain women's burdens."

The history of the pill is just one fascinating episode in this richly detailed, wide-ranging and enraging history of how conventional medicine has pathologised, dismissed and abused women from antiquity to the present. A male-dominated medical establishment, influenced by religious, cultural and political ideas about women's bodies - particularly with regard to sexuality and reproduction - has inflicted immeasurable suffering on women and girls, often with a sense of righteous zeal. Some of the cases Cleghorn unearths could come straight from The Handmaid's Tale. There's the 19th-century London surgeon Isaac Baker Brown, an avid proponent of clitoridectomy to cure the hysteric and nervous disorders thought to be brought about by excessive masturbation in young middle-class women. Or the American neurologists Walter Freeman and James Watts, who pioneered the craze for lobotomies in the 1930s and 40s - by 1942, 75% of their patients were women. In an era when a mentally healthy woman was a serene wife and mother, almost any behaviour or emotion that disrupted domestic harmony could be interpreted as justification for a lobotomy."