Histories of Sexual Health in Britain, 1918–1980

Principal Investigator

Dr Anne Hanley, Department of Applied Health Sciences

Research Fellow

Dr Claire Martin, Department of Applied Health Sciences

Affiliated postgraduate researcher

Ms Aleph Ross, Department of Applied Health Sciences

Affiliated postgraduate researcher

Mr Joseph Price, University of Warwick

The United Kingdom experienced radical transformations of its sexual health throughout the twentieth century. These developments brought huge benefits and helped to break down the stigma and inequalities that had impeded access to care. Yet fundamental challenges remain, and history has much to teach us as we face those challenges. Understanding the historical impact of clinical practices, health infrastructure, social conditions, cultural attitudes and policy interventions enables us to recognise long-term trends and patterns. And it makes us better equipped to tackle persistent and emerging challenges today.

Today, sexual health is defined as the ability to lead a pleasurable and safe sex life and is recognised as a vital component of overall health and wellbeing. Historically, its definition was much narrower. In clinical practice, it meant combating syphilis and gonorrhoea—the principle ‘venereal diseases’ preoccupying health authorities. In the public imagination, it meant remaining morally and eugenically ‘fit’ to ensure the future health of the race and nation. Gradually, sexual health ballooned, becoming its own clinical field and encompassing a variety of other, newly identified diseases like chlamydia as well as diverse provisions for women’s health, maternal welfare and family planning.

Key to these changes was the UK’s state-funded sexual health service. Established in 1916, the Venereal Disease Service was the UK’s first universally available health service, free at the point of use and responsible for delivering sexual healthcare to millions of people throughout the twentieth century. Integrated into the NHS after 1948, it was a vital part of the UK’s shift towards socialised medicine and among the UK’s most important pieces of health infrastructure, changing the way that people thought about, talked about and experienced sexual health.

The VD Service was intended to help overcome the enormous inequalities and stigma that had defined sexual health for the Victorians and Edwardians. And while it went a long way towards correcting a variety of social injustices and endemic health challenges prejudice and stigma persisted. Demographic groups including migrants, sex workers, the working classes, teenagers and LGBTQ+ communities continued to be viewed as irresponsible ‘vectors’ or ‘reservoirs’ of disease in need of management and surveillance. They also faced various forms of structural violence, public and political hostility, state surveillance and criminalisation. And many of these problems persist.

In mapping the complex interplay of personal, social, cultural and political factors that shaped people’s health experiences, the project aims to fill major gaps in scholarly and public understandings of our historical sexual health.

Despite its historical importance, very little is known about almost every aspect of sexual health in the decades before the AIDS crisis. Especially scarce are personal stories and recorded memories. To fill these gaps, we are collaborating with the British Library and National Life Stories to create the first oral history collection of stories and memories from the VD Service’s health workers and service users.

To date, we have recorded interviews with nurses, contact tracers, doctors, LGBTQ+ activists, sex workers and other patients from a range of demographics. As the first collection focused on sexual health before the AIDS crisis, it already constitutes a unique and significant resource on a range of under-documented topics, including staff training and working conditions, the delivery of care and wider attitudes to sexuality and illness. It will be deposited in late 2027 with the British Library, whose oral history collections are among the largest in the world, where it will become a permanent, publicly accessible resource.

If you or someone you know accessed or staffed a VD clinic at any time before 1980 and would like to contribute your stories to our project, please get in touch with Dr Anne Hanley or email Dr Claire Martin.

Alongside our archival research and oral history collecting, we have developed a portfolio of public engagement through a range of collaborations with national and international partners.

RSHE Resources

Recognising the value of History for high-quality Relationships, Sex and Health Education, we built skills and networks to translate historical research into dynamic and effective RSHE. In 2023, we worked with Sex Education Forum to develop high-impact strategies for integrating historical material and themes into RSHE for UK secondary-school students. We have since applied these skills to a collaboration with Sexpression — a grassroots charity that trains university students across the UK to deliver RSHE to secondary-school students — to redesign their resource portfolio and produce a source pack utilising a range of archival and anonymised oral history data. This source pack is being rolled out in Sexpression branches across the UK and will be used to deliver RSHE to thousands of secondary-school students, helping to stimulate historical curiosity and destigmatise discussion of sexual health.

Health Comics

Following our project’s multidisciplinary workshop on past, present and future challenges facing sexual health, we facilitated a series of creative collaborations to produce highly accessible health comics based on workshop proceedings. Eight artists worked with speakers from organisations across the UK, including the Universities of Cambridge, London and Edinburgh, the UK Health Security Agency and the Newcastle Hospitals NHS Foundation Trust. These short comics are now being used for health education and public engagement, and we are exploring where we might publish them digitally as a compilation.

Examples of accessible health comics:

• Drawing both sides of the hospital curtain
• What does HIV mean?
• Think syphilis

Graphic Novel

The compelling personal stories from our project have enormous translative potential for audiences beyond academia. In our project’s renewal phase, we have therefore partnered with The Comics Cultural Impact Collective and are working with a team of comics artists to translate vast quantities of historical data into a graphic novel. Centred around a fictional 1950s metropolitan VD clinic, it follows four intwined storylines involving characters whose experiences are based on project research. These characters include homosexual men, sex workers, migrants and the wives and children of infected men. And accompanying these characters on their journeys are a supporting cast of doctors, nurses and contract tracers. Engagement with sexual healthcare among these groups was particularly fraught and the novel will explore how forces like homophobia, sexism, paternalism and racism shaped their experiences.

Script for Theatre

Set in the 1930s and drawing heavily on archival research, the script will be a fictionalised reimagining of the serious emotional, psychological, social and medical implications of contracting an STI in an age before antibiotics and the NHS. In contrast to the graphic novel’s multiple storylines, the script focuses on a single central protagonist, allowing for sustained emotional investment and dramatic development. Theatre is a powerful form of critical engagement with history, feeding a deep interest in heritage and identity. But it also encourages dialogue, reflection and debate on themes and experiences that resonate across time and place. In this way, our script also serves as commentary on current sexual health challenges, with the potential for positive impact on attitudes and health-seeking behaviours. Our aim is to apply for future funding to develop the script into a short-run production.

• Martin, C. and Hanley, A. ‘Confidentiality, Concealment and Erasure in the United Kingdom's Postwar VD Service’ (forthcoming).
• Hanley, A. ‘“We all of us make mistakes.” Medical negligence in interwar general practice’, Social History of Medicine (2025).
• Hanley, A. ‘Migration, racism and sexual health in postwar Britain’, History Workshop Journal (2022): 202–22.
• Hanley, A. ‘Histories of “a loathsome disease”: Sexual health in modern Britain’, History Compass (2022).
• Hanley, A. ‘“Sex Prejudice” and Professional Identity: Women Doctors and their Patients in Britain’s Interwar VD Service’, Journal of Social History (2020): 569–98.

• British Association for Sexual Health and HIV
• British Library and National Life Stories
• The Comics Cultural Impact Collective
• The College of Sexual and Reproductive Healthcare

• Person-Centred Research
• Department of Applied Health Sciences
• Centre for Modern British Studies
• Birmingham Research Institute for History and Cultures