In 2019, for the first time in history, the majority of students in American medical schools were female. The battle for women’s access to the medical profession has been long and arduous since 1849, when Elizabeth Blackwell became the first woman to graduate from an American medical college. Even in 1969, women still only made up less than 10 percent of accepted medical school applicants.
The Center for Women’s History sat down for a virtual conversation with journalist Olivia Campbell to discuss the history of female doctors and pioneering women like Blackwell, Elizabeth (Lizzie) Garrett, and Sophia Jex-Blake who are featured in her new book, Women in White Coats: How the First Women Doctors Changed the World of Medicine.
Why do we hear so little about the contributions women have made to medicine?
In early history, women’s professions often weren’t recorded as frequently as men’s were or deemed not worthy of recording. And a man’s entire family would’ve been involved in his profession, even if his name was the only one recorded. What’s more, activities we would now consider medicine were often performed by mothers, daughters, or other female relatives within the home, which meant they were dismissed or disregarded by historians as mere domestic caregiving. When men took medical authority away from midwives, herbalists, and other lay women healers, they demonized their knowledge as inferior and dangerous, demanding only through a university education could one attain proper medical knowledge. And of course, women were largely barred from universities.
Historically, why was there a need for female doctors?
Nearly all of the women who attempted to break into the male domain of medicine in the Victorian era did so after witnessing female friends or relatives suffering through illnesses or dying slow, agonizing deaths because they didn’t want to consult a male doctor or waited too long to consult one. These illnesses might have been treatable had they sought medical assistance sooner. The female physician hopefuls wanted to give women a doctor they could tell all of their troubles to without shame or embarrassment, a doctor who might even understand what they were going through. They were also interested in interrogating the sexist beliefs around the etiology of women’s diseases.
What institutional and social impediments did women who wanted to become doctors face?
While applying to medical school was a mere formality for men in the 1800s, women were almost uniformly rejected. If they did manage to get accepted, that didn’t mean the university would grant them a degree. And if they managed to get a degree, there was little hope of getting a job. That’s why so many of these women founded medical schools and hospitals just for women—because they weren’t welcome elsewhere. Women med students faced societal scorn and potential familial rejection for their unfeminine interest in the grotesque practice of medicine or surgery.
You argue that for women like Elizabeth Blackwell, Lizzie Garrett, and Sophia Jex-Blake to enter into medicine, they had to become women’s rights activists. What do you mean by that and why do you think that was the case?
Middle- and upper-class Victorian women were expected to remain in the domestic sphere, especially if they were married and had kids. Teacher, artist, or writer were among the few jobs considered potentially acceptable for women. What Elizabeth Blackwell, Lizzie Garrett, and Sophia Jex-Blake were doing—seeking university-level education and a career in a male profession—was by default a request for women to have more. They were demanding the right to be educated as highly as men and to practice in a profession of their choosing, to enjoy the same independence men did. Any application to a school, job, or professional society could never be only about them as individuals, but would always represent the broader question “should women be allowed in?”
One of the more compelling aspects of the book is the many ways these women’s lives continued to intersect as they pursued their passion for medical knowledge. How important were social networks to the success of the first female doctors?
Cultivating a sisterhood of scientific women was essential. As the first women who earned MDs saw how difficult it was to obtain an education, training, and a job, they came to realize they must do everything in their power to help those who came after them. A letter of recommendation, mentorship, help with securing accommodation, sharing information about which doctors or hospitals were amenable to training women, help finding open positions—these were just some of the things the first wave of women doctors did to help ensure others had a less lonely and frustrating journey than they did.
What role did social privilege play in the success of Blackwell, Garrett, and Jex-Blake?
Lizzie and Sophia both came from well-off families, which definitely helped them achieve their career goals. Lizzie’s father bankrolled her education. Given all of the private tutors she ended up employing after no school would have her, it ended up being quite an expensive endeavor. After Lizzie set up a private practice in London, her family sent her weekly hampers of food from their estate. Elizabeth, on the other hand, had to put off her dreams of med school while she earned enough money to pay for it by teaching. When her private practice in New York struggled at first, she had to ration her food and coal.
New York City holds special significance in the history of women in medicine. Tell us about the founding of the New York Infirmary for Indigent Women and Children and the Women’s Medical College. How did these institutions change the lives of New York City residents?
Founded in 1857 by Elizabeth Blackwell, her sister Emily, and their colleague Marie Zakrzewska, the Infirmary was a godsend to the women of New York—especially its poorer inhabitants. Care was free of charge for those who couldn’t afford it. The Infirmary was always busy because it backed up to the Five Points neighborhood, where overcrowding, poor sanitation, and poverty converged to create a perfect storm of illness and fast-spreading epidemics. In its first eight months, the Infirmary’s outpatient dispensary saw 866 patients and its hospital accepted 48 inpatients, numbers that doubled the following year. Demand always exceeded supply; they were constantly turning away women who wanted to give birth there. The Infirmary was home to the nation’s first community outreach and health education service, run by Rebecca Cole, the second Black woman in America to earn an MD. As for the Women’s Medical College, 364 women earned their degrees there during its three decades of operation. It was an incredibly high-quality institution, with unparalleled entrance and graduation standards.
In many ways, this is a story about the battle for women’s right to education. How did the actions of Blackwell, Garrett, and Jex-Blake impact the opportunities available to the women who came after them?
At first, each woman’s individual actions led to a closing of the door they just exited: After Elizabeth graduated from Geneva College, they decided not to let other women in because they didn’t like the negative attention it garnered; after Lizzie was licensed to practice medicine by the Society of Apothecaries, they changed the wording in their charter to explicitly exclude women; after Sophia completed a full course of study at the University of Edinburgh, they refused to grant her a degree and definitely were not interested in allowing any more women to attend anytime soon. Yet simply by virtue of their endeavors, these women forced society to consider the topic of women doctors. Luckily for other women, these three women were determined to open up new doors. Elizabeth established a medical college for women in New York, then moved to London to help Sophia and Lizzie establish the first medical school for women in the UK. All three women also established women’s hospitals where women med students could find training and women doctors could find jobs. These women are the reason there are women doctors waiting to treat you today.
Written by Brenann Sutter, Andrew W. Mellon Predoctoral Fellow in Women’s History and Public History, Center for Women’s History.