The medical community also supported religious doctrine by declaring that nonconformist sexual behaviour was a form of insanity.

The late nineteenth-century was a time of dynamic change for the United States. High ideals, progressive reform movements, accelerated industrial expansion, explosive immigration rates, and an increase in urban growth all characterised the Gilded Age of America.

Social reform movements such as women’s suffrage, temperance, and campaigns to reform labour laws were beginning to transform the American social and cultural landscape. Empirical science and the theory of evolution, along with the new disciplines of physics and psychology, revolutionised the way people perceived the world and thought about themselves.

New technological advances allowed people access to news events — information that previously took days to reach all parts of the nation — in just a few hours.

During this time of major changes within American society, traditional attitudes continued to play a role in the daily lives of many people. In addition, institutional forces were central proponents in dictating established attitudes and values regarding social conduct, acceptable sexual relations, and the clearly defined gender roles that governed people’s behaviour.

Among the middle and upper classes, and especially among women, sex was regarded as a taboo subject for conversation. Ironically, although the topic of sex was avoided in polite company, proper sexual — and gender — appropriate behaviour was reinforced from the pulpit.

The medical community also supported religious doctrine by declaring that nonconformist sexual behaviour was a form of insanity. The religious establishment stood upon nearly 2,000 years of biblical doctrine, insisting that sex was for procreation only, while the medical community struggled to understand the inner workings of the mind.

Throughout the nineteenth-century, leading medical experts debated the causes of mental disorders while struggling over how to apply their clinical findings in the courtroom. Despite the M’Naughten Rule of 1843, which defined criminal responsibility, the American judicial system found it difficult to apply the rule evenly in all insanity cases, particularly when inappropriate sexual or gender behaviours were involved.

Cultural misunderstanding of the meaning of insanity by juries, the hesitancy of judges to accept a medical rather than a legal definition of insanity, and the inability of the medical community to agree as to what causes insanity all combined to created widespread discrepancies in the outcomes of criminal insanity trials.

The problem lay in the fact that since there were conflicting medical opinions on the origins of insanity, the judicial system and the medical experts could not agree on how a defendant should be adjudicated. Often in similar cases, one defendant would be acquitted and another convicted, while others were judged insane and confined to an institution.

This article will examine the factors and social conditions that revolutionised how abnormal sexual and gender behaviour was interpreted as insanity in and out of the courtroom. While the American judicial system continued to be committed to holding defendants legally responsible for their crimes despite the presence of unrecognised mental illness, misperceptions of insanity found their way into the courtroom through the juries who sat in judgment of a defendant.

Both the jury and the court looked to the medical experts for answers to unexplainable behaviour. Their answers, however, were often inconsistent and confusing. Secondly, the American press was not blind to this confusion and often took advantage of the situation to further its own agenda.

When defendants were accused of deviant sexual or gender behaviour in criminal cases, newspapers sensationalised the cases and extolled the importance of maintaining established social values.

Juries holding traditional ideas of what constituted appropriate gender behaviour, along with the refusal of the judicial system to accept a medical definition of insanity, prompted many medical professionals to seek new theories on the meaning of insanity.

As a result, there was an explosion of articles in the medical literature during the 1890’s that debated the causes of insanity. While all forms of insanity were written about in the medical journals, the origins of insanity among women, and in particular deviant sexual behaviour, were of great interest to the leading alienists.

In the search to uncover the true origins of insanity, the previously held concept that “moral” insanity was a form of mental illness came to be regarded as invalid. In its place, the theory that physiological origins, and not psychic malfunction, were the root causes of mental disorders gained greater acceptance within the medical community.

The belief that mental illnesses had physical causes, and were perhaps hereditary, would not only be tested in the laboratory, but before the American public through the court system and the press as well.

One such test case, which a noted medical journal characterized as the first time sexual perversion had been used as the basis for a plea of criminal insanity, occurred in 1892. Alice Mitchell and Freda Ward, both from Memphis, Tennessee, had been engaged in a love affair. Tragically, however, Alice publicly slit Freda’s throat shortly after Freda was forced by her parents to end the relationship.

The ensuing case made headline news nationwide. Later that year the nation was shocked by the arrest of Lizzie Borden for the double homicide of her parents, and just a few years later the Oscar Wilde trials in England rocked the English-speaking world.

The nation struggled to understand the sexual and gender issues raised by these trials. These and other prominent criminal cases fueled the debate in the growing field of psychology regarding the origins of what was considered abnormal gender-related behaviour.

The debate centered on whether these behaviours were a degenerative sickness, as Richard von Krafft-Ebing described in his book ‘Psychopathia Sexualis’ (1889) or — as Freud would come to argue — were inborn rather than the result of disease or immorality. While the nation had long been accustomed to violence, the incidence of murder committed by women had begun to rise during the late nineteenth-century.

Society at large did not understand this alarming trend or the motives of women who committed sex-related crimes. Female insanity came to be the only means both to defend and to explain these crimes, since the nature of the crimes challenged society’s concepts of what constituted the normally accepted reasons for committing murder.

The use of the insanity defence was not an entirely new feature in American jurisprudence, the roots of which are grounded in English law. One case that helped set English precedent dates to 1760. The defendant, the Earl of Ferrers, accused of murdering one of his servants, alleged that his derangement amounted to “occasional” insanity.

Dr John Monro, a well known “mad doctor” at that time, supported his argument. The Earl, however, was convicted on the grounds that only complete insanity — a total lack of memory and understanding — could be the basis for an acquittal on the grounds of mental derangement.

The House of Lords rejected the occasional insanity argument as a condition that was too likely to leave the afflicted in a “lucid interval,” in which the defendant was as culpable for his wrongdoing as any person.

The ruling set the legal precedent for determining criminal insanity in England and her colonies in America. And until the early nineteenth-century, the courts held that only if a “total want of memory and understanding” could be proven would the law consider insanity as grounds for acquittal.

However, this did not prevent defendants from attempting to use the insanity strategy, both in England and America. In Boston, for example, a random sampling of the Police Court during the first half of the 1800’s suggests that not only was the insanity defence used occasionally, but that defence counsels had a limited understanding of how to effectively employ the insanity tactic.

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