‘Initially this work was done by doctors, often ineffectively …’: the History of Sexual Health Advising in twentieth-century England

Much has been written about the history of policy and practice on venereal diseases/sexually transmitted infections in twentieth-century England, but one key group of actors has been overlooked: sexual health advisers and their predecessors. From the introduction of venereal disease clinics c. 1918, workers variously titled hospital almoners, health visitors, contact tracers, social workers, and, latterly, sexual health advisers have been involved in a range of interconnected activities including counselling, health education, contact tracing, and seeking defaulters from treatment in the community. Leading medical venereologists have generally expressed strong support for the value of such workers, but throughout the century there has been continuing diversity in the background, employment, training, roles, and responsibilities of those workers. In the last decades of the twentieth century, sexual health advisers sought to professionalize by establishing a professional organization and seeking other professional attributes including certified training and professional registration. Although there appeared to be policy support for such steps, by the early twenty-first century a change of government disappointed such professionalization hopes. The history of sexual health advising provides a unique lens on the challenges facing occupational groups seeking to professionalize within the National Health Service.