Prostitution Regulation and Public Health: The Contagious Diseases Acts of Britain

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Content warning: this research project speaks frankly about misogyny, sexual assault, trauma, police misconduct, and prostitution (a word which in itself is, we recognize, controversial). 

When people are asked to reflect on feminist history, many start with what has been labelled as “first-wave feminism” and the decades-long fight for female suffrage. However, this somewhat arbitrary origin point ascribed to the feminist movement overlooks the work of many earlier Victorian social reformers who advocated for feminist causes such as the treatment of female prison inmates, access to higher education for women, and the organized campaign to repeal the Contagious Diseases Acts.

Over the last 4 years, I have dedicated my time to researching and writing about the Contagious Diseases Acts of Britain (CD Acts) (1864-1886). Despite being an important moment in medical, military, and feminist history, the CD Acts have become a relatively forgotten phenomenon. In my conversations with curious friends and family over the years, most have been shocked to learn that the British government once detained women accused of prostitution, forcing them to undergo invasive vaginal examinations to search for signs of venereal disease.

In many ways, the Contagious Diseases Acts and the subsequent repeal movement represent a turning point in the limits of public health legislation, the field of gynaecology and the medical treatment of female patients, and women’s public participation in matters of politics and sex.

What were the Contagious Diseases Acts?

Following what was characterized as somewhat clumsy efforts in the Crimean War (1853-1856) and the Indian Rebellion of 1857, the British army and navy became the subject of public scrutiny. Composed mostly of bachelor male soldiers, the British military was seen as undisciplined, disorganized, and worst of all, immoral, with mounting fears of potential homosexual activity among its rank and file.

Figure 1. Report of the Commissioners appointed to inquire into the regulations affecting the sanitary condition of the army […] (Title Page), 1858. Digitization courtesy of the Wellcome Collection.

Amid these controversies, the British public increasingly called for military reform. As a part of these efforts, a Royal Commission was formed to study the physical and moral health of military men. In 1858, the Royal Commission on the Health of the Army published their findings in a report that revealed shockingly high rates of venereal disease among soldiers. While many members of the Commission (including the likes of Florence Nightingale) advocated against taking an overtly regulationist approach to the issue, it was resolved that some action was required to address the spread of these diseases without damaging the morale of existing soldiers or discouraging future enlistment.

The first Contagious Diseases Act (1864) was passed through parliament at 2AM on the 21st of July in what would later be described as a “conspiracy of silence”.[1] Coupled with the secrecy of its passage through parliament, the CD Acts re-used the name of another piece of legislation. A Contagious Diseases Act designed to control the spread of a deadly virus amongst cattle had already been in operation for several years, leading many to title this new act the Contagious Diseases Act (Women) to prevent what was certainly intentionally created confusion on the part of legislators. These factors meant that the early iterations of the CD Acts went relatively unreported by the press and unnoticed by the general public.

The 1864 Act covered 11 port and garrison towns in the south of England and Ireland and allowed for the compulsory medical examination of women suspected of prostitution. If a suspected prostitute was determined to be diseased, she would be confined to a lock hospital for up to 3 months.[2] 

In 1866, a renewal bill was passed with slight amendments; the number of subjected districts was extended to 12, and the mandatory medical examinations for registered women were to become fortnightly for up to a year. Any woman who was determined to be ill would be detained in a lock hospital for 6 months. In 1869, the third iteration of the CD Acts was passed, bringing the total number of subjected districts to 18 and increasing the possible detention of prostitutes up to 9 months.

Enforcement of the CD Acts fell on the Metropolitan police force which used what we would call undercover or plain-clothes officers, and what the Victorians called “spy police”, to surveil women who were suspected of conducting prostitution. No evidence was required to detain a woman for prostitution other than the accusing officers’ testimony that he had “good cause to think or believe that the accused is no better than she should be”.[3] Accused women were summoned by police and ordered to sign what was referred to as a “voluntary submission form” which registered them as a prostitute, after which, they were required to begin attending medical examinations by an appointed surgeon. Any woman who refused to report for her inspection would be brought before the local magistrate and could face imprisonment with or without hard labour.

Many supporters of the Contagious Diseases Acts argued that the Acts were a necessary piece of not only military, but also sanitary reform legislation. This kind of legislation was part of a larger Victorian movement to regulate the lives of the “disrespectable” poor and working classes. The 1830s and 1840s had seen the origins of sanitary reform in which social investigations and home-visiting schemes increasingly blamed poor and working-class neighbourhoods for the spread of disease. The discourse of public health that emerged at the time, connected physical and moral health suggesting that the immoral behaviours and lifestyles of the lower classes fostered ill health and disease. Women became the target of this sanitary reform discourse which increasingly tied public health to domestic hygiene, meaning that poor and working-class women were ultimately to blame for their failure to properly maintain the physical health of the home and the moral health of the family.

Eventually, the prostitute would become the focus of medical and sanitary discourses. Labelled as the ultimate “social evil”, the Victorian prostitute represented the poor and working-class woman’s potential for deviant sexual behaviour and contamination. As a piece of public health legislation, the Contagious Diseases Acts codified into law and cemented into the public conscience the idea that the prostitute was the source of contagion—a woman in need of sanitation.

The Repeal Campaign

Organized efforts to repeal the Contagious Diseases Acts began in 1869 as a response to the work of the Extensionist Association, a group of CD Act supporters who called for the extension of the Acts to civilian populations, consequently making the previously secretive Acts public knowledge. Several organizations were formed in order to combat the Contagious Diseases Acts and the efforts of the Extensionists, the two main groups being the National Anti-Contagious Diseases Acts Association (NA) and the Ladies’ National Association for the Repeal of the Contagious Diseases Acts (LNA) which formed in response to the NA’s initial exclusion of women. 

Figure 2. Notice of a public meeting issued by Josephine Butler during the Pontefract by-election, 1872. Produced by the Ladies National Association for the Repeal of the Contagious Diseases Acts.

Many elements of the repeal campaign shocked the Victorian public. Beyond the atrocities of the CD Acts themselves, the efforts of the mostly upper and middle-class women involved in the campaign directly contradicted gender norms of the period. For instance, women repealers insisted on collaborating with working-class men and even known prostitutes. This crossing of distinctly defined class boundaries could be understood as having dangerous physical and moral implications for the propriety of bourgeois women. Furthermore, as the repeal campaign began before women’s suffrage became an issue of consequence in the public consciousness, women repealers were seen as meddling in the world of politics, which was defined as the sphere of men. Parliamentarians described their efforts as a “revolt of women”, and the British press described them as a “shrieking sisterhood”.[4][5]

Perhaps the most controversial element of the repeal campaign was the license it seemed to give respectable women to talk about matters of sexuality. Repealers argued that the CD Acts were dangerous on two fronts. Firstly, they suggested that the Acts amounted to a state sanctioning of vice; that in detaining, inspecting, and rendering these young women “clean” in order to return them to their sinful lives, the government was complicit in the practice of prostitution. Secondly, the Acts reinforced the sexual double standard, the ideology in Victorian culture that suggested men, as a result of their uncontrollable sexual nature, should be allowed to engage in the kind of sexual behaviours that would be unthinkable for women.

Under the charismatic leadership of the noted social reformer, Josephine Butler, and with branches in operation across the country, the LNA campaigned for 16 years. In 1886 the campaigners reached their goal, and the Contagious Diseases Acts were officially repealed.


[1] Paul McHugh, Prostitution and Victorian Social Reform, Croom Helm Social History Series (London: Croom Helm, 1980), 135. See also Judith R. Walkowitz, Prostitution and Victorian Society: Women, Class, and the State (Cambridge; New York: Cambridge University Press, 1980).

[2] Beginning in the eighteenth century, lock hospitals were special wards for the treatment of those with venereal diseases built outside the hospital to keep VD sufferers and the destitute separate from so-called “clean” patients. While these wards did keep windows and doors locked as an effort to control contagion, the term “lock” had originally been used for hospitals where leprosy patients were kept. When the Contagious Diseases Acts were passed, more lock hospitals were specially built in garrison and port towns such as Aldershot, Chatham, and Portsmouth. In addition to treatment for venereal disease, patients in these institutions also received religious and moral education designed to make them reconsider their sinful ways. For further information see Maria Isabel Romero Ruiz, The London Lock Hospital in the Nineteenth Century: Gender, Sexuality and Social Reform (Bern, Switzerland: Peter Lang, 2014).

[3] Charles Bell Taylor, A Speech Delivered at Exeter in Reference to the Proposed Extension of the Contagious Diseases Acts to That City (London: Dyer Brothers, 1880), 7.

[4] The LNA published the “Ladies Manifesto” in The Daily News (31 December 1869) outlining the group’s objections to the Contagious Diseases Acts. Following the publication, Josephine Butler recalled a conversation with a member of parliament who stated, “Your manifesto has shaken us very badly in the House of Commons. We know how to manage any other opposition in the House or in the country, but this is very awkward for us—this revolt of the women. It is quite a new thing; what are we to do with such an opposition as this?”

[5] The Saturday Review. “The Shrieking Sisterhood”. 12 March 1870.

[6] Ornella Moscucci, The Science of Woman: Gynaecology and Gender in England, 1800–1929 (Cambridge: Cambridge University Press, 1990), 123.

Special thanks to Ian M. Fraser and Janine M. Schweitzer for their generous support of the 2022 Margaret Angus Research Fellowship.

Jessica Sealey (Margaret Angus Research Fellow 2023)

Jessica Sealey is a PhD candidate in Cultural Studies at Queen’s University. Jessica holds a Masters in the History of Art from the University of Western Ontario and has previously worked in the visual arts, tourism and heritage sectors as a curator and educator. Her doctoral research focuses on the Contagious Diseases Acts of Britain (1864-1886) and explores narratives of sexual immorality, public health, performance, and surveillance. Her research interests include the history of gender, sexuality, and medicine, as well as visual culture and museum studies.

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