What had been almost entirely a moral issue became the focus of discussions concerning sexual ethics. Although few physicians had any specialized knowledge of human sexuality and behavior outside the treatment of sexually transmitted diseases, physicians were viewed as authorities in the infant field of sexology. Discussions of sexuality gave rise to the first programs of public and private sex education as well as new classifications and documentation of sexual behaviors. Samuel Tissot's published 1760 warning against masturbation, in order to prevent "masturbatory insanity," became a dominant theme in adolescent sex education.
By the nineteenth century, the medical view of sexual behavior was expanded to include sexual behaviors classified as mental diseases. Heinrich Kaan's Psychopathia sexualis (1843) introduced the concept of deviance, behavior that diverges from the accepted norm, and perversion, behavior caused by a determination not to do that which is expected, both regarded as functions of mental illness. Less than 30 years later, as a result of the publication of case histories by prominent psychiatrists, homosexuality became viewed by the medical community—and, therefore, by society—as a mental illness.
In 1873 Anthony Comstock (1844-1915) lead a campaign to regulate sexual behavior, resulting in the passage of the Comstock Laws, which further limited sexual freedom, particularly that of women.
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