I suppose it’s an occupational hazard, but I find myself surprised when I hear women today—many of whom are self-declared feminists—remark that of course female alcoholics are different. I am brought up short by the straightforward, un-self-conscious way in which this pronouncement is made by friends and colleagues who are social scientists and clinicians. I cannot listen to the expression of that sentiment without hearing echoes of nineteenth-century physicians and reformers and twentieth-century psychiatrists who made the same claim to quite different ends.
Throughout U.S. history, most Americans believed that female alcoholics were less common than their male counterparts, so much less common that their very existence—in any number—represented a phenomenon that needed to be explained. Drinking, at least to excess, was not something believed to come naturally to women, and therefore women who did it were unusual in some way—more sinful, more deviant, more pathological, just more of whatever explanatory model was in vogue at the time.
Women’s drinking seemed to mean more in cultural terms, too. Another common theme here has been the perpetual warning that women are “closing the gap” with men, both in recreational consumption and in the number and rate of problem drinkers. Clearly, a persistent belief remains that men’s habits represent the baseline to which women’s behaviors are always compared. And because alcohol consumption, particularly in public settings, and the recreational use of many psychoactive substances have been considered masculine prerogatives through much of American history, participation by women in these practices has been interpreted as a sign of changing gender roles, for good or ill. Some commentators have argued that women’s drinking and smoking should be celebrated as liberation—think of the 1920s flapper or the Virginia Slims cigarette ads of the 1970s. Agreeing that such behaviors indicate an important shift in gender roles, others have insisted with equal fervor that the pattern augurs disaster, a breakdown in the family and social order. During World War II, for example, a purported increase in alcoholism among women was seen as the result of women on the home front taking on men’s roles in work and leisure—another sign, in short, that the world had turned upside down. As well as reflecting contemporary gender roles, then, alcohol-related customs have structured beliefs about how men and women are supposed to act.
Defining addiction has never been easy, but the particular constellation of gendered meanings associated with alcohol has rendered boundaries between problem drinking and any drinking especially blurry in the case of women. This lack of clarity matters because, at least since the repeal of national Prohibition in 1933, many aspects of research, treatment, and policy hinge on how those boundaries are drawn and enforced. The example of Fetal Alcohol Syndrome, in which any drinking by a woman who might be pregnant became cause for social criticism, and sometimes medical and legal sanction, shows the extent to which beliefs about women’s alcohol use continue to shape concepts of gender—even during the last decades of the twentieth century, when many other markers of traditional roles had eroded or been overturned.
Today, my friends and colleagues who study alcoholism and care for alcoholic women are not alone in emphasizing gender difference. The booklet “Alcohol: A Women’s Health Issue,” produced by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) in conjunction with the Office of Research on Women’s Health, Office of the Director, National Institutes of Health, similarly highlights disparities in many realms, including how alcohol is metabolized in the bodies of men and women, the dangers of drug interaction, and the reproductive and sexual risks associated with drinking. http://pubs.niaaa.nih.gov/publications/brochurewomen/women.htm
My point is not to question the clinical accuracy of these conclusions, but to offer a reminder that such claims circulate in a milieu that carries many echoes of the past, when assertions about gender difference fueled a double standard that depicted alcoholic women as beyond hope of redemption. Clearly, much is at stake today as researchers, clinicians, policy makers, and drinking women themselves seek to use beliefs about gender difference strategically in order to craft humane and effective treatment and policy. Historians can help, I believe, by illuminating how the complicated cultural mix we have inherited shapes our present-day terrain, whether we like it or not.