Blank H (2012) The surprisingly short history of heterosexuality. Beacon Press

I did some research into the writings of Hanne Blank, the author of 'Straight: The Surprisingly Short History of Sexuality,' see this brief interview with Thomas Rogers at Salon. I realised that there are some surprising and interesting links between Hanne's work and the history of physiotherapy.

Firstly, Blank reminds us that heterosexuality was a social construct invented to normalise sexuality at a time when late-Victorian anxieties imposed some now taken-for-granted, but no less draconian notions of 'normal' sexuality. This was exactly the time when physiotherapy as a profession was being formalised.

Normative values around (hetero)sexuality were pivotal to the founders of physiotherapy. The founders of the Society of Trained Masseuses - the forerunner of the Chartered Society of Physiotherapy, and many other physiotherapy professional bodies around the world - were heavily 'gendered' in their early years, as Grafton made clear in 1934 - 'We will make massage a safe, clean and honourable profession, and it shall be a profession for British women’ Grafton, S. A. (1934). The history of the Chartered Society of Massage and Medical Gymnastics. Journal of the Chartered Society of Massage and Medical Gymnastics, March, 229.' The professions' founders in the UK forebode men joining the profession and only massaged men under strict instruction of a referring doctor (and only then for 'nursing' cases). Still to this day, physiotherapy is a predominantly female profession.

I discovered that Blank had also published a book titled 'The Unapologetic Fat Girl's Guide to Exercise and Other Incendiary Acts'. Which reminded me of a similar book written by Linda Finn called 'Largely Happy'. (The book is out of print now, but you can still buy copies online.)

Linda's work was interesting. She lived in Auckland near to our physiotherapy school and we would bring her in to talk to the students about exercise for large people. Like most developing countries, New Zealand has its own issues with body size, and we wanted to get our students to grapple with some of the issues around largeness and activity.

The conventional wisdom is that fat people are lazy, overeat, and don't do enough exercise. They gain weight because of the imbalance of inputs to outputs, and that our role as physiotherapists is to increase the outputs. Linda's book challenges a lot of those assumptions. With an exhaustive analysis of the existing literature, she argues that one of the greatest causes of ill health for large people is actually the constant dieting.

Dieting, as we know, deliberately denies the body resources and sometimes these can be vital calories, vitamins and minerals. Forcing the body to consume itself to lose weight may, she argues, be as much of a cause of heart disease, diabetes, liver problems, etc., as the body weight itself.

Linda's suggestions for activities to keep people healthy and active relied on the acceptance of people's size, not a persistent criticism of it. Physiotherapy is very body-centric, and sometimes we can inadvertently focus on the very thing that people dispose and distrust the most. This does nothing for people's motivation or perseverance.

Both Blank and Finn's work reminds us that our assumptions about what is normal are socially constructed. They have their own history and are specific to their time. Revisiting our assumptions - particularly the ones we take most for granted - is a key feature of critical thinking today and one that we could do with nurturing a lot more in our students and professional colleagues.