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  • Writer's pictureDale DeBakcsy

The Path of Most Resistance: Sophia Jex-Blake and the Fight for Women’s Medical Education

Updated: Jan 21

She had founded first England’s and then Scotland’s first medical school for women, and been instrumental in the passing of the Medical Act that allowed women to take the examinations for medical licensing, but by the end of her life Sophia Jex-Blake (1840–1912) was a woman living far from the centre of the movement she had honed, her opinions unheeded and her institutions either collapsed or doing their best to leave the memory of her behind.

There are few examples in the history of women in science of individuals who threw themselves so completely and readily into the public arena, forming alliances and challenging long-standing institutions with a steadfast refusal to be cowed into inaction or intimidated into silence, as that of Jex-Blake. Where others advised caution, she flew to confrontation, demanding equality and leveraging the full force of the law and public opinion to throttle the pace of progress forward. She would not wait to battle injustice, or trust in the inevitable flow of history to right systemic wrongs. Act she must, and act she did, and in the process made herself a hero to many, and a figure of primal Victorian embarrassment to not a few.

Sophia Jex-Blake had never been one for the demure road. She was a source of constant and alternating exasperation and delight to her parents, both deeply devout and social justice minded individuals who could not quite understand their high-spirited daughter. Her mother suffered from a long-standing but poorly defined illness pervaded by a nervous irritability that defined Sophia’s youth. When at home, Sophia could not restrain her high-spirited ways, tumbling about, making noise, and getting into arguments for the pure intellectual fun of it. It was all too much for the nerves of her mother, and the child was sent away to boarding school time and time again, and bombarded with letters about how she could not return home until she had curbed her wickedness.

Jex-Blake’s adolescence, then, was spent in the company of a revolving cast of teachers and classmates, some of whom understood and appreciated her flashes of brilliance and creativity, and others of whom took them as marks of a stubborn and unrepentant youth who must be compelled to reform. She certainly had a fast temper when contradicted, and a tendency to use her intelligence to get the better of her slower teachers in argument, which infuriated them. Fundamentally she was simply a deeply lonely child being taught to loathe her basic nature by everybody around her, who lost herself in constructing elaborate imaginary utopian societies and in attempting to bend herself to the religious orthodoxies that, surely, must change her into a good person someday – the kind her mother would take pride in and allow home again at last.

It took many years but finally, in 1857, Sophia returned home, her basic schooling completed, to consider her future and be a support to the family that was finally beginning to understand and appreciate the extent of her gifts and potential. Her mother, long her greatest critic, would, in the years that followed, grow to be her staunchest supporter, encouraging her in pursuits the mere contemplation of which would have had most Victorian mothers quailing in abject social terror. Having been a first-hand witness of so many different schools and educational systems, it was perhaps inevitable that Sophia’s first inclination would be towards teaching as a profession, and that she would turn with alacrity towards the announcement that a new institution, Queen’s College, had opened in London in 1858, with the goal of providing advanced instruction to the rising generation of women wishing to become professional teachers in England.

During her elementary school years, Jex-Blake had discovered in herself a love of mathematics and a particularly keen interest in mathematical puzzles. Arriving at Queen’s College, she found that her mathematical skills were far in advance of her contemporaries, and she was soon offered a paid position as a tutor to a small group of students. Excited at the prospect of finally earning her own money, she wrote home to inform her parents of the offer, only to meet her father’s steady refusal. As a woman from a tolerably wealthy family, he wrote, she should not consider for a moment taking pay for work such as that. She should, by all means, do the job as a means of putting her talents to good social use, but should refuse all pay for it. He could not see the importance to her of earning her own money, or the double-think he was in engaging in by allowing his son to take money for working but not his daughter, and ultimately Sophia agreed in deference to his wishes to refuse payment for the current term, but to reinvestigate the issue in the future.

That disagreement notwithstanding, Sophia’s life was moving forward at a promising clip when she made a fateful acquaintance. Octavia Hill was a pious, proper and brilliant woman two years Sophia’s senior. To an outside observer, the two students could not have been less alike. Sophia was all sparkle, wit and motion, the brilliant daughter of a wealthy and respected family, while Octavia was the slow-moving, reclusive daughter of a single mother of greatly reduced means. Sophia was a wizard at mathematics, and Octavia had a mind for accountancy, and their relationship began in an excited mutual exchange of knowledge, and blossomed into a full and deep respect for each other’s gifts and personalities.

When Sophia heard about the difficulties Octavia’s family was having in finding housing, she characteristically and impulsively threw herself into the problem of solving all of her friend’s difficulties for her. She suggested that she and Octavia should find a home where the two of them could live together with Octavia’s family, with Sophia bearing more than her fair share of the cost. It was a generous offer that a few more moments of reflection might have suggested was doomed to failure. Octavia hated conflict and would do anything to avoid it. Sophia to some degree thrived upon it, as did Octavia’s mother who was used to having her way in things. Octavia stood squarely in the middle, torn between loyalty to friend and mother, and in the end decided the only way out would be to make a clean and total break with Sophia. She would have to move out, and the friendship would have to end.

Sophia was heartbroken, struck to the core by the loss of the person she thought would be her lifetime support, her true soulmate through all of the adversities to come. She limped back home and threw herself once again into excessive religious declamations in an attempt to convince herself that, really, everything was fine, that religion, not people, was where true happiness was to be had, and that love of Jesus would cure all her ills. She was not fooling anyone, however, and the depth of the hurt demanded a new thrust of action to keep her from lingering over her wounds. She resolved that the next step in her education would be to seek a position at a school in Germany, France, or the United States, to learn how other countries educated their children. Her father vetoed France out of fear that she would turn Catholic, and her mother the United States because of the distance involved, and so she went to Germany, where she arrived and presented herself at a school which had already told her it had no position for her, confident that her pluck and determination would win her a job somehow.

It did. She experienced all of the ups and downs of a new teacher – the self-doubt that comes with feeling you do not know the topic well enough to teach it, the agony over having to discipline students, and the frustration of dealing with children who took pains to make fun of her every mistake, clothing choice and cultural difference. These were tough times, but she had learned from her fellow teachers the value of mutual religious tolerance, which went far to taking the edge off her self-righteous upbringing, and stored away details of school organisation that would come in handy in her great educational pursuits of mid-life.

As of yet, medicine as a career had not remotely entered Sophia Jex-Blake’s mind. She wanted to devote herself to designing and running a new school with her family’s resources, and in 1865 travelled to the United States to survey educational theories and institutions there. It was on this trip that she met Lucy Sewall, the resident physician at the New England Hospital for Women and Children, which had been founded in 1862 by Marie Zakrzewska after her time with the Blackwell sisters. Sophia was thus thrust into the centre of the women’s medical movement in the United States, and met its leading figures as they heroically built up the institutions to support women’s medical training and practice from the bare ground.

These were heady surroundings, and Sophia found that, at the end of her tour of American colleges, the desire to return to England as a teacher had been overwritten by a need to participate in the cause of women’s medicine. She worked at the New England Hospital as an accountant and aid, while picking up the rudiments of the trade, and intended to attend Blackwell’s new school in New York to begin her formal training, when the death of her father recalled her to England.

After recovering from her father’s passing, Jex-Blake began formulating plans for her British medical education. The only other British woman who had successfully obtained a licence as a practising medical doctor was Elizabeth Garrett Anderson, who as we learned last chapter had used a loophole in 1865 to take a valid medical examination from the Society of Apothecaries. Her route to a qualifying exam was closed instantly after she obtained it, and since then the medical community had closed ranks to prevent future female aspirants from following her example.

Jex-Blake, therefore, had to find a new path to medical education. During some time spent in Edinburgh gathering information about educational practices, she had been favourably impressed by their relative progressivism, and so decided to begin her campaign at the University of Edinburgh in 1869, beginning thereby four of the hardest but most rewarding years of her life. Her opponent during these years was Sir Robert Christison, an eminent physician who was vehemently opposed to the idea of women receiving a medical education. At every step of her harrowing experience fighting for the right to learn, Christison would be there, mobilising his official power and unofficial influence to foil her. After the ultimate failure of her first application, she gathered a core group of six other women interested in a medical education. Collectively known as the Edinburgh Seven, they were to suffer indignities and setbacks of shameful scale in the coming years.

Their application to the university once approved, they had to find a way to learn under the staggering series of restrictions that had been placed on their acceptance. There were some classes from which they were simply banned, but even in those allowed to them, they had to appeal to the professors to form a separate class just for them because the male students protested vigorously at the idea of being forced to sit in the same classroom as women students. Since those separate classes were so much smaller in size, they were correspondingly more expensive, and more often than not it was Sophia Jex-Blake who had to make up the difference from her own pocket. Upon their first examinations, several of the Seven earned top scores that would ordinarily have entitled them to prizes for academic distinction – which were of course refused them – which bred so much resentment among the male students who saw themselves beaten so soundly that they leant an increasingly ready ear to professors like Christison who urged that the ladies’ lives be made as unpleasant as possible.

The Seven began having to walk to classes together to avoid being accosted by male students, and even then had to bear verbal insults to and from class and regular pelting with garbage from students who felt that education was their right and theirs alone, all culminating in the Surgeons’ Hall Riot of 1870. The women were due to take an anatomy exam when they found a large crowd barring their way, with Dr Christison’s assistant leading the mob as they threatened the ladies trying to enter Surgeons’ Hall. Stones and refuse were thrown at them and they were only rescued from further physical violence by a group of students who forced the doors open for them and conducted them to the examination hall, where they took their exam in spite of another group of students having thrust a sheep into the room to further disrupt them.

The Surgeons’ Hall Riot was the high-water mark of the physical intimidation of the Edinburgh Seven, but as much as they had gained sympathy as a result of it, their administrative woes were far from over. No sooner would they win one right than complicated wrangling in the upper echelons of the university would wrest it away from them again. Christison and his phalanx of traditionalists expertly appealed each victory until they obtained the results they wanted, and by 1873 the university declared that, even if the women managed to take all the necessary classes (which they largely had thanks to Edinburgh’s extra-mural system) and obtain the necessary ward experience (which had been made as difficult as possible by the Royal Infirmary’s restrictions on their attendance at the hospital), they still would not be allowed to take a medical degree.

The Edinburgh campaign was over. Jex-Blake had staked her reputation on combating the academic system through every legal and public means at her disposal, tirelessly collecting allies, signatures and legal opinions at the expense of her own studies, and in the end it had not been enough. The Seven broke up to further their education elsewhere, while Jex-Blake, more convinced than ever of the rightness of her cause, planned to move the fight to London itself and the halls of parliament.

Transplanted to London, Jex-Blake combined her gift for organisation with her years of educational observation to set about the dual task of establishing a new medical school for women and to provide information to lawmakers about the progress and obstacles faced by women doctors around the world. She and Elizabeth Garrett Anderson disagreed fundamentally on how the cause of women doctors was best served – Jex-Blake favoured aggressive legislative lobbying and appeal to the courts while Anderson thought women should get their degrees in Europe and practise unlicensed in Britain until the establishment deigned to take notice of the good work they did – but both put aside their differences long enough to found the London School of Medicine for Women in 1875. Jex-Blake did most of the organising and planning for the school while Anderson reluctantly lent her name to the cause to avoid the appearance of dissent in the medical ranks. Likewise in politics it was Jex-Blake who paid visits to politicians, providing them with facts and figures from her correspondents in the United States and her time in Edinburgh to prove women’s capacity for medical work. As a result, members of parliament proposed a series of bills which, after several bitter defeats, resulted in 1876 in an Act which enabled all universities to award degrees to women if they so chose.

Ireland took the lead in taking advantage of the new bill, and it was there that the first British women, Jex-Blake included, took their qualifying exams to become, at long last, licensed doctors. This should have been the beginning of a new dawn for Jex-Blake’s career, with the London School booming and her degree finally in hand, but instead it was the moment that saw Jex-Blake progressively and insistently shunted to the sidelines of the movement she had risked so much to see succeed. She was passed over for the position of Acting Secretary of the London School because her personality, which had been perfectly suited to a new school struggling to find its way, was deemed too volatile for an established and thriving institution.

She returned to Edinburgh and there founded the Edinburgh School of Medicine while concurrently developing her own practice and a dispensary for the poor. Once again, initial success gave way to frustration as Jex-Blake demonstrated an inflexibility as a school administrator, which drove several students into establishing a rival school whose connections to a more prestigious intern hospital (in fact the same one that Jex-Blake had spent voluminous energy trying to open to women in the early 1870s) attracted students away from the Edinburgh School. In 1898, the school closed, and the following year Jex-Blake moved to a small farm in Sussex with one of her students, Margaret Todd, to enjoy a serene retirement far from the struggles that she had given over so much of her life to undertaking.

There she happily oversaw the workers bringing in the yearly harvest, enjoyed visits from a steadily decreasing number of old friends, and took a daily carriage ride that she often fell asleep in the middle of, all while the women’s medical profession forged steadily on, remembering her only now and then but resolutely taking no heed of her occasional and dwindling advice. Sophia Jex-Blake died on 7 January 1912, among her last words a piece of characteristically thoughtful advice to her companion Ms. Todd, who was watching over her, ‘Now do go and have a good rest.’

The Edinburgh Seven were awarded posthumous degrees by the University of Edinburgh in July 2019.


The main source for the life and work of Jex-Blake is Margaret Todd’s classic biography of her, The Life of Sophia Jex-Blake (1918), which you can find in inexpensive reprint editions, but I probably would not recommend that unless you are a serious Jex-Blake enthusiast. The wealth of letters and diary entries it provides are great sources for those who want a deep dive into her personality, but are probably on the dense side for those who are taking their first pass through her life. For those, I would say Sophia Jex-Blake: A Woman Pioneer in Nineteenth-Century Medical Reform (1993) by Shirley Roberts is your best bet. Extensively based on Todd’s book, it is a much smoother account which is more selective in the original sources it quotes.

Jex-Blake's story is also one of 140 stories of women in Medicine I told in A History of Women in Medicine and Medical Research, available on Amazon and from Pen and Sword books US or UK!


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