When I wrote a cover ­story about the so-called “father of gynecology,” J. Marion Sims, for the November 2017 edition of Harper’s Magazine, I wanted to take him down. To ruin his reputation and topple the statues of him. I didn’t realize it would make me an apologist for cancel culture.

Opinions vary as to whether the term “cancel culture” comes from rap or ill-fated television shows, and it didn’t exist when I began researching Sims in 2015. Sims was historically lauded, but he had been more recently demonized for a series of surgical experiments conducted without anesthesia on enslaved women from 1846–49. Still, the bulk of Sims’s career had gone unscrutinized in evaluations of his legacy. I found it easy enough to demonstrate that the whole of Sims’s history was a self-serving fiction. He was a fraudulent celebrity surgeon—something like Trump with a knife.

The Harper’s piece played a backup role to activist groups in East Harlem that had been protesting Sims’s statue in Central Park for the better part of a decade. In the wake of the 2017 white nationalist march in Charlottesville, the groups staged a rally at the site of the monument—and this time the long-overlooked crimes of J. Marion Sims went viral. His statue was removed in 2018. Two other statues of Sims, in Alabama and South Carolina, still stand.

From the start, my goal had been a book that would expose Sims’s false legacy and reconstruct the life of the most consequential of his experimental subjects, the young enslaved woman known as Anarcha. The work on Say Anarcha: A Young Woman, a Devious Surgeon, and the Harrowing Birth of Modern Women’s Health continued as Confederate monuments began to come down across the South.

By June 2020, as the monument debate crept into the presidential campaign, Harper’s staffers were tweeting out quotes from my then-two-and-a-half-year-old article.

Then in July of that year, the so-called “Harper’s letter,” a genteel, group-authored complaint about abrasive complaints that also arise from groups, landed. Widely read and criticized, the Harper’s letter suffered from leaked details of how it came about, and several signatories requested that their names be removed from it.

I was surprised that I wasn’t asked to sign the letter—until I read it. The letter, I thought, was guilty of bothsidesism, of attempting to stanch the speech of others in the most genteel of ways, and of presuming to decide on others’ behalf what ought to be perceived as offensive. Despite Supreme Court Justice Elena Kagan’s observation that free speech has come to be weaponized by the far right, Harper’s had become the most august of a number of ostensibly liberal institutions to slip into the moral panic of cancel culture.

Several weeks later, I wrote a short piece for Columbia Journal titled “In Defense of Cancel Culture.” I argued that cancel culture was not a threat to free speech but an example of it—a rhetorical picket line that was perhaps rude, but entirely legal. Over the next few months, I would be invited to speak on cancel culture at the Menard Center for the Study of Institutions and Innovations, the Chicago Union (debating Bret Stephens of The New York Times), the Oxford Union, and the Federalist Society (debating Charles Murray, notorious for The Bell Curve, who has been attempting to parlay the fears over cancel culture into renewed interest in his long-discredited arguments about race and intelligence).

For the record, you can no longer read “In Defense of Cancel Culture.” Columbia faculty criticized the decision to publish the piece, and it has now disappeared from the Journal‘s website.

Every cancel culture debate I’ve participated in has suffered from a failure to begin with well-defined terms. Of these, “cancellation” itself is the most difficult to pin down.

In the e-mail exchange that led up to my debate with Murray, I insisted that we define cancellation in advance. Pressed to provide a definition of my own, I suggested that a commonsense meaning of “cancel” had to refer to something that has ended, completely and irrevocably.

“If that’s the definition of cancellation,” Murray wrote back, “we do not live in a cancellation culture.” This surprisingly reasonable position did not prevent Murray, in his most recent book, from likening online shaming campaigns to China’s Red Guard.

In fact, the “cancellations” of cancel culture are criticisms that result in investigations, suspensions, and changes of publisher or employer. It is rare that anything is truly “canceled.”

So what would a real cancellation look like?

The best example I know of returns to J. Marion Sims—but not Sims himself. In the late 1850s, an English doctor named Isaac Baker Brown set about emulating Sims’s success. After his now-infamous experiments, Sims left his home in Alabama to open a new hospital for women in New York, based on the “cure” he claimed to have perfected on Anarcha. Sims’s “Woman’s Hospital” became a field of experimentation, and he claimed many cures on many additional women, riding fame and wealth to the title of “father of gynecology.”

Brown followed suit. He opened a private hospital, The London Home, devoted to a surgery he had devised for women, and before long he too was demonstrating his techniques to fellow doctors and claiming to have cured every woman who underwent his procedure.

In 1866, both men published books about their surgical triumphs. Sims’s Clinical Notes on Uterine Surgery came first, and within months, Brown followed with On the Curability of Certain Forms of Insanity, Epilepsy, Catalepsy, and Hysteria in Females.

The books were jointly—and harshly—reviewed by an English physician named Eugene Tilt. Sims, Tilt wrote, was guilty of believing that “the knife is the omnipotent means” of curing most of the diseases of women. Brown “estimates still higher the value of the knife.”

Brown’s procedure was clitoridectomy. He was amputating women’s clitorises to prevent masturbation, which he believed led to hysteria, cataleptic fits, “idiocy,” and death. (Sims’s procedures were no better. They included a surgery for “vaginismus” in which he expanded the vaginal orifice to enable coitus and an incision of the cervical canal for scanty menses and sterility. The only thing that may have saved Sims from Brown’s fate is the fact that his book came out first.)

As is the case with modern cancel culture, what happened next can’t be pinned down to any particular event.

The British Medical Journal criticized Brown for, among other things, exaggerating the value of his operation. When the first motion came for his censure and removal from the Obstetrical Society of London, Brown responded vigorously, publicly identifying physicians who had supported his methods. Calls for his removal multiplied. Friends denied association with Brown, journals published vicious anonymous attacks, and doctors told stories of women who were subjected to Brown’s procedure in complete ignorance of its nature. The pinnacle of the campaign was a Jonathan Swift–style pamphlet that ought to be counted among the world’s great satires. Rather than criticize clitoridectomy directly, the pamphlet celebrated Brown for a “kleptodectomic procedure” and operations for “gyromania” and “glossodectomy,” which cured women, respectively, of shoplifting, obsessive dancing, and talking too much by severing muscles in their hands, legs, and tongues.

Brown was reduced to calling for a scientific investigation of his method: If amputating clitorises were found to be ineffective, he would abandon it. It was too late. The process to banish Brown was launched, and his fate was decided at a mock trial held on the evening of April 3, 1867. The full transcript of the proceeding was published in the BMJ, including the jeering cheers (Hear, hear! Order! Much laughter!) that accompanied speeches by the doctors who had moved for Brown’s removal and by Brown’s own shouted-down effort to defend himself.

A meeting scheduled for one-hour went on for more than five. Brown was expelled by an overwhelming majority of votes, and thereafter the BMJ refused to make mention of either him or clitoridectomy. Brown disappeared from public view, suffered a series of debilitating strokes, and died a short time later at 61. He was canceled, and the world was better for it.

In 1796, in his farewell address, George Washington, referring to a debate over seditious speech that would result in the Sedition Laws, advised instead “discountenancing” and “indignant frowning” on anyone who suggested that a part of our country ought to be alienated from the rest.

Washington didn’t mean government should silence speech. Rather, he meant what we would now call cancel culture. For the president who had presided over the ratification of the Bill of Rights, the ability to shame fellow citizens for bad speech was precisely a thing enabled by the First Amendment. If citizens could check the bad speech of other citizens, the government didn’t have to.

The same basic principle applied to the case of political candidate Xavier Alvarez, who in 2007 falsely claimed to have been awarded the Congressional Medal of Honor, in violation of the Stolen Valor Act of 2005. In 2012, the Supreme Court overturned Alvarez’s conviction: Lying about military honors was protected speech. The 6-3 decision, authored by Justice Anthony Kennedy, relied on Washington’s logic. The government did not need to create addition curbs on free speech, even for something as “bad” as lying about wartime honors, because “counterspeech”—an immediate, caustic online reaction—had succeeded in derailing Alvarez’s candidacy.

The gradual evolution of the First Amendment from a “positive” value—a proactive monitoring of the existing curbs on speech to “give truth a fighting chance”—to a “negative” value that answers every question with a singular refrain, “the solution to bad speech is more speech,” is ably described in Laura Weinreb’s The Taming of Free Speech: America’s Civil Liberties Compromise. For Weinreb, like Kagan, the slow drip away from the original incarnation of the First Amendment to a market of ideas so free it’s effectively anarchy, has made speech “a potent tool for the Right.”

That’s ironic, because those who lament cancel culture say they want free speech, but they fear counterspeech. The logical implication of the panic over cancel culture is that, well, something ought to be done about it. Yet a curb on what the Supreme Court called “counterspeech”—the term used in the Harper’s letter—would not only result in a world with less free speech in it; it would also chill a form of speech that acts as the only check we have left on speech that is universally regarded as bad.

In other words, if you truly desire an expansive, “negative” interpretation of the First Amendment, you absolutely need counterspeech, or cancel culture.

In the wake of U.S. v. Alvarez and the Harper’s letter, New York Representative George Santos lied about where he went to high school and college, about where he worked, about the lives of his mother and grandmother, and about founding an animal charity while swindling an Amish dog breeder and a vet whose service animal was dying. That’s a partial list—yet Santos won his election. The Age of Trump demonstrates that the Fourth Estate alone is not enough to check bad actors. The challenge to cancel culture muffles a necessary check on bad speech—a check that was part of what Washington’s original interpretation of the First Amendment envisioned.

But the problem is not limited to back-bench political mediocrities. It’s diabolical figures like J. Marion Sims, whose legacy survived even as the memory of equally devious physicians crumbled. Statues of Sims linger still, and Clinical Notes on Uterine Surgery continues to stand as a classic of medical history.