Difficulties with communication about bodily differences are strongly linked to sexual experiences. In Chapter 13, the author critiques the dominant ways of talking about sexuality in the wider society. These oppressive ideas can give rise to insecurities, self-objectification and body shame for people in general. Adults who have been medically managed are particularly vulnerable to the effects of objectification and shame. The author outlines typical components of sex therapy programs. However, rather than fix sexual problems, which can perpetuate people’s sense of inadequacy, the author suggests that psychological care providers support clients to process any trauma and develop a more relaxed and appreciative relationship with the body. This work, which requires generic therapy knowledge and skills, can be integrated with a range of specific sex therapy techniques and resources to reimagine a sexual future that focuses on bodily pleasure rather than gender performance. Although the practice vignette is built around a female couple, one of whom has partial androgen insensitivity syndrome, the care principles have wide applications for people with variations more generally.

Though railways have been frequently depicted as icons of the progressive and the dynamic within British Victorian fiction, their secular and timetabled culture is, in fact, more often than not freighted with a disruptive Gothic presence. This chapter begins by noting how the construction of the railways in the nineteenth century literally impacted upon the built and cultural environments, laying waste to familiar landmarks and marking the bodies of those who travel as well as those who serve the engines of progress. The chapter considers the theme of physical violence and sexual interference within the closed space of the railway carriage, making reference to popular newspaper reportage and erotic fiction before engaging with the issue of psychological trauma and isolation, particularly among those whose task is as much to protect, as to transport, the travelling public.

The Romans had a difficult relationship with the kind of luxury and excess that we think of as indicators of moral and social decadence. But in many ways they revelled in such luxury. Readily accepting the financial rewards of empire, they spent huge sums on their own benefits. Whether in the colossal public games in the amphitheatre and the circus, in the opulent imperial bath complexes, or in extravagant private villas, Romans of all social levels delighted in the very best that life was thought to offer. Chapter 1 examines how far the evidence supports this somewhat melodramatic view of Rome by looking at the ways in which luxury spread in the Roman world. It also looks at the ways this growth in luxury compelled the Romans to create new concepts to understand the phenomenon. Luxury was almost never seen as a simple index of increased wealth. Rather, it raised all manner of moral issues among Rome’s ruling classes, many of which long outlived the end of the Roman empire itself.

The modern concept of decadence owes its origins not only to ancient Rome but also to Europe and Great Britain during the Enlightenment era, a period notorious for the hedonism and hypocrisy of the aristocracy. The social decadence of the period was reflected in its libertine literature, but there is also a close association between libertine behaviour and enlightenment thought. The term ‘libertine’ can be traced back to such rational, scholarly associations of freethinkers as les libertins érudits, a group whose intellectual and ideological goal was the liberation of society from the strictures of religious dogma and authoritarian rule. By providing a rational basis for immorality, Sade and other libertine authors did much to influence later writers customarily regarded as decadent. Yet despite its comprehensibility and even its power and attractiveness today, Enlightenment decadence thrived within a unique nexus of material wealth, transgressive intellectualism, and politicized eroticism that was very much of its time.