How much do we really know about the vagina? In her book, “Vagina Obscura: An Anatomical Voyage,” published last month by W. W. Norton, former Knight Science Journalism (KSJ) Fellow Rachel E. Gross makes a compelling case that we don’t know nearly as much as we should.
“Vagina Obscura” is, in many ways, a corrective to that knowledge gap, laying bare the vast disparity between our understanding of the male and the female anatomy. In medicine, the male anatomy has long been used as a standard to understand all bodies. As Gross writes, it was only about 30 years ago that the federal government, pressured by the women’s health movement, required researchers to include women and minorities in clinical research. The female body is still shrouded in mystery because science, a profession that historically excluded women from its ranks, has neglected to ask questions about it.
For her book, Gross set out to ask those questions. She spoke with scientists like Marci Bowers — the first trans women to perform gender affirmation surgery and an innovator who has elevated this science to an artform that helps create beautiful and sensitive vaginas and vulvas. Gross challenged science’s assumptions and biases and told deeply personal stories of scientists who are at the forefront of the shift in the way we think about female anatomy.
KSJ recently spoke with Gross about the inspiration behind her new book, and about the challenges of covering a sensitive, complex topic that scientists still know relatively little about. This interview has been lightly edited for length and clarity.
KSJ@MIT: When did you first start thinking about the lack of science on women’s bodies?
Rachel E. Gross: I was the digital science editor for Smithsonian Magazine in 2018, and I was doing a lot of coverage around women in science. I had launched a column on unsung women who shaped science and the history of science. At the same time, I was covering a lot of reproductive health, reproductive biology, and animal sex. And I started to realize that there was an intersection between these two areas of coverage, where there was clearly this dearth of women in the history of science. And once they got into the field, they were asking all these new questions that nobody had thought to ask. Meanwhile, on the reproductive biology and health side, it was clearly behind in many ways and we were still learning this very basic science [of female anatomy], and so I realized that the two things were part of the same problem: The lack of good science on women’s bodies had a lot to do with the lack of women in the history of science.
I like to talk about my body and other bodies. And I definitely like to talk about topics that make other people uncomfortable, which — unfortunately — includes vaginas.
KSJ: Why are you personally drawn to this issue?
RG: I’m the daughter of scientists. My mom is a medical doctor, my dad’s a theoretical physicist, and my step-mom’s a molecular geneticist. So I’ve always been very outspoken, nerdy, and shameless. I like to talk about my body and other bodies. And I definitely like to talk about topics that make other people uncomfortable, which — unfortunately — includes vaginas. So I do think that made me the right person to try and illuminate some of these issues that people get really squeamish about and don’t want to talk directly about.
KSJ: Your book is about the inclusion of female bodies in science. How did you make this book inclusive for people who do not identify with the gender binary?
RG: It did start out as a book about the science of vaginas. But it quickly became apparent that I was talking about a larger constellation of body parts—what we might call the sexual and the reproductive system. And there are so many types of people with so many types of bodies who have these body parts, who resonate with these stories, and who are also part of this narrative. Trans-men, trans-women, non-binary people, intersex people, all of these groups came into the story at some point, and it was really important to me that they felt themselves reflected in its pages. So it really became more about looking at all bodies through the lens of what we’ve historically thought of as a female body.
For instance, there’s a whole chapter on the the history of gender affirmation surgery, and it’s about how a growing understanding of male and female anatomy — and really all the shared anatomy between them — is pushing the advancement of gender affirmation surgery and the surgical creation of vaginas that are aesthetically pleasing, feel pleasure, and have the same sensory qualities as any other vagina. I also talk a lot about the history of endometriosis and how historically it has been seen as a disease that affects career minded, neurotic white women who aren’t having children. And so I made a lot of effort to include how the experience is different for Black and Brown women and for trans-men who have endometriosis, and the stereotyping that affects diagnosis and treatment.
KSJ: What were some of the biggest challenges you faced while reporting on this issue?
RG: Well, there were a lot of challenges. I set a really broad mandate for myself in trying to cover most of the organs in the female reproductive system. Each chapter is essentially an entirely different field of science. So it’s not just anatomy, it’s the science of hormones, bioengineering, micro-dissection, and surgery. And having to wrap my head around each of these fields was massively challenging.
Another huge challenge is that, as the title suggests, there is a huge dearth of knowledge about the body parts I’m talking about. So to write a book on the science that we know about these body parts was always going to be difficult. It actually turned out that one of the hardest chapters to structure was the vagina chapter, which was completely ironic because, again, this book was about the science of vaginas, and vaginas are very central [to the book] in more ways than one. I assumed that would actually kind of be the easy chapter… but it turns out that all these very basic questions I had about vagina science have not been answered by anyone. So things as basic as what is the size and shape of the vagina? What is the spectrum of vagina shapes and sizes? How does the vagina change as we age, hit puberty, give birth?
KSJ: What was the most rewarding experience in this process?
RG: Oh my gosh. It’s already been so rewarding. I don’t even know where to start. I have a small example. Patty Brennan, the animal vagina researcher, we’d been talking for a year over zoom because of the pandemic. Together, we spent so many hours delving into her childhood in an all-girls Catholic school in Columbia and how she first came across duck penises and got so involved in illuminating female genitalia and the experiences she’d had with older male colleagues who were so taken aback by her work. So we had all these like really intimate conversations, but I’d never met her. And just as I finished the book and the pandemic restrictions lifted, I was able to go visit her in person at Mount Holyoke University and we dissected some snake vaginas together. So, I got to actually connect with her in person and see her lab, which is fantastic and full of vaginas and clitorises, and have this experience with her. And I just felt that it kind of made the experience [of writing the book] feel so much more whole and complete for me. It also made me more confident in my reporting, in that I had captured the essence of what drives her in her work and what she’s trying to do.
KSJ: Why did you choose to call your book “Vagina Obscura”?
RG: I’ve always been fascinated by the camera obscura. So these are the early pinhole cameras that will take an image and project it onto a wall. But in doing so, it kind of distorts the image. It gets a lot dimmer and it’s often turned upside down. And I always thought that was really interesting because it’s doing something really important. It is capturing and reflecting the outside world in a way that wasn’t possible before the advent of this technology. But it’s still giving you a very specific lens, a narrow lens, that is kind of blocking out other interpretations and other ways of seeing the same world. And that’s how I saw early anatomists mapping the female body. They absolutely gathered information and came up with names that help us talk about these parts and think of them concretely. But what’s often overlooked is that they came from this specific narrow viewpoint. There is so much more to learn and to know about this landscape. And it took new types of thinkers and explorers to reveal that and to kind of broaden out this pinhole camera to full, wide-lens perspective.
Shafaq Zia is a research associate with the Knight Science Journalism Program and a student in the MIT Graduate Program in Science Writing.