This feminist gynecologist wants you to know your body and fight the patriarchy

Christina Animashaun/Vox

With her new book, Jen Gunter aims to fight the myths that plague women.

Before the advent of C-sections, every human passed through one. But not everybody knows where it is.

The vagina.

Surveys have repeatedly shown that there’s a startling level of ignorance about female anatomy. Dr. Jen Gunter, an OB-GYN at Kaiser Permanente in the San Francisco Bay Area, is on a quest to change that.

On August 27, she’ll publish The Vagina Bible, an encyclopedic guide to vagina-related topics born of what Gunter is calling a “vagenda” to empower people with facts about their own bodies.

The book builds on her eponymous blog, which became a viral sensation when she took on jade eggs for the vagina sold on Gwyneth Paltrow’s lifestyle website, Goop. The eggs were being marketed as devices “queens and concubines used … to stay in shape for emperors.” In an open letter to Paltrow, Gunter debunked the website’s claims and noted how sexist they were: “Nothing,” she wrote, “says female empowerment more than the only reason to do this is for your man!”

Now officially Paltrow’s nemesis — the actress has subtweeted Gunter with Goop’s response to the doctor’s criticisms — Gunter says, “The basic tenet that I go by is that you can’t be an empowered patient with inaccurate information. It’s just not possible.”

Over the years, in Gunter’s blog posts and, more recently, columns in the New York Times, she’s set the record straight on myriad vagina-adjacent topics: vaginal steaming, abortion at or after 24 weeks, misinformation about the HPV vaccine, and best practices for pubic hair care.

Recently, I spoke to Gunter about the top vagina myths, the complex reasons women seek sex, and whether she’ll send Paltrow her book. Here’s our conversation, edited for length and clarity.

Julia Belluz

Can you tell me a little about your vagenda? By the way, I love that word.

Jen Gunter

Well, I don’t think I came up with it. It was around the [2016 US] election. There was all this misogynistic crap floating around everywhere. Some dude had written about Hillary Clinton, that she had a “vagenda of manocide.”

Julia Belluz

So you’re reappropriating it.

Jen Gunter

Yeah, I repurposed that. Manocide is really where we’re going here.

Julia Belluz

You’ve been writing about women’s health for a long time, but there’s finally a broad awareness on how policies around reproductive health have been written by men for women’s bodies. What’ll it take for that to change?

Jen Gunter

The patriarchy has to end. This system where men hold the power and women are largely excluded — it is toxic.

Julia Belluz

It seems like the big vagenda, the overarching theme in the book, is exposing all the ways the patriarchy obscures information about women’s bodies or leads to a failure to investigate basic things about women’s bodies. Also, how this often leaves women uninformed. Why are women out of the loop on their own bodies? What do you think are the cultural forces behind it?

Jen Gunter

There is so much misinformation, so if what you have been told has been riddled with half-truths and sometimes even lies, it is hard to know the facts. Western medicine has been linked with the patriarchy since the beginning. If you can’t dissect female cadavers, how can you know the anatomy?

Also, we speak with euphemisms to appease societal and religious mores. If you don’t use the words for female anatomy and normal function, then that imparts shame and can also lead to confusion.

Now we also have the “natural” fallacy gaining traction. Multiple influencers and even celebrities and some doctors advance the false notion that “your body knows” and “nature is best.” And if women look up vaginal garlic [yes, this is a thing] on a naturopath’s website and see it in Our Bodies, Ourselves, of course they will think it is a valid therapy when it is not.

I get that women have been ignored — that is why I am fighting for facts — but the answer isn’t magic and mystics. The answer is demanding that science do better, both with the bench and clinical research and communication.

Julia Belluz

Okay, so let’s start with the very basic facts. You begin the book by pointing to the difference between the vulva and vagina — largely because many people don’t even know what it is. Can you lay it out?

Jen Gunter

Oh, my gosh, that’s so common! The vulva is the external part, where your underwear touches your skin. The part on the inside — where you reach up to find a tampon or check an IUD string — is the vagina. The part where the two overlap is the vestibule.

Julia Belluz

And you made a very good case in the book for why the clitoris is so cool but also really underappreciated.

Jen Gunter

Yeah, it’s the only organ in the human body that exists only for pleasure. It has no other dual function. The penis is for peeing as well. Also for procreation. The clitoris is just there for the party.

Julia Belluz

That brings me to [a] common sex idea that you explain is not quite right: Penile penetration alone leads to orgasm through the G-spot, absent the clitoris. You cite MRI studies that have shown that even when people think it’s penetration [that leads to orgasm], it’s actually the clitoris.

Jen Gunter

This comes down to the fact that so many people don’t understand how large the clitoris is and how much of it is under the labia and wrapped around the urethra. So for some women, you’re going to get some part of your clitoris stimulated with penile penetration. And for some women, you won’t, and that’s okay. It’s not how you had an orgasm, it’s that you did have an orgasm. There’s this fixation that it has to come by way of penile thrusting.

When I started writing this book, every piece of information I thought I believed or everything that we as society believe about women’s bodies, I asked myself: How does this benefit the patriarchy? And if you think about this penile thrusting, well, that makes men feel like, “Oh, I’m the big man, I’ve brought your orgasm around with my mighty sword.” You can quote me on that.

How offensive is that to women who partner with women? Like, their sex is going to be less? Please.

Julia Belluz

Right. And you found two-thirds of women aren’t having orgasm from penetrative sex, and maybe they feel disappointed about that. And clearly, they shouldn’t.

Jen Gunter

Sex should be pleasure-oriented, not metric-oriented.

Julia Belluz

That’s the aphorism for our time.

Jen Gunter

Yeah, right. It’s not did you come with his penis? It’s did you have a good time and did you enjoy yourself?

We also often get fixated on orgasm being the money shot, that penile thrusting is causing this incredible orgasm. Instead, I love the new approach to the female sexual response that is this idea that women can come to sex for many reasons. They can come to sex to have an orgasm. They can come to sex to have physical closeness with their partner. They can come to sex to feel taken care of. They can come to sex for comfort. It’s not all about being horny.

Julia Belluz

Do you think the “sex recession” is real?

Jen Gunter

I have no idea if this is really a thing or not. I often wonder if people feel pressured to say that sex is the most important thing ever in their lives, and now many people are just being more honest and practical. Also, in a heterosexual relationship — how we have largely discussed sex until relatively recently — women were just supposed to say yes, and, if things sucked, just count ceiling tiles. I hope this is changing.

We have been led to believe, [because of] the pressures of a largely patriarchal society, that sex is the one true goal, and we use sex to sell almost everything, so that just reinforces that belief. Good sex is wonderful, don’t get me wrong. But life is a lot of things.

Julia Belluz

What message do you have for men who partner with women?

Jen Gunter

I would say stop asking your female partner if she came. It’s not ticking a box. Ask, instead, what feels good for you now? What can I do for you now? What do you like? Are you having fun? Is this good? Open-minded communication. Think of it as making dinner with someone, not serving them the meal and saying, well, I hope you like that.

Julia Belluz

Would you give the same kind of advice to women who partner with women or couples with a trans partner?

Jen Gunter

I hear horrible things that women who partner with men are told by their male partners about their intimate places — such as there “can’t be any blood” or “you stink” or “why don’t you shave all your pubic hair.” I have seen women break down because they have irregular spotting on every method of birth control and “he won’t wear condoms” and “thinks blood is gross” yet expects regular sex on his schedule. The things some men tell women about their normal bodies enrage me. I struggle to think of a woman who partners with women who has come to see me because of the shame her partner had made her feel about her body or who has had a partner say vile things about her body. That is a glaring difference I have seen that sticks with me.

Julia Belluz

What, if any, conversations have you had with trans women and trans men who may still carry children?

Jen Gunter

I see trans men who have vaginal irritation, pain with sexual activity, and pelvic pain or pain with sex. Many of these patients get their care in the trans health clinic and so already have an IUD for contraception. Since I no longer insert IUDs or Implanon [a contraception implant], I wouldn’t have an in-depth discussion about these methods with any patient unless specifically asked. I would have a brief discussion about contraception with a trans patient if they are at risk of pregnancy partner-wise and not using contraception, as I would with any patient.

Julia Belluz

What have you learned about sexual health from this community?

Jen Gunter

I think the biggest takeaway I have from seeing trans patients is how hard it can be for so many to access care — either due to services not available locally, prejudice, finances, or all three — and how many different people they have to see to have their symptoms taken seriously. I hear this from many patients, but sadly, there seem to be even more barriers for trans patients, and we must work to end that.

Julia Belluz

One other theme that permeates the book, as well as a lot of your other writing and your copious word spills on Gwyneth Paltrow, is this idea that there are too many people out there trying to sell people stuff for their vaginas that they don’t need.

Jen Gunter

Oh, my god, yes. My goal is to put everybody who sells feminine hygiene bullshit out of business. When I say feminine hygiene stuff, I don’t mean menstrual products. I hate calling menstrual products feminine hygiene. They’re menstrual products!

Julia Belluz

Are you going to send the book to Gwyneth Paltrow?

Jen Gunter

No, no, I wouldn’t.

Julia Belluz

I think she needs it.

Jen Gunter

Of course she does. But it wouldn’t sit with her desire to profit off telling people that they need liver detoxes and [jade eggs for the vagina].

Julia Belluz

There’s also so much talk of natural birth control methods, IUDs, and other moves away from the Pill. What do you see shifting in the way people take control of their sexual health?

Jen Gunter

I see a lot of conversations here, and unfortunately, many are based on misinformation and fear. I am firmly for reproductive choices, but scaring people about contraception is gaining traction, and fear is not part of informed consent. So we are seeing the radical right and radical left (nature-knows-best types) joining forces. I think people should have solid facts so they can weigh their personal risk-benefit ratio and go from there. I think it is very important for people to consider what will happen if they have a method failure — how important is it to not be pregnant? Do they have access to full reproductive health if they have an unplanned pregnancy? How will they feel if they have an unintended pregnancy?

Julia Belluz

You got the HPV vaccine recently, according to Twitter. This may have been surprising to some because you are in your early 50s, and in the past, the recommendation has been that the HPV vaccine is only for girls and women up to the age of 26. But there’s this new broadening of the age range for people who should get the shots. Can you explain?

Jen Gunter

Gardasil 9, which is the one that protects against nine strains of HPV — seven high-risk and the two that cause genital warts — is now approved from ages 9 to 45. If you’re going to vaccinate people, you want to catch the people that you’re more likely to help. The younger you are, the less likely you are to have had HPV. The younger you can get people, the more likely you can protect them from all nine strains. As we age and have sexual partners, we’re more likely to be exposed to different strains of HPV. But the chance that you’re going to be exposed to all of them is low.

So I figured that since I’m dating again, and I personally have never had a positive HPV test, and I have no history of having had an abnormal Pap smear or HPV, I thought, well, I’m in a pretty good category then. The chance that I’ve had all nine strains of HPV is probably low. So I just thought, why not get the shot to protect myself from any of the additional strains?

Julia Belluz

Are there other things that you wish more women did to keep their vaginas happy and healthy — and their vulvas and vestibules too?

Jen Gunter

Well, I wish HPV shots for all my friends. I wish that nobody smoked. That’s a very bad thing. People think about lung cancer and smoking. People don’t think about cardiovascular disease from smoking. It’s also very deleterious for the good bacteria in your vagina. And people who smoke have a higher risk of having HPV-related diseases like cervical cancer, so it’s a co-factor in HPV becoming more aggressive. Not smoking, that would be a wonderful thing.

Condoms. You know, there is a little bit of a drop in condom use, and that is probably due to the increasing use of the IUD. That doesn’t mean that people are having risky sex — they’re actually not. But if you’re switching from a method of barrier protection to a method of non-barrier protection, then you’ll have an increased risk of exposure.

Julia Belluz

Great advice.

Jen Gunter

I wish everybody could talk about the genital tract in the same way we talk about the elbow or the foot. It’s just a body part.

Author: Julia Belluz

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