21 May 2022 | New Scientist | 43vaginal infections. They were aware of
that history and reacting to it by being extra
careful and transparent and taking a long
time to find the right subjects and have them
be completely informed. I think it has made
a lot of researchers more careful.Speaking of microbiomes, I was interested to
learn that humans have a vaginal microbiome
that seems to be completely different from
those of other animals. Why is that?
Human beings are the only animals that have
Lactobacillus-dominated microbiomes with
certain traits that are really important for
protection. I think of it as this semipermeable
membrane protecting this space between
you and not-you. People have called it an army,
but I really love the metaphor of a garden, with
a specific ecosystem of flowers and plants.
There might be a few new plants or weeds
in the mix, but, overall, you have the right
balance to be healthy.
One theory of why we have this ecosystem is
that when nomadic humans settled down and
started fermenting food, that fermentation
was created by lactobacilli. It seems that these
bacteria got into the vagina and set up a home
and it was a really good environment for them.
Over time, they could have co-evolved with us
to make this their primary niche. Now, there is
a personal protective ecosystem down there.
There are a lot of things that make us human,
but one thing is our vaginal microbiomes.Vaginal microbiome transplants are a hot area
of research right now. Are they about to take off?
Unlike many of the lethal diseases we treat
with faecal transplants, such as C. difficile
infection, the imbalances in the vaginalIn her new book, Rachel E. Gross uncovers the
sexism, misconceptions and biases that have led
to our fragmented understanding of the female
reproductive system. It’s time to fill in the gaps,
she tells Catherine de Lange
>J
OURNALIST Rachel E. Gross was working
as the science editor at Smithsonian.com
when she developed an “obnoxious”
vaginal infection that set her on a mission
to better understand her own body. It may
have started with her genitals, but in her
new book, Vagina Obscura: An anatomical
voyage, Gross not only unravels many
misunderstandings about the female body,
but also rewrites the history of the science
of gynaecology with women and LGBTQ+
researchers front and centre. She spoke
to New Scientist about why this matters.
Catherine de Lange: What made you want
to write this book?
Rachel E. Gross: I was doing a lot of coverage
of women in the history of science. These
themes kept coming up of women in
scientific fields that had been left out of
the conversation or blocked from attaining
certain levels. And at the same time, there
were all these questions about women’s bodies
and bodies [of people] with a uterus and
ovaries that weren’t being asked. I made the
connection: the deceptively simple reason
why these questions weren’t being asked
was because women weren’t at the table.
How did you find these incredible stories
of women who were written out of the
history books?
The darkest section of the book is about
James Marion Sims and the development
of the speculum. It’s well known that he
was a southern slaveholder who made his
advancements on the bodies of enslaved Black
women. But there is a lot more to that story.
I relied a lot on historians who had excavated
the stories of some of those women, namely
Betsy, Lucy and Anarcha. Deirdre Cooper
Owens is the historian who spearheaded the
argument that these women, and others,
became surgical assistants who ended up
knowing as much about fistulas (openings
between the walls of the bladder and the
vagina that can occur after a long or obstructed
childbirth) as any doctor. They gained all this
medical knowledge and potentially went back
and used it to help their own communities.
That was just such a paradigm shift for me.I was shocked to read about experiments
in the 1950s that involved transplanting
microbiomes of people with vaginal infections
into pregnant women, and other examples in
which the female body was seen as available
for people to do what they want with. Do you
feel optimistic that this is changing?
A lot of the history of gynaecology is a
history of experimentation on vulnerable
populations. But I think that this growing
awareness about the importance of true
medical consent, and about these vast gender
disparities that have happened throughout
history, is changing things. The experiment
you refer to was performed by a well-known
bacteriologist, Herman Gardner, in Texas,
who did the first experiments on what we now
call bacterial vaginosis. He transplanted fluid
from women who had infections into women
who didn’t – many of whom were pregnant,
many of whom ended up infecting their
husbands. And there’s no documentation of
any meaningful consent involved. But then
I spoke to scientists who are now trying to
do the first vaginal microbiome transplants
in order to help people who have recurrent