Don't be an *, be a 🐈

Megan and Carrie talk with Rachel E. Gross about her book, Vagina Obscura, and the language we use to describe pregnancy, vaginas, cervixes, etc.

Whale vocal fry:

• npr
• wapo
• nytimes

Background on phonic lips

Chapters

• 11:54 Interview with Rachel Gross

Transcript

Megan Figueroa: Hi and welcome to the Vocal Fries Podcast, the podcast about linguistics discrimination. 

Carrie Gillon: I'm Carrie Gillon. 

Megan: I'm Megan Figueroa. Today we're going to talk about whales. I mean, well, first of all, whales. Did you know? We talked about this before, but oh, my god, dolphins or whales? I did not know that. I don't know what I thought. I thought dolphins and porpoises were a separate category. 

Carrie: I did too. I know that I had, if I went through the educational system of Arizona, which is the second worst in the United States. But I feel like dolphins represented me as something different than whales. 

Megan: Yeah, right. Yep. Informally, whales are just  separate from porpoises and dolphins. But formally, actually species genus-wise, they are all whales. It's not your fault and not my fault that we thought there was a hard and fast difference because that's how informally we use the word "whale" is that we have a separate category. 

Carrie: Wow. That's the informal use, basically?

Megan: Yeah, the informal use is that whales are one category. Dolphins, orcas, porpoises are another. But actually, when you look at the taxonomy, they're all whales. 

Carrie: Wow. We've been sent this NPR science article. Actually, no, we were sent different versions. 

Megan: Really? 

Carrie: We're sent a New York Times version by someone. Then I don't remember what the other person sent. There's many different articles that we've been sent on this one topic. 

Megan: People are excited and I don't mean like the people sending it to us. I mean, everybody. Toothed whales use a vocal fry to hunt for food. First, let's talk about what a toothed whale is. Yes, please, because this picture on NPR has a picture of a dolphin. I'm like, what the heck, when I first opened this, right? I'm like, apparently a tooth whale, which includes bottlenose dolphins, orcas, and pilot whales. 

Carrie: Well, it includes all dolphins, all porpoises, and any other whale that has teeth. There are beaked whales and sperm whales that also have teeth. Then there's another set of whales that are baleen whales. They suck in krill. They have like a sieve, they're plates, I guess. They use these plates like a colander.

Megan: Kind of like a sieve. I don't know if you know this about me, Carrie, but I actually think that orcas are terrifying. 

Carrie: Well, they are. I mean, they don't go out of the way to attack humans. But if you happen to look like a seal, you're wearing a wetsuit.

Megan: It could happen and they have teeth. 

Carrie: Because they're a toothed whale and they go after seals. They're very vicious. I love them but they are very scary. 

Megan: I love seals. 

Carrie: I also love seals. 

Megan: I'm just guessing right off the bat that people love a story like this because we all love animal stories. But I think vocal fry is still something that people are obsessed with.

Carrie: Very much.

Megan: All right. You got two things. I get people to click this. But it's actually really interesting because having teeth allow these toothed whales to produce an array of vocalizations. 

Carrie: Is it the teeth that is helping them do it or the lips? 

Megan: The phonic lips. 

Carrie: But I think you have to have teeth to have the right kind of lips or is it an accident? 

Megan: An accident of what, evolution? 

Carrie: Yeah.

Megan: I thought it was the former that it was both of it. But it could be. I don't know. I mean, we don't know. You know what? A marine biologist can tell us. But what I have gathered is that they have learnix but it doesn't produce sound. 

Carrie: A learnix?

Megan: How do you say it?

Carrie: Larynx.

Megan: But that doesn't produce sound. It's something called phonic lips, which is in their nose. I guess this is a new development because whoever it is that studies toothed whales hasn't really been able to look at phonic lips in action. But they decided to put one of those little cameras through their little blowhole to see it in action. When they did that, they were able to see that the phonic lips going at high speed and that these were definitely moving when echolocation clicks were being made. 

Carrie: They were creating the echolocation?

Megan: Yes, clicks. That is the conclusion that was to be made of this. 

Carrie: Phonic lips seems like such a weird name. It's the nasal pharyngeal airspace. There's these lip-like structures inside. 

Megan: They move the air through the nasal tracks. We have a nasal track, right? But the phonic lips are basically acting as the vocal cords. 

Carrie: It's as if we had vocal cords halfway up our nose. 

Megan: Exactly. The movement of the phonic lips vibrates surrounding tissue, which causes the sound. It's kind of like when we think about vocal fry in humans, it's our vocal cords. Not our phonic lips, our vocal cords when we are using vocal fry are mostly slack and heavy. Then the air is being passed through something that slack and heavy. 

Carrie: When they're slack, they are creating sound at a lower frequency than if they were more taut. 

Megan: Exactly. If they were extremely taut, you get something like a falsetto, right? Actually, toothed whales can do a falsetto too. They have, I guess, three different registers, vocal fry, falsetto, and then baseline. 

Carrie: For humans, we would call this a modality, right? We have five in human speech. But we share those three, vocal fry, regular, and falsetto. 

Megan: Really cool. These three things and toothed whales have different functions. It's the vocal fry register that's responsible for the echolocation, which, if you don't know or need a reminder, echolocation is basically using sound to figure out where things are in space. Because the sound vibrates off of. 

Carrie: Whales and bats use it. Actually, humans can too. 

Megan: It's true. 

Carrie: Well, anyway, when their phonic lips are the slackest, that's when they're echolocating. 

Megan: Exactly. That's doing the vocal fry, just as if a human has their slack vocal cords and it's creating sound at a lower frequency. But we're not echolocating when we do that. 

Carrie: We could, you could echolocate using anything, any part of your range. Although as far as I know, the people who do use echolocation just use clicks. 

Megan: Apparently, when this whale is a few thousand feet below the surface of the water, its lungs collapse under the pressure. But inside the bony structure, the nose, air can continue to move around and power echolocation. I mean, does seems to be an evolutionary thing. I mean, by moving all the air into the nose, then they're able to generate much higher pressures. They can make basically the loudest sounds any human or any animal can make on the planet. It's really cool. This NPR article ends, "and more importantly, feed themselves in the process turning vocal fry into fish fry." 

Carrie: I saw that, nice. 

Megan: I always thought echolocation was really neat. I thought about it more with bats, I guess. I just never really thought about how dolphins were doing it or toothed whales in general. I certainly know they make noises but this is really neat. Although, isn't it interesting? Because I feel like a lot of people think vocal fry is just this really nasally thing, because they're associated with so many different things. In this case, it's truly is nasally. But then literally, all three ways of making sound for them is nasal. That's super cool, though. I mean, super cool. Well, thanks for sharing, everyone. 

Carrie: Really thank you, everybody who sent us this to talk about because it's fascinating and I want to learn more. I learned something about English and how the word whale has a different meaning than it does in science. 

Megan: I mean, I'm happy to go on with my life knowing that dolphins and porpoises are whales. I mean, I just didn't know. 

Carrie: Yes, and orcas. I just always would say orca, because I thought killer whale was incorrect. No, it's correct. They do kill and they are whales. 

Megan: It's actually very descriptive and accurate. Wow. That's so funny. We're actually talking to a science journalist today. 

Carrie: That's very true. But something very different but still biology. 

Megan: A lot of fun anatomy. I know. 

Carrie: A lot of fun, for sure. If you want to join, if you want to become a patron, you can join at www.patreon.com/vocalfriespod and we've got stickers and bonus episodes. 

Megan: Our latest bonus episode is about what is it? Fan elect? 

Carrie: Yeah, it's about the word fan elect. Well, it's about whether Swifties lacked their own version of English, right? It might not be a fan elect.

Megan: That's fun, too. Please join, we appreciate you all and we hope you enjoy the episode. We're so excited to have Rachel E. Gross, an award-winning science journalist based in Brooklyn. She is the author of Vagina Obscura: An Anatomical Voyage, published in 2022. Actually, March 2022. Vagina Obscura recently made the 2023 PEN/E.O. Wilson Literary Science Writing Award long list. It was shortlisted for the 2023 Andrew Carnegie Medal for Excellence in Nonfiction. It's a New York Times Editor's Choice and the Science Friday Best Science Book to Read This Summer. Congrats on the paperback release. 

Rachel E. Gross: Thank you so much for having me, Megan. I'm really excited to be here. 

Megan: I still don't really know who our fans are. But on Twitter, you had tweeted about a recent Atlantic piece I'll get to later. But I said, oh, my gosh, please come on our podcast. Then I saw that we had some people that are like, "Oh, my gosh, yes, make this happen." I'm like, these people actually listen to us? But it seems like this is a magical collab here right now. 

Rachel: I mean, I think that you're really interested in the implications of the words we use in a bunch of different fields. I've specifically been looking really closely at medical language and how it seeps into our culture in many unexpected ways. I was super excited to come on. 

Carrie: Can you give us a little hint of something that seeps into our language? 

Rachel: Yeah. Recently, I was working on a piece about the weirdness of pregnancy language. I think that everybody has heard this phrase, "geriatric pregnancy," which actually is not used that much in the medical sphere, and yet has made its way into the popular imagination and signifies how medicine views women who are, in this case, 35 or older. It has this ageist bent to it. It feels like we're being called decrepit or blamed for our own "choices" later in life, many scare quotes. But it's become the symbol of something that maybe it wasn't intended to be. I think it has grown larger in the public imagination than it might have even been in medicine. 

Megan: I turned 35 this past summer.

Rachel: Congratulations.

Megan: Thank you. 

Rachel: Your power is growing. 

Megan: Exactly, thank you. When I went to the gynecologist this year, I had mentioned to her that term, just because I like to talk to my doctors about things because I'm curious. [crosstalk] She rolled her eyes at it basically. She is beyond that. She's more thoughtful than that. That carries a lot of baggage through geriatric pregnancy, as if you make the choice to have a baby after 35, you are a terrible person. Like you said, the blame part comes in. 

Rachel: Exactly. I agree with you, most especially younger gynecologists that I talked to often roll their eyes at that word and they clearly wouldn't use it. But at the same time, there are many other generations who do think that way. It's a crapshoot and it's not like you would say all of medicine views women this way or anything.

Megan: Right. Absolutely. I had heard of it, right? I went in knowing that 35 was this not magical, terrible age. 

Rachel: Right, it's a cliff.

Megan: Exactly. Can you take us back and tell us why you wanted to write Vagina Obscura? 

Rachel: Absolutely. I mean, I've always loved the vaginas and reproductive biology. I've been a science writer for more than 10 years now. But this particular book germinated when I was a science editor at Smithsonian Magazine. I was doing a lot of coverage of reproductive health stuff. At the same time, I was also running a column called Unsung Women in the History of Science. It still lives on at Smithsonian.com. Leila McNeal is the academic writer who was behind most of those columns. I began to notice this overlap between the two areas of coverage, where this one column was about women and LGBTQ and minority scientists who had often been pushed out of their fields or faced a ton of systemic challenges to get their questions answered and make a mark in science. Often, they didn't get to center the type of people and questions they wanted to. Here on the other hand, we're covering reproductive biology and we're learning all of these incredibly basic things, like what's the composition of vaginal mucus in 2018. I began to feel like there's no coincidence that there's a lack of women in science and a lack of women's bodies and knowledge about them in science. The marginalization of women in science directly leads to the marginalization of women's bodies in science. I wanted to write about that connection in a way that was a wonder-filled voyage into what we think of as the female body and both why we don't know so much and what we're finally learning. That's how the book came about. 

Carrie: Why do you love the vagina? 

Rachel: I mean, who doesn't? My mom is a doctor and I have always, I think, felt comfortable being very frank about body stuff. I like to make people uncomfortable. I think an editor's grabbed me recently is like my entire career is like poking hornet's nest that nobody else wants to touch. 

Carrie: That's such a huge compliment. 

Rachel: Yeah, you're right. I mean, I think you'd be the recipient of all that hate and hornet. I mean, I didn't think about it that way. But I do feel comfortable and, in fact, relish addressing topics that other people don't want to take on. I just find it fascinating when there is a squeamishness and this taboo around something that I find pretty joyous and cool and fascinating. I'd like to tease out why we are so uncomfortable with these things. 

Megan: Well, I was going to ask you if you're a big fan of biology when you're growing up. But if you had a mom who was a doctor, I'm sure biology has organically crept into things anyway. Or you could always ask her questions you had about biology. 

Rachel: Yeah, I mean, I'm the daughter of three scientists. My dad's a physicist and my stepmom is a molecular biologist. It did run in my family. We would listen to an audio book about The Real Science of Jurassic Park when we were in the car. I grew up on Animorphs, which dubiously science, but to me, it was biology. Absolutely, I have loved science of biology from a very young age. I used to take college astronomy courses when I was, I think, 11 because it was cheaper than daycare. My dad would just leave me there while he taught in his college.

Carrie: You recently wrote a piece for Atlantic about outdated medical terms and we talked about one of them. It's not just that they're outdated, they're inaccurate. Can you tell us about some of the other terms besides geriatric pregnancy? 

Rachel: Yeah. There were a lot of words that just really rub you in a weird way and don't feel particularly neutral and medical. A few of them are incompetent cervix, hostile uterus, and failure to progress. A couple of ways that those are inaccurate, failure to progress has recently received a lot of critique for being actually a product of how hospital care is delivered. If you just consider a birth not progressing after a certain amount of time, it might be a failure to wait, actually. There might be other things you can do instead of immediately switch to a Caesarian section. The term "failure to progress" implies that it's a failure on the part of the mother's body and that the best thing to do is now go to the more invasive option. The incompetent cervix is, it's just weird, but it means that a cervix dilates earlier than it's supposed to and earlier than when a baby's supposed to come out. But it's doing its job in many other ways. 

Megan: That is so wildly not neutral, that term.

Rachel: The interesting thing is many doctors do not notice these things. Because they're used to words like failure and competent and exhaustion being in their medical textbooks. They just read them really differently. It's always interesting to bring them up to doctors and have them be like, "Huh, that is messed up." Or like, "I never saw it this way. But now that you mention it, I did have a patient react to this way." Hostile uterus implies that the uterus's whole reason for existing is to play nice with sperm and to accept it to its folds, whereas it's actually doing a lot of other things which we can talk about. Hostile is what you call a misbehaving dog or something. I don't know. 

Megan: Right. I chose to be hostile in this situation where it's basically acting like it has one job. 

Rachel: Right. You define it by its ability to accept or receive sperms. You define it as a passive entity that does the receiving, which is actually incredibly dynamic and active. 

Megan: You're right. I have it opposite as it's not that it gives it, what is that word?

Carrie: Agency.

Megan: Yeah, it's taking away agency. 

Rachel: I mean, it's both, giving it a weird agency and making it sound like an employee that is not doing its job. Then take new agency by defining its role very narrowly.

Carrie: It's quiet quitting. 

Rachel: I love that. It's this quiet quitting. Wait, oh, my God. One way that a lot of these terms are less accurate also is that they make a very binary split between two things. Geriatric suggests there is a cliff. After it, everything becomes way more risky. Just like the calculus changes dramatically, and maybe similarly, in the weight science realm, obese is a term that means you're above a certain percentage, your BMI is above this. Doctors are now saying that there's many more precise and useful terms. If you say, pregnancy 35 to 40, pregnancy 40 to 45, that gives you a lot more information to work with. Similarly with obesity, which can be considered a judgmental term, you say they're in the 91st percentile of weight for their age. That's a concrete way that this language is not just judgmental, but medically imprecise. 

Megan: When it comes to the medical field, precision would be preferred. It seems important.

Rachel: Right. Well, language always has to do many things in medicine. It often is very descriptive. If you think about anatomical terms, they tell you exactly where a body part is in the body, often what its function is. They now have to be acceptable and often readable to the patient, because now we have open notes and patients are able to read all their medical notes. They have to convey information easily from doctor to doctor. You do need to tell your colleague that this cervix has opened earlier than it should and now you need to move on to the next mode of treatment. You need to convey that precisely and quickly. 

Carrie: What does the uterus do besides rejecting sperm? 

Rachel: Wow, I am so happy you asked that, Carrie. The uterus is one of the most dynamic and regenerative organs in the body. Not only does it grow to 40 times its size, create the placenta, the only temporary organ in the human body, and maintain the delicate, semi-permeable mother baby barrier during pregnancy. But when you are not pregnant, which for many of us is our entire lives, it is actually essentially creating a new organ every month. Every month, triggered by the cycling hormones going on your body, the uterus grows a whole new lining, which are just all new cells. They're called deciduous cells because they fall away at some point. 

Carrie: Like trees. 

Rachel: Exactly. It also grows entirely new spiraling blood vessels to supply this tissue with nutrients and what it needs. Then the drop in estrogen and progesterone that happens around your period basically tells these vessels to cut off oxygen. They die violently and that causes the lining to shed. It's full of stem cells. It's generating new growth constantly. Some people talk about it in terms of almost like practicing how to create the best composition of lining and how to do this job best. But it's pretty amazing. Literally, the stem cells in the uterus have been used, partially because they're so easily available compared to blood marrow to specialize them, turn them into neurons or insulin producing cells to treat Parkinson's or diabetes. Your uterus is doing a lot for you. It's not just the organ of pregnancy, 

Megan: Rachel, you're making me cry over here. That is the most beautiful thing I've ever heard. I'm thinking about Oprah vajayjay. We play linguistic gymnastics so much to avoid saying vagina or to talk about these things. We just accept it. A lot of us just passively accept that. 

Rachel: Absolutely. 

Megan: To be introduced to the idea that you don't have to be grossed out by these things, even in fact, it's quite a beautiful process, our bodies are doing things that are quite beautiful. 

Carrie: It almost makes the pain worth it. 

Rachel: Right. I can't speak, I've not experienced childbirth.

Carrie: I just had the period pain. It used to make me vomit. I used to get such horrible pain that I would actually vomit. 

Rachel: Oh, my God. 

Carrie: There were times when I really hated my uterus. 

Rachel: Right, I think this was a very tricky line that I had to walk during the book. I think that putting the "female body on a pedestal" and saying we are all goddesses and we have all of this amazing feminine biology, I think that just centralizes women in a way that is not helpful. But you are fighting against, I would say, a very biased bent of history that has treated these organs as unmentionable, taboo, shameful, and like you just said, Megan, disgusting. There does need to be a push back there. I argue that the scientists that are pushing back against that are actually the ones making these really important new discoveries and reimagining these organs. I also do talk a lot about exactly the kind of language that you were saying, Megan. This euphemistic, often cutesy language, the fact that mothers, like in the UK, some of the words were the craziest to me, so I'll just mentioned those. But we'll introduce the vagina as your mini, your fufu, your fairy, your tuppence. There's one strain of cutesy euphemisms. 

Then there's a strain of literally, the vagina is Voldemort. You cannot say its name. It's the nether regions, the private parts, the down there the between your legs. How can you have empowered knowledge about your own body? How can you convey knowledge about your own body if you literally can't even talk about it? It's like the Bermuda Triangle. I think it really affects our intimate relationships with ourselves. If we automatically are thinking of it, it's just down there at the place you don't touch or you don't think about unless you're giving birth or having sex, that really affects how you think about your parts. Periods often suck and suck for some people more than others. But wouldn't it change our relationship if we were introduced to them with this curiosity and this is what is happening, this is what your body is doing, and why it's important for the health of your entire body, not just for if you choose to get pregnant. 

Megan: Well, I feel like this leads to dangerous body image things, but also like sexual situations too, because...

Rachel: You're disempowered.

Megan: Yeah. Then something's cutesy, like you call it cutesy thing like fairy. That was one of them, right? Then you're also saying like, down there. It's this little princess. Also, it's also very shameful. None of those are right. That's not the whole picture at all. 

Rachel: But there's definitely some cognitive dissonance there, right? It's shameful. But also, it's a princess and it needs to be pure and you should do shit. There's a lot of dissonance. How can you come up with a more balanced view of your own body when you're getting all of this mixed messaging? 

Megan: How do we move away from that? I think your book is a good start. But you also mentioned the scientists that are in the lab doing some great things. How do we move away from saying nether region?

Rachel: I mean, on the one hand, we just do. We, in our individual circles, use frank terminology and teach it to our kids. But I understand that's much harder done than said. I've thought a lot about sex ed in this country and that I would really like to see it disrupted. I know there is some really good progressive and really inclusive sex ed happening right now, partly through planned parenthood. But I think that's a really good inflection point. When kids are hitting puberty and having all these questions about their own bodies, that's the time to give them this precise vocabulary and make sure that it's not full of this baggage of shame and off limits to talk about their pleasure and the changes in their body in a positive way to say like, isn't this awesome that your ovaries are starting to pump out these hormones that support your brain health, your bone health, every organ in your body, and will be doing so for the rest of your life? 

Also, our ovulating eggs in this crazy wild way where these little follicles are like Han Solo trapped in this moment of being frozen in time until your body says, "It's time to take action." They burst out of the ovary in this really violent and crazy explosion. Make it a journey. Make it fun. I don't think you have to try that hard because it's really amazing what's happening inside of you. But I think labeling things correctly at that age is pretty important. I think you're also getting a lot of slang and hearing a lot of different terms at that time. That's maybe a good time to establish some standard words. I think it's important for kids to be able to talk about their own bodies in accurate way, whether it's because the worst-case scenario is a kid has had an assault experience and needs to be able to explain what happened. But also, they're exploring themselves and their sexuality. It's very important to have clear communication. There's a lot of ways but I think having these frank conversations and hopefully more mainstream media taking this kind of thing seriously. Sexual health and conditions that are often thought of as women's health conditions, that's a great start. 

Megan: Even just using the word "vagina". I remember, this was a long time ago now, close to 20 years ago, here in Vancouver on CBC Radio, one of the announcers struggled to say, The Vagina Monologues. I was embarrassed for her that this was so hard for her. I was just like, this shouldn't be that bad. It's just a word.

Rachel: Right, and that was 20 years ago. Come on. 

Megan: It wasn't like 50. I had terrible sex ed. Did we have sex ed? I don't even know. But even then, we need the person giving the class to not be hesitant about saying the words. I'm imagining we still even run into the problem of, well, I can tell that the teacher is struggling to say "vagina". 

Rachel: Right, what kind of message does that give you? It's really off limits. Exactly. I was just remembering, my sex ed was also terrible in Southern California. But at one point, they pulled all the female students in fourth grade aside and told us about our periods and people's moms came. But my mom couldn't, she was a doctor. She was busy. I remember raising my hand and being like, "Wait, so it's like peeing, you can decide when to bleed and then stop it?" Which totally made sense in retrospect, but all the moms laughed at me. They were just like, "No, that's not how it works." I'm like, what kind of a shutdown was that? Why does it not work that way? Why weren't you just like, this is someone's curious. It's a good opportunity to talk about how this works. But they probably didn't know how it worked either. 

Carrie: No, seriously, and they were also probably just feeling ashamed about it because there was just so much shame around it. 

Rachel: Definitely. 

Carrie: As a kid, it was still pretty shameful to talk about. I had okay sex ed.

Megan: That's because you're Canadian. 

Rachel: Maybe. But I mean, I think vagina is in the air. I like that. 

Megan: I do too.

Rachel: Is vagina in the air? Spring is coming. But no, I mean, I am in a specific bubble, but I see more and more books with the word vagina on the title. I see it in mainstream news articles. One really interesting thing I've noticed is since the fall of Roe v. Wade, there has been so much more public discussion about what used to be really technical terms about reproductive health. Ectopic pregnancy, endometriosis, those words are all in the milieu now and I think people understand why it's important and that in a weird way makes me hopeful. 

Megan: I've also seen a lot of conversations about, hey, the vulva and the vagina are different. That was never a thing that would have come up 20 years ago.

Rachel: Actually, my next language article is on the etymology of the word "vulva". That's something I bring up as well. 

Megan: Cool. It's not really too vulgar? 

Rachel: No, I mean, not as far as my research shows.

Megan: I'm just making sure. Because it's on my mind, I'm thinking there are linguists who look at this too where it's like, what is taboo? What is vulgar? I spend more time in the race, ethnicity part of linguistics. I'm thinking, vulgar is defined as, for some people, the way that black people speak, so African American English. This is just playing out the biases that we have. It's the same thing here, when there are even people who have vaginas or who have vulvas that are afraid to say these words out loud because society at large has decided this is vulgar because of how we feel about women. 

Carrie: Well, also, sex too because even terms for men are a little still a little taboo too. We don't go around talking about penises as much as maybe we should.

Rachel: I don't know. I think that these biases definitely harm men and people with penises.

Megan: Not as much, though. Not as much, for sure. 

Rachel: Correct. But I do think that penis is so much more acceptable and so much more funny, rather than shameful.

Carrie: It's funnier.

Rachel: There's a different connotation. 

Carrie: It's funnier, but I still think it's considered vulgar. 

Rachel: Interesting. Then, I mean, you can look at things like erectile dysfunction and how really Big Pharma made that a completely acceptable thing to say. There's ED, it was almost neutralized in a way and medicalized in a way that a lot of female sexual health has not been. But I just wanted to address the race bias thing. That's something that I talked about a lot in my book. I usually do it in the way of showing what type of bodies were considered the ideal, which is often the white male, and how anything that deviated from that ideal got described in a certain way, not quite vulgar but more like inferior, deviant, unhealthy, and not ideal. One example is that the ovaries didn't have their own word, their own name, until the 1600s. They were just called female testicles and considered just kind of a poor, inferior version that might make something called female sperm, but might just be a remnant of the perfect male body. I talk a lot about the vaginal microbiome, which is recently getting a boost in research. But one big problem, I think, with the early research on it was that any type of vaginal microbiome, which is the ecosystem in your vagina, that wasn't what normal white women had was considered unbalanced or unhealthy. That was often the typical flora of Hispanic and Black women. I think, like you said, it's automatically considered less than desirable, based on our biases about entire groups, which is not scientific.

Megan: Not scientific at all. I'm thinking about medical research, where they find if you're a menstruating person, you are a confounding factor. You are not included in the "typical participant". We know how white male bodies do in this medical research. But we don't know about anything else because it's "confounding variable". 

Rachel: That's especially ironic. I think it was 1993 that the NIH said that women and minorities, which weirdly leaves out with the minorities, had to be included in most medical research. But the logic is so interesting because they're saying, if you menstruate, then you are just so confounding that you would mess up the data and you can't possibly be in this dataset. However, we will do this research with white men and then extrapolate it to all people who menstruate, because you're similar enough that this will work. It's like, wait, you don't see the cognitive dissonance there? But then why is my menstruation such a problem/not all women menstruate/wow, it's 2023, we can work with this data, guys. 

Megan: Right. This idea that it's, "bad data", no, it's data. We need that data too. 

Rachel: Oh, my gosh, absolutely. Right. If it is such a huge confounding factor, that means it's even more important to study, if you really think it affects your health that much. 

Megan: All of this is just perpetuating bias among doctors that sometimes they don't even realize it. Like you said that you talk to doctors bring up these terms and they're like, "Oh, yeah." Do you think that's how it usually plays out where people just haven't thought about these things? If we're moving past this, we start seeing things like vagina, we can go to these doctors and be more empowered. How would that look like? How is this interaction looking like now between patient and doctor do you think with these bias terms?

Rachel: I think medical culture is a pretty rigid and standardized system. You are getting indoctrinated for four years and then your residency with a specific set of language and ideas and thoughts about what Western medicine can and should do for people's body and health. It makes a lot of sense that you have to do a lot of accepting these terms. You're doing so much intake that it's very hard to interrogate or close read every term you're getting. Some stuff definitely just won't have come to your attention. Some stuff patients also won't notice it, and so it won't ever come up. One thing I'm thinking of is there are an incredible number of diseases and even body parts named after very problematic male discoverers, including a lot of Nazi doctors. About 10 years ago, there was a big movement in medicine when people realized this and started uncovering the roots of these words. Then they would try to purge all of these from medicine, which was a huge effort and sometimes really complicated things to come up with replacements that ended up being longer and more unwieldy, harder to learn. There was a whole reckoning. I do think when people know better, they do better. 

Megan: That's what our podcast is all about. 

Rachel: Some stuff just hasn't come to people's attention. It totally makes sense and it's no one's individual fault. I mean, on the other hand, it just depends where you're situated, right? I think that if you haven't had the experience of being dismissed and gaslit from having a chronic illness, that's considered to be a female illness. For most of your life, it is harder for you to be as aware and sensitive to that if you need to be exposed to it in some way. Fortunately, I think those conversations are now happening, including in the mainstream media. I definitely know there's a lot of individual doctors who are part of this movement to have more frank and empowered discussions with their patients, treat their patient as a colleague in their own treatment. Of course, not all, but specifically a lot of doctors that are very active on social media. Two I know are Dr. Rachel Rubin, Dr. Maria Oloco. They are sexual health medicine doctors and they're also neurologists. 

Basically, they would describe it as they talk about peeing and sex and penises. They're really comfortable with stuff that nobody wants to talk about. They're the ideal doctors to start this frank conversation, to use all of this direct language, and to champion patients coming in with their own research and wanting to talk about what affects them. I think that's a really good model of what these conversations could look like. I think a problem is that most of those doctors work in private practices that often don't take insurance and they're not accessible to quite a lot of people. They're super rare, like a sexual medicine specialist, we don't have very many in this country. It's a niche area of gynecology and urology. I think it's good to look at what those people are doing. But I got to acknowledge that many doctors don't have this luxury. They only have 15 minutes with the patient. They maybe can't focus on some of these issues that are so super important to people's well-being and quality of life. But they have to do your pap smear and deliver your baby and that's it. There are a lot of restrictions. I do think there is room for many doctors to be less threatened by patient knowledge and by a patient's interpretation of what's happening in their own body and respect their embodied knowledge more. I think that that could happen in 15 minutes. 

Megan: Amen. This is just reminding me of how I really thought that getting a pap smear was punishment for having a vagina. I mean, when did it start?

Rachel: Punishment? 

Megan: Yeah.

Rachel: I see that obviously. 

Megan: It is horrible. 

Rachel: Getting the speculum in there, I was just getting an appointment the other day with a speculum and I was like, oh, sometimes they're worse than others, whatever. The gynecologist is like, "Oh, it's not that bad." I'm like, "Don't tell me how my body feels."

Megan: You can't say that. Oh my God.

Carrie: Why are they still so horrible? How haven't we gotten a better speculum? 

Rachel: But the speculum, that's interesting. There is an Atlantic article, not by me, that is why we can't have a better speculum, what are the limitations on this tool. But many people are now aware that the original speculum is said to be developed by J. Marion Sims and is still in some hospitals called the Sims speculum. I mean, this was not a fun device, that was not meant for the comfort of women. The fact that we still have something very similar is it's horrifying. It's interesting how the speculum became a feminist tool during the 70s. It wasn't that some versions of our bodies ourselves, I think, maybe a similar book came with your own plastic speculum to do your own look down there. I thought that was super cool. I hope they were more comfortable because I obviously didn't get my hands on one. 

Megan: Well, just thinking about putting plastic in there in my vagina, no, thank you. 

Rachel: No, I prefer the plastic to the metal. I hate the coldness of the metal and the plastic. 

Carrie: I know is that really safe, is it? Maybe it's BPA free? 

Rachel: I mean, I don't know. We put a lot of things in there. I'm like, I got all my vibrator. 

Carrie: But those are silicone.

Rachel: I'm just thinking out loud here, why don't we have a silicone?

Carrie: Plastic is permeable or something, unlike silicone. 

Rachel: I don't know exactly what type of plastic it is. This was the 70s, very likely. [crosstalk] 

Carrie: Not safe.

Rachel: But how about a silicone speculum? Can someone work that up? 

Carrie: Well, that's what I was thinking. But then when you said something about all the limitations, my immediate thought was it's probably too soft. It's probably hard to make it rigid enough. 

Rachel: Metal covered in silicone. 

Carrie: There we go. Problem solved. 

Rachel: I don't know here. I'm just thinking there's got to be out there.

Carrie: There's got to be. It's just so horrible because the coldness is awful. It does feel like you're undergoing some sort of experiment, as opposed to getting health care. 

Megan: You got to imagine since, historically, women aren't in the room where these things are happening because they're not allowed. Things like J Marion Sims, and I'm looking at this speculum. They're not considering our bodies, our embodied experiences, because they can't possibly understand. It's the same now with medical research and all this. Well, at least there are more women, at least there are more minoritized people in the room that can say, "We need to know what menstruating bodies are doing. Excuse me, why are you like asking that question or not considering this?" These kinds of things, right? 

Rachel: Right. Then why do we still not have a good speculum? That's what we're asking. 

Megan: Absolutely. Exactly. A lot of advancements are going to happen, I think, because more people are allowed into the room. 

Rachel: I don't know any people know that you can always ask for a smaller speculum. There's multiple sizes and you don't really get told that when you go into the room. That's one thing, doesn't help everyone but help some people. When Sims in his autobiography wrote about developing the speculum, he wrote about it as that it was like the telescope, that it would make this obscure dark wilderness of the female body obvious and visible. He was like, "I could see the cervix as plain as the nose on my face." The idea was a tool for science to view the material, the female body, not a tool to make you feel comfortable and at ease and think about your experience. 

Megan: No, it's like the moon landing. He's going uncharted territory.

Rachel: That was like all of these anatomists, they were always describing it in terms of conquest and often colonialism. There's a lot of weird either architectural or city planning type words. I really was amused that the entrance to the vagina is called the vestibule, which is basically a waiting room or a lobby. We're just waiting to enter.

Megan: It's so funny. I'm just thinking of funny things that, well, Carrie says often, like, why do we say someone's a pussy? We should say someone's a scrotum? 

Carrie: I'm not the only one who said that. I didn't come up with that.

Megan: I know. 

Rachel: I hear that a lot. Being a pussy, I don't know, I do like that term, actually. We could reclaim it as something different. If you're soft, but strong, you're a softy but also very powerful. 

Megan: Then I'm such a pussy. 

Rachel: Exactly. I'm a pussy. I'm a Pisces moon. 

Megan: You use the word medicalized. What do you mean by that? 

Rachel: I think I was talking about erectile dysfunction and how having problems with erection sometimes became a very specific medical term that also became okay to talk about in Subway ads and to your doctor. In a way, that's really powerful. Similarly, there are some terms that are controversial, like sexual dysfunction for women. That would be not reaching orgasm or being aroused at certain times, that having a name for it that's understandable in the medical realm allows you to be taken more seriously to talk about it and to discuss certain options depending perhaps in a menopausal phase like vaginal estrogen might be helpful. On the flip side, there's really important arguments that overmedicalizing the female body has led to a lot of issues. Because things like hysteria and neuroses were common medical bases for removing women's ovaries or even amputating the clitoris in Victorian times. You want to be careful about pathologizing bodies, because there's many reasons why you might have issues orgasming with a certain partner that have nothing to do with your biology and anatomy. 

But there's been a turn towards we want to validate women and people with phobias, experiences as being real, and real often means biological or medical to people. That's super important with things like endometriosis that literally were called hysteria or all in your head or just deal with it. It was really important that we acknowledged the biological bases and therefore the medical treatments possible for that. But there is a danger, I think, of going too far in medicalizing everything that has to do with your sexual experience, or excluding the possibility that psychological treatments and attention to stress and anxiety help because those issues really are implicated in chronic diseases as well. 

Megan: I've often in my head referred to myself or said to myself, stop being hysterical. I know. I'm in therapy. Don't worry. It's just even this is what it is to be empowered, right? Where I'm like, wait, I know where hysteria comes from. I know the history of this, right? Why am I telling myself? Have you read Kate Mann stuff? 

Rachel: Yeah, I quote her. 

Megan: I found that stuff to be very helpful to being more empowered about, I guess, being a woman or knowing that society is basically gaslighting you.

Rachel: There is a step in empowerment that is cognitive dissonance, which is for some reason, a phrase I keep saying in this conversation. 

Megan: But it's important.

Rachel: Because we cannot help but internalize all these messages and that kind of language. At the same time, this other part of us is more distant and aware and it's saying you shouldn't use that term or that's not feminist. But I just think you can't judge your first instincts and the first vocabulary that's so entrenched in you. It's rough. 

Carrie: It's just interesting because to me, hysterical feels really old. The only interpretation I have for that term now is funny. If I was going to call myself hysterical, I'd be patting myself on the back, which no. 

Rachel: I mean, that's a good use to it. It's weird that it means both those things, actually. 

Megan: I forgot about that. [crosstalk]

Carrie: Semantic drift, that's the thing that happens.

Megan: That determine linguistics. I just like to remind everyone that neutrality is also something that's defined in a way that vulgar is defined or what's taboo. Neutral is also defined by humans who are not neutral. 

Rachel: Oh my gosh, absolutely. 

Megan: Do you think that science can be feminist? Do you think that this medical research world can be feminist? Do you think the sterile halls of medicine can be feminist? 

Rachel: How funny you ask that. I recently wrote an essay called Feminist Science is Not an Oxymoron. 

Megan: I didn't know that is not at all. 

Rachel: That's why you asked this. Sorry. Wow. Indeed, I do believe that feminist science is not only possible, but it's being done in really powerful ways in many sterile halls of science. It was really important to me to articulate some of those ideas. Because even the scientists doing the work that I have been talking about, reimagine the uterus as dynamic and regenerative, even they did not see themselves as feminist scientists. They thought that the word sounded like an oxymoron. Whereas what feminist science is, there's a lot of definitions, but it's often about making visible those invisible assumptions that we have that are baked into so called objective scientific literature. Once you make those obvious, then you can counter them, come up with new hypotheses, test them using all the same tools of science you've already been using. But come up with something that accounts for those biases, counteracts them, and reaches something closer to reality, acknowledging that we all bring our own biases to the table, but the more perspectives you bring, particularly marginalized perspectives because those are the people most affected by things like calling a certain type of body the ideal and calling a certain type of natural ecosystem disbalanced. The more of those perspectives we can bring, the closer we get to a fuller picture of reality. That is feminist. 

Carrie: What an excellent place to end the conversation. Thank you so much. 

Megan: I want to talk to you for 10 more hours. [crosstalk]

Rachel: I know, I really want to talk more about linguistics. Can we?

Megan: Sure, let's do a linguistics conversation. 

Carrie: We always leave our listeners with one final message: Don't be an asshole.

Rachel: Don't be an asshole. Be a pussy. 

Megan: Exactly. 

Carrie: The Vocal Fries Podcast is produced by me, Carrie Gillen. Theme music by Nick Grantham. You can find us on Tumblr, Twitter, Facebook, and Instagram at vocalfriespod. You can email us at vocalfriespod@gmail.com and our website is vocalfriespod.com.

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