In the 17th century, ovaries got their modern name, which essentially means “place for eggs”. Before that, they were known only as female testicles, thought to be vestigial versions of male gonads that may or may not produce “female sperm”. A young Dutch anatomist, Regnier de Graaf, was the first to show that they actually made eggs, by dissecting just-mated rabbits. “Nature had her mind on the job when generating the female as well as when generating the male,” he wrote.
But in the 19th century, the trend of surgeons removing healthy ovaries to treat “ailments” such as hysteria made it clear that they were doing far more than acting as egg baskets. These unassuming organs were, in fact, supporting women’s wellbeing in a much more fundamental way. Eventually, the discovery of estrogen helped scientists piece together the fact that the ovaries were powerhouses of female health, nodes in a complex feedback mechanism between brain and body. They orchestrated the production of hormones that supported nearly every physical system, from bones to brain development.
The “egg basket” concept is typical of the way that, for centuries, scientists have viewed women primarily in one dimension: as baby-makers. And yet, even when it comes to the organs that participate directly in reproduction, this can lead to bad science and missed opportunities.
For example, menopause is often described as the end of a woman’s “reproductive years” and the point at which her ovaries “fail” or “exhaust” themselves. In fact, we now know that ovaries continue to make crucial hormones even after that transition. And, astonishingly, scientists have identified ovarian stem cells with the potential to grow into new eggs, including in postmenopausal women. This raises the prospect of new treatments for infertility or hormonal disorders, and calls into question just how much we actually know about the mechanisms behind menopause.
The roots of this reproductive bias go back thousands of years. In ancient Greece, women were believed to be controlled by their unruly wombs – with the unruliness often caused by a failure to bear children in a timely manner. If she stayed unmarried too long after puberty, it was thought, a woman’s uterus would trample around her body like a bratty toddler, causing all manner of unpleasant symptoms. That idea would ultimately evolve into the notion of hysteria, with its roots in the Greek word for womb, hystera.
This deeply ingrained prejudice once again led to gaps in our knowledge, and a great deal of suffering. Consider endometriosis, a condition that arises when tissue similar to the lining of the womb grows in other places around the body. Medical textbooks as late as the 1990s deemed it “the career woman’s disease”, describing it as afflicting women who had foregone marriage and children to pursue their professional lives. Some doctors even suggested pregnancy as a “cure” (and still do today, despite the fact that the idea has long been disproved).
This kind of thinking has stymied our understanding of an incredibly common, painful disease – one that affects women who have already given birth, girls before their periods as well as trans men and nonbinary people. Today, researchers are finally beginning to see endometriosis for what it really is: a body-wide chronic inflammatory disease. That new understanding is opening the door to potential treatments that don’t rely on manipulating hormone levels or shutting down the menstrual cycle altogether.
Centring reproduction has also sidelined body parts that, while nominally considered part of “the reproductive system,” are really more about sex and pleasure. Specifically, the clitoris, which was once famously dismissed by the father of modern anatomy, Andreas Vesalius, as “this new and useless part”. In his eyes, the female body was an inversion of the male’s: the uterus was an inside-out penis, and the ovaries were interior testicles. According to that framework, women already had all the body parts they needed, no clitoris required.
It is no coincidence that the clitoris would continue to be lost and rediscovered by men of science throughout anatomical history. In the 1990s, it was often omitted or minimised in medical textbooks, with diagrams pointing to the glans clitoris – equivalent to the head of the penis – as the entire thing. Even today, this organ is glossed over in medical training, its role in healthy sexual function, and therefore human health in general, downplayed. The resulting lack of understanding can lead to clitoral injury for women who go under the knife for things such as pelvic mesh removal, urethral procedures, vulval biopsies, and even hip surgeries. Because gynaecologists rarely examine the clitoris, problems such as clitoral adhesions or cancers of the vulva may also be missed or diagnosed late.
In some ways, the consequences of all this skewed science down the ages are obvious: we now face a huge knowledge gap when it comes to half the bodies on Earth. The fact that science still doesn’t know exactly how these important organs work when they aren’t contributing to making a baby is disturbing, to say the least.
But the effects are broader than that. Female health is not its own planet, divorced from male health. We all share the same universal body plan, the same origins in the womb, the same hormones and basic bodily processes. Therefore, almost all of these issues have parallels in male bodies. Researchers who study endometriosis, for example, find that patterns of inflammation that underlie this disease also affect male health. Research into the vaginal microbiome sheds light on the penile microbiome. Studying menstruation teaches us about universal biological processes such as regeneration and scarless wound healing.
For centuries, science has been treating women as walking wombs, baby machines and incubators of new life. This narrow perspective has prevented us from asking questions and making advancements that could help all of us live longer, healthier lives. It’s time for a paradigm shift. We need to finally see the female body for what it truly is: a powerful constellation of interlocking elements, each part indivisible from the whole, that work together to support our health from cradle to grave. As we fill in the missing parts of this picture, we will undoubtedly expand our understanding of all bodies.
Rachel E Gross is the author of Vagina Obscura: An Anatomical Voyage (WW Norton).
Sexing the Body by Anne Fausto-Sterling (Basic, £18.99)
The Seeds of Life by Edward Dolnick (Basic, £18.99)
Inferior by Angela Saini (4th Estate, £9.99)