Susan’s note: I admit it, I’m a National Public Radio fan. I take an hour-long walk in the morning and listen to podcasts of NPR shows I’ve missed. Yesterday I listened to an interview with Dr. Jen Gunter, a Canadian-American obstetrician-gynecologist, a specialist in women’s health and pain medicine. She frequently challenges dubious health and medical claims. The interview, from NPR’s On Point with Meghna Chakrabarti, was the first I’d heard about Dr. Gunter’s new book “The Vagina Bible: The Vulva and the Vagina — Separating the Myth from the Medicine.” The following is an interview with Dr. Gunter, published in Chatelaine, a leading Canadian magazine published in French and English.
Meet Goop’s Number-One Enemy
There are a lot of things Dr. Jen Gunter would like you to know. For starters, most supplements are a waste of money. CBD is a scam. Underwire bras do not cause cancer. You actually can get an IUD if you’ve never been pregnant. Your vagina, under no circumstances, should smell like a pina colada. And, for the love of yoni, please don’t shove a jade egg up there.
The 53-year-old Winnipeg-born ob-gyn will tell you this with the conviction that comes from 24 years of clinical experience and the sass of your saltiest girlfriend. (There will be f-bombs.) And she’ll tell you this anywhere and everywhere — on Twitter and Facebook and Instagram, on her blog, in her monthly columns in the New York Times, in her upcoming book, The Vagina Bible, or her upcoming web series, Jensplaining, or, if you’re lucky, in person. Her vagenda (her portmanteau, not mine): to call BS on every single falsehood we’ve ever been sold about our bodies and to empower women with the straight facts about reproductive health, from the complexities of vulvar pain to basic female anatomy. (To that end, she recently built a 3-D model of the clitoris out of her kids’ modelling clay, complete with a toilet-paper-tube vagina and a urethra fashioned from a McDonald’s straw.)
We need Gunter now—desperately. While the realm of women’s health has long been riddled with fiction, thanks to a murky stew of old wives’ tales, patriarchy and shame, it feels particularly fraught in 2019. “Twenty years ago, it seemed we just had to combat word of mouth and the paper propaganda handed out on the corner,” she says. “But it all feels different and more malevolent now.”
There is an array of sources behind the health misinformation that proliferates like yeast on the Internet, from influencers to celebrities like Gwyneth Paltrow to clickbait farms. “There are entities in play that were not 20 years ago, such as professional provocateurs and trolls,” says Gunter. “Some exist to drive traffic; others are organized by forced-birth political groups and maybe even some by foreign entities interested in creating chaos.”
Some, like influencers associated with the wellness industry, are capitalizing on long-standing gaps in women’s health research. Science is still catching up on evidence-based recommendations for such issues as hormone replacement therapy and female sexual dysfunction; in the meantime, there’s an abundance of expensive alternatives that often lack extensive scientific research to support their claims. “Sites like Goop are especially bad, because they do actually have some good information,” says Gunter. “But when you put sh-t next to quality, people can’t always tell the difference.”
Also contributing to this tense moment is the fact our bodily autonomy is a target of right-wing extremists. In May, several U.S. states placed severe restrictions on abortion, in most cases banning it after fetal cardiac activity is detected, which can happen before a woman even knows she’s pregnant; meanwhile, in Canada, a 21-year-old male MPP recently vowed to make the procedure “unthinkable” in our lifetime. Then, there’s the shortage of family doctors across many areas of Canada, which makes trustworthy medical advice hard to come by. Plus, Gunter often hears about the insidious intimate shaming some men inflict on their partners. (Patients have asked her more times than she can count whether their vaginal smell is normal, because, as she puts it, “some asshole dropped some comment.”)
Many doctors, no doubt, are furious about the myriad ways women’s health continues to be underserved by conventional medicine and undermined by misogyny—but there few as vocal about it as Gunter. Since the publication in 2010 of her first book, The Preemie Primer—based on her own experience as a mom of twins born at 26 weeks—Gunter has steadily built an ardent following with her smarts, humour and zeal for calling out quackery, misogyny and plain old stupidity. She’s a thorn in Paltrow’s side, a relentless agitator of the extreme right, and a badass advocate for women’s health in a rather bananas time. In other words, she’s exactly what we need right now.
Gunter does not sound like most medical experts. For one thing, there’s the swearing. But more importantly, it’s what she doesn’t do: There’s no cautious couching of facts, no constant spouting of statistics. That’s because for Gunter, the work is as personal as it is political. It’s about the ex who once told her that her vagina smelled; the clueless legislator she had to ask permission from to perform a life-saving abortion; the doctors who wouldn’t confirm the best course of action for her critically ill sons.
“I just don’t want women to take this sh-t anymore.”
She’s also utterly unafraid of appearing human—being angry, despondent, incredulous, vulnerable—as she shares her knowledge and experience, and unvarnished opinions of the medical system as both a doctor and a patient. “That is incredibly rare,” says Timothy Caulfield, professor of health law at the University of Alberta and author of Is Gwyneth Paltrow Wrong About Everything? “Providing facts alone won’t get people to listen.”
Gunter has long had an exceedingly low tolerance for bullsh-t. “I’ve always been outspoken,” she says. When she was nine, she started reading the feminist books of the late 1960s and early ’70s—Betty Friedan, Margaret Atwood, Erica Jong—and when she was 15, she rode her bike to her first pro-choice protest. In medical school at the University of Manitoba, she remembers thinking how annoying it was to have all of the women’s health lectures delivered by men.
She first encountered the impact of misinformation in the early 1990s, during her ob-gyn residency at the University of Western Ontario. There wasn’t a widely available Internet at the time, and some patients from rural communities who were seeking abortions mentioned to her that they had initially been told—by friends, family and even their physicians—that the procedure was illegal. It wasn’t; abortion had been decriminalized in Canada in 1988, after Dr. Henry Morgentaler successfully challenged the federal abortion law. Eventually, those women discovered the truth, found the clinic Gunter was working at and received a routine medical procedure that likely altered the course of their lives for the better. But others didn’t, and that fact continues to rile Gunter. “That really stuck with me, the campaign of misinformation women in rural Canada faced at the time,” she says.
After graduating from Western at 28, Gunter spent a year in a fellowship at the University of Kansas and ended up working five more years at the hospital there. “It was pretty intoxicating for someone to say, ‘Yes, come down,’” she says. “It’s such a Canadian thing to think you haven’t made it big until you’ve made it in the States.” As part of her fellowship, she also worked at a free STI clinic—where one grateful patient would “pay” her in fried chicken—and once had to call a legislator to ask permission to perform an abortion for a woman who would likely enter kidney failure without one. He had written a law banning the procedure unless a woman’s life was in danger; he dismissively told Gunter to do “whatever [she] thought was best.” She did the abortion.
Yearning to get out of Republican Kansas, she accepted a teaching position at the University of Colorado Hospital in Denver, where she underwent a series of life- and career-altering experiences. She was married to her second husband at the time and became pregnant with triplets. (Despite being a wide-open book about most aspects of her life, Gunter prefers not to discuss either of her ex-husbands “in any material capacity, except to say they existed.”) When her water broke at 22 weeks and three days, Gunter headed to the hospital, convinced she would lose all three boys. Instead, nearly two days later, she delivered one son, Aidan, while she was alone in a bathroom. He weighed one pound and died shortly after birth. (The trauma of watching Aidan die caused Gunter to give up obstetrics; she continued to practise gynecology with a specialization in vaginal and vulval conditions.)
Her two other sons, Victor and Oliver, were delivered at 26 weeks and survived, but faced severe health complications. Both boys had lung disease and had to be on oxygen for a year because of the altitude (Denver is 5,280 feet above sea level). Oliver remained on and off oxygen into his second year due to recurring bouts of pneumonia, which was incredibly painful for him. Even worse, Gunter knew that long-term oxygen use was damaging his lungs—but no doctor would tell her whether it’d be better for Oliver to live at sea level. “Let me get this straight,” she recalls saying to one. “There’s going to be more natural oxygen in the air at sea level, not harmful oxygen in a tube. He’s low on oxygen, and you can’t tell me that would be better?”
Finally, one cardiologist confirmed that life expectancy is typically better for everyone at sea level, and Gunter and her then husband started packing for California. (They both remain in the Bay Area today and share custody of the boys, who are 16 and thriving.) The move didn’t cure Oliver’s recurring pneumonia, but he no longer relied on oxygen. And Gunter had a major aha moment. “People want doctors to be definitive. A lot of times in medicine, we say, ‘Oh, there’s a 99 percent chance this procedure will work,’ and that’s true, and if you do 1,000 procedures a year that means they won’t be successful for 10 people,” she says. “But you can also say, ‘Yes, there is a greater chance you can be better with this procedure than not.’”
Gunter eventually published The Preemie Primer, and signed up to Twitter to promote it. She also started a website while juggling a full-time practice. Like any savvy content creator, she noticed that whenever she wrote about vaccination, her traffic skyrocketed. “The anti-vaccine people came out, and that’s how I really got interested in fighting pseudo-science,” she says. “Because I was like, ‘Wait, people don’t believe in vaccines?’”
The issue hit home for Gunter because of Oliver’s weakened immune system. Around this time, actor Jenny McCarthy famously—and erroneously—argued that vaccines can trigger autism, which infuriated her. “Why would you use your privilege for that?” Gunter rages. “You could be doing so much good, and this is what you choose?”
Following the school of “write what you know”—or, more accurately, in Gunter’s case, “write what you alone know uniquely well from both your professional and personal experience”—she focused her writing on prematurity for a few years but switched gears as her kids got older, starting a blog where she wrote about everything from Cosmo’s sex positions app (“sophomoric”) to a very good recipe for black bean brownies. (During this time, Gunter was called out by several doctors, many of them men, for her prolific swearing and was advised to maintain separate Twitter accounts for her personal and professional lives. She briefly switched to separate accounts, but found it “stupid and inauthentic.”)
And then came Goop. In 2008, Gwyneth Paltrow launched the newsletter that would eventually become, in the words of the New York Times, the “most controversial brand in the wellness industry.” Gunter wrote scathing takedowns on her blog about Goop posts on vaginal steaming (straddling a pot of steaming herbs to “cleanse” one’s uterus), the unproven link between underwire bras and breast cancer (for the record, Gunter sleeps in her Natori Feathers bra) and the suggestion that inserting a jade oval—conveniently available for $90 at goop.com—into one’s vagina could help “prevent uterine prolapse” among other benefits (“the biggest load of garbage I have read on [Goop] since vaginal steaming,” Gunter wrote).
While gutting Goop, Gunter started calling out other sources of shoddy health information—including a Teen Vogue article on how to get a “summer” vagina—and writing her own content about topics such as placenta eating (no proven benefits) and the HPV vaccine (safe and effective). Her work drew in an increasing number of readers, more than tripling in annual views between 2013 and 2016. But her biggest traffic driver came from Paltrow herself.
A Goop post published in July 2017 was a direct hit at a certain “San Francisco–based ob-gyn-blogger” who had been “taking advantage of the attention and issuing attacks to build her personal platform.”
Gunter wrote a response that went viral, helping drive her 2017 traffic to an all-time high of six million views and bringing her work to the attention of editors at BuzzFeed, The Atlantic and the New York Times. Paltrow’s takedown also served as a tipping point in Goop’s authority. “Increasingly, Gwyneth is viewed as a punchline, and that wasn’t the case when I wrote my book,” says Caulfield. Aside from an increased amount of snark levelled at Paltrow and Goop in the media, there have been more serious repercussions. In 2018, Goop paid a US$145,000 settlement to California state prosecutors related to making claims—about the jade oval, a quartz egg and an essential oil purported to cure depression—that were not based in science. (Oh, and Goop agreed to refund all egg purchases. Oeuf!) Also in 2018, the company was reported to British regulators for 113 alleged breaches of British advertising law for promoting “potentially dangerous” advice related to unproven health products. Paltrow’s reputation in this realm currently seems to be in need of a good steaming.
Please note that when Goop aired its Gunter grievance, Caulfield had already published Is Gwyneth Paltrow Wrong About Everything?—a bestselling dismantlement of pseudo-science with Paltrow’s name on its cover—and he hadn’t heard boo from her. So why was she so PO’d about Gunter? “Jen is this strong female voice who is speaking to Gwyneth’s audience,” says Caulfield. “And that’s a threat.”
You may be unsurprised to learn that Gunter isn’t one to shy away from conflict. “Sometimes, it’s just fun to swipe at trolls,” she says, noting wellness fiends are among the nastiest. Today, she’s focusing her energy and ire on the U.S. abortion reforms, agitating politicians and sharing her experience with restrictive abortion laws as a provider in Kansas. “It’s the same arguments, just packaged differently, and I’m pretty unique in my ability to fight them,” she says. “I’ve done the procedures; I’ve had a premature delivery and a loss; I know the science and the news media; and I know the arguments because it’s the same pseudo-science.”
Here in Canada, access to abortion remains a challenge, especially for women in rural areas and the North, but rights are not under siege in the same way as they are in the U.S. “I don’t think we’re in any danger of Alabama-style laws here, but we can’t be complacent,” says Joyce Arthur, executive director of the Abortion Rights Coalition of Canada. Arthur tells me a joke she heard about Ontario Conservative MPP Sam Oosterhoff’s vow to make abortion unthinkable (“just don’t think about it then, Sam”) but says the one thing Canadians should be angry about is the fact that New Brunswick continues to prohibit the funding of the one private abortion clinic in the province. “It violates the Canada Health Act,” says Arthur, “and they’ve been doing it for 30 years.” So why hasn’t the Trudeau government done anything about this yet? We just might need Gunter on the case.
“Her reach is expanding all the time,” says Yolanda Kirkham, an ob-gyn at Women’s College Hospital and St. Joseph’s Health Centre in Toronto. “Doctors fight pseudo-science through one-on-one encounters with patients every day, but Dr. Gunter has really been able to leverage social media to engage with a wider audience.” Gunter is also engaging with her fan base in new ways. At an event with author Ayelet Waldman in San Francisco last May, several hundred women—and a few men—hung on Gunter’s every word from the moment she strode onto the stage, wearing a very boss pair of embellished jeans and asking if they were ready to talk about vaginas. (Were they ever.)
This summer, she’ll further her vagenda with Jensplaining, a 10-episode web series on women’s health that debuts on CBC’s streaming service, Gem, on August 23. Each 12-minute episode features multiple segments around a central theme (including menstruation, wellness and vaccines), with guest experts, props—the aforementioned 3-D clitoris makes an appearance—and Gunter’s signature brand of exuberant skepticism. “Isn’t it awesome,” she says half-jokingly, “that your tax dollars are being used to discuss the clitoris?” She’s also releasing The Vagina Bible, a glorious and impressively detailed manual, which will be published in Canada on August 20, with 14 other countries and a nine-city book tour to follow.
Gunter has also entered a new phase in her life—menopause—which is the subject of her next book, The Menopause Manifesto. She’ll employ her “been there, done that” approach (in her case, using estrogen patches that took about four months to start controlling her hot flashes) alongside an exhaustive look at all the possible symptoms and science-based solutions. “Many doctors do not adequately treat hot flashes or accept how problematic they can be,” she says, noting they may also be responsible for other symptoms associated with menopause, like mood changes and sleep issues. Gunter says a good doctor should always communicate a subsequent course of action should the first treatment not work.
“What I learned from being a patient with my kids is that it’s reassuring to know there’s a plan,” she says. “If your doctor is an asshole about it, find a new one.” That’s a proposition so straightforward, it’s revolutionary. Just like Gunter herself.
Susan’s note: watch this video from Jimmy Kimmel. Each time he asks how something works, Gwyneth says she doesn’t know. And laughs. Not really that funny. If you just want to watch about the jade egg, go to minute 1:50.