‘And she shall be called woman, because she was taken out of man’: androcentrism and the creation of knowledge-driven ignorance

Abstract

In this paper, I critically analyse biomedical clinical studies and literature reviews regarding the physiological phenomenon known as female ejaculation to demonstrate a process by which androcentric bias, which positions the male body as the scientific ‘standard human’, produces what I term as knowledge-driven ignorance. I show how even though knowledge about female ejaculation has expanded, its biomedical ontological status remains vague and controversial. The production of ignorance in this case does not result from active erasure or concealment, but rather from unintentional disregard, and is a by-product of knowledge-creation itself. As such, it is not only the narration of the scientific story that has the power to abject and exclude certain bodies from culture, but also what is untold and unknown.

Keywords:

• Female ejaculation
• ignorance
• androcentrism
• female sexuality

At a medical conference held in the USA in 1980, a physiological phenomenon known as female ejaculation was introduced for the first time as a non-pathological reaction to sexual stimulation. Martin Weisberg, then an assistant professor at Thomas Jefferson University Hospital, who was present at the conference, later published a paper in which he described his initial response to learning about the phenomenon. He wrote, ‘I'm confused. […] I spend half of my waking hours examining, cutting apart, putting together, removing or rearranging female reproductive organs. There is no prostate and women don’t ejaculate’ (Weisberg 1981, 90). Weisberg went on to explain, however, that after the presentation, he and three other conference participants challenged the presenters to produce solid evidence of so-called female ejaculation, and in response, the presenters took the group to a nearby hotel room where the person whose experience had been described in their paper was hosted, and asked her to demonstrate the phenomenon. In the conclusion to his paper, Weisberg writes ‘I still have no explanation for this, but I can attest to the fact that the Grafenberg spot and female ejaculation exist. Years from now I am sure that a medical school lecturer will joke about how it wasn’t until 1980 that the medical community accepted the fact that women really do ejaculate’ (1981, 91). Somewhat surprisingly, however, Weisberg’s prediction was never fulfilled. Now, more than forty years since his paper was first published, and even though the body of biomedical knowledge regarding female ejaculation has expanded, not only is no medical school lecturer laughing, but much is still unknown about the phenomenon. Considered a myth or at best controversial by lay people and scientists alike, the ontological status of female ejaculation remains very unstable.

In this paper, I analyse 31 biomedical clinical studies and literature reviews regarding the phenomenon of female ejaculation to illustrate a process in which the positioning of the male body as the scientific ‘standard human’ (Almeling 2020, 9) affects and creates what I term as knowledge-driven ignorance. As the analysis suggests, the narration of the scientific story not only has the power to abject and exclude certain bodies from what is considered to be normative and mainstream (Butler 1993; Kristeva 1982; Tyler 2013), but also to govern what is untold and unknown, i.e. our ignorance. As such, this paper contributes to the study of ignorance - agnotology - by demonstrating how the production of ignorance does not necessarily result from active erasure or concealment, but sometimes rather from unintentional disregard, and can be a by-product of knowledge-creation itself. Furthermore, by undertaking a critical analysis of biomedical-knowledge about female ejaculation, this study joins the very limited scope of critical-cultural studies about the phenomenon, which are typically focused on subjective women’s experience (Gilliland 2009; Påfs 2023); socio-historical research (Korda, Goldstein and Sommer 2010); critical analysis of how female ejaculation is theorised in western biomedicine, philosophy, and anthropology (Bell 1991); or the ability of female ejaculation as a root metaphor to challenge organisational phallocentrism (Linstead 2000). However, within this paper I seek to enrich the critical analysis of female ejaculation by offering a critical cultural analysis of biomedical knowledge production itself in relation to the phenomenon.

In order to explore female ejaculation’s liminal position in biomedicine, I use Kristeva’s (1982) conception of abjection. Abjection as Kristeva describes it is an ambiguous, liminal state, something that is neither an object nor a subject, an incomplete casting out which is needed in order to define the object. The abjected body lies outside the social order and boundaries and yet, like female ejaculation, does not cease to challenge them. In the case study focused on in this paper, the abjection of female ejaculation is manifested in its constant unstable and ambiguous ontological state, between existence and myth, between male and female, and between order and disorder. Its materialistic existence, its liquidity and viscosity, both of which are associated with femininity as Grosz (1994) suggests, do not allow for its complete disregard, preventing it from being utterly excluded thus positioning it as an abjected phenomenon.

As this paper will demonstrate, the ongoing discursive comparison of the phenomenon of female ejaculation to male ejaculation not only abjects and denies the female body as an independent object (and subject) of biomedical investigation, but also causes explanations of the phenomenon to be ignored. This results in an unintentional knowledge-driven ignorance, which is a by-product of scientific knowledge making itself. In the case of female ejaculation, this ignorance results from a process intended to shed light on a controversial, understudied feminine phenomenon. As such, this type of ignorance is not caused by ignoring or dismissing ‘unwanted’ knowledge, or via intentional ideological biases (Nisbet, Cooper, and Ellithorpe 2015), as commonly seen in scientific investigation of female sexuality (Tuana 2004, 195–196), but rather is an unintentional outcome of knowledge creation aimed at exploring the female sexual body and sexual pleasure.

Knowledge, and in particular biomedical knowledge, has long been the focus of feminist critique of science, with scholars arguing that biomedical knowledge-production is driven by social power relations and biases that reinforce the male heteronormative hegemony (Fausto-Sterling 1987; Fox Keller 1987; Harding 1991; Longino 1990). Feminist epistemologies of ignorance ask that we pay critical attention to the ways in which gender, race, and power relations shape not only what we know, but also what we cannot and do not know (Proctor 2008; Tuana 2006). In what follows, I argue that an additional paradigm of ignorance exists, one that can be an unintentional by-product of knowledge-making itself, the consequence of gendered power relations that position the male body as the normative biomedical body to which the female’s is subjugated.

The connection between knowledge making and the production of ignorance as an intentional, wilful or unintentional outcome is not a new one (Back 2007; Croissant 2014; Schiebinger 1991). However, it typically addresses knowledge which already exists, and the conscious or unconscious motivation to hide or neglect it. In the case of biomedical knowledge regarding female ejaculation, intentionality and ignorance take a completely different form. The knowledge-making in this case aims to transcend controversies and to shed light on what is unknown, and therefore aims to overcome existing ignorance regarding female ejaculation. As such, there is no intentional bias or unintentional erasure of pre-existing knowledge, rather there is an active and conscious willingness to overcome ignorance. Nevertheless, due to the cultural symbolic privilege associated with the male sexual body and male bodily fluids over women’s (Linstead 2000), ignorance is produced as an unexpected, unintentional causality. Using the theoretical framing of Nisbet, Cooper, and Ellithorpe (2015), biased knowledge about female ejaculation is situated in a phallocentric root metaphor (Linstead 2000), and causes unintentional ignorance, or non-knowledge – as a scientific knowledge gap.

Method

A feminist critical discourse analytic approach was used in this study. This highlights the importance of language and discourse in understanding knowledge and ignorance (Janich and Simmerling 2015) as social ideologies linked to the production of inequality (Gavey 1989; Lazar 2007). Using feminist critical discourse analysis it was possible to enquire into how knowledge about female ejaculation, power and language interact, and how they affect what we know, and do not know.

The clinical studies analysed in this paper were obtained using Harzing’s Publish or Perish tools which enable a wide range of biomedical databases, including Web of Science, Scopus, Google Scholar and PubMed, to be searched (Gusenbauer and Haddaway 2020). I used the keywords ‘female ejaculation’ ‘squirting’ and ‘female orgasmic expulsion’ to conduct the search. I reviewed the identified papers published in peer reviewed journals after 1981, when female ejaculation was first acknowledged as non-pathological (Addiego et al. 1981) and which addressed the phenomenon directly. Altogether, 11 clinical studies, and 25 systematic reviews as well as historical reviews concerning female ejaculation were collected.

I undertook a structured analysis of the texts, analysing the language used to describe what female ejaculation is perceived as being, its primary features, and the biomedical models used to explain it, with specific attention paid to what was not said. Throughout this analysis, I found an overarching comparison of the phenomenon to semen or urine, which prevented independent enquiry into the female sexual body, resulting in unintentional knowledge-driven ignorance.

Manning up: the ongoing biomedical comparison of female ejaculation to male semen

Throughout the investigation of female ejaculation, biomedicine has viewed the male model – and in particular semen – as normative, deeming female ejaculation a non-pathological, normative phenomenon only if it carries aspects of the male within it. This biomedical model that positions the male body as the standard, normal body, to which the female’s body is compared, results in an analysis focusing on the resemblance between the two bodies (and sexes) rather than on their differences, a comparison that biomedical knowledge has been typically criticised for (Almeling 2020; Oudshoorn 2003). Nevertheless, the social hierarchy between the two remains the same, as the male body is considered the unmarked prototype, while the female body is seen as an imitation.

Prior to 1981, when for the first time a sample of female ejaculate was biochemically analysed, the physiological phenomenon of fluid expulsion by cisgender women during sexual activity was regarded by the biomedical literature as urinary incontinence, and therefore a dysfunction. It was not until 1981 that a group of six physicians set out to explore the ‘question of whether or not some women ejaculate upon orgasm’ (Addiego et al. 1981, 13), and established a new understanding of the phenomenon. Their research showed that the fluid expelled during female ejaculation was significantly different from urine since ‘[it] contained higher levels of glucose and of an enzyme, prostatic acid phosphatase (PAP), characteristic of the prostatic component of semen’ (Addiego et al. 1981, 17). The team therefore referred to the expulsion of the particular fluid as female ejaculation which they described an ‘orgasmic expulsion which is at least partially homologous to male ejaculation, rather than to any other sort of expulsion of liquid which might occur at the time of a woman’s orgasm (e.g. urine, vaginal secretion)’ (Addiego et al. 1981, 14).

An analysis of the social and cultural construction of biomedical knowledge (and ignorance) reveals that the framing of this ‘newborn’ phenomenon was based primarily on the resemblance between the fluid ejaculated by cisgender women and that ejaculated by a cisgender man. This was emphasised by the very naming of the phenomenon as female ejaculation – being the marked variation of (male) ejaculation. At a deeper level, however, the rejection of the previous assumption that the fluid expelled during sexual activity was urine and therefore a dysfunction (incontinence) necessitated proof of its resemblance to a normative phenomenon. To categorise female ejaculation as normative, it had to be ‘manned up’. This androcentric positioning is also manifest in the biomedical ‘checklist’ of vaginal fluid expulsions, which are categorised as either urine, female ejaculation, or vaginal secretions. Since the last does not manifest as an emission of fluids, an expulsion of fluid during sexual activity is limited either to one that resembles male semen (female ejaculation), or the emission of urine (voluntary or involuntary): being either manlike or a dysfunction.

These processes leading to the term female ejaculation and its definition as non-pathological are crucial to understanding the theoretical framing that influenced knowledge-making some forty years ago, and still governs our knowledge production today. The identification of female ejaculation as a phenomenon distinct from urinary incontinence depended on the resemblance of the fluid expelled to the male prototype, a paradigm that governed enquiry not only at the moment of the biomedical recognition of female ejaculation, but also in all future clinical and historical biomedical research regarding the phenomenon. Testing for the presence of prostatic acid phosphatase (PAP) and, in later studies, prostate specific antigen (PSA), substances which were at the time believed to be produced only in the male prostate, proved to be one of the most significant ways through which female ejaculation was analysed. In fact, Addiego et al. 1981 research team concluded that female ejaculation was a distinct phenomenon producing a fluid different from urine solely due to the fact that the analysed fluid contained PAP.

Further research to study the phenomenon of female ejaculation followed a similar pattern. In 1983, a follow up study was conducted in order to confirm or reject the ‘hypothesis […] that female ejaculation did indeed exist and was not merely the fantasy of male writers’ (Goldberg et al. 1983, 28). Based on a biochemical analysis of the ejaculate produced by six female subjects, it was concluded that female ejaculation did not exist since the team failed to ‘detect elevated levels of prostatic acid phosphatase and the substance appeared similar in biochemical properties to urine’ (Goldberg et al. 1983, 27). Here, even though the study produced findings that questioned the existence of female ejaculation, the methods and ‘mindset’ were the same. The hypothesis investigated equated female ejaculation to a male fantasy and the creation of male writers, rather than to the female body. Furthermore, proof of its existence necessitated that the fluid expelled resembled male semen based on the detection of PAP within it. Without this evidence, the phenomenon would of necessity be categorised as a dysfunction – urinary incontinence.

As biomedical knowledge regarding female ejaculation, as well as of the male and female prostate developed over the years, additional indicators and models were taken into consideration in the analysis of the fluids expelled by cisgender women during orgasm. Nevertheless, the rules of the game persisted: female ejaculation was designated a normative phenomenon only if the fluids expelled resembled male semen. In a clinical study from 2007, for example, a research team concluded that female ejaculation was a normative phenomenon based once again on the ejaculated fluid’s similarity to male semen (Wimpissinger et al. 2007). The aim of that research was to examine the ‘possible existence of a ‘female prostate gland’ and ‘female ejaculation’ […] in two women who reported actual ejaculations during orgasm’ (Wimpissinger et al. 2007, 1388). This time, the determination was based not solely on the existence of PAP, but through a wider biochemical analysis of urine, female ejaculate, and male ejaculate.

Within Wimpissinger et al.'s study, only three comparable substances were examined: female ejaculation, urine, and male ejaculate. In its findings, the research team declared that ‘biochemically, parameters of the examination of the fluid emitted were clearly different from urine voided prior to sexual activity. Biochemical parameters—with special reference to prostate specific antigen (PSA) […] show that the source of fluid expulsion during orgasm is not urine, but is rather similar to male ejaculate’ (Wimpissinger et al. 2007, 1389) (my emphasis). Based on this finding, as well as an ultrasound examination of the two women subjects, the team concluded that ‘The fluid emitted during orgasm was biochemically comparable to male prostatic plasma’ (Wimpissinger et al. 2007, 1391), and hence female ejaculation was determined as non-pathological based on the fluid emitted’s similarity to male semen, and its differentiation from urine. No other explanation or comparison was considered or tested.

This narrow comparison was also apparent in a study conducted in 2011, which argued that two different phenomena exist – squirting and female ejaculation. The research team concluded, in contrast to previous assumptions, that ‘while the first has the features of diluted urine […] the second is biochemically comparable to some components of male semen’ (Rubio-Casillas and Jannini 2011, 3500). Again, the existence of female ejaculation was determined by its similarity to male semen; otherwise it is regarded simply as diluted urine.

Since female ejaculation is defined by its relationship to the male body, comparison between urine (squirting) and the female body cannot be avoided. If two different fluids exist, and one is masculine, then the other one must be feminine. It is important to note though that even though the biomedical existence of female ejaculation was determined by comparison to the male model, urine is not naturally ascribed the category of feminine. Nevertheless, as a result of the male-female division between female ejaculation and urine, a binary which, as Ortner (1972) argues, is never a neutral one but always hierarchical, and since man is traditionally attributed the upper, stronger side of the equation, especially when the sexual body and bodily fluids are considered (Linstead 2000), the analogy was formed as follows: urine = dysfunction = female, with the newly emerged category of squirting being epistemologically positioned on the weaker, dysfunctional and feminine side of the equation.

This emphasis on gendered resemblance between female ejaculation and male semen is rather surprising since biomedical knowledge production has long been critiqued for actively imposing unnatural differentiations between the two sexes (Richardson 2013; Oudshoorn 2003). This division of sexes has not always been the governing dogma in biomedicine however. Until the eighteenth century, the division of the human sexes in Europe was not based on two opposite sexes as we know today, but rather as one morphological body – ‘The one sex model’ (Laqueur 1990). According to Laqueur, the one sex model relied on the male body providing the model for the ‘one sex’, and on the female body as being a variation of it, rather than an opposite (Laqueur 1990). While the two sex and gender categories remain stable in the case study presented here, since female ejaculation is only regarded as real based on the resemblance rather than the difference between the male and female bodies, the presence of the one sex model is tracible in the background.

This practice of blurring the lines between the male and female is evident not only in the insistence on comparing female ejaculation to male semen, but also in the metaphorical as well as practical mirroring of the male onto the female in order to investigate the phenomenon. Since the designation of female ejaculation as a normative physiological function relied primarily on the detection of PAP in the female ejaculate, and later on the detection of other substances affiliated to male semen, the researchers’ ability to detect PAP in other fluids that might appear during sexual activity, such as urine, had to be proved. The fear was that PAP and other materials might be diluted in female ejaculate to the extent that biochemical analysis could not trace it, and thus the exact nature of female ejaculation would not be possible to determine. In the first case study in 1981 (Addiego et al. 1981), therefore, the team introduced diluted male semen that contained PAP into four urine samples collected from different women. Since PAP originating in male semen was traced in those specimens, the team confirmed the validity of the research and their ability to trace PAP in female orgasmic expulsions. This practice also occurred in the follow-up study in 1983 by Goldberg et al. The team gathered urine samples from five women, to which diluted male semen was added. However, based on the low PAP levels identified in the specimens collected, the team concluded that it had ‘failed to detect elevated levels of prostatic acid phosphatase (PAP) and the substance appeared similar in biochemical properties to urine’ (Goldberg et al. 1983, 33).

Even though the results of the study conducted by Goldberg et al. enabled them to reject the hypothesis that female ejaculation exists, the measurements behind this statement relied on differentiating the ejaculated fluid from urine, as well as its resemblance to male semen (Goldberg et al. 1983, 35). This resemblance was verified based on biochemical analysis through the introduction of a male semen sample diluted in the female sample fluid. In other words, metaphorically speaking, to verify the existence of female ejaculation as a normative physiological phenomenon, the male must necessarily be inserted into the female: both theoretically by determining the existence of PAP in female ejaculation; and methodologically, by introducing male semen into women’s urine as a means by which the validity of the research could be ensured. However, similarity is a double-edged sword, as verifying female ejaculation as ‘real’ necessitated that its features are similar to, but sufficiently different from male semen. Therefore, the establishment of female ejaculation as a normative, recognised phenomenon required confirmation that none of the fluid had been contaminated by male semen.

To prove this, in the study conducted by Addiego et al. (1981), ‘four specimens of the subject’s orgasmic expulsion were collected […] after the subject had refrained from coitus for more than 48 h’ (Addiego et al. 1981, 17). By these means, the team confirmed that the biochemical analysis had not been tainted by the contamination of male semen. In a different case study from 2011, the research team concluded that PSA ‘is found in female ejaculate at high concentrations compared with the other orgasmic fluids, but at lower concentration than that of male semen’ (Rubio-Casillas and Jannini 2011, 3502). In both cases, the necessary condition is essentially the same: to establish the existence of female ejaculation, due to its acknowledged similarity to male semen, the difference between the two must be verified. Since the existence of female ejaculation was based on having a composition homologous to male semen, the biomedical community endeavoured to verify that female ejaculation was not the ‘real’ thing itself.

As this analysis suggests, even though time has passed since female ejaculation was first acknowledged by biomedicine, and new knowledge and definitions have been created, the basic assumptions that influenced knowledge-making in 1981 still govern our way of thinking and knowledge-making about female ejaculation. The nature of the fluids expelled from female genitalia during sexual activity can be only one of two types: urine (whether diluted or not, i.e. urine or squirting) or female ejaculate, which is verified by its similarity to male semen. The existence of female ejaculation relies on projecting the female substance onto the male one and on male characteristics existing within the female body. Without them, the phenomenon is regarded as non-existent – that is, a myth.

The conceptualisation of the male as the biomedical standard has been central to feminist critique of science. Steven Epstein (2008) points out that the ‘standard human’ in biomedicine is a 35-year-old cisgender white man, a notion heavily criticised by Second Wave feminism via canonical works such as ‘Our Bodies, Ourselves’ (1971) advocating a reclamation of knowledge production, as well as the body itself, to the control of women. Likewise, just as the cisgender white man has been constructed as the standard human, the standard reproductive body is that of a (white) cisgender woman. As Rene Almeling puts it, ‘If male bodies are standard, then female bodies are not. If female bodies are reproductive, then male bodies are not’. (Almeling 2020, 13). In the case study of female ejaculation, it seems that not only is the male body presented as a standard to which the female body is compared, even when it comes to reproduction (or at least potentially reproductive capacities), but the male body remains the normative body to which the female’s is compared.

Mapping the unknown: the creation of knowledge-driven ignorance due to the creation and restriction of knowledge

As a result of deeply ingrained cultural and medical biases privileging androcentric paradigms, proof of female ejaculation as a normative phenomenon has been made dependent on the resemblance between the female body and the male body, compelling an ongoing comparison between female sexual fluids and male semen. I argue that this practice restricts knowledge production, as it excludes other explanations, thereby producing unintentional ignorance.

Ignorance regarding female ejaculation is evident in the biomedical literature related to the phenomenon. Even though more than forty years have passed since the phenomenon was first acknowledged as non-pathological, female ejaculation remains controversial and ambiguous. This situation is not due to a lack of biomedical investigation, as the studies cited herein indeed aimed to overcome ignorance and to shed light on a phenomenon previously ignored, and dismissed as a dysfunction. I refer to this particular kind of ambiguity and ignorance – the result of knowledge production itself, rather than of an intentional concealment and erasure (Tuana 2006) – as knowledge-driven ignorance. As such, it does not involve the dismissal of the phenomenon, nor is it a conscious bias as argued for by Bell (1991). Rather, it is the result of a deeply rooted metaphor (Linstead 2000) and ideology that positions the male body as the prototype to which the female’s is compared, which sets limitations on explanatory systems.

In the biomedical literature, there are two limitations on knowledge that results in ignorance. The first limitation on knowledge concerns the proposition that only two options for vaginal fluid expulsion exist: female ejaculation or urine. The second limitation is the necessity of female ejaculation to resemble male semen. In 2018, a wide-ranging review of existing biomedical knowledge regarding female sexual fluid expulsion, as well as the female prostate, was published (Pastor and Chmel 2018). In the introduction, the authors argue that ‘controversial opinions on the fluids’ origin, quantity, composition, and expulsion mechanism exist, and discrepancy in terminology, inaccurate characteristics, and unclear fluid expulsion mechanisms have resulted in an incorrect understanding’ (Pastor and Chmel 2018, 621). They then move on to mapping and categorising different fluids that might be expelled during sexual activity: vaginal lubrication, coital incontinence, and finally – ‘real female ejaculation’ and squirting (Pastor and Chmel 2018, 621). The characteristics of ‘real’ female ejaculation are described with respect to male semen: ‘“real” female ejaculation is the secretion of an extremely scanty (few millilitres), milky fluid by the female prostate’ (Pastor and Chmel 2018, 621). Immediately following, the authors review existing knowledge regarding the female prostate, without further explanation regarding female ejaculation. A subsequent section of the paper mentions that real female ejaculation contains PAP (or PSA); however, the authors claim that since this is also true of fluids expelled from other sources, the presence of PAP cannot offer proof of female ejaculation.

This vague description of female ejaculation, which is intended to offer the most up to date explanation of the phenomenon as of 2018, is organised around an extensive comparison to male ejaculation, without providing substantial insight into female ejaculation. The fluid’s components are described only in respect to male semen: it contains PAP, as does semen, but no other information is provided. It is known to be generated in the female prostate, but it is unclear how much fluid is emitted, what its function is (if any), and so on.¹ The sum total of existing biomedical knowledge about female ejaculation up to 2018 that is presented in this paper, is based only on its similarity to male ejaculation, leaving much unexplored and in the realm of the unknown.

A lack of clarity and specificity is also true of knowledge-making about squirting, the contents of which is generally described as diluted urine. squirting was first acknowledged as a phenomenon different from female ejaculation in 2011, when

[a] case report [.] provided new biochemical evidence demonstrating that the clear and abundant fluid that is ejected in gushes (squirting) is different from the real female ejaculation. While the first has the features of diluted urine […] the second is biochemically comparable to some components of male semen (Rubio-Casillas and Jannini 2011, 3500).

The term ‘real’ female ejaculation positions squirting as an inauthentic duplication and hence a lesser version of the phenomenon. Furthermore, as in the case of female ejaculation, the production of knowledge about squirting is based on an ongoing comparison between squirting and urine. The main findings in the paper are based on a ‘comparison of different biochemical parameters in the voided urine, squirting fluid, and female ejaculate’ (Rubio-Casillas and Jannini 2011, 3501), using as measurements for comparison four biochemical components: PSA that is detected in male semen and therefore provides an indicator for the existence of ‘real’ female ejaculation, and three biochemical components of urine: uric acid, urea and creatinine. Alongside these criteria, the study compared the colour, density and volume of urine, squirting and female ejaculation. Within Rubio-Casillas and Jannini’s study (2011), the leading node of comparison here is urine, to which both squirting and female ejaculation are compared. As such, the new insight from this clinical study maps the ways in which squirting and female ejaculation include features of urine, yet tell us nothing about them without regards to urine.

The requirement that expelled female sexual fluids conform to one of only two options leads to consequences left unexplained and questions left unanswered. To use a metaphor, attempting to shove a piece from one jigsaw puzzle into a different one results in inevitable gaps and mismatches. I refer to these gaps and discrepancies in knowledge as knowledge-driven ignorance. A good example of this can be found in a clinical study from 2015 that set out to enquire into the existence of female ejaculation and squirting. In this research:

Seven women […] who reported recurrent and massive fluid emission during sexual stimulation, underwent provoked sexual arousal. Pelvic ultrasound scans were performed after voluntary urination […], and during sexual stimulation just before […] and after squirting. Urea, creatinine, uric acid, and prostatic-specific antigen (PSA) concentrations were assessed in urinary samples before sexual stimulation […] and after squirting […], and squirting sample itself. (Salama et al. 2015, 661)

The vaginal fluid emitted by seven woman was compared with urine expelled before and after squirting, and a biochemical analysis involving four measurements was made. Out of the four selected biochemical measurements, three are usually associated with urine (urea, creatinine, uric acid) while the last (PSA) is traditionally assigned to male ejaculate, which is considered evidence that would authenticate the existence of female ejaculation. As such, the undeclared goal of the paper is to enquire into the resemblance between squirting and urine, and to solidify differentiation between squirting and female ejaculation. The authors concluded ‘that squirting essentially is an involuntary emission of urine with a relative and unnecessary contribution of female prostatic secretions and support the hypothesis that squirting and the so-called “female ejaculation” essentially are two distinct events’ (Salama et al. 2015, 665) (my emphasis). The words ‘relative and unnecessary’ to account for the presence of PSA in five out of seven samples highlights the author’s supposition that the fluid should fit into one out of the two presented categories. And as mismatches occur, they are dismissed as ‘unnecessary’.

A dismissal of incongruencies also occurs in a 2018 article by Pastor and Chmel, in which they describe the existence of PSA in squirting as a possible contamination ‘by the female prostate secretion during simultaneous expulsions from the other sources’, and therefore frame the presence of PSA as not only irrelevant, but also as an interruption to finding out the ‘true’ nature of women’s vaginal fluid expulsion (2018, 624). In both cases, PSA is not considered to be an inherent element of the expelled fluid, since its presence does not correspond with existing definitions and components of urinary incontinence. By comparing squirting both to urine and to ‘real’ female ejaculation, squirting is marked as an imitation of a second degree. It is understood essentially as diluted urine that differs from ‘real’ female ejaculation, which itself is described as semen. Therefore, besides resembling urine and being categorised as an unwanted and unclean sexual response, squirting is also labelled as a fake imitation that lies outside the social order and norms (Douglas 2003). Interestingly, male semen also contains the same four components (urea, creatinine, uric acid and PSA) on which the comparison between squirting and urine is made. Importantly, male semen is not regarded as diluted (or dense) urine since it is perceived as the substance produced by the prototypical male body. Female sexual fluids on the other hand, and by extension the female body, are investigated only by means of comparison to other biological phenomena, shaping them as dependent variations rather than independent phenomena.

As shown above, biomedical science’s dependence on comparing previously known models to female bodily phenomena results in the rejection of other exploratory systems and the prevention of new alternative knowledge formation. This ‘narrowing’ of possibilities and the exclusion of alternative theories results in the creation of a specific form of ignorance that is an unintentional outcome of knowledge-making itself. This ignorance is not an intentional act due to race or gender bias (Almeling 2020), nor is it an intentional act of concealment or erasure of existing knowledge (Proctor 2008). Ignorance in regard to female ejaculation is rather the ‘passive’ prevention of a more capacious understanding, as a result of an active creation of knowledge. This kind of ignorance results in uncertainty, controversy and ambiguity manifested throughout biomedical studies regarding female sexual fluid in various ways. This can be witnessed in the phenomenon’s unstable name (female orgasmic expulsion, female sexual fluids, female ejaculation, squirting etc.), and unstable categorisation (as urine or ‘female semen’), but perhaps most definitively in its ‘unstable existence’.

The ontological status of female ejaculation is repeatedly disputed in the biomedical literature (and of course by many outside of biomedicine). Many of the studies cited in this paper use terms such as ‘controversial’, (Goldberg et al. 1983; Pastor and Chmel 2018; Rubio-Casillas and Jannini 2011), ‘speculation’, (Wimpissinger et al. 2007) or ‘opinions vary’ in their descriptions of the phenomenon, entertaining doubt as a valid scientific position while unquestioningly describing the expulsion of fluids from female genitalia as a fact. The key question has now become not whether female ejaculation or squirting exists, but whether those kinds of fluids are biochemically compatible with male ejaculation. Without the resemblance, the very existence of the female phenomenon is questioned, rather than its components. The comparative approach that drives the literature thus produces as much doubt as knowledge, since female ejaculation and squirting are not the objects of independent scientific exploration.

In a detailed essay, Kristeva describes abjection as an ambiguous state, rendering something as neither an object nor a subject, but instead an in-between space (Kristeva 1982). Following Freud and the work of Mary Douglas, Kristeva suggests that the social self is constructed mainly through the force of expulsion. Abjection, therefore, is categorised as something that lies outside the social order and boundaries and yet does not cease to challenge them. It is the border line that defines what is accepted and what is outside the limits, but its mere existence challenges these lines constantly (Kristeva 1982, 2–6). The unique status afforded to female sexual fluid, be it squirting or female ejaculation, lies between the known and the unknown, between the male and female bodies, and between the wanted and unwanted. Together, these contribute to the social abjection of the phenomenon, and furthermore the social abjection of the female body as an autonomous object of investigation.

Abjecting ignorance

Scholarship has long established that biomedical knowledge is influenced by social norms, ideologies and power relations. In her canonical article ‘The Egg and the Sperm’, Emily Martin (1991) argues that gender stereotypes and gendered ideologies strongly inform biomedical accounts of human reproduction. However, as the case study of biomedical knowledge of female ejaculation demonstrates, social power relations and gender stereotypes not only shape what we know and how we tell the biomedical story, but also what we cannot know and cannot tell.

In this way, gender power and gender stereotypes shape science and biomedicine not only as social knowledge (Longino 1990), but also as social ignorance. In the case study provided here, the ongoing comparison of the female body to the male’s results in a significant exclusion of potential knowledge production. This exclusion not only positions the female body as inferior to the ‘normative’ male (Anderson 2006), but also results in the abjection of the female body, and in particular, female bodily fluids (Kristeva 1982), marking them as unclean or misplaced (Douglas 2003). As such, while the results of the knowledge-driven ignorance presented in this paper are abjection and exclusion, the objectives of the biomedical knowledge production that initiated them are derived primarily from exactly the opposite. The clinical studies and reviews cited in this paper were intended to shed light on a controversial, understudied feminine phenomenon, to provide additional knowledge, and to bring to the fore the understudied female sexual body. However, deeply rooted gender stereotypes and metaphors that position the male body as the prototype to which other bodies should be compared, have caused the knowledge produced to be limited, vague and fundamentally uninformative.

It is important to note that even though this paper signals the need to rethink the connection between social power and the creation of ignorance that abjects the autonomy of the female body, an awareness of these conditions would not necessarily result in a more objective, ‘clean’ science. Knowledge, and therefore also ignorance, will always be embedded within social relations and social power. But being aware of how social forces shape what we can and cannot know, could enable us to create less biased and more conscious knowledge that is aware of how it is being affected and how it affects social power relation. Finally, as argued by Nielsen and Sørensen (2017), ‘Attention to the ways in which ignorance is (mis)construed and how it works in different settings allows us to develop even more diverse and socially responsible practices within science communication’ (386). Taking ignorance seriously can therefore open up questions about the nature, purpose, limitations and opportunities of science, and help create a more pluralistic and equal democratic deliberation about science and scientific practices themselves (ibid).

Acknowledgements

I am grateful to Gili Hammer and Otniel Dror for their insightful and helpful remarks, to Janet Christensen for her editorial help, and to Culture, Health & Sexuality’s editor and the anonymous reviewers for their time, effort and invaluable comments.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This article is based on research generously supported by fellowships received from The Hebrew University of Jerusalem. They include support from the Department of Sociology and Anthropology scholarship programme, the Brenda Danet Excellence Scholarship, and The Samuel and Lottie Rudin Scholarship Foundation.

Notes

1 The female prostate, also known as the Skene's gland, is also at the centre of controversy regarding its similarity to the male prostate.