Abstract
Given that cisgender men’s bodies are considered the medical standard, how is it that there is no “guynecology” to parallel gynecology? Why do we know so little about how men’s health affects reproductive outcomes? And, critically, what are the consequences of this “non-knowledge”? These questions are the springboard for Rene Almeling’s GUYnecology: The Missing Science of Men’s Reproductive Health. Drawing on interviews and extensive archival research, she answers each across centuries, with impressive detail and care. Over the course of eight conceptually capacious but tightly written chapters, Almeling argues convincingly that historical and contemporary understandings of gender as biological and binary work to reify reproduction as the exclusive domain of women’s bodies. The result, she writes, is a profound lack of knowledge about men’s reproduction, with concrete and diverse implications for men’s health and reproductive outcomes. While this argument will likely be of particular interest to scholars of gender, masculinities, medicine, and reproduction, Almeling also draws on theories of culture and knowledge to make sense of her data in ways both innovative and deeply generative.
The book unfolds in three sections, nodding to the sociology of culture as it traces three aspects of biomedical knowledge about men’s reproductive health: its production, its circulation, and its reception. Almeling first presents the history of men’s reproductive healthcare provision as a medical field, with particular attention to the late 1800s and the late 1960s—two periods when it nearly became a medical subspecialty. Drawing on historical record and science studies scholarship on patterned areas of ignorance, she argues that the fact that this subspecialty did not manifest is the foundation of today’s “non-knowledge” about men’s reproductive health. The absence of professional scaffolding and institutional support, she suggests, rendered production of this kind of knowledge nearly impossible. Almeling next argues that the scant knowledge that does exist circulates only minimally. She focuses specifically on paternal effects, the relatively new study of how men’s health affects reproductive outcomes. Through an extensive review of biomedical research and news outlets, consumer websites, and formal statements from public health organizations, she demonstrates how recent and scarce this research is, and how minimally it has circulated to the broader public.
Finally, Almeling turns to public reception of such research. Her 55 interviewees, asked how they conceptualize men’s role in reproduction, emphasized participation in sexual intercourse, provision of sperm, and breadwinning, almost entirely eliding paternal effects. Almeling, prepared for this response, then presented them with a leaflet on the topic, eliciting broad surprise at what they generally received as entirely new information. The men emphasized their desire to change their health and reproductive behavior in response. Yet, critically, they also identified several structural barriers to their own participation, which Almeling argues is a telling concern: men, like women, cannot mitigate structural and environmental health risks through individual actions alone.
GUYnecology makes a compelling case that the absence of knowledge about men’s reproductive health stems from lack of professional association infrastructure, that what knowledge does exist is minimally circulated, and that the result is a dramatic lack of general knowledge. For its incredible wealth of information and long historical reach, some might critique GUYnecology for choosing breadth over depth. Almeling makes a clear and decisive case for this decision in the book’s introduction, however, where she argues convincingly that this approach is necessary in areas of inquiry about which very little is known. Her absorbing storytelling and her analytic distinction among the production, dissemination, and reception of knowledge, moreover, neatly organize what could have been an unruly corpus of data into a well-defined and compelling narrative.
The empirical and theoretical contributions Almeling makes in GUYnecology are a welcome addition to research on reproductive healthcare and on masculinities—two fields that, she notes, rarely address one another directly. Both popular audiences and academics—particularly those interested in gender, culture, medicine, or reproduction—will likely find the book useful and stimulating. Its engaging style and accessible approach render it appropriate even for undergraduate courses, but it has the theoretical heft to keep more advanced readers likewise engaged. In its core argument that knowledge and non-knowledge about reproductive health stem from binary and “opposite” conceptualizations of gender, GUYnecology: The Missing Science of Men’s Reproductive Health is a critical contribution to our understanding of men, masculinities, and reproduction.