The History of Gräfenberg

By the time of his death in New York City in 1957, Dr. Ernst Gräfenberg was the most famous German gynecologist in the world, which is a respectable achievement but less than what it takes to have your death noted in a newspaper or medical journal. That’s less surprising when you consider that Gräfenberg (GRAY-fen-berg) spent his life crusading against “the undervaluation of female secrets” in a time when a woman’s orgasmic response hardly mattered in her ordained role as an incubator of children. In his late 30s—after returning from duty as a sanitation officer in World War I, where he saw enough carnage to write seven papers on treating gunshot wounds to the chest and abdomen—Gräfenberg completed a 29-page analysis of the contents of vaginal lubrication. Ten years later, in Berlin, he lectured on using silk placed on a coiled silver ring as a contraceptive, which became known as the IUD and which he hoped would ease female anxiety about sex. In 1933, after the Nazis forced Gräfenberg, a Jew, to give up his position as head of the gynecology department at a Berlin hospital, he didn’t flee, believing himself safe because so many of his patients were the wives of top party officials. But healthy Aryan vaginas couldn’t save him, and the Gestapo imprisoned Gräfenberg on the questionable charge of illegally exporting a rare postage stamp. After lobbying by Margaret Sanger, the founder of Planned Parenthood, the Nazis accepted a ransom for his release.

Gräfenberg immigrated to the U.S., where in 1944 he and another prominent but now largely forgotten sex researcher, Dr. Robert Latou Dickinson, argued in The Western Journal of Medicine for a then-radical contraceptive: a plastic cap placed over the entrance of the uterus to block sperm. As an aside, the men noted some patients had reported “a zone of erogenous feeling” on the anterior, i.e., front, vaginal wall. Gräfenberg continued the investigation while examining patients. In a 1950 issue of The International Journal of Sexology he reported that the urethra (which carries urine from the bladder) seems to be surrounded by erectile tissue similar to that inside the penis. Gräfenberg found the anterior wall in every woman to be more sensitive than any other part of the vagina to pressure from his finger. Many women may not realize the zone exists, he suggested, because in the missionary position a thrusting erection would not hit it unless the woman draped her legs over the man’s shoulders. It would be stimulated, however, if humans consistently had sex in the manner most common among other mammals—coitus a tergo, or doggy style, in which the erect penis can apply pressure to the anterior wall. Further, Gräfenberg observed that stimulation of the area caused many women to ejaculate a clear liquid that wasn’t urine. These “profuse secretions” apparently had no lubricating effect, he wrote, since they did not appear until climax.

And that was that. Gräfenberg’s study was filed away for the next quarter century—and it might have gathered dust for a while longer but for the curiosity of a 49-year-old widow named Josephine Lowndes Sevely. Following the death of her husband, Sevely enrolled at Tulane University to pursue a degree. One day in spring 1976 she was listening to a biology professor describe the work of sex researchers Alfred Kinsey and Masters and Johnson. These respected scientists, the instructor explained, had identified the clitoris as the sole source of female sexual pleasure and ejaculation as the sole province of men.

Sevely was taken aback. That’s not quite right, she thought. Glancing around at her much younger classmates, she wondered, Do they believe this?

When the professor, a fungal geneticist named Joan Bennett, assigned the class to write term papers, Sevely already had a topic in mind. A few weeks later, Bennett found herself immersed in and deeply impressed by Sevely’s report, in which the English literature major offered a parade of historical references to vaginally induced orgasms accompanied by the release of fluid. Sevely’s first citation was the work of Dutch anatomist Regnier de Graaf. His 1672 textbook, New Treatise Concerning the Generative Organs of Women, contains 15 chapters filled with descriptions and drawings of female genitalia, including the membranous lining of the urethra, which he called the female prostate. “The function of the prostate,” he observed, “is to generate a pituito-serous juice which makes women more libidinous with its pungency and saltiness and lubricates their sexual parts in an agreeable fashion during coitus.” He added, “It should be noted that the discharge from the female prostate causes as much pleasure as does that from the male prostate,” which produces a milkywhite fluid that accounts for 25 percent of semen. Women can be enticed to this pleasure, he said, by “frisky fingers.”

Bennett gave Sevely an A+, wrote her a long note of encouragement and told her she thought the paper should be published. That fall Sevely began graduate studies at Harvard, expanding her research and soliciting feedback from sexologists such as John Money in Baltimore and Dr. William Masters in St. Louis. Bennett helped prepare the material, and in February 1978 The Journal of Sex Research published J. Lowndes Sevely and J.W. Bennett’s “Concerning Female Ejaculation and the Female Prostate,” followed by 38 references. They included Gräfenberg’s study, which Sevely first learned about from a citation in Kinsey’s 1953 best-seller Sexual Behavior in the Human Female but which Harvard Medical School librarians had some trouble tracking down. Reporters began calling Sevely about this amazing “new” erogenous zone, and the publicity caught the eye of Edwin Belzer Jr., a professor of health education at Dalhousie University in Halifax, Nova Scotia. He suspected from personal experience that many women who complained of incontinence during sex (and who were sometimes “fixed” with debilitating surgery) were not expelling urine but had, prior to Sevely and Bennett’s review, accepted the dismissive authority of Kinsey and Masters and Johnson. Soon after, he visited Albuquerque to catch up with colleagues from his days teaching at the University of New Mexico. When they asked what he was up to, Belzer explained his interest in the puzzle of female ejaculation. A graduate student who happened to be listening asked if they could meet privately. Over coffee at the student union, she explained how, to satisfy her own curiosity, she had on numerous occasions taken pills that contain Urised, a medical dye that turns urine blue. She would then masturbate by stimulating the front wall of her vagina. The fluid that stained her sheets at climax had either no color or a slightly bluish tinge. “It was her report that convinced me this was no unicorn hunt,” Belzer says.

And then the dam broke. In New Jersey sex researchers Beverly Whipple and John Perry had examined a number of women who complained of urinary incontinence but who had pelvic muscles far too strong to account for it. They had followed up with a study in which doctors or nurses examined the vaginas of 400 women to determine if they had any sensitivite spots; every woman reported an area on the anterior wall. Belzer, who had retrieved each source cited by the Tulane researchers, heard Whipple and Perry speak, in turn, at a conference; a week later he mailed them a copy of Gräfenberg’s paper. Whipple and Perry were astounded. Gräfenberg had identified the same sensitive area women visiting their lab were describing to them. Because it lies deep within the vaginal wall rather than on its surface, the area requires firm, rhythmic pressure and is usually not sensitive unless the woman is aroused, when it swells to the size of anything from a small bean to a half dollar. It’s difficult for a woman to find on her own unless she is squatting. Because of its proximity to the bladder, putting pressure on the area will make a woman feel as if she has to urinate. That may discourage women from exploring or prevent them from enjoying a vaginal orgasm.

As they prepared their “evidence in support of a new theory of orgasm” for the February 1981 issue of The Journal of Sex Research (Belzer would contribute a report in the same issue on “orgasmic expulsions”), Whipple and Perry decided to honor Gräfenberg for his discovery. The world’s most famous dead German gynecologist would no longer be overlooked. In fact, he would have his own spot in history, his name on—and behind—the lips of millions of women.

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