The thumb may be tucked against the palm or – in a variation on the gesture – extended.
[2] The gesture refers to the sex act of inserting the index and middle fingers into a partner's vagina and the little finger into their anus, the latter of which is presumed to "shock" them.
If the thumb is extended, it refers to simultaneously stimulating their clitoris.
[2] The hand gesture is not necessarily practical for the sex act it represents, however.
[2][3] The standard form of the gesture is known colloquially as "two in the pink, one in the stink", referring to the number of fingers inserted into the vagina and anus.