Healthy Sex: My Homage to the Clitoris
It’s Time to Be Proud of the Clitoris!
This is my little tribute to the wonderful clitoris!
For too long the clitoris has been misunderstood, misrepresented, and neglected in medical literature and public knowledge, and also by individuals.
By neglecting this organ, we neglect sexual pleasure for half of the population which is unfair when we know sexual pleasure is intrinsic to human existence and serves as an important factor for quality of life.
In medicine the vulva (everything visible on the outside) is often treated as a porthole to the ‘important stuff’, the cervix and the womb.
Too little attention is paid, or instruction given, on how to properly examine the vulva.
Accurate depictions of the clitoral anatomy are often absent from many medical textbooks.
Our current knowledge? Could do better!
Although we have come a long way over the last few decades in becoming more ‘clitorate’, the lay opinion of this organ is often as ‘a small blob of sensitive tissue on the outside of the body’, illustrated by some of the slang terms for the clitoris such as ‘butter bean’ or ‘love bud’.
There is still a lack of education and knowledge of genital anatomy as shown by a ‘YouGov’ survey in 2019 revealing that a third of men and women could not label where the clitoris was located on an anatomical diagram.
The vagina and the urethra interestingly fared even worse in the labelling exercise revealing nearly half of women were unsure about the location of the vagina with just over half correctly labelling the urethra.
Historical errors have not helped
We are only ever as knowledgeable as our teachers and so it is important to consider how our history and society has influenced our ideas and beliefs over time.
We know that references to the clitoris can be found in ancient Greek, Persian and Arabic texts but it was not until the 16th Century that the clitoris was described in relation to sexual pleasure.
Sadly, due to social stigma associated with female sexuality, the structure and function of the clitoris has been censored by anatomists throughout history.
In the 16th Century the anatomist Vesalius claimed that the clitoris did not exist in healthy cisgendered women, only in hermaphrodites.
This widely accepted misinformation lead to clitoridectomy’s (removal of the clitoris) for many cited reasons including masturbation, heavy menstruation, depression, epilepsy, nymphomania and other mental health conditions, with these practices continuing as late as the 1950’s in the UK.
If masturbation could result in your clitoris being removed, it was not surprising that riding astride a bike in the Victorian era caused such distress and concern; the concern that women may masturbate themselves into a state of euphoria did not appeal to the men of society!
Fast forward a few decades and the story does get better!
What we see is the tip of the iceberg!
In 2005 Helen O’Connell, an Australian Urologist, published the ground-breaking study describing our current understanding of the clitoris using cross-sectional imaging.
This 3 dimensional, and mainly internal organ, is much larger than most people expected measuring up to 10cm from tip of the glans to the end of one crus, or leg.
The clitoris, often shown on an anatomical diagram of the vulva and what can be stimulated externally, is the glans clitoris, equivalent to the glans penis.
There are now accurate depictions of the full clitoral structure available to view by doing a quick google search!
Another piece of clitoris research by Uloko, Isabey and Peters in 2023 looked at the number of nerve endings in the human clitoris.
Before this research came out, I had heard, on social media, the rallying cry that there were 8,000 nerve endings in the glans clitoris, twice that of the glans penis no less!
As it turns out, this number was estimated from a bovine model, research done on a cow!
Uloko, Isabey and Peters showed via research on human clitoris from people going through gender affirming surgeries that there are over 10,000 nerve endings. Far more than previously thought. This can only be a bonus!
Despite recent advances, however, there still remains a gap in our fundamental knowledge of this organ, with research on the glans penis outstripping that of the clitoris by 20-1.
That hits the G-spot
We are still unsure if the ‘G-spot’, named after the anatomist Grafenberg who described an erotic zone on the anterior wall of the vagina in the 1950’s, is part of the clitoral network or not, although most feel it likely to be so.
One of the reasons female sexuality and female anatomy has been so neglected compared to the male is because the cis-gendered male sexual pleasure has always been the forefront of focus throughout history.
Pleasure for other groups has often being associated with shame, control, and oppression.
Even considering the origin of the word ‘Vagina’ from the Latin for ‘Sheath’ or ‘scabbard for a sword’ would indicate that its purpose is to ‘house’ the mighty penis!
This subscribes to the heterosexual script of penile penetration of a vagina being what most people still view as ‘sex’.
This is a view that we need to rethink.
Orgasm Gap
What some may not know is that most people with vulval anatomy do not orgasm from penetration alone, they need clitoral stimulation to climax, and lots of it!
When women are not aware of this fact it can lead to sexual performance anxiety and feelings of inadequacy.
Some may resort to faking climax which often makes the problem worse as it results in the same sexual script becoming ingrained as the ‘status quo’.
Although I do not think there should be any pressure put on those with a clitoris to reach orgasm, it is interesting to look at the data on the ‘orgasm gap’.
Most people (95%) can orgasm alone during solo sex. When it comes to partnered sex, men maintain this percentage whether in long term relationships or in casual sex. Heterosexual women are a different story with only 66% reporting orgasming regularly in long term relationships, dropping to 20% in casual sex.
The fact that ‘women who have sex with women’ climax about 90% of the time in partnered sex, indicates that there is some breakdown in communication about what is needed and desired in some heterosexual relationships from the female perspective.
To empower women to embrace their sexuality and their bodies we need better sex education and freedom from judgement.
When I bring up the topic of masturbation in my clinic with a man it is often welcomed with open conversation, yet sadly the opposite is often true with females.
In our society it is almost presumed that those with a penis will masturbate but it is still sometimes considered taboo for women.
I believe there should be no shame in masturbation for either sex and it is important to remember that pleasure is a wonderful and important thing for everyone.
Pay homage to the clitoris!
So, in summary, to pay homage to the clitoris we need to understand this organ better which requires further medical research.
This is essential to prevent damage to clitoral nerves during surgery, to understand the impact of hormones on this organ and to also ensure that the trans communities, who have been similarly neglected to cis women, can have surgeries to optimise sexual pleasure. There also needs to be better education for health care professionals on clitoral anatomy and understanding. I would dearly love to see better education about the subject of sexology for all.
On an individual level we need to explore and experiment with what brings us pleasure so we can understand our own bodies better. It is important to communicate our likes and dislikes with our partners and change the sexual script if it is not working.
Dr Naomi Sutton is a Consultant Physician, Integrated Sexual Health Services and FPA Ambassdor. Graduating from Sheffield Medical School in 2003, Naomi starred in E4’s ‘The Sex Clinic’ which helps young people get their sex lives back on track, as well as C4’s ‘Steph’s Packed Lunch’.
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