clitoris: Definition from Answers.com

Unlike the penis, of which it is usually described as the female homologue, the clitoris does not enjoy an array of nicknames, euphemisms or slang terms. There is even some controversy as to its pronunication, whether this should be clitt-oris or cly-toris; dictionaries vary and some give both as correct (although the Oxford English Dictionary prefers ‘cly-toris’), but this means that there is still a decision to be made, which may cause hesitation in referring to this organ in speech. The derivation of the word is commonly alleged to derive from the Greek ‘Kleis’, meaning ‘key’, but there is some philological debate about this, as discussed in a 1937 article by Professor Marcel Cohen — reprinted by Thomas Power Lowry in The Classic Clitoris (1978).

The anatomy of the clitoris was described in 1559 by Renaldus Columbus of Padua, who claimed that previous anatomists had overlooked the very existence of ‘so pretty a thing’. His primacy was, however, contested by another eminent anatomist of Padua, Gabrielo Fallopio. Although they claimed to have discovered this organ, since antiquity there had been a powerful belief that mutual orgasm was necessary for conception, which suggests that, though unnamed, the clitoris was known to be there. Renaldus had discovered something that had not been named or mapped, but which other people (though not, perhaps, the people he would recognize as colleagues) and other traditions had already known about.

The clitoris is a tiny organ which even the woman to whom it belongs may find difficulty in seeing, except with the aid of a mirror (unless she is very flexible). It may be so concealed as only to come into view when the labia majora — the outer lips of the vagina — are separated. Located above and in front of the urethral and vaginal openings, it is structurally connected to the labia minora (the inner lips of the vagina). The visible glans of the clitoris, which is hooded by a prepuce formed by the meeting of the labia minora, is, however, only the outward and visible manifestation of much more extensive erectile tissue, which forms a padding over the pubic bone. These concealed parts are anatomically continuous with and functionally linked to the vagina. The whole structure is densely packed with nerve endings: although there are a similar number to those of the penis, they are much more concentrated and closer together. It may be noted that, although, anatomically speaking, the clitoris is homologous to the penis, the female genitalia are far more differentiated than those of the male: instead of one organ which conveys sperm and urine, and is the source of sexual pleasure, a woman has three different parts for three distinct purposes. When erotically stimulated, the clitoris becomes engorged and erectile; when a high degree of arousal is reached it retracts, with the effect that it appears to have reduced in size. Vaginal lubrication takes place along with the engorgement of the outer part of the vagina. When sexual excitement reaches its peak, orgasm takes place, with rhythmic contractions of the muscles around the clitoris and vagina. Unlike men, women have the capacity for multiple orgasm without an intervening refractory period.

The appearance of the external glans of the clitoris is very various. In some women it may be quite noticeable and an obvious analogue to the penis, in others it may be small and barely visible. Although these are innate physiological characteristics, the size of the clitoris has been assumed to relate to the sexual activity of the female, and to be excessively developed by masturbation or indulgence in lesbian practices. Successive editions of a standard British textbook of forensic medicine rather gratuitously (since female homosexuality has never been in itself a crime in Britain) included a photograph of a ‘tribade's’ clitoris well into the middle of the twentieth century.

The role of the clitoris in orgasm has been the subject of very heated controversy. Although for centuries it had been known by medical and religious authorities in Europe that titillating the clitoris had a beneficial effect on conjugal relations, rendering them more pleasant and more likely to be fertile, from the later eighteenth century this information apparently became increasingly hidden. Popular handbooks which went on being reprinted in the nineteenth century underwent expurgation and referred, if at all, much more generally to the necessity of mutual caresses and pleasure between the married couple. However, although the arousing role of the clitoris had been recognized, and even that a woman might bring about an orgasm by self-stimulation if her husband failed to give her an orgasm through intercourse, the assumption was very persistent that if women masturbated, they did so with a dildo in order to mimic penetrative intercourse. (Even today, although vibrators are most often used for clitoral stimulation, the large number of the models available vary in shape from the generally phallic to the hyper-realistically penile.) This supposition extended to the idea of women having sex with one another being thought impossible or else involving this substitution. There are some grounds, however, for believing that there may well have been an oral culture, mainly among women, which, if it could not scientifically name and describe the clitoris, nevertheless knew about its significance. This, however, was increasingly eroded by the rise of a print culture privileging published writings (the vast majority by men) above oral information, and by a variety of social changes including greater privacy and greater separation between social classes.

A new ethos of mutual sexual pleasure in marriage arose during the early twentieth century: though shared pleasure had been an ideal in the Victorian era, suppression and ignorance meant that it had not always been achieved even with the best intentions. Authors of marriage manuals emphasized the important contribution of the clitoris to the sexual arousal and satisfaction of the woman, even going so far as to suggest, in some cases, that the bridegroom should give his wife her first orgasm by manual stimulation before proceeding to defloration. Even so, clitoral stimulation was seen as something ancillary to penetrative heterosexual intercourse, which was defined as the central conjugal act.

The clitoris received, as it were, a setback as a result of the wide acceptance and popularization of Freudian psychoanalytic ideas. According to this, clitoral stimulation was immature and masculine in its nature (though it may well be doubted that little girls relate this concealed if sensitive spot to the penis, if they have ever seen a penis), and, to be truly women, women needed to abandon clitoral pleasures and effect a transfer to achieving orgasm vaginally. This theory was contested by a developing school of empirical sex research — and it should be noted that marriage advice manuals continued to stress the importance of clitoral stimulation, at least until the wife's sexual responsiveness was ‘fully developed’ Alfred Kinsey, in his study of the sex life of the American female (published in 1953), noted the vast difference in sensitivity between the vaginal wall and the clitoris and labia minora. (William) Masters and (Virginia) Johnson observed sexual interactions in a laboratory setting, and, on the basis of these observations, which involved various technological devices to measure arousal and orgasm, they concluded that orgasm was always clitoral: even if the clitoris was not being directly stimulated, indirect stimulation was taking place as a result of friction from the pulling on the labia caused by penile thrusting during intercourse. Vaginal contractions were one manifestation of the orgasm produced by the clitoris. These findings came out in 1966, contemporaneously with the enormous social changes which led to the ‘second wave’ of feminism and the short-lived ‘Sexual Revolution’. Women found that this research supplied them with a way of describing experiences which had been neglected or distorted by the masculine assumption that the acme of sexual pleasure consisted of penis-in-vagina thrusting (probably mostly quite uninfluenced by psychoanalytic ideas of the superior maturity of the vaginal over the clitoral orgasm). Works such as Danish author Mette Ejlersen's I Accuse! (British edition 1969) and Anne Koedt's 1970 article ‘The Myth of the Vaginal Orgasm’ made a forceful if anecdotal case for the preceding obliteration of women's actual experience. Shere Hite's more extensive (though methodologically much criticized) survey, published as The Hite Report in 1976, to enormous publicity, revealed the importance of clitoral stimulation to women's sexual pleasure. The notion was disseminated in a range of popular publications, handbooks on women's health from a feminist perspective, works of sexual advice, and also in numerous novels taking advantage of a new explicitness.

However, other sex researchers have contested the conclusion that there is only one kind of orgasm, suggesting that, at least from subjective experience, some women do have orgasms, which they describe as ‘vaginal’ or ‘uterine’ from penetrative intercourse, and that these are qualitatively distinct from those achieved through specific clitoral stimulation. The connotation of immaturity has been lifted from the clitoral orgasm, and there is some evidence that women who prefer vaginal orgasms tend to be more passive, dependent, and anxious. It can be argued that the focus of attention on the clitoris has perhaps obscured the contribution to sexual pleasure and orgasm of the sensitive erectile tissues of the rest of the vulva.

Although the clitoris is such a small and apparently insignificant organ, there are and have been widespread conceptions that it is dangerous and threatening. There are substantial areas of the world today, in Africa and the Middle East, in which clitoridectomy is still routinely practised on ritual and hygienic grounds — though the number of cultures which practice it are far fewer than those in which some kind of circumcision of the penis is performed on boy children or youths in transition to manhood. The practice is deeply embedded in national and religious cultures, and has proved very difficult to extirpate; attempts to do so have caused crises for colonial powers in Africa. While many of the cultures which practice it are Islamic, clitoridectomy is not coterminous with the Muslim world: it is found among other religious groups in the regions in which it is common, and is not practised in all Islamic nations.

Clitoridectomy takes different forms, from a relatively minor removal of a small amount of flesh from the tip of the clitoris to almost complete extirpation, along with other practices such as infibulation and sewing up of the labia. The effect of this mutilating operation on the subsequent sexual life of the women involved is usually assumed to be deleterious in the extreme, although there is a little, perhaps rather anecdotal, ethnographic evidence that some women who have undergone clitoridectomy are nevertheless capable of experiencing orgasm. This may depend upon how much of the underlying concealed erectile tissue remains. The trauma of the operation, performed normally on young girls around the age of 8, without anaesthetic, by traditional practitioners, must be considerable. Subsequent infection and scarring can have long-term implications for future fertility and safety in childbirth. Such operations are regarded as reprehensible and unethical by Western medicine, although there have been cases of private practitioners performing the operation under surgical conditions in the UK for members of cultures in whom it is regarded as an essential attribute of the marriageable female.

However, there is no reason for an attitude of complacent superiority. During the 1860s the British surgeon Isaac Baker Brown performed an unknown number of clitoridectomies at his London Surgical Home. He believed that female masturbation was widely prevalent and the cause of a number of nervous ailments, including epilepsy, a point of view he advanced in his book On the Curability of Certain Forms of Insanity, Epilepsy, Catalepsy and Hysteria in Females (1866). The operation was, however, widely regarded as mutilating and shocking (especially given Baker Brown's rather cavalier attitude towards consent), and in 1867 he was expelled from the London Obstetrical Society and the London Surgical Home was closed. Baker Brown subsequently became insane. Clitoridectomy in Britain never recovered from this and did not become part of the medical repertoire, although it went on being practised in the US, to an extent which it is probably impossible to ascertain, well into the twentieth century. While the excesses of the advocates of ‘Orificial Surgery’, who advocated excising the clitoris as the remedy for a range of ailments, were probably not typical, as late as 1936 Holt's Diseases of Infancy and Childhood was not averse to recommending circumcision or cauterization of the clitoris as a cure for masturbation in girls. These might be extreme options, but there were certainly devices available to prevent girls (and possibly women) gaining access to their clitoris for self-stimulation.

Surgery of the clitoris still takes place. There are, of course, various legitimate medical reasons for operating on this organ, such as various forms of malignancy, but they are fairly rare. These days the clitoris is not, in Western medicine, excised to take away the unruly sexual desires of women, but adjusted to make it more conformable to the demands of penetrative intercourse. It has been observed that, in most coital positions, when the penis is in the vagina, there is rarely direct stimulation of the clitoris as well, without the intervention of hands (or devices such as ‘French ticklers’). Operations have been reported endeavouring to relocate the clitoris somewhere where it will be more likely to receive stimulation from simple penile thrusting, nearer the vaginal entrance. The equivalent to circumcision of the penis has also been performed, trimming back the clitoral hood to expose the glans to increase ‘sensitivity’. Alleged ‘adhesions’ have also been removed. The value of these operations is exceedingly dubious. They reflect a mechanistic approach to sexual functioning similar to the use of vaginal dilators for spastic contraction of the vagina: altering or trying to alter the female genitals to make them conform to the cultural norm rather than recognizing that the cultural norm has ignored the requirements of the female genitalia.

Perceptions of, and attitudes towards, the clitoris, provide a powerful reflection of wider societal attitudes to female sexuality, whether this is seen as so dangerous that it must be eradicated, or simply needing to be brought into a greater complementarity with male sexual needs.

— Lesley A. Hall

Clitoris

The internal anatomy of the human vulva, with the clitoral hood and labia minora indicated as lines. The clitoris extends from the visible portion to a point below the pubic bone.
Gray's	subject #270 1266
Artery	Dorsal artery of clitoris, deep artery of clitoris
Vein	Superficial dorsal veins of clitoris, deep dorsal vein of clitoris
Nerve	Dorsal nerve of clitoris
Precursor	Genital tubercle
MeSH	Clitoris
Dorlands/Elsevier	Clitoris

Pronunciation and etymology

The plural forms are clitorises in English and clitorides in Latin. In slang, it is sometimes abbreviated as clit, which originated in the 1950s. The OED suggests that the pronunciation /ˈklaɪtɒrɨs/ is also used in the United Kingdom, and gives the likely etymology as coming from the Greek κλειτορίς, kleitoris, perhaps derived from the verb κλείειν, kleiein, to shut. The Online Etymology Dictionary states that the etymology of this diminutive is uncertain. Possible etymological candidates are a Greek word meaning "key", "latch", "hook"; a Greek verb meaning "to touch or titillate lasciviously", "to tickle" (one German synonym for the clitoris is der Kitzler, "the tickler"), although this verb is more likely derived from "clitoris"; and a Greek word meaning "side of a hill", from the same root as "climax".^[9] Its Latin genitive is clitoridis, as in "glans clitoridis". In medical and sexological literature, the clitoris is sometimes referred to as "the female penis" or pseudo-penis.^[10]

Anatomy

Embryonic development

Stages in the development of clitoris

During the development of an embryo, at the time of development of the urinary and reproductive organs, the previously undifferentiated genital tubercle develops into either a clitoris or penis, along with all other major organ systems, making them homologous.^[11] The clitoris is formed from the same tissues that would have become the glans and upper shaft of a penis if the embryo had been exposed to "male" hormones. Changes in appearance of male and female embryos begin roughly eight weeks after conception. By birth, the genital structures have developed into the female reproductive system.^[12]

Embryo sex based on external genitalia is apparent to a doctor at the end of the 14th menstrual week, and the sex can usually be identified by an ultrasound after 16 to 18 menstrual weeks.^[13] A condition that can develop from naturally occurring or deliberate exposure to higher than average levels of testosterone is clitoromegaly.

Structure

Human vulva

Human vulva stretched to show externally-visible features of the clitoris in relation to other components: 1. Clitoral hood (prepuce); 2. Clitoral glans; 3. Urethral orifice; 4. Vulval vestibule; 5. Labia minora; 6. Vaginal opening; 7. Labia majora (hair removed); 8. Perineum
MeSH	Vulva
Dorlands/Elsevier	vulva

Researcher Atilla Şenaylı states, "Histological evaluation of the clitoris, especially of the corpora cavernosa, is incomplete because for many years the clitoris was considered a rudimentary and nonfunctional organ. Baskin and colleagues evaluated the masculinized clitoris after dissection and put the serial dissected specimens together using imaging software after Massion chrome staining." This revealed that the nerves of the clitoris surround the whole corpus. It is "known that the subalbugineal layer between the erectile tissue and tunica albuginea is absent in the clitoris, but desmin and vimentin immunoreactivity evaluations in arterial and vein muscle cells of the clitoris are not clear from previous reports".^[14]

The head or glans of the clitoris is roughly the size and shape of a pea, although it can be significantly larger or smaller. The clitoris is a complex structure, with both external and internal components. Projecting at the front of the labial commissure where the edges of the outer lips (labia majora) meet at the base of the pubic mound is the clitoral hood (prepuce), which in full or part covers the head (clitoral glans). Following from the head back and up along the shaft, it is found that this extends up to several centimeters before reversing direction and branching. The resulting branched shape forms an inverted "V", extending as a pair of "legs" known as the clitoral crura formed of the corpora cavernosa. The clitoral crura are concealed behind the labia minora, and terminate with attachment to the pubic arch (according to some),^[15] or follow interior to the labia minora to meet at the fourchette (according to others).^[2]

Associated are the urethral sponge, clitoral/vestibular bulbs, perineal sponge, a network of nerves and blood vessels, suspensory ligaments, muscles and pelvic diaphragm.^[11] The clitoris displays a hood that is the equivalent to the foreskin in men, which covers the glans, and a shaft that is attached to the glans.^[11]^[14]^[16] The corpus clitoridis has two corpora cavernosa with erectile tissue surrounded by dense fibrous tissue around each corpora. These corpora are separated incompletely from each other with a medial located by a fibrous pectiniform septum. Each crus clitoridis is attached to the corresponding ischial ramus.^[14]

The tip or glans of the clitoris alone has more than 8,000 sensory nerve endings,^[16] as much as or more than the human penis, as well as more than any other part of the human body.^[16]^[17] There is considerable variation in how much of the clitoris protrudes from the hood and how much is covered by it, ranging from complete, covered invisibility to full, protruding visibility. An article published in the Journal of Obstetrics and Gynecology in July 1992 states that the average width of the clitoral glans lies within the range of 2.5 to 4.5 millimetres (0.098 to 0.18 in), indicating that the average size is smaller than a pencil-top eraser. There is no identified correlation between the size of a clitoris and a woman's age, height, weight, use of hormonal contraceptives, or being post-menopausal. Recent discoveries about the size of the clitoris show that clitoral tissue extends considerably inside the vagina and that the vaginal walls may in fact be the clitoris, making the clitoris more prominent than the small visible part most people associate with the word.^[3]

Findings and debates

Sexual stimulation

During sexual arousal and orgasm, the clitoris and the whole of the genitalia engorge and change color as these erectile tissues fill with blood, and the individual experiences vaginal contractions. Masters and Johnson documented the sexual response cycle, which has four phases and is still the clinically accepted definition of the human orgasm. More recent research has determined that some can experience a sustained intense orgasm through stimulation of the clitoris and remain in the orgasmic phase for much longer than the original studies indicated, evidenced by genital engorgement, color changes, and vaginal contractions,^[18] although knowledge of the measurement of physiologic parameters of sexual function in women is lacking "and far behind that in men".^[14]

Click here to see a video showing clitoris becoming engorged with blood.

Because the clitoris is homologous to the penis, it is the equivalent in its capacity to receive sexual stimulation.^[11]^[16]^[19] Research into the female sexual response cycle demonstrates that most women (70-80%) achieve orgasm only through direct clitoral stimulation,^[19]^[20]^[21]^[22] though indirect clitoral stimulation may also be sufficient.^[3]^[22]^[23] Alfred Kinsey was the first to harshly criticize Sigmund Freud's theory that clitoral orgasms are a prepubertal or adolescent phenomenon and that vaginal (or G-Spot) orgasms are something that only physically mature females have.^[4]^[8]^[24] Through his interviews with thousands of women,^[25] Kinsey found that most women could not have vaginal orgasms.^[4] He criticized Freud and other theorists for projecting male constructs of sexuality onto women and viewed the clitoris as the main center of sexual response and the vagina as relatively unimportant for sexual satisfaction, noting that few women inserted fingers or objects into their vaginas when they masturbated. Believing that vaginal orgasms are a physiological impossibility because the vagina has insufficient nerve endings for sexual pleasure or climax, he concluded that satisfaction from penile penetration is mainly psychological or perhaps the result of referred sensation.^[4]

Masters and Johnson's research, as well as Shere Hite's, supported Kinsey's findings about the female orgasm.^[4]^[6]^[7]^[23]^[26] Masters and Johnson were the first to determine that the clitoral structures surround and extend along and within the labia. They observed that both clitoral and vaginal orgasms had the same stages of physical response, and found that the majority of their subjects could only achieve clitoral orgasms, while a minority achieved vaginal orgasms. On this basis, they argued that clitoral stimulation is the source of both kinds of orgasms.^[7]^[23] The research came at the time of the second-wave feminist movement, which inspired feminists to reject the distinction made between clitoral and vaginal orgasms. "Men have orgasms essentially by friction with the vagina, not the clitoral area, which is external and not able to cause friction the way penetration does. Women have thus been defined sexually in terms of what pleases men; our own biology has not been properly analyzed," stated feminist Anne Koedt in her 1970 article The Myth of the Vaginal Orgasm. "Today, with extensive knowledge of anatomy, with [C. Lombard Kelly], Kinsey, and Masters and Johnson, to mention just a few sources, there is no ignorance on the subject [of the female orgasm]. There are, however, social reasons why this knowledge has not been popularized. We are living in a male society which has not sought change in women's role."^[8]

Supporting Masters and Johnson's conclusion of an anatomical relationship between the clitoris and vagina is a 2005 study which investigated the size of the clitoris; Australian urologist Dr. Helen O'Connell, while using MRI technology, noted a direct relationship between the legs or roots of the clitoris and the erectile tissue of the clitoral bulbs and corpora, and the distal urethra and vagina. While some studies, using ultrasound, have found physiological evidence of the G-Spot in women who report having orgasms during intercourse,^[27]^[28] O'Connell asserts that this interconnected relationship is the physiological explanation for the conjectured G-Spot and experience of vaginal orgasms, taking into account the stimulation of the internal parts of the clitoris during vaginal penetration.^[3] "The vaginal wall is, in fact, the clitoris," said O'Connell. "If you lift the skin off the vagina on the side walls, you get the bulbs of the clitoris – triangular, crescental masses of erectile tissue." O'Connell and her team were already aware that the clitoris is more than just its glans – the "little hill". They reasoned that it is possible that some women have more extensive clitoral tissues and nerves than others, and therefore whereas many women can only achieve orgasm by direct stimulation of the external parts of the clitoris, for others the stimulation of the more generalized tissues of the clitoris via intercourse may be sufficient.^[3]

O'Connell's findings have been criticized by Vincenzo Puppo, who, while agreeing that the clitoris is the locus of female sexual pleasure, disagrees with O'Connell and other researchers' terminological and anatomical descriptions of the clitoris. "Clitoral bulbs is an incorrect term from an embryological and anatomical viewpoint, in fact the bulbs do not develop from the phallus, and they do not belong to the clitoris: 'clitoral bulbs' is not a term used in human anatomy, the correct term is the vestibular bulbs," stated Puppo. "Gynecologists, sexual medicine experts, and sexologists should spread certainties for all women, not hypotheses or personal opinions, they should use scientific terminology: clitoral/vaginal/uterine orgasm, G/A/C/U spot orgasm, and female ejaculation, are terms that should not be used by sexologists, women, and mass media." Puppo argues that O'Connell et al. "fail to describe" the anatomy of the distal vagina, the differences between lateral and posterior walls of the vagina, and that there are no exocrine glands in the walls of the vagina. He challenges an anatomical relationship between the vagina and the clitoris, saying that the "anterior vaginal wall is separated from the posterior urethral wall by the urethrovaginal septum (its thickness is 10–12 mm)" and that the "inner clitoris" does not exist. "The female perineal urethra, which is located in front of the anterior vaginal wall, is about one centimeter in length and the G-Spot is located in the pelvic wall of the urethra, 2-3 cm into the vagina," Puppo stated. "The male penis cannot come in contact with the venous plexus of Kobelt (situated until the angle of the clitoris) or with the roots of the clitoris (which do not have sensory receptors or erogenous sensitivity) during vaginal intercourse." Puppo did, however, dismiss the orgasmic definition of the G-Spot that emerged after Ernst Gräfenberg, stating that "there is no anatomical evidence of the vaginal orgasm which was invented by Freud in 1905, without any scientific basis".^[10]

Whether or not the clitoris is vestigial or serves a reproductive function has also been subject to debate.^[22] At the 2002 conference for Canadian Society of Women in Philosophy, Dr. Nancy Tuana asserted that the clitoris is unnecessary in reproduction, but that this is why it has been "historically ignored," mainly because of "a fear of pleasure. It is pleasure separated from reproduction. That's the fear". She reasoned that this fear is the cause of the ignorance that veils female sexuality.^[7] O'Connell said, "It boils down to rivalry between the sexes: the idea that one sex is sexual and the other reproductive. The truth is that both are sexual and both are reproductive."^[3] She reiterates that the bulbs appear to be part of the clitoris and that the distal urethra and vagina are intimately related structures, although they are not erectile in character, forming a tissue cluster with the clitoris that appears to be the locus of female sexual function and orgasm.^[3]

Pulled-out clitoral glans

Existence and accuracy in illustrations

The clitoris has been thought of as "discovered" and "rediscovered" through empirical documentation by male scholars repeatedly over the centuries.^[29]^[30] Over a period of more than 2,500 years, some have considered the clitoris and the penis equivalent in all respects except their arrangement.^[2] Realdo Colombo (also known as Matteo Renaldo Colombo) was a lecturer in surgery at the University of Padua, Italy, and in 1559 he published a book called De re anatomica^[31] in which he described the "seat of woman's delight". In his role as researcher, Colombo concluded, "Since no one has discerned these projections and their workings, if it is permissible to give names to things discovered by me, it should be called the love or sweetness of Venus."^[32]

Colombo's claim was disputed by his successor at Padua, Gabriele Falloppio (who discovered the fallopian tube), who claimed that he was the first to discover the clitoris. Caspar Bartholin, a 17th-century Danish anatomist, dismissed both claims, arguing that the clitoris had been widely known to medical science since the second century. Hippocrates used the term columella (little pillar). Avicenna named the clitoris the albatra or virga (rod). Albucasis, an Arabic medical authority, named it tentigo (tension). It was additionally known to the Romans, who named it (vulgar slang) landica.^[33]

This cycle of suppression and discovery continued, notably in the work of Regnier de Graaf in the 17th century^[34] and Georg Ludwig Kobelt in the 19th.^[3]^[35] De Graaf also criticized Columbo's claim.^[29]^[30] O'Connell describes typical textbook descriptions of the clitoris as lacking detail and including inaccuracies, and credits the work of Georg Ludwig Kobelt with providing a most comprehensive and accurate description of clitoral anatomy.^[3] The full extent of the clitoris was additionally alluded to by Masters and Johnson in 1966, but in such a muddled fashion that the significance of their description became obscured. In 1981, the Federation of Feminist Women's Health Clinics (FFWHC) continued this process with anatomically precise illustrations.^[2] Today, MRI complements these efforts, as it is both a live and multi-planar method of examination.^[3]

Modification and mutilation

Main articles: Genital modification and mutilation and Female genital mutilation

The clitoris may be partially or totally removed during female genital mutilation (FGM), also known as a clitoridectomy, or female circumcision. This is carried out in several countries in Africa, and to a lesser extent in the Middle East and Southeast Asia, on girls from a few days old to the age of 15.^[36] Amnesty International estimates that over two million FGM procedures are performed every year.^[37] Removing the glans of the clitoris does not mean that the whole structure is lost, since the clitoris reaches deep into areas of the genitals.^[3]

The largest group requiring surgical genital correction are females with adrenogenital syndrome. Researcher Atilla Şenaylı stated, "The main expectations for the operations are to create a normal female anatomy, with minimal complications and improvement of life quality. Cosmesis, structural integrity, and coital capacity of the vagina, and absence of pain during sexual activity are the parameters to be judged by the surgeon." Atilla added that although "expectations can be standardized within these few parameters, operative techniques have not yet become homogeneous. Investigators have preferred different operations for different ages of patients".^[14] Gender assessment and surgical treatment are the two main steps in intersex operations. "The first treatments for clitoromegaly were simply resection of the clitoris. Later, it was understood that the clitoris glans and sensory input are important to facilitate orgasm," stated Atilla. "The epithelium of the glans clitoridis has high cutaneous sensitivity, which is important in sexual responses. Therefore, recession clitoroplasty was later devised as an alternative, but reduction clitoroplasty is the method currently performed. In this operation, the glans is preserved and parts of the erectile bodies are excised." Problems with the technique, include loss of sensation, sexual function, and sloughing of the glans.^[14] One way to preserve the organ with its innervations and function is to imbricate and bury the glans clitoris, "although pain during stimulus because of trapped tissue under the scarring is nearly routine. In another method, 50% of the ventral clitoris is removed through the level base of the clitoral shaft, and it is reported that good sensation and clitoral function are observed in follow up. However, it has also been reported that the complications are from the same as those in the older procedures for this method".^[14]

In various cultures, the clitoris is sometimes pierced directly. In U.S. body modification culture, it is actually extremely rare for the clitoral shaft itself to be pierced, as of the already few people who desire the piercing, only a small percentage are anatomically suited for it; furthermore, most piercing artists are reluctant to attempt such a delicate procedure. Some styles, such as the Isabella, do pass through the clitoris but are placed deep at the base, where they provide unique stimulation; they still require the proper genital build, but are more common than shaft piercings. Additionally, what is referred to as a "clit piercing" is almost always the much more common (and much less complicated) clitoral hood piercing.

Enlargement may be intentional or unintentional. Those taking hormones or other medications, or both, as part of female-to-male transition usually experience dramatic clitoral growth; individual desires (and the difficulties of surgical phalloplasty) often result in the retention of the original genitalia, the enlarged clitoris analogous to a penis as part of the transition. However, the clitoris cannot reach the size of most cissexual men's penises through hormones. Surgery to add function to the clitoris, such as metoidioplasty or clitoral release, are alternatives to phalloplasty (construction of a penis) which permit retention of sexual sensation in the clitoris.

On the other hand, use of anabolic steroids by bodybuilders and other athletes can result in significant enlargement of the clitoris in concert with other masculinizing effects on their bodies. Temporary engorgement results from suction pumping, practiced to enhance sexual pleasure or for aesthetic purposes.

Additional images

Outer anatomy of clitoris.
Muscles of the perineum.
Sagittal section of the lower part of the trunk, right segment.

References

^ Baskina, Laurence S. et al (January 2006). "A Neuroanatomical Comparison of Humans and Spotted Hyena, a Natural Animal Model for Common Urogenital Sinus: Clinical Reflections on Feminizing Genitoplasty". Journal of Urology 175 (1): 276–83. doi:10.1016/S0022-5347(05)00014-5. PMID 16406926.
^ ^a ^b ^c ^d Chalker, Rebecca (2000). The Clitoral Truth. Seven Seas Press. p. 1. ISBN 1-58322-473-4. http://www.sevenstories.com/Book/index.cfm?GCOI=58322100427350.
^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ ^j ^k ^l O'Connell HE, Sanjeevan KV, Hutson JM (October 2005). "Anatomy of the clitoris". The Journal of Urology 174 (4 Pt 1): 1189–95. doi:10.1097/01.ju.0000173639.38898.cd. PMID 16145367. Time for rethink on the clitoris: Lay summary – BBC News (11 June 2006).
^ ^a ^b ^c ^d ^e Janice M. Irvine (2005). Disorders of desire: sexuality and gender in modern American sexology. Temple University Press. pp. 304 pages. ISBN 1592131514, 9781592131518. http://books.google.com/books?id=uIJXT7ZCTCsC&pg=PA37&dq=Kinsey+criticized+Freud&hl=en&sa=X&ei=jFADT5u0KKWo2wXY9pSeAg&ved=0CD4Q6AEwAg#v=onepage&q=Kinsey%20criticized%20Freud&f=false. Retrieved January 3, 2012.
^ Wayne Weiten, Dana S. Dunn, Elizabeth Yost Hammer (2011). Psychology Applied to Modern Life: Adjustment in the 21st Century. Cengage Learning. pp. 688 pages. ISBN 1111186634, 9781111186630. http://books.google.com/books?id=CGu96TeAZo0C&pg=PT423&dq=&hl=en&sa=X&ei=MwIGT-jxEojU2AWzv5ylCg&ved=0CDwQ6AEwAA#v=onepage&q=false. Retrieved January 5, 2012.
^ ^a ^b Shere Hite: "I was making the point that clitoral stimulation wasn't happening during coitus. That's why women 'have difficulty having orgasms' - they don't have difficulty when they stimulate themselves.
Tracey Cox: "It's disappointing that one of Hite's main messages - that 70 per cent of women don't have orgasms through penetration - is not completely accepted today. Plenty of women don't feel comfortable admitting it, even to themselves, for fear their partners will love them less. But women are far more experimental now." "Shere Hite: On female sexuality in the 21st century". The Independent. April 30, 2006. http://www.independent.co.uk/news/people/profiles/shere-hite-on-female-sexuality-in-the-21st-century-475981.html. Retrieved April 10, 2011.
^ ^a ^b ^c ^d Cairney, Richard (October 21, 2002). "Exploring female sexuality". ExpressNews. Archived from the original on June 29, 2011. http://liveweb.archive.org/http://www.archives.expressnews.ualberta.ca/article/2002/10/3201.html. Retrieved December 21, 2011.
^ ^a ^b ^c Koedt, Anne (1970). "The Myth of the Vaginal Orgasm". Chicago Women's Liberation Union (CWLU). http://www.uic.edu/orgs/cwluherstory/CWLUArchive/vaginalmyth.html. Retrieved December 12, 2011.
^ Harper, Douglas. "clitoris". Online Etymology Dictionary. http://www.etymonline.com/index.php?term=clitoris.
^ ^a ^b Vincenzo Puppo (September 2011). "Anatomy of the Clitoris: Revision and Clarifications about the Anatomical Terms for the Clitoris Proposed (without Scientific Bases) by Helen O'Connell, Emmanuele Jannini, and Odile Buisson.". ISRN Obstetrics and Gynecology 2011 (ID 261464): 5. doi:10.5402/2011/261464. PMID 21941661.
^ ^a ^b ^c ^d Francoeur, Robert T. (2000). The Complete Dictionary of Sexology. The Continuum Publishing Company. p. 180. ISBN 0-82640-672-6.
^ Reinisch, Beasley, June and Ruth (1990). The Kinsey Institute New Report on Sex. St. Martin’s Press. ISBN 0312063865.
^ Heffner, Linda (2001). Human Reproduction at a Glance. Blackwell Sciences, Ltd. ISBN 0632054611.
^ ^a ^b ^c ^d ^e ^f ^g Atilla Şenaylı, Etlik Ankara (December 2011). "Controversies on clitoroplasty". Therapeutic Advances in Urology 3 (6): 273–277. doi:10.1177/1756287211428165. PMID 22164197.
^ Vulva on MedicaLook Human Anatomy
^ ^a ^b ^c ^d Cornforth, Tracee (17 July 2009). "The Clitoral Truth. Interview with author and sex educator Rebecca Chalker.". About.com. http://womenshealth.about.com/cs/sexuality/a/clitoraltruthin.htm. Retrieved 21 April 2010.
^ "I'm a woman who cannot feel pleasurable sensations during intercourse". Go Ask Alice!. October 08, 2004 (Last Updated/Reviewed on October 17, 2008). http://goaskalice.columbia.edu/im-woman-who-cannot-feel-pleasurable-sensations-during-intercourse. Retrieved November 19, 2011.
^ Bodansky, Vera & Steve (2002). The Illustrated Guide to Extended Massive Orgasm. Hunter House. ISBN 0897933621.
^ ^a ^b "'I Want a Better Orgasm!'". WebMD. Archived from the original on 2009-01-13. http://web.archive.org/web/20090113132443/http://www.webmd.com/sex/want-better-orgasms. Retrieved August 18, 2011.
^ Jeffrey Weeks (1985). Sexuality and its discontents: meanings, myths, & modern sexualities. Psychology Press. pp. 324 pages. ISBN 0415045037, 9780415045032. http://books.google.com/books?id=QzkTiK9oQVIC&pg=PA89&dq=&hl=en&sa=X&ei=cv4FT_bSFeu62gXp8KyKAg&ved=0CEQQ6AEwAQ#v=onepage&q=false. Retrieved January 5, 2012.
^ "The amount of time of sexual arousal needed to reach orgasm is variable — and usually much longer — in women than in men; thus, only 20-30% of women attain a coital climax. b. Many women (70-80%) require manual clitoral stimulation..." Joseph A. Flaherty, John Marcell Davis, Philip G. Janicak (1993, Digitized Oct 29, 2010). Psychiatry: Diagnosis & therapy. A Lange clinical manual. Appleton & Lange (Original from Northwestern University). pp. 544 pages. ISBN 0838512674, 9780838512678. https://www.google.com/search?hl=en&noj=1&biw=1024&bih=629&tbm=bks&q=The+amount+of+time+of+sexual+arousal+needed+to+reach+orgasm+is+variable+%E2%80%94+and+usually+much+longer+%E2%80%94+in+women+than+in+men%3B+thus%2C+only+20-30%25+of+women+attain+a+coital+climax.+b.+Many+women+%2870-80%25%29+require+manual+clitoral+stimulation.&btnG=Search&oq=The+amount+of+time+of+sexual+arousal+needed+to+reach+orgasm+is+variable+%E2%80%94+and+usually+much+longer+%E2%80%94+in+women+than+in+men%3B+thus%2C+only+20-30%25+of+women+attain+a+coital+climax.+b.+Many+women+%2870-80%25%29+require+manual+clitoral+stimulation.&aq=f&aqi=&aql=&gs_sm=s&gs_upl=2326483l2326991l0l2328690l1l1l0l0l0l0l0l0ll0l0. Retrieved January 5, 2012.
^ ^a ^b ^c Elisabeth Anne Lloyd (2005). The case of the female orgasm: bias in the science of evolution. Harvard University Press. pp. 311 pages. ISBN 0674017064, 9780674017061. http://books.google.com/books?id=6GFNvA6TvlwC&pg=PA53&dq=en&sa=X&ei=Jg0GT_3QNoqQ2QWL-KSBCg&ved=0CEMQ6AEwADgo#v=onepage&q=false. Retrieved January 5, 2012.
^ ^a ^b ^c Federation of Feminist Women’s Health Centers (1991). A New View of a Woman’s Body. Feminist Heath Press. p. 46. ISBN 0-9629945-0-2.
^ "Difference between clitoral and vaginal orgasm". Go Ask Alice!. December 23, 1994 (Last Updated/Reviewed on March 28, 2008). http://www.goaskalice.columbia.edu/0469.html. Retrieved April 21, 2010.
^ Margaret L. Andersen, Howard Francis Taylor (2007). Sociology: understanding a diverse society. Cengage Learning. pp. 151 pages. ISBN 0495007420, 9780495007425. http://books.google.com/books?id=UILcQZS6Bi4C&pg=PA338&dq=Kinsey+criticized+Freud&hl=en&sa=X&ei=jFADT5u0KKWo2wXY9pSeAg&ved=0CDcQ6AEwAQ#v=onepage&q=Kinsey%20criticized%20Freud&f=false. Retrieved January 3, 2012.
^ "The Hite Reports: What do they say?". hite-research.com. Archived from the original on June 1, 2009. http://web.archive.org/web/20090601230726/http://www.hite-research.com/thehitereports.htm. Retrieved November 19, 2011.
^ "Finding the G-spot: Is it real?". CNN.com. January, 05, 2010. http://www.cnn.com/2010/HEALTH/01/05/g.spot.sex.women/index.html. Retrieved November 7, 2011.
^ Gravina GL, Brandetti F, Martini P, et al. (2008). "Measurement of the Thickness of the Urethrovaginal Space in Women with or without Vaginal Orgasm". J Sex Med 5 (3): 610. doi:10.1111/j.1743-6109.2007.00739.x. PMID 18221286.
^ ^a ^b Laqueur, T. W. (1989) "Amor Veneris, vel Dulcedo Appeletur", in Fragments for a History of the Human Body. No.3 Feher, M., Naddaff, R., Tazi, N. (eds.) New York: Zone; pp. 91–131
^ ^a ^b Harvey, E. (2002) "Anatomies of Rapture: clitoral politics/medical blazons", Signs 27(2) Winter 2002, pp. 315–46
^ Realdi Columbi Cremonensis, De re anatomica, libri XV. Venetiis: Ex typographia Nicolai Beuilacquæ, 1559.
^ "Hos igitur processus, atque eorundem usum cum nemo hactenus animadverterit, si nomina rebus a me inventis imponere licet, amor Veneris, vel dulcedo appeletur." Realdo Colombo, De re anatomica, 1562. Old Latin version in Google Books.
^ J.N. Adams (1982). The Latin Sexual Vocabulary. Johns Hopkins University Press. pp. 97–98.
^ (Tractatus de Virorum Organis Generationi Inservientibus, De Mulierum Organis Generationi Inservientibus Tractatus Novus)
^ (Die männlichen und weiblichen Wollustorgane des Menschen und einiger Säugetiere)
^ Momoh, Comfort. "Female Genital Mutilation", Radcliffe Publishing, 2005, pp. 5–9.
^ <Please add first missing authors to populate metadata.> (30). "What is Female Genital Mutilation?". Amnesty International: 2. doi:ACT77/06/97. http://www.Amnesty.org/en. Retrieved 25 April 2010.

External links

Look up clitoris in Wiktionary, the free dictionary.

Media related to Clitoris at Wikimedia Commons

Time for rethink on the clitoris BBC News Online 11 June 2006
The truth about women Williamson, S; Nowak, R. New Scientist 1 August 1998 pp. 1–5 - the story of Helen O'Connell

Female reproductive system (TA A09.1–2, TH H3.07.01, GA 11.1254)

Internal

Adnexa

Ovaries

Follicles	corpus hemorrhagicum luteum albicans Theca of follicle externa interna Follicular antrum Follicular fluid Corona radiata Zona pellucida Membrana granulosa Perivitelline space

Other	Germinal epithelium Tunica albuginea cortex Cumulus oophorus Stroma Medulla

Regions	corpus/body Uterine cavity Fundus cervix/neck External orifice Canal of the cervix Internal orifice Supravaginal portion of cervix Vaginal portion of cervix Cervical ectropion Uterine horns

Layers	Endometrium Myometrium Perimetrium Parametrium

Ligaments	Round ligament of uterus Cardinal ligament Uterosacral ligament Pubocervical ligament

General	Uterine glands

Vagina

External

Vulva

Labium	Mons pubis Labia majora Anterior commissure Posterior commissure Pudendal cleft Labia minora Frenulum of labia minora Frenulum of clitoris Vulval vestibule Interlabial sulci Bulb of vestibule Vaginal orifice vestibular glands/ducts Bartholin's glands/Bartholin's ducts Skene's glands/Skene's ducts

Clitoris	Crus of clitoris Corpus cavernosa Clitoral glans Hood

Urethra	Urethral crest Lacunae of Morgagni

Other

M: ♀ FRS

anat/phys/devp

noco/cong/npls, sysi/epon

proc/asst, drug (G1/G2B/G3CD)

Human regional anatomy (TA A01.1)

Head

Forehead · Ear · Jaw · Face (Cheek, Eye, Nose, Mouth, Chin) · Occiput · Scalp · Temple

Neck

Throat · Adam's apple

Trunk

Chest (Breast) · Abdomen (Navel) · Back · Pelvis (Sex organs)

Limbs

Upper limb	Shoulder · Axilla · Arm Elbow · Forearm Wrist · Hand · Finger (Thumb · Index · Middle · Ring · Little)

Lower limb/ (see also leg)	Hip · Buttocks · Thigh Knee · Calf · Crus Ankle · Heel · Foot · Toe (Hallux · Long • Third • Fourth • Fifth) · Sole

General anatomy: systems and organs, regional anatomy, planes and lines, superficial axial anatomy, superficial anatomy of limbs

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clitoris

clit·o·ris