So, at the end of October an article came out in the the New York Times titled, "Half the World Has a Clit. Why Don't Doctors Study It?" I kept seeing people post it on social media. Obviously, I was super interested, but I'll be honest, when new clit or lady-gasm related media comes out, I get...I don't know...exhausted, maybe? So, I avoided it for a while. I get worried that as is the case often, I will find they reinforce ideas that seem progressive and are super popular among the sex-positive, educated crowd, but are actually quite scientifically incorrect and backwards. I have to kind of get in the mood for them because I know I'm going to want to write about them in a critical and detailed way. I know that not only will it take a fair amount of time and effort, but it will just be a drag that this shit fake-science is still making its way into high end media outlets where a large chunk of otherwise educated, thoughtful people take it in as if it's settled fact. It's annoying and little depressing, ya know. However, a cousin in New York sent me the link, and I was like, 'alright, it's time. I gotta check this out now.'
And you know what? I was pleasantly surprised because this article really just stuck to the absolutely sensible assertion that there is a lack of care and knowledge related to the location of nerves, which is a huge problem for surgeries, etc. I'm 100% down for getting that info to a wider audience.
It begins by following the story of a woman that had a biopsy around her clit that resulted in damaged nerves to her clitoral glans which seemed to sever her ability to orgasm. It was possibly related to some extremely hard pressure from the doctor's hand put against her pelvic bone to stop some bleeding. When she realized what happened and how permanent it seemed, she talked to all kinds of doctors. They didn't really believe her, and suggested things like hormone creams, that she get over the trauma of the biopsy in her mind, or get an "o-shot" in her vagina (a completely unverified, and frankly silly attempt at helping women with low libido and orgasming). She said the doctors just avoided the topic of her clit all together.
I mean, this so tracks in my opinion. Even though the clitoral glans is absolutely as important to female orgasm as the penis, it is ignored and minimized constantly in discussion about female orgasm. It's bonkers actually. It's similar to if the penis were often only mentioned in discussion of how males come after a long discussion of mental relaxation, overall arousal, hormone balance and all the other erotic spots on the body like the anus and nipples (and vaginal canal - but that doesn't fit in my male body metaphor at this moment), and then only mentioning the penis as just another important erotic area - and if there's real progressive thinking - that 'most' men need penis simulation to come. It's like even though the clit gets name dropped by the sex-positive and progressive professionals, it still doesn't really factor in a deep, real way as the central piece for female orgasm. It's just skipped over. Why would the medical profession be any better? The discussion from her doctors, just like general discussion about female orgasm, minimizes the clit and focuses on those same things that get thrown around to try and justify why women seem to have such a problem reaching orgasm with a partner; hormones, mental strength, and vaginal-related topics. The very first topic that should be discussed is ensuring that the clitoral glans is getting the stimulation it needs. Is there actual, appropriate, physical simulation happening to the clit, and such as in the case above, is the stimulations getting where it needs to go through healthy nerves? These would be the first thoughts given to a male and his penis if orgasms were not happening. All that to say this lack on knowledge, interest and focus on the clit is a whole world problem, so of course it's a medical problem. I very much love that there is more and more push on the medical community, with things like this article, to not be so fucking stupid about it...because that just might trickle down into the rest of the world.
The article goes on to talk about a Dr. Rachel Rubin , who after an internship with Dr. Irwin Goldstein, has focused on the clit in her practice and advocates for other gynecologists' to take more notice as well. She exams women's vulvas and clits when they come in. There are common problems that could be easily helped with this simple practice, such as "clitoral adhesions, which occur when the hood of the clitoris sticks to the glans and can lead to irritation, pain and decreased sexual pleasure." Also, it is noted that, "There have been documented injuries to the clitoris in procedures including pelvic mesh surgeries, episiotomies during childbirth and even hip surgeries. When performed poorly, a labiaplasty — a procedure to reduce the size of the labia minora, and one of the fastest-growing cosmetic surgeries worldwide — can also damage nerves, leading to genital pain and loss of sexual sensation."
I only had one problem with this article, which in the scheme of things is pretty small and nitpicky. There's this 1998 article authored by Urologist, Dr. Helen O'Connell that sometime in the late 2010s got picked up in pop-science media as a scientific article that finally discovered the full structure of the clitoris - as in that there was this huge inner portion that people didn't know about. You might have seen things online showing the outrageous "fact" that the the full structure of the clit wasn't discovered until 1998! Yikes, right? But, it's 100% not true. I have a whole, long-winded, piece showing how that article did not and never claimed to have discovered the inner structures of the clit, and that it actually only asserted that another known structure close to the clit should also be called part of the clit - a still controversial, not settled anatomical idea.
However, TONS of pop-science media refereeing to this article goes even further, and absolutely incorrectly assert that O'Connell article also now allows us to understand where vaginal orgasms come from. It in no way does, and now I've been seeing pop media less referencing the 1998 O'Connell article, and more references to some of her later articles that expand on the work in that 1998 article, but again, don't assert the things pop media says they do. So, when I saw O'Connell's name in this NY Times article, I was worried, and indeed it incorrectly spoke of her 2005 article as "showing that the outer nub of the clitoris — the part that can be seen and touched — was just the tip of the iceberg." As I said, her article did not do that, and she does not claim in the article to have done that because the full clitoral structure was well known for at least a century prior.
I'm happy to say, though, that this NYT article stopped at that first incorrect assertion about the O'Connell article and didn't take it to the place that really infuriate me - very incorrectly asserting it shows us how 'vaginal orgasms' are actually 'inner clitoral orgasms.' All that to say, it was actually quite a delight to see that. It's truly a relief not to read a wildly popular article in a widely respected news outlet that isn't riddled with backwards, uninformed, incorrect lines of discussion about clits and orgasms.
Actually O'Connell, interviewed in the NYT article, was beautifully advocating for better understanding and awareness of nerve structure in the female pelvis from the medical community. "By failing to appreciate this anatomy, she warned, surgeons working in this region risked damaging the sensitive nerves responsible for pleasure and orgasm, which run along the top of the shaft. In procedures like pelvic mesh surgeries or urethral surgeries, 'things are potentially in the crossfire,' Dr. O’Connell said. 'You always need to be thinking of what’s underneath, what’s hidden from view that you’re potentially altering.'"
The article goes on to point out some doctors and advocates that are doing the damn thing. They are investigating female pelvic nerves, relaying information to areas of the medical community about this and showing 'danger zones' for cutting to surgeons. There is advocacy for more information in medical books and medical training, and social media consciousness raising.
If you area able to get a free read or have a subscription to the NYT, I highly suggest a read. Despite my sometimes avoidance of and exhaustion with clit/ladygasm pop science article, this was a good one that gave me some hope. This element of the Orgasm Equality Movement is getting a bit of traction. I mean, a good first step in ladies having more partner orgasms is to, ya know, not accidently sever their clitoral nerves during routine procedures and for gynocologists and urologists to actually care about and talk about the clitoris. Love it.
