The Clitoris: Anatomical and Psychological Issues

ABSTRACT

The anatomy of the clitoris is much larger than commonly believed. Besides the small tip of the clitoris known as the glans, which protrudes in the external genitalia, the crura (or legs) of the clitoris extend 9 cm inside the body, with erectile tissue adjacent to the vagina and urethra. This finding has significance for theories of female sexual responsiveness, including the differentiation of clitoral and vaginal orgasms. It also offers guidelines for preserving erotic response during pelvic surgery in women. The facts of clitoral anatomy, clarified with modern scanning procedures by surgeon Helen O’Connell and colleagues (2005), have been repeatedly discovered, forgotten, and rediscovered, at least since 1844, when the German anatomist Kobelt made accurate drawings. Psychological reasons for why the true anatomy of the clitoris has so often been repressed or misrepresented by anatomists, psychologists, and other scientists are proposed. That most anatomists have historically been men may have led to disregard for precise charting of the clitoris that might lead to greater preservation of female sexual response. Envy by male anatomists of female sexual response may also play a role. Correct anatomical knowledge may significantly alter psychoanalytic theory and practice.

Notes

¹ Vesalius (1564) wrote, “It is unreasonable to blame others for incompetence on the basis of some sport of nature you have observed in some women and you can hardly ascribe this new and useless part, as if it were an organ, to healthy women. I think that such a structure appears in hermaphrodites who otherwise have well formed genitals, as Paul of Aegina describes, but I have never once seen in any woman a penis (which Avicenna called albaratha and the Greeks called an enlarged nympha and classed as an illness) or even the rudiments of a tiny phallus.”

² Contemporary literature in gender and sexuality does not tend to think about the tensions between men and women or masculinity and femininity outside of their relations with other axes of power, such as race; however, it is beyond the scope of this paper to deal with these issues.

³ There is debate in the psychoanalytic literature about whether analysts can and should educate patients (e.g., McWilliams, 2003). It is my view that it is appropriate for analysts to present their view of facts to the patient while acknowledging the limits and uncertainty of the analyst’s knowledge.

⁴ Others are Rycroft (1960) and Samuels (1980), with a drawing of the clitoris.

⁵ There have been enormous changes in public attitudes toward the equality of the sexes during the last half century, yet biases continue to appear in negative reactions and lack of interest among the scientific community toward issues like female ejaculation (Ladas et al., 1982), research into pharmacotherapeutics of sexual excitatory dysfunction among women (compared with men; Segraves and Althof, 2002), and other matters of sexuality.

⁶ Freud, who was knowledgeable about Greek myths, never cited this one.

⁷ Clitoridectomy (removal of the clitoris) is often just part of the kinds of surgeries that are performed on girls, which can also remove external and internal labia and involve suturing the vaginal opening to close it off. These surgeries are known collectively as “female genital mutilation.”

⁸ This resonates with Sherfey (1966), who also noted the power of female sexuality and the defenses it can elicit. Sherfey observed that many anatomists studying nonhuman mammals also avoided an investigation of clitoral anatomy.

⁹ It will be apparent from this paper that I am more of an empiricist than many of my colleagues in sex and gender studies (Blechner, in press). Although I acknowledge the subjective contexts in which empirical findings are situated, I am attentive to the crucial role of empirical data in shaping theory.

¹⁰ See Rees (2013) for a related argument in an interdisciplinary context.

Additional information

Notes on contributors

Mark J. Blechner

Mark J. Blechner, Ph.D., is Training and Supervising Analyst at the William Alanson White Institute and faculty and supervisor at the New York University Postdoctoral Program in Psychoanalysis. His books include The Dream Frontier (Routledge, 2001) and Sex Changes: Transformations in Society and Psychoanalysis (Routledge, 2009). He is former Editor-in-Chief of Contemporary Psychoanalysis and Co-Chair of the International Council of Editors of Psychoanalytic Journals.