Clitoris

The clitoris is a sexual organ that is present in biologically female mammals. In humans, the visible button-like portion is located near the anterior junction of the labia minora, above the opening of the urethra and vagina. Unlike the penis, which is homologous to the clitoris, the clitoris does not contain the distal portion of the urethra and functions solely to induce sexual pleasure. The only known exception to this is in the Spotted Hyena. In this species, the urogenital system is unique in that the female urinates, mates and gives birth via an enlarged, erectile clitoris, known as a pseudo-penis.^[1]

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Pronunciation

The word is pronounced /ˈklɪtɒrɪs/ (listen) or /klɪˈtɔərɪs/ (listen). The plural forms are clitorises in English and clitorides in Latin. In slang, it is sometimes abbreviated as clit, which originated in the 1960s. The OED suggests that the pronunciation /ˈklaɪtɒrɪs/) is also used in the UK, and gives the likely etymology as coming from the Greek κλειτορἰς, perhaps derived from the verb κλεἰ-ειν, to shut. The Online Etymology Dictionary maintains that the etymology of this diminutive is still uncertain noting that many sources take kleitoris “Κλειτορίδ” literally from the Greek "little hill”. Other etymological candidates are key or latch, to touch or titillate lasciviously, to tickle, to be inclined (toward pleasure) and slope, from the same root as climax. It has been noted in German as der Kitzler meaning "the tickler".

Its Latin genitive is clitoridis, as in "glans clitoridis".

Development and formation

At the time of development of the urinary and reproductive organs in embryogenesis the previously undifferentiated genital tubercle develops into the clitoris or the penis, along with all other major organ systems, making them homologous. ^[2]

The head or glans of the clitoris is a simple bundle of 8000 nerve fibers, estimated to be twice the number found in the penis ^[3]making it particularly well-suited for sexual stimulation.

The clitoris is a complex structure that includes the external and internal components. Visible to the eye is the clitoral hood (prepuce), which in full or part covers the head (clitoral glans), shaft and inner lips (labia minora). Inside the body are the legs or clitoral crura, urethral sponge, clitoral bulb (previously referred to as vestibule bulb) and corpora, perineal sponge, a network of nerves and blood vessels, suspensory ligaments, muscles and pelvic diaphragm.^[2] The clitoris extends from the front commissure where the edges of the outer lips (labia majora) meet at the base of the pubic mound to the fourchette.^[4] In humans, the clitoral shaft then extends several centimeters upwards and to the back, before splitting into the two legs, and shaped like an inverted "V", these crura extend around and to the interior of the outer labia.

There is considerable variation with regard to 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 – 4.5 mm (0.10-0.18 in) indicating that the average size is smaller than a pencil eraser. There is no correlation between the size of a clitoris and the person's age, neither to being post-menopausal, nor to height, weight or use of oral contraceptives. Those who have given birth do tend to have slightly larger measurements.

Masters and Johnson were the first to determine that the clitoral structures surround and extend along the vagina, determining that all orgasms are of clitoral origin. ^[5] More recently, Australian urologist Dr. Helen O'Connell 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. ^[6]She asserts that this interconnected relationship is the physiological explanation for the G-spot and experience of vaginal orgasm taking into account the stimulation of the internal parts of the clitoris during vaginal penetration. ^[7] Some individuals who experience orgasm from both direct clitoral stimulation of the glans and vaginal access to the internal bodies may distinguish between them in terms of both the physical and general sensations associated with each.

During sexual arousal and during 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 indicate, evidenced by genital engorgement and color changes, and vaginal contractions. ^[8]

Recognition of existence

For more than 2,500 years the clitoris and the penis were considered equivalent in all respects except their arrangement.^[4] Medical literature first recognized the existence of the clitoris in the 16th century^{[citation needed]}. This is the subject of some dispute: 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 in which he described the "seat of woman's delight". 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."

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 2nd century. Indeed, 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 also known to the Romans, who named it landica. (The Latin Sexual Vocabulary by J.N. Adams Baltimore: The Johns Hopkins University Press, 1982. pp. 95-6.)

This cycle of suppression and discovery continued, notably in the work of De Graaf (Tractatus de Virorum Organis Generationi Inservientibus, De Mulierub Organis Generationi Inservientibus Tractatus Novus) in the 17th century and Kobelt (Die männlichen und weiblichen Wollustorgane des Menschen und einiger Säugethiere) in the 19th.

The full extent of the clitoris was alluded to by Masters and Johnson in 1966, but in such a muddled fashion that the significance of their description became obscured. That same year, feminist psychiatrist Mary Jane Sherfey published an article on female sexuality that described in detail the extensive nature of the internal anatomy of the clitoris and in 1981, the Federation of Feminist Women's Health Clinics (FFWHC) continued this process with anatomically precise illustrations. ^[4] Today, MRI compliments these efforts, as it is both a live and multiplanar method of examination ^[9].

Female genital modification

Main article: genital modification and mutilation

The external part of the clitoris may be partially or totally removed during female genital cutting, also known as a clitoridectomy, female circumcision, or female genital mutilation (FGM); this may be a voluntary or involuntary procedure. The topic is highly controversial with many countries condemning the traditions that give rise to involuntary procedures, and with some countries outlawing even voluntary procedures. Amnesty International estimates that over 2 million involuntary female circumcisions are being performed every year, mainly in African countries.

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 understandably reluctant to attempt such a delicate procedure. Some styles, such as the Isabella, and the Nefertiti 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 (erroneously) 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 and/or other medications 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. 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.

Intersex and transgender people

Intersex people

Further information: Genital integrity

Some intersex infants (who may be genetically XX or chimera) are born with ambiguous genitalia, and are assigned a female gender role by doctors. The doctors often reduce or remove the infant's clitoris, if they view it as being "too large" or "too penile". This procedure is controversial because it destroys nerve endings that are central to the intersex person's sexual satisfaction, and in some cases, can make it impossible for the individual to orgasm. Clitoral reduction in infants is medically unnecessary. Many intersex people protest medically unnecessary genital surgery on infants; asserting that ambiguous genitals are not incompatible with quality of life, and that people have the right to choose whether to elect for cosmetic surgery on their genitals.^[10] Intersex people and their supporters who support ending medically unnecessary surgery on intersex infants comprise part of the genital integrity movement.

Transwomen

Main articles: Vaginoplasty#Neoclitoris and Sex reassignment surgery (male-to-female)

Transwomen who undergo sex reassignment surgery may choose to have their surgeon design a clitoris, using their existing genital tissue. The new clitoris may be referred to as a neoclitoris.

Additional images

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