Lesley A. Hall
from Oxford Companion to the Body, further details
©OUP, reproduced here by permission of Oxford University Press
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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 pronunciation, whether this should be clitt-oris or cly-toris, dictionaries vary and some give both as correct (although the OED 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. Like his namesake, Renaldus had discovered something that had been there all the time, if not named or mapped, and which other people (though not, perhaps, the people he would recognise as colleagues) and other traditions had already known about.
The clitoris is, to the outward appearance, a tiny organ which even the woman to whom it belongs may find difficulty in seeing, unless 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 or outer lips of the vagina are separated. Located above the vaginal and urethral openings, it is structurally connected to the labia minora or 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 structures of erectile tissue, which form 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, urine and is the source of sexual pleasure, a woman has three different parts for these 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 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 recognised, 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 most women employ vibrators for clitoral stimulation, a 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, conceived of as either impossible or else involving this substitution. There are some grounds, however, for believing that there may well have been an oral, mainly women's culture, 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 of which were by men, and a variety of other social changes including increasing levels of privacy and class separation.
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, repression and ignorance meant that it had not always been achieved even with the best intentions. Authors of marriage manuals emphasised 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 popularisation 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, though 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 (in probably the majority of cases 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 criticised 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 to describe female sexual experience.
However, other sex researchers have contested the conclusion that there is only one kind of orgasm, suggesting that, at least to subjective experience, some women do have orgasms which they describe as 'vaginal' or 'uterine' from penetrative intercourse, which 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 elided 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 having 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, being found among other religious groups in the regions in which it is common, and not being 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 the subsequent sexual life of the women involved of this mutilating operation 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 eight without anaesthetic by traditiona1 practitioners, must be considerable. Subsequent infection and scarring can have long-term implications for future fertility and safety in childbirth. Such an operation is regarded as reprehensible and unethical by Western medicine, although there have been cases of private practitioners performing the operation under surgical conditions in the United Kingdom 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, to an extent which it is probably impossible to ascertain, in the United States well into the twentieth century. While the excesses of the advocates of 'Orificial Surgery', which 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 cauterisation of the clitoris as a cure for masturbation in girls. These might be extreme options but there were certainly devices available to prevent girl children (and, it is possible, more mature women) gaining access to their clitorises for self-stimulation.
Surgery of the clitoris still takes place. There are, of course, various legitimate medical reasons for operating on this organ, e.g. 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 infrequently also direct stimulation of the clitoris, 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 received 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 recognising 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.
*For further information on contemporary female genital mutilation, see The Female Genital Cutting Education and Networking Project. Back to text
**But in North America (at least) when a child is born with a large clitoris (medically defined as > 3/8 inch stretched length at birth), it is standard practice to remove most of the tissue, in a modified clitorectomy (though doctors no longer use that now disgraced word; now it is called a "clitoroplasty" or "clitoral reduction"). This is discussed on the website of the Intersex Society of North America. Back to text
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