Modern medical textbooks actually contain less detail on clitoral anatomy than they did in the 19th century. The most detailed illustrations to date are from 1844.
The main challenge with vulvar anatomy and physiology isn’t even getting the research conducted. Much has already been done. Lepidi and Di Marino’s Anatomic Study of the Clitoris and Bulbo Clitoral Organ is very comprehensive, for example. But though published in 2014, it didn’t get cited in any English-language medical journals until this year. I’d like to think it’s because I was spamming doctors with it. I wanted them to learn the course of the nerves shown in these photos. Normally textbook anatomy stops around “1.”
Some have changed slightly since I first started looking into this in 2008-2010. In 2010, I wrote a letter to an OB/GYN who cut the dorsal nerve of my clitoris in a clitoral hood reduction performed without my consent, asking for his help improving OB/GYN education. He refused and told me he stayed far away from my clitoris though I have visible scars. The problem is the proximal clitoral hood is shaft skin and the nerves are just underneath, traveling above the clitoral body. As of 2010, there were two adult studies (Vaze, O’Connell) that described the course of the dorsal nerve of the clitoris but they did not show it. I had to refer to the literature on the dorsal nerve of the penis to figure out what was going on.
It took me a long time to be vocal about this problem I have known about for a long time. Though it has been 8 years since I first tried to do something about it, little as changed. Williams Gynecology and Williams Obstetrics show the dorsal nerve of the clitoris now in rudimentary detail, but it is not in any other OB/GYN textbooks. Netter was finally updated this March (2018). It is still omitted from most anatomy textbooks.
Most OB/GYN textbook authors are not receptive. They tell me they don’t think they have room or they ignore me. ABOG insists it is already in the textbooks when it isn’t. They refuse to add it to board exams. When I asked one residency program to teach it, they contacted their legal counsel to make sure they can’t get sued for not teaching it.
This is the most recent version of Netter, which is really great progress.
I guess I should be happy about this. The challenge from here is to get this detail into all major OB/GYN textbooks and to get the course of the dorsal nerve described in the text as well. It is also a challenge to get female genital cosmetic surgeons to take note of this anatomy, which is never mentioned in peer reviewed literature on cosmetic surgeries that put it at risk.
But why can’t we have illustrations like this for the clitoris? I know it is small, but so are eyelids.
