Dealing with resistance from OB/GYNs at the ACOG convention and “clit feminists”

I wrote this in anger, so it isn’t great, but I don’t want to take it down.

At this point, I have emailed the board members of ABOG, the director of the ACGME OB/GYN committee, leadership at ACOG, 20+ textbook authors, and 100+ other OB/GYNs, who I selected due to leadership roles or alleged interest in female sexual health. I also emailed most of OB/GYN faculty at UCSF (looking for an excuse to move back to SF) with minimal luck getting them to acknowledge any problem or support the inclusion of detailed clitoral anatomy in their literature and on board exams.

So far only the plastic surgery department at UTSW are supportive. The plastic surgery residents readily acknowledge they don’t know this anatomy well and want to learn. This is in stark contrast to reactions I’ve gotten from most OB/GYNs. OB/GYNs are supposed to be devoted to women’s health. How can they care so little about vulvar anatomy?

One, who an old college professor connected me with, was supportive after I sent multiple emails. She suggested I hire an illustrator. Right, because this is my job. Most simply ignore me. My biggest OB/GYN ally essentially tells me he has given up trying to change anything because it’s a losing battle.

I tried handing out these flyers at an ACOG convention, and I wish I’d had a hidden mic or hidden camera. One literally told me this anatomy was not relevant to his practice.

None of the OB/GYNs who said they wanted to help ever emailed me. Several explained how they just shouldn’t have to know this anatomy, how ACOG actually opposes these procedures (though their committee opinions literally say “may be medically indicated” even in women under 18), how it isn’t their problem women are getting elective procedures they “shouldn’t” be getting (maybe because they trust ABOG when they certify OB/GYNs are qualified), how this just isn’t that important and they have other problems to worry about. The ones who agreed seemed to think they just couldn’t do anything about it, and I suppose I failed to give them an action to take.

I am so frustrated.

Even women who call themselves “clit feminists” would not help. They kicked me out of their Women of Sex Tech group for being “combative” when I had to argue why this is a real problem. They told me no one would ever take me seriously unless I published a peer-reviewed article. One insisted “we don’t have enough sonograms!” But all you need is a cadaver and a knife to dissect the giant, easily visible nerves of the clitoris. My plastic surgeon father says they are as large as the nerves in your finger and larger than the facial nerves they cover in depth.

How can people who claim to care about women’s sexual health be so apathetic about the exclusion of clitoral neurovascular anatomy?

I’ve also emailed a lot of journalists. What journalists want are victims. The more victims there are, the more important it is. It isn’t a big deal if doctors are doing surgeries they aren’t trained to do on anatomy they don’t know unless we have enough mutilated people speaking up about it. I can’t imagine anything someone would want to be speak up about less. Luckily, one awesome journalist is now pitching this story.

The thing is it’s not even just about avoiding harm. These nerves look big enough, if damaged, to surgically repair. If a woman has a straddle injury or a tear during childbirth that damages the dorsal nerve, wouldn’t she want it repaired? Eh, probably not because female orgasms aren’t important. Women just need to feel pretty.

I emailed some 3D anatomy model companies. They said I can pay them to add anatomy that should already be included. They at least acknowledged it was missing. That was nice of them.

I was thinking I could 3D print some kind of giant anatomically accurate sculpture based on cadaver dissections. And maybe I could display cross sections and all the other views that simply do not exist for the clitoris behind it. This could be some kind of science or art exhibit somewhere maybe. Then I could have a stack of all the most popular OB/GYN textbooks sitting next to it. If I could get enough smart people to engage with my “art,” maybe it would register that there is a problem.

We have come so far in acknowledging that female sexuality is important. We talk about female desire and female orgasms. We talk about women asking what they want in bed. We talk about the superficial anatomy. We even talk about the bulbs and crura (I’m still waiting for the media hype around the penis being much bigger than we thought because it obviously has a bulb and crura too). We insist the clitoral glans has double the nerve endings of the penile glans even though this is not supported by any research on humans. The point of this is supposed to be that female sexual function is important.

So why don’t we care how it works? The literature on male sexual function is all about how it works. The literature on female sexual function is about emotions.