Thanks. The 8,000 nerve endings claim isn’t supported by any research on humans. It is the number of nerve endings in the glans of bovine clitorises. It comes from the 1976 book The Clitoris by Thomas Lowry.

However, if people believe the clitoral glans of humans has even an equal number of nerve endings as the penile glans, this would require each dorsal nerve to have an equal number of axons. Given that histological studies show the types and distributions of nerve endings are the same, this would mean the dorsal nerve of the penis and dorsal nerve of the clitoris would be equal in size all the way up to the point of entry to the glans. If this is true, then why is the course of the dorsal nerve all the way to the glans hardly ever shown? Netter was just updated in March of this year (2018).

The point I was trying to make in this article is that vulvar anatomy should be studied more in depth. I wrote it after someone gave me the feedback that they did not understand my original article (the one with the most claps). I’m not sure trying to tell the same story in different ways is productive. But I can’t figure out how to explain it.

When I reach out to journalists to tell them the problem with female genital cosmetic surgeries isn’t that they are being done but that there are no training standards and surgeons are doing surgeries on anatomy they don’t know, they don’t think this is a story. The only story they see is that genital cosmetic surgeries are happening at all. Female genital cosmetic surgeries have been going on for 4 decades and increasing exponentially. Doctors who actually know what they are doing get results. There is no stopping them. The controversy around them is actually just causing professional organizations normally responsible for upholding a reasonable standard of care from getting involved.

So I keep trying to reframe the issue. And it isn’t just about avoiding damage. It should also just be about having a basic understanding of how things work. Female sexual dysfunction is common and it is unreasonable to always attribute it to psychology and hormones. Shouldn’t we want to understand how vulvas work just as much as penises? Or how about half as much?

I think the biggest thing finally driving some motivation to learn this anatomy is increasing demand for trans surgeries. But it is mainly urologists and plastic surgeons doing those (thank goodness). You still have ABOG and ACGME certifying that OB/GYNs are qualified to do labiaplasties and clitoral hood reductions based on OB/GYN residency, where they are not trained and do not generally learn this anatomy. And there is significant financial incentive for OB/GYNs in particular because they make far more doing these than they normally do.