This is how I feel about how clitoral neural anatomy is still omitted from OB/GYN literature.
This has wide reaching effects. It means that OB/GYN treatment of female sexual dysfunction is not informed by an adequate understanding of how the clitoris works or how to diagnose physical causes of dysfunction. It means that they are ill-equipped to safely repair injuries, treat clitoral cysts, treat issues that can arise with piercings, etc. It means any procedures in this area put patients excessively at risk.
I do not understand why other women don’t care about this and don’t see it for the obvious gender inequality issue it is. Even female OB/GYNs are not interested. Even women who care about educating laywomen about the anatomy of the clitoris are apathetic about this gap in medical education.
My clitoris was denervated in a clitoral hood reduction performed without my consent during a labiaplasty, due to this ignorance. I had been told my surgery carried no risk to sexual function. After my surgery, I was told my perceived loss of clitoral function “couldn’t have happened.”
Having dissected clitorises myself with my plastic surgeon father, I know just how vulnerable the dorsal nerves of the clitoris are to potential injury, as they travel relatively externally, just under the hood, along the clitoral body. Unfortunately, most surgeons doing genital cosmetic surgery (or surgery to correct hypertrophy — approved by ACOG even for women under 18) do not know this.
To this day, there are no training standards for labiaplasties and clitoral hood reductions. Most surgeons doing them, especially the OB/GYNs, are doing surgeries they are not trained to do on anatomy they do not know. This is effectively sanctioned by ACOG, ABOG, and ACGME.
It has been 14 years since my surgery, and despite my efforts, nothing has changed to protect other patients from the harm I suffered. It is as predictable and preventable today as it was then. And I’m getting emails from women who this just happened to.
The standard of care for vulvar cosmetic surgery is lower than for any other cosmetic surgeries. Nowhere else do you see surgical anatomy so disregarded in the literature. It reads as if vulvas are less important than ears, noses, breasts, eyelids, etc.