Clitoris

The clitoris is a smooth round knob of tissue located just above the urethra at the opening of the vagina and is the major site of female sexual stimulation. The word clitoris comes from the Greek kleitoris, meaning "little hill" or "slope," or possibly klei-eo, meaning "to shut." It is sometimes referred to as "clit" in slang, a term that is also used derogatorily to describe a contemptible female. The French call the clitoris a bijou, meaning "jewel," the Russians call it a pokhotnic, meaning "lust," and the Tuamotuan people of Polynesia have at least ten different words for this sexual organ.

PHYSIOLOGY OF THE CLITORIS

Embryologically, the clitoris derives from the same tissue as the penis. The presence of the male hormone testosterone during early fetal development causes this tissue to differentiate into a penis, and the absence of the hormone causes the tissue to develop into a clitoris. Though both organs function to transmit and receive sexual sensation, the penis also contains the urethra, which provides the means for expelling sperm and urine from the body. As the sex researchers William H. Masters and Virginia E. Johnson (1966) point out, the clitoris's only known function is to give sexual pleasure to the woman.

The body of the clitoris consists of a shaft with a glans located at its distal end. Though the average clitoris is approximately 1 inch long and 1/4 inch wide, there is considerable variability in the size among women. There is no connection between the size of the organ and its sensitivity to sexual stimulation. The clitoris contains a rich network of nerve endings and is highly sensitive to both direct and indirect stimulation. Accordingly, during sexual activity, women often prefer indirect stimulation of the organ by stroking the clitoral hood or the mons, the fatty tissue above the clitoral area. Lubrication from the vagina, saliva, or personal lubricant products also helps to improve sensation on the glans by eliminating discomfort caused by direct friction on the sensitive tissue. Like its homologue the penis, the clitoris is composed of erectile tissue consisting of the corpora cavernosa, two spongy masses of tissue filled with numerous tiny blood vessels that become engorged with blood during sexual stimulation and cause the organ to enlarge. Physiologically, the process is similar to that of a penile erection in that the clitoris emerges away from the body, but because of its smaller size, this movement is not always obvious.

The clitoris is covered by a prepuce or clitoral hood (analogous to the male foreskin) that is a continuation of the skin of the upper portion of the labia minora. The clitoral glans (the visible and most sensitive aspect of the organ) may be revealed by parting the labia minora and retracting the hood (it is usually the prepuce that is pierced in what is often mistakenly called a clitoral piercing). Smegma, from the Greek word meaning "that which is wiped off," is a cheeselike secretion that often accumulates under the clitoral hood or around the clitoris and is formed by the deposit of local secretions and sloughed-off skin. It has no known physiological purpose and can sometimes become infected by microscopic organisms that form lumps under the prepuce, and these lumps can make sexual activity painful. This can easily be avoided by retracting the hood during bathing to wash off any accumulated material.

FUNCTION OF THE CLITORIS

During sexual stimulation (through direct genital contact or erotic psychological factors), the clitoris and its surrounding genital tissue experience myotonia (muscular tension or rigidity) and vasocongestion (the pooling of blood in the corpora cavernosa). The accumulation of blood causes the clitoris to swell and the nearby labia to flatten and spread, exposing the clitoris to stimulation. Masters and Johnson describe this early phase of sexual response as the excitement stage. As stimulation continues, the woman enters a plateau stage, an advanced state of arousal that immediately precedes orgasm and is characterized by further vasocongestion and swelling of the clitoris and other external genital organs. As a result, the clitoris shortens and withdraws beneath the clitoral hood. This is sometimes mistaken as a sign of diminished arousal, but in fact it is a physiological manifestation that the woman's sexual response is increasing. Orgasm, the next stage, follows soon after and provides a release of sexual tension. Climax is marked, on average, by three to fifteen contractions or pulsations that occur at close intervals. During the final or resolution stage, the orgasm triggers the release of the pooled blood in the clitoris and other engorged areas. Within five to ten seconds following sexual climax, the clitoris returns to its normal, unaroused state. Though the clitoris may remain sensitive to further stimulation immediately following this resolution, women, unlike men, do not experience a refractory period when they are incapable of experiencing another orgasm. As a result, if sexual stimulation continues, women can become aroused again and achieve multiple orgasms. When orgasm does not occur after arousal, sexual tension gradually diminishes as pooled blood slowly leaves the clitoris and other genital areas.

HISTORICAL AND CULTURAL BELIEFS ABOUT THE CLITORIS

Freudian psychoanalytic theory describes two types of female orgasm: the clitoral and the vaginal. Clitoral orgasms were believed to result from direct clitoral stimulation (such as with masturbation) and were symptomatic of childhood fixation. Vaginal orgasms, achieved through coitus, were thought to signal the passage of the woman to a mature sexuality. Masters and Johnson, who monitored women's sexual response, later refuted this theory. Their findings suggested that female orgasm involves the same physiological events whether the stimulation is clitoral or vaginal. They did note, however, that orgasms achieved through masturbation (especially of the clitoris) were frequently more intense than those reached through coitus alone. This may be the result of the indirect stimulation of the clitoris during coitus (as the thrusting of the penis causes the clitoral hood to move back and forth over the clitoris). Other researchers suggest that there may be three categories of female orgasm—vulval, uterine, and blended—and that the source of stimulation (whether clitoral or vaginal) is not a determining factor in the type of climax.

In the early nineteenth century, physicians used to treat hysteria, a condition named for the Greek word for uterus, hystera, by manually stimulating the clitoris until the woman reached a cathartic release. One enterprising doctor devised a mechanical vibrator to give his fingers a rest and to speed up the time necessary for treatments. Clitorectomies, the surgical removal of the clitoris, were performed in the United States in the nineteenth and early twentieth centuries to cure chronic masturbation or promiscuity in women. Clitorectomies and clitoralplasties (surgical reduction of the clitoris) continue to be performed even into the early twenty-first century in cases in which an infant girl is born with a prominent clitoris, even when there is no other indication other than aesthetic.

In many African and Middle Eastern cultures, especially in Muslim countries including Indonesia, young girls undergo a circumcision that may involve the nontherapeutic surgical removal of portions or all of the external genitalia, including the clitoris, the clitoral hood, and labia (a procedure that would correspond to the removal of the penis as well as other external genitalia in males). Female circumcision also may involve sewing the opening to the vagina closed, leaving only a very small hole for urine and menses to exit the body. Though the practice may have originated in ancient efforts to improve genital hygiene (perhaps by eliminating or reducing the amount of accumulated smegma under the prepuce), there is no medical indication for female circumcision. Nevertheless, the procedure is widely practiced, with roughly 100 to 140 million women having undergone the procedure and an additional two million females circumcised each year. Various groups, including Amnesty International and the World Health Organization, condemn the practice as female genital mutilation (FGM), the most common form being the excision of the clitoris and the labia minora.

Proponents of female circumcision defend the practice, citing the following as deeply held beliefs:

1. It is a traditional rite of passage for young girls into womanhood;
2. It maintains culturally mandated chastity and fidelity by suppressing sexual desire in women;
3. It improves a woman's fertility and survival of the fetus (despite medical evidence that it can interfere with both);
4. The practice is required by the Islamic faith (though female circumcisions were practiced prior to Islam).

While most female circumcisions (80%) are performed on young girls or infants, adult women voluntarily submit to the procedure because of societal beliefs that women with intact genitals are impure. Female genital mutilation may lead to medical consequences including shock, pain, hemorrhage, urine retention, and scarring. In addition, damage may result in urinary incontinence, sexual dysfunction, complications in childbirth, and psychological anxiety and depression.

By the twenty-first century, the clitoris has become a figure in the struggle for women's rights. One of the major focuses of this fight is the eradication of the practice of FGM, a controversial position that has generated counterclaims that efforts to ban female circumcision represents a Western condescension of traditional Islamic beliefs. Women's advocacy groups also assert that the clitoris has been neglected and misunderstood even by Western cultures for centuries, noting that the most important organ for female sexual sensation rarely receives more than a brief paragraph in anatomy or physiology textbooks. Further, they claim that young girls are culturally conditioned to deny their clitorises by well-meaning parents who teach their daughters that they have vaginas but omit the presence of the clitoris even though it is part of the external and visible genitalia. In addition, young girls are commonly taught to wear underpants at night, a practice that subliminally sends the message that the female genitalia is unclean and should not be touched.

see also Orgasm.

BIBLIOGRAPHY

Chalker, Rebecca. 2000. The Clitoral Truth: The Secret World at Your Fingertips. New York: Seven Stories Press.

Masters, William H., and Virginia E. Johnson. 1966. Human Sexual Response. Boston: Little, Brown.

Rathus, Spencer A.; Jeffrey S. Nevid; and Lois Fichner-Rathus. 2005. Human Sexuality in a World of Diversity. 6th edition. Boston: Pearson Allyn and Bacon.

                                            Diane Sue Saylor