Notes on why this needs to change

Though clitoral tears have been reported in childbirth, there is no literature on the subject of repairing such tears. Considering that about 4 million births occur per year, even if the risk of a clitoral tear is low, this would likely affect a significant number of women.

Similarly, 1 in 2000 women are born with ambiguous genitalia. This translates to about 2000 per year in the US. Treatment is normally done by urologists and/or plastic surgeons. However, urology education is certainly much better in this area, coverage is still not great. Plastic surgery education in this anatomy is definitely lacking.

Data on the number of women who undergo clitoral hood reductions is lacking. However, based on NHS data and considering the much larger population of the United States, as well as based on numbers performed by plastic surgeons (10k), and the number of OB/GYNs who say they would offer these surgeries (77% according to one study), I would bet around 50k of these are done per year in the US. I’d welcome any help getting access to real numbers, though this will be tricky due to a lack of a CPT code.

As transpeople gain wider acceptance, FtM gender-reassignment surgeries become more and more common. I’m not sure what the prevalence for these procedures is, but it seems like the people undergoing these procedures would want there to be detailed surgical anatomy and would want standards in place to keep them safe.

Around the internet (sorry, I only have anecdotal evidence), I’ve seen women talk about issues with their clitorises. They have questions about loss of sensation, clitoral pain, etc. These questions cannot be answered adequately or truthfully by doctors who don’t know anatomy.

Sexual dysfunction is common among women. Many women have difficulty with arousal and orgasm. It is often assumed such difficulties, when present in young, healthy women, derive from psychological issues. But such assumptions are invalid when the physiology and anatomy is not adequately studied. Injuries to the dorsal nerve, including compressive injury from riding a bike, are possible. For every woman who has tried to talk about sexual problems with her OB/GYN, this should be relevant.

It is estimated that 200 million women alive today have undergone female genital mutilation. Most of these cases involve excision of the the glans and some of the distal body of the clitoris. In all cases involving the clitoris, some of the clitoral body remains intact. Reconstruction, which can help women regain some clitoral function, is possible but can only occur when doctors fully understand this anatomy.

Lifetime prevalence of vulvodynia is 10–28% among reproductive-aged women in the general population. Meanwhile, among 430 patients with vulvodynia in one study, 15 had clitorodynia. This would indicate a lifetime prevalence of approximately 0.35-.98%. This may not sound very common, but this translates to 0.550–1.54 million women in the US. How can we expect doctors who don’t know basic neural anatomy to treat this competently?