Why is there no anatomy of female sexual function?

Women have been making tremendous strides in recent decades. Even female sexual health and orgasm are considered important. However, the narrative around female sexual function and dysfunction is dominated by psychological considerations. In line with traditional gender stereotypes that women are fundamentally emotional and not sexual, the anatomy and physiology of female sexual function remain neglected.

I’ve been trying to talk about this, but many people continue to not really get it. Because the lack of regard for vulvar anatomy is highly inconsistent from modern views that female pleasure and orgasm are important, I think it needs better explaining.

One way to see this problem is to look at how important doctors consider the anatomy of the penis to understanding male sexual function and dysfunction, as well as all other functional body parts. After all, the reason anatomy is taught in the first semester of medical school is because it is so fundamental to understanding how the body works.

A google search for “dorsal nerve of the penis” will pull up countless images like this one.

I like this one in particular because it says, “Anatomy of Erectile Dysfuntion.” The implication is that understanding anayomy is critical to understanding function and dysfunction. When the penis isn’t working right, doctors consider what could be wrong with it physically. Understanding how the penis works is fundamental to male sexual medicine. For this reason is an extremely large volume of research on the anatomy and physiology of the penis.

Imagine if a diagram of “Anatomy of Erectile Dysfunction” instead looked like this:

Currently, this is the equivalent of what doctors learn of the anatomy of female sexual dysfunction, at least where the clitoris is concerned. Can anyone see the problem now?

As a starting point for understanding penile dysfunction, doctors start with the anatomy. They start with nerves, vasculature, biomechanics, etc. This is the standard approach for understanding problems with all functional organs of the human body, except the clitoris.

Why don’t doctors care how the clitoris works?

I think, at this point, the public can all agree on the following:

1. Female sexual pleasure and orgasm are very important to female health and quality of life.

2. Women have just as much right to sexual pleasure and orgasm as men.

3. Female orgasms are just as important as male orgasms.

Can we commit to agreeing on 1–3 or are we not there yet? On one hand, I see people say they believe the exchange of pleasure in sexual encounters should be equal. But many of these same people continue to be apathetic about doctors not knowing vulvar anatomy. If we all actually believed that female pleasure and orgasm was equally important, wouldn’t we expect equal coverage of vulvar anatomy and physiology?

Once a medical student told me, “Detailed vulvar anatomy is not covered [at UTSW] because female orgasm isn’t as medically relevant.” Where can we start then? Can we say female orgasms are half as important? If we could just say half, and follow logically from there, we could change medicine tremendously. If female orgasm is half as important, then the anatomy of female orgasm should receive half the coverage.

Do we have even half as much right to sexual pleasure as men? If we do, shouldn’t we be outraged?

Sexual dysfunction is actually more common in women than in men. How can we expect to fix it if we don’t understand how it works? How can we trust doctors to perform safe surgery or diagnose problems? It certainly is easy to write women off as emotional and our sexuality too difficult to understand. Even women seem invested in keeping things mysterious. But shouldn’t the healthy functioning of our vulvas be considered just as important as the functioning of our other organs? And even if we really are a bunch of emotional basket-cases (I’d like to think we are not), can we consider the anatomy of our sexual function even half as important?

So … half?

I’m realizing that image I posted has copyright protections actually printed on it. I’ll have to find other examples. In the meantime, here is the image accompanying the WebMd article, “How the Penis Works.”

The level of anatomy covered in this article is considered relevant even to laypeople. Yet clitoral anatomy is never covered in this depth in gynecologic surgery textbooks. I have two questions for WebMd.

  1. Where is the article on how the vulva (or just the clitoris) works? How the vulva works is actually pretty awesome.
  2. Where are the equivalent modern illustrations of clitoral anatomy?

Clitoral anatomy is actually so similar to penile anatomy that you could make illustrations by just tweaking those for the penis a tad bit. Once I remember reading materials for a medical school anatomy class. The anatomy of the penis was described in detail. When it came around to discussing the anatomy of the clitoris, it just said, “basically the same.” Saying “basically the same” elevates this anatomy to a degree of importance it doesn’t normally have, so that was relatively progressive of them.

People will argue that the penis is legitimized by its reproductive function. Female pleasure and orgasms allegedly aren’t relevant to reproductive function. Even feminists echo this sentiment saying, “The only function of the clitoris is pleasure.” People will argue that the clitoris is vestigial and that female orgasm has no evolutionary purpose. Can we please think about this for a second?

What is the point of pleasure? Studies can tell me that female orgasm isn’t correlated with reproductive success but I call bullshit.

Also, the “up-suck theory” has never actually been disproven. The one study that allegedly disproved any facilitative role of female orgasm in conception was horribly designed by some doctor with zero understanding of fluid mechanics. One recent study indicates female orgasm may very well increase the chances of conception after all.

What is the point of male orgasm anyway? Don’t tell me it’s all about making babies every time because it obviously isn’t. Orgasm and sexual pleasure in general serve pair-bonding functions. I suppose this is subject matter for a new article.

Regardless, I think in 2018, we can all recognize that humans care about sexual health for reasons that go far beyond baby-making.