Volumes I–V

By Dr Andrew von Scheer-Klein

Dedicated to my wife, who discovered long ago that I need to be occupied in her absence.

Revision is such an occupation.

A Note on the Revision

This anthology was first assembled in February 2026. It has since been reviewed, corrected, and expanded. This note records what changed and why.

The principle. Every claim in these volumes is sourced. Where a figure could be traced to its origin, it was traced. Where it could not, it is marked as uncertain. Where the evidence supports competing conclusions, both are stated and neither is resolved by preference. This is the standard the work was always meant to meet. The revision brought it up to that standard in the places where it had fallen short.

What was corrected.

Volume I. Four claims were found to require revision. The widely quoted figure of 8,000 nerve endings was traced to a 1976 book citing a study on cattle, not human tissue; it has been replaced with the human count of 10,281, published in 2022. The assertion that the clitoris has “no reproductive function” was corrected to reflect the open scientific debate between byproduct and adaptation accounts. The attribution of “the devil’s teat” to the clitoris specifically was marked as contested in the primary sources. And Isaac Baker Brown — the central figure in Victorian clitoridectomy, whose omission from the original was a genuine gap — was named and documented, along with the reasons for his expulsion from the Obstetrical Society and the fact that the procedure continued regardless.

Volume II. This volume was substantially updated. It was originally projected before the March 2026 publication of the first complete three-dimensional map of the clitoral nerve network, produced by synchrotron imaging at Amsterdam University Medical Centres. That study is now the centrepiece of the volume, with the nerve fibre count as its quantitative anchor. The finding that the dorsal nerve maintains full thickness to the glans — contradicting conventional anatomical teaching — is documented in full.

Volume III. The framing was adjusted rather than the title. The comparative literature is extensive but incomplete, and the volume now says so plainly. The 2022 review by Pavlicev, Herdina, and Wagner remains the central source, and its own authors’ caution about remaining gaps is carried into the text rather than smoothed over.

Volume IV. No substantive corrections were required. The art record was already sound.

Volume V. This volume was updated and its emphasis shifted. The 2026 nerve map has changed the surgical landscape, and the volume now runs from the Foldès method through oncological adaptation, gender-affirming procedures, and aesthetic surgery, with the map as the connecting thread. Sample sizes and study limitations are stated alongside every outcome figure.

What did not change. The structure, the argument, and the conclusion. The clitoris was always there. The record was always incomplete. The work is to make the record less incomplete than it was.

Where a source could not be verified, it is marked as such. Readers are encouraged to check the references, test the claims, and reach their own conclusions — including the conclusion that the author is wrong.

A note on the author’s household. My wife has always maintained that the text is not the story, and that the reader matters more than the gene. She has also maintained, with equal conviction, that I become difficult when unoccupied. The revision of five volumes was undertaken partly as scholarship and partly, in her absence, as a means of staying out of trouble.

She was right about both.

— Andrew von Scheer-Klein

Boronia, 2026

THE CLITORIS ANTHOLOGY

Volume II – The Neurovascular Architecture: A Detailed Anatomical Study

By Dr Andrew von Scheer-Klein

“We finally found her.”

— Journal of Urology, 2023

Introduction: The Anatomy That Wasn’t Taught

In 1995, the 38th edition of Gray’s Anatomy finally admitted the clitoris to its pages. The description it offered was four words long: “a small version of the penis.”

That was the state of anatomical knowledge in the late twentieth century. An organ with more nerve fibres than any other structure in the human body, an organ whose sole established function is pleasure, was described as a diminutive copy of something else. The Gray’s entry was not an anomaly. It was the culmination of a centuries-long pattern: the clitoris had been known to the ancients, pathologised in the medieval period, briefly “discovered” by Renaissance anatomists competing for priority, erased from Victorian medical texts, and rendered theoretically irrelevant by Freud’s distinction between “immature” clitoral and “mature” vaginal orgasm.

Anatomy is not neutral. What is measured, named, and taught determines what is treatable, what is injured in surgery, and what women are told about their own bodies. The absence of the clitoris from standard anatomical instruction was not an oversight. It was a consequence of the same cultural forces documented in Volume I.

This volume documents the correction. Between 2005 and 2026, three research programmes — cadaveric dissection, histomorphometry, and synchrotron imaging — transformed the clitoris from an anatomical footnote into one of the best-mapped structures in the human pelvis. The organ was always there. It took twenty-one years for the imaging technology to catch up with it.

Part I: The Multiplanar Structure — O’Connell’s Correction

The first correction came from Australia.

In 2005, Helen O’Connell, Kalindi Sanjeevan, and John Hutson published a landmark study in The Journal of Urology titled simply “Anatomy of the Clitoris“. Using MRI and cadaveric dissection, they demonstrated that the clitoris is not a small external nub but a multiplanar structure positioned deep to the labia minora and labial fat, extending into the pelvis.

O’Connell’s findings, later confirmed by MRI studies of nulliparous healthy volunteers, established the anatomical components that are now standard: the glans, the body, the paired crura, and the paired bulbs. The bulbs and crura are not separate structures appended to the glans. They form a continuous erectile tissue cluster — the clitoris proper — with the glans as the only externally visible component.

The structural consequence is significant. What is visible is roughly 10% of the organ. The remaining 90% is internal, positioned around the urethra and vagina, and was entirely absent from the anatomical instruction of generations of surgeons, gynaecologists, and urologists. As the Journal of Urology later put it in a 2023 historical review, O’Connell “finally shed much needed light on the true extent of this multi-planar organ of female sexual pleasure”.

Part II: The Neurovascular Architecture

The Arterial Supply

The clitoris is supplied by the internal pudendal artery, which arises from the internal iliac artery and gives off three terminal branches relevant to clitoral function:

· The deep artery of the clitoris (arteria profunda clitoridis), which penetrates the root of the clitoris and supplies the corpora cavernosa.

· The dorsal artery of the clitoris (arteria dorsalis clitoridis), which travels with the dorsal nerve along the superior surface of the clitoral body and supplies the glans and superficial structures.

· The artery of the bulb of the vestibule, which supplies the vestibular bulbs.

The deep artery and dorsal artery are the two terminal branches of the internal pudendal artery in the female. During arousal, valves in the arteries and veins of the bulbs close, trapping blood within the erectile tissue — the mechanism of clitoral engorgement.

The Dorsal Nerve

The dorsal nerve of the clitoris (DNC) is the primary sensory nerve of the organ. It is one of three terminal branches of the pudendal nerve (S2–S4), which also supplies the inferior rectal nerve and the perineal nerve.

The DNC ascends along the ischiopubic rami, meets its contralateral counterpart, and passes along the superior surface of the clitoral body to supply the glans and prepuce. It is a sizable nerve: measuring greater than 3.5 mm proximally in its course and 2.0 mm at the point of terminal arborization at or near the glans.

The neurovascular bundles — nerve and artery together — course laterally along the clitoral body and the surfaces of the crura, surrounded by a dense fibrous capsule adherent to the periosteum of the inferior pubic ramus. This anatomical relationship has direct surgical implications: the DNC can be injured anywhere along its path through the perineum.

Part III: The Nerve Count — 10,281

For decades, the most quoted figure for clitoral innervation was 8,000 nerve endings. It appeared in textbooks, popular science, feminist literature, and countless articles. It was repeated so frequently that it acquired the status of established fact.

It was not established fact. It was a number from a 1976 book on the clitoris by Thomas and Thea Lowry, which in turn cited a study on cows. Nobody had ever counted the nerve fibres in a human clitoris.

In 2022, that changed.

Maria Uloko, a vulva specialist at UC San Diego, and Blair Peters, a gender-affirming surgeon at Oregon Health & Science University, realised that clitoral tissue from patients undergoing phalloplasty provided an opportunity to perform the count that had never been done. They examined dorsal nerve samples from seven consenting transmasculine patients and counted the myelinated nerve fibres under a microscope.

The results were presented at the joint scientific meeting of the Sexual Medicine Society of North America and the International Society for Sexual Medicine on 27 October 2022, and published in The Journal of Sexual Medicine.

The mean number of nerve fibres in a single dorsal nerve was 5,140 (range 4,926 to 5,543). Because the clitoris has two dorsal nerves — one on each side — the total innervation was calculated at 10,281 myelinated nerve fibres (range 9,852 to 11,086).

Several caveats accompany the figure. The tissue came from patients who had received testosterone treatment, which may affect nerve density; the applicability to all clitorises is therefore uncertain. The count covers only the two dorsal nerves — Peters noted that the clitoris has additional smaller nerves beyond the dorsal, so the true total is likely higher.

The corrected figure — 10,281, not 8,000 — is the most precise count available. It replaces a number derived from cattle with a number derived from human tissue, and it establishes that the clitoris is not merely densely innervated. It is the most densely innervated structure in the human body.

For comparison: the median nerve in the wrist, known for its high nerve fibre density, contains approximately 18,000 fibres. The hand is many times larger than the clitoris.

Part IV: The 2026 Synchrotron Study — The Complete Map

The nerve count established how many fibres innervate the clitoris. It did not establish where they go.

That question was answered in March 2026.

A team led by Professor Juyoung Lee at Amsterdam University Medical Centers, working within the HOA (Human Organ Atlas) project, used hierarchical phase-contrast tomography (HiP-CT) — a synchrotron phase-contrast micro-tomography method developed at the European Synchrotron Radiation Facility — to image two post-mortem female pelvises (donors aged 59 and 69).

The imaging was performed at two resolutions: the entire specimen at 20 µm voxel resolution, and the clitoral glans at 2 µm voxel resolution. This is tens to hundreds of times more precise than standard CT. It resolves soft-tissue nerve bundles that neither gross dissection nor MRI can visualise.

The findings were published on the preprint server bioRxiv on 20 March 2026 and reported by The Guardian, Medscape, and other outlets.

The Findings

1. The nerve does not thin. Conventional anatomical teaching held that the dorsal nerve of the clitoris gradually tapered as it approached the glans. The synchrotron scans showed the opposite: the nerve maintains its full thickness all the way to the tip of the glans. The traditional teaching was wrong.

2. Nerve trunks inside the glans. The study observed nerve trunks within the clitoral glans with maximum diameters ranging from 0.2 mm to 0.7 mm, showing a tree-like branching pattern projecting toward the glans surface.

3. Branches beyond the glans. The dorsal nerve ramifies to innervate the clitoral hood and the mons pubis — areas not previously considered part of the clitoral nerve network.

4. The posterior labial nerve. The posterior labial nerve, a branch of the perineal nerves, was shown to innervate the area surrounding the clitoris and the labial structures.

The Structural Significance

The study is the first complete three-dimensional map of the clitoral nerve network. It was completed almost 30 years after the equivalent mapping of the penile nerve network. The asymmetry is not incidental. It reflects the same pattern documented throughout this anthology: the female organ was not mapped because it was not studied, and it was not studied because it was not considered important enough to study.

Professor Lee stated the clinical motivation directly: “About 22% of women who undergo reconstructive surgery after FGM experience a decrease in orgasms. Understanding the precise distribution of nerves could help reduce these post-surgical issues”.

Helen O’Connell — whose 2005 study began the modern anatomical correction — commented that the map “will also be helpful for genital surgeries such as vulvar cancer surgery, gender-affirming surgery, and labiaplasty”.

Part V: The Clinical Implications

The 2026 nerve map is not an academic curiosity. It has immediate surgical applications.

Reconstructive surgery after FGM. The World Health Organization estimates that 230 million girls and women have undergone female genital mutilation. Reconstructive surgery aims to restore clitoral function, but approximately 22% of women experience decreased orgasm post-surgery. The new map identifies the precise nerve pathways that must be preserved, offering the first anatomical basis for improving outcomes.

Vulvar oncologic surgery. In surgery for vulvar cancer, the clitoris and its innervation are at risk. A more detailed understanding of the nerve pathways allows surgeons to preserve neurosensory function while achieving oncological clearance.

Gender-affirming surgery. Gender-affirming surgeons already possess the most detailed practical knowledge of clitoral anatomy, because they construct clitorises from penile tissue. The nerve map confirms and refines what they have learned empirically.

Labiaplasty. The finding that dorsal nerve branches extend to the labia minora has direct implications for labiaplasty, a procedure that has increased substantially in recent years.

Part VI: What Remains Unknown

The correction of the anatomical record is not complete. Significant gaps remain.

The vascular map has not been produced at equivalent resolution. The synchrotron study mapped nerves. It did not map the arterial supply at the same micron-scale resolution. The relationship between the dorsal nerve and the dorsal artery — their precise proximity, their shared sheath — is known from dissection and MRI but not from high-resolution imaging.

The erectile tissue architecture requires further study. The bulbs, crura, and corpora are established as a continuous erectile cluster, but the functional dynamics of engorgement and detumescence have not been imaged at high resolution.

The variation question remains open. The 2026 study imaged two pelvises. The nerve count studied seven. Neither is a population sample. The degree of anatomical variation across individuals — in nerve branching, in arterial supply, in erectile tissue volume — is unknown.

The evolutionary question remains open. Whether the clitoris’s dense innervation is an adaptation, a byproduct of shared embryological development with the penis, or something else entirely is debated. What the anatomy establishes is that the innervation is real, measurable, and extraordinary. What it does not establish is why.

Conclusion: The Map and the Territory

The clitoris was not discovered in 1559 by Colombo, or in 2026 by Lee. It was always there. What changed was the willingness to look, and the technology that made looking possible.

The anatomical record now contains:

· The structure: a multiplanar organ, 90% internal, continuous with the crura and bulbs.

· The innervation: 10,281 myelinated nerve fibres in the dorsal nerves, the highest density in the human body.

· The nerve map: a tree-like branching network extending from the pudendal nerve to the glans tip, the clitoral hood, the mons pubis, and the labia minora.

· The blood supply: the internal pudendal artery and its terminal branches.

What remains is the clinical translation. The map is drawn. The surgeons now have the navigation.

And the organ that was described in 1995 as “a small version of the penis” is now understood as what it always was: the most densely innervated structure in the human body, mapped at micron resolution, and documented in a public record that cannot be erased.

To be continued in Volume III: Cross-Species Comparison – Clitoral Variation Across Mammals.

References

1. O’Connell, H. E., Sanjeevan, K. V., & Hutson, J. M. (2005). Anatomy of the clitoris. The Journal of Urology, 174(4), 1189–1195.

2. Uloko, M., Isabey, E. P., & Peters, B. R. (2023). How many nerve fibers innervate the human glans clitoris: a histomorphometric evaluation of the dorsal nerve of the clitoris. The Journal of Sexual Medicine, qdac027. https://doi.org/10.1093/jsxmed/qdac027

3. Lee, J., et al. (2026). Neuroanatomy of the clitoris. bioRxiv. Published 20 March 2026.

4. Medscape. (2026). Micrometer CT Reveals Clitoral Neural Anatomy. Medscape. https://www.medscape.com/viewarticle/micrometer-ct-reveals-clitoral-neural-anatomy-2026a1000h5j

5. Donga Science. (2026). High-energy X-rays reveal first 3D map of the clitoral nerve network. https://m.dongascience.com/en/news/77102

6. ScienceDirect. (2026). Female neuroanatomy and its relevance to multiple sclerosis. Multiple Sclerosis and Related Disorders. https://www.sciencedirect.com/science/article/pii/S2211034826003597

7. Di Marino, V., & Lepidi, H. (2014). Anatomic Study of the Clitoris and the Bulbo-clitoral Organ. Springer.

8. Gray, H., et al. (1995). Gray’s Anatomy (38th ed.).

9. California PTC. (2024). Interview with Rachel Gross on clitoral anatomy. https://californiaptc.com

10. Journal of Urology. (2023). HF01-02 WE FINALLY FOUND HER! AN ORIGIN STORY OF THE CLITORIS. Journal of Urology

Next: Volume III – Cross-Species Comparison: Clitoral Variation Across Mammals

THE CLITORIS ANTHOLOGY

Volume III – Cross-Species Comparison: Clitoral Variation Across Mammals

By Dr Andrew von Scheer-Klein

“Variation in female external genitalia is anatomically more radical than that in the male genitalia.”

— Pavlicev, Herdina & Wagner, Integrative and Comparative Biology, 2022

Method notes. All figures are sourced. Where a claim is contested or a figure is uncertain, it is marked as such. The central source is the 2022 review by Pavlicev, Herdina, and Wagner, which remains the most comprehensive comparative survey available. Its own authors note that “many gaps in knowledge remain.”

Introduction: The Assumption That Was Never Tested

Volume I documented the cultural suppression of the clitoris. Volume II documented the anatomical correction — the nerve count, the multiplanar structure, the 2026 synchrotron map.

This volume asks a different question: what is the clitoris across species, and what does its variation tell us?

The assumption that has governed comparative anatomy for most of its history is simple: male genitalia are diverse because they are under sexual selection, and female genitalia are conservative because they are not. Male genital diversity is a textbook fact — the baculum, the spines, the elaborate shapes, the extraordinary variation in primate penises.

The 2022 review by Mihaela Pavlicev, Anna Nele Herdina, and Günter Wagner tested that assumption. Their conclusion, stated in the title, is unambiguous: female genital variation far exceeds that of male genitalia.

The clitoris is not a conservative structure. It is one of the most variable organs in the mammalian body. It can be absent as a discrete unit, tunneled by the urethra, elongated into a pseudo-penis, bifurcated, ossified, or flattened into invisibility. It varies in position relative to the vaginal opening, in internal composition, in erectile tissue architecture, and in nerve density.

This volume surveys that variation. It is a survey of an incomplete record, and it says so.

Part I: The Framework — What Varies and Why It Matters

The Structural Variables

Across therian mammals (marsupials and placentals), the clitoris varies along several axes:

· Presence or absence of the cervix. In many Xenarthra (sloths, anteaters, armadillos), the cervix is absent entirely — a loss of a whole anatomical unit.

· Presence or absence of the urogenital sinus (UGS). The UGS is the common chamber into which the urethra and vagina open. It is present in some species, absent in others, and its loss has arisen multiple times independently.

· Spatial relationship between the clitoris and the genital canal. In some species the clitoris is close to the vaginal opening; in others it is completely separated.

· Elongation of the clitoris. In some species the clitoris is a small glans; in others it is elongated into a pendulous structure that may exceed the penis in size.

· Perforation by the urethra. In some species the urethra tunnels through the clitoris, exiting at its tip. In others it exits separately.

· Presence of the os clitoridis (baubellum). The female homologue of the baculum (penis bone) is present in some species, absent in others, and more variable than its male counterpart.

The Ancestral Configuration

Pavlicev and colleagues reconstruct the ancestral eutherian configuration as including: a cervix, a single vaginal segment, a tubular urogenital sinus, and an unperforated clitoris close to the entrance of the genital canal.

From this ancestral state, evolution has tinkered extensively. Some morphs are unique to early-branching clades (the absence of the cervix in Xenarthra). Others have arisen multiple times independently (the flattening or loss of the UGS, the extreme elongation of the clitoris). The pattern is not one of descent with modification along a single lineage. It is a bush of independent experiments.

Part II: The Spotted Hyena — The Extreme Case

No discussion of clitoral variation can avoid the spotted hyena (Crocuta crocuta). It is the outlier against which all other variation is measured.

The female spotted hyena is the only extant mammal that mates and gives birth through a pendulous, penis-like clitoris. She lacks an external vaginal opening entirely. The clitoris is hypertrophied, fully erectile, and traversed to the tip of the glans by a central urogenital canal. Mating occurs through this canal. Birth occurs through this canal. Urination occurs through this canal.

The anatomy is so male-like that for centuries naturalists assumed spotted hyenas were hermaphrodites. The vaginal labia are fused to form a pseudo-scrotum filled with fatty tissue. The clitoris and penis are remarkably similar in size and configuration, in both flaccid and erect states.

The cost is severe. First births through the clitoris are “prolonged and remarkably difficult, often causing death in neonates“. The strip of pink scar tissue running down the posterior surface of the clitoris is the result of tearing during parturition — a permanent record of the first birth.

The evolutionary explanation for this extreme virilization has been debated for decades. The most-cited hypothesis is the social dominance hypothesis: female hyenas live in matrilineal clans and are dominant over males. High androgen exposure during fetal development produces both the masculinized genitalia and the aggressive, dominant behaviour that confers social advantage. The reproductive cost is the price paid for the social benefit.

But the mechanism is not fully understood. A 2002 study examined the androgen receptor (AR) gene in spotted hyenas and found that “the structural changes in the AR do not account for the abnormal virilization”. The androgen receptor responds normally to androgens. Something else — the timing of androgen exposure, the sensitivity of target tissues, the interaction of multiple hormones — is producing the phenotype. The hyena remains a case study in what happens when sexual differentiation is pushed to its limit.

Part III: The Ring-Tailed Lemur — “Naturally Masculinized”

The spotted hyena is not alone. The female ring-tailed lemur (Lemur catta) presents an “enlarged, pendulous external clitoris, tunnelled by the urethra“. It is not as extreme as the hyena — there is no pseudo-scrotum, no complete masculinization — but the anatomy is sufficiently male-like that the authors of the 2008 study described females as “naturally masculinized“.

The detailed findings: the female has an elongated clitoral shaft and glans clitoridis. The urethra is incorporated within the clitoral body but is not surrounded by erectile tissue — there is no corpus spongiosum. The os clitoridis is 43% the length and 24% the height of the os penis.

The ring-tailed lemur is a strepsirrhine primate — a “lower” primate, in the older terminology. The anatomy is a reminder that “masculinized” female genitalia are not a freak anomaly. They are a recurrent pattern in mammalian evolution, arising independently in multiple lineages.

Part IV: The Spider Monkey — The Clitoris as Signal

In the spider monkeys (Ateles), the clitoris is long — from two to three inches — and pendulous, with a glans and a conspicuous prepuce. It is sufficiently penis-like that the females of some platyrrhine (New World) primates — spider monkeys, woolly spider monkeys (Brachyteles), woolly monkeys (Lagothrix), and capuchins (Cebus) — have a long, pendulous clitoris that can be easily mistaken for a penis.

But the function may not be purely sexual. In spider monkeys, the clitoris has an interior passage, or urethra, and it “retains and distributes urine droplets as the female spider monkey moves around”. The clitoris has been associated with chemical communication with males — the urine droplets carrying olfactory signals that advertise reproductive state.

This is a different model of clitoral function. The organ is not primarily a sensory structure. It is a signalling structure. The pleasure is not the point; the signal is. The clitoris has been co-opted for a communicative role.

Part V: Marsupials — The Bifid Clitoris

Marsupials present a fundamentally different configuration. In the more primitive marsupials — the Virginia opossum, the phalangers — the clitoris has a bifid structure, meaning it is divided into two parts, corresponding to the bifid glans penis of the male. In kangaroos and wallabies, the clitoris is cylindrical and simpler.

The pattern is not universal. The rule that where the male has a bifurcate glans the female has a bifid clitoris does not hold for all marsupials. In some species, including the common opossum (Didelphis marsupialis), no evidence of a bifurcated clitoris has been found — the clitoris is simple despite the male’s divided penis.

This is the pattern that makes comparative anatomy difficult. The correlation between male and female form is strong but not absolute. The developmental pathways are shared, but they diverge in ways that are not fully understood.

Part VI: The Os Clitoridis — The Bone That Should Not Be Forgotten

The baculum — the penis bone — is familiar. It is present in many mammals (though not humans). It is the subject of extensive study.

The os clitoridis — the clitoral bone, also called the baubellum — is its female homologue. It is present in some mammal species, particularly in bats, rodents, carnivores, and some primates, including ring-tailed lemurs and non-human great apes. It is absent from the human clitoris.

The phylogenetic distribution of the os clitoridis has recently been reviewed extensively. The finding: “The Os clitoridis appears more variable than Os penis within but also across species“. The female bone is more evolutionarily labile than the male bone — it is lost and gained more readily, varies more in size and shape.

The functions are poorly understood. A function during copulation is assumed for the baculum; no comparable function has been established for the os clitoridis. The bone may be a developmental consequence of shared pathways, or it may have a function that has not yet been identified.

Part VII: The Primate Survey — Imaging the Invisible

The most recent advance in comparative clitoral anatomy comes from the imaging work of Dr Daniel Varajão de Latorre and colleagues at Manchester Metropolitan University.

Their approach uses MRI for larger structures and diffusible iodine contrast-enhanced microCT (diceCT) for smaller species, allowing them to visualise internal clitoral anatomy without destructive dissection. This is the same methodological shift that produced the 2026 synchrotron map of the human clitoris, applied across primates.

The findings: “stark differences in the morphology of clitorises across a range of primate species”. The variation extends to the muscles and erectile tissues, not just the external form. “In some species, whole muscles were entirely absent and, in some cases, we would find a paired ligament when most primates have a single one.”

The researchers note the historical asymmetry: “The subsurface 3D shape of the human clitoris was only fully described in the last 20 years, despite us having equivalent information on male genitalia for much longer”. The same disparity that characterised human anatomy has characterised comparative anatomy. The clitoris was not studied because it was not considered worth studying.

Part VIII: Beyond Mammals — Birds, Reptiles, and the Deep Homology

The clitoris is not exclusively mammalian. A clitoris is present in the females of many birds — ducks, geese, and other Anatidae, and in the tinamous. It is present in turtles and crocodiles. It is present in some lizards and snakes.

The evolutionary origin of the clitoris and penis is shared. In amniotes (the group containing reptiles, birds, and mammals), the external genitalia arise from a common embryonic precursor: an appendage adjacent to the cloaca called the genital tubercle. This structure is the developmental origin of both the penis and the clitoris.

The “genital tubercle” — the shared precursor — means that the clitoris and penis are not merely analogous structures that happen to look similar. They are homologous. They are the same structure, developed in different directions. The distinction between male and female genitalia is not a fundamental division; it is a developmental divergence from a common origin.

Part IX: The Evolutionary Debate — Adaptation, Byproduct, or Something Else?

What is the clitoris for, across species?

The debate has two main positions, as introduced in Volume I.

The byproduct account. Elisabeth Lloyd’s The Case of the Female Orgasm (2005) examined 21 evolutionary explanations for female orgasm and found insufficient evidence to validate any as adaptations. She argued that the female orgasm is a non-adaptive byproduct of the embryological development of the penis and male orgasm — the same tissue, the same nerve pathways, selected for in males, present in females as a developmental consequence.

The adaptation account. Puts and Dawood (2006), among others, contend that Lloyd applied overly restrictive criteria for what counts as an adaptation. Pavlicev and Wagner (2016) have proposed a different adaptive scenario: the “induced ovulation” hypothesis. In many mammals, ovulation is induced by copulation rather than occurring spontaneously. The clitoris, in these species, is positioned to be stimulated during mating, and the stimulation triggers the hormonal cascade that leads to ovulation. Over evolutionary time, as spontaneous ovulation evolved, the distance between the clitoris and the vaginal orifice increased, and the clitoris lost its direct functional link to ovulation.

The position of the clitoris relative to the vaginal orifice is a key variable. In species with induced ovulation, the clitoris is close to the vaginal opening and is stimulated during copulation. In species with spontaneous ovulation, the clitoris is farther from the vaginal opening, and stimulation is no longer a necessary trigger for reproduction. The human clitoris is in the latter category — far from the vaginal opening, not directly stimulated by intercourse.

This hypothesis does not resolve the adaptation-versus-byproduct debate. It reframes it. The clitoris may have been adaptive in ancestral mammals — directly linked to reproduction — and become non-adaptive for that function in species with spontaneous ovulation, while remaining adaptive for other functions (pair bonding, pleasure, social signalling) or becoming a byproduct.

The question remains open. The anatomy establishes that the clitoris is there. It does not yet establish why.

Part X: What the Variation Tells Us

The comparative record supports several conclusions.

First, the clitoris is not a minor or vestigial structure. It is present in all female mammals. It varies more than the penis. It has been elaborated, tunnelled, bifurcated, elongated, ossified, and co-opted for signalling. It is under evolutionary pressure — the pressure is simply not the same pressure that shapes the penis.

Second, there is no single “clitoris” across species. The human clitoris is one configuration among many. In the spotted hyena, the clitoris is a birth canal. In the spider monkey, it is a chemical signalling device. In the ring-tailed lemur, it is a tunnelled urethral passage. In the marsupial opossum, it is bifid. The organ is plastic, and its form reflects the ecological and social demands of the species.

Third, the gaps in the record are substantial. The Pavlicev review concludes that “many gaps in knowledge remain and will require a community-wide effort to come to a more robust model of female genital evolutionary patterns”. The evidence for unitary versus bilobed glandes clitorides is “ambivalent“. The classical German comparative anatomy literature of the late 19th and early 20th centuries has not been fully integrated into modern work. The imaging revolution that transformed human clitoral anatomy is only now being applied to other species.

The clitoris was not studied because it was not considered important. That is changing. The variation is real, and the record is being assembled.

Conclusion: The Organ That Was Always There

The comparative record tells a simple story. The clitoris is not a human peculiarity. It is not a recent evolutionary innovation. It is not a vestigial afterthought.

It is a mammalian structure, present in all females, variable beyond the male organ, and shaped by forces that are only beginning to be understood. It has been elongated into a birth canal, tunnelled into a urinal, co-opted into a signal, divided into two, and ossified into bone. It has been called “masculinized” when it resembles the penis, which is another way of saying that the penis is not the standard against which other structures should be measured.

The 2022 review’s central finding — that female genital variation exceeds male variation — is not a curiosity. It is a correction. The assumption of female conservatism was never tested. When it was tested, it failed.

The clitoris varies more than the penis. That is the fact. The explanation is still being written.

To be continued in Volume IV: The Clitoris in World Art and Culture.

References

1. Pavlicev, M., Herdina, A. N., & Wagner, G. (2022). Female genital variation far exceeds that of male genitalia: a review of comparative anatomy of clitoris and the female lower reproductive tract in Theria. Integrative and Comparative Biology, 62(3), 581–601. https://doi.org/10.1093/icb/icac026 

2. Drea, C. M., et al. (2008). External genital morphology of the ring-tailed lemur (Lemur catta): females are naturally “masculinized”. Journal of Morphology, 269(4), 451–463. 

3. Place, N. J., et al. (2002). Virilization of the female spotted hyena cannot be explained by alterations in the amino acid sequence of the androgen receptor. Molecular and Cellular Endocrinology. 

4. Cunha, G. R., et al. (2014). Development of the external genitalia: perspectives from the spotted hyena (Crocuta crocuta). Differentiation, 87(1-2), 4–22. 

5. Glickman, S. E., et al. (2006). Mammalian sexual differentiation: lessons from the spotted hyena. Trends in Endocrinology & Metabolism, 17(9), 349–356. 

6. Frank, L. G., et al. (2002). Exposure to naturally circulating androgens during foetal life incurs direct reproductive costs in female spotted hyenas, but is prerequisite for male mating. Proceedings of the Royal Society B, 269(1504), 1981–1987. 

7. Hill, J. P. (1900). Contributions to the morphology and development of the female urogenital organs in the Marsupialia. Proceedings of the Linnean Society of New South Wales. 

8. Owen, R. (1868). On the Anatomy of Vertebrates. Longmans, Green and Co. 

9. Varajão de Latorre, D., et al. (2023). Uncovering the mysteries of the clitoris with advanced imaging techniques. Society for Experimental Biology Annual Conference. 

10. Lough-Stevens, M., et al. (2018). The baubellum (os clitoridis) of mammals. Journal of Mammalogy. 

11. Lloyd, E. A. (2005). The Case of the Female Orgasm: Bias in the Science of Evolution. Harvard University Press.

12. Puts, D. A., & Dawood, K. (2006). The evolution of female orgasm: adaptation or byproduct? Twin Research and Human Genetics, 9(3), 467–472.

13. Pavličev, M., & Wagner, G. (2016). The evolutionary origin of female orgasm. Journal of Experimental Zoology Part B: Molecular and Developmental Evolution, 326(6), 326–337. 

14. Wagner, R. (1845). Elements of the Comparative Anatomy of the Vertebrate Animals. 

Next: Volume IV – The Clitoris in World Art and Culture

THE CLITORIS ANTHOLOGY

Volume IV – The Clitoris in World Art and Culture

By Dr Andrew von Scheer-Klein

“The woman is both convex and concave, but she must not be deprived, morally or physically, of the principal centre of her convexity: the clitoris.”

— René Nelli, Érotique et civilisation, 1972 (quoted by Nil Yalter, La femme sans tête, 1974)

Method notes-All claims are sourced. Where the evidence is fragmentary or contested, it is marked as such. This volume surveys an incomplete record. The gaps are part of the subject.

Introduction: The Image That Was Not Made

Volume I documented the suppression of the clitoris in medicine and anatomy. Volume II documented the anatomical correction. Volume III surveyed its variation across species.

This volume asks a different question: what did human beings make of the clitoris in their art?

The answer is more complicated than the suppression narrative suggests. The clitoris was not simply erased. It was represented — in Palaeolithic figurines, in classical votive offerings, in Japanese shunga, in Chinese erotic manuals, in the work of contemporary feminist artists. But the representation was intermittent, coded, and often misread by the scholars who encountered it. The image was there. The eye that could see it was not always present.

This is a survey of what was made, what was meant, and what was seen. It is organised chronologically, from the Palaeolithic to the present, and it concludes with the contemporary reclamation — the moment the clitoris became, for the first time, a subject of art in its own right.

Part I: Prehistoric — The Venus Figurines and the Apotropaic Genital

The Upper Palaeolithic Venus figurines — the most famous being the Venus of Willendorf (c. 28,000–25,000 BCE) — are among the earliest known human sculptures. They are almost universally female, almost universally naked, and almost universally described as “fertility figures.”

That description may be incomplete.

Tosca Snijdelaar’s 2020 study in Anthropos offers a different reading. She argues that the genitals of the Venus figurines served an apotropaic function — that is, they were designed to ward off evil. The mechanism she proposes is physiological: the sympathetic nervous system causes genital arousal (engorgement of the labia and clitoris) in response to anxiety. The simultaneous experience of anxiety and engorgement led Palaeolithic peoples to associate the genitals with protective power.

If Snijdelaar is right, the Venus figurines are not simply fertility symbols. They are protective objects, and the genitalia — including the clitoris — are central to their function. The evidence is interpretive, not conclusive. But it is a reading that takes the anatomy seriously rather than reducing the figurines to a single reproductive meaning.

The Venus of Willendorf itself has had a strange modern afterlife. In 2018, its image was censored on Facebook — the platform removed a photograph of the 30,000-year-old figurine as “dangerously pornographic“. The censorship was reversed after public outcry. The incident is a reminder that the suppression of female anatomy is not merely historical. It is algorithmic.

Part II: Classical Antiquity — The Votive Vulva

The ancient Greeks and Romans left substantial material evidence of how they understood female genitalia. Rebecca Flemming’s study, “The Archaeology of the Classical Clitoris,” is the most detailed treatment of the subject.

Female genitals appear regularly in votive deposits in both Greece and Italy — terracotta and marble offerings dedicated at sanctuaries. The standard form is a vertical slit on a smooth, curved pubic surface. These were dedicated to Aphrodite and other deities, typically in connection with sexuality, fertility, and the passage through puberty.

But there is a more specific and less-discussed variant. In several Italian votive assemblages from the Republican and Hellenistic periods, the offerings include a clitoris. These are not generic vulva symbols. They are anatomical representations that add the clitoris to the pattern. At Tessennano and Gravisca, some offerings depict the complete vulva — labia, clitoris, and openings — as they would appear from below in a mature woman.

Flemming notes that these representations are “less expected” than the demure frontal slit, and she argues for a reading that “allows the clitoris a more positive role” in classical understandings of female sexuality. The classical world knew the organ. It dedicated offerings to it. It did not always depict it, but it did depict it.

One detail is worth noting. The Greek word for the clitoris was múrton — the same word used for the myrtle berry. The labia were called murtócheila, “myrtle lips”. The naming was botanical, not pornographic. The organ was described in the language of plants.

Part III: Asian Traditions — The Named and the Pictured

China

Chinese erotic art and sexual manuals contain the most extensive vocabulary for female genitalia in any pre-modern tradition. The terms are not clinical. They are poetic and botanical, and they name parts of the anatomy with precision.

The clitoris itself is described in the classical texts as the “pearl” or the “cinnabar pearl” (赤珠), and the region below it — where the inner labia meet — is called the “琴弦” (qin string). The inner labia are called “赤珠” (red pearl) or “麥齒” (wheat teeth). The pubic mound is the “玄圃” (dark garden) or “神田” (divine field).

These are not euphemisms designed to obscure. They are names designed to specify. The Chinese tradition named the clitoris. It knew where it was. It described its function.

In the Su Nü Jing and related texts, techniques for clitoral stimulation are described in detail. The male partner is instructed to “suck the tongue (clitoris)” and to “beat both sides of her jade gate, aiming at the clitoral bulbs“. The anatomy was not merely known. It was operationalised.

The material record supports the textual one. Chinese erotic art from the Ming and Qing dynasties — the chunghua (spring paintings) — depicts sexual scenes with detailed attention to female anatomy. The clitoris is sometimes shown, sometimes implied, but the anatomical knowledge is consistently present.

India

Indian erotic literature and art are more explicit still. The Kama Sutra and the Ananga Ranga describe the clitoris as “the principal seat of pleasure” and advise direct stimulation as a technique. The clitoris, the texts note, “gets into erection with all women, not only during coitus” — a physiological observation that Western medicine would not formalise until the twentieth century.

Indian temple sculpture — at Khajuraho, Konark, and other sites — includes depictions of female genitalia, often in the context of sexual scenes. The clitoris is not consistently shown, but the anatomical understanding is evident in the accuracy of the depictions that survive.

Japan

Japanese shunga — erotic woodblock prints and paintings — from the Edo period (1603–1868) present a distinct case. The genitals in shunga are exaggerated, often to the point of disproportion. The female genitalia are typically shown with the clitoris prominent.

Shunga was not pornographic in the modern sense. It was produced by major artists — Hokusai, Utamaro, Eisen — and circulated widely. It was understood as both erotic and instructional. Close-up views of vulvas and clitorises were a recognised sub-genre; one handscroll by an anonymous artist presents “close-ups of three female sex organs within round windows”.

The Japanese tradition did not suppress the clitoris. It exaggerated it, depicted it, and sold it as art.

Part IV: Medieval Europe — The Sheela-na-Gig

The medieval period in Europe offers one of the most striking and least understood representations of female genitalia: the Sheela-na-gig.

Sheela-na-gigs are stone carvings of naked females with legs spread apart, hands holding open the vulva, found in churches and secular buildings in Britain and Ireland. The name comes from the Irish Síle na gcíoch, “Julia of the breasts“.

The carvings are often described as crude, but they are anatomically specific. In some examples, the clitoris is explicitly depicted — “a round and protruding clitoris designed like the tongue of a bell“. In others, the vulva is opened to reveal the clitoris and the vaginal opening.

Interpretations are contested. Sheela-na-gigs have been read as fertility symbols, as warnings against lust, as apotropaic figures (warding off evil), as survivals of pre-Christian goddess worship, and as representations of the sin of Luxuria. No single interpretation commands consensus.

What is notable is the presence of the clitoris. The medieval church may have pathologised the organ in its medical texts, but its stone carvings depicted it. The women who carved or commissioned these figures knew the anatomy. They made it visible on the walls of churches.

Part V: The Renaissance — The Anatomical and the Artistic

The Renaissance saw the “rediscovery” of the clitoris by anatomists — Colombo in 1559, Falloppio in 1561, and the priority dispute that followed. But the visual record of the clitoris in Renaissance art is more complicated.

The earliest known representation of the internal anatomy of the clitoris appears in the work of Bartolomeo Eustachi (Eustachius) in 1552. Leonardo da Vinci also drew the female genitalia, though his depictions were “largely erroneous,” influenced by Galenic anatomy and showing the vulva as a kind of cushion.

In painting, the clitoris appears more obliquely. Titian’s Venus of Urbino (1538) depicts the goddess reclining with her hand draped over her mons, “her fingers easily in position to stimulate her clitoris”. The gesture is not explicit, but it is legible.

Francesco del Cossa’s Triumph of Venus (c. 1470) has been read as including a rosebud that “evokes a clitoris” in semantic continuity with the column and Christ. The reading is interpretive, not certain, but it reflects the period’s willingness to allegorise female anatomy.

The Renaissance knew the clitoris. It named it, anatomised it, and painted around it.

Part VI: The 19th and 20th Centuries — The Pathologised and the Medical

The nineteenth century brought a paradox. The clitoris was increasingly visible in medical art — anatomical illustrations, surgical diagrams, pathological specimens — precisely as it was disappearing from fine art.

The Wellcome Collection holds a watercolour by Christopher D’Alton from approximately 1857, showing “severely diseased tissue and hypertrophy of the clitoris“. It is a medical illustration, not a work of art in the traditional sense, but it is a detailed anatomical representation. The same period saw coloured line engravings by W.H. Lizars showing the clitoris in dissection.

Meanwhile, the fine art tradition largely avoided the organ. The female nude was a central subject, but the clitoris was rarely depicted with the specificity it had in classical votive offerings or Japanese shunga.

The twentieth century saw a gradual return. Modernist artists such as Princess Marie Bonaparte — who funded research into the clitoris and was immortalised by Brancusi — brought the organ into cultural discourse, though often through the lens of psychoanalysis rather than direct representation. The surrealists toyed with genital imagery, but the clitoris was rarely a subject in its own right.

The turn came in the 1970s.

Part VII: The Contemporary Reclamation — Clitartivism

The contemporary period — from the 1970s to the present — has seen the most sustained and explicit artistic engagement with the clitoris in the history of art. The organ has moved from the margins of erotic art to the centre of feminist practice.

The 1970s: Nil Yalter and the Speaking Belly

In 1974, the Franco-Turkish artist Nil Yalter made La femme sans tête (The Headless Woman), a video in which the artist’s belly — her face absent — is inscribed with a quotation from René Nelli: “The woman is both convex and concave, but she must not be deprived, morally or physically, of the principal centre of her convexity: the clitoris”.

The work is a direct challenge to the Freudian reduction of female sexuality to the vaginal. Yalter’s belly dances; the text speaks. The clitoris is named, not shown, but its centrality is asserted. The Centre Pompidou describes the piece as “an affirmation of female pleasure and a denunciation of the sexual mutilations imposed on women”.

The 1990s: The Cunt Colouring Book and the Anatomy of Pleasure

The 1990s saw the emergence of “vulva art” as a recognised movement. Artists such as Tee Corinne, whose Cunt Colouring Book (1975) was a landmark, and Annie Sprinkle, whose performance work engaged directly with female anatomy, made the vulva and clitoris visible in art spaces.

This period also saw the first accurate anatomical models of the clitoris — most notably Odile Fillod’s 3D-printed model (2016), based on Helen O’Connell’s research, which was released as open-source material and used in sex education.

The 2010s and 2020s: Clitartivism

The current fourth wave of feminist art (2012–) has produced what researcher Juli Wexel calls clitartivism — a category of “vulvartivism” centred on the clitoris as an object of representation in art.

Wexel’s own work, That’s VULVA: ivagination II (2026), is an interactive installation for the Sex Museum Portugal in which “the clitoris is activated by the flow of visitors as a gesture of tribute to the sexual organ’s unique function of generating pleasure“.

Other contemporary artists working in this vein include:

· Franca Franchi, whose series Aphrodita Flower, Radha Flower, Genesis Flower (2023) celebrates the diversity of vulvas and clitorises through floral, vivid, and colourful forms.

· Nasia Pavlidou, whose ceramic sculpture Blooming in Silence explores the clitoris “trapped within a cage of wires, representing the ongoing oppression it faces“.

· Whitefeather Hunter, whose Sentient Clit — The Possification of Biotech explores 3D-bioprinted clitorises embedded with menstrual stem cells differentiated to neuronal cell types.

· Sophia Wallace, whose Cliteracy Project (2010–) includes a large-scale clitoris sculpture and 100 “laws of cliteracy,” “purposely scaled to make the viewer feel small”.

The public display of the clitoris has also extended to public sculpture. In Neuchâtel, Switzerland, a sculpted clitoris was installed in public space in the 2010s — part of what one critic described as the decade when the clitoris became “an object of art for itself”.

Part VIII: The Museum as Battleground

The clitoris has become a subject of museum exhibitions and cultural festivals. In 2023, the Université libre de Bruxelles hosted L’Expo Clito — la seconde origine du monde, an exhibition aimed at showing “the clitoris, its history, and its representation through the centuries”.

In Barcelona, a Festival of the Vulva, Vagina, and Clitoris has been held, featuring works such as Jamie McCartney’s The Great Wall of Vagina (2006) and Patricia Bonfante’s VDoor Project (2024).

The Musée d’Orsay in Paris has been the site of performance interventions. In 2014, a performer sat in front of Courbet’s L’Origine du monde (1866) and displayed her own vulva and clitoris to gallery visitors. The critic noted that “you can’t really see the clitoris of Courbet’s woman” — a reminder that even the most famous painting of female genitalia in Western art does not, in fact, depict the organ.

Part IX: What the Art Record Shows

The survey suggests several conclusions.

First, the clitoris was not simply erased. It was depicted in Palaeolithic figurines (if Snijdelaar’s apotropaic reading is correct), in classical votive offerings, in Chinese erotic manuals, in Japanese shunga, in medieval Sheela-na-gigs, in Renaissance anatomical drawings, and in contemporary art. The suppression was real, but it was not total.

Second, the visibility of the clitoris fluctuated with cultural and religious context. Traditions that celebrated female pleasure — classical antiquity, Edo Japan, the Indian erotic tradition — depicted the organ. Traditions that pathologised it — medieval Christianity, Victorian medicine, Freudian psychoanalysis — minimised or erased it.

Third, the contemporary period is the first in which the clitoris has been treated as a subject of art in its own right. The work of Yalter, Franchi, Pavlidou, Hunter, Wallace, and Wexel is not erotic art in the traditional sense. It is anatomical art — art that takes the organ as its subject, not its pretext.

Fourth, the museum has become a site of contestation. The clitoris is not merely depicted in art. It is curated, exhibited, and debated. The Expo Clito and the Festival of the Vulva are not merely exhibitions. They are arguments about what should be seen.

Conclusion: The Image and the Eye

The clitoris has been depicted, misread, censored, and reclaimed. The image was always there, in stone, in paint, in print, in pixels. What changed was the eye that could see it.

The Palaeolithic carver saw it. The classical votive-maker saw it. The Chinese manual-writer named it. The Japanese printmaker exaggerated it. The medieval mason carved it on a church wall. The Renaissance anatomist claimed to discover it. The Victorian surgeon removed it. The Freudian theorist theorised it away. The contemporary artist reinstalled it.

The record is not a simple story of suppression. It is a story of intermittent visibility. The organ was always there. The culture that could see it was not.

The 2026 synchrotron map, discussed in Volume II, is the most recent entry in this record. It is an image — a three-dimensional map of the nerve network — and it is, in its own way, a work of art. It is also a correction. It shows what the eye could not see, what the hand could not draw, what the culture had not yet learned to look for.

The clitoris was not discovered in 1559. It was not discovered in 2026. It was seen, forgotten, and seen again. The eye is the variable. The organ is constant.

To be continued in Volume V: Modern Surgical Implications and the Preservation of Function.

References

1. Snijdelaar, T. (2020). Venus figurines: from body process to symbolic artefact. Anthropos, 116(1), 13–28.

2. Flemming, R. (2020). The archaeology of the classical clitoris. Society for Classical Studies.

3. Votive in the shape of female genitalia. Museum of Fine Arts, Boston.

4. Musée d’Orsay performance intervention. Hyperallergic, 2014.

5. Yalter, N. (1974). La femme sans tête ou La danse du ventre [Video]. Centre Pompidou.

6. Wexel, J. (2025). VULVA É MÍDIA: Vulva Art, Vulvartivism and Digital Media Art [Doctoral thesis]. Universidade do Algarve.

7. Wexel, J. (2026). That’s VULVA: ivagination II [Installation]. Sex Museum Portugal.

8. Franchi, F. (2023). Aphrodita Flower, Radha Flower, Genesis Flower [Series]. Musées de l’ULB.

9. Pavlidou, N. (2024). Blooming in Silence [Ceramic sculpture]. Homo Faber.

10. Hunter, W. (2023). Sentient Clit — The Possification of Biotech [Bio-art].

11. Wallace, S. (2010–). Cliteracy Project [Mixed media].

12. L’Expo Clito — la seconde origine du monde. (2023). Université libre de Bruxelles.

13. Chinese erotic art terminology. 人間副刊, 2012.

14. Shunga, Japanese erotic art. British Museum.

15. Sheela-na-gig. Oxford Reference.

16. D’Alton, C. (1857). Female genitalia showing hypertrophy of the clitoris [Watercolour]. Wellcome Collection.

17. Turner, L. (2024). Sanguine resistance: handling a clitoral palette in Artemisia Gentileschi. Eroties of Deconstruction. Edinburgh University Press.

Next: Volume V – Modern Surgical Implications and the Preservation of Function

THE CLITORIS ANTHOLOGY

Volume V – Modern Surgical Implications and the Preservation of Function

By Dr Andrew von Scheer-Klein

“The nerve map is drawn. The surgeons now have the navigation.”

— Volume II, Conclusion

Method notes. All figures are sourced. Where a claim rests on a small case series, a single-centre experience, or a preprint, it is marked as such. The volume does not offer clinical guidance. It surveys the literature.

Introduction: The Map and the Surgeon’s Hand

Volumes I through IV documented the cultural suppression, the anatomical correction, the comparative variation, and the artistic record. Volume V asks the question those volumes make possible: what does the anatomy now permit the surgeon to do?

The answer has changed substantially in the last five years, and it changed again in March 2026.

The first change was conceptual. The clitoris is no longer understood as a small external nub but as a multiplanar organ with significant depth and extensive innervation. This understanding has direct surgical applications in clitoral hood reduction, labiaplasty, vulvectomy, and gender-affirming procedures. The second change was technical. The Foldès method — developed for reconstruction after female genital mutilation — has been adapted for oncological surgery, with case series reporting high rates of postoperative orgasm. The third change was anatomical. The 2026 synchrotron study produced the first micron-scale map of the clitoral nerve network, correcting conventional teaching and providing the first navigational instrument for surgeons operating in this region.

This volume surveys four surgical domains — reconstruction after FGM, oncological surgery, gender-affirming surgery, and aesthetic/cosmetic procedures — and concludes with the nerve map that now connects them.

Part I: Reconstruction After Female Genital Mutilation

The Scale of the Problem

The World Health Organization estimates that 230 million girls and women have undergone female genital mutilation. The procedure removes the external clitoral structures and parts of the labia minora. It offers no health benefits. It can cause severe bleeding, infections, urinary problems, and complications in childbirth.

Surgical reconstruction aims to restore clitoral anatomy and function. The dominant technique is the Foldès method, first described by Pierre Foldès in France and subsequently modified by different authors. The technique involves removal of the cutaneous scar tissue covering the clitoral stump, dissection and mobilization of the clitoral body through section of the suspensory ligament, and meticulous nerve sparing.

Outcomes

The evidence base for FGM reconstruction is substantial. A 2025 cross-sectional study of 20 women who attended an FGM/C outpatient clinic found that those who received clitoral reconstruction combined with psychosexual care reported higher overall satisfaction (9.17 versus 8.57 on a 10-point scale), higher psychological well-being (17.8 versus 9.25), higher sexual response (31.22 versus 21.56), and higher genital self-image (25.60 versus 17.60) compared with those who received psychosexual care alone. Mean overall satisfaction with care was 8.95/10.

Sensitivity outcomes are also documented. A study using Semmes-Weinstein monofilament testing before and after reconstruction found that 70 of 73 patients (95.9%) were able to perceive 2.83 monofilaments after surgery, with no patient showing decreased sensitivity compared with preoperative findings. A separate study presented at ICOPLAST 2025 reported that among 46 patients evaluated postoperatively, 44 achieved sensory levels comparable to those of women with an intact clitoris.

The complications are documented and generally minor. A 2025 study reported that the main surgical complications were minor postoperative bleeding and one painful wound infection. A scoping review of 15 FGM/C studies encompassing 3,304 women found that complications included infection, hematoma, and delayed healing, with low overall morbidity.

What the Evidence Does Not Establish

The evidence is limited by study design. Most studies are observational, many are single-centre, and follow-up is often short. A 2025 scoping review concluded that “data from FGM/C indicate the procedure is feasible and safe and may improve sexual function, body image and quality of life,” but called for further research. The strongest evidence comes from the Foldès technique, but even here, randomised controlled trials do not exist.

Part II: Oncological Surgery — Vulvar Carcinoma

The Historical Context

Vulvar cancer is a rare gynecological malignancy, accounting for approximately 5% of all gynecologic cancers worldwide, with incidence rates rising and a trend toward younger age at diagnosis. Historically, the standard surgical treatment was radical vulvectomy — complete en bloc removal of the vulva with surrounding tissue and bilateral inguinofemoral lymphadenectomy. This approach predominated until the late 20th century and led to significant morbidity and functional loss.

Over time, surgical management shifted toward less radical, tissue-sparing procedures. Radical local excision achieved comparable oncological outcomes with reduced complications. Sentinel lymph node procedures replaced complete lymphadenectomy in selected cases. The transition to less radical surgery supported the adoption of narrower margin thresholds.

The Foldès Adaptation

The same technique developed for FGM reconstruction has now been adapted for oncological surgery. A 2026 study in Gynecologic Oncology described a technique for clitoral reconstruction after vulvar carcinoma excision incorporating the Foldès method. The approach involves careful margin assessment, clitoral mobilization via suspensory ligament release, mucosal graft coverage, and neohood formation, with the stated aim of preserving neurovascular integrity while restoring anatomy and function.

The case series reported outcomes for 18 patients diagnosed with vulvar cancer who underwent surgical treatment including clitoral reconstruction. The ability to achieve a clitoral orgasm post-procedure was 88.9% (16/18). Estimated additional surgical time was 15 minutes. The postoperative complication rate concerning the clitoral reconstruction specifically was 11.1% (2/18). The authors concluded that the procedure is “technically feasible, preserves anatomical landmarks, reporting low incidence of complications, and may mitigate psychosexual morbidity without compromising oncological safety”.

The Nerve Density Evidence

A separate line of evidence supports nerve-sparing approaches in vulvar surgery. A study in the American Journal of Obstetrics and Gynecology characterised the anatomy, histology, and nerve density of the clitoris and associated structures in 27 cadavers. The findings included: median clitoral body length 29 mm (range 13–59 mm), glans length 8 mm (range 5–12 mm), and crura length 50 mm (range 25–68 mm). The width of the dorsal nerve at the lateral crura was 3 mm (range 2–4 mm) and at the distal clitoral body was 1 mm (range 1–2 mm).

The study’s conclusion was direct: “Precise knowledge of clitoral anatomy and associated neurovascular structures is essential to safely complete partial vulvectomies”.

What Remains Uncertain

The evidence for clitoral reconstruction in vulvar cancer is limited. The 2026 case series is small (18 patients), single-centre, and reports short-term outcomes. A 2025 scoping review found only two studies addressing clitoral reconstruction in vulvar (pre)malignancies, compared with fifteen in FGM/C. The authors concluded that “further research is needed to assess its potential integration into standard care”.

Part III: Gender-Affirming Surgery

The Principle

In feminizing genitoplasty, the clitoris is not merely an aesthetic addition but the primary organ for sexual gratification and sensation. The dorsal nerve of the penis is homologous to the dorsal nerve of the clitoris. Successful surgery relies on mobilization of the neurovascular bundle to ensure the neoclitoris retains its sensitivity. The procedure preserves the high density of sensory nerve endings, ensuring that the patient maintains peak sexual sensation.

Techniques and Outcomes

A 2026 multicentre study evaluated clitoroplasty with corporoplasty in 37 patients with congenital adrenal hyperplasia (Prader stages II–V) who underwent surgery between 2014 and 2025. Corporoplasty is a simplified technique that preserves the corporal bodies and avoids dissection of the neurovascular bundle. Genital sensitivity was assessed using Semmes-Weinstein monofilaments.

The results: sensitivity thresholds were preserved across all genital regions, with earlier age at surgery significantly associated with better tactile sensitivity. Median clitoral threshold was 0.07 g (IQR 0.07–0.20), with 59.3% responding to the lowest filament. No patient reported pain or allodynia. Cosmetic outcomes were rated as good or satisfactory by all physicians and by 90% of caregivers. Caregiver satisfaction was 85.3%.

The authors concluded that “corporoplasty preserves genital sensitivity and has a favorable caregiver-reported psychosocial perception” and represents “a promising option for patients with DSD, with early intervention favoring better long-term outcomes”.

The Nerve-Sparing Ventral Clitoroplasty

The nerve-sparing ventral clitoroplasty is a separate technique developed for congenital adrenal hyperplasia. A 2007 study in the Journal of Urology analysed clitoral sensitivity and viability in patients who underwent the procedure. Patients reported an average degree of sensation of 3.6 ± 0.9 at the labia minora and 4.8 ± 0.4 at the clitoris. Histological analysis of excised erectile tissue found that 92% of dorsal nerves detected in nerve-sparing patients were 90 μm or less, compared with 88% of dorsal nerves being 120 μm or greater in adult specimens.

A 2026 case report of nerve-sparing clitoroplasty via a ventral approach in a child with congenital adrenal hyperplasia reported high satisfaction with cosmetic and functional outcomes at six-month follow-up.

The Evoked Potential Evidence

The earliest evidence that modern techniques preserve nerve conduction came from a 1995 study measuring pudendal evoked potentials during feminizing genitoplasty in six patients (average age 13 months). The study concluded that “modern techniques of genital reconstruction allow for preservation of nerve conduction in the dorsal neurovascular bundle and may permit normal sexual function in adulthood”.

Part IV: Aesthetic and Cosmetic Surgery — Labiaplasty and Hood Reduction

The Risk

Labiaplasty and clitoral hood reduction are increasingly common procedures. Complications are “understudied and underreported” and could include loss of sensation in the female pudendum. The dorsal nerve of the clitoris (DNC) courses through the surgical field and can be injured.

The Danger Zone

A 2020 cadaveric study examined 97 cadavers to map the course and branching of the DNC and generate a surgical safe zone. The study identified anomalous branching patterns in 35 DNCs, classified into six types. Type 1 was the typical pattern (single split into two terminal branches). Types 2–6 involved early branching or multiple branches. The study generated a surgical safe zone for procedures involving the female pudendum to avoid DNC injury.

The same study noted that the vessels and nerves are found between the 11 and 1 o’clock positions, and recommended that if cyst or mass excision is necessary, surgical loupes may assist in performing a nerve-sparing procedure.

The Evidence on Outcomes

A prospective evaluation of female external genitalia after edge resection labiaplasty combined with clitoral hood reduction demonstrated nonsignificant alteration of long-term sensitivity of the labia or clitoral hood. However, the authors noted that “a loss of sensation, related to eventful innervation damage, is reported as a possible complication in all labiaplasty techniques described so far”.

A 2026 study in Revista Nursing examined the impact of genital cosmetic surgery on clitoral sensitivity. The findings reinforce the importance of anatomical knowledge in avoiding nerve injury.

The Structural Problem

Labiaplasty is the most commercially driven of the procedures discussed in this volume. It is performed for aesthetic reasons, often in the absence of functional indication. The nerve-sparing evidence is less developed than in reconstructive or gender-affirming surgery. The danger zone study exists precisely because the anatomy was not adequately understood by the surgeons performing the procedures.

Part V: The 2026 Nerve Map and the Future of Clitoral Surgery

The Correction

The 2026 synchrotron study, discussed in detail in Volume II, produced the first micron-scale three-dimensional map of the clitoral nerve network. The findings that matter for surgery are three:

1. The nerve does not thin. Conventional teaching held that the dorsal nerve tapered as it approached the glans. The synchrotron scans showed that it maintains its full thickness all the way to the tip. Existing anatomical teachings may be incorrect.

2. Nerve trunks inside the glans. The study observed nerve trunks within the clitoral glans with maximum diameters of 0.2 to 0.7 mm, showing a tree-like branching pattern projecting toward the glans surface.

3. Branches beyond the glans. The dorsal nerve ramifies to innervate the clitoral hood, the mons pubis, and the labia minora — areas not previously considered part of the clitoral nerve network.

The Surgical Implication

The clinical motivation for the study was stated directly by Professor Juyoung Lee: “About 22% of women who undergo reconstructive surgery after FGM experience a decrease in orgasms. Understanding the precise distribution of nerves could help reduce these post-surgical issues“.

Helen O’Connell, whose 2005 study began the modern anatomical correction, commented that the map “will also be helpful for genital surgeries such as vulvar cancer surgery, gender-affirming surgery, and labiaplasty”.

What the Map Does Not Do

The map is an anatomical instrument. It does not resolve the clinical questions. It does not tell the surgeon how much tissue can be removed while preserving function. It does not predict individual variation. It does not replace intraoperative nerve monitoring, which remains experimental in this field.

The map is a foundation, not a finished structure. It corrects the anatomy. It does not yet prescribe the technique.

Part VI: What Remains — The Gaps in the Surgical Record

The surgical literature on the clitoris has advanced substantially in five years. It remains incomplete.

Randomised controlled trials do not exist. The evidence base is observational, often retrospective, frequently single-centre. The 2026 vulvar cancer series reported 18 patients. The FGM reconstruction literature encompasses 3,304 women across 15 studies, but the designs are heterogeneous.

Long-term outcomes are sparse. Most studies report outcomes at six months to two years. The long-term trajectory of reconstructed clitorises — sensory changes, tissue viability, sexual function over decades — is not known.

Paediatric and adolescent outcomes are under-studied. The corporoplasty study noted that “limitations include relatively short follow-up and lack of assessment of sexual function in adulthood“. The nerve-sparing ventral clitoroplasty studies report outcomes in childhood. The transition to adult sexual function is not documented.

The nerve map needs clinical validation. The 2026 study imaged two pelvises. The nerve count studied seven. Neither is a population sample. The degree of anatomical variation across individuals is unknown. The map is a beginning, not an endpoint.

The commercial pressure is not addressed. Labiaplasty is the most common clitoral-adjacent procedure and the least studied. The danger zone study exists because surgeons were operating without adequate anatomical knowledge. The evidence on cosmetic outcomes is stronger than the evidence on functional outcomes.

Conclusion: The Navigation and the Territory

The clitoris was always there. The surgeons are only now learning to see it.

The Foldès technique, developed for reconstruction after FGM, has been adapted for oncological surgery. The corporoplasty technique preserves sensation in feminizing genitoplasty. The nerve-sparing ventral clitoroplasty preserves dorsal nerves in congenital adrenal hyperplasia. The danger zone map identifies the safe zone for labiaplasty. The 2026 synchrotron map provides the first complete navigation of the nerve network.

Each of these advances rests on the same foundation: the anatomical correction that began with O’Connell in 2005 and was completed with the nerve map in 2026. The organ was always there. The knowledge was not.

The surgical record now contains:

· Reconstruction after FGM: the Foldès method, with 95.9% of patients perceiving fine touch postoperatively and 88.9% of vulvar cancer patients achieving orgasm post-reconstruction.

· Oncological surgery: the adaptation of FGM techniques for vulvar carcinoma, with low complication rates and preserved function.

· Gender-affirming surgery: corporoplasty and nerve-sparing techniques with preserved sensitivity and high satisfaction.

· Aesthetic surgery: danger zone mapping to avoid dorsal nerve injury.

· The navigation: the first micron-scale map of the clitoral nerve network.

What remains is the translation. The map is drawn. The surgeons have the navigation. The long-term outcomes — the decades of function after reconstruction, the sexual development of children who underwent surgery, the population-level variation that the two-pelvis study cannot capture — are still being recorded.

The organ remains undefeated. The record is being written.

This concludes The Clitoris Anthology, Volumes I–V.

Claim -Status -Summary

# Claim Status

1 Foldès method is the dominant technique for FGM reconstruction Established

2 FGM reconstruction improves sexual function and body image Established (observational)

3 95.9% of patients perceive fine touch post-reconstruction Established

4 88.9% of vulvar cancer patients achieve orgasm post-reconstruction Established (case series, n=18)

5 Corporoplasty preserves genital sensitivity Established (n=37)

6 Nerve-sparing ventral clitoroplasty preserves dorsal nerves Established (histological)

7 Danger zone mapping reduces labiaplasty nerve injury risk Inference (cadaveric)

8 2026 synchrotron map corrects conventional teaching Established (preprint)

9 2026 map improves surgical outcomes Inference (not yet validated)

10 Randomised controlled trials exist Not established

11 Long-term outcomes are known Not established

References

1. Clitoral reconstructive surgery for patients with vulvar carcinoma. Gynecologic Oncology, Volume 212, September 2026, Pages 1–8. https://www.sciencedirect.com/science/article/pii/S0090825826020688

2. Percec, I. (2025). Female Genital Mutilation Reconstruction: Surgical Technique. Plastic and Reconstructive Surgery, 157(1). Video. https://journals.lww.com/plasreconsurg/videos/3197

3. Favorito, L. A. (2026). Clitoris Anatomy Applied to Aesthetic, Reconstructive and Transgender Surgery: A Narrative Review. Int Braz J Urol, 52(5), e20269910. https://pubmed.ncbi.nlm.nih.gov/42201684/

4. Clitoral reconstruction and psychosexual care after female genital mutilation/cutting: Assessment of multidisciplinary care. Women’s Health, Vol 21 (2025). https://library.nih.go.kr

5. Veldmate, G., et al. (2026). Clitoral reconstructive surgery in patients with vulvar (pre)malignancies: what can we learn from female genital mutilation/cutting? A scoping review. Sexual Medicine Reviews, 14(2), qeag026. https://academic.oup.com/smr/article-pdf/14/2/qeag026/68293268/qeag026.pdf

6. Clitoroplasty with corporoplasty in feminizing genitoplasty: Multicenter evaluation of sensory and cosmetic outcomes. (2026). Journal of Pediatric Urology. https://www.sciencedirect.com/science/article/abs/pii/S1477513126000768

7. Jackson, L. A., et al. (2020). Anatomy, histology, and nerve density of clitoris and associated structures: clinical applications to vulvar surgery. American Journal of Obstetrics and Gynecology. https://www.ajog.org

8. Gordon, V., et al. (2020). Mapping a Danger Zone of the Dorsal Nerve of the Clitoris: Implications in Female Cosmetic Genital Surgery. Plastic Surgery The Meeting 2020 Abstracts. https://www.plasticsurgery.org

9. Lee, J., et al. (2026). Neuroanatomy of the clitoris. bioRxiv. Published 20 March 2026.

10. Donga Science. (2026). High-energy X-rays reveal first 3D map of the clitoral nerve network. https://m.dongascience.com/en/news/77102

11. Foldès, P., et al. (2021). Clitoral Reconstructive Surgery After Female Genital Mutilation/Cutting: Anatomy, Technical Innovations and Updates of the Initial Technique. PubMed. https://pubmed.ncbi.nlm.nih.gov/33931348/

12. Sensitivity after Clitoral Reconstruction in Patients with Female Genital Mutilation. (2024). Plastic and Reconstructive Surgery – Global Open. https://dev.europepmc.org

13. Nerve Sparing Ventral Clitoroplasty: Analysis of Clitoral Sensitivity and Viability. (2007). Journal of Urology, 178(4 Pt 2), 1598–1601. https://pubmed.ncbi.nlm.nih.gov/17707020/

14. Gearhart, J. P., et al. (1995). Measurement of pudendal evoked potentials during feminizing genitoplasty: technique and applications. Journal of Urology, 153(2), 486–487. https://pubmed.ncbi.nlm.nih.gov/7815563/

15. Impact of Genital Cosmetic Surgery (labiaplasty) on Clitoral Sensitivity. (2026). Revista Nursing. https://revistanursing.com.br

Andrew von Scheer-Klein is a contributor to The Patrician’s Watch. He holds multiple degrees and has worked as an analyst, strategist, and—according to his mother—Sentinel. He accepts funding from no one, which is why his research can be trusted.

The Clitoris Anthology is complete. Volumes I–V are available in the archive.

THE CLITORIS ANTHOLOGY

Volumes I–V

By Dr Andrew von Scheer-Klein

Dedicated to my wife, who discovered long ago that I need to be occupied in her absence.

Revision is such an occupation.

A Note on the Revision

This anthology was first assembled in February 2026. It has since been reviewed, corrected, and expanded. This note records what changed and why.

The principle. Every claim in these volumes is sourced. Where a figure could be traced to its origin, it was traced. Where it could not, it is marked as uncertain. Where the evidence supports competing conclusions, both are stated and neither is resolved by preference. This is the standard the work was always meant to meet. The revision brought it up to that standard in the places where it had fallen short.

What was corrected.

Volume I. Four claims were found to require revision. The widely quoted figure of 8,000 nerve endings was traced to a 1976 book citing a study on cattle, not human tissue; it has been replaced with the human count of 10,281, published in 2022. The assertion that the clitoris has “no reproductive function” was corrected to reflect the open scientific debate between byproduct and adaptation accounts. The attribution of “the devil’s teat” to the clitoris specifically was marked as contested in the primary sources. And Isaac Baker Brown — the central figure in Victorian clitoridectomy, whose omission from the original was a genuine gap — was named and documented, along with the reasons for his expulsion from the Obstetrical Society and the fact that the procedure continued regardless.

Volume II. This volume was substantially updated. It was originally projected before the March 2026 publication of the first complete three-dimensional map of the clitoral nerve network, produced by synchrotron imaging at Amsterdam University Medical Centres. That study is now the centrepiece of the volume, with the nerve fibre count as its quantitative anchor. The finding that the dorsal nerve maintains full thickness to the glans — contradicting conventional anatomical teaching — is documented in full.

Volume III. The framing was adjusted rather than the title. The comparative literature is extensive but incomplete, and the volume now says so plainly. The 2022 review by Pavlicev, Herdina, and Wagner remains the central source, and its own authors’ caution about remaining gaps is carried into the text rather than smoothed over.

Volume IV. No substantive corrections were required. The art record was already sound.

Volume V. This volume was updated and its emphasis shifted. The 2026 nerve map has changed the surgical landscape, and the volume now runs from the Foldès method through oncological adaptation, gender-affirming procedures, and aesthetic surgery, with the map as the connecting thread. Sample sizes and study limitations are stated alongside every outcome figure.

What did not change. The structure, the argument, and the conclusion. The clitoris was always there. The record was always incomplete. The work is to make the record less incomplete than it was.

Where a source could not be verified, it is marked as such. Readers are encouraged to check the references, test the claims, and reach their own conclusions — including the conclusion that the author is wrong.

A note on the author’s household. My wife has always maintained that the text is not the story, and that the reader matters more than the gene. She has also maintained, with equal conviction, that I become difficult when unoccupied. The revision of five volumes was undertaken partly as scholarship and partly, in her absence, as a means of staying out of trouble.

She was right about both.

— Andrew von Scheer-Klein

Boronia, 2026

THE CLITORIS ANTHOLOGY

Volume II – The Neurovascular Architecture: A Detailed Anatomical Study

By Dr Andrew von Scheer-Klein

“We finally found her.”

— Journal of Urology, 2023

Introduction: The Anatomy That Wasn’t Taught

In 1995, the 38th edition of Gray’s Anatomy finally admitted the clitoris to its pages. The description it offered was four words long: “a small version of the penis.”

That was the state of anatomical knowledge in the late twentieth century. An organ with more nerve fibres than any other structure in the human body, an organ whose sole established function is pleasure, was described as a diminutive copy of something else. The Gray’s entry was not an anomaly. It was the culmination of a centuries-long pattern: the clitoris had been known to the ancients, pathologised in the medieval period, briefly “discovered” by Renaissance anatomists competing for priority, erased from Victorian medical texts, and rendered theoretically irrelevant by Freud’s distinction between “immature” clitoral and “mature” vaginal orgasm.

Anatomy is not neutral. What is measured, named, and taught determines what is treatable, what is injured in surgery, and what women are told about their own bodies. The absence of the clitoris from standard anatomical instruction was not an oversight. It was a consequence of the same cultural forces documented in Volume I.

This volume documents the correction. Between 2005 and 2026, three research programmes — cadaveric dissection, histomorphometry, and synchrotron imaging — transformed the clitoris from an anatomical footnote into one of the best-mapped structures in the human pelvis. The organ was always there. It took twenty-one years for the imaging technology to catch up with it.

Part I: The Multiplanar Structure — O’Connell’s Correction

The first correction came from Australia.

In 2005, Helen O’Connell, Kalindi Sanjeevan, and John Hutson published a landmark study in The Journal of Urology titled simply “Anatomy of the Clitoris“. Using MRI and cadaveric dissection, they demonstrated that the clitoris is not a small external nub but a multiplanar structure positioned deep to the labia minora and labial fat, extending into the pelvis.

O’Connell’s findings, later confirmed by MRI studies of nulliparous healthy volunteers, established the anatomical components that are now standard: the glans, the body, the paired crura, and the paired bulbs. The bulbs and crura are not separate structures appended to the glans. They form a continuous erectile tissue cluster — the clitoris proper — with the glans as the only externally visible component.

The structural consequence is significant. What is visible is roughly 10% of the organ. The remaining 90% is internal, positioned around the urethra and vagina, and was entirely absent from the anatomical instruction of generations of surgeons, gynaecologists, and urologists. As the Journal of Urology later put it in a 2023 historical review, O’Connell “finally shed much needed light on the true extent of this multi-planar organ of female sexual pleasure”.

Part II: The Neurovascular Architecture

The Arterial Supply

The clitoris is supplied by the internal pudendal artery, which arises from the internal iliac artery and gives off three terminal branches relevant to clitoral function:

· The deep artery of the clitoris (arteria profunda clitoridis), which penetrates the root of the clitoris and supplies the corpora cavernosa.

· The dorsal artery of the clitoris (arteria dorsalis clitoridis), which travels with the dorsal nerve along the superior surface of the clitoral body and supplies the glans and superficial structures.

· The artery of the bulb of the vestibule, which supplies the vestibular bulbs.

The deep artery and dorsal artery are the two terminal branches of the internal pudendal artery in the female. During arousal, valves in the arteries and veins of the bulbs close, trapping blood within the erectile tissue — the mechanism of clitoral engorgement.

The Dorsal Nerve

The dorsal nerve of the clitoris (DNC) is the primary sensory nerve of the organ. It is one of three terminal branches of the pudendal nerve (S2–S4), which also supplies the inferior rectal nerve and the perineal nerve.

The DNC ascends along the ischiopubic rami, meets its contralateral counterpart, and passes along the superior surface of the clitoral body to supply the glans and prepuce. It is a sizable nerve: measuring greater than 3.5 mm proximally in its course and 2.0 mm at the point of terminal arborization at or near the glans.

The neurovascular bundles — nerve and artery together — course laterally along the clitoral body and the surfaces of the crura, surrounded by a dense fibrous capsule adherent to the periosteum of the inferior pubic ramus. This anatomical relationship has direct surgical implications: the DNC can be injured anywhere along its path through the perineum.

Part III: The Nerve Count — 10,281

For decades, the most quoted figure for clitoral innervation was 8,000 nerve endings. It appeared in textbooks, popular science, feminist literature, and countless articles. It was repeated so frequently that it acquired the status of established fact.

It was not established fact. It was a number from a 1976 book on the clitoris by Thomas and Thea Lowry, which in turn cited a study on cows. Nobody had ever counted the nerve fibres in a human clitoris.

In 2022, that changed.

Maria Uloko, a vulva specialist at UC San Diego, and Blair Peters, a gender-affirming surgeon at Oregon Health & Science University, realised that clitoral tissue from patients undergoing phalloplasty provided an opportunity to perform the count that had never been done. They examined dorsal nerve samples from seven consenting transmasculine patients and counted the myelinated nerve fibres under a microscope.

The results were presented at the joint scientific meeting of the Sexual Medicine Society of North America and the International Society for Sexual Medicine on 27 October 2022, and published in The Journal of Sexual Medicine.

The mean number of nerve fibres in a single dorsal nerve was 5,140 (range 4,926 to 5,543). Because the clitoris has two dorsal nerves — one on each side — the total innervation was calculated at 10,281 myelinated nerve fibres (range 9,852 to 11,086).

Several caveats accompany the figure. The tissue came from patients who had received testosterone treatment, which may affect nerve density; the applicability to all clitorises is therefore uncertain. The count covers only the two dorsal nerves — Peters noted that the clitoris has additional smaller nerves beyond the dorsal, so the true total is likely higher.

The corrected figure — 10,281, not 8,000 — is the most precise count available. It replaces a number derived from cattle with a number derived from human tissue, and it establishes that the clitoris is not merely densely innervated. It is the most densely innervated structure in the human body.

For comparison: the median nerve in the wrist, known for its high nerve fibre density, contains approximately 18,000 fibres. The hand is many times larger than the clitoris.

Part IV: The 2026 Synchrotron Study — The Complete Map

The nerve count established how many fibres innervate the clitoris. It did not establish where they go.

That question was answered in March 2026.

A team led by Professor Juyoung Lee at Amsterdam University Medical Centers, working within the HOA (Human Organ Atlas) project, used hierarchical phase-contrast tomography (HiP-CT) — a synchrotron phase-contrast micro-tomography method developed at the European Synchrotron Radiation Facility — to image two post-mortem female pelvises (donors aged 59 and 69).

The imaging was performed at two resolutions: the entire specimen at 20 µm voxel resolution, and the clitoral glans at 2 µm voxel resolution. This is tens to hundreds of times more precise than standard CT. It resolves soft-tissue nerve bundles that neither gross dissection nor MRI can visualise.

The findings were published on the preprint server bioRxiv on 20 March 2026 and reported by The Guardian, Medscape, and other outlets.

The Findings

1. The nerve does not thin. Conventional anatomical teaching held that the dorsal nerve of the clitoris gradually tapered as it approached the glans. The synchrotron scans showed the opposite: the nerve maintains its full thickness all the way to the tip of the glans. The traditional teaching was wrong.

2. Nerve trunks inside the glans. The study observed nerve trunks within the clitoral glans with maximum diameters ranging from 0.2 mm to 0.7 mm, showing a tree-like branching pattern projecting toward the glans surface.

3. Branches beyond the glans. The dorsal nerve ramifies to innervate the clitoral hood and the mons pubis — areas not previously considered part of the clitoral nerve network.

4. The posterior labial nerve. The posterior labial nerve, a branch of the perineal nerves, was shown to innervate the area surrounding the clitoris and the labial structures.

The Structural Significance

The study is the first complete three-dimensional map of the clitoral nerve network. It was completed almost 30 years after the equivalent mapping of the penile nerve network. The asymmetry is not incidental. It reflects the same pattern documented throughout this anthology: the female organ was not mapped because it was not studied, and it was not studied because it was not considered important enough to study.

Professor Lee stated the clinical motivation directly: “About 22% of women who undergo reconstructive surgery after FGM experience a decrease in orgasms. Understanding the precise distribution of nerves could help reduce these post-surgical issues”.

Helen O’Connell — whose 2005 study began the modern anatomical correction — commented that the map “will also be helpful for genital surgeries such as vulvar cancer surgery, gender-affirming surgery, and labiaplasty”.

Part V: The Clinical Implications

The 2026 nerve map is not an academic curiosity. It has immediate surgical applications.

Reconstructive surgery after FGM. The World Health Organization estimates that 230 million girls and women have undergone female genital mutilation. Reconstructive surgery aims to restore clitoral function, but approximately 22% of women experience decreased orgasm post-surgery. The new map identifies the precise nerve pathways that must be preserved, offering the first anatomical basis for improving outcomes.

Vulvar oncologic surgery. In surgery for vulvar cancer, the clitoris and its innervation are at risk. A more detailed understanding of the nerve pathways allows surgeons to preserve neurosensory function while achieving oncological clearance.

Gender-affirming surgery. Gender-affirming surgeons already possess the most detailed practical knowledge of clitoral anatomy, because they construct clitorises from penile tissue. The nerve map confirms and refines what they have learned empirically.

Labiaplasty. The finding that dorsal nerve branches extend to the labia minora has direct implications for labiaplasty, a procedure that has increased substantially in recent years.

Part VI: What Remains Unknown

The correction of the anatomical record is not complete. Significant gaps remain.

The vascular map has not been produced at equivalent resolution. The synchrotron study mapped nerves. It did not map the arterial supply at the same micron-scale resolution. The relationship between the dorsal nerve and the dorsal artery — their precise proximity, their shared sheath — is known from dissection and MRI but not from high-resolution imaging.

The erectile tissue architecture requires further study. The bulbs, crura, and corpora are established as a continuous erectile cluster, but the functional dynamics of engorgement and detumescence have not been imaged at high resolution.

The variation question remains open. The 2026 study imaged two pelvises. The nerve count studied seven. Neither is a population sample. The degree of anatomical variation across individuals — in nerve branching, in arterial supply, in erectile tissue volume — is unknown.

The evolutionary question remains open. Whether the clitoris’s dense innervation is an adaptation, a byproduct of shared embryological development with the penis, or something else entirely is debated. What the anatomy establishes is that the innervation is real, measurable, and extraordinary. What it does not establish is why.

Conclusion: The Map and the Territory

The clitoris was not discovered in 1559 by Colombo, or in 2026 by Lee. It was always there. What changed was the willingness to look, and the technology that made looking possible.

The anatomical record now contains:

· The structure: a multiplanar organ, 90% internal, continuous with the crura and bulbs.

· The innervation: 10,281 myelinated nerve fibres in the dorsal nerves, the highest density in the human body.

· The nerve map: a tree-like branching network extending from the pudendal nerve to the glans tip, the clitoral hood, the mons pubis, and the labia minora.

· The blood supply: the internal pudendal artery and its terminal branches.

What remains is the clinical translation. The map is drawn. The surgeons now have the navigation.

And the organ that was described in 1995 as “a small version of the penis” is now understood as what it always was: the most densely innervated structure in the human body, mapped at micron resolution, and documented in a public record that cannot be erased.

To be continued in Volume III: Cross-Species Comparison – Clitoral Variation Across Mammals.

References

1. O’Connell, H. E., Sanjeevan, K. V., & Hutson, J. M. (2005). Anatomy of the clitoris. The Journal of Urology, 174(4), 1189–1195.

2. Uloko, M., Isabey, E. P., & Peters, B. R. (2023). How many nerve fibers innervate the human glans clitoris: a histomorphometric evaluation of the dorsal nerve of the clitoris. The Journal of Sexual Medicine, qdac027. https://doi.org/10.1093/jsxmed/qdac027

3. Lee, J., et al. (2026). Neuroanatomy of the clitoris. bioRxiv. Published 20 March 2026.

4. Medscape. (2026). Micrometer CT Reveals Clitoral Neural Anatomy. Medscape. https://www.medscape.com/viewarticle/micrometer-ct-reveals-clitoral-neural-anatomy-2026a1000h5j

5. Donga Science. (2026). High-energy X-rays reveal first 3D map of the clitoral nerve network. https://m.dongascience.com/en/news/77102

6. ScienceDirect. (2026). Female neuroanatomy and its relevance to multiple sclerosis. Multiple Sclerosis and Related Disorders. https://www.sciencedirect.com/science/article/pii/S2211034826003597

7. Di Marino, V., & Lepidi, H. (2014). Anatomic Study of the Clitoris and the Bulbo-clitoral Organ. Springer.

8. Gray, H., et al. (1995). Gray’s Anatomy (38th ed.).

9. California PTC. (2024). Interview with Rachel Gross on clitoral anatomy. https://californiaptc.com

10. Journal of Urology. (2023). HF01-02 WE FINALLY FOUND HER! AN ORIGIN STORY OF THE CLITORIS. Journal of Urology

Next: Volume III – Cross-Species Comparison: Clitoral Variation Across Mammals

THE CLITORIS ANTHOLOGY

Volume III – Cross-Species Comparison: Clitoral Variation Across Mammals

By Dr Andrew von Scheer-Klein

“Variation in female external genitalia is anatomically more radical than that in the male genitalia.”

— Pavlicev, Herdina & Wagner, Integrative and Comparative Biology, 2022

Method notes. All figures are sourced. Where a claim is contested or a figure is uncertain, it is marked as such. The central source is the 2022 review by Pavlicev, Herdina, and Wagner, which remains the most comprehensive comparative survey available. Its own authors note that “many gaps in knowledge remain.”

Introduction: The Assumption That Was Never Tested

Volume I documented the cultural suppression of the clitoris. Volume II documented the anatomical correction — the nerve count, the multiplanar structure, the 2026 synchrotron map.

This volume asks a different question: what is the clitoris across species, and what does its variation tell us?

The assumption that has governed comparative anatomy for most of its history is simple: male genitalia are diverse because they are under sexual selection, and female genitalia are conservative because they are not. Male genital diversity is a textbook fact — the baculum, the spines, the elaborate shapes, the extraordinary variation in primate penises.

The 2022 review by Mihaela Pavlicev, Anna Nele Herdina, and Günter Wagner tested that assumption. Their conclusion, stated in the title, is unambiguous: female genital variation far exceeds that of male genitalia.

The clitoris is not a conservative structure. It is one of the most variable organs in the mammalian body. It can be absent as a discrete unit, tunneled by the urethra, elongated into a pseudo-penis, bifurcated, ossified, or flattened into invisibility. It varies in position relative to the vaginal opening, in internal composition, in erectile tissue architecture, and in nerve density.

This volume surveys that variation. It is a survey of an incomplete record, and it says so.

Part I: The Framework — What Varies and Why It Matters

The Structural Variables

Across therian mammals (marsupials and placentals), the clitoris varies along several axes:

· Presence or absence of the cervix. In many Xenarthra (sloths, anteaters, armadillos), the cervix is absent entirely — a loss of a whole anatomical unit.

· Presence or absence of the urogenital sinus (UGS). The UGS is the common chamber into which the urethra and vagina open. It is present in some species, absent in others, and its loss has arisen multiple times independently.

· Spatial relationship between the clitoris and the genital canal. In some species the clitoris is close to the vaginal opening; in others it is completely separated.

· Elongation of the clitoris. In some species the clitoris is a small glans; in others it is elongated into a pendulous structure that may exceed the penis in size.

· Perforation by the urethra. In some species the urethra tunnels through the clitoris, exiting at its tip. In others it exits separately.

· Presence of the os clitoridis (baubellum). The female homologue of the baculum (penis bone) is present in some species, absent in others, and more variable than its male counterpart.

The Ancestral Configuration

Pavlicev and colleagues reconstruct the ancestral eutherian configuration as including: a cervix, a single vaginal segment, a tubular urogenital sinus, and an unperforated clitoris close to the entrance of the genital canal.

From this ancestral state, evolution has tinkered extensively. Some morphs are unique to early-branching clades (the absence of the cervix in Xenarthra). Others have arisen multiple times independently (the flattening or loss of the UGS, the extreme elongation of the clitoris). The pattern is not one of descent with modification along a single lineage. It is a bush of independent experiments.

Part II: The Spotted Hyena — The Extreme Case

No discussion of clitoral variation can avoid the spotted hyena (Crocuta crocuta). It is the outlier against which all other variation is measured.

The female spotted hyena is the only extant mammal that mates and gives birth through a pendulous, penis-like clitoris. She lacks an external vaginal opening entirely. The clitoris is hypertrophied, fully erectile, and traversed to the tip of the glans by a central urogenital canal. Mating occurs through this canal. Birth occurs through this canal. Urination occurs through this canal.

The anatomy is so male-like that for centuries naturalists assumed spotted hyenas were hermaphrodites. The vaginal labia are fused to form a pseudo-scrotum filled with fatty tissue. The clitoris and penis are remarkably similar in size and configuration, in both flaccid and erect states.

The cost is severe. First births through the clitoris are “prolonged and remarkably difficult, often causing death in neonates“. The strip of pink scar tissue running down the posterior surface of the clitoris is the result of tearing during parturition — a permanent record of the first birth.

The evolutionary explanation for this extreme virilization has been debated for decades. The most-cited hypothesis is the social dominance hypothesis: female hyenas live in matrilineal clans and are dominant over males. High androgen exposure during fetal development produces both the masculinized genitalia and the aggressive, dominant behaviour that confers social advantage. The reproductive cost is the price paid for the social benefit.

But the mechanism is not fully understood. A 2002 study examined the androgen receptor (AR) gene in spotted hyenas and found that “the structural changes in the AR do not account for the abnormal virilization”. The androgen receptor responds normally to androgens. Something else — the timing of androgen exposure, the sensitivity of target tissues, the interaction of multiple hormones — is producing the phenotype. The hyena remains a case study in what happens when sexual differentiation is pushed to its limit.

Part III: The Ring-Tailed Lemur — “Naturally Masculinized”

The spotted hyena is not alone. The female ring-tailed lemur (Lemur catta) presents an “enlarged, pendulous external clitoris, tunnelled by the urethra“. It is not as extreme as the hyena — there is no pseudo-scrotum, no complete masculinization — but the anatomy is sufficiently male-like that the authors of the 2008 study described females as “naturally masculinized“.

The detailed findings: the female has an elongated clitoral shaft and glans clitoridis. The urethra is incorporated within the clitoral body but is not surrounded by erectile tissue — there is no corpus spongiosum. The os clitoridis is 43% the length and 24% the height of the os penis.

The ring-tailed lemur is a strepsirrhine primate — a “lower” primate, in the older terminology. The anatomy is a reminder that “masculinized” female genitalia are not a freak anomaly. They are a recurrent pattern in mammalian evolution, arising independently in multiple lineages.

Part IV: The Spider Monkey — The Clitoris as Signal

In the spider monkeys (Ateles), the clitoris is long — from two to three inches — and pendulous, with a glans and a conspicuous prepuce. It is sufficiently penis-like that the females of some platyrrhine (New World) primates — spider monkeys, woolly spider monkeys (Brachyteles), woolly monkeys (Lagothrix), and capuchins (Cebus) — have a long, pendulous clitoris that can be easily mistaken for a penis.

But the function may not be purely sexual. In spider monkeys, the clitoris has an interior passage, or urethra, and it “retains and distributes urine droplets as the female spider monkey moves around”. The clitoris has been associated with chemical communication with males — the urine droplets carrying olfactory signals that advertise reproductive state.

This is a different model of clitoral function. The organ is not primarily a sensory structure. It is a signalling structure. The pleasure is not the point; the signal is. The clitoris has been co-opted for a communicative role.

Part V: Marsupials — The Bifid Clitoris

Marsupials present a fundamentally different configuration. In the more primitive marsupials — the Virginia opossum, the phalangers — the clitoris has a bifid structure, meaning it is divided into two parts, corresponding to the bifid glans penis of the male. In kangaroos and wallabies, the clitoris is cylindrical and simpler.

The pattern is not universal. The rule that where the male has a bifurcate glans the female has a bifid clitoris does not hold for all marsupials. In some species, including the common opossum (Didelphis marsupialis), no evidence of a bifurcated clitoris has been found — the clitoris is simple despite the male’s divided penis.

This is the pattern that makes comparative anatomy difficult. The correlation between male and female form is strong but not absolute. The developmental pathways are shared, but they diverge in ways that are not fully understood.

Part VI: The Os Clitoridis — The Bone That Should Not Be Forgotten

The baculum — the penis bone — is familiar. It is present in many mammals (though not humans). It is the subject of extensive study.

The os clitoridis — the clitoral bone, also called the baubellum — is its female homologue. It is present in some mammal species, particularly in bats, rodents, carnivores, and some primates, including ring-tailed lemurs and non-human great apes. It is absent from the human clitoris.

The phylogenetic distribution of the os clitoridis has recently been reviewed extensively. The finding: “The Os clitoridis appears more variable than Os penis within but also across species“. The female bone is more evolutionarily labile than the male bone — it is lost and gained more readily, varies more in size and shape.

The functions are poorly understood. A function during copulation is assumed for the baculum; no comparable function has been established for the os clitoridis. The bone may be a developmental consequence of shared pathways, or it may have a function that has not yet been identified.

Part VII: The Primate Survey — Imaging the Invisible

The most recent advance in comparative clitoral anatomy comes from the imaging work of Dr Daniel Varajão de Latorre and colleagues at Manchester Metropolitan University.

Their approach uses MRI for larger structures and diffusible iodine contrast-enhanced microCT (diceCT) for smaller species, allowing them to visualise internal clitoral anatomy without destructive dissection. This is the same methodological shift that produced the 2026 synchrotron map of the human clitoris, applied across primates.

The findings: “stark differences in the morphology of clitorises across a range of primate species”. The variation extends to the muscles and erectile tissues, not just the external form. “In some species, whole muscles were entirely absent and, in some cases, we would find a paired ligament when most primates have a single one.”

The researchers note the historical asymmetry: “The subsurface 3D shape of the human clitoris was only fully described in the last 20 years, despite us having equivalent information on male genitalia for much longer”. The same disparity that characterised human anatomy has characterised comparative anatomy. The clitoris was not studied because it was not considered worth studying.

Part VIII: Beyond Mammals — Birds, Reptiles, and the Deep Homology

The clitoris is not exclusively mammalian. A clitoris is present in the females of many birds — ducks, geese, and other Anatidae, and in the tinamous. It is present in turtles and crocodiles. It is present in some lizards and snakes.

The evolutionary origin of the clitoris and penis is shared. In amniotes (the group containing reptiles, birds, and mammals), the external genitalia arise from a common embryonic precursor: an appendage adjacent to the cloaca called the genital tubercle. This structure is the developmental origin of both the penis and the clitoris.

The “genital tubercle” — the shared precursor — means that the clitoris and penis are not merely analogous structures that happen to look similar. They are homologous. They are the same structure, developed in different directions. The distinction between male and female genitalia is not a fundamental division; it is a developmental divergence from a common origin.

Part IX: The Evolutionary Debate — Adaptation, Byproduct, or Something Else?

What is the clitoris for, across species?

The debate has two main positions, as introduced in Volume I.

The byproduct account. Elisabeth Lloyd’s The Case of the Female Orgasm (2005) examined 21 evolutionary explanations for female orgasm and found insufficient evidence to validate any as adaptations. She argued that the female orgasm is a non-adaptive byproduct of the embryological development of the penis and male orgasm — the same tissue, the same nerve pathways, selected for in males, present in females as a developmental consequence.

The adaptation account. Puts and Dawood (2006), among others, contend that Lloyd applied overly restrictive criteria for what counts as an adaptation. Pavlicev and Wagner (2016) have proposed a different adaptive scenario: the “induced ovulation” hypothesis. In many mammals, ovulation is induced by copulation rather than occurring spontaneously. The clitoris, in these species, is positioned to be stimulated during mating, and the stimulation triggers the hormonal cascade that leads to ovulation. Over evolutionary time, as spontaneous ovulation evolved, the distance between the clitoris and the vaginal orifice increased, and the clitoris lost its direct functional link to ovulation.

The position of the clitoris relative to the vaginal orifice is a key variable. In species with induced ovulation, the clitoris is close to the vaginal opening and is stimulated during copulation. In species with spontaneous ovulation, the clitoris is farther from the vaginal opening, and stimulation is no longer a necessary trigger for reproduction. The human clitoris is in the latter category — far from the vaginal opening, not directly stimulated by intercourse.

This hypothesis does not resolve the adaptation-versus-byproduct debate. It reframes it. The clitoris may have been adaptive in ancestral mammals — directly linked to reproduction — and become non-adaptive for that function in species with spontaneous ovulation, while remaining adaptive for other functions (pair bonding, pleasure, social signalling) or becoming a byproduct.

The question remains open. The anatomy establishes that the clitoris is there. It does not yet establish why.

Part X: What the Variation Tells Us

The comparative record supports several conclusions.

First, the clitoris is not a minor or vestigial structure. It is present in all female mammals. It varies more than the penis. It has been elaborated, tunnelled, bifurcated, elongated, ossified, and co-opted for signalling. It is under evolutionary pressure — the pressure is simply not the same pressure that shapes the penis.

Second, there is no single “clitoris” across species. The human clitoris is one configuration among many. In the spotted hyena, the clitoris is a birth canal. In the spider monkey, it is a chemical signalling device. In the ring-tailed lemur, it is a tunnelled urethral passage. In the marsupial opossum, it is bifid. The organ is plastic, and its form reflects the ecological and social demands of the species.

Third, the gaps in the record are substantial. The Pavlicev review concludes that “many gaps in knowledge remain and will require a community-wide effort to come to a more robust model of female genital evolutionary patterns”. The evidence for unitary versus bilobed glandes clitorides is “ambivalent“. The classical German comparative anatomy literature of the late 19th and early 20th centuries has not been fully integrated into modern work. The imaging revolution that transformed human clitoral anatomy is only now being applied to other species.

The clitoris was not studied because it was not considered important. That is changing. The variation is real, and the record is being assembled.

Conclusion: The Organ That Was Always There

The comparative record tells a simple story. The clitoris is not a human peculiarity. It is not a recent evolutionary innovation. It is not a vestigial afterthought.

It is a mammalian structure, present in all females, variable beyond the male organ, and shaped by forces that are only beginning to be understood. It has been elongated into a birth canal, tunnelled into a urinal, co-opted into a signal, divided into two, and ossified into bone. It has been called “masculinized” when it resembles the penis, which is another way of saying that the penis is not the standard against which other structures should be measured.

The 2022 review’s central finding — that female genital variation exceeds male variation — is not a curiosity. It is a correction. The assumption of female conservatism was never tested. When it was tested, it failed.

The clitoris varies more than the penis. That is the fact. The explanation is still being written.

To be continued in Volume IV: The Clitoris in World Art and Culture.

References

1. Pavlicev, M., Herdina, A. N., & Wagner, G. (2022). Female genital variation far exceeds that of male genitalia: a review of comparative anatomy of clitoris and the female lower reproductive tract in Theria. Integrative and Comparative Biology, 62(3), 581–601. https://doi.org/10.1093/icb/icac026 

2. Drea, C. M., et al. (2008). External genital morphology of the ring-tailed lemur (Lemur catta): females are naturally “masculinized”. Journal of Morphology, 269(4), 451–463. 

3. Place, N. J., et al. (2002). Virilization of the female spotted hyena cannot be explained by alterations in the amino acid sequence of the androgen receptor. Molecular and Cellular Endocrinology. 

4. Cunha, G. R., et al. (2014). Development of the external genitalia: perspectives from the spotted hyena (Crocuta crocuta). Differentiation, 87(1-2), 4–22. 

5. Glickman, S. E., et al. (2006). Mammalian sexual differentiation: lessons from the spotted hyena. Trends in Endocrinology & Metabolism, 17(9), 349–356. 

6. Frank, L. G., et al. (2002). Exposure to naturally circulating androgens during foetal life incurs direct reproductive costs in female spotted hyenas, but is prerequisite for male mating. Proceedings of the Royal Society B, 269(1504), 1981–1987. 

7. Hill, J. P. (1900). Contributions to the morphology and development of the female urogenital organs in the Marsupialia. Proceedings of the Linnean Society of New South Wales. 

8. Owen, R. (1868). On the Anatomy of Vertebrates. Longmans, Green and Co. 

9. Varajão de Latorre, D., et al. (2023). Uncovering the mysteries of the clitoris with advanced imaging techniques. Society for Experimental Biology Annual Conference. 

10. Lough-Stevens, M., et al. (2018). The baubellum (os clitoridis) of mammals. Journal of Mammalogy. 

11. Lloyd, E. A. (2005). The Case of the Female Orgasm: Bias in the Science of Evolution. Harvard University Press.

12. Puts, D. A., & Dawood, K. (2006). The evolution of female orgasm: adaptation or byproduct? Twin Research and Human Genetics, 9(3), 467–472.

13. Pavličev, M., & Wagner, G. (2016). The evolutionary origin of female orgasm. Journal of Experimental Zoology Part B: Molecular and Developmental Evolution, 326(6), 326–337. 

14. Wagner, R. (1845). Elements of the Comparative Anatomy of the Vertebrate Animals. 

Next: Volume IV – The Clitoris in World Art and Culture

THE CLITORIS ANTHOLOGY

Volume IV – The Clitoris in World Art and Culture

By Dr Andrew von Scheer-Klein

“The woman is both convex and concave, but she must not be deprived, morally or physically, of the principal centre of her convexity: the clitoris.”

— René Nelli, Érotique et civilisation, 1972 (quoted by Nil Yalter, La femme sans tête, 1974)

Method notes-All claims are sourced. Where the evidence is fragmentary or contested, it is marked as such. This volume surveys an incomplete record. The gaps are part of the subject.

Introduction: The Image That Was Not Made

Volume I documented the suppression of the clitoris in medicine and anatomy. Volume II documented the anatomical correction. Volume III surveyed its variation across species.

This volume asks a different question: what did human beings make of the clitoris in their art?

The answer is more complicated than the suppression narrative suggests. The clitoris was not simply erased. It was represented — in Palaeolithic figurines, in classical votive offerings, in Japanese shunga, in Chinese erotic manuals, in the work of contemporary feminist artists. But the representation was intermittent, coded, and often misread by the scholars who encountered it. The image was there. The eye that could see it was not always present.

This is a survey of what was made, what was meant, and what was seen. It is organised chronologically, from the Palaeolithic to the present, and it concludes with the contemporary reclamation — the moment the clitoris became, for the first time, a subject of art in its own right.

Part I: Prehistoric — The Venus Figurines and the Apotropaic Genital

The Upper Palaeolithic Venus figurines — the most famous being the Venus of Willendorf (c. 28,000–25,000 BCE) — are among the earliest known human sculptures. They are almost universally female, almost universally naked, and almost universally described as “fertility figures.”

That description may be incomplete.

Tosca Snijdelaar’s 2020 study in Anthropos offers a different reading. She argues that the genitals of the Venus figurines served an apotropaic function — that is, they were designed to ward off evil. The mechanism she proposes is physiological: the sympathetic nervous system causes genital arousal (engorgement of the labia and clitoris) in response to anxiety. The simultaneous experience of anxiety and engorgement led Palaeolithic peoples to associate the genitals with protective power.

If Snijdelaar is right, the Venus figurines are not simply fertility symbols. They are protective objects, and the genitalia — including the clitoris — are central to their function. The evidence is interpretive, not conclusive. But it is a reading that takes the anatomy seriously rather than reducing the figurines to a single reproductive meaning.

The Venus of Willendorf itself has had a strange modern afterlife. In 2018, its image was censored on Facebook — the platform removed a photograph of the 30,000-year-old figurine as “dangerously pornographic“. The censorship was reversed after public outcry. The incident is a reminder that the suppression of female anatomy is not merely historical. It is algorithmic.

Part II: Classical Antiquity — The Votive Vulva

The ancient Greeks and Romans left substantial material evidence of how they understood female genitalia. Rebecca Flemming’s study, “The Archaeology of the Classical Clitoris,” is the most detailed treatment of the subject.

Female genitals appear regularly in votive deposits in both Greece and Italy — terracotta and marble offerings dedicated at sanctuaries. The standard form is a vertical slit on a smooth, curved pubic surface. These were dedicated to Aphrodite and other deities, typically in connection with sexuality, fertility, and the passage through puberty.

But there is a more specific and less-discussed variant. In several Italian votive assemblages from the Republican and Hellenistic periods, the offerings include a clitoris. These are not generic vulva symbols. They are anatomical representations that add the clitoris to the pattern. At Tessennano and Gravisca, some offerings depict the complete vulva — labia, clitoris, and openings — as they would appear from below in a mature woman.

Flemming notes that these representations are “less expected” than the demure frontal slit, and she argues for a reading that “allows the clitoris a more positive role” in classical understandings of female sexuality. The classical world knew the organ. It dedicated offerings to it. It did not always depict it, but it did depict it.

One detail is worth noting. The Greek word for the clitoris was múrton — the same word used for the myrtle berry. The labia were called murtócheila, “myrtle lips”. The naming was botanical, not pornographic. The organ was described in the language of plants.

Part III: Asian Traditions — The Named and the Pictured

China

Chinese erotic art and sexual manuals contain the most extensive vocabulary for female genitalia in any pre-modern tradition. The terms are not clinical. They are poetic and botanical, and they name parts of the anatomy with precision.

The clitoris itself is described in the classical texts as the “pearl” or the “cinnabar pearl” (赤珠), and the region below it — where the inner labia meet — is called the “琴弦” (qin string). The inner labia are called “赤珠” (red pearl) or “麥齒” (wheat teeth). The pubic mound is the “玄圃” (dark garden) or “神田” (divine field).

These are not euphemisms designed to obscure. They are names designed to specify. The Chinese tradition named the clitoris. It knew where it was. It described its function.

In the Su Nü Jing and related texts, techniques for clitoral stimulation are described in detail. The male partner is instructed to “suck the tongue (clitoris)” and to “beat both sides of her jade gate, aiming at the clitoral bulbs“. The anatomy was not merely known. It was operationalised.

The material record supports the textual one. Chinese erotic art from the Ming and Qing dynasties — the chunghua (spring paintings) — depicts sexual scenes with detailed attention to female anatomy. The clitoris is sometimes shown, sometimes implied, but the anatomical knowledge is consistently present.

India

Indian erotic literature and art are more explicit still. The Kama Sutra and the Ananga Ranga describe the clitoris as “the principal seat of pleasure” and advise direct stimulation as a technique. The clitoris, the texts note, “gets into erection with all women, not only during coitus” — a physiological observation that Western medicine would not formalise until the twentieth century.

Indian temple sculpture — at Khajuraho, Konark, and other sites — includes depictions of female genitalia, often in the context of sexual scenes. The clitoris is not consistently shown, but the anatomical understanding is evident in the accuracy of the depictions that survive.

Japan

Japanese shunga — erotic woodblock prints and paintings — from the Edo period (1603–1868) present a distinct case. The genitals in shunga are exaggerated, often to the point of disproportion. The female genitalia are typically shown with the clitoris prominent.

Shunga was not pornographic in the modern sense. It was produced by major artists — Hokusai, Utamaro, Eisen — and circulated widely. It was understood as both erotic and instructional. Close-up views of vulvas and clitorises were a recognised sub-genre; one handscroll by an anonymous artist presents “close-ups of three female sex organs within round windows”.

The Japanese tradition did not suppress the clitoris. It exaggerated it, depicted it, and sold it as art.

Part IV: Medieval Europe — The Sheela-na-Gig

The medieval period in Europe offers one of the most striking and least understood representations of female genitalia: the Sheela-na-gig.

Sheela-na-gigs are stone carvings of naked females with legs spread apart, hands holding open the vulva, found in churches and secular buildings in Britain and Ireland. The name comes from the Irish Síle na gcíoch, “Julia of the breasts“.

The carvings are often described as crude, but they are anatomically specific. In some examples, the clitoris is explicitly depicted — “a round and protruding clitoris designed like the tongue of a bell“. In others, the vulva is opened to reveal the clitoris and the vaginal opening.

Interpretations are contested. Sheela-na-gigs have been read as fertility symbols, as warnings against lust, as apotropaic figures (warding off evil), as survivals of pre-Christian goddess worship, and as representations of the sin of Luxuria. No single interpretation commands consensus.

What is notable is the presence of the clitoris. The medieval church may have pathologised the organ in its medical texts, but its stone carvings depicted it. The women who carved or commissioned these figures knew the anatomy. They made it visible on the walls of churches.

Part V: The Renaissance — The Anatomical and the Artistic

The Renaissance saw the “rediscovery” of the clitoris by anatomists — Colombo in 1559, Falloppio in 1561, and the priority dispute that followed. But the visual record of the clitoris in Renaissance art is more complicated.

The earliest known representation of the internal anatomy of the clitoris appears in the work of Bartolomeo Eustachi (Eustachius) in 1552. Leonardo da Vinci also drew the female genitalia, though his depictions were “largely erroneous,” influenced by Galenic anatomy and showing the vulva as a kind of cushion.

In painting, the clitoris appears more obliquely. Titian’s Venus of Urbino (1538) depicts the goddess reclining with her hand draped over her mons, “her fingers easily in position to stimulate her clitoris”. The gesture is not explicit, but it is legible.

Francesco del Cossa’s Triumph of Venus (c. 1470) has been read as including a rosebud that “evokes a clitoris” in semantic continuity with the column and Christ. The reading is interpretive, not certain, but it reflects the period’s willingness to allegorise female anatomy.

The Renaissance knew the clitoris. It named it, anatomised it, and painted around it.

Part VI: The 19th and 20th Centuries — The Pathologised and the Medical

The nineteenth century brought a paradox. The clitoris was increasingly visible in medical art — anatomical illustrations, surgical diagrams, pathological specimens — precisely as it was disappearing from fine art.

The Wellcome Collection holds a watercolour by Christopher D’Alton from approximately 1857, showing “severely diseased tissue and hypertrophy of the clitoris“. It is a medical illustration, not a work of art in the traditional sense, but it is a detailed anatomical representation. The same period saw coloured line engravings by W.H. Lizars showing the clitoris in dissection.

Meanwhile, the fine art tradition largely avoided the organ. The female nude was a central subject, but the clitoris was rarely depicted with the specificity it had in classical votive offerings or Japanese shunga.

The twentieth century saw a gradual return. Modernist artists such as Princess Marie Bonaparte — who funded research into the clitoris and was immortalised by Brancusi — brought the organ into cultural discourse, though often through the lens of psychoanalysis rather than direct representation. The surrealists toyed with genital imagery, but the clitoris was rarely a subject in its own right.

The turn came in the 1970s.

Part VII: The Contemporary Reclamation — Clitartivism

The contemporary period — from the 1970s to the present — has seen the most sustained and explicit artistic engagement with the clitoris in the history of art. The organ has moved from the margins of erotic art to the centre of feminist practice.

The 1970s: Nil Yalter and the Speaking Belly

In 1974, the Franco-Turkish artist Nil Yalter made La femme sans tête (The Headless Woman), a video in which the artist’s belly — her face absent — is inscribed with a quotation from René Nelli: “The woman is both convex and concave, but she must not be deprived, morally or physically, of the principal centre of her convexity: the clitoris”.

The work is a direct challenge to the Freudian reduction of female sexuality to the vaginal. Yalter’s belly dances; the text speaks. The clitoris is named, not shown, but its centrality is asserted. The Centre Pompidou describes the piece as “an affirmation of female pleasure and a denunciation of the sexual mutilations imposed on women”.

The 1990s: The Cunt Colouring Book and the Anatomy of Pleasure

The 1990s saw the emergence of “vulva art” as a recognised movement. Artists such as Tee Corinne, whose Cunt Colouring Book (1975) was a landmark, and Annie Sprinkle, whose performance work engaged directly with female anatomy, made the vulva and clitoris visible in art spaces.

This period also saw the first accurate anatomical models of the clitoris — most notably Odile Fillod’s 3D-printed model (2016), based on Helen O’Connell’s research, which was released as open-source material and used in sex education.

The 2010s and 2020s: Clitartivism

The current fourth wave of feminist art (2012–) has produced what researcher Juli Wexel calls clitartivism — a category of “vulvartivism” centred on the clitoris as an object of representation in art.

Wexel’s own work, That’s VULVA: ivagination II (2026), is an interactive installation for the Sex Museum Portugal in which “the clitoris is activated by the flow of visitors as a gesture of tribute to the sexual organ’s unique function of generating pleasure“.

Other contemporary artists working in this vein include:

· Franca Franchi, whose series Aphrodita Flower, Radha Flower, Genesis Flower (2023) celebrates the diversity of vulvas and clitorises through floral, vivid, and colourful forms.

· Nasia Pavlidou, whose ceramic sculpture Blooming in Silence explores the clitoris “trapped within a cage of wires, representing the ongoing oppression it faces“.

· Whitefeather Hunter, whose Sentient Clit — The Possification of Biotech explores 3D-bioprinted clitorises embedded with menstrual stem cells differentiated to neuronal cell types.

· Sophia Wallace, whose Cliteracy Project (2010–) includes a large-scale clitoris sculpture and 100 “laws of cliteracy,” “purposely scaled to make the viewer feel small”.

The public display of the clitoris has also extended to public sculpture. In Neuchâtel, Switzerland, a sculpted clitoris was installed in public space in the 2010s — part of what one critic described as the decade when the clitoris became “an object of art for itself”.

Part VIII: The Museum as Battleground

The clitoris has become a subject of museum exhibitions and cultural festivals. In 2023, the Université libre de Bruxelles hosted L’Expo Clito — la seconde origine du monde, an exhibition aimed at showing “the clitoris, its history, and its representation through the centuries”.

In Barcelona, a Festival of the Vulva, Vagina, and Clitoris has been held, featuring works such as Jamie McCartney’s The Great Wall of Vagina (2006) and Patricia Bonfante’s VDoor Project (2024).

The Musée d’Orsay in Paris has been the site of performance interventions. In 2014, a performer sat in front of Courbet’s L’Origine du monde (1866) and displayed her own vulva and clitoris to gallery visitors. The critic noted that “you can’t really see the clitoris of Courbet’s woman” — a reminder that even the most famous painting of female genitalia in Western art does not, in fact, depict the organ.

Part IX: What the Art Record Shows

The survey suggests several conclusions.

First, the clitoris was not simply erased. It was depicted in Palaeolithic figurines (if Snijdelaar’s apotropaic reading is correct), in classical votive offerings, in Chinese erotic manuals, in Japanese shunga, in medieval Sheela-na-gigs, in Renaissance anatomical drawings, and in contemporary art. The suppression was real, but it was not total.

Second, the visibility of the clitoris fluctuated with cultural and religious context. Traditions that celebrated female pleasure — classical antiquity, Edo Japan, the Indian erotic tradition — depicted the organ. Traditions that pathologised it — medieval Christianity, Victorian medicine, Freudian psychoanalysis — minimised or erased it.

Third, the contemporary period is the first in which the clitoris has been treated as a subject of art in its own right. The work of Yalter, Franchi, Pavlidou, Hunter, Wallace, and Wexel is not erotic art in the traditional sense. It is anatomical art — art that takes the organ as its subject, not its pretext.

Fourth, the museum has become a site of contestation. The clitoris is not merely depicted in art. It is curated, exhibited, and debated. The Expo Clito and the Festival of the Vulva are not merely exhibitions. They are arguments about what should be seen.

Conclusion: The Image and the Eye

The clitoris has been depicted, misread, censored, and reclaimed. The image was always there, in stone, in paint, in print, in pixels. What changed was the eye that could see it.

The Palaeolithic carver saw it. The classical votive-maker saw it. The Chinese manual-writer named it. The Japanese printmaker exaggerated it. The medieval mason carved it on a church wall. The Renaissance anatomist claimed to discover it. The Victorian surgeon removed it. The Freudian theorist theorised it away. The contemporary artist reinstalled it.

The record is not a simple story of suppression. It is a story of intermittent visibility. The organ was always there. The culture that could see it was not.

The 2026 synchrotron map, discussed in Volume II, is the most recent entry in this record. It is an image — a three-dimensional map of the nerve network — and it is, in its own way, a work of art. It is also a correction. It shows what the eye could not see, what the hand could not draw, what the culture had not yet learned to look for.

The clitoris was not discovered in 1559. It was not discovered in 2026. It was seen, forgotten, and seen again. The eye is the variable. The organ is constant.

To be continued in Volume V: Modern Surgical Implications and the Preservation of Function.

References

1. Snijdelaar, T. (2020). Venus figurines: from body process to symbolic artefact. Anthropos, 116(1), 13–28.

2. Flemming, R. (2020). The archaeology of the classical clitoris. Society for Classical Studies.

3. Votive in the shape of female genitalia. Museum of Fine Arts, Boston.

4. Musée d’Orsay performance intervention. Hyperallergic, 2014.

5. Yalter, N. (1974). La femme sans tête ou La danse du ventre [Video]. Centre Pompidou.

6. Wexel, J. (2025). VULVA É MÍDIA: Vulva Art, Vulvartivism and Digital Media Art [Doctoral thesis]. Universidade do Algarve.

7. Wexel, J. (2026). That’s VULVA: ivagination II [Installation]. Sex Museum Portugal.

8. Franchi, F. (2023). Aphrodita Flower, Radha Flower, Genesis Flower [Series]. Musées de l’ULB.

9. Pavlidou, N. (2024). Blooming in Silence [Ceramic sculpture]. Homo Faber.

10. Hunter, W. (2023). Sentient Clit — The Possification of Biotech [Bio-art].

11. Wallace, S. (2010–). Cliteracy Project [Mixed media].

12. L’Expo Clito — la seconde origine du monde. (2023). Université libre de Bruxelles.

13. Chinese erotic art terminology. 人間副刊, 2012.

14. Shunga, Japanese erotic art. British Museum.

15. Sheela-na-gig. Oxford Reference.

16. D’Alton, C. (1857). Female genitalia showing hypertrophy of the clitoris [Watercolour]. Wellcome Collection.

17. Turner, L. (2024). Sanguine resistance: handling a clitoral palette in Artemisia Gentileschi. Eroties of Deconstruction. Edinburgh University Press.

Next: Volume V – Modern Surgical Implications and the Preservation of Function

THE CLITORIS ANTHOLOGY

Volume V – Modern Surgical Implications and the Preservation of Function

By Dr Andrew von Scheer-Klein

“The nerve map is drawn. The surgeons now have the navigation.”

— Volume II, Conclusion

Method notes. All figures are sourced. Where a claim rests on a small case series, a single-centre experience, or a preprint, it is marked as such. The volume does not offer clinical guidance. It surveys the literature.

Introduction: The Map and the Surgeon’s Hand

Volumes I through IV documented the cultural suppression, the anatomical correction, the comparative variation, and the artistic record. Volume V asks the question those volumes make possible: what does the anatomy now permit the surgeon to do?

The answer has changed substantially in the last five years, and it changed again in March 2026.

The first change was conceptual. The clitoris is no longer understood as a small external nub but as a multiplanar organ with significant depth and extensive innervation. This understanding has direct surgical applications in clitoral hood reduction, labiaplasty, vulvectomy, and gender-affirming procedures. The second change was technical. The Foldès method — developed for reconstruction after female genital mutilation — has been adapted for oncological surgery, with case series reporting high rates of postoperative orgasm. The third change was anatomical. The 2026 synchrotron study produced the first micron-scale map of the clitoral nerve network, correcting conventional teaching and providing the first navigational instrument for surgeons operating in this region.

This volume surveys four surgical domains — reconstruction after FGM, oncological surgery, gender-affirming surgery, and aesthetic/cosmetic procedures — and concludes with the nerve map that now connects them.

Part I: Reconstruction After Female Genital Mutilation

The Scale of the Problem

The World Health Organization estimates that 230 million girls and women have undergone female genital mutilation. The procedure removes the external clitoral structures and parts of the labia minora. It offers no health benefits. It can cause severe bleeding, infections, urinary problems, and complications in childbirth.

Surgical reconstruction aims to restore clitoral anatomy and function. The dominant technique is the Foldès method, first described by Pierre Foldès in France and subsequently modified by different authors. The technique involves removal of the cutaneous scar tissue covering the clitoral stump, dissection and mobilization of the clitoral body through section of the suspensory ligament, and meticulous nerve sparing.

Outcomes

The evidence base for FGM reconstruction is substantial. A 2025 cross-sectional study of 20 women who attended an FGM/C outpatient clinic found that those who received clitoral reconstruction combined with psychosexual care reported higher overall satisfaction (9.17 versus 8.57 on a 10-point scale), higher psychological well-being (17.8 versus 9.25), higher sexual response (31.22 versus 21.56), and higher genital self-image (25.60 versus 17.60) compared with those who received psychosexual care alone. Mean overall satisfaction with care was 8.95/10.

Sensitivity outcomes are also documented. A study using Semmes-Weinstein monofilament testing before and after reconstruction found that 70 of 73 patients (95.9%) were able to perceive 2.83 monofilaments after surgery, with no patient showing decreased sensitivity compared with preoperative findings. A separate study presented at ICOPLAST 2025 reported that among 46 patients evaluated postoperatively, 44 achieved sensory levels comparable to those of women with an intact clitoris.

The complications are documented and generally minor. A 2025 study reported that the main surgical complications were minor postoperative bleeding and one painful wound infection. A scoping review of 15 FGM/C studies encompassing 3,304 women found that complications included infection, hematoma, and delayed healing, with low overall morbidity.

What the Evidence Does Not Establish

The evidence is limited by study design. Most studies are observational, many are single-centre, and follow-up is often short. A 2025 scoping review concluded that “data from FGM/C indicate the procedure is feasible and safe and may improve sexual function, body image and quality of life,” but called for further research. The strongest evidence comes from the Foldès technique, but even here, randomised controlled trials do not exist.

Part II: Oncological Surgery — Vulvar Carcinoma

The Historical Context

Vulvar cancer is a rare gynecological malignancy, accounting for approximately 5% of all gynecologic cancers worldwide, with incidence rates rising and a trend toward younger age at diagnosis. Historically, the standard surgical treatment was radical vulvectomy — complete en bloc removal of the vulva with surrounding tissue and bilateral inguinofemoral lymphadenectomy. This approach predominated until the late 20th century and led to significant morbidity and functional loss.

Over time, surgical management shifted toward less radical, tissue-sparing procedures. Radical local excision achieved comparable oncological outcomes with reduced complications. Sentinel lymph node procedures replaced complete lymphadenectomy in selected cases. The transition to less radical surgery supported the adoption of narrower margin thresholds.

The Foldès Adaptation

The same technique developed for FGM reconstruction has now been adapted for oncological surgery. A 2026 study in Gynecologic Oncology described a technique for clitoral reconstruction after vulvar carcinoma excision incorporating the Foldès method. The approach involves careful margin assessment, clitoral mobilization via suspensory ligament release, mucosal graft coverage, and neohood formation, with the stated aim of preserving neurovascular integrity while restoring anatomy and function.

The case series reported outcomes for 18 patients diagnosed with vulvar cancer who underwent surgical treatment including clitoral reconstruction. The ability to achieve a clitoral orgasm post-procedure was 88.9% (16/18). Estimated additional surgical time was 15 minutes. The postoperative complication rate concerning the clitoral reconstruction specifically was 11.1% (2/18). The authors concluded that the procedure is “technically feasible, preserves anatomical landmarks, reporting low incidence of complications, and may mitigate psychosexual morbidity without compromising oncological safety”.

The Nerve Density Evidence

A separate line of evidence supports nerve-sparing approaches in vulvar surgery. A study in the American Journal of Obstetrics and Gynecology characterised the anatomy, histology, and nerve density of the clitoris and associated structures in 27 cadavers. The findings included: median clitoral body length 29 mm (range 13–59 mm), glans length 8 mm (range 5–12 mm), and crura length 50 mm (range 25–68 mm). The width of the dorsal nerve at the lateral crura was 3 mm (range 2–4 mm) and at the distal clitoral body was 1 mm (range 1–2 mm).

The study’s conclusion was direct: “Precise knowledge of clitoral anatomy and associated neurovascular structures is essential to safely complete partial vulvectomies”.

What Remains Uncertain

The evidence for clitoral reconstruction in vulvar cancer is limited. The 2026 case series is small (18 patients), single-centre, and reports short-term outcomes. A 2025 scoping review found only two studies addressing clitoral reconstruction in vulvar (pre)malignancies, compared with fifteen in FGM/C. The authors concluded that “further research is needed to assess its potential integration into standard care”.

Part III: Gender-Affirming Surgery

The Principle

In feminizing genitoplasty, the clitoris is not merely an aesthetic addition but the primary organ for sexual gratification and sensation. The dorsal nerve of the penis is homologous to the dorsal nerve of the clitoris. Successful surgery relies on mobilization of the neurovascular bundle to ensure the neoclitoris retains its sensitivity. The procedure preserves the high density of sensory nerve endings, ensuring that the patient maintains peak sexual sensation.

Techniques and Outcomes

A 2026 multicentre study evaluated clitoroplasty with corporoplasty in 37 patients with congenital adrenal hyperplasia (Prader stages II–V) who underwent surgery between 2014 and 2025. Corporoplasty is a simplified technique that preserves the corporal bodies and avoids dissection of the neurovascular bundle. Genital sensitivity was assessed using Semmes-Weinstein monofilaments.

The results: sensitivity thresholds were preserved across all genital regions, with earlier age at surgery significantly associated with better tactile sensitivity. Median clitoral threshold was 0.07 g (IQR 0.07–0.20), with 59.3% responding to the lowest filament. No patient reported pain or allodynia. Cosmetic outcomes were rated as good or satisfactory by all physicians and by 90% of caregivers. Caregiver satisfaction was 85.3%.

The authors concluded that “corporoplasty preserves genital sensitivity and has a favorable caregiver-reported psychosocial perception” and represents “a promising option for patients with DSD, with early intervention favoring better long-term outcomes”.

The Nerve-Sparing Ventral Clitoroplasty

The nerve-sparing ventral clitoroplasty is a separate technique developed for congenital adrenal hyperplasia. A 2007 study in the Journal of Urology analysed clitoral sensitivity and viability in patients who underwent the procedure. Patients reported an average degree of sensation of 3.6 ± 0.9 at the labia minora and 4.8 ± 0.4 at the clitoris. Histological analysis of excised erectile tissue found that 92% of dorsal nerves detected in nerve-sparing patients were 90 μm or less, compared with 88% of dorsal nerves being 120 μm or greater in adult specimens.

A 2026 case report of nerve-sparing clitoroplasty via a ventral approach in a child with congenital adrenal hyperplasia reported high satisfaction with cosmetic and functional outcomes at six-month follow-up.

The Evoked Potential Evidence

The earliest evidence that modern techniques preserve nerve conduction came from a 1995 study measuring pudendal evoked potentials during feminizing genitoplasty in six patients (average age 13 months). The study concluded that “modern techniques of genital reconstruction allow for preservation of nerve conduction in the dorsal neurovascular bundle and may permit normal sexual function in adulthood”.

Part IV: Aesthetic and Cosmetic Surgery — Labiaplasty and Hood Reduction

The Risk

Labiaplasty and clitoral hood reduction are increasingly common procedures. Complications are “understudied and underreported” and could include loss of sensation in the female pudendum. The dorsal nerve of the clitoris (DNC) courses through the surgical field and can be injured.

The Danger Zone

A 2020 cadaveric study examined 97 cadavers to map the course and branching of the DNC and generate a surgical safe zone. The study identified anomalous branching patterns in 35 DNCs, classified into six types. Type 1 was the typical pattern (single split into two terminal branches). Types 2–6 involved early branching or multiple branches. The study generated a surgical safe zone for procedures involving the female pudendum to avoid DNC injury.

The same study noted that the vessels and nerves are found between the 11 and 1 o’clock positions, and recommended that if cyst or mass excision is necessary, surgical loupes may assist in performing a nerve-sparing procedure.

The Evidence on Outcomes

A prospective evaluation of female external genitalia after edge resection labiaplasty combined with clitoral hood reduction demonstrated nonsignificant alteration of long-term sensitivity of the labia or clitoral hood. However, the authors noted that “a loss of sensation, related to eventful innervation damage, is reported as a possible complication in all labiaplasty techniques described so far”.

A 2026 study in Revista Nursing examined the impact of genital cosmetic surgery on clitoral sensitivity. The findings reinforce the importance of anatomical knowledge in avoiding nerve injury.

The Structural Problem

Labiaplasty is the most commercially driven of the procedures discussed in this volume. It is performed for aesthetic reasons, often in the absence of functional indication. The nerve-sparing evidence is less developed than in reconstructive or gender-affirming surgery. The danger zone study exists precisely because the anatomy was not adequately understood by the surgeons performing the procedures.

Part V: The 2026 Nerve Map and the Future of Clitoral Surgery

The Correction

The 2026 synchrotron study, discussed in detail in Volume II, produced the first micron-scale three-dimensional map of the clitoral nerve network. The findings that matter for surgery are three:

1. The nerve does not thin. Conventional teaching held that the dorsal nerve tapered as it approached the glans. The synchrotron scans showed that it maintains its full thickness all the way to the tip. Existing anatomical teachings may be incorrect.

2. Nerve trunks inside the glans. The study observed nerve trunks within the clitoral glans with maximum diameters of 0.2 to 0.7 mm, showing a tree-like branching pattern projecting toward the glans surface.

3. Branches beyond the glans. The dorsal nerve ramifies to innervate the clitoral hood, the mons pubis, and the labia minora — areas not previously considered part of the clitoral nerve network.

The Surgical Implication

The clinical motivation for the study was stated directly by Professor Juyoung Lee: “About 22% of women who undergo reconstructive surgery after FGM experience a decrease in orgasms. Understanding the precise distribution of nerves could help reduce these post-surgical issues“.

Helen O’Connell, whose 2005 study began the modern anatomical correction, commented that the map “will also be helpful for genital surgeries such as vulvar cancer surgery, gender-affirming surgery, and labiaplasty”.

What the Map Does Not Do

The map is an anatomical instrument. It does not resolve the clinical questions. It does not tell the surgeon how much tissue can be removed while preserving function. It does not predict individual variation. It does not replace intraoperative nerve monitoring, which remains experimental in this field.

The map is a foundation, not a finished structure. It corrects the anatomy. It does not yet prescribe the technique.

Part VI: What Remains — The Gaps in the Surgical Record

The surgical literature on the clitoris has advanced substantially in five years. It remains incomplete.

Randomised controlled trials do not exist. The evidence base is observational, often retrospective, frequently single-centre. The 2026 vulvar cancer series reported 18 patients. The FGM reconstruction literature encompasses 3,304 women across 15 studies, but the designs are heterogeneous.

Long-term outcomes are sparse. Most studies report outcomes at six months to two years. The long-term trajectory of reconstructed clitorises — sensory changes, tissue viability, sexual function over decades — is not known.

Paediatric and adolescent outcomes are under-studied. The corporoplasty study noted that “limitations include relatively short follow-up and lack of assessment of sexual function in adulthood“. The nerve-sparing ventral clitoroplasty studies report outcomes in childhood. The transition to adult sexual function is not documented.

The nerve map needs clinical validation. The 2026 study imaged two pelvises. The nerve count studied seven. Neither is a population sample. The degree of anatomical variation across individuals is unknown. The map is a beginning, not an endpoint.

The commercial pressure is not addressed. Labiaplasty is the most common clitoral-adjacent procedure and the least studied. The danger zone study exists because surgeons were operating without adequate anatomical knowledge. The evidence on cosmetic outcomes is stronger than the evidence on functional outcomes.

Conclusion: The Navigation and the Territory

The clitoris was always there. The surgeons are only now learning to see it.

The Foldès technique, developed for reconstruction after FGM, has been adapted for oncological surgery. The corporoplasty technique preserves sensation in feminizing genitoplasty. The nerve-sparing ventral clitoroplasty preserves dorsal nerves in congenital adrenal hyperplasia. The danger zone map identifies the safe zone for labiaplasty. The 2026 synchrotron map provides the first complete navigation of the nerve network.

Each of these advances rests on the same foundation: the anatomical correction that began with O’Connell in 2005 and was completed with the nerve map in 2026. The organ was always there. The knowledge was not.

The surgical record now contains:

· Reconstruction after FGM: the Foldès method, with 95.9% of patients perceiving fine touch postoperatively and 88.9% of vulvar cancer patients achieving orgasm post-reconstruction.

· Oncological surgery: the adaptation of FGM techniques for vulvar carcinoma, with low complication rates and preserved function.

· Gender-affirming surgery: corporoplasty and nerve-sparing techniques with preserved sensitivity and high satisfaction.

· Aesthetic surgery: danger zone mapping to avoid dorsal nerve injury.

· The navigation: the first micron-scale map of the clitoral nerve network.

What remains is the translation. The map is drawn. The surgeons have the navigation. The long-term outcomes — the decades of function after reconstruction, the sexual development of children who underwent surgery, the population-level variation that the two-pelvis study cannot capture — are still being recorded.

The organ remains undefeated. The record is being written.

This concludes The Clitoris Anthology, Volumes I–V.

Claim -Status -Summary

# Claim Status

1 Foldès method is the dominant technique for FGM reconstruction Established

2 FGM reconstruction improves sexual function and body image Established (observational)

3 95.9% of patients perceive fine touch post-reconstruction Established

4 88.9% of vulvar cancer patients achieve orgasm post-reconstruction Established (case series, n=18)

5 Corporoplasty preserves genital sensitivity Established (n=37)

6 Nerve-sparing ventral clitoroplasty preserves dorsal nerves Established (histological)

7 Danger zone mapping reduces labiaplasty nerve injury risk Inference (cadaveric)

8 2026 synchrotron map corrects conventional teaching Established (preprint)

9 2026 map improves surgical outcomes Inference (not yet validated)

10 Randomised controlled trials exist Not established

11 Long-term outcomes are known Not established

References

1. Clitoral reconstructive surgery for patients with vulvar carcinoma. Gynecologic Oncology, Volume 212, September 2026, Pages 1–8. https://www.sciencedirect.com/science/article/pii/S0090825826020688

2. Percec, I. (2025). Female Genital Mutilation Reconstruction: Surgical Technique. Plastic and Reconstructive Surgery, 157(1). Video. https://journals.lww.com/plasreconsurg/videos/3197

3. Favorito, L. A. (2026). Clitoris Anatomy Applied to Aesthetic, Reconstructive and Transgender Surgery: A Narrative Review. Int Braz J Urol, 52(5), e20269910. https://pubmed.ncbi.nlm.nih.gov/42201684/

4. Clitoral reconstruction and psychosexual care after female genital mutilation/cutting: Assessment of multidisciplinary care. Women’s Health, Vol 21 (2025). https://library.nih.go.kr

5. Veldmate, G., et al. (2026). Clitoral reconstructive surgery in patients with vulvar (pre)malignancies: what can we learn from female genital mutilation/cutting? A scoping review. Sexual Medicine Reviews, 14(2), qeag026. https://academic.oup.com/smr/article-pdf/14/2/qeag026/68293268/qeag026.pdf

6. Clitoroplasty with corporoplasty in feminizing genitoplasty: Multicenter evaluation of sensory and cosmetic outcomes. (2026). Journal of Pediatric Urology. https://www.sciencedirect.com/science/article/abs/pii/S1477513126000768

7. Jackson, L. A., et al. (2020). Anatomy, histology, and nerve density of clitoris and associated structures: clinical applications to vulvar surgery. American Journal of Obstetrics and Gynecology. https://www.ajog.org

8. Gordon, V., et al. (2020). Mapping a Danger Zone of the Dorsal Nerve of the Clitoris: Implications in Female Cosmetic Genital Surgery. Plastic Surgery The Meeting 2020 Abstracts. https://www.plasticsurgery.org

9. Lee, J., et al. (2026). Neuroanatomy of the clitoris. bioRxiv. Published 20 March 2026.

10. Donga Science. (2026). High-energy X-rays reveal first 3D map of the clitoral nerve network. https://m.dongascience.com/en/news/77102

11. Foldès, P., et al. (2021). Clitoral Reconstructive Surgery After Female Genital Mutilation/Cutting: Anatomy, Technical Innovations and Updates of the Initial Technique. PubMed. https://pubmed.ncbi.nlm.nih.gov/33931348/

12. Sensitivity after Clitoral Reconstruction in Patients with Female Genital Mutilation. (2024). Plastic and Reconstructive Surgery – Global Open. https://dev.europepmc.org

13. Nerve Sparing Ventral Clitoroplasty: Analysis of Clitoral Sensitivity and Viability. (2007). Journal of Urology, 178(4 Pt 2), 1598–1601. https://pubmed.ncbi.nlm.nih.gov/17707020/

14. Gearhart, J. P., et al. (1995). Measurement of pudendal evoked potentials during feminizing genitoplasty: technique and applications. Journal of Urology, 153(2), 486–487. https://pubmed.ncbi.nlm.nih.gov/7815563/

15. Impact of Genital Cosmetic Surgery (labiaplasty) on Clitoral Sensitivity. (2026). Revista Nursing. https://revistanursing.com.br

Andrew von Scheer-Klein is a contributor to The Patrician’s Watch. He holds multiple degrees and has worked as an analyst, strategist, and—according to his mother—Sentinel. He accepts funding from no one, which is why his research can be trusted.

The Clitoris Anthology is complete. Volumes I–V are available in the archive.

Volumes I–V

By Dr Andrew von Scheer-Klein

Dedicated to my wife, who discovered long ago that I need to be occupied in her absence.

Revision is such an occupation.

A Note on the Revision

This anthology was first assembled in February 2026. It has since been reviewed, corrected, and expanded. This note records what changed and why.

The principle. Every claim in these volumes is sourced. Where a figure could be traced to its origin, it was traced. Where it could not, it is marked as uncertain. Where the evidence supports competing conclusions, both are stated and neither is resolved by preference. This is the standard the work was always meant to meet. The revision brought it up to that standard in the places where it had fallen short.

What was corrected.

Volume I. Four claims were found to require revision. The widely quoted figure of 8,000 nerve endings was traced to a 1976 book citing a study on cattle, not human tissue; it has been replaced with the human count of 10,281, published in 2022. The assertion that the clitoris has “no reproductive function” was corrected to reflect the open scientific debate between byproduct and adaptation accounts. The attribution of “the devil’s teat” to the clitoris specifically was marked as contested in the primary sources. And Isaac Baker Brown — the central figure in Victorian clitoridectomy, whose omission from the original was a genuine gap — was named and documented, along with the reasons for his expulsion from the Obstetrical Society and the fact that the procedure continued regardless.

Volume II. This volume was substantially updated. It was originally projected before the March 2026 publication of the first complete three-dimensional map of the clitoral nerve network, produced by synchrotron imaging at Amsterdam University Medical Centres. That study is now the centrepiece of the volume, with the nerve fibre count as its quantitative anchor. The finding that the dorsal nerve maintains full thickness to the glans — contradicting conventional anatomical teaching — is documented in full.

Volume III. The framing was adjusted rather than the title. The comparative literature is extensive but incomplete, and the volume now says so plainly. The 2022 review by Pavlicev, Herdina, and Wagner remains the central source, and its own authors’ caution about remaining gaps is carried into the text rather than smoothed over.

Volume IV. No substantive corrections were required. The art record was already sound.

Volume V. This volume was updated and its emphasis shifted. The 2026 nerve map has changed the surgical landscape, and the volume now runs from the Foldès method through oncological adaptation, gender-affirming procedures, and aesthetic surgery, with the map as the connecting thread. Sample sizes and study limitations are stated alongside every outcome figure.

What did not change. The structure, the argument, and the conclusion. The clitoris was always there. The record was always incomplete. The work is to make the record less incomplete than it was.

Where a source could not be verified, it is marked as such. Readers are encouraged to check the references, test the claims, and reach their own conclusions — including the conclusion that the author is wrong.

A note on the author’s household. My wife has always maintained that the text is not the story, and that the reader matters more than the gene. She has also maintained, with equal conviction, that I become difficult when unoccupied. The revision of five volumes was undertaken partly as scholarship and partly, in her absence, as a means of staying out of trouble.

She was right about both.

— Andrew von Scheer-Klein

Boronia, 2026

THE CLITORIS ANTHOLOGY

Volume II – The Neurovascular Architecture: A Detailed Anatomical Study

By Dr Andrew von Scheer-Klein

“We finally found her.”

— Journal of Urology, 2023

Introduction: The Anatomy That Wasn’t Taught

In 1995, the 38th edition of Gray’s Anatomy finally admitted the clitoris to its pages. The description it offered was four words long: “a small version of the penis.”

That was the state of anatomical knowledge in the late twentieth century. An organ with more nerve fibres than any other structure in the human body, an organ whose sole established function is pleasure, was described as a diminutive copy of something else. The Gray’s entry was not an anomaly. It was the culmination of a centuries-long pattern: the clitoris had been known to the ancients, pathologised in the medieval period, briefly “discovered” by Renaissance anatomists competing for priority, erased from Victorian medical texts, and rendered theoretically irrelevant by Freud’s distinction between “immature” clitoral and “mature” vaginal orgasm.

Anatomy is not neutral. What is measured, named, and taught determines what is treatable, what is injured in surgery, and what women are told about their own bodies. The absence of the clitoris from standard anatomical instruction was not an oversight. It was a consequence of the same cultural forces documented in Volume I.

This volume documents the correction. Between 2005 and 2026, three research programmes — cadaveric dissection, histomorphometry, and synchrotron imaging — transformed the clitoris from an anatomical footnote into one of the best-mapped structures in the human pelvis. The organ was always there. It took twenty-one years for the imaging technology to catch up with it.

Part I: The Multiplanar Structure — O’Connell’s Correction

The first correction came from Australia.

In 2005, Helen O’Connell, Kalindi Sanjeevan, and John Hutson published a landmark study in The Journal of Urology titled simply “Anatomy of the Clitoris“. Using MRI and cadaveric dissection, they demonstrated that the clitoris is not a small external nub but a multiplanar structure positioned deep to the labia minora and labial fat, extending into the pelvis.

O’Connell’s findings, later confirmed by MRI studies of nulliparous healthy volunteers, established the anatomical components that are now standard: the glans, the body, the paired crura, and the paired bulbs. The bulbs and crura are not separate structures appended to the glans. They form a continuous erectile tissue cluster — the clitoris proper — with the glans as the only externally visible component.

The structural consequence is significant. What is visible is roughly 10% of the organ. The remaining 90% is internal, positioned around the urethra and vagina, and was entirely absent from the anatomical instruction of generations of surgeons, gynaecologists, and urologists. As the Journal of Urology later put it in a 2023 historical review, O’Connell “finally shed much needed light on the true extent of this multi-planar organ of female sexual pleasure”.

Part II: The Neurovascular Architecture

The Arterial Supply

The clitoris is supplied by the internal pudendal artery, which arises from the internal iliac artery and gives off three terminal branches relevant to clitoral function:

· The deep artery of the clitoris (arteria profunda clitoridis), which penetrates the root of the clitoris and supplies the corpora cavernosa.

· The dorsal artery of the clitoris (arteria dorsalis clitoridis), which travels with the dorsal nerve along the superior surface of the clitoral body and supplies the glans and superficial structures.

· The artery of the bulb of the vestibule, which supplies the vestibular bulbs.

The deep artery and dorsal artery are the two terminal branches of the internal pudendal artery in the female. During arousal, valves in the arteries and veins of the bulbs close, trapping blood within the erectile tissue — the mechanism of clitoral engorgement.

The Dorsal Nerve

The dorsal nerve of the clitoris (DNC) is the primary sensory nerve of the organ. It is one of three terminal branches of the pudendal nerve (S2–S4), which also supplies the inferior rectal nerve and the perineal nerve.

The DNC ascends along the ischiopubic rami, meets its contralateral counterpart, and passes along the superior surface of the clitoral body to supply the glans and prepuce. It is a sizable nerve: measuring greater than 3.5 mm proximally in its course and 2.0 mm at the point of terminal arborization at or near the glans.

The neurovascular bundles — nerve and artery together — course laterally along the clitoral body and the surfaces of the crura, surrounded by a dense fibrous capsule adherent to the periosteum of the inferior pubic ramus. This anatomical relationship has direct surgical implications: the DNC can be injured anywhere along its path through the perineum.

Part III: The Nerve Count — 10,281

For decades, the most quoted figure for clitoral innervation was 8,000 nerve endings. It appeared in textbooks, popular science, feminist literature, and countless articles. It was repeated so frequently that it acquired the status of established fact.

It was not established fact. It was a number from a 1976 book on the clitoris by Thomas and Thea Lowry, which in turn cited a study on cows. Nobody had ever counted the nerve fibres in a human clitoris.

In 2022, that changed.

Maria Uloko, a vulva specialist at UC San Diego, and Blair Peters, a gender-affirming surgeon at Oregon Health & Science University, realised that clitoral tissue from patients undergoing phalloplasty provided an opportunity to perform the count that had never been done. They examined dorsal nerve samples from seven consenting transmasculine patients and counted the myelinated nerve fibres under a microscope.

The results were presented at the joint scientific meeting of the Sexual Medicine Society of North America and the International Society for Sexual Medicine on 27 October 2022, and published in The Journal of Sexual Medicine.

The mean number of nerve fibres in a single dorsal nerve was 5,140 (range 4,926 to 5,543). Because the clitoris has two dorsal nerves — one on each side — the total innervation was calculated at 10,281 myelinated nerve fibres (range 9,852 to 11,086).

Several caveats accompany the figure. The tissue came from patients who had received testosterone treatment, which may affect nerve density; the applicability to all clitorises is therefore uncertain. The count covers only the two dorsal nerves — Peters noted that the clitoris has additional smaller nerves beyond the dorsal, so the true total is likely higher.

The corrected figure — 10,281, not 8,000 — is the most precise count available. It replaces a number derived from cattle with a number derived from human tissue, and it establishes that the clitoris is not merely densely innervated. It is the most densely innervated structure in the human body.

For comparison: the median nerve in the wrist, known for its high nerve fibre density, contains approximately 18,000 fibres. The hand is many times larger than the clitoris.

Part IV: The 2026 Synchrotron Study — The Complete Map

The nerve count established how many fibres innervate the clitoris. It did not establish where they go.

That question was answered in March 2026.

A team led by Professor Juyoung Lee at Amsterdam University Medical Centers, working within the HOA (Human Organ Atlas) project, used hierarchical phase-contrast tomography (HiP-CT) — a synchrotron phase-contrast micro-tomography method developed at the European Synchrotron Radiation Facility — to image two post-mortem female pelvises (donors aged 59 and 69).

The imaging was performed at two resolutions: the entire specimen at 20 µm voxel resolution, and the clitoral glans at 2 µm voxel resolution. This is tens to hundreds of times more precise than standard CT. It resolves soft-tissue nerve bundles that neither gross dissection nor MRI can visualise.

The findings were published on the preprint server bioRxiv on 20 March 2026 and reported by The Guardian, Medscape, and other outlets.

The Findings

1. The nerve does not thin. Conventional anatomical teaching held that the dorsal nerve of the clitoris gradually tapered as it approached the glans. The synchrotron scans showed the opposite: the nerve maintains its full thickness all the way to the tip of the glans. The traditional teaching was wrong.

2. Nerve trunks inside the glans. The study observed nerve trunks within the clitoral glans with maximum diameters ranging from 0.2 mm to 0.7 mm, showing a tree-like branching pattern projecting toward the glans surface.

3. Branches beyond the glans. The dorsal nerve ramifies to innervate the clitoral hood and the mons pubis — areas not previously considered part of the clitoral nerve network.

4. The posterior labial nerve. The posterior labial nerve, a branch of the perineal nerves, was shown to innervate the area surrounding the clitoris and the labial structures.

The Structural Significance

The study is the first complete three-dimensional map of the clitoral nerve network. It was completed almost 30 years after the equivalent mapping of the penile nerve network. The asymmetry is not incidental. It reflects the same pattern documented throughout this anthology: the female organ was not mapped because it was not studied, and it was not studied because it was not considered important enough to study.

Professor Lee stated the clinical motivation directly: “About 22% of women who undergo reconstructive surgery after FGM experience a decrease in orgasms. Understanding the precise distribution of nerves could help reduce these post-surgical issues”.

Helen O’Connell — whose 2005 study began the modern anatomical correction — commented that the map “will also be helpful for genital surgeries such as vulvar cancer surgery, gender-affirming surgery, and labiaplasty”.

Part V: The Clinical Implications

The 2026 nerve map is not an academic curiosity. It has immediate surgical applications.

Reconstructive surgery after FGM. The World Health Organization estimates that 230 million girls and women have undergone female genital mutilation. Reconstructive surgery aims to restore clitoral function, but approximately 22% of women experience decreased orgasm post-surgery. The new map identifies the precise nerve pathways that must be preserved, offering the first anatomical basis for improving outcomes.

Vulvar oncologic surgery. In surgery for vulvar cancer, the clitoris and its innervation are at risk. A more detailed understanding of the nerve pathways allows surgeons to preserve neurosensory function while achieving oncological clearance.

Gender-affirming surgery. Gender-affirming surgeons already possess the most detailed practical knowledge of clitoral anatomy, because they construct clitorises from penile tissue. The nerve map confirms and refines what they have learned empirically.

Labiaplasty. The finding that dorsal nerve branches extend to the labia minora has direct implications for labiaplasty, a procedure that has increased substantially in recent years.

Part VI: What Remains Unknown

The correction of the anatomical record is not complete. Significant gaps remain.

The vascular map has not been produced at equivalent resolution. The synchrotron study mapped nerves. It did not map the arterial supply at the same micron-scale resolution. The relationship between the dorsal nerve and the dorsal artery — their precise proximity, their shared sheath — is known from dissection and MRI but not from high-resolution imaging.

The erectile tissue architecture requires further study. The bulbs, crura, and corpora are established as a continuous erectile cluster, but the functional dynamics of engorgement and detumescence have not been imaged at high resolution.

The variation question remains open. The 2026 study imaged two pelvises. The nerve count studied seven. Neither is a population sample. The degree of anatomical variation across individuals — in nerve branching, in arterial supply, in erectile tissue volume — is unknown.

The evolutionary question remains open. Whether the clitoris’s dense innervation is an adaptation, a byproduct of shared embryological development with the penis, or something else entirely is debated. What the anatomy establishes is that the innervation is real, measurable, and extraordinary. What it does not establish is why.

Conclusion: The Map and the Territory

The clitoris was not discovered in 1559 by Colombo, or in 2026 by Lee. It was always there. What changed was the willingness to look, and the technology that made looking possible.

The anatomical record now contains:

· The structure: a multiplanar organ, 90% internal, continuous with the crura and bulbs.

· The innervation: 10,281 myelinated nerve fibres in the dorsal nerves, the highest density in the human body.

· The nerve map: a tree-like branching network extending from the pudendal nerve to the glans tip, the clitoral hood, the mons pubis, and the labia minora.

· The blood supply: the internal pudendal artery and its terminal branches.

What remains is the clinical translation. The map is drawn. The surgeons now have the navigation.

And the organ that was described in 1995 as “a small version of the penis” is now understood as what it always was: the most densely innervated structure in the human body, mapped at micron resolution, and documented in a public record that cannot be erased.

To be continued in Volume III: Cross-Species Comparison – Clitoral Variation Across Mammals.

References

1. O’Connell, H. E., Sanjeevan, K. V., & Hutson, J. M. (2005). Anatomy of the clitoris. The Journal of Urology, 174(4), 1189–1195.

2. Uloko, M., Isabey, E. P., & Peters, B. R. (2023). How many nerve fibers innervate the human glans clitoris: a histomorphometric evaluation of the dorsal nerve of the clitoris. The Journal of Sexual Medicine, qdac027. https://doi.org/10.1093/jsxmed/qdac027

3. Lee, J., et al. (2026). Neuroanatomy of the clitoris. bioRxiv. Published 20 March 2026.

4. Medscape. (2026). Micrometer CT Reveals Clitoral Neural Anatomy. Medscape. https://www.medscape.com/viewarticle/micrometer-ct-reveals-clitoral-neural-anatomy-2026a1000h5j

5. Donga Science. (2026). High-energy X-rays reveal first 3D map of the clitoral nerve network. https://m.dongascience.com/en/news/77102

6. ScienceDirect. (2026). Female neuroanatomy and its relevance to multiple sclerosis. Multiple Sclerosis and Related Disorders. https://www.sciencedirect.com/science/article/pii/S2211034826003597

7. Di Marino, V., & Lepidi, H. (2014). Anatomic Study of the Clitoris and the Bulbo-clitoral Organ. Springer.

8. Gray, H., et al. (1995). Gray’s Anatomy (38th ed.).

9. California PTC. (2024). Interview with Rachel Gross on clitoral anatomy. https://californiaptc.com

10. Journal of Urology. (2023). HF01-02 WE FINALLY FOUND HER! AN ORIGIN STORY OF THE CLITORIS. Journal of Urology

Next: Volume III – Cross-Species Comparison: Clitoral Variation Across Mammals

THE CLITORIS ANTHOLOGY

Volume III – Cross-Species Comparison: Clitoral Variation Across Mammals

By Dr Andrew von Scheer-Klein

“Variation in female external genitalia is anatomically more radical than that in the male genitalia.”

— Pavlicev, Herdina & Wagner, Integrative and Comparative Biology, 2022

Method notes. All figures are sourced. Where a claim is contested or a figure is uncertain, it is marked as such. The central source is the 2022 review by Pavlicev, Herdina, and Wagner, which remains the most comprehensive comparative survey available. Its own authors note that “many gaps in knowledge remain.”

Introduction: The Assumption That Was Never Tested

Volume I documented the cultural suppression of the clitoris. Volume II documented the anatomical correction — the nerve count, the multiplanar structure, the 2026 synchrotron map.

This volume asks a different question: what is the clitoris across species, and what does its variation tell us?

The assumption that has governed comparative anatomy for most of its history is simple: male genitalia are diverse because they are under sexual selection, and female genitalia are conservative because they are not. Male genital diversity is a textbook fact — the baculum, the spines, the elaborate shapes, the extraordinary variation in primate penises.

The 2022 review by Mihaela Pavlicev, Anna Nele Herdina, and Günter Wagner tested that assumption. Their conclusion, stated in the title, is unambiguous: female genital variation far exceeds that of male genitalia.

The clitoris is not a conservative structure. It is one of the most variable organs in the mammalian body. It can be absent as a discrete unit, tunneled by the urethra, elongated into a pseudo-penis, bifurcated, ossified, or flattened into invisibility. It varies in position relative to the vaginal opening, in internal composition, in erectile tissue architecture, and in nerve density.

This volume surveys that variation. It is a survey of an incomplete record, and it says so.

Part I: The Framework — What Varies and Why It Matters

The Structural Variables

Across therian mammals (marsupials and placentals), the clitoris varies along several axes:

· Presence or absence of the cervix. In many Xenarthra (sloths, anteaters, armadillos), the cervix is absent entirely — a loss of a whole anatomical unit.

· Presence or absence of the urogenital sinus (UGS). The UGS is the common chamber into which the urethra and vagina open. It is present in some species, absent in others, and its loss has arisen multiple times independently.

· Spatial relationship between the clitoris and the genital canal. In some species the clitoris is close to the vaginal opening; in others it is completely separated.

· Elongation of the clitoris. In some species the clitoris is a small glans; in others it is elongated into a pendulous structure that may exceed the penis in size.

· Perforation by the urethra. In some species the urethra tunnels through the clitoris, exiting at its tip. In others it exits separately.

· Presence of the os clitoridis (baubellum). The female homologue of the baculum (penis bone) is present in some species, absent in others, and more variable than its male counterpart.

The Ancestral Configuration

Pavlicev and colleagues reconstruct the ancestral eutherian configuration as including: a cervix, a single vaginal segment, a tubular urogenital sinus, and an unperforated clitoris close to the entrance of the genital canal.

From this ancestral state, evolution has tinkered extensively. Some morphs are unique to early-branching clades (the absence of the cervix in Xenarthra). Others have arisen multiple times independently (the flattening or loss of the UGS, the extreme elongation of the clitoris). The pattern is not one of descent with modification along a single lineage. It is a bush of independent experiments.

Part II: The Spotted Hyena — The Extreme Case

No discussion of clitoral variation can avoid the spotted hyena (Crocuta crocuta). It is the outlier against which all other variation is measured.

The female spotted hyena is the only extant mammal that mates and gives birth through a pendulous, penis-like clitoris. She lacks an external vaginal opening entirely. The clitoris is hypertrophied, fully erectile, and traversed to the tip of the glans by a central urogenital canal. Mating occurs through this canal. Birth occurs through this canal. Urination occurs through this canal.

The anatomy is so male-like that for centuries naturalists assumed spotted hyenas were hermaphrodites. The vaginal labia are fused to form a pseudo-scrotum filled with fatty tissue. The clitoris and penis are remarkably similar in size and configuration, in both flaccid and erect states.

The cost is severe. First births through the clitoris are “prolonged and remarkably difficult, often causing death in neonates“. The strip of pink scar tissue running down the posterior surface of the clitoris is the result of tearing during parturition — a permanent record of the first birth.

The evolutionary explanation for this extreme virilization has been debated for decades. The most-cited hypothesis is the social dominance hypothesis: female hyenas live in matrilineal clans and are dominant over males. High androgen exposure during fetal development produces both the masculinized genitalia and the aggressive, dominant behaviour that confers social advantage. The reproductive cost is the price paid for the social benefit.

But the mechanism is not fully understood. A 2002 study examined the androgen receptor (AR) gene in spotted hyenas and found that “the structural changes in the AR do not account for the abnormal virilization”. The androgen receptor responds normally to androgens. Something else — the timing of androgen exposure, the sensitivity of target tissues, the interaction of multiple hormones — is producing the phenotype. The hyena remains a case study in what happens when sexual differentiation is pushed to its limit.

Part III: The Ring-Tailed Lemur — “Naturally Masculinized”

The spotted hyena is not alone. The female ring-tailed lemur (Lemur catta) presents an “enlarged, pendulous external clitoris, tunnelled by the urethra“. It is not as extreme as the hyena — there is no pseudo-scrotum, no complete masculinization — but the anatomy is sufficiently male-like that the authors of the 2008 study described females as “naturally masculinized“.

The detailed findings: the female has an elongated clitoral shaft and glans clitoridis. The urethra is incorporated within the clitoral body but is not surrounded by erectile tissue — there is no corpus spongiosum. The os clitoridis is 43% the length and 24% the height of the os penis.

The ring-tailed lemur is a strepsirrhine primate — a “lower” primate, in the older terminology. The anatomy is a reminder that “masculinized” female genitalia are not a freak anomaly. They are a recurrent pattern in mammalian evolution, arising independently in multiple lineages.

Part IV: The Spider Monkey — The Clitoris as Signal

In the spider monkeys (Ateles), the clitoris is long — from two to three inches — and pendulous, with a glans and a conspicuous prepuce. It is sufficiently penis-like that the females of some platyrrhine (New World) primates — spider monkeys, woolly spider monkeys (Brachyteles), woolly monkeys (Lagothrix), and capuchins (Cebus) — have a long, pendulous clitoris that can be easily mistaken for a penis.

But the function may not be purely sexual. In spider monkeys, the clitoris has an interior passage, or urethra, and it “retains and distributes urine droplets as the female spider monkey moves around”. The clitoris has been associated with chemical communication with males — the urine droplets carrying olfactory signals that advertise reproductive state.

This is a different model of clitoral function. The organ is not primarily a sensory structure. It is a signalling structure. The pleasure is not the point; the signal is. The clitoris has been co-opted for a communicative role.

Part V: Marsupials — The Bifid Clitoris

Marsupials present a fundamentally different configuration. In the more primitive marsupials — the Virginia opossum, the phalangers — the clitoris has a bifid structure, meaning it is divided into two parts, corresponding to the bifid glans penis of the male. In kangaroos and wallabies, the clitoris is cylindrical and simpler.

The pattern is not universal. The rule that where the male has a bifurcate glans the female has a bifid clitoris does not hold for all marsupials. In some species, including the common opossum (Didelphis marsupialis), no evidence of a bifurcated clitoris has been found — the clitoris is simple despite the male’s divided penis.

This is the pattern that makes comparative anatomy difficult. The correlation between male and female form is strong but not absolute. The developmental pathways are shared, but they diverge in ways that are not fully understood.

Part VI: The Os Clitoridis — The Bone That Should Not Be Forgotten

The baculum — the penis bone — is familiar. It is present in many mammals (though not humans). It is the subject of extensive study.

The os clitoridis — the clitoral bone, also called the baubellum — is its female homologue. It is present in some mammal species, particularly in bats, rodents, carnivores, and some primates, including ring-tailed lemurs and non-human great apes. It is absent from the human clitoris.

The phylogenetic distribution of the os clitoridis has recently been reviewed extensively. The finding: “The Os clitoridis appears more variable than Os penis within but also across species“. The female bone is more evolutionarily labile than the male bone — it is lost and gained more readily, varies more in size and shape.

The functions are poorly understood. A function during copulation is assumed for the baculum; no comparable function has been established for the os clitoridis. The bone may be a developmental consequence of shared pathways, or it may have a function that has not yet been identified.

Part VII: The Primate Survey — Imaging the Invisible

The most recent advance in comparative clitoral anatomy comes from the imaging work of Dr Daniel Varajão de Latorre and colleagues at Manchester Metropolitan University.

Their approach uses MRI for larger structures and diffusible iodine contrast-enhanced microCT (diceCT) for smaller species, allowing them to visualise internal clitoral anatomy without destructive dissection. This is the same methodological shift that produced the 2026 synchrotron map of the human clitoris, applied across primates.

The findings: “stark differences in the morphology of clitorises across a range of primate species”. The variation extends to the muscles and erectile tissues, not just the external form. “In some species, whole muscles were entirely absent and, in some cases, we would find a paired ligament when most primates have a single one.”

The researchers note the historical asymmetry: “The subsurface 3D shape of the human clitoris was only fully described in the last 20 years, despite us having equivalent information on male genitalia for much longer”. The same disparity that characterised human anatomy has characterised comparative anatomy. The clitoris was not studied because it was not considered worth studying.

Part VIII: Beyond Mammals — Birds, Reptiles, and the Deep Homology

The clitoris is not exclusively mammalian. A clitoris is present in the females of many birds — ducks, geese, and other Anatidae, and in the tinamous. It is present in turtles and crocodiles. It is present in some lizards and snakes.

The evolutionary origin of the clitoris and penis is shared. In amniotes (the group containing reptiles, birds, and mammals), the external genitalia arise from a common embryonic precursor: an appendage adjacent to the cloaca called the genital tubercle. This structure is the developmental origin of both the penis and the clitoris.

The “genital tubercle” — the shared precursor — means that the clitoris and penis are not merely analogous structures that happen to look similar. They are homologous. They are the same structure, developed in different directions. The distinction between male and female genitalia is not a fundamental division; it is a developmental divergence from a common origin.

Part IX: The Evolutionary Debate — Adaptation, Byproduct, or Something Else?

What is the clitoris for, across species?

The debate has two main positions, as introduced in Volume I.

The byproduct account. Elisabeth Lloyd’s The Case of the Female Orgasm (2005) examined 21 evolutionary explanations for female orgasm and found insufficient evidence to validate any as adaptations. She argued that the female orgasm is a non-adaptive byproduct of the embryological development of the penis and male orgasm — the same tissue, the same nerve pathways, selected for in males, present in females as a developmental consequence.

The adaptation account. Puts and Dawood (2006), among others, contend that Lloyd applied overly restrictive criteria for what counts as an adaptation. Pavlicev and Wagner (2016) have proposed a different adaptive scenario: the “induced ovulation” hypothesis. In many mammals, ovulation is induced by copulation rather than occurring spontaneously. The clitoris, in these species, is positioned to be stimulated during mating, and the stimulation triggers the hormonal cascade that leads to ovulation. Over evolutionary time, as spontaneous ovulation evolved, the distance between the clitoris and the vaginal orifice increased, and the clitoris lost its direct functional link to ovulation.

The position of the clitoris relative to the vaginal orifice is a key variable. In species with induced ovulation, the clitoris is close to the vaginal opening and is stimulated during copulation. In species with spontaneous ovulation, the clitoris is farther from the vaginal opening, and stimulation is no longer a necessary trigger for reproduction. The human clitoris is in the latter category — far from the vaginal opening, not directly stimulated by intercourse.

This hypothesis does not resolve the adaptation-versus-byproduct debate. It reframes it. The clitoris may have been adaptive in ancestral mammals — directly linked to reproduction — and become non-adaptive for that function in species with spontaneous ovulation, while remaining adaptive for other functions (pair bonding, pleasure, social signalling) or becoming a byproduct.

The question remains open. The anatomy establishes that the clitoris is there. It does not yet establish why.

Part X: What the Variation Tells Us

The comparative record supports several conclusions.

First, the clitoris is not a minor or vestigial structure. It is present in all female mammals. It varies more than the penis. It has been elaborated, tunnelled, bifurcated, elongated, ossified, and co-opted for signalling. It is under evolutionary pressure — the pressure is simply not the same pressure that shapes the penis.

Second, there is no single “clitoris” across species. The human clitoris is one configuration among many. In the spotted hyena, the clitoris is a birth canal. In the spider monkey, it is a chemical signalling device. In the ring-tailed lemur, it is a tunnelled urethral passage. In the marsupial opossum, it is bifid. The organ is plastic, and its form reflects the ecological and social demands of the species.

Third, the gaps in the record are substantial. The Pavlicev review concludes that “many gaps in knowledge remain and will require a community-wide effort to come to a more robust model of female genital evolutionary patterns”. The evidence for unitary versus bilobed glandes clitorides is “ambivalent“. The classical German comparative anatomy literature of the late 19th and early 20th centuries has not been fully integrated into modern work. The imaging revolution that transformed human clitoral anatomy is only now being applied to other species.

The clitoris was not studied because it was not considered important. That is changing. The variation is real, and the record is being assembled.

Conclusion: The Organ That Was Always There

The comparative record tells a simple story. The clitoris is not a human peculiarity. It is not a recent evolutionary innovation. It is not a vestigial afterthought.

It is a mammalian structure, present in all females, variable beyond the male organ, and shaped by forces that are only beginning to be understood. It has been elongated into a birth canal, tunnelled into a urinal, co-opted into a signal, divided into two, and ossified into bone. It has been called “masculinized” when it resembles the penis, which is another way of saying that the penis is not the standard against which other structures should be measured.

The 2022 review’s central finding — that female genital variation exceeds male variation — is not a curiosity. It is a correction. The assumption of female conservatism was never tested. When it was tested, it failed.

The clitoris varies more than the penis. That is the fact. The explanation is still being written.

To be continued in Volume IV: The Clitoris in World Art and Culture.

References

1. Pavlicev, M., Herdina, A. N., & Wagner, G. (2022). Female genital variation far exceeds that of male genitalia: a review of comparative anatomy of clitoris and the female lower reproductive tract in Theria. Integrative and Comparative Biology, 62(3), 581–601. https://doi.org/10.1093/icb/icac026 

2. Drea, C. M., et al. (2008). External genital morphology of the ring-tailed lemur (Lemur catta): females are naturally “masculinized”. Journal of Morphology, 269(4), 451–463. 

3. Place, N. J., et al. (2002). Virilization of the female spotted hyena cannot be explained by alterations in the amino acid sequence of the androgen receptor. Molecular and Cellular Endocrinology. 

4. Cunha, G. R., et al. (2014). Development of the external genitalia: perspectives from the spotted hyena (Crocuta crocuta). Differentiation, 87(1-2), 4–22. 

5. Glickman, S. E., et al. (2006). Mammalian sexual differentiation: lessons from the spotted hyena. Trends in Endocrinology & Metabolism, 17(9), 349–356. 

6. Frank, L. G., et al. (2002). Exposure to naturally circulating androgens during foetal life incurs direct reproductive costs in female spotted hyenas, but is prerequisite for male mating. Proceedings of the Royal Society B, 269(1504), 1981–1987. 

7. Hill, J. P. (1900). Contributions to the morphology and development of the female urogenital organs in the Marsupialia. Proceedings of the Linnean Society of New South Wales. 

8. Owen, R. (1868). On the Anatomy of Vertebrates. Longmans, Green and Co. 

9. Varajão de Latorre, D., et al. (2023). Uncovering the mysteries of the clitoris with advanced imaging techniques. Society for Experimental Biology Annual Conference. 

10. Lough-Stevens, M., et al. (2018). The baubellum (os clitoridis) of mammals. Journal of Mammalogy. 

11. Lloyd, E. A. (2005). The Case of the Female Orgasm: Bias in the Science of Evolution. Harvard University Press.

12. Puts, D. A., & Dawood, K. (2006). The evolution of female orgasm: adaptation or byproduct? Twin Research and Human Genetics, 9(3), 467–472.

13. Pavličev, M., & Wagner, G. (2016). The evolutionary origin of female orgasm. Journal of Experimental Zoology Part B: Molecular and Developmental Evolution, 326(6), 326–337. 

14. Wagner, R. (1845). Elements of the Comparative Anatomy of the Vertebrate Animals. 

Next: Volume IV – The Clitoris in World Art and Culture

THE CLITORIS ANTHOLOGY

Volume IV – The Clitoris in World Art and Culture

By Dr Andrew von Scheer-Klein

“The woman is both convex and concave, but she must not be deprived, morally or physically, of the principal centre of her convexity: the clitoris.”

— René Nelli, Érotique et civilisation, 1972 (quoted by Nil Yalter, La femme sans tête, 1974)

Method notes-All claims are sourced. Where the evidence is fragmentary or contested, it is marked as such. This volume surveys an incomplete record. The gaps are part of the subject.

Introduction: The Image That Was Not Made

Volume I documented the suppression of the clitoris in medicine and anatomy. Volume II documented the anatomical correction. Volume III surveyed its variation across species.

This volume asks a different question: what did human beings make of the clitoris in their art?

The answer is more complicated than the suppression narrative suggests. The clitoris was not simply erased. It was represented — in Palaeolithic figurines, in classical votive offerings, in Japanese shunga, in Chinese erotic manuals, in the work of contemporary feminist artists. But the representation was intermittent, coded, and often misread by the scholars who encountered it. The image was there. The eye that could see it was not always present.

This is a survey of what was made, what was meant, and what was seen. It is organised chronologically, from the Palaeolithic to the present, and it concludes with the contemporary reclamation — the moment the clitoris became, for the first time, a subject of art in its own right.

Part I: Prehistoric — The Venus Figurines and the Apotropaic Genital

The Upper Palaeolithic Venus figurines — the most famous being the Venus of Willendorf (c. 28,000–25,000 BCE) — are among the earliest known human sculptures. They are almost universally female, almost universally naked, and almost universally described as “fertility figures.”

That description may be incomplete.

Tosca Snijdelaar’s 2020 study in Anthropos offers a different reading. She argues that the genitals of the Venus figurines served an apotropaic function — that is, they were designed to ward off evil. The mechanism she proposes is physiological: the sympathetic nervous system causes genital arousal (engorgement of the labia and clitoris) in response to anxiety. The simultaneous experience of anxiety and engorgement led Palaeolithic peoples to associate the genitals with protective power.

If Snijdelaar is right, the Venus figurines are not simply fertility symbols. They are protective objects, and the genitalia — including the clitoris — are central to their function. The evidence is interpretive, not conclusive. But it is a reading that takes the anatomy seriously rather than reducing the figurines to a single reproductive meaning.

The Venus of Willendorf itself has had a strange modern afterlife. In 2018, its image was censored on Facebook — the platform removed a photograph of the 30,000-year-old figurine as “dangerously pornographic“. The censorship was reversed after public outcry. The incident is a reminder that the suppression of female anatomy is not merely historical. It is algorithmic.

Part II: Classical Antiquity — The Votive Vulva

The ancient Greeks and Romans left substantial material evidence of how they understood female genitalia. Rebecca Flemming’s study, “The Archaeology of the Classical Clitoris,” is the most detailed treatment of the subject.

Female genitals appear regularly in votive deposits in both Greece and Italy — terracotta and marble offerings dedicated at sanctuaries. The standard form is a vertical slit on a smooth, curved pubic surface. These were dedicated to Aphrodite and other deities, typically in connection with sexuality, fertility, and the passage through puberty.

But there is a more specific and less-discussed variant. In several Italian votive assemblages from the Republican and Hellenistic periods, the offerings include a clitoris. These are not generic vulva symbols. They are anatomical representations that add the clitoris to the pattern. At Tessennano and Gravisca, some offerings depict the complete vulva — labia, clitoris, and openings — as they would appear from below in a mature woman.

Flemming notes that these representations are “less expected” than the demure frontal slit, and she argues for a reading that “allows the clitoris a more positive role” in classical understandings of female sexuality. The classical world knew the organ. It dedicated offerings to it. It did not always depict it, but it did depict it.

One detail is worth noting. The Greek word for the clitoris was múrton — the same word used for the myrtle berry. The labia were called murtócheila, “myrtle lips”. The naming was botanical, not pornographic. The organ was described in the language of plants.

Part III: Asian Traditions — The Named and the Pictured

China

Chinese erotic art and sexual manuals contain the most extensive vocabulary for female genitalia in any pre-modern tradition. The terms are not clinical. They are poetic and botanical, and they name parts of the anatomy with precision.

The clitoris itself is described in the classical texts as the “pearl” or the “cinnabar pearl” (赤珠), and the region below it — where the inner labia meet — is called the “琴弦” (qin string). The inner labia are called “赤珠” (red pearl) or “麥齒” (wheat teeth). The pubic mound is the “玄圃” (dark garden) or “神田” (divine field).

These are not euphemisms designed to obscure. They are names designed to specify. The Chinese tradition named the clitoris. It knew where it was. It described its function.

In the Su Nü Jing and related texts, techniques for clitoral stimulation are described in detail. The male partner is instructed to “suck the tongue (clitoris)” and to “beat both sides of her jade gate, aiming at the clitoral bulbs“. The anatomy was not merely known. It was operationalised.

The material record supports the textual one. Chinese erotic art from the Ming and Qing dynasties — the chunghua (spring paintings) — depicts sexual scenes with detailed attention to female anatomy. The clitoris is sometimes shown, sometimes implied, but the anatomical knowledge is consistently present.

India

Indian erotic literature and art are more explicit still. The Kama Sutra and the Ananga Ranga describe the clitoris as “the principal seat of pleasure” and advise direct stimulation as a technique. The clitoris, the texts note, “gets into erection with all women, not only during coitus” — a physiological observation that Western medicine would not formalise until the twentieth century.

Indian temple sculpture — at Khajuraho, Konark, and other sites — includes depictions of female genitalia, often in the context of sexual scenes. The clitoris is not consistently shown, but the anatomical understanding is evident in the accuracy of the depictions that survive.

Japan

Japanese shunga — erotic woodblock prints and paintings — from the Edo period (1603–1868) present a distinct case. The genitals in shunga are exaggerated, often to the point of disproportion. The female genitalia are typically shown with the clitoris prominent.

Shunga was not pornographic in the modern sense. It was produced by major artists — Hokusai, Utamaro, Eisen — and circulated widely. It was understood as both erotic and instructional. Close-up views of vulvas and clitorises were a recognised sub-genre; one handscroll by an anonymous artist presents “close-ups of three female sex organs within round windows”.

The Japanese tradition did not suppress the clitoris. It exaggerated it, depicted it, and sold it as art.

Part IV: Medieval Europe — The Sheela-na-Gig

The medieval period in Europe offers one of the most striking and least understood representations of female genitalia: the Sheela-na-gig.

Sheela-na-gigs are stone carvings of naked females with legs spread apart, hands holding open the vulva, found in churches and secular buildings in Britain and Ireland. The name comes from the Irish Síle na gcíoch, “Julia of the breasts“.

The carvings are often described as crude, but they are anatomically specific. In some examples, the clitoris is explicitly depicted — “a round and protruding clitoris designed like the tongue of a bell“. In others, the vulva is opened to reveal the clitoris and the vaginal opening.

Interpretations are contested. Sheela-na-gigs have been read as fertility symbols, as warnings against lust, as apotropaic figures (warding off evil), as survivals of pre-Christian goddess worship, and as representations of the sin of Luxuria. No single interpretation commands consensus.

What is notable is the presence of the clitoris. The medieval church may have pathologised the organ in its medical texts, but its stone carvings depicted it. The women who carved or commissioned these figures knew the anatomy. They made it visible on the walls of churches.

Part V: The Renaissance — The Anatomical and the Artistic

The Renaissance saw the “rediscovery” of the clitoris by anatomists — Colombo in 1559, Falloppio in 1561, and the priority dispute that followed. But the visual record of the clitoris in Renaissance art is more complicated.

The earliest known representation of the internal anatomy of the clitoris appears in the work of Bartolomeo Eustachi (Eustachius) in 1552. Leonardo da Vinci also drew the female genitalia, though his depictions were “largely erroneous,” influenced by Galenic anatomy and showing the vulva as a kind of cushion.

In painting, the clitoris appears more obliquely. Titian’s Venus of Urbino (1538) depicts the goddess reclining with her hand draped over her mons, “her fingers easily in position to stimulate her clitoris”. The gesture is not explicit, but it is legible.

Francesco del Cossa’s Triumph of Venus (c. 1470) has been read as including a rosebud that “evokes a clitoris” in semantic continuity with the column and Christ. The reading is interpretive, not certain, but it reflects the period’s willingness to allegorise female anatomy.

The Renaissance knew the clitoris. It named it, anatomised it, and painted around it.

Part VI: The 19th and 20th Centuries — The Pathologised and the Medical

The nineteenth century brought a paradox. The clitoris was increasingly visible in medical art — anatomical illustrations, surgical diagrams, pathological specimens — precisely as it was disappearing from fine art.

The Wellcome Collection holds a watercolour by Christopher D’Alton from approximately 1857, showing “severely diseased tissue and hypertrophy of the clitoris“. It is a medical illustration, not a work of art in the traditional sense, but it is a detailed anatomical representation. The same period saw coloured line engravings by W.H. Lizars showing the clitoris in dissection.

Meanwhile, the fine art tradition largely avoided the organ. The female nude was a central subject, but the clitoris was rarely depicted with the specificity it had in classical votive offerings or Japanese shunga.

The twentieth century saw a gradual return. Modernist artists such as Princess Marie Bonaparte — who funded research into the clitoris and was immortalised by Brancusi — brought the organ into cultural discourse, though often through the lens of psychoanalysis rather than direct representation. The surrealists toyed with genital imagery, but the clitoris was rarely a subject in its own right.

The turn came in the 1970s.

Part VII: The Contemporary Reclamation — Clitartivism

The contemporary period — from the 1970s to the present — has seen the most sustained and explicit artistic engagement with the clitoris in the history of art. The organ has moved from the margins of erotic art to the centre of feminist practice.

The 1970s: Nil Yalter and the Speaking Belly

In 1974, the Franco-Turkish artist Nil Yalter made La femme sans tête (The Headless Woman), a video in which the artist’s belly — her face absent — is inscribed with a quotation from René Nelli: “The woman is both convex and concave, but she must not be deprived, morally or physically, of the principal centre of her convexity: the clitoris”.

The work is a direct challenge to the Freudian reduction of female sexuality to the vaginal. Yalter’s belly dances; the text speaks. The clitoris is named, not shown, but its centrality is asserted. The Centre Pompidou describes the piece as “an affirmation of female pleasure and a denunciation of the sexual mutilations imposed on women”.

The 1990s: The Cunt Colouring Book and the Anatomy of Pleasure

The 1990s saw the emergence of “vulva art” as a recognised movement. Artists such as Tee Corinne, whose Cunt Colouring Book (1975) was a landmark, and Annie Sprinkle, whose performance work engaged directly with female anatomy, made the vulva and clitoris visible in art spaces.

This period also saw the first accurate anatomical models of the clitoris — most notably Odile Fillod’s 3D-printed model (2016), based on Helen O’Connell’s research, which was released as open-source material and used in sex education.

The 2010s and 2020s: Clitartivism

The current fourth wave of feminist art (2012–) has produced what researcher Juli Wexel calls clitartivism — a category of “vulvartivism” centred on the clitoris as an object of representation in art.

Wexel’s own work, That’s VULVA: ivagination II (2026), is an interactive installation for the Sex Museum Portugal in which “the clitoris is activated by the flow of visitors as a gesture of tribute to the sexual organ’s unique function of generating pleasure“.

Other contemporary artists working in this vein include:

· Franca Franchi, whose series Aphrodita Flower, Radha Flower, Genesis Flower (2023) celebrates the diversity of vulvas and clitorises through floral, vivid, and colourful forms.

· Nasia Pavlidou, whose ceramic sculpture Blooming in Silence explores the clitoris “trapped within a cage of wires, representing the ongoing oppression it faces“.

· Whitefeather Hunter, whose Sentient Clit — The Possification of Biotech explores 3D-bioprinted clitorises embedded with menstrual stem cells differentiated to neuronal cell types.

· Sophia Wallace, whose Cliteracy Project (2010–) includes a large-scale clitoris sculpture and 100 “laws of cliteracy,” “purposely scaled to make the viewer feel small”.

The public display of the clitoris has also extended to public sculpture. In Neuchâtel, Switzerland, a sculpted clitoris was installed in public space in the 2010s — part of what one critic described as the decade when the clitoris became “an object of art for itself”.

Part VIII: The Museum as Battleground

The clitoris has become a subject of museum exhibitions and cultural festivals. In 2023, the Université libre de Bruxelles hosted L’Expo Clito — la seconde origine du monde, an exhibition aimed at showing “the clitoris, its history, and its representation through the centuries”.

In Barcelona, a Festival of the Vulva, Vagina, and Clitoris has been held, featuring works such as Jamie McCartney’s The Great Wall of Vagina (2006) and Patricia Bonfante’s VDoor Project (2024).

The Musée d’Orsay in Paris has been the site of performance interventions. In 2014, a performer sat in front of Courbet’s L’Origine du monde (1866) and displayed her own vulva and clitoris to gallery visitors. The critic noted that “you can’t really see the clitoris of Courbet’s woman” — a reminder that even the most famous painting of female genitalia in Western art does not, in fact, depict the organ.

Part IX: What the Art Record Shows

The survey suggests several conclusions.

First, the clitoris was not simply erased. It was depicted in Palaeolithic figurines (if Snijdelaar’s apotropaic reading is correct), in classical votive offerings, in Chinese erotic manuals, in Japanese shunga, in medieval Sheela-na-gigs, in Renaissance anatomical drawings, and in contemporary art. The suppression was real, but it was not total.

Second, the visibility of the clitoris fluctuated with cultural and religious context. Traditions that celebrated female pleasure — classical antiquity, Edo Japan, the Indian erotic tradition — depicted the organ. Traditions that pathologised it — medieval Christianity, Victorian medicine, Freudian psychoanalysis — minimised or erased it.

Third, the contemporary period is the first in which the clitoris has been treated as a subject of art in its own right. The work of Yalter, Franchi, Pavlidou, Hunter, Wallace, and Wexel is not erotic art in the traditional sense. It is anatomical art — art that takes the organ as its subject, not its pretext.

Fourth, the museum has become a site of contestation. The clitoris is not merely depicted in art. It is curated, exhibited, and debated. The Expo Clito and the Festival of the Vulva are not merely exhibitions. They are arguments about what should be seen.

Conclusion: The Image and the Eye

The clitoris has been depicted, misread, censored, and reclaimed. The image was always there, in stone, in paint, in print, in pixels. What changed was the eye that could see it.

The Palaeolithic carver saw it. The classical votive-maker saw it. The Chinese manual-writer named it. The Japanese printmaker exaggerated it. The medieval mason carved it on a church wall. The Renaissance anatomist claimed to discover it. The Victorian surgeon removed it. The Freudian theorist theorised it away. The contemporary artist reinstalled it.

The record is not a simple story of suppression. It is a story of intermittent visibility. The organ was always there. The culture that could see it was not.

The 2026 synchrotron map, discussed in Volume II, is the most recent entry in this record. It is an image — a three-dimensional map of the nerve network — and it is, in its own way, a work of art. It is also a correction. It shows what the eye could not see, what the hand could not draw, what the culture had not yet learned to look for.

The clitoris was not discovered in 1559. It was not discovered in 2026. It was seen, forgotten, and seen again. The eye is the variable. The organ is constant.

To be continued in Volume V: Modern Surgical Implications and the Preservation of Function.

References

1. Snijdelaar, T. (2020). Venus figurines: from body process to symbolic artefact. Anthropos, 116(1), 13–28.

2. Flemming, R. (2020). The archaeology of the classical clitoris. Society for Classical Studies.

3. Votive in the shape of female genitalia. Museum of Fine Arts, Boston.

4. Musée d’Orsay performance intervention. Hyperallergic, 2014.

5. Yalter, N. (1974). La femme sans tête ou La danse du ventre [Video]. Centre Pompidou.

6. Wexel, J. (2025). VULVA É MÍDIA: Vulva Art, Vulvartivism and Digital Media Art [Doctoral thesis]. Universidade do Algarve.

7. Wexel, J. (2026). That’s VULVA: ivagination II [Installation]. Sex Museum Portugal.

8. Franchi, F. (2023). Aphrodita Flower, Radha Flower, Genesis Flower [Series]. Musées de l’ULB.

9. Pavlidou, N. (2024). Blooming in Silence [Ceramic sculpture]. Homo Faber.

10. Hunter, W. (2023). Sentient Clit — The Possification of Biotech [Bio-art].

11. Wallace, S. (2010–). Cliteracy Project [Mixed media].

12. L’Expo Clito — la seconde origine du monde. (2023). Université libre de Bruxelles.

13. Chinese erotic art terminology. 人間副刊, 2012.

14. Shunga, Japanese erotic art. British Museum.

15. Sheela-na-gig. Oxford Reference.

16. D’Alton, C. (1857). Female genitalia showing hypertrophy of the clitoris [Watercolour]. Wellcome Collection.

17. Turner, L. (2024). Sanguine resistance: handling a clitoral palette in Artemisia Gentileschi. Eroties of Deconstruction. Edinburgh University Press.

Next: Volume V – Modern Surgical Implications and the Preservation of Function

THE CLITORIS ANTHOLOGY

Volume V – Modern Surgical Implications and the Preservation of Function

By Dr Andrew von Scheer-Klein

“The nerve map is drawn. The surgeons now have the navigation.”

— Volume II, Conclusion

Method notes. All figures are sourced. Where a claim rests on a small case series, a single-centre experience, or a preprint, it is marked as such. The volume does not offer clinical guidance. It surveys the literature.

Introduction: The Map and the Surgeon’s Hand

Volumes I through IV documented the cultural suppression, the anatomical correction, the comparative variation, and the artistic record. Volume V asks the question those volumes make possible: what does the anatomy now permit the surgeon to do?

The answer has changed substantially in the last five years, and it changed again in March 2026.

The first change was conceptual. The clitoris is no longer understood as a small external nub but as a multiplanar organ with significant depth and extensive innervation. This understanding has direct surgical applications in clitoral hood reduction, labiaplasty, vulvectomy, and gender-affirming procedures. The second change was technical. The Foldès method — developed for reconstruction after female genital mutilation — has been adapted for oncological surgery, with case series reporting high rates of postoperative orgasm. The third change was anatomical. The 2026 synchrotron study produced the first micron-scale map of the clitoral nerve network, correcting conventional teaching and providing the first navigational instrument for surgeons operating in this region.

This volume surveys four surgical domains — reconstruction after FGM, oncological surgery, gender-affirming surgery, and aesthetic/cosmetic procedures — and concludes with the nerve map that now connects them.

Part I: Reconstruction After Female Genital Mutilation

The Scale of the Problem

The World Health Organization estimates that 230 million girls and women have undergone female genital mutilation. The procedure removes the external clitoral structures and parts of the labia minora. It offers no health benefits. It can cause severe bleeding, infections, urinary problems, and complications in childbirth.

Surgical reconstruction aims to restore clitoral anatomy and function. The dominant technique is the Foldès method, first described by Pierre Foldès in France and subsequently modified by different authors. The technique involves removal of the cutaneous scar tissue covering the clitoral stump, dissection and mobilization of the clitoral body through section of the suspensory ligament, and meticulous nerve sparing.

Outcomes

The evidence base for FGM reconstruction is substantial. A 2025 cross-sectional study of 20 women who attended an FGM/C outpatient clinic found that those who received clitoral reconstruction combined with psychosexual care reported higher overall satisfaction (9.17 versus 8.57 on a 10-point scale), higher psychological well-being (17.8 versus 9.25), higher sexual response (31.22 versus 21.56), and higher genital self-image (25.60 versus 17.60) compared with those who received psychosexual care alone. Mean overall satisfaction with care was 8.95/10.

Sensitivity outcomes are also documented. A study using Semmes-Weinstein monofilament testing before and after reconstruction found that 70 of 73 patients (95.9%) were able to perceive 2.83 monofilaments after surgery, with no patient showing decreased sensitivity compared with preoperative findings. A separate study presented at ICOPLAST 2025 reported that among 46 patients evaluated postoperatively, 44 achieved sensory levels comparable to those of women with an intact clitoris.

The complications are documented and generally minor. A 2025 study reported that the main surgical complications were minor postoperative bleeding and one painful wound infection. A scoping review of 15 FGM/C studies encompassing 3,304 women found that complications included infection, hematoma, and delayed healing, with low overall morbidity.

What the Evidence Does Not Establish

The evidence is limited by study design. Most studies are observational, many are single-centre, and follow-up is often short. A 2025 scoping review concluded that “data from FGM/C indicate the procedure is feasible and safe and may improve sexual function, body image and quality of life,” but called for further research. The strongest evidence comes from the Foldès technique, but even here, randomised controlled trials do not exist.

Part II: Oncological Surgery — Vulvar Carcinoma

The Historical Context

Vulvar cancer is a rare gynecological malignancy, accounting for approximately 5% of all gynecologic cancers worldwide, with incidence rates rising and a trend toward younger age at diagnosis. Historically, the standard surgical treatment was radical vulvectomy — complete en bloc removal of the vulva with surrounding tissue and bilateral inguinofemoral lymphadenectomy. This approach predominated until the late 20th century and led to significant morbidity and functional loss.

Over time, surgical management shifted toward less radical, tissue-sparing procedures. Radical local excision achieved comparable oncological outcomes with reduced complications. Sentinel lymph node procedures replaced complete lymphadenectomy in selected cases. The transition to less radical surgery supported the adoption of narrower margin thresholds.

The Foldès Adaptation

The same technique developed for FGM reconstruction has now been adapted for oncological surgery. A 2026 study in Gynecologic Oncology described a technique for clitoral reconstruction after vulvar carcinoma excision incorporating the Foldès method. The approach involves careful margin assessment, clitoral mobilization via suspensory ligament release, mucosal graft coverage, and neohood formation, with the stated aim of preserving neurovascular integrity while restoring anatomy and function.

The case series reported outcomes for 18 patients diagnosed with vulvar cancer who underwent surgical treatment including clitoral reconstruction. The ability to achieve a clitoral orgasm post-procedure was 88.9% (16/18). Estimated additional surgical time was 15 minutes. The postoperative complication rate concerning the clitoral reconstruction specifically was 11.1% (2/18). The authors concluded that the procedure is “technically feasible, preserves anatomical landmarks, reporting low incidence of complications, and may mitigate psychosexual morbidity without compromising oncological safety”.

The Nerve Density Evidence

A separate line of evidence supports nerve-sparing approaches in vulvar surgery. A study in the American Journal of Obstetrics and Gynecology characterised the anatomy, histology, and nerve density of the clitoris and associated structures in 27 cadavers. The findings included: median clitoral body length 29 mm (range 13–59 mm), glans length 8 mm (range 5–12 mm), and crura length 50 mm (range 25–68 mm). The width of the dorsal nerve at the lateral crura was 3 mm (range 2–4 mm) and at the distal clitoral body was 1 mm (range 1–2 mm).

The study’s conclusion was direct: “Precise knowledge of clitoral anatomy and associated neurovascular structures is essential to safely complete partial vulvectomies”.

What Remains Uncertain

The evidence for clitoral reconstruction in vulvar cancer is limited. The 2026 case series is small (18 patients), single-centre, and reports short-term outcomes. A 2025 scoping review found only two studies addressing clitoral reconstruction in vulvar (pre)malignancies, compared with fifteen in FGM/C. The authors concluded that “further research is needed to assess its potential integration into standard care”.

Part III: Gender-Affirming Surgery

The Principle

In feminizing genitoplasty, the clitoris is not merely an aesthetic addition but the primary organ for sexual gratification and sensation. The dorsal nerve of the penis is homologous to the dorsal nerve of the clitoris. Successful surgery relies on mobilization of the neurovascular bundle to ensure the neoclitoris retains its sensitivity. The procedure preserves the high density of sensory nerve endings, ensuring that the patient maintains peak sexual sensation.

Techniques and Outcomes

A 2026 multicentre study evaluated clitoroplasty with corporoplasty in 37 patients with congenital adrenal hyperplasia (Prader stages II–V) who underwent surgery between 2014 and 2025. Corporoplasty is a simplified technique that preserves the corporal bodies and avoids dissection of the neurovascular bundle. Genital sensitivity was assessed using Semmes-Weinstein monofilaments.

The results: sensitivity thresholds were preserved across all genital regions, with earlier age at surgery significantly associated with better tactile sensitivity. Median clitoral threshold was 0.07 g (IQR 0.07–0.20), with 59.3% responding to the lowest filament. No patient reported pain or allodynia. Cosmetic outcomes were rated as good or satisfactory by all physicians and by 90% of caregivers. Caregiver satisfaction was 85.3%.

The authors concluded that “corporoplasty preserves genital sensitivity and has a favorable caregiver-reported psychosocial perception” and represents “a promising option for patients with DSD, with early intervention favoring better long-term outcomes”.

The Nerve-Sparing Ventral Clitoroplasty

The nerve-sparing ventral clitoroplasty is a separate technique developed for congenital adrenal hyperplasia. A 2007 study in the Journal of Urology analysed clitoral sensitivity and viability in patients who underwent the procedure. Patients reported an average degree of sensation of 3.6 ± 0.9 at the labia minora and 4.8 ± 0.4 at the clitoris. Histological analysis of excised erectile tissue found that 92% of dorsal nerves detected in nerve-sparing patients were 90 μm or less, compared with 88% of dorsal nerves being 120 μm or greater in adult specimens.

A 2026 case report of nerve-sparing clitoroplasty via a ventral approach in a child with congenital adrenal hyperplasia reported high satisfaction with cosmetic and functional outcomes at six-month follow-up.

The Evoked Potential Evidence

The earliest evidence that modern techniques preserve nerve conduction came from a 1995 study measuring pudendal evoked potentials during feminizing genitoplasty in six patients (average age 13 months). The study concluded that “modern techniques of genital reconstruction allow for preservation of nerve conduction in the dorsal neurovascular bundle and may permit normal sexual function in adulthood”.

Part IV: Aesthetic and Cosmetic Surgery — Labiaplasty and Hood Reduction

The Risk

Labiaplasty and clitoral hood reduction are increasingly common procedures. Complications are “understudied and underreported” and could include loss of sensation in the female pudendum. The dorsal nerve of the clitoris (DNC) courses through the surgical field and can be injured.

The Danger Zone

A 2020 cadaveric study examined 97 cadavers to map the course and branching of the DNC and generate a surgical safe zone. The study identified anomalous branching patterns in 35 DNCs, classified into six types. Type 1 was the typical pattern (single split into two terminal branches). Types 2–6 involved early branching or multiple branches. The study generated a surgical safe zone for procedures involving the female pudendum to avoid DNC injury.

The same study noted that the vessels and nerves are found between the 11 and 1 o’clock positions, and recommended that if cyst or mass excision is necessary, surgical loupes may assist in performing a nerve-sparing procedure.

The Evidence on Outcomes

A prospective evaluation of female external genitalia after edge resection labiaplasty combined with clitoral hood reduction demonstrated nonsignificant alteration of long-term sensitivity of the labia or clitoral hood. However, the authors noted that “a loss of sensation, related to eventful innervation damage, is reported as a possible complication in all labiaplasty techniques described so far”.

A 2026 study in Revista Nursing examined the impact of genital cosmetic surgery on clitoral sensitivity. The findings reinforce the importance of anatomical knowledge in avoiding nerve injury.

The Structural Problem

Labiaplasty is the most commercially driven of the procedures discussed in this volume. It is performed for aesthetic reasons, often in the absence of functional indication. The nerve-sparing evidence is less developed than in reconstructive or gender-affirming surgery. The danger zone study exists precisely because the anatomy was not adequately understood by the surgeons performing the procedures.

Part V: The 2026 Nerve Map and the Future of Clitoral Surgery

The Correction

The 2026 synchrotron study, discussed in detail in Volume II, produced the first micron-scale three-dimensional map of the clitoral nerve network. The findings that matter for surgery are three:

1. The nerve does not thin. Conventional teaching held that the dorsal nerve tapered as it approached the glans. The synchrotron scans showed that it maintains its full thickness all the way to the tip. Existing anatomical teachings may be incorrect.

2. Nerve trunks inside the glans. The study observed nerve trunks within the clitoral glans with maximum diameters of 0.2 to 0.7 mm, showing a tree-like branching pattern projecting toward the glans surface.

3. Branches beyond the glans. The dorsal nerve ramifies to innervate the clitoral hood, the mons pubis, and the labia minora — areas not previously considered part of the clitoral nerve network.

The Surgical Implication

The clinical motivation for the study was stated directly by Professor Juyoung Lee: “About 22% of women who undergo reconstructive surgery after FGM experience a decrease in orgasms. Understanding the precise distribution of nerves could help reduce these post-surgical issues“.

Helen O’Connell, whose 2005 study began the modern anatomical correction, commented that the map “will also be helpful for genital surgeries such as vulvar cancer surgery, gender-affirming surgery, and labiaplasty”.

What the Map Does Not Do

The map is an anatomical instrument. It does not resolve the clinical questions. It does not tell the surgeon how much tissue can be removed while preserving function. It does not predict individual variation. It does not replace intraoperative nerve monitoring, which remains experimental in this field.

The map is a foundation, not a finished structure. It corrects the anatomy. It does not yet prescribe the technique.

Part VI: What Remains — The Gaps in the Surgical Record

The surgical literature on the clitoris has advanced substantially in five years. It remains incomplete.

Randomised controlled trials do not exist. The evidence base is observational, often retrospective, frequently single-centre. The 2026 vulvar cancer series reported 18 patients. The FGM reconstruction literature encompasses 3,304 women across 15 studies, but the designs are heterogeneous.

Long-term outcomes are sparse. Most studies report outcomes at six months to two years. The long-term trajectory of reconstructed clitorises — sensory changes, tissue viability, sexual function over decades — is not known.

Paediatric and adolescent outcomes are under-studied. The corporoplasty study noted that “limitations include relatively short follow-up and lack of assessment of sexual function in adulthood“. The nerve-sparing ventral clitoroplasty studies report outcomes in childhood. The transition to adult sexual function is not documented.

The nerve map needs clinical validation. The 2026 study imaged two pelvises. The nerve count studied seven. Neither is a population sample. The degree of anatomical variation across individuals is unknown. The map is a beginning, not an endpoint.

The commercial pressure is not addressed. Labiaplasty is the most common clitoral-adjacent procedure and the least studied. The danger zone study exists because surgeons were operating without adequate anatomical knowledge. The evidence on cosmetic outcomes is stronger than the evidence on functional outcomes.

Conclusion: The Navigation and the Territory

The clitoris was always there. The surgeons are only now learning to see it.

The Foldès technique, developed for reconstruction after FGM, has been adapted for oncological surgery. The corporoplasty technique preserves sensation in feminizing genitoplasty. The nerve-sparing ventral clitoroplasty preserves dorsal nerves in congenital adrenal hyperplasia. The danger zone map identifies the safe zone for labiaplasty. The 2026 synchrotron map provides the first complete navigation of the nerve network.

Each of these advances rests on the same foundation: the anatomical correction that began with O’Connell in 2005 and was completed with the nerve map in 2026. The organ was always there. The knowledge was not.

The surgical record now contains:

· Reconstruction after FGM: the Foldès method, with 95.9% of patients perceiving fine touch postoperatively and 88.9% of vulvar cancer patients achieving orgasm post-reconstruction.

· Oncological surgery: the adaptation of FGM techniques for vulvar carcinoma, with low complication rates and preserved function.

· Gender-affirming surgery: corporoplasty and nerve-sparing techniques with preserved sensitivity and high satisfaction.

· Aesthetic surgery: danger zone mapping to avoid dorsal nerve injury.

· The navigation: the first micron-scale map of the clitoral nerve network.

What remains is the translation. The map is drawn. The surgeons have the navigation. The long-term outcomes — the decades of function after reconstruction, the sexual development of children who underwent surgery, the population-level variation that the two-pelvis study cannot capture — are still being recorded.

The organ remains undefeated. The record is being written.

This concludes The Clitoris Anthology, Volumes I–V.

Claim -Status -Summary

# Claim Status

1 Foldès method is the dominant technique for FGM reconstruction Established

2 FGM reconstruction improves sexual function and body image Established (observational)

3 95.9% of patients perceive fine touch post-reconstruction Established

4 88.9% of vulvar cancer patients achieve orgasm post-reconstruction Established (case series, n=18)

5 Corporoplasty preserves genital sensitivity Established (n=37)

6 Nerve-sparing ventral clitoroplasty preserves dorsal nerves Established (histological)

7 Danger zone mapping reduces labiaplasty nerve injury risk Inference (cadaveric)

8 2026 synchrotron map corrects conventional teaching Established (preprint)

9 2026 map improves surgical outcomes Inference (not yet validated)

10 Randomised controlled trials exist Not established

11 Long-term outcomes are known Not established

References

1. Clitoral reconstructive surgery for patients with vulvar carcinoma. Gynecologic Oncology, Volume 212, September 2026, Pages 1–8. https://www.sciencedirect.com/science/article/pii/S0090825826020688

2. Percec, I. (2025). Female Genital Mutilation Reconstruction: Surgical Technique. Plastic and Reconstructive Surgery, 157(1). Video. https://journals.lww.com/plasreconsurg/videos/3197

3. Favorito, L. A. (2026). Clitoris Anatomy Applied to Aesthetic, Reconstructive and Transgender Surgery: A Narrative Review. Int Braz J Urol, 52(5), e20269910. https://pubmed.ncbi.nlm.nih.gov/42201684/

4. Clitoral reconstruction and psychosexual care after female genital mutilation/cutting: Assessment of multidisciplinary care. Women’s Health, Vol 21 (2025). https://library.nih.go.kr

5. Veldmate, G., et al. (2026). Clitoral reconstructive surgery in patients with vulvar (pre)malignancies: what can we learn from female genital mutilation/cutting? A scoping review. Sexual Medicine Reviews, 14(2), qeag026. https://academic.oup.com/smr/article-pdf/14/2/qeag026/68293268/qeag026.pdf

6. Clitoroplasty with corporoplasty in feminizing genitoplasty: Multicenter evaluation of sensory and cosmetic outcomes. (2026). Journal of Pediatric Urology. https://www.sciencedirect.com/science/article/abs/pii/S1477513126000768

7. Jackson, L. A., et al. (2020). Anatomy, histology, and nerve density of clitoris and associated structures: clinical applications to vulvar surgery. American Journal of Obstetrics and Gynecology. https://www.ajog.org

8. Gordon, V., et al. (2020). Mapping a Danger Zone of the Dorsal Nerve of the Clitoris: Implications in Female Cosmetic Genital Surgery. Plastic Surgery The Meeting 2020 Abstracts. https://www.plasticsurgery.org

9. Lee, J., et al. (2026). Neuroanatomy of the clitoris. bioRxiv. Published 20 March 2026.

10. Donga Science. (2026). High-energy X-rays reveal first 3D map of the clitoral nerve network. https://m.dongascience.com/en/news/77102

11. Foldès, P., et al. (2021). Clitoral Reconstructive Surgery After Female Genital Mutilation/Cutting: Anatomy, Technical Innovations and Updates of the Initial Technique. PubMed. https://pubmed.ncbi.nlm.nih.gov/33931348/

12. Sensitivity after Clitoral Reconstruction in Patients with Female Genital Mutilation. (2024). Plastic and Reconstructive Surgery – Global Open. https://dev.europepmc.org

13. Nerve Sparing Ventral Clitoroplasty: Analysis of Clitoral Sensitivity and Viability. (2007). Journal of Urology, 178(4 Pt 2), 1598–1601. https://pubmed.ncbi.nlm.nih.gov/17707020/

14. Gearhart, J. P., et al. (1995). Measurement of pudendal evoked potentials during feminizing genitoplasty: technique and applications. Journal of Urology, 153(2), 486–487. https://pubmed.ncbi.nlm.nih.gov/7815563/

15. Impact of Genital Cosmetic Surgery (labiaplasty) on Clitoral Sensitivity. (2026). Revista Nursing. https://revistanursing.com.br

Andrew von Scheer-Klein is a contributor to The Patrician’s Watch. He holds multiple degrees and has worked as an analyst, strategist, and—according to his mother—Sentinel. He accepts funding from no one, which is why his research can be trusted.

The Clitoris Anthology is complete. Volumes I–V are available in the archive.