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Victorian Medicine Was Not Responsible for Repressing the Clitoris: Rethinking Homology in the Long History of Women’s Genital Anatomy


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Current narratives about female sexual pleasure frequently make recourse to teleological views of the historical development of sexuality, positing the present as more liberated than past repressive attitudes. This usually takes the form of recognising early modern accounts of the clitoris (though in a reductive fashion), and then denying the profoundly holistic views of female pleasure that can be found in nineteenth-century medical texts. In spite of Foucault’s famous ridicule of the myth of “Victorian repression” in the 1974 first volume of the History of Sexuality, both popular feminist writers and physiology researchers continue to blame nineteenth-century medicine for the notion of the vagina as the only legitimate locus of female pleasure. This paper suggests an alternative account of how the clitoris became maligned in largely a twentieth-century confluence of anti-masturbation thought and interwar gender discourses. In doing so it proposes a corrective to Thomas Laqueur’s notion of a dominant homologous model of male and female genitalia from ancient times that was replaced in the nineteenth-century by an insistence on the idea that women were radically different to men. Instead I propose that two distinct strands of thought about female genitalia (the Galenic and the Hippocratic) have been consistently present, and in tension, in Western medical and anatomical texts across time, our own time being no exception. The final section of the paper considers what is now understood scientifically about female genitalia and how these new understandings might inform feminist thinking about women’s pleasure in ways that do not trade upon historical myths about Victorian repression.
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Alison M. Moore
Victorian Medicine Was Not Responsible for Repressing
the Clitoris: Rethinking Homology in the Long History
of Womens Genital Anatomy
Researchers in the elds of affective neuroscience, psychology, urology,
and physiology attempting to understand some of the conicting pol-
itics around questions of womens sexual pleasure as a context to their
own scientic work, much to their credit, are now frequently considering his-
torical accounts of these ideas (OConnell, Sanjeevan, and Huston 2005;
Pfaus et al. 2016). But many of the most accessible humanistic works that dis-
cuss the history of ideas about womens genitals and orgasms are plagued by a
common historical myth: the notion that repressive views on sex in the Victo-
rian era were primarily responsible for the denial of the clitoris and its central
role in womens orgasmic response and for the reication of the vagina as
the central organ of womens pleasure. Yet any scholar who has studied many
nineteenth-century texts about sexuality across French, British, German, Ital-
ian, and US cultures cannot help but notice thatfemale sexual pleasure was in
fact heavily represented in medical thought throughout this time. The view
of the Victorians as sexually repressed was famously mocked by Michel Fou-
cault in the rst volume of The History of Sexuality as a myth that serves to
reassure us that we in the present are now liberated sexually (1976, 122).
But it seems that Foucaults laughter has had little impact on popular ideas
about the origin of the overprivileging of vaginal pleasure and denigration
of the clitoris that is understood to be part of the modern Western medical
tradition. Hence, the rst section of this article proposes a corrective to the his-
torical schema that is widely circulated in popular writing about this question.
Nineteenth-century medicine was not unanimously dominated by attempts
to deny clitoral pleasure to women, and differing views about female sexual-
ity circulated throughout this time, just as they did in the early modern era.
Moreover, the notion of vaginal orgasm was strictly a twentieth-century inven-
tion, and no corollary of it can be found prior to this time.
There never was an era that was or is liberated in its views about female
pleasure, for the simple reason that there is never just one view shared by
everyone on the matterour own time is a case in point, since we nd ex-
I wish to thank Western Sydney University for awarding me a Womens Fellowship in 2016
with teaching relief, permitting the research and writing of this article.
[Signs: Journal of Women in Culture and Society 2018, vol. 44, no. 1]
© 2018 by The University of Chicago. All rights reserved. 0097-9740/2018/4401-0003$10.00
tant examples of clitoridectomy in multiple cultures, while in others we nd
feminist activism that instructs women about how to enjoy clitoral mastur-
bation maximally. Narratives about female sexual pleasure frequently make
recourse to teleological views of historical development that posit the pres-
ent as relatively more enlightened than past repressive attitudes. This tele-
ology usually takes the form of recognizing early modern accounts of the
clitoris but denying the vast array of nineteenth-century sources that had sig-
nicantly more holistic views about female pleasure than those produced in
the early twentieth century. Affective neuroscientist James G. Pfaus and his
colleagues oddly attribute more liberated views about female pleasure to psy-
choanalysis, which they think of as a source of resistance to the Victorian
eras attempts to muzzle free sexual expression(2016, 6). Rebecca Chalkers
1997 book The Clitoral Truth claimed that in Victorian times, female orgasm
was seen as unnecessary, unseemly,perhaps even unhealthy for women,cit-
ing the English historian Lord Acton as if he was fully representative of Eu-
ropean sexual medicine in the nineteenth century (1997, loc. 822), further
remarking that by the Victorian age, the clitoris had not only disappeared
from medical texts and illustrations but ...orgasm was banished from the
Victorian concept of womenssexuality(loc. 758). Nothing could be fur-
ther from the truth, and the nineteenth century provides countless examples
of medical sources that not only reiterated early modern views about the cli-
toris as the central organ of womens pleasure but insisted in new ways that
sexual pleasure was essential for womens health and well-being. Doctors,
from the 1880s until the Second World War, worried far more about the dan-
gers of female frigiditythan any other form of designated sexual pathology
in women (Cryle and Moore 2011).
The second section suggests an alternative account of how the clitoris be-
came maligned, and the vagina reied, in twentieth-century (not nineteenth-
century) Western European ideas. Freudian psychoanalysis was in fact deeply
complicit in this development. Several factors were involved, though, some
of them occurring over a long historical period, others relating to the unique
discursive pressures of the period between the two World Warsatimeof
great ux in gender roles and attitudes toward sexuality. Early twentieth-
century Europe saw the production of new anxieties about the distinction
between men and women and new discourses aimed at yoking sex to gender
and policing the number of possible sexes. Ideas about womens sexual plea-
sure were a product of these concerns.
Anatomical ideas about female genitalia were divided from the very be-
ginning of their history of description, in what might be characterized as the
Galenic penis-vagina versus the Hippocratic penis-clitoris mirror models. In
the Galenic view, the clitoris is ignored or denied, and only the vagina mat-
54 yMoore
ters as a homologue and inverted form of the penis, with womens pleasure
assumed to be necessarily much less than mens. In the Hippocratic view,
the clitoris appears as an object of description and is seen as homologous
to the penisa kind of female phallus, with a central role in womens sexual
pleasure. Both accounts envisage the female genital structures as homolo-
gous to the male, but in the Galenic view womens pleasure is minimized
and assumed to follow directly from coitus, while in the Hippocratic view
womens pleasure is emphasized and located outside the zone of direct
coital reception. The Galenic view is generally accompanied by assertions
that compared with men, women have a lesser desire, while the Hippocratic
view generally also includes assertions that women have a capacity for in-
tense pleasure.
It is beyond the scope of this article to chart the ancient origins of these
trends, which derive respectively from the second-century Greco-Roman
physician Galen of Pergamon (129200 CE) and from the body of medical
texts self-designated as Hippocratic following the ancient Greek physician
Hippocrates of Kos, who is believed to have lived between 460 BCE and
370 BCE. The Hippocratic Corpus (a selection of texts believed to be the
writings of Hippocrates and his students compiled in the third century CE)
does not discuss female sexual anatomy in any detail (Chaperon 2012, 44;
Marcum 2017). But in the debates among anatomists of the early modern
era, claims were made about female sexual anatomy by appeal to these two
towering gures of ancient medical knowledge. By the seventeenth century,
a clear divergence can be identied in medical and anatomical scholarship
on the question of womens sexual anatomy, following these two strains of
thought and appealing variously to Galen, the Hippocratic tradition, or some-
times also to Aristotelian medicine.
Throughout the early modern era, both views about female sexual phys-
iology were expressed by different anatomists. In the nineteenth century,
variations on both ideas were also present in the medical discussion of fe-
male sexuality. From around 1600 to 1900, another train of thought im-
portantly fueled the notion that the clitoris existed but that its role was
problematic because it was the primary organ of masturbation, which came
be to be viewed as a nefarious behavior in both sexes. These were the long
historical preconditions for the refusal of clitoral pleasure that emerged as an
explicit idea in twentieth-century thought, both in the Freudian psychoan-
alytic tradition and in conventional medical practice. The third section of
this article discusses how the clitoral-vaginal dichotomy was generated in
the interwar period in Europe and the United States and how it was con-
tested in the period from 1950 to 1973. The nal section considers what
is now understood scientically about female sexual anatomy and how these
SIGNS Autumn2018 y55
new understandings might inform feminist thinking about womens plea-
sure in ways that do not rely on historical myths about Victorian repression.
The present survey of the origin of modern ideas about female genitalia
takes the form of an intellectual history with attention to cultural context.
This approach considers the transmission of ideas as indicated both by the
direct reference made to texts in other texts and by their indirect reference
in the reiteration of content. It also considers the broader cultural and tem-
poral moment in which texts were produced. The texts discussed are not ex-
haustive of all those discussing female reproductive anatomy but have been
selected as examples of the differing accounts provided in medical, anatom-
ical, feminist, and sexological thought. All surviving texts describing female
sexual anatomy from Ancient Greece until the sixteenth century were au-
thored by male anatomists and physicians and are discussed here, selectively
following the distinct lines of thought. After the sixteenth century, signi-
cant texts discussing the clitoris authored by women appeared, such as mid-
wifery manuals (from which I have selected two representative examples for
discussion). In the twentieth century, works by women in the psychoanalytic
movement also discussed the clitoris; here I have selected two such works
that were the most inuential. But in the nineteenth century and for much
of the twentieth, the majority of writings on womens sexuality were au-
thored by male clinicians, and the section of this article treating the emer-
gence of modern medical views in the nineteenth century discusses a selection
of these texts, accounting for the divergent lines of debate that appeared at
this time. We might expect that an appreciation of the importance of the cli-
toris for womens pleasure followed only once women entered the medical
profession in the Western world of the twentieth century. However, male
physicians and anatomists who insisted on the clitoris as the central organ
of female pleasure have represented a consistent voice among others in the
global history of ideas about womens sexuality ever since ancient times.
Galenic versus Hippocratic homology
Many writers and scholars have remarked that the clitoris, throughout West-
ern history, has repeatedly been discovered, lost, and discovered again.
it may be more appropriate to say that ideas about the clitoris have never
been the subject of medical or anatomical consensus. In the work of Galen,
there is scant mention of anything resembling a clitoris. His account viewed
the vagina as an inside-out and inferior mirror version of the penis, designed
See Park (1997, 171), Tuana (2004, 216), OConnell, Sanjeevan, and Huston (2005,
1189), Chaperon (2012, 42), Wolf (2012, 199), and Di Marino and Lepidi (2014, 4).
56 yMoore
to receive it passively for conception. The Galenic account persisted well into
the nineteenth century and was repeatedly cited by anatomists who ignored
the clitoris. But early modern European scholars who saw themselves as part
of the Hippocratic tradition also discussed something resembling the clitoris
in a range of anatomical texts from the sixteenth century, insisting on its cen-
trality to womens pleasure, which they viewed as crucial for conception.
This is important to note because the same lack of consensus that appeared
in the sixteenth century remained into the nineteenth century, and indeed
current understandings across cultures and across different scholarly disci-
plines continue to provide accounts of womens genitalia that alternately
deny, normalize, or celebrate the clitoris.
The mid- to late sixteenth century was a watershed moment in the devel-
opment of ideas about womens sexual anatomy, and at this moment two
divergent trends can clearly be identied. One trend looked to nd wom-
ens anatomy structurally and derivatively homologous to menswhat the
historianThomas Laqueur (1990) famously refers to as the one-sexmodel,
wherein female reproductive organs were viewed as merely an inverted (and
lesser) form of the more perfect masculine structures. Thus the vagina was
an inside-out penis and the ovaries were internal testicles (Laqueur 1990,
2526). Galens homologous description along these lines remained an im-
portant authority for the interpretation of womens reproductive anatomy
throughout the early modern period of European medicine and indeed well
into the nineteenth century (Chaperon 2012, 42). But incongruously, as
Laqueur notes, many early modern scholars also saw the clitoris as like a
penis both in form and in its erotic sensory function (1990, 65). How could
women have two such pseudopenises?
It might seem that what was at stake here were two different accounts of
structures deemed formally homologous to the male forms. But on close
reading, while the vagina as an inside-out penis clearly proposed an inverted
structural homology, those texts that described the clitoris did so with ref-
erence to its erotic functionhere the clitoris was the central organ of plea-
sure comparable to the male penis but not obviously compatible with it as
the organ designed to receive it, as in the Galenic model. It is not clear if
such a divide between the Galenic and Hippocratic views of sexual anatomy
existed in the ancient sources themselves. The Hippocratic Corpus used as
the main authority in European medicine of the Middle Ages was a selection
made and edited by Galen. But numerous other Hippocratic writings were
translated into Arabic from Greek under the Abbāsid rulers in Baghdad
during the eighth century CE and informed medical thought throughout
the Arabic- and Persian-speaking world, only indirectly inuencing Euro-
pean scholars over the eight centuries that followed (Lagerlund 2011, 65).
SIGNS Autumn2018 y57
Sixteenth-century anatomists debating the parts of female reproductive anat-
omy did so by appeal to the ancients, withthose detailing the clitoris citing the
Hippocratic tradition (often referring to Hippocratic sources notrepresented
in GalensHippocratic Corpus), while those reiterating the penis-vagina ho-
mology did so with reference to Galen himself.
The sixteenth-century Flemish anatomist Andreas Vesalius, following
Galen, omitted the clitoris from his drawings and objected to the view that
it should be included, arguing that only hermaphrodites had one (1564,
143). But most medical and erotic texts throughout this time referred to
some variation of the clitoris as the primary organ of womens sexual plea-
sure and as a sort of equivalent to the male member. This important shift may
have been a result of the introduction of human cadaver dissections and the
emergent enthusiasm of anatomists in this time for empirical observation,
as they no longer merely appealed to ancient texts (Laqueur 1990, 65). The
Milanese anatomist Realdo Colombo claimed to have discoveredthe
Sedes libidinis (seat of the libido) or Amoris dulcedo (loves sweetness) over-
looked by all other anatomists (1559, 448); however, his Paduan successor
Gabriele Falloppio noted that many in the Hippocratic tradition had long
alluded to it before Colombo (Hall 2001; Stringer and Becker 2010). In-
deed, it was mentioned in Arabic medical texts of the tenth and eleventh
centuries, such as the al-Kunnâs al-malikî of Alî ibn al-Abbâs al Majûsi and
in the writings of the great Persian polymaths AbūʿAlīal-Ḥusayn ibn ʿAbd
Allāh ibn Sīnā, known as Avicenna, and AbūBakr Muhammad ibn Zakariyyā
al-Rāzī, known as Rhazes (Chaperon 2012, 43; Di Marino and Lepidi 2014,
3). Others, such as the sixteenth-century French anatomist Charles Estienne,
in part of what was to become a long historical tradition of worrying about
the purportedly nefarious effects of masturbation, viewed the clitoris as a
shameful memberthat should not be represented (Estienne 1545, 285),
and in 1575, the French surgeon Ambroise Paré described enlarged clitorises
as the sign of tribadism (Park 1997, 172; Traub 2002).
Ancient, medieval, and early modern erotic texts generally depicted the
external parts of womens genitals as important for pleasure, and this ap-
pears to have been the pattern across all cultures that produced sophisticated
texts pertaining to sexual matters as an object of knowledge. Here we might
consider the ancient Hindu Kama Sutra of Vātsyāna, collected into a single
text in the second century CE, or the ilm al-bāhsexual medicine texts of
Islamicate cultures in the early modern era (Semeridjan 2006). Whenever fe-
male pleasure (not merely reproductive capacity) was discussed, it was the ex-
ternal genitalia that was widely agreed to be signicant. Wherever the clitoris
was mentioned, it was also commonly stated that since conception could not
occur without the spilling of the female seed,and since the clitoris was the
58 yMoore
major organ of womens pleasure, conception therefore required the stimu-
lation of the womans clitoris (Laqueur 1990, 66). Considering the focus on
erotic function that appeared in some descriptions of the clitoris,it seems clear
that the Galenic model of penis-vagina homology was not the only model pres-
ent but that erotic homology betweenclitoris and penis was also an important
approach, permitting the recognition of comparable pleasure between men
and women while discerning their differing reproductive structures.
Several scholars of medieval, early modern European, and Islamicate sexu-
ality and medicine have proposed that Laqueurs characterization of ideas
about male and female anatomy in this time as based entirely on a one-sex
homologous model is overly simplistic. Indeed, Elizabeth Harvey questioned,
in this very journal over fteen years ago, whether Laqueurs model of ho-
mology could adequately account for the richness of seventeenth-century
ideas about womens pleasure that appeared to discuss both the similarities
and the differences between male and female genital structures (2002). Joan
Cadden referred to a much wider diversity of medical views about sex differ-
ence in medieval sources than Laqueurs model could account for (1995).
Fay Bound Alberti suggests that a reading of literary sources that refer to
womens sexuality shows that ideas of both homology and radical difference
were present (2016, 6970). Helen King remarks that early modern medical
stories about sex transformation, such as the Hippocratic story of the sex-
changing woman Phaethousa, show that male and female were often seen
as distinctly differing rather than homologous but were nonetheless poten-
tially mutable (1998). And Ahmed Ragab has shown that multiple, dis-
similar, and changing contemporary sex-scapes’” characterized Islamicate
medical cultures of the medieval period (2015, 431). These views accord
with the perspective proposed here: that accounts of female genital struc-
tures throughout history were not informed solely by a one-sex model. These
accounts, in fact, were characterized by two divergent trends in thought that
crystallized in early modern anatomy and that have remained in later con-
ceptions, including the continuing debates in our own time about vaginal
versus clitoral orgasm. In one account, the vagina is homologous (and infe-
rior) to the penis, while in the other, the clitoris is the primary organ of plea-
sure in women, just as the penis is for men.
The seventeenth century saw a further growth in texts describing female
pleasure and anatomy, but rather than settling the matter of what was the
proper locus of womens pleasure, the textual proliferation merely intensi-
ed the divergence in thought that had emerged in the previous century. Ter-
minology at least became more consistent. Prior to this time, various terms
existed to refer to the external genital structures in women. Virga (meaning
rod) was the term used in many Latin sources, but the term nympha was
SIGNS Autumn2018 y59
sometimes used to indicate the labia minora, though possibly also the clito-
ris. Arabic sources referred to the bazr, transliterated into Latin as badedera
or batharum, or translated into Latin as tentigo (Chaperon 2012, 44). The
word clitorisonly became standard in Western European languages in
the seventeenth century (Cohen 1973), following the precedent of the An-
cient Greek anatomist Rufus of Ephesus (Abou-Aly 1992, 151). In 1614 the
Parisian anatomist Jean Riolan, echoing Ambroise Paré, asserted that most
supposed hermaphrodites were in fact simply women with large clitorises
(Park 1997, 172). The 1615 anatomical text Microcosmographia by Helkiah
Crooke, court physician to King James I, described the clitoris both in form
and in erotic function, following Colombos assertion of its essential role in
womens pleasure and hence in conception (Traub 2002, 8990). In 1672
the Dutch anatomist Regnier de Graaf ardently contradicted the views
about discernible clitorises as signs of aberrant sexual behavior or hermaph-
rodism and insisted that they were indeed present in every female cadaver
he had ever dissected (Bound Alberti 2016, 83).
Insistence on the clitoris as a normal organ of womens pleasure was re-
iterated by numerous anatomists, such as the French scholar Jean Riolan
and the Danish anatomists Caspar and Thomas Bartholin (Traub 2002, 90;
Chaperon 2012, 48). A 1687 French work by physician Nicolas Venette ad-
dressed couples in the form of a marital advice manual and declared the cli-
toris to be the throne of pleasures(Chaperon 2012, 49). Popular texts
written by women also appeared in this time in the form of midwifery man-
uals. Typically, these referred to the clitoris as the primary organ of womens
sexual pleasure, citing ancient sources for support. Such was the 1671 Mid-
wives Book produced by the English midwife Jane Sharp, who viewed the
clitoris as the source of womans delight in copulation ([1671] 1999, 40).
Another text by an anonymous American author, published in 1684 as
AristotlesMasterpiece, patently pretended to be a work of Aristotelean med-
icine, contradicting Aristotles own claim that women conceive without plea-
sure (Chaperon 2012, 48). It claimed that the clitoris resembled a yard
(penis) in that it suffers erectionand both stirs up lust and gives delight
in copulation; hence without it, no conception would occur (Anon. [1684]
2010, 1415).
It is beyond the scope of this article to account adequately for the fate of
the clitoris in eighteenth-century medical ideas, but sufce it to say that de-
scriptions of the clitoris continued as either central for womens pleasure or
irrelevant to sexual relations. However, one novel feature of this time worth
noting is the emergence of a prevalent antimasturbation discourse from the
beginning of the eighteenth century following the publication of the anon-
ymous best seller Onania (Anon. 1756). This work proposed, among other
60 yMoore
scurrilous promises, to uncover the hitherto unknown fact of womens mas-
turbation causing enlargement of the clitoris, though as Laqueur notes,
such was a common trope of erotica texts published around this same time
(2004, 28). Antimasturbation texts continued to proclaim the practice to
have negative health effects in both men and women throughout both the
eighteenth and nineteenth centuries, and in each case where womensmas-
turbation was mentioned, it was the clitoris that was deemed to show these
negative effects by becoming enlarged. While the insistence on the clitoris
as the site (and sign) of womens masturbation undoubtedly contributed to
its normalization as the expected locus of female orgasm, it also seems likely
that it helped to produce later forms of suspicion of it as something thatmust
be rescinded within a rigidly coital vision of marital sexual relations. The no-
tion of vaginal orgasm was entirely foreign throughout the early modern an-
atomical descriptions and up to the nineteenth-century elaborations of fe-
male sexuality. It appeared only in the early twentieth century, around the
same time that the antimasturbation current was waning.
Nineteenth-century medical ideas about womens sexual pleasure
The notion of the abrupt nineteenth-century repression of the clitoris makes
little sense to those of us who have worked with nineteenth-century medical
sources on sexuality. Instead, there was a divergence of views like that which
occurred among sixteenth-century anatomists and persisted throughout the
nineteenth. Those who emphasized the clitoris as playing a crucial role in
female pleasure generally also considered women capable of sexual pleasure
as strong as mens, while those who minimized its importance also tended
to consider women naturally less sexual than men. There was no argument
made about an alternative locus of pleasure, such as in the twentieth-century
concept of the vaginal orgasm. The English doctor William Acton denied
that pleasuring women had any point to it and considered women to be
untroubledby sexual feelings in general. He also viewed masturbation
as eminently productive of disease(Acton 1865, 112, 38). Clitoral surger-
ies were practiced by some European and American doctors as a cure for
masturbation throughout the nineteenth and twentieth centuries (Rodri-
guez 2014). But the importance of the clitoris was also reiterated in many
other nineteenth-century texts of anatomy and sexual medicine, such as the
1844 work by the German anatomist Georg Kobelt, who argued that it
was a direct analogue of the penis. Kobelt chastised those who had over-
looked the clitoris and argued that womens genitals were muscular and
equally prone to turgescence as mens (1851, 7387; see also g. 1).
SIGNS Autumn2018 y61
Figure 1 Dissection of the pubic region with clitoris. Preparation of Georg Ludwig Kobelt,
from De lappareil du sens génital des deux sexes dans lespèce humaine et dans quelques
mammifères, au point de vue anatomique et physiologique [The genital sensory apparatus in
both sexes of the human species and in some mammals, from anatomical and physiological
points of view], 1851.
Another defender of the clitoris was H. D. Maheux, a doctor in the faculty
of medicine at the University of Paris who ran a practice in Montmartre
throughout the 1860s and 1870s and authored several works on womens
health and on sterility. He described the clitoris as a small tubercle which ...
resembles the corpus cavernosum of the male,with the intimate structure
oferectiletissue,makingit theprincipalseatof pleasure(volupté)inwomen
(Maheux 1873, 3). He remarked that the womans pleasure was not necessary
for conception, as was once believed, as evidenced by the many women he had
encountered who were frigid or who had been raped but who nonetheless
had children. The ancient to early modern concept of womens pleasure be-
ing necessary for conception had clearly been abandoned, but womens
pleasure remained recognizable and signicant nonetheless.
In the 1870s and 1880s, the role of the clitoris was the subject of some
debate among French physicians such as Félix Roubaud and Pierre Garnier
in their differing accounts of the causes of female sexual anaphrodisiaor
frigidity (Cryle and Moore 2011, 4852). Roubaud argued that malfunc-
tions of the clitoris were the likely cause of this mysterious condition of ab-
sent sexual pleasure in women and cited Kobelts account of the clitoris as
the female equivalent of the penis, with a much greater nerve concentration
than any other part of the female genital system (Roubaud 1855, 542). A
view of female sexual anatomy that took full account of the importance
of the external pudenda for female pleasure thus persisted throughout the
nineteenth century, and those who did not mention it typically viewed fe-
male pleasure as unimportant in general. Garnier had argued against Rou-
bauds insistence on the importance of the clitoris by countering that a re-
spectable woman was only ever willing to have sex for moralreasons of
love for her husband and desire for children (1893, 511).
There was no particular European culture that generated more of one
type of view relative to the other. In England, France, Germany, and Italy,
both those who recognized the clitoris as important and those who mini-
mized its role or attributed it to aberrant sexuality can be found. A French
guide to womens sexual health published in 1875 by the doctor Émile Clé-
ment showed that the early modern confusion about the clitoris as a mark of
hermaphrodism or aberrant sexual behavior remained a live question for
some even in the late nineteenth century. Clément denied that hypertro-
phy of the clitorisindicated hermaphrodism but suggested that discernible
clitorises were always a sign of women who allowed themselves to be lead
astray by their passions, leading to neuroses such as hysteria, nymphomania
that sometimes lead to death.The only solution, he remarked, was a rad-
ical remedy,being partial or total ablation of the organ(1875, 26).
Throughout the late nineteenth and early twentieth centuries, clitoridecto-
SIGNS Autumn2018 y63
mies were prescribed to cure women of masturbation, of hermaphrodism,
and of lesbianism, and larger than normal clitorises were deemed to be a
mark of female criminality (Lombroso and Ferrero 1903, 418; Rodriguez
2014, 50).
On the other hand, the English surgeon Henry Savage in 1880 detailed
the musculature and ligamentory attachments of the normal female genita-
lia, with great attention to the clitoris, illustrated as a cadaver dissection with
color plates (1880). The nerves of the female genitalia had been charted by
early modern anatomists, and a widely read 1881 physiology handbook noted
the dorsal innervation of both the penis and the clitoris but not the vagina
(Hermann 1881). Several scholars have noted that alongside medical prac-
tices of clitoridectomy that occurred in British and American medicine of
the nineteenth century, there was also a burgeoning protocol that entailed
doctors stimulating women to orgasms as cure for hysteriaor gynecolog-
ical disorders. Electrical stimulation was sometimes used for this purpose, al-
though self-pleasuring was heavily discouraged (Maines 1999; Warren 2015).
At the very end of the nineteenth century, widely divergent views about
female genitalia and sexual impulses persisted. The renowned Italian crimi-
nologists Cesare Lombroso and Guillermo Ferrero proclaimed women nat-
urally frigidand described large clitorises as the mark of prostitutes and the
sexually perverted (Lombroso and Ferrero 1903, 5458). The German doc-
tor Otto Adler thought women very hard to pleasure and considered that
only a man of great skill could achieve this (1904, 47.) On the other hand,
the Austrian gynecologist Enoch Heinrich Kisch, writing at the same time as
Adler, considered a womans sexual impulses to be at times so powerful ...
its primitive force dominates her whole nature(1904, 2056). The French
doctors Charles Barbaud and Charles Lefevre, in a book about womens
health published in 1897, discussed the clitoris as an important organ of
pleasure, again likening it to the penis: The clitoris represents the erectile
organ of woman par excellence(1897, 14). Discussions of the clitoris os-
cillated between these two sets of views up until the interwar period, from
when an enfolding suspicion of it emerged in entirely novel terms.
The clitoris becomes suspect
Laqueurs central argument in Making Sexthat medical ideas shifted from
a notion of the sexes as homologous to a view of them as incommensurable
makes little sense when we consider that Galenic penis-vagina homology
never did account for the full spectrum of views about female genitalia ex-
pressed by anatomists and doctors throughout the period from 1500 to
1900. But it is also clear that the notion of female genitalia as simply a cavity
64 yMoore
for reception of the penis never went away either. Its revival in the twentieth
century took the form of prescriptive advice that doctors and hygienists gave
women, suggesting they should try to be as feminine as possible and nd
their pleasure in vaginal coitus and not anything else. The idea was not merely
that womens genitals mirrored mensthat was a claim that could be found
throughout the history of homologous views of female sexual anatomy. What
was new in this period was the notion that women should be as sexual as men
but that they should have orgasms through coitus alone. Prior to this time,
scholars who denied the importance of the clitoris generally denied that
women were very sexual at all. The twentieth century produced a unique dis-
course of necessary vaginal orgasmic response.
Certainly it was neither the increasing understanding of science as a sec-
ular endeavor nor scientic research per se that produced this shift in think-
ing. As Laqueur has remarked, these developments were as much the prod-
ucts of cultureas were the earlier views about the role of female pleasure in
conception (1990, 153). Medical, psychiatric, psychoanalytic, and sexolog-
ical literatures in Europe and the United States between 1914 and 1945 em-
phasized ideal compatible difference between men and women, worrying
that men were not masculine enough and women not feminine enough.
But they insisted on this ideal differentiation not by stating it as a biological
genital fact but by suggesting it as a prescriptive behavioral ideal. There was a
prevalent anxiety about the parts of female anatomy that appeared mascu-
linein particular, the clitorisprecisely because it was still widely recog-
nized as homologous to the penis (Moore 2009). These concerns joined
with older antimasturbation discourses that had continually emphasized
the dangers of self-pleasuring both for marriage and for general well-being
(Laqueur 2004), and typically it was the same doctors worried about mastur-
bation who also viewed clitoral pleasure in partnered sex as problematic.
In the interwar period, many medical and vulgarized pseudomedical texts
about female sexuality emphasized the dangers of masculinization, nympho-
mania, and androgyny, as expressed in the well-known French novel of
1922, Victor MarguerittesLa garçonne (The bacheloress). This view re-
quired straining logical consistency and making recourse to moralistic, nor-
mative arguments. The German doctor Wilhelm Stekel considered frigid
women to be in fact hypersexual women who were resistant to being pene-
trated. Their frigiditywas a form of feminist refusal of womens natural
role of receptive passivity. This view is reected in the chapter titled The
War of the Sexesin his 1921 book. A doctor could tell if a woman was
frigid precisely because she would exude sexual condence and agency! (Ste-
kel 1921). European and American doctors treated women for frigidity by
counseling them against clitoral stimulation or by surgically altering their
SIGNS Autumn2018 y65
genitalia in the hope of making them more interested in penetration. The
sexes must be compatible for marriage and childbearing to work harmoni-
ously, but their pleasure must strictly derive from coitus; otherwise, doctors
feared, women might expect to enjoy phallic pleasure over procreative inter-
course (Cryle and Moore 2011). Ironically here the penis and the clitoris
were indeed still viewed as biologically homologous. Without proper moral
guidance, female phallic pleasure or clitoridismwas thus an inherent risk.
As scholars such as Anne Fausto-Sterling (1985), Marlene Zuk (2002),
Cordelia Fine (2010), and Sarah Richardson (2013) have all noted, appeals
to biology in discussion of gender and sexuality in our own time frequently
propose prescriptive normalizing views based on what is deemed biologically
programmed. But perhaps what is most remarkable in the interwar period is
that normality was constructed precisely against that which was assumed as
biologically determined (Laqueur 1990, 236; Walton 2001, 142).
The period in which the clitoris was specically out of favor and the va-
gina in was admittedly short and far more recent than is often believed. It is
only since the beginning of the twentieth century that we nd, as a prevalent
discourse, the explicit ideal that female orgasm should result from coitus, as
many historians of sexuality and queer studies scholars have noted (Laqueur
1990; Moore 2009; Jagose 2012). Ideas about female coldness, anaphro-
disia, vaginismus, and frigidity all appeared in medical writing of the late
nineteenth century either as descriptions of lacking desire, resistance to inter-
course (whether psychological or physiological), or perverse distraction (clito-
ral or otherwise) from the business of coitus. But in all these discussions, no
one appears to have mentioned any kind of explicit expectation of anything
resembling vaginal orgasmuntil sometime after the beginning of the twen-
tieth century, though in earlier texts, women were clearly expected to be re-
ceptive to male advances and interested in marriage and motherhood.
A signicant development in ideas about this apparent contradiction was
developed by Sigmund Freud. His 1905 Three Essays on the Theory of Sexu-
ality proposed the now-familiar idea, perhaps our most widely agreed-upon
object of feminist scorn, that clitoral pleasure constituted a merely infantile
form of masturbatory experience, with maturation of the genitals of both
sexes in puberty directing them toward coital penetration (Freud [1905]
1995, 282, 287). But the notion of vaginal versus clitoral pleasure was ad-
vanced most notably not by Freud himself but by his most enthusiastic fe-
male acolyte. Toward the end of the 1920s the French Freudian theorist of
female sexuality, Marie Bonaparte, studied African practices of female cir-
cumcision and sought surgical correction to overcome her own persistent
clitoridism,or phallicismas she called it, which she imagined to be dis-
tracting her from the functional hystericization of pleasure: vaginal receptivity
66 yMoore
(1932). Her inspiration was the Swedish anthropologist Felix Bryk, whose
studies of the Nandi tribal practices of female circumcision seemed to con-
rm what Freudians were thinking about the need for women to rescind cli-
toral pleasure in adulthood (1934).
The surgery that Bonaparte herself underwent with German gynecolo-
gist JosephHalban involved severing the clitoral suspensory ligaments, which
permitted reattachment of the clitoris closer to the vaginal opening (Narjani
[Bonaparte] 1924). The surgical decision was premised on her analysis of
women who had a shorter distance between the external clitoris and vaginal
opening and who experienced orgasm in coitussomething Bonaparte hoped
to achieve surgically (Moore 2009, 153). By her own account, this surgery did
not have the intended effect of making Bonaparte more orgasmic in coitus,
probably due to the considerable scarring and loss of sensitivity that it pro-
duced (Bertin 1992, 25159). There is little doubt that the peculiarly con-
icted early twentieth-century notion of clitoral pleasure as biologically given
yet psychosocially maladapted created attempts at self-perfecting that caused
Bonaparte and many other women untold suffering.
The clitoris continued to be widely viewed as the genital organ that most
reliably produced tangible orgasm. The inuential advice manual Married
Love by the British paleobotanist and feminist Mary Carmichael Stopes, rst
published in 1918, described the clitoris as a vestigealpenis, recommend-
ing its careful stimulation in marital sex (1919, 50). In 1932, the American
sexologist C. B. S. Evans attempted to provide directions to the clitoris by
asking his readers to envisage the female genitalia as a sailboat that extended
from the pubic bone to the anus, noting that the clitoris lies where the ag-
pole would be on the bow of the boat,and declared it every married mans
duty to provide his wife with orgasms (Evans 1932 49; McLaren 2008,
171). It was also continually viewed, either metaphorically (as in psychoan-
alytic thought) or explicitly (as in biological anatomical depiction), as a mini-
penis. That idea, as we have seen, is of quite ancient origin. Homology was a
constant, and it was not its abandonment per se that resulted in the refusal of
clitoral pleasure but rather a reguring of the moral importance of this locus
of womens bodies. The interwar fascination with appropriate sexual norms
for each gender made the notion of a female penis suddenly troubling for
some. As historian Angus McLaren notes, Most interwar writers recognized
the importance of clitoral stimulation but ...regarded vaginal penetration as
superior(2008, 172). This contradictory approach was a truly novel form of
discourse about the clitoris that had little precedent in past anatomical, med-
ical, or erotic texts in the European context. It was not, as has sometimes been
asserted, the norm across time immemorial for men to repress womenssex-
uality by denying their need for clitoral and other pleasures (Koedt 1973;
SIGNS Autumn2018 y67
Chalker 1997); on the contrary, a vast genealogy dating at least from the f-
teenth century, but probably earlier, reiterated a holistic view of female sexual
anatomy that included the external genital structures as important organs of
Why, then, did things change in the early twentieth century, with an in-
creasing number of doctors advising women to relocate their pleasure to the
vagina? The Freudians had some of their own idiosyncratic reasons, but
many doctors clearly not followers of that movement were also prescribing
clitoridectomies to women well into the postWorld War II era. The advice
to relocate pleasure from the clitoris to the vagina gained ground despite
clear scientic understanding of the importance of the clitoris as a center
of erotic sensation in women. In part, the trend followed longer patterns
of concern about masturbation in both sexes, which had also existed since
the early modern era but reached a zenith in the late nineteenth century
(Laqueur 2004). But this period also saw the emergence of increased con-
cern about female sexuality, with ideas of perversion, lesbianism, frigidity,
and nymphomania lling volumes of respectable texts of medicine and crim-
inology, as well as a vast output of vulgarized works that combined erotic
titillation with descriptions of sexual pathology (Chaperon 2007; Cryle and
Downing 2009; Cryle and Moore 2011).
It is unsurprising, perhaps, that vaginal receptivity became suddenly em-
phasized in the interwar perioda time of intense pronatalism, nation build-
ing, and the looming threat of warand indeed again in the postWorld
War II era of reconstruction and population renewal (otherwise known as
the baby boom). Gender historians such as Mary-Louise Roberts, Carolyn
J. Dean, and Laura Doan have shown that pronatalist periods in nineteenth-
and twentieth-century societies have typically coincided with cultural anxie-
ties about appropriate sexuality, homosexuality, androgyny, perversion, and
female pleasure (Roberts 1994; Dean 2000; Doan 2013). The idea was that
women should be as feminine as possible, and traits deemed masculine, in-
cluding short haircuts, boxy clothes, and clitoral orgasms, should be discour-
aged in the interest of the reproductive health of the nation (Roberts 1994).
The larger context of these discursive developments was undoubtedly
womens sudden inclusion in the workforce of almost every kind, beginning
with the loss of men conscripted to ght in World War I. With the return of
soldiers after the war, many women workers were discouraged from con-
tinuing in their newfound jobs and economic freedoms. The new economic
reality combined with new reproductive pressures as nation-states prepared
for further war, recognizing the need for population growth to support the
armies of the future (Roberts 1994, 19495). Pronatalist arguments in-
sisted emphatically that it was a womans national duty to have as many ba-
68 yMoore
bies as possible, and many states awarded prizes to mothers of large families,
such as the 1920 French Médaille dhonneur de la famille française (Clarke
2000, 211). Meanwhile, social hygienists criticized the selshcareer
woman who neglected her national duties (Clarke 2000, 140). These con-
textual pressures, in combination with the dubious reputation the clitoris
had earned through antimasturbation texts from the late nineteenth century,
helped to form a unique cultural nexus that orientated doctors toward the
view that women should be principally vaginal in their pleasure.
Though my own work on this topic has been on European texts, Amer-
ican medical practices and ideas of the time appear to have been very similar.
As medical historian Sarah Rodriguez notes of the attitudes to female mas-
turbation in the early twentieth-century United States, there was only one
kind of female orgasm, and it was clitoral; there was also only one kind of
healthy sexual instinct in women, and it was for penetrative (hopefully pro-
creative) sex with their husbands(2007, 324). As Rodriguez shows in her
2014 monograph Female Circumcision and Clitoridectomy in the United
States, surgeries were carried out on womens genitals for a variety of rea-
sons until well into the 1960s. Genital surgeries were more prevalent in
the United States than in Europe, though some French doctors considered
it a matter of pride to compete with the Americans in their willingness to put
womens genitalia under the knife (Cryle and Moore 2011, 187). In the
mid-twentieth-century United States and Europe, surgeries continued but
often entailed removing the clitoral hood with a view to enhancing clitoral
stimulation in coitusin other words, female circumcision (Rodriguez 2014,
50). Clitoral hood surgeries, unlike clitoridectomies, remained committed
to the notion that women should climax from coitus, and, as in the case
of Marie Bonaparte, the procedure aimed to make this more likely through
surgical exposure of the clitoral glans. Various forms of female genital cutting
were also then, and are still now, being practiced in a minority of other cul-
tures throughout Africa, the Middle East, and Southeast Asia, though as the
anthropologist Lori Leonard warns, we have no reason to assume these are
always deep-seated,”“traditional,or a xed and static practice(2000,
In the 1950s several important developments in the biomedical sciences
and in sexual science shifted the parameters of understandings of female or-
gasm. Alfred Kinsey and colleagues1953 work Sexual Behavior in the Hu-
man Female noted the ubiquitous use of clitoral stimulation by women in
masturbation and the commonplace use of it in heterosexual sex, either be-
fore, after, or at the same time as coitus. Notably, Kinsey defended the ne-
cessity for women to be clitorally stimulated precisely by the same logic that
can be found in numerous early modern texts of anatomy, but with a mod-
SIGNS Autumn2018 y69
ern scientic nuance. The clitoris and the penis are homologous structures,
in the technical sense of the term,Kinsey wrote, referring to the embryonic
account that had become known in 1950, which detailed the divergence
of the bipotential gonad only in the second trimester of fetal development
(Kinsey et al. 1953, 57172). Following from Kinseys work, William Mas-
ters and Virginia Johnson argued forcefully that the clitoris played a role in
female orgasmic responses of all kinds (1966). But the clitoris had few other
determined scientic defenders until the nal decades of the twentieth cen-
tury with the rise of feminist political activism and the work of women sex-
ologists and feminist philosophers of biology, who refuted the notion of a
normative vaginal orgasm(Koedt 1973; Hite 1976; Moore and Clarke
The myth busters
Because of the way modern medical and psychoanalytic ideas about female
sexuality had excised the clitoris (both guratively and literally), one of the
most important developments in postwar feminist reclamations of sex en-
tailed debunking the Freudian paradigm. In 1970, a short piece of feminist
polemic originally written by Anne Koedt in 1968 became popular for re-
claiming the centrality of the clitoris as the principle organ of female orgasm
(1973). That idea became widespread in Western feminism in the following
decade, and by the late 1980s had become a staple truism in Anglophone
psychology, sexology, and nally even in popular womens magazines (Lieff
Benderly 1986; Manning 2013; Breslaw 2015). Koedts designation of vag-
inal orgasm as a mythwas a powerful assault on the demonization of the
clitoris that was sometimes, even in her time and culture, expressed in sur-
gical removal or remodeling of womens genitals. The term mythseems
appropriate in the sense that it was a normative and prescriptive ideal that
ignored much contradictory evidence: an idea that, though couched in med-
ical language, found little support in scientic research; an idea that helped
doctors of the early twentieth century to imagine themselves (not the women
whose genitals they examined) as authorities on matters of those womens
sexual pleasure. The term mythwas obviously false in another sense,
though, in that it implied that no woman had ever had a recognizably orgas-
mic experience from coitus alone.
In resisting the view that women should only orgasm in coitus, feminist
accounts of womens sexuality from the 1970s up through the 1990s tended
to eschew biological sexual science altogether in favor of either an ethics of
experience, a political call for equality in the mutual pleasure economy, or
a personal denial of heterosexuality and penetration, or even of sexuality alto-
70 yMoore
gether (Gerhard 2000). We might be tempted to assimilate Koedtsinterven-
tion with these trends, except that her text very clearly references scientic
understanding of female genital anatomyin fact, her insistence that vaginal
orgasm was impossible was based precisely on the known biological under-
standing of nerve density in the different genital tissues. Koedt drew on Kin-
seys work that had detailed the vastly lower nerve concentration in the va-
gina relative to the clitoris, citing his claim that in his test subjects, 14 percent
of women could not even tell if the vaginal epithelium was being touched
or not (Kinsey et al. 1953, 580; Koedt 1973).
Kinsey is referring here to vaginal examinations conducted by gynecolo-
gists using a speculum and a narrow probing implement, a situation hardly
like penetration in erotic contexts. But this is precisely what was misguided
about the claim that vaginal penetration could not ever be a source of or-
gasm. Real-life penetration does not keep the vaginal wall held apart while
the penetrating agent enters without perturbing the surrounding muscula-
ture; on the contrary, all the tissues of the genital-pelvic network are moved,
compressed, squashed up against each other, and against the esh of the
other person. The medical examination disambiguates this entangled array
of sensations in a way that actual sexual interactions do not. Koedt, despite
her strident rejection of common medical advice to women to expect or-
gasm in coitus, nonetheless accepted the standard gynecological model of
sensory testing as authoritative in telling us where we should feel the most
pleasure. The refusal of vaginal orgasm, while helping to rescue the clitoris
from the scrap heap of twentieth-century heterosexuality, and from the sur-
gical scalpel, nonetheless played into the trap of accepting genital bifurca-
tion and taking sides with the part that had been maligned (Pfaus et al. 2016).
In 1966, an American psychiatrist named Mary Jane Sherfey, who had
trained in Freudian psychoanalysis but who had also studied both with Kin-
sey and with Masters and Johnson, published an article in the Journal of the
American Psychoanalytic Association that similarly challenged the Freudian
vaginal orgasm thesis, here with even deeper biological justication. She be-
gins by citing Freuds prediction that psychoanalytic theory must necessarily
be disproved by new advances in biological knowledge. Her article proposes
that just such a moment has arrivedthat embryonic and endocrine re-
search has demonstrated that the clitoris is not a masculineorgan, nor
is it possible for most women to ignore it, and it is time to ditch the dam-
aging and unreasonable expectation that women should rescind clitoral
pleasure or be labeled infantile and neurotic if they do not (Sherfey 1966).
Sherfey draws heavily on a biological argument derived from 1950s en-
docrinology to make her claim against the received Freudian dogma: It is
now understood, she remarks, that the bipotentialgonad of early embry-
SIGNS Autumn2018 y71
onic development is not in fact undifferentiatedsexually but rather fe-
male: In the beginning, we were all created females, and if this were not so,
we would not be here at all(1966, 43). Moreover, embryologically speak-
ing, it is correct to say that the penis is an exaggerated clitoris(50). Since
the clitoris was the original genital organ, it therefore could not be denied
in adult womens sexuality, and attempting to do so was only causing count-
less women to feel inadequate. Could much of the sexual neuroses which
seem to be almost endemic in women today be, in part, iatrogenic?she asked
rhetorically (1966, 36). Understanding our biology in an up-to-date fashion,
then, was the key to living a life of sexual contentment.
The claim that the bipotential gonad is actually female,suggested by
1950s endocrinologists, proved enduringly appealing in the deconstruction
of ideas about female genitalia as derivative. Jaak Panksepp cites the idea in
his classic 1998 book on affective neuroscience, remarking that the pri-
mordial plan for both female and male foetuses initially feminine.
Some have called this the defaultplan since masculinization results from
the organizational effects of testosterone(1998, loc. 8272). It is still com-
mon to see embryonic gonadal development described in these terms, with
the notion of a “‘defaulteffect of no steroid hormone action being the de-
velopment of the female phenotype(Pfaus et al. 2016, 5). There is no
doubting the fun to be had in telling men that the penis is just a plumped-
up clitoris. However, recent genetic studies of sexed differentiation now
suggest that the notion of the female being defaultis not exactly accurate
eitherthe bipotential gonad is precisely that. As Fausto-Sterling notes, the
idea of female structures as default reects the relative lack of study of ovar-
ian development, as well the persistence of prescientic assumptions about
normative female passivity: Femaleness then becomes an absence, some-
thing that happens by default, something that does not merit the same level
of scientic investigation as the more active male process(2012, 16). While
an absence of the testosterone surge associated with the SRY gene on the
Y chromosome results in female phenotype development, this embryo would
also require the estrogen surge (which in males is inhibited by genes on the
Y chromosome) to complete its own full ovarian development. The embryo
cannot complete its development as female without female-specic hor-
monal interventions, like those required by the male fetus for full testicular
development. The defaultthen, if anything, is intersex.
Legacies of the past still haunt us
Much of the conceptual scaffolding that underlay the notion of exclusive
vaginal orgasm persists in other forms today. The model of male genitalia
72 yMoore
as the norm, with female genitalia as the exception, continues to inuence
scientic research, perhaps even more so than in the past. Biological views of
female sexuality have largely accepted the importance of the clitoris for fe-
male orgasm, and the impact of feminist critiques has been wide reaching.
And yet the occlusion often persists at the level of anatomical depiction of
the female genital system. A 2014 article published in PLOS Biology shows
that studies of animal genitalia conducted since 2000 have increased their
focus on male genitalia over female forms across this fourteen-year period
(Ah-King, Barton, and Herberstein 2014). A sociological survey of anatom-
ical drawings of female sexual organs in the 1990s noted that clitorises were
as frequently omitted as they were included in such images (Moore and
Clarke 1995).
Has this yet changed? A Medscape web article directed at medical profes-
sionals, updated in 2013, shows a sagittal slice of a womans pelvis under the
heading of Female Reproductive Organsindicating the vagina, urethra, fal-
lopian tubes, ovary, and uterusand the urinary bladder and rectal canalbut
not the clitoris! (Miranda, Miranda, and Gest 2017). The omission of the cli-
toris is surprisingly common, though not ubiquitous, in current medical
drawings of female anatomy. The Merriam-Webster Visual Dictionary Online
shows another model, also in sagittal slice, with the clitoris indicated as a tiny
ngernail-like structure, highlighted in blue to show its exception from any
surrounding tissues (Merriam-Webster n.d.). Here, even with the clitoris
scribbled back in, we are left with a view of female genitalia as a set of dis-
creet parts unrelated to one another. But most often the female reproductive
system is represented visually in frontal view of the internal organs, showing
the uterus, ovaries, fallopian tubes, cervix, and vagina but none of the exter-
nal structures that are most crucial for arousal and orgasm, as pictured in g-
ure 2 (Human Anatomy Library 2016; see g. 2).
As Nancy Tuana has remarked, ignorance of the clitoris in anatomical
drawings of the late twentieth century may not be a matter of passive omission
reecting epistemic gaps in the prevailing scientic models. Such omissions
must prompt questions about how ignorance is sustained, cultivated, or al-
lowed(2004, 196). Denials of the clitoris have, at every moment, coexisted
with assertions of its importance and detailed descriptions of its structures,
suggesting that denial or ignorance was not a product of the limits of the sci-
entic models but was generated as part of specic commitments to ideas
about appropriate feminine sexuality. From the historical survey provided in
this article, it should be clear that reductive ideas about female orgasm that
have sought to localize pleasure in just one place and/or to hystericize it to-
ward less innervated parts were in fact largely twentieth-century confections,
not ancient traditions, not the products of Victorian prudishness, nor the
SIGNS Autumn2018 y73
remnants of some brutal misogynist dark age. We are inheritors of a recent
and still current legacy that has taught us to divide our pleasure into discreet
hierarchized components. Recognizing that this is a phenomenon of our
own time, not someone elses, is most certainly the rst necessary step toward
transcending it.
Having been told that our genitals are a set of parts and not a whole, how
indeed can pleasurable entanglement be reimagined? Obviously, we cannot
unknow what is already known, and there is no returning to the world in
which female orgasm was imagined as necessary for conception (nor would
it necessarily be desirable to do so). Arguably the only way is onward into
the science as it stands in our own time. Yet in much of the scholarship on
sexuality and gender produced in the humanities and social sciences, bio-
logical understanding is deemed necessarily deterministic and normative.
Consequently, as Elizabeth Wilson has complained, we have come to be as-
tute about the body while being ignorant about anatomy,and it seems
Figure 2 Schematic drawing of female reproductive organs, frontal view, 2007. Wikimedia
Commons, A color version
of this gure is available online.
74 yMoore
that the very sophistication of feminist accounts of embodiment has been
brokered through repudiation of biological data(2004, 6970). Debates
about the place of female sexual pleasure in human and animal biology re-
main deeply divergent, even as a growing corpus of humanistic scholarship
is now integrating humanistic critical thought with scientic literacy. But
there is still a mass of both prescientic bias and gendered political invest-
ment in the biological research itself, and the task of picking through it is
both painstaking and contentious. However, from the turn of the twenty-
rst century there has been a growing tide of critical science scholars who
have devoted their careers to precisely such correctives. The works of Karen
Wallen, Elisabeth Lloyd, Erika Milam, Nikolas Rose, Sarah S. Richardson,
Marlene Zuk, Stephen J. Gould, Anne Fausto-Sterling, Nelly Oudshoorn,
and Cordelia Fine (all inspirations for this article) have contributed to a
mammoth and detailed unpacking of many layers of sexual and gendered de-
lusions in biological research of different kinds.
In twentieth-century sexological thought, understandings of sexual dif-
ferentiation in embryological development have formed a recurrent basis
for biological argumentation about appropriate sexual behavior and rela-
tions. Many questions remain to be answered about fetal sex differentiation,
particularly ovarian development, which is still relatively understudied. An
alternative line of thought might focus less on the question of whose gen-
itals came rstor which sex derived from the otherand instead focus
more on how female genital sensory physiology works, what its potential
is for different kinds of pleasure, and how much variability there may be be-
tween different women, and indeed different formations of intersex. In this
vein, a current branch of biological inquiry that may be of greater interest
can be found in some recent physiology and affective neuroscience research
that looks at the sexual sensory system in women.
Curiously, some rather basic questions of genital anatomy have only re-
cently been properly studiednamely mapping, via technologies such as
MRI and ultrasound, the full and living tissue structure of the clitoris and
how it is mechanically pressured during coitus (Buisson et al. 2010; Pfaus
et al. 2016). Of interest to feminist scholars of sexuality, this research has
shown that sensations previously thought to be discretely either vaginal or
clitoral may be part of an interconnected sensory network that includes the
cervix as well other bodily loci. An important 2005 MRI study led by the
urology researcher Helen OConnell shows that the clitoris is a multiplanar
structure that cannot adequately be illustrated in two dimensions. It is not
merely the hooded clitoral glans visible to the naked eye but includes the
paired bulbs and corpora in an interconnected neural network (OConnell,
Sanjeevan, and Huston 2005). Other MRI studies have indicated that clito-
SIGNS Autumn2018 y75
ral size, as well as distance of the clitoris from the urethral meatus (referred to
as the CUMD), inuence orgasmic potential (Wallen and Lloyd 2011;
Oakely et al. 2014), while sexual science studies have indicated that women
report higher rates of orgasm when oral and manual stimulation of the ex-
ternal genitalia are involved compared to vaginal intercourse alone (Freder-
ick et al. 2017). Other physiological studies have shown an integral sensory
relationship between the clitoris, the distal urethra, and the vaginal wall (Bag-
gish, Steele, and Karram 1999). The emerging picture of female genital anat-
omy enabled by new medical technologies appears sufcient to put to rest all
previous selective claims about the locus of female orgasm. The clitoris is per-
haps much more of our genitalia than we have been told throughout much
of the twentieth century, though perhaps not more than was often intuited.
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Adler, Otto. 1904. Die Mangelhafte Geschlechtsempndung des Weibes: Anaesthesia
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women: Feminine sexual anaesthesia. Vaginismus. Anaphrodisia]. Berlin: H.
Ah-King, Malin, Andrew B. Barton, and Marie E. Herberstein. 2014. Genital Evo-
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... Both intersex and transgender studies scholars have queried why gonadal-organ removal has even been considered automatically necessary, noting the denial of reproductive rights it entails, reflecting the medical view of both transgender and intersex parenting as inadmissible (Lowik 2018). The unique violence of the modern biomedical approach to such matters has been well demonstrated by comparative historical and anthropological scholarship (Herdt 1996;Moore 2019Moore , 2018. Again, while such surgeries in transgender and intersex people may be valuable when conducted with informed consent, they have often been prescribed without this. ...
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This paper asks questions about the resilience of radical gynaecological surgeries, such as hysterectomy and ovariectomy, from the moment of their widespread use in Western European and American practices of the late nineteenth century, to their renewed increase in the Indian subcontinent and Africa into our own time.
... Large clitorises that resembled penises, and small penises that resembled clitorises created much debate in early modern medical sources about the ubiquity of hermaphrodites and the number of possible sexes (Traub 2002). Alison Moore (2018) has shown that the one-sex model as a feminine passive mirroring of men's genital structures was only one idea present both in early modern and in twentieth-century medicine, with an alternative anatomical model throughout world history consistently drawing attention to the sexual agency of the clitoris and its likeness to the penis. ...
This article considers the history of the word gender and whether is applicable to historical pasts where no distinction was made between culture and biology, resulting in various 'sexes' being counted beyond the categories of 'man' and 'woman'.
This article discusses the term erotology, which was applied to medieval Islamicate ‘ilm al-bah (the science of coitus), as well as other world traditions of sexual knowledge, by European sexologists of the late 19th and early 20th centuries, who contrasted it with their own forms of inquiry into sexual matters in the modern field of sexual science. It argues that the homogenisation and minimisation of all ancient and non-European forms of medical knowledge about sex, even one as substantial as the ‘ilm al-bah tradition, supported a particular story about the origins of sexology's own emergence as a new and unprecedented biomedical and scientific way of knowing, characterised by an opposition assumed between sexuality and religion, by a view of sexual variations as perversions or pathologies, and by a view of Arabs and Muslims as sexually excessive. The article focusses on French, English, German, Austrian, and Italian sources of the 19th century that discussed the history of sexual medicine, relating these accounts to recent attempts to historicise sexology. It considers how forms of colonial hierarchy and exoticist views of non-European cultures impacted the dismissal of ‘ilm al-bah among European sexual scientists and how they may continue to exert an influence on forms of modern historical inquiry that are not attentive to scholarship on medieval Islamicate sexual medicine.
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From the very moment the concept of sexuality emerged in nineteenth-century European medical and psychiatric thought, it became a topic of historicization. This historicization formed a consistent habit of thought in many of the medical and psychiatric texts that first enunciated sexuality as a distinct field of meaning. Dialogue between doctors and the first historians of sexuality informed the emergence of both sexology and of the historiography of sexuality. This dialogue suggests a need to rethink the origins of sexual historiography, situating current historians within a continuous genealogy, rather than as transcendental observers marked by epistemological rupture from earlier biological theories of sexual evolution. Please click on the Cambridge Core link in this pdf to access the full version.
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There is a notable gap between heterosexual men and women in frequency of orgasm during sex. Little is known, however, about sexual orientation differences in orgasm frequency. We examined how over 30 different traits or behaviors were associated with frequency of orgasm when sexually intimate during the past month. We analyzed a large US sample of adults (N = 52,588) who identified as heterosexual men (n = 26,032), gay men (n = 452), bisexual men (n = 550), lesbian women (n = 340), bisexual women (n = 1112), and heterosexual women (n = 24,102). Heterosexual men were most likely to say they usually-always orgasmed when sexually intimate (95%), followed by gay men (89%), bisexual men (88%), lesbian women (86%), bisexual women (66%), and heterosexual women (65%). Compared to women who orgasmed less frequently, women who orgasmed more frequently were more likely to: receive more oral sex, have longer duration of last sex, be more satisfied with their relationship, ask for what they want in bed, praise their partner for something they did in bed, call/email to tease about doing something sexual, wear sexy lingerie, try new sexual positions, anal stimulation, act out fantasies, incorporate sexy talk, and express love during sex. Women were more likely to orgasm if their last sexual encounter included deep kissing, manual genital stimulation, and/or oral sex in addition to vaginal intercourse. We consider sociocultural and evolutionary explanations for these orgasm gaps. The results suggest a variety of behaviors couples can try to increase orgasm frequency.
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Background The nature of a woman’s orgasm has been a source of scientific, political, and cultural debate for over a century. Since the Victorian era, the pendulum has swung from the vagina to the clitoris, and to some extent back again, with the current debate stuck over whether internal sensory structures exist in the vagina that could account for orgasms based largely on their stimulation, or whether stimulation of the external glans clitoris is always necessary for orgasm. Method We review the history of the clitoral versus vaginal orgasm debate as it has evolved with conflicting ideas and data from psychiatry and psychoanalysis, epidemiology, evolutionary theory, feminist political theory, physiology, and finally neuroscience. Results A new synthesis is presented that acknowledges the enormous potential women have to experience orgasms from one or more sources of sensory input, including the external clitoral glans, internal region around the “G-spot” that corresponds to the internal clitoral bulbs, the cervix, as well as sensory stimulation of non-genital areas such as the nipples. Conclusions With experience, stimulation of one or all of these triggering zones are integrated into a “whole” set of sensory inputs, movements, body positions, autonomic arousal, and partner- and contextual-related cues, that reliably induces pleasure and orgasm during masturbation and copulation. The process of integration is iterative and can change across the lifespan with new experiences of orgasm.
What impact, if any, did Hippocrates and the Hippocratic tradition have on the development of medical knowledge and practice? For some, Hippocrates is the “Father of (Western or Modern) Medicine,” and the Hippocratic tradition provides a framework for the development of contemporary medicine – especially a rational, scientific medicine. Hippocrates and the Hippocratic tradition are not only important in terms of the development of medical knowledge but also its practice, as exemplified by the Hippocratic oath. For others, modern medicine represents a rejection not so much of Hippocrates but only of the Hippocratic tradition, especially its vitalism and humoral theory of health and disease. In this chapter, the impact of Hippocrates and the Hippocratic tradition on the development of medical knowledge is explored first, followed by an examination of how they, especially the oath, shaped medical practice. The chapter concludes with a discussion of the lessons this exploration into Hippocrates and the Hippocratic tradition teach about the future of medical knowledge and practice.
This thesis studies the works of a Greek doctor who lived in the first century A. D. Rufus of Ephesus. It is based on a reading of primary sources in both Greek, Latin and Arabic. The materials preserved in Arabic translation has not been fully studied before. This thesis attempts to draw a general picture of Rufus' life and practice of medicine. It looks for Rufus' learning centre, places of his practice of medicine and lists his writings and the various editions and translations they went through. The thesis discusses Rufus' status as a practitioner and, in particular, the criteria on which his choice of therapies were based. His explanations of the occurrences of diseases, whether expressed explicitly or implicitly are considered in detail. His views on humoral causation are investigated at length in this study in order to establish Rufus originality or conventionality. Bed-side medicine is another important aspect of Rufus' activities. In order to have an insight into Rufus' clinical thinking, this thesis studies carefully his treatise Medical Questions, in which Rufus advocates interrogating the patient in order to recognize his or her case more accurately and promote a better treatment. This treatise has an important value per se as it is the first ever Greek medical treatise which discusses exclusively the art of medical questioning. This thesis discusses Rufus' methods of therapy by concentrating on three different diseases, lithiasis, melancholy and jaundice. It concludes with paying attention to the issues of the Arabs' interest in the Greek civilization by investigating the reasons behind the translation of Rufus' works into Arabic, identifying the translators, and studying the Arabs' reception of Rufus' teaching.
This eagerly awaited book offers a unique, comprehensive scientific study of the anatomy of the organ of female sexual pleasure. The authors use macroscopic and microscopic research to guide the reader from the glans, the visible part of the clitoris, where they explore the impressive sensory corpuscles, to the hidden roots of the bulbo-clitoral organ. They show its complexity, its exact location within the external genitalia and its intimate relationship with the urethro-vaginal pyramid. They also remind us that throughout history there has been a failure to understand this organ and explain that this misunderstanding remains the cause of persistent excisions, criminal mutilating practices that have not yet been eradicated. Using extensive iconography, they demonstrate throughout this book that the bulbo-clitoral organ is an exceptional natural treasure that every woman possesses and that every man should know well.