Contemporary Psychoanalysis in Action

A roundup of psychoanalytic points of view

Female Sexual Pleasure

Recent research reminds us of abundant possibility for female sexuality.

By Mark J. Blechner, Ph.D.

Some people call it “the love button” or “the little man in the boat.”  But the clitoris, the pivotal organ of female sexual response, is hardly little.  Many people assume that all there is to the clitoris is what they can see, a sensitive little button of flesh ensconced between the labia under the hood of its foreskin. Helen O’Connell, an Australian urologist, has changed that.  Using modern imaging techniques, O’Connell (2005) has shown that there is much more to the clitoris than meets the eye.

It turns out that the entire clitoris is a wishbone-shaped structure about 3 ½ inches in length and 2 ½ inches in width. The glans of the clitoris is the visible tip that protrudes at the top of the female genitalia. But the clitoris extends into the body and then splits downward into two leglike parts, the crura, which are composed of erectile tissue and are adjacent to the vagina and urethra. As O’Connell puts it: “The vaginal wall is, in fact, the clitoris. If you lift the skin off the vagina on the side walls, you get the bulbs of the clitoris - triangular, crescental masses of erectile tissue."

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This knowledge has begun to change our understanding of female sexuality.  It makes the clitoris central to sexual responsiveness but also shows how the clitoris is integrated with other parts of female genitalia.  Freud posited that mature women transfer the center of sexual responsiveness from the clitoris to the vagina. But now we know that parts of the clitoris we cannot see are adjacent to the anterior wall of the vagina, and can receive stimulation either through the vagina, urethra, or anus.  So perhaps a different part of the clitoris gets more stimulated during sexual intercourse than in masturbation, but the pleasure is still clitoral.

And the mysterious G-spot at the front of a woman’s vagina may actually be a spot in some women where stimulation strongly affects the clitoris.  There is still much work to do before we understand how the clitoris is connected with other anatomical structures, the circulatory system, and the nervous system.

You might think that you could consult an anatomy textbook and get those facts.  But many anatomy textbooks give inadequate information about the clitoris or neglect to mention it at all.  The 1901 edition of Gray’s Anatomy, one of the standard anatomical guides, illustrates only a tiny protrusion on the female genitalia with the label “clitoris.”  The 1948 edition banishes the protrusion altogether--there is no clitoris at all!  Somehow, over time, knowledge about the clitoris was forgotten, ignored, or deemed inconsequential.

This loss of knowledge about the clitoris has happened many times in history.  Although O’Connell’s recent descriptions of the clitoris have been hailed in the press as new discoveries, O’Connell herself notes that her findings are not so new.  In 1844, the German anatomist, Georg Ludwig Kobelt, provided a comprehensive and accurate description of clitoral anatomy in his book The Male and Female Organs of Sexual Arousal in Humans and some other Mammals.  The details are not as vividly portrayed as those by modern MRI scans, but Kobelt was precise and thorough, and the basics are all there.

So how did Kobelt’s discoveries about the clitoris become the objects of neglect? One might expect that a science like anatomy would be concrete enough that it could not adjust its facts based on psychological issues. But that does not seem to be the case.  How can we explain the inconsistent attention accorded the clitoris?  Why do facts about a fundamental human organ get lost or suppressed repeatedly?

One issue may be the sex of anatomists.  Most anatomists have been men.  Are men more concerned with organs of male sexual responsiveness than those of women?  It is hard to imagine that if a woman were in charge of an anatomy textbook, she would leave out the clitoris.

Does male privilege in our society extend to deciding which facts about human sexuality can be known and considered important?  Freud himself referred to the “dark continent” of female sexuality.  He noted that the details of female sexual anatomy are not as visible as those of the male. But visibility is not enough of an explanation. Anatomists have paid a great deal of attention to the male prostate gland, which is not visible at all from the exterior body.

Perhaps the problem is a fear of sexuality itself.  The clitoris is the only human organ whose sole function is sexual pleasure.  The penis, besides sexual pleasure, has the tasks of urination and fertilizing the ovum.  Is there something troubling about pure sexuality and a wish to eliminate an organ with no other “practical” purpose? 

The Greek myth of Tiresias is relevant.  Tiresias lived first as a man, then as a woman, and then as a man. The gods Zeus and Hera were arguing about who gets more pleasure in sex, men or women. They asked Tiresias, and he replied, “Of ten parts a man enjoys one only.”  The statement that women enjoy sex ten times more than men was troubling, and Tiresias was struck blind.

Do men have a psychological need to diminish female sexuality?  Do men envy the power of a woman’s eroticism? Perhaps men wish to deny that females can have multiple orgasms, thanks to an organ devoted exclusively to pleasure, and so they make that organ small and insignificant or erase it from the textbooks entirely. Men try to form-fit a woman’s anatomy to a male standard and describe it in male-centric terms. Why, after all, is the clitoris referred to as “a little man” rather than “a little woman”?  The “little man in the boat” may actually be better described as a full-sized lady standing solidly on the terrain around her and joyfully moving with whatever dances come her way.

Mark J. Blechner, Ph.D. is Training and Supervising Analyst at the William Alanson White Institute, teaching faculty at New York University, and Editor Emeritus of the journal Contemporary Psychoanalysis.  He is the author of the books Sex Changes: Transformations in Society and Psychoanalysis and The Dream Frontier.  He is in private practice in New York City.

Dr. Blechner will be speaking at the conference, “Unknowable, Unspeakable and Unsprung: Navigating the Thrill and Danger of Living amidst Truth, Fantasy and Privacy” on Saturday, October 5th, 2013 at the Mt. Sinai Medical Center and the NY Academy of Medicine in New York City. Click to register.

A longer paper on the subject of the clitoris will be presented by Dr. Blechner on November 10, 2013 at the conference of the International Association of Relational Psychoanalysis and Psychotherapy (IARRP) in Santiago, Chile.

Contemporary Psychoanalysis in Action, edited by Susan Kolod, Ph.D., and Melissa Ritter, Ph.D, is under the auspices of Contemporary Psychoanalysis, the journal of the William Alanson White Institute.

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