US National Medical Library + the MeSH: Redefine Clitoris

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In the United States, inequality is rife. And while we don’t usually prefer to discuss humanity in gendered and binary terms*, there is a proven wage gap, and a proven orgasm gap. Therefore, it’s no surprise that when it comes to the scientific study of female genitalia*, sexual function, and pleasure, there's profound work to be done toward equality.

Words matter. They shape and mold our ideas and beliefs about our purpose, our bodies, our self-worth, and our place in the world around us.

In its outdated definition of clitoris, the United States National Medical Library and the MeSH do not reflect American values of democracy or equality; this is evident when reading their definitions of external female genitalia compared to how it defines external male genitalia.

The MeSH defines the clitoris as homologous (different versions of the same structure) with the penis, but it does not define the penis as homologous with the clitoris. This is a grave injustice to all women around the globe, as if the existence of any female body part depended on the validation provided by the existence, understanding, and recognition of male body parts. Furthermore, the definition does not describe the esoteric function of the clitoris, but does describe it for the penis.

While there are surely much bigger issues to resolve in the world, a wonderful small first step toward change and equality, would be for the NLM, and its employment of the MeSH to reflect just, logical, current, and scientific terms. 

Here’s why:

1.     It is culturally toxic. Framing a woman’s sexual organs within the context of a man, denies a woman the right to own her body and sexuality independent of men.

2.     It’s scientifically illogical. When we are conceived, the same tissues that form the clitoris and the upper shaft and glans of the penis are homologous. But it’s not until we reach between weeks 6-12 in the womb (the exact week is debated within the medical community), when the sex-determining gene triggers the creation of testosterone and Anti-Mullerian hormone for the embryo to develop into a male. Essentially, we all begin as females. Dr. Helen Fisher's book, The First Sex touches on this brilliant fact. Following this scientific logic, we should therefore be calling penises male clitorises. (We do not support this idea, we simply mention it to make a point).

3.     Some cultures believe that a female is not fully a woman until her external genitalia is removed, because any external genitalia is considered masculine. Referring to the clitoris as a female penis, or defining it within the context of a male, perpetuates the need for FGM in many cultures.

Blatant inequality within government, academia, and medicine is no longer acceptable in this day and age. Bodily politics are an imminent threat to the rights, identities, and dignity of women. Furthermore, words matter, and the words used by our nation’s top medical library as well as our nation's top search engine are antiquated, doing a major disservice to the plight of equality of women in our country.

Therefore, it is with great urgency, we petition the United States National Medical Library, and the MeSH to update and change their definition of clitoris, if for no other reason, than for being a leader for the equitable values that democracy, humanity, and the United States should embody.

For further reading, please see this article from the Journal of Sexual Medicine, by Safieh Shah, MBBS, MSc, and Guillermo Martínez Pérez, PhD:

http://www.jsm.jsexmed.org/article/S1743-6095(17)30107-8/fulltext



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