Young woman tells why she had surgery to reduce her clitoris – 05/24/2023 – Equilíbrio

Having a large, out-of-the-ordinary clitoris is not a pathology, but rather a dysfunction currently known as sexual developmental difference (DSD). The cause can range from genetic problems to hormonal disorders (for example, as a result of the use of anabolic steroids).

Recently, the Maternidade-Escola Assis Chateaubriand (MEAC), of the Hospital Complex of the Federal University of Ceará, linked to the Ebserh network, performed two clitoroplasty surgeries – a clitoral correction procedure.

One of the operated patients was a 22-year-old woman from Ceará. In an interview with BBC News Brasil, the young Maria* says that she had been undergoing hormone treatment at the hospital complex since December 2021, but she always complained to the doctor about the size of her clitoris, which increased even more during her sexual intercourse, something that it made her extremely uncomfortable.

“When I started having intercourse, aged 18, I noticed that my clitoris swelled out of the ordinary. And that was something that bothered me a lot”, she says.

She asked the gynecologist in one of the consultations if there was a possibility of reducing the organ, as she had suffered with this situation for years.

According to doctors, Maria has a genetic condition that ended up causing hypertrophy, that is, an abnormal growth of the clitoris.

“On a day-to-day basis, he [o órgão] it didn’t bother me, I felt normal, but during the act of sexual intercourse, I looked at it and kept thinking that it wasn’t normal. That’s why I wanted to reduce it anyway, “reports the young woman, adding that her sexual partner never showed discomfort with the situation, but advised her to seek treatment as she herself complained constantly.

As there was no specialist surgeon at the hospital, the procedure took a while. Finally, on the eve of last Christmas, the hospital in Ceará had the help of a specialist gynecologist from São Paulo, who agreed to travel to perform the operation.

“The surgery went very well and my recovery is going great. Now I feel like a complete woman, because, for me, I wasn’t normal before. For many people, this is just a small problem, but for those who live like this, it’s difficult “, describe.

“Having an enlarged clitoris is a common developmental alteration, but it is not a disease”, says Marcelo Praxedes Monteiro Filho, gynecologist responsible for the surgeries and doctoral student in urology at the University of São Paulo (USP).

The patient concludes that “there will be two months of recovery, but today I am a fulfilled woman and I will no longer be embarrassed during sexual intercourse”.

What is clitoroplasty?

It is surgery to reduce the size of the clitoris – but not its function. After all, the organ has more than 8,000 nerve endings responsible, especially, for generating pleasure in the sexual act.

This organ, similar to a “little button”, varies in size from person to person, but usually has 10 cm long bulbs on each side of the glans, inside the vagina.

Clitoromegaly is the technical name for clitoral enlargement. Monteiro Filho, whose line of research is based on gender affirmation surgery, cites some causes for this hypertrophy. Are they:

• genetic alterations, which can be perceived from birth;
• increased production of the group of male hormones, androgens;
• use of anabolic steroids. Testosterone, for example, is a type of hormone used to gain muscle mass faster. On the other hand, it produces excess masculinizing hormones;
• use of hormones during pregnancy;
• hormonal changes due to various causes;
• tumors that increase the production of male hormones;
• polycystic ovary syndrome, in extreme cases;
• without definite cause

The expert explains that in polycystic ovary syndrome (PCOS), for example, there is an increase in androgenic (male) hormones.

“PCOS is considered the most common endocrine disease in women of reproductive age. Its prevalence ranges from 5% to 17% in this age group. And it can cause menstrual irregularity, acne, excess body hair. And, in more severe cases, increased of the clitoris”, comments Monteiro Filho.

The clitoris has tissues (corpora cavernosa) that fill with blood when there is excitement, which causes it to naturally increase in size. This is common in all women, but in the case of those with clitoromegaly, it increases even more due to erectile tissue.

This can cause an erection that is larger than expected, causing discomfort during intercourse.

In addition, according to experts, many women also do not feel comfortable wearing bikinis or very tight clothes (such as jeans) due to the size of their bodies, which can attract attention.

“In surgery, we remove precisely those tissues that are enlarged, which are the corpora cavernosa. But we preserve all the sensitive and vascular parts of the patient, which are the most important”, explains the gynecologist.

Does the clitoris have a defined size?

There is no standard clitoris size. Therefore, the ideal is to seek an expert when there really is a visual or sexual nuisance.

“The patient should not be measuring whether the clitoris is enlarged or not, because, in fact, this is a very personal issue. And if it is slightly enlarged and she is satisfied, there is no problem”, advises the researcher in affirmation surgery of gender.

However, there is a classification in the medical literature called Prader, which varies numerically from 1 to 4, used to define the degree of physical anomaly of the genitalia. This assessment, however, can only be made by an expert.

Surgery is not common in public hospitals

Despite causing great discomfort in many women, the enlarged clitoris is still not a priority in public hospitals. Experts heard by BBC News Brasil claim that it is a delicate procedure that requires a specialized surgeon – hence the difficulty of access.

In any case, the gateway is the large public hospitals, such as university hospitals, which have trained professionals.

After the initial evaluation and examinations, the doctors themselves refer the patients to the hospital that performs the procedure closest to their residence.

To give you an idea of ​​the difficulty of access, this is only the third time clitoroplasties have been performed at the Hospital Complex of the Federal University of Ceará. And all were for the purpose of medical education.

Zenilda Vieira Bruno, gynecologist, head of the Medical Division at Maternidade-Escola Assis Chateaubriand and professor at the Faculty of Medicine at the Federal University of Ceará (Famed-UFC), points out that the division’s proposal is to reduce the clitoris of women who have genetic or who suffered from some pathology that caused the enlargement of the organ.

“If the person takes anabolic steroids, he knows that he will run the risk of having reactions and, among them, is the enlargement of the clitoris, the appearance of pimples and hair on the body. Our indication is that the patient stops taking it and normally the symptom regresses afterwards”, explains the UFC professor.

She claims that the surgeries were not performed on transsexual patients, but on women with changes in their genitals.

The doctors who usually operate on the clitoris are pediatric surgeons, as the ideal is to correct anomalies in childhood. Gynecologists and urologists also specialize in these types of procedures.

Finally, it is worth mentioning that there is still a very big taboo when it comes to sex, but it is important that women have a greater knowledge of their own body so that they seek medical help in case of aesthetic or even functional discomfort.

*Name changed to preserve the identity of the interviewee

This text was published here