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More than 10,000 nerve fibers -- many more than expected -- power the human clitoris, according to Oregon researchers who were able to count them for the first time while performing gender-affirming genital surgery.
That's about 20% more than previous estimates, they said.
"It's startling to think about more than 10,000 nerve fibers being concentrated in something as small as [the] clitoris," said Dr. Blair Peters, a plastic surgeon from the Transgender Health Program at Oregon Health & Sciences University (OHSU) in Portland.
He said it's particularly surprising if you compare the clitoris to other, larger parts of the body, including the human hand.
"Even though the hand is many, many times larger than the clitoris, the median nerve only contains about 18,000 nerve fibers, or fewer than two times the nerve fibers that are packed into the much-smaller clitoris," Peters said in a university news release.
The clitoris' only job is enabling pleasurable sensations.
It consists of the highly sensitive glans outside the body and more tissue internally. Internal parts of the clitoris include the dorsal nerve, which is the main one responsible for sensation.
Peters collected samples of dorsal nerve tissue from seven transmasculine (assigned female at birth but do not identify as female) volunteers who were undergoing gender-affirming genital surgery. A small amount of the tissue is typically trimmed during phalloplasty, a surgical procedure to create a penis.
Researchers dyed the tissues and magnified them 1,000 times under a microscope, then counted them with the aid of image analysis software.
Software counted an average of about 5,140 dorsal clitoral nerve fibers in the sample. Those were doubled to estimate the total for both sides, about 10,281 nerve fibers.
Peters said the clitoris actually has more nerve fibers in total, because other smaller nerves lie beyond the dorsal nerve.
The research fills part of a huge gap in the field of sexual health for women or those assigned female at birth.
Peters' interest in studying clitoral nerves is to improve outcomes for phalloplasty surgery patients.
He also hopes to count nerve fibers in the tip of the penis (glans) with an eye to improving construction of a clitoris in gender-affirming genital surgeries for transfeminine patients. That count would also increase understanding of comparable nerve structures between the two pleasure centers.
The aim is to use the findings to improve sensation for patients and to develop new surgical techniques to repair injured nerves, according to the researchers.
"Better understanding the clitoris can help everyone, regardless of their gender identity, but it's important to acknowledge this research is only possible because of gender-affirming surgeries and transgender patients," Peters said. "There's something profound about the fact that gender-affirming care becoming more commonplace also benefits other areas of health care. A rising tide lifts all boats. Oppressing or limiting transgender health care will harm everyone."
Peters presented the findings Thursday at a joint meeting of the Sexual Medicine Society of North America and the International Society for Sexual Medicine, in Miami. Findings presented at medical meetings are considered preliminary until published in a peer-reviewed journal.
The Office of Population Affairs has more on gender-affirming care.
SOURCE: Oregon Health & Science University, news release, Oct. 27, 2022
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