As genital piercing becomes more common, doctors may need to learn more about it.
Reviewed By Brunilda Nazario
Genital piercing: the very idea of it is enough to send many of us, whimpering, into the fetal position. But it's a practice, whether it intrigues or disgusts you, that's becoming more and more popular for men and women alike.
"It isn't something done only by the fringes of society," says Elayne Angel, a professional piercer in New Orleans and Medical Coordinator for the Association of Professional Piercers. "Most people probably already know at least several adults who have genital piercings. They just haven't had the occasion to find out."
And true enough, while a glance can establish whether someone has a nose ring or pierced eyebrow, you'd need to know a person intimately -- or possess an unobtrusive metal detector -- to discover a genital piercing. Who knows what lurks beneath the boxers or panties of that person you've been flirting with at work, or for that matter, your landlord or mail carrier?
In a recent article in the medical journal The Lancet, Aglaja Stirn, MD, assistant director of the Frankfurt University Teaching Hospital for Psychosomatic Medicine and Psychotherapy in Germany, surveys the history of the practice and argues that because of its increasing popularity, medical professionals need to learn more about the phenomenon -- and to avoid the impulse to pathologize those who have gotten pierced.
A Short History of Piercing Down There
Genital piercing has probably been around for a while, although just how long is difficult to say; histories of piercing tend to be woven with myths. According to Stirn, genital piercing of men has only been confirmed among a few tribes in Borneo, who implant bones in the glans, or head of the penis. There's also some evidence from the Kamasutra -- the ancient Sanskrit text that establishes the rules of love and sensuality in Hindu society -- of men who had penis implants adorned with jewelry. However, claims that Arabs, Africans, or Greek cultures engaged in routine genital piercing -- or that nipple rings were developed by the Romans to hold up sagging togas -- are fabrications or legend, Stirn says.
In fact, while piercing as a general practice is common to many cultures, genital piercing is largely a recent and Western phenomenon. This may be disconcerting to a few ill-informed proponents of the practice, who might prefer to imagine that they are rediscovering a venerable and ancient rite of passage, rather than practicing a newfangled invention. But as Angel and Stirn assert, most of the exotic sounding names for different types of genital piercings were actually made up in the 1970s in the U.S. and Europe.
The Western origins of genital piercing are also disconcerting to those uncomfortable with the practice, who would prefer to imagine it is a barbaric custom imported from far, far away and not something domestic. A public information officer at the American Medical Association in Chicago was disbelieving and then aghast when informed about the practice and asked, hopefully, whether it was a custom only "practiced in tribes somewhere." Little did the she know, it was probably done every day at piercing parlors within a few miles of her office.
By the 19th century, some men and women in European society were having their genitals pierced. One common type of penis piercing -- the Prince Albert -- is actually named after Queen Victoria's husband, the prince consort. The story goes that Albert had his penis pierced with a ring -- called a "dressing ring" -- so that he could manipulate his privates to prevent an unseemly bulge when he wore tight trousers. Whether there's any truth to the tale is unknown, although the accounts of 19th century genital piercing do demonstrate that the Victorians weren't quite the prudes that we imagine them to be.
Genital piercing became more common in Europe in America after World War II, but it only became popular -- in a relative sense --since the 1970s. Piercing became fashionable with the punk movement and among some gay and S&M subcultures during this time, and practiced at landmark piercing studios like Gauntlet in Los Angeles, where Angel was manager. From there, the phenomenon moved out into mainstream society.
Types of Piercing
Piercers are an ingenious lot when it comes to devising new methods of and locations for piercing, and there are many, many ways of sprucing up your genitals with holes and jewelry. For the brave of heart, read on.
"For women, the VCH [vertical clitoral hood] is by far the most popular," says Angel, who is widely considered a seminal figure in the piercing phenomenon. "It is easy to get, quick to heal, and fun to have there." The VCH is a piercing through the tissue above the clitoris that can stimulate the clitoris during sex. According to Angel, variations on this type of piercing are also popular, such as the triangle -- also a piercing through the clitoral hood, but deeper and behind the clitoris.
However, women are often restricted in their choice of piercings by their anatomy. For instance, while piercing the clitoris is possible, it is rare that a person actually has a clitoris large enough to accommodate it. Piercings of the inner and outer labia are also dependant on a person having enough loose skin in the area.
Men have a wide selection of piercings to choose from. One of the most popular is the aforementioned Prince Albert, in which a ring is inserted vertically through the urethra and out the bottom of the glans. While it's fairly common type of piercing for men, it can cause some problems; the piercing of the urethra can sometimes make urinating standing up a messy business. Angel says that other places of piercing popular among men are between the base of the scrotum and the anus and the frenum (through the lose skin on the underside of the penis).
Part of the appeal of piercing has typically been in its visibility, the way in which a pierced nose or tongue sets a person off from most of the people around him or her, or perhaps challenges societal norms. Of course, the meaning of piercings has shifted as they became more popular. They are no longer just symbols for countercultural rebels but also fashion accessories for primped celebrities.
But surely, getting your genitals pierced must have a different motivation, since very few people will presumably know you did it. If you're just trying to look cool, getting a Prince Albert isn't the way to go; it's the equivalent of buying a $250 pair of shoes but only wearing them to bed. So who pierces their genitals, and why?
A common motivation for genital piercing is, obviously, sexual. Implants in the penis can increase stimulation for a person's partner during intercourse and implants around the clitoris, like a VCH, can stimulate the piercee. Angel reports that couples will often decide to get pierced together and get "compatible" piercings. In surveys of women with VCH piercings, some women reported having their first orgasm only after getting pierced.
Though Angel says that while some of her clients start with nipple piercings and "move south from there," she reports that it's common for people to only pierce their genitals.
"Many of our genital piercing clients do not have any other piercings," she says. "Lots of them are suburban housewives looking to spice up their love lives. These are very 'normal' looking people with no other body art at all."
Some critics believe that genital piercing is motivated by masochism -- after all, what could seem more masochistic than driving a needle through the most sensitive part of your anatomy? The practice is also sometimes associated with self-destructive behaviors, like cutting.
Believe it or not, it may sound worse than it is, and Angel and Stirn both dispute the idea that masochism plays much of a role in the desire to be pierced. If pain is what you're after, genital piercing isn't really what you want because it doesn't really hurt that much, they say.
"It may pinch or sting a bit, but the word pain is really too strong to apply to what most people experience during a piercing," says Angel. "It is a common if largely unfounded assumption that it must be more painful to pierce the nether regions than other parts of the body. But I have plenty of clients tell me that their ear piercings hurt more."
Angel emphasizes that genital piercing is about increasing pleasure and not causing pain (or preventing sex, a misconception that perhaps stems from confusion between genital piercing and the practice of female circumcision).
Rites of Passage?
For some, genital piercing has a spiritual component. Some piercing devotees can get a little fuzzy and mystical on you when they start talking about piercing, lamenting the loss of ancient "rites of passage" in our dysfunctional modern society. Of course, we do have rites of passage in our society -- dressing up in a gown and mortarboard and getting a diploma, for instance -- and genital piercing never had symbolic meaning for most cultures. Besides, a rite of passage is usually a ceremony sanctioned and enforced by a person's society. Some might argue that a do-it-yourself rite of passage lacks this social context and could be considered the equivalent of making a diploma out of construction paper and crayons -- it might mean something to you, but it doesn't have any inherent significance to anyone else.
But this is precisely the point: for some, a piercing is imbued with individual meaning.
"People can and do use piercing to mark events," says Angel. "I have pierced people to mark everything -- births, deaths, anniversaries, graduations, clean and sober time, and reclaiming the body after childbirth."
After conducting research into piercing, Stirn agrees. "What struck me the most is that each piercee seems to have a story to tell," she says. "All of them seem to do it for a reason of which fashion seems to be the least important."
Stirn is particularly interested in how some women who have been sexually abused will use genital piercing therapeutically, and she is currently researching the subject further.
"In some of these cases, experiencing the pain of metal struck through private parts serves as a liberation of the formerly felt emotional pain," says Stirn. She believes that for some, piercing can mark a way of "reclaiming" body parts from memories of abuse.
Of course, there are risks to genital piercing, just as there are risks with any kind of piercing. What's tricky is that the degree of risk isn't really known, since piercing has proved to be a difficult practice to study.
"The possible variety of side effects is yet to be discovered," says Stirn, "and they will increase with the number of people getting pierced."
The most common side effect of piercing is infection, which can often be prevented by conscientious aftercare practices and good hygiene. However, infection should not be considered insignificant; it can spread and cause serious health problems, including sterility and potentially life-threatening conditions. If equipment isn't being sterilized at a piercing studio, the procedure has the potential to pass on any number of diseases, including leprosy, tetanus, tuberculosis, hepatitis, HIV, and other STDs.
Genital piercings do pose some distinct risks of their own. More invasive kinds of piercing, such as a piercing that runs through the head of the penis, should only be done by experienced piercers if by anyone at all, according to Stirn. Such piercings can result in serious bleeding and "the risk of impotence caused by hitting the erectile tissue by mistake is simply too high," she says. Piercing the clitoris itself, rather than the clitoral hood, is also a potentially risky procedure. Some genital piercings can result in scars or a narrowing of the urethra.
While certain types of genital piercings are prone to bleeding, their advantage is that the increased blood flow makes the tissue heal faster. While a VCH or a Prince Albert can heal in four to six weeks, a pierced navel can take up to 12 months. Stirn asserts that the risks of complications are "certainly higher" with navel piercings than genital.
On the whole, the biggest dangers posed by getting pierced stem from what you don't know. Since piercers aren't very heavily regulated, you don't really know whether the person piercing you is qualified or practicing the necessary safety precautions.
"Unfortunately, some studios are still operating without adequate sterilization equipment and pierce minors without even checking I.D., which is against the law," says Angel. "Enforcement is definitely lagging."
Piercing vs. Medicine
Given the potentially serious risks, many medical organizations have issued advisories warning against the practice. And obviously, no doctor can really be enthusiastic about piercing -- viewed medically, it's either an unnecessary medical procedure or a self-inflicted injury.
"I don't think any physician could endorse what is, essentially, self-mutilation," says Shelly Ann Sekula-Gibbs, clinical assistant professor of dermatology at Baylor College of Medicine in Houston. "I always discourage it in my practice when I'm asked about it."
But Stirn argues that doctors can be more sympathetic without endorsing the practice. She also believes that the tendency to react to pierced people with horror or condescension isn't very helpful.
"Doctors need to have a neutral attitude toward pierced individuals," Stirn tells WebMD. "It can be hard because a person with a lot of piercings can be distracting, I know. But most of the people with body piercings will get them no matter what the doctor says."
In addition, there are some practical concerns for the medical treatment of people with piercings. For instance, doctors in emergency rooms should know how the basic clasps work on piercings, so that they can be removed if necessary before surgery or other procedures.
Genital piercing is a "social reality," says Stirn, and as such, we -- and especially medical professionals -- need to accept it. She's almost certainly right: Whether you're fascinated by the idea or so repulsed by it that reading this article was torture, genital piercing is probably not going away any time soon.
SOURCES: BJU International, February 2003. Elayne Angel, medical coordinator, Association of Professional Piercers; owner of piercing studio Rings of Desire Inc., New Orleans. British Medical Journal, Dec. 18, 1999. Shelley Ann Sekula-Gibbs, MD, clinical assistant professor of dermatology, Baylor College of Medicine, Houston; former president , Texas Dermatological Society. The Lancet, April 5, 2003. Aglaja Stirn, MD, assistant director, Frankfurt University Teaching Hospital for Psychosomatic Medicine and Psychotherapy, Johann Wolfgang Goethe University Clinic, Frankfurt, Germany.