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Human sexuality

This article is about human sexual anatomy, sexuality and perceptions. For information specifically about sexual activities, see Human sexual activity.

The way people experience and express themselves sexually

Human sexuality is the way people experience and express themselves sexually.[1][2] This involves biological, erotic, physical, emotional, social, or spiritual feelings and behaviors.[3][4] Because it is a broad term, which has varied with historical contexts over time, it lacks a precise definition.[4] The biological and physical aspects of sexuality largely concern the human reproductive functions, including the human sexual response cycle.[3][4]

Someone's sexual orientation is their pattern of sexual interest in the opposite or same sex.[5] Physical and emotional aspects of sexuality include bonds between individuals that are expressed through profound feelings or physical manifestations of love, trust, and care. Social aspects deal with the effects of human society on one's sexuality, while spirituality concerns an individual's spiritual connection with others. Sexuality also affects and is affected by cultural, political, legal, philosophical, moral, ethical, and religious aspects of life.[3][4]

Interest in sexual activity typically increases when an individual reaches puberty.[6] Although no single theory on the cause of sexual orientation has yet gained widespread support, there is considerably more evidence supporting nonsocial causes of sexual orientation than social ones, especially for males. Hypothesized social causes are supported by only weak evidence, distorted by numerous confounding factors.[7] This is further supported by cross-cultural evidence, because cultures that are very tolerant of homosexuality do not have significantly higher rates of it.[8][9]

Evolutionary perspectives on human coupling, reproduction and reproduction strategies, and social learning theory provide further views of sexuality.[10] Sociocultural aspects of sexuality include historical developments and religious beliefs. Some cultures have been described as sexually repressive. The study of sexuality also includes human identity within social groups, sexually transmitted infections (STIs/STDs), and birth control methods.

There is considerably more evidence supporting innate causes of sexual orientation than learned ones, especially for males. This evidence includes the cross-cultural correlation of homosexuality and childhood gender nonconformity, moderate genetic influences found in twin studies, evidence for prenatal hormonal effects on brain organization, the fraternal birth order effect, and the finding that in rare cases where infant males were raised as girls due to physical deformity, they nevertheless turned out attracted to females. Hypothesized social causes are supported by only weak evidence, distorted by numerous confounding factors.[7]

Cross-cultural evidence also leans more toward non-social causes. Cultures that are very tolerant of homosexuality do not have significantly higher rates of it. Homosexual behavior is relatively common among boys in British single-sex boarding schools, but adult Britons who attended such schools are no more likely to engage in homosexual behavior than those who did not. In an extreme case, the Sambia people ritually require their boys to engage in homosexual behavior during adolescence before they have any access to females, yet most of these boys become heterosexual.[8][9]

It is not fully understood why genes causing homosexuality persist in the gene pool. One hypothesis involves kin selection, suggesting that homosexuals invest heavily enough in their relatives to offset the cost of not reproducing as much directly. This has not been supported by studies in Western cultures, but several studies in Samoa have found some support for this hypothesis. Another hypothesis involves sexually antagonistic genes, which cause homosexuality when expressed in males but increase reproduction when expressed in females. Studies in both Western and non-Western cultures have found support for this hypothesis.[7][11]

Psychological theories exist regarding the development and expression of gender differences in human sexuality. A number of them (including neo-analytic theories, sociobiological theories, social learning theory, social role theory, and script theory) agree in predicting that men should be more approving of casual sex (sex happening outside a stable, committed relationship such as marriage) and should also be more promiscuous (have a higher number of sexual partners) than women. These theories are mostly consistent with observed differences in males' and females' attitudes toward casual sex before marriage in the United States. Other aspects of human sexuality, such as sexual satisfaction, incidence of oral sex, and attitudes toward homosexuality and masturbation, show little to no observed difference between males and females. Observed gender differences regarding the number of sexual partners are modest, with males tending to have slightly more than females.[12]

Like other mammals, humans are primarily grouped into either the male or female sex,[13] with a small proportion (around 1% or 0.018%[14]) of intersex individuals, for whom sexual classification may not be as clear.[15]

The biological aspects of humans' sexuality deal with the reproductive system, the sexual response cycle, and the factors that affect these aspects. They also deal with the influence of biological factors on other aspects of sexuality, such as organic and neurological responses,[16] heredity, hormonal issues, gender issues, and sexual dysfunction.[17][pageneeded]

Males and females are anatomically similar; this extends to some degree to the development of the reproductive system. As adults, they have different reproductive mechanisms that enable them to perform sexual acts and to reproduce. Men and women react to sexual stimuli in a similar fashion with minor differences. Women have a monthly reproductive cycle, whereas the male sperm production cycle is more continuous.[18][19][20]

The hypothalamus is the most important part of the brain for sexual functioning. This is a small area at the base of the brain consisting of several groups of nerve cell bodies that receives input from the limbic system. Studies have shown that within lab animals, destruction of certain areas of the hypothalamus causes the elimination of sexual behavior.[citation needed] The hypothalamus is important because of its relationship to the pituitary gland, which lies beneath it. The pituitary gland secretes hormones that are produced in the hypothalamus and itself. The four important sexual hormones are oxytocin, prolactin, follicle-stimulating hormone, and luteinizing hormone.[18][pageneeded]

Oxytocin, sometimes referred to as the "love hormone,"[citation needed] is released in both sexes during sexual intercourse when an orgasm is achieved.[citation needed] Oxytocin has been suggested as critical to the thoughts and behaviors required to maintain close relationships.[21][22][verification needed] The hormone is also released in women when they give birth or are breastfeeding.[23] Both prolactin and oxytocin stimulate milk production in women.[citation needed] Follicle-stimulating hormone (FSH) is responsible for ovulation in women, which acts by triggering egg maturity; in men it stimulates sperm production.[24] Luteinizing hormone (LH) triggers ovulation, which is the release of a mature egg.[18][pageneeded]

Males also have both internal and external genitalia that are responsible for procreation and sexual intercourse. Production of spermatozoa (sperm) is also cyclic, but unlike the female ovulation cycle, the sperm production cycle is constantly producing millions of sperm daily.[18][pageneeded]

The male genitalia are the penis and the scrotum. The penis provides a passageway for sperm and urine. An average-sized flaccid penis is about 334 inches (9.5cm) in length and 115 inches (3.0cm) in diameter. When erect, the average penis is between 412 inches (11cm) to 6 inches (15cm) in length and 112 inches (3.8cm) in diameter. The penis's internal structures consist of the shaft, glans, and the root.[18][pageneeded]

The shaft of the penis consists of three cylindrical bodies of spongy tissue filled with blood vessels along its length. Two of these bodies lie side-by-side in the upper portion of the penis called corpora cavernosa. The third, called the corpus spongiosum, is a tube that lies centrally beneath the others and expands at the end to form the tip of the penis (glans).[25]

The raised rim at the border of the shaft and glans is called the corona. The urethra runs through the shaft, providing an exit for sperm and urine. The root consists of the expanded ends of the cavernous bodies, which fan out to form the crura and attach to the pubic bone and the expanded end of the spongy body (bulb). The root is surrounded by two muscles; the bulbocavernosus muscle and the ischiocavernosus muscle, which aid urination and ejaculation. The penis has a foreskin that typically covers the glans; this is sometimes removed by circumcision for medical, religious or cultural reasons.[18][pageneeded] In the scrotum, the testicles are held away from the body, one possible reason for this is so sperm can be produced in an environment slightly lower than normal body temperature.[26][27]

Male internal reproductive structures are the testicles, the duct system, the prostate and seminal vesicles, and the Cowper's gland.[18][pageneeded]

The testicles (male gonads), are where sperm and male hormones are produced. Millions of sperm are produced daily in several hundred seminiferous tubules. Cells called the Leydig cells lie between the tubules; these produce hormones called androgens; these consist of testosterone and inhibin. The testicles are held by the spermatic cord, which is a tubelike structure containing blood vessels, nerves, the vas deferens, and a muscle that helps to raise and lower the testicles in response to temperature changes and sexual arousal, in which the testicles are drawn closer to the body.[18][pageneeded]

Sperm gets transported through a four-part duct system. The first part of this system is the epididymis. The testicles converge to form the seminiferous tubules, coiled tubes at the top and back of each testicle. The second part of the duct system is the vas deferens, a muscular tube that begins at the lower end of the epididymis.[18][pageneeded] The vas deferens passes upward along the side of the testicles to become part of the spermatic cord.[25] The expanded end is the ampulla, which stores sperm before ejaculation. The third part of the duct system is the ejaculatory ducts, which are 1-inch (2.5cm)-long paired tubes that pass through the prostate gland, where semen is produced.[18][pageneeded] The prostate gland is a solid, chestnut-shaped organ that surrounds the first part of the urethra, which carries urine and semen.[18][pageneeded][25] Similar to the female G-spot, the prostate provides sexual stimulation and can lead to orgasm through anal sex.[29]

The prostate gland and the seminal vesicles produce seminal fluid that is mixed with sperm to create semen.[18][pageneeded] The prostate gland lies under the bladder and in front of the rectum. It consists of two main zones: the inner zone that produces secretions to keep the lining of the male urethra moist and the outer zone that produces seminal fluids to facilitate the passage of semen.[25] The seminal vesicles secrete fructose for sperm activation and mobilization, prostaglandins to cause uterine contractions that aid movement through the uterus, and bases that help neutralize the acidity of the vagina. The Cowper's glands, or bulbourethral glands, are two pea sized structures beneath the prostate.

The mons veneris, also known as the Mound of Venus, is a soft layer of fatty tissue overlaying the pubic bone.[30] Following puberty, this area grows in size. It has many nerve endings and is sensitive to stimulation.[18][pageneeded]

The labia minora and labia majora are collectively known as the lips. The labia majora are two elongated folds of skin extending from the mons to the perineum. Its outer surface becomes covered with hair after puberty. In between the labia majora are the labia minora, two hairless folds of skin that meet above the clitoris to form the clitoral hood, which is highly sensitive to touch. The labia minora become engorged with blood during sexual stimulation, causing them to swell and turn red.[18][pageneeded]

The labia minora are composed of connective tissues that are richly supplied with blood vessels which cause the pinkish appearance. Near the anus, the labia minora merge with the labia majora.[31] In a sexually unstimulated state, the labia minora protects the vaginal and urethral opening by covering them.[32] At the base of the labia minora are the Bartholin's glands, which add a few drops of an alkaline fluid to the vagina via ducts; this fluid helps to counteract the acidity of the outer vagina since sperm cannot live in an acidic environment.[18][pageneeded]

The clitoris is developed from the same embryonic tissue as the penis; it or its glans alone consists of as many (or more in some cases) nerve endings as the human penis or glans penis, making it extremely sensitive to touch.[33][34][35] The clitoral glans, which is a small, elongated erectile structure, has only one known functionsexual sensations. It is the main source of orgasm in women.[36][37][38][39] Thick secretions called smegma collect in the clitoris.[18][pageneeded]

The vaginal opening and the urethral opening are only visible when the labia minora are parted. These opening have many nerve endings that make them sensitive to touch. They are surrounded by a ring of sphincter muscles called the bulbocavernosus muscle. Underneath this muscle and on opposite sides of the vaginal opening are the vestibular bulbs, which help the vagina grip the penis by swelling with blood during arousal. Within the vaginal opening is the hymen, a thin membrane that partially covers the opening in many virgins. Rupture of the hymen has been historically considered the loss of one's virginity, though by modern standards, loss of virginity is considered to be the first sexual intercourse. The hymen can be ruptured by activities other than sexual intercourse. The urethral opening connects to the bladder with the urethra; it expels urine from the bladder. This is located below the clitoris and above the vaginal opening.[18][pageneeded]

The breasts are the subcutaneous tissues on the front thorax of the female body.[31] Though they are not technically part of a woman's sexual anatomy, they do have roles in both sexual pleasure and reproduction.[40] Breasts are modified sweat glands made up of fibrous tissues and fat that provide support and contain nerves, blood vessels and lymphatic vessels.[31] Their main purpose is to provide milk to a developing infant. Breasts develop during puberty in response to an increase in estrogen. Each adult breast consists of 15 to 20 milk-producing mammary glands, irregularly shaped lobes that include alveolar glands and a lactiferous duct leading to the nipple. The lobes are separated by dense connective tissues that support the glands and attach them to the tissues on the underlying pectoral muscles.[31] Other connective tissue, which forms dense strands called suspensory ligaments, extends inward from the skin of the breast to the pectoral tissue to support the weight of the breast.[31] Heredity and the quantity of fatty tissue determine the size of the breasts.[18][pageneeded]

Men typically find female breasts attractive[41] and this holds true for a variety of cultures.[42][43][44] In women, stimulation of the nipple seems to result in activation of the brain's genital sensory cortex (the same region of the brain activated by stimulation of the clitoris, vagina, and cervix).[45] This may be why many women find nipple stimulation arousing and why some women are able to orgasm by nipple stimulation alone.[40]

The female internal reproductive organs are the vagina, uterus, Fallopian tubes, and ovaries. The vagina is a sheath-like canal that extends from the vulva to the cervix. It receives the penis during intercourse and serves as a depository for sperm. The vagina is also the birth canal; it can expand to 10cm (3.9in) during labor and delivery. The vagina is located between the bladder and the rectum. The vagina is normally collapsed, but during sexual arousal it opens, lengthens, and produces lubrication to allow the insertion of the penis. The vagina has three layered walls; it is a self-cleaning organ with natural bacteria that suppress the production of yeast.[18][pageneeded] The G-spot, named after the Ernst Grfenberg who first reported it in 1950, may be located in the front wall of the vagina and may cause orgasms. This area may vary in size and location between women; in some it may be absent. Various researchers dispute its structure or existence, or regard it as an extension of the clitoris.[47][48][49]

The uterus or womb is a hollow, muscular organ where a fertilized egg (ovum) will implant itself and grow into a fetus.[18][pageneeded] The uterus lies in the pelvic cavity between the bladder and the bowel, and above the vagina. It is usually positioned in a 90-degree angle tilting forward, although in about 20% of women it tilts backwards.[31] The uterus has three layers; the innermost layer is the endometrium, where the egg is implanted. During ovulation, this thickens for implantation. If implantation does not occur, it is sloughed off during menstruation. The cervix is the narrow end of the uterus. The broad part of the uterus is the fundus.[18][pageneeded]

During ovulation, the ovum travels down the Fallopian tubes to the uterus. These extend about four inches (10cm) from both sides of the uterus. Finger-like projections at the ends of the tubes brush the ovaries and receive the ovum once it is released. The ovum then travels for three to four days to the uterus.[18][pageneeded] After sexual intercourse, sperm swim up this funnel from the uterus. The lining of the tube and its secretions sustain the egg and the sperm, encouraging fertilization and nourishing the ovum until it reaches the uterus. If the ovum divides after fertilization, identical twins are produced. If separate eggs are fertilized by different sperm, the mother gives birth to non-identical or fraternal twins.[31]

The ovaries (female gonads), develop from the same embryonic tissue as the testicles. The ovaries are suspended by ligaments and are the source where ova are stored and developed before ovulation. The ovaries also produce female hormones progesterone and estrogen. Within the ovaries, each ovum is surrounded by other cells and contained within a capsule called a primary follicle. At puberty, one or more of these follicles are stimulated to mature on a monthly basis. Once matured, these are called Graafian follicles.[18][pageneeded] The female reproductive system does not produce the ova; about 60,000 ova are present at birth, only 400 of which will mature during the woman's lifetime.[31]

Ovulation is based on a monthly cycle; the 14th day is the most fertile. On days one to four, menstruation and production of estrogen and progesterone decreases, and the endometrium starts thinning. The endometrium is sloughed off for the next three to six days. Once menstruation ends, the cycle begins again with an FSH surge from the pituitary gland. Days five to thirteen are known as the pre-ovulatory stage. During this stage, the pituitary gland secretes follicle-stimulating hormone (FSH). A negative feedback loop is enacted when estrogen is secreted to inhibit the release of FSH. Estrogen thickens the endometrium of the uterus. A surge of Luteinizing Hormone (LH) triggers ovulation.

On day 14, the LH surge causes a Graafian follicle to surface the ovary. The follicle ruptures and the ripe ovum is expelled into the abdominal cavity. The fallopian tubes pick up the ovum with the fimbria. The cervical mucus changes to aid the movement of sperm. On days 15 to 28the post-ovulatory stage, the Graafian folliclenow called the corpus luteumsecretes estrogen. Production of progesterone increases, inhibiting LH release. The endometrium thickens to prepare for implantation, and the ovum travels down the Fallopian tubes to the uterus. If the ovum is not fertilized and does not implant, menstruation begins.[18][pageneeded]

The sexual response cycle is a model that describes the physiological responses that occur during sexual activity. This model was created by William Masters and Virginia Johnson. According to Masters and Johnson, the human sexual response cycle consists of four phases; excitement, plateau, orgasm, and resolution, also called the EPOR model. During the excitement phase of the EPOR model, one attains the intrinsic motivation to have sex. The plateau phase is the precursor to orgasm, which may be mostly biological for men and mostly psychological for women. Orgasm is the release of tension, and the resolution period is the unaroused state before the cycle begins again.[18][pageneeded]

The male sexual response cycle starts in the excitement phase; two centers in the spine are responsible for erections. Vasoconstriction in the penis begins, the heart rate increases, the scrotum thickens, the spermatic cord shortens, and the testicles become engorged with blood. In the plateau phase, the penis increases in diameter, the testicles become more engorged, and the Cowper's glands secrete pre-seminal fluid. The orgasm phase, during which rhythmic contractions occur every 0.8 seconds[verification needed], consists of two phases; the emission phase, in which contractions of the vas deferens, prostate, and seminal vesicles encourage ejaculation, which is the second phase of orgasm. Ejaculation is called the expulsion phase; it cannot be reached without an orgasm. In the resolution phase, the male is now in an unaroused state consisting of a refactory (rest) period before the cycle can begin. This rest period may increase with age.[18][pageneeded]

The female sexual response begins with the excitement phase, which can last from several minutes to several hours. Characteristics of this phase include increased heart and respiratory rate, and an elevation of blood pressure. Flushed skin or blotches of redness may occur on the chest and back; breasts increase slightly in size and nipples may become hardened and erect. The onset of vasocongestion results in swelling of the clitoris, labia minora, and vagina. The muscle that surrounds the vaginal opening tightens and the uterus elevates and grows in size. The vaginal walls begin to produce a lubricating liquid. The second phase, called the plateau phase, is characterized primarily by the intensification of the changes begun during the excitement phase. The plateau phase extends to the brink of orgasm, which initiates the resolution stage; the reversal of the changes begun during the excitement phase. During the orgasm stage the heart rate, blood pressure, muscle tension, and breathing rates peak. The pelvic muscle near the vagina, the anal sphincter, and the uterus contract. Muscle contractions in the vaginal area create a high level of pleasure, though all orgasms are centered in the clitoris.[18][pageneeded][50][51][52]

Sexual disorders, according to the DSM-IV-TR, are disturbances in sexual desire and psycho-physiological changes that characterize the sexual response cycle and cause marked distress and interpersonal difficulty. The sexual dysfunctions is a result of physical or psychological disorders. The physical causes include hormonal imbalance, diabetes, heart disease and more. The psychological causes includes but are not limited to stress, anxiety, and depression.[53] The sexual dysfunction affects men and women. There are four major categories of sexual problems for women: desire disorders, arousal disorders, orgasmic disorders, and sexual pain disorders.[18][pageneeded] The sexual desire disorder occurs when an individual lacks the sexual desire because of hormonal changes, depression, and pregnancy.The arousal disorder is a female sexual dysfunction. Arousal disorder means lack of vaginal lubrication. In addition, blood flow problems may affect arousal disorder. Lack of orgasm, also known as, anorgasmia is another sexual dysfunction in women. The anorgasmia occurs in women with psychological disorders such as guilt and anxiety that was caused by sexual assault. The last sexual disorder is the painful intercourse. The sexual disorder can be result of pelvic mass, scar tissue, sexually transmitted disease and more.[54]

There are also three common sexual disorders for men including, sexual desire, ejaculation disorder, and erectile dysfunction. The lack of sexual desire in men is because of loss of libido, low testosterone. There are also psychological factors such as anxiety, and depression.[55]The ejaculation disorder has three types: retrograde ejaculation, retarded ejaculation, premature ejaculation. The erectile dysfunction is a disability to have and maintain an erection during intercourse.[56]

As one form of behavior, the psychological aspects of sexual expression have been studied in the context of emotional involvement, gender identity, intersubjective intimacy, and Darwinian reproductive efficacy. Sexuality in humans generates profound emotional and psychological responses. Some theorists identify sexuality as the central source of human personality.[57] Psychological studies of sexuality focus on psychological influences that affect sexual behavior and experiences.[17][pageneeded] Early psychological analyses were carried out by Sigmund Freud, who believed in a psychoanalytic approach. He also proposed the concepts of psychosexual development and the Oedipus complex, among other theories.[58]

Gender identity is a person's sense of their own gender, whether male, female, or non-binary.[59] Gender identity can correlate with assigned sex at birth or can differ from it.[60] All societies have a set of gender categories that can serve as the basis of the formation of a person's social identity in relation to other members of society.[61]

Sexual behavior and intimate relationships are strongly influenced by a person's sexual orientation.[62]

Sexual orientation is an enduring pattern of romantic or sexual attraction (or a combination of these) to persons of the opposite sex, same sex, or both sexes.[62] Heterosexual people are romantically/sexually attracted to the members of the opposite sex, gay and lesbian people are romantically/sexually attracted to people of the same sex, and those who are bisexual are romantically/sexually attracted to both sexes.[5]

The idea that homosexuality results from reversed gender roles is reinforced by the media's portrayal of male homosexuals as effeminate and female homosexuals as masculine.[63][pageneeded] However, a person's conformity or non-conformity to gender stereotypes does not always predict sexual orientation. Society believes that if a man is masculine he is heterosexual, and if a man is feminine he is homosexual. There is no strong evidence that a homosexual or bisexual orientation must be associated with atypical gender roles. By the early 21st century, homosexuality was no longer considered to be a pathology. Theories have linked many factors, including genetic, anatomical, birth order, and hormones in the prenatal environment, to homosexuality.[63][pageneeded]

Other than the need to procreate, there are many other reasons people have sex. According to one study conducted on college students (Meston & Buss, 2007), the four main reasons for sexual activities are; physical attraction, as a means to an end, to increase emotional connection, and to alleviate insecurity.[64]

Until Sigmund Freud published his Three Essays on the Theory of Sexuality in 1905, children were often regarded as asexual, having no sexuality until later development. Sigmund Freud was one of the first researchers to take child sexuality seriously. His ideas, such as psychosexual development and the Oedipus conflict, have been much debated but acknowledging the existence of child sexuality was an important development.[65]

Freud gave sexual drives an importance and centrality in human life, actions, and behavior; he said sexual drives exist and can be discerned in children from birth. He explains this in his theory of infantile sexuality, and says sexual energy (libido) is the most important motivating force in adult life. Freud wrote about the importance of interpersonal relationships to one's sexual and emotional development. From birth, the mother's connection to the infant affects the infant's later capacity for pleasure and attachment.[66] Freud described two currents of emotional life; an affectionate current, including our bonds with the important people in our lives; and a sensual current, including our wish to gratify sexual impulses. During adolescence, a young person tries to integrate these two emotional currents.[67]

Alfred Kinsey also examined child sexuality in his Kinsey Reports. Children are naturally curious about their bodies and sexual functions. For example, they wonder where babies come from, they notice the differences between males and females, and many engage in genital play, which is often mistaken for masturbation. Child sex play, also known as playing doctor, includes exhibiting or inspecting the genitals. Many children take part in some sex play, typically with siblings or friends.[65] Sex play with others usually decreases as children grow, but they may later possess romantic interest in their peers. Curiosity levels remain high during these years, but the main surge in sexual interest occurs in adolescence.[65]

Adult sexuality originates in childhood. However, like many other human capacities, sexuality is not fixed, but matures and develops. A common stereotype associated with old people is that they tend to lose interest and the ability to engage in sexual acts once they reach late adulthood. This misconception is reinforced by Western popular culture, which often ridicules older adults who try to engage in sexual activities. Age does not necessarily change the need or desire to be sexually expressive or active. A couple in a long-term relationship may find that the frequency of their sexual activity decreases over time and the type of sexual expression may change, but many couples experience increased intimacy and love.[68]

Human sexuality can be understood as part of the social life of humans, which is governed by implied rules of behavior and the status quo. This narrows the view to groups within a society.[17][pageneeded] The socio-cultural context of society, including the effects of politics and the mass media, influences and forms social norms. Throughout history, social norms have been changing and continue to change as a result of movements such as the sexual revolution and the rise of feminism.[71][72]

The age and manner in which children are informed of issues of sexuality is a matter of sex education. The school systems in almost all developed countries have some form of sex education, but the nature of the issues covered varies widely. In some countries, such as Australia and much of Europe, age-appropriate sex education often begins in pre-school, whereas other countries leave sex education to the pre-teenage and teenage years.[73] Sex education covers a range of topics, including the physical, mental, and social aspects of sexual behavior. Geographic location also plays a role in society's opinion of the appropriate age for children to learn about sexuality. According to TIME magazine and CNN,[full citation needed] 74% of teenagers in the United States reported that their major sources of sexual information were their peers and the media, compared to 10% who named their parents or a sex education course.[18][pageneeded]

In the United States, most sex education programs encourage abstinence, the choice to restrain oneself from sexual activity. In contrast, comprehensive sex education aims to encourage students to take charge of their own sexuality and know how to have safe, healthy, and pleasurable sex if and when they choose to do so.[74]

Proponents for an abstinence-only education believe that teaching a comprehensive curriculum would encourage teenagers to have sex, while proponents for comprehensive sex education argue that many teenagers will have sex regardless and should be equipped with knowledge of how to have sex responsibly. According to data from the National Longitudinal Survey of Youth, many teens who intend to be abstinent fail to do so, and when these teenagers do have sex, many do not use safe sex practices such as contraceptives.[75]

Sexuality has been an important, vital part of human existence throughout history.[76][pageneeded] All civilizations have managed sexuality through sexual standards, representations, and behavior.[76][pageneeded]

Before the rise of agriculture, groups of hunter/gatherers (H/G) and nomads inhabited the world. Within these groups, some implications of male dominance existed, but there were signs that women were active participants in sexuality, with bargaining power of their own. These hunter/gatherers had less restrictive sexual standards that emphasized sexual pleasure and enjoyment, but with definite rules and constraints. Some underlying continuities or key regulatory standards contended with the tension between recognition of pleasure, interest, and the need to procreate for the sake of social order and economic survival. H/G groups also placed high value on certain types of sexual symbolism.

Two common tensions in H/G societies are expressed in their art, which emphasizes male sexuality and prowess, with equally common tendencies to blur gender lines in sexual matters. One example of these male-dominated portrayals is the Egyptian creation myth, in which the sun god Atum masturbates in the water, creating the Nile River. In Sumerian myth, the Gods' semen filled the Tigris.[76][pageneeded]

Once agricultural societies emerged, the sexual framework shifted in ways that persisted for many millennia in much of Asia, Africa, Europe, and parts of the Americas. One common characteristic new to these societies was the collective supervision of sexual behavior due to urbanization, and the growth of population and population density. Children would commonly witness parents having sex because many families shared the same sleeping quarters. Due to landownership, determination of children's paternity became important, and society and family life became patriarchal.[citation needed] These changes in sexual ideology were used to control female sexuality and to differentiate standards by gender. With these ideologies, sexual possessiveness and increases in jealousy emerged. With the domestication of animals, new opportunities for bestiality arose.

Males mostly performed these types of sexual acts and many societies acquired firm rules against it. These acts also explain the many depictions of half-human, half-animal mythical creatures, and the sports of gods and goddesses with animals.[76] While retaining the precedents of earlier civilizations, each classical civilization established a somewhat distinctive approach to gender, artistic expression of sexual beauty, and to behaviors such as homosexuality. Some of these distinctions are portrayed in sex manuals, which were also common among civilizations in China, Greece, Rome, Persia, and India; each has its own sexual history.[76][pageneeded]

Before the High Middle Ages, homosexual acts appear to have been ignored or tolerated by the Christian church.[77] During the 12th century, hostility toward homosexuality began to spread throughout religious and secular institutions. By the end of the 19th century, it was viewed as a pathology.[77]

During the beginning of the industrial revolution of the 18th and 19th centuries, many changes in sexual standards occurred. New, dramatic, artificial birth control devices such as the condom and diaphragm were introduced. Doctors started claiming a new role in sexual matters, urging that their advice was crucial to sexual morality and health. New pornographic industries grew and Japan adopted its first laws against homosexuality. In Western societies, the definition of homosexuality was constantly changing; Western influence on other cultures became more prevalent. New contacts created serious issues around sexuality and sexual traditions. There were also major shifts in sexual behavior. During this period, puberty began occurring at younger ages, so a new focus on adolescence as a time of sexual confusion and danger emerged. There was a new focus on the purpose of marriage; it was increasing regarded as being for love rather than only for economics and reproduction.[76][pageneeded]

Havelock Ellis and Sigmund Freud adopted more accepting stances toward homosexuality; Ellis said homosexuality was inborn and therefore not immoral, not a disease, and that many homosexuals made significant contributions to society.[77] Freud wrote that all human beings as capable of becoming either heterosexual or homosexual; neither orientation was assumed to be innate.[63][pageneeded] According to Freud, a person's orientation depended on the resolution of the Oedipus complex. He said male homosexuality resulted when a young boy had an authoritarian, rejecting mother and turned to his father for love and affection, and later to men in general. He said female homosexuality developed when a girl loved her mother and identified with her father, and became fixated at that stage.[63][pageneeded]

Alfred Kinsey initiated the modern era of sex research. He collected data from questionnaires given to his students at Indiana University, but then switched to personal interviews about sexual behaviors. Kinsey and his colleagues sampled 5,300 men and 5,940 women. He found that most people masturbated, that many engaged in oral sex, that women are capable of having multiple orgasms, and that many men had had some type of homosexual experience in their lifetimes. Many[who?]believe he was the major influence in changing 20th century attitudes about sex. Kinsey Institute for Research in Sex, Gender, and Reproduction at Indiana University continues to be a major center for the study of human sexuality.[18][pageneeded]

Before William Masters, a physician, and Virginia Johnson, a behavioral scientist, the study of anatomy and physiological studies of sex was still limited to experiments with laboratory animals. Masters and Johnson started to directly observe and record the physical responses in humans that are engaged in sexual activity under laboratory settings. They observed 10,000 episodes of sexual acts between 312 men and 382 women. This led to methods of treating clinical problems and abnormalities. Masters and Johnson opened the first sex therapy clinic in 1965. In 1970, they described their therapeutic techniques in their book, Human Sexual Inadequacy.[full citation needed][18][pageneeded]

In the first edition of The Diagnostic and Statistical Manual of Mental Disorders, the American Psychiatric Association classified homosexuality as a mental illness, and more specifically, a "sociopathic personality disturbance".[78] This definition remained the professional understanding of homosexuality until 1973 when the American Psychiatric Association removed homosexuality from their list of diagnoses for mental disorders.[78] Through her research of heterosexual and homosexual men, Evelyn Hooker revealed that there was no correlation between homosexuality and psychological maladjustment,[79] and her findings played a pivotal role in shifting the scientific community away from the perspective that homosexuality was something that needed to be treated or cured.[citation needed]

European conquerors/colonists found sexuality out of their norm about 1516 when Vasco Nunez de Balboa, a Spanish explorer, discovered indigenous people in Central America with different sexual practices. Balboa found some indigenous men dressed up as women,[clarification needed] resulting in him feeding forty of these men to his dogs for having different sexual practices. In North America and the United States, Europeans have used claims of sexual immorality to justify discrimination against racial and ethnic minorities.[80][full citation needed]

Scholars also study the ways in which colonialism has affected sexuality today and argue that due to racism and slavery it has been dramatically changed from the way it had previously been understood.[81]

In her book, Carnal Knowledge and Imperial Power: Gender, Race, and Morality in Colonial Asia, Laura Stoler investigates how the Dutch used sexual control and gender-specific sexual sanctions to distinguish between the rulers from the ruled and enforce colonial domination onto the people of Indonesia.[82]

In America, there are 155 native tribes that are recorded to have embraced two-spirit people within their tribes, but the total number of tribes could be greater than what is documented.[83] Two-spirit people were and still are members of communities who do not fall under Western gender categories of male and female, but rather under a "third gender" category.[84] This system of gender contradicts both the gender binary and the assertion that sex and gender are the same.[85] Instead of conforming to traditional roles of men and women, two-spirit fill a special niche in their communities.

For example, two-spirited people are commonly revered for possessing special wisdom and spiritual powers.[85] Two-spirited people also can take part in marriages, either monogamous and polygamous ones.[86] Historically, European colonizers perceived relationships involving two-spirited people as homosexuality, and therefore believed in the moral inferiority of native people.[85] In reaction, colonizers began to impose their own religious and social norms on indigenous communities, diminishing the role of two-spirit people in native cultures.[87] Within reservations, the Religious Crime Code of the 1880s explicitly aimed to "aggressively attack Native sexual and marriage practices".[85] The goal of colonizers was for native peoples to assimilate into Euro-American ideals of family, sexuality, gender expression, and more.[85]

The link between constructed sexual meanings and racial ideologies has been studied. According to Joane Nagel, sexual meanings are constructed to maintain racial-ethnic-national boundaries by the denigration of "others" and regulation of sexual behavior within the group. She writes, "both adherence to and deviation from such approved behaviors, define and reinforce racial, ethnic, and nationalist regimes".[88][89] In the United States people of color face the effects of colonialism in different ways with stereotypes such as the Mammy, and Jezebel for Black women; lotus blossom, and dragon lady for Asian women; and the "spicy" Latina.[90] These stereotypes contrast with standards of sexual conservatism, creating a dichotomy that dehumanizes and demonizes the stereotyped groups. An example of a stereotype that lies at the intersection of racism, classism, and misogyny is the archetype of the welfare queen. Cathy Cohen describes how the "welfare queen" stereotype demonizes poor black single mothers for deviating from conventions surrounding family structure.[91]

Reproductive and sexual rights encompass the concept of applying human rights to issues related to reproduction and sexuality.[92] This concept is a modern one, and remains controversial since it deals, directly and indirectly, with issues such as contraception, LGBT rights, abortion, sex education, freedom to choose a partner, freedom to decide whether to be sexually active or not, right to bodily integrity, freedom to decide whether or not, and when, to have children.[93][94] These are all global issues that exist in all cultures to some extent, but manifest differently depending on the specific contexts.

According to the Swedish government, "sexual rights include the right of all people to decide over their own bodies and sexuality" and "reproductive rights comprise the right of individuals to decide on the number of children they have and the intervals at which they are born."[95] Such rights are not accepted in all cultures, with practices such criminalization of consensual sexual activities (such as those related to homosexual acts and sexual acts outside marriage), acceptance of forced marriage and child marriage, failure to criminalize all non-consensual sexual encounters (such as marital rape), female genital mutilation, or restricted availability of contraception, being common around the world.[96][97]

In 1915, Emma Goldman and Margaret Sanger,[98] leaders of the birth control movement, began to spread information regarding contraception in opposition to the laws, such as the Comstock Law,[99] that demonized it. One of their main purposes was to assert that the birth control movement was about empowering women with personal reproductive and economic freedom for those who could not afford to parent a child or simply did not want one. Goldman and Sanger saw it necessary to educate people as contraceptives were quickly being stigmatized as a population control tactic due to being a policy limiting births, disregarding that this limitation did not target ecological, political, or large economic conditions.[100] This stigma targeted lower-class women who had the most need of access to contraception.

Birth control finally began to lose stigma in 1936 when the ruling of U.S. v. One Package[101] declared that prescribing contraception to save a person's life or well-being was no longer illegal under the Comstock Law. Although opinions varied on when birth control should be available to women, by 1938, there were 347 birth control clinics in the United States but advertising their services remained illegal.

The stigma continued to lose credibility as First Lady Eleanor Roosevelt publicly showed her support for birth control through the four terms her husband served (19331945). However, it was not until 1966 that the Federal Government began to fund family planning and subsidized birth control services for lower-class women and families at the order of President Lyndon B. Johnson. This funding continued after 1970 under the Family Planning Services and Population Research Act.[102] Today, all Health Insurance Marketplace plans are required to cover all forms of contraception, including sterilization procedures, as a result of The Affordable Care Act signed by President Barack Obama in 2010.[103]

In 1981, doctors diagnosed the first reported cases of AIDS in America. The disease disproportionately affected and continues to affect gay and bisexual men, especially black and Latino men.[104] The Reagan administration is criticized for its apathy towards the AIDS epidemic, and audio recordings reveal that Ronald Reagan's press secretary Larry Speakes viewed the epidemic as a joke, mocking AIDS by calling it the "gay plague".[105] The epidemic also carried stigma coming from religious influences. For example, Cardinal Krol voiced that AIDS was "an act of vengeance against the sin of homosexuality", which clarifies the specific meaning behind the pope's mention of "the moral source of AIDS."[106]

Activism during the AIDS crisis focused on promoting safe sex practices to raise awareness that the disease could be prevented. The "Safe Sex is Hot Sex" campaign, for example, aimed to promote the use of condoms.[107] Campaigns by the U.S. government, however, diverged from advocacy of safe sex. In 1987, Congress even denied federal funding from awareness campaigns that "[promoted] or [encouraged], directly or indirectly, homosexual activities".[107] Instead, campaigns by the government primarily relied on scare tactics in order to instill fear in men who had sex with other men.[107]

In addition to prevention campaigns, activists also sought to counteract narratives that led to the "social death" for people living with AIDS.[108] Gay men from San Francisco and New York City created the Denver Principles, a foundational document that demanded the rights, agency, and dignity of people living with AIDS.[108]

In his article "Emergence of Gay Identity and Gay Social Movements in Developing Countries", Matthew Roberts discusses how international AIDS prevention campaigns created opportunities for gay men to interact with other openly gay men from other countries.[109] These interactions allowed western gay "culture" to be introduced to gay men in countries where homosexuality wasn't an important identifier. Thus, group organizers self-identified as gay more and more, creating the basis for further development of gay consciousness in different countries.[109]

In humans, sexual intercourse and sexual activity in general have been shown to have health benefits, such as an improved sense of smell,[citation needed] reduction in stress and blood pressure,[110][111] increased immunity,[112] and decreased risk of prostate cancer.[113][114][115] Sexual intimacy and orgasms increase levels of oxytocin, which helps people bond and build trust.[116][117][118]

A long-term study of 3,500 people between ages 30 and 101 by clinical neuropsychologist David Weeks, MD, head of old-age psychology at the Royal Edinburgh Hospital in Scotland, said he found that "sex helps you look between four and seven years younger", according to impartial ratings of the subjects' photographs. Exclusive causation, however, is unclear, and the benefits may be indirectly related to sex and directly related to significant reductions in stress, greater contentment, and better sleep that sex promotes.[119][120][121]

Sexual intercourse can also be a disease vector.[122] There are 19 million new cases of sexually transmitted diseases (STD) every year in the U.S.,[123] and worldwide there are over 340 million STD infections each year.[124] More than half of these occur in adolescents and young adults aged 1524 years.[125] At least one in four U.S. teenage girls has a sexually transmitted disease.[123][126] In the U.S., about 30% of 15- to 17-year-olds have had sexual intercourse, but only about 80% of 15- to 19-year-olds report using condoms for their first sexual intercourse.[127] In one study, more than 75% of young women age 1825 years felt they were at low risk of acquiring an STD.[128]

People both consciously and subconsciously seek to attract others with whom they can form deep relationships. This may be for companionship, procreation, or an intimate relationship. This involves interactive processes whereby people find and attract potential partners and maintain a relationship. These processes, which involve attracting one or more partners and maintaining sexual interest, can include:

Sexual attraction is attraction on the basis of sexual desire or the quality of arousing such interest.[135][136] Sexual attractiveness or sex appeal is an individual's ability to attract the sexual or erotic interest of another person, and is a factor in sexual selection or mate choice. The attraction can be to the physical or other qualities or traits of a person, or to such qualities in the context in which they appear. The attraction may be to a person's aesthetics or movements or to their voice or smell, besides other factors. The attraction may be enhanced by a person's adornments, clothing, perfume, hair length and style, and anything else which can attract the sexual interest of another person. It can also be influenced by individual genetic, psychological, or cultural factors, or to other, more amorphous qualities of the person. Sexual attraction is also a response to another person that depends on a combination of the person possessing the traits and also on the criteria of the person who is attracted.

Though attempts have been made to devise objective criteria of sexual attractiveness, and measure it as one of several bodily forms of capital asset (see erotic capital), a person's sexual attractiveness is to a large extent a subjective measure dependent on another person's interest, perception, and sexual orientation. For example, a gay or lesbian person would typically find a person of the same sex to be more attractive than one of the other sex. A bisexual person would find either sex to be attractive.

In addition, there are asexual people, who usually do not experience sexual attraction for either sex, though they may have romantic attraction (homoromantic, biromantic or heteroromantic). Interpersonal attraction includes factors such as physical or psychological similarity, familiarity or possessing a preponderance of common or familiar features, similarity, complementarity, reciprocal liking, and reinforcement.[137]

The ability of a person's physical and other qualities to create a sexual interest in others is the basis of their use in advertising, music video, pornography, film, and other visual media, as well as in modeling, sex work and other occupations.

Globally, laws regulate human sexuality in several ways, including criminalizing particular sexual behaviors, granting individuals the privacy or autonomy to make their own sexual decisions, protecting individuals with regard to equality and non-discrimination, recognizing and protecting other individual rights, as well as legislating matters regarding marriage and the family, and creating laws protecting individuals from violence, harassment, and persecution.[138]

In the United States, there are two fundamentally different approaches, applied in different states, regarding the way the law is used to attempt to govern a person's sexuality. The "black letter" approach to law focuses on the study of pre-existing legal precedent, and attempts to offer a clear framework of rules within which lawyers and others can work.[138] In contrast, the socio-legal approach focuses more broadly on the relationship between the law and society, and offers a more contextualized view of the relationship between legal and social change.[138]

Issues regarding human sexuality and human sexual orientation have come to the forefront in Western law in the latter half of the twentieth century, as part of the gay liberation movement's encouragement of LGBT individuals to "come out of the closet" and engaging with the legal system, primarily through courts. Therefore, many issues regarding human sexuality and the law are found in the opinions of the courts.[139]

While the issue of privacy has been useful to sexual rights claims, some scholars have criticized its usefulness, saying that this perspective is too narrow and restrictive. The law is often slow to intervene in certain forms of coercive behavior that can limit individuals' control over their own sexuality (such as female genital mutilation, forced marriages or lack of access to reproductive health care). Many of these injustices are often perpetuated wholly or in part by private individuals rather than state agents, and as a result, there is an ongoing debate about the extent of state responsibility to prevent harmful practices and to investigate such practices when they do occur.[138]

State intervention with regards to sexuality also occurs, and is considered acceptable by some, in certain instances (e.g. same-sex sexual activity or prostitution).[138]

The legal systems surrounding prostitution are a topic of debate. Proponents for criminalization argue that sex work is an immoral practice that should not be tolerated, while proponents for decriminalization point out how criminalization does more harm than good. Within the feminist movement, there is also a debate over whether sex work is inherently objectifying and exploitative or whether sex workers have the agency to sell sex as a service.[140]

When sex work is criminalized, sex workers do not have support from law enforcement when they fall victim to violence. In a 2003 survey of street-based sex workers in NYC, 80% said they had been threatened with or experienced violence, and many said the police were no help. 27% said they had experienced violence from police officers themselves.[141] Different identities such as being black, transgender, or poor can result in a person being more likely to be criminally profiled by the police. For example, in New York, there is a law against "loitering for the purpose of engaging in prostitution", which has been nicknamed the "walking while trans" law because of how often transgender women are assumed to be sex workers and arrested for simply walking out in public.[142]

In some religions, sexual behavior is regarded as primarily spiritual. In others it is treated as primarily physical. Some hold that sexual behavior is only spiritual within certain kinds of relationships, when used for specific purposes, or when incorporated into religious ritual. In some religions there are no distinctions between the physical and the spiritual, whereas some religions view human sexuality as a way of completing the gap that exists between the spiritual and the physical.[143]

Many religious conservatives, especially those of Abrahamic religions and Christianity in particular, tend to view sexuality in terms of behavior (i.e. homosexuality or heterosexuality is what someone does) and certain sexualities such as bisexuality tend to be ignored as a result of this.[citation needed] These conservatives tend to promote celibacy for gay people, and may also tend to believe that sexuality can be changed through conversion therapy[144] or prayer to become an ex-gay. They may also see homosexuality as a form of mental illness, something that ought to be criminalised, an immoral abomination, caused by ineffective parenting, and view same-sex marriage as a threat to society.[145]

On the other hand, most religious liberals define sexuality-related labels in terms of sexual attraction and self-identification.[144] They may also view same-sex activity as morally neutral and as legally acceptable as opposite-sex activity, unrelated to mental illness, genetically or environmentally caused (but not as the result of bad parenting), and fixed. They also tend to be more in favor of same-sex marriage.[145]

According to Judaism, sex between man and woman within marriage is sacred and should be enjoyed; celibacy is considered sinful.[18][pageneeded]

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Human sexuality

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‘The Goop Lab’ and other controversial documentaries: Why Netflix is facing criticism for promoting ‘pseudoscience’ – Yahoo Lifestyle

Netflix is stirring up controversy by giving Gwyneth Paltrow a platform to share what several critics are calling pseudoscience with her new show, The Goop Lab, which debuted this week.

The show, which Netflix files under provocative and quirky, is described as the following: Leading with curiosity, Gwyneth Paltrow and her goop team look at psychedelics, energy work and other challenging wellness topics.

The topics being tackled in the series range from energy healing, psychic mediums and orgasm workshops to taking psychedelics as a form of therapy and plunging into freezing water to stimulate the immune system.

Along with the Daily Beast calling the show a nightmare, Time writer Judy Berman writes: As with the brand itself, whats disturbing about the show is that when you combine Gwyneths aura of trustworthiness with a mishmash of real science, New Age nonsense, vague female empowerment rhetoric, naked commercialism and some startling knowledge gaps in areas where Goop claims expertise, the result has its unique dangers.

Related Video: Gwyneth Paltrows The Goop Lab: Fact-Checking the Health Claims

But in the shows defense, some of the featured wellness practices are supported by science. In one episode, for example, it appears that Paltrow is getting a PRP, or platelet-rich plasma, facial (what some call a vampire facial, which is a trademarked term) an anti-aging treatment thats popular with celebrities.

With the facial, venous blood is taken from the patient and separated into the cellular component and the plasma component, Nava Greenfield, MD, of Schweiger Dermatology Group in New York City, explains to Yahoo Lifestyle. The plasma is then injected or topically applied back to the patient in specific locations. It can be used for hair loss, or in combination with microneedling for the face. Microneedling is a popular procedure where tiny needles are used to induce a specific kind of injury to the first and second layer of skin, promoting collagen synthesis. When used in combination with PRP, superior results are often obtained.

Although it may sound out there, the facial stimulates the production of collagen to help tighten, smooth, and improve skin tone, according to the Cleveland Clinic. As with any injection, the treatment does carry a small risk of bleeding, pain or infection, but is considered safe.

In another episode, people really, Goops employees who have volunteered to try these experimental wellness treatments take psychedelic drugs, leaving one employee sobbing on the floor and then later saying, I went through years of therapy in about five hours.

David Spiegel, MD, director of the Stanford Center for Integrative Medicine, tells Yahoo Lifestyle that theres actually some interesting research on the psychotherapeutic effects of psychedelics (such as MDMA and magic mushrooms), with one 2018 National Institutes of Health study calling the therapy potentially life-preserving. Some clinical trials are showing it helps with post-traumatic stress disorder and depression in people nearing the end of life, he says. It can help people come to terms with impending death.

But Spiegel emphasizes that psychedelic drugs need to be used in a controlled setting and in combination with psychotherapy for these mental health benefits.

Gwyneth Paltrow getting a PRP (or platelet rich plasma) facial on an episode of Netflix's The Goop Lab. (Screenshot: Netflix)

Still, plenty criticize The Goop Lab (or really, anything Goop or Gwyneth Paltrow-related, for that matter), and question the legitimacy and safety of some of the practices in the series, pointing out the lack of objective experts. But while many may view the decision as an oversight, Elise Loehnen, chief content officer at Goop and executive producer of The Goop Lab, suggested to Fast Company that it was deliberate: We felt like we would be manufacturing drama by trying to find a detractor.

Timothy Caulfield, research chair in health law and policy and professor in the Faculty of Law and School of Public Health at the University of Alberta in Canada has been vocal about his criticism of The Goop Lab, writing on Twitter that the series is an infomercial for [Paltrows] pseudoscience business a business worth an estimated $250 million.

The topics covered are classic wellness woo: a mashup of the supernatural, spiritual and science-y, Caulfield tells Yahoo Lifestyle. Some topics, like the cold therapy, use the familiar strategy of a powerful testimonial the 'inventor Wim Hof with an extreme experience cold! and a dash of scientific speculation to make it seem credible.

Spiegel is also wary of the series, telling Yahoo Lifestyle: Goop is her company so its an infomercial, basically. Shes a great actress, but that doesn't make her an expert on these so-called treatments. Its fine to explore things as long as you dont pretend your exploration is more than what it is. I dont like the pretense of it being a scientific examination.

Several other doctors, most notably Jennifer Gunter, MD, have repeatedly called out Paltrow and Goop in the past for what Business Insider calls scientifically indefensible and potentially harmful health information and products, including the now-famous jade and rose quartz vaginal eggs. Goop claimed the stone eggs provided health benefits when inserted vaginally namely, balance their hormones, regulate menstrual cycles, prevent uterine prolapse and increase bladder control, according to the Los Angeles Times. But after a lawsuit was filed by 10 state prosecutors in California over advertisements not backed by competent and reliable scientific evidence, the company ended up paying $145,000 in civil penalties. (Jade eggs, $66, are currently unavailable on the site.)

Goop has some fine advice, for example, [in] an article on sleep on their site, Gunter said in a statement provided to Yahoo Lifestyle. They also distribute some dangerous advice, for example drinking goats milk to treat parasites (the parasites are non-existent). When good information is next to harmful and presented in the same way, how can people distinguish? In addition, they sell useless and potentially harmful products, such as supplements.

Gunter continued: Finally, they have used their international platform to advance harmful ideas, many of which are medical conspiracy theories. For example, bras cause breast cancer (they don't), fears about vaccine safety and concerns about fluoride, adding, The supplements are not supported by science. At all. The idea that a medium can help with health is as anti-science as one can be; it is the definition of snake oil. So you'll have to ask Goop for the science behind their myriad of false claims.

Critics are concerned that those misleading claims will now have an even bigger platform on The Goop Lab, with Netflixs 167 million subscribers worldwide. Ars Technicas Beth Mole writes that, on the show, Paltrows ignorance and lack of critical thinking skills are on full display as a parade of questionable experts with the noted exception of sex educator Betty Dodson, PhD and ridiculous claims about health and science march across the small screen unchallenged.

Caulfield tells Yahoo Lifestyle, The spreading of misinformation can have a real impact. Just being exposed to this nonsense can make it seem more plausible, especially if it is packaged in a memorable manner.

He adds, I also think that a show like this adds more noise to an already confused health information environment. In this age of misinformation, it is disappointing to see an entity like Goop, which has a long history of profiting from misinformation, have the opportunity to push more pseudoscience. We shouldn't forget that Goop and Gwyneth benefit financially from the growth of their brand, which is what this show does. It is an infomercial for Goop, not an independent science-informed documentary.

Critics have also called out Netflix, saying this isnt the first time the streaming service has created controversy with its health documentaries. As HuffPost U.K. (HuffPost U.K. and Yahoo are owned by the same parent company, Verizon Media) put it: The streaming service has a history of producing irresponsible health programs that could potentially affect viewers.

In 2019, RealClearScience.com posted a list of multiple shows that have aired on Netflix, which the publication dubbed anti-science documentaries, while the American Council on Science and Health shared their own list back in 2017. The documentaries called out include What the Health, Cowspiracy and The Magic Pill.

In What the Health, Vox wrote that the film cherry-picks studies about nutrition and often exaggerates their findings or reports them out of context, to drive home his case for veganism and cranks the food fear sirens to irresponsibly high levels, such as claiming that eating processed meats is as bad for you as smoking.

As Vox points out, theres a causal link between eating processed meat and certain types of cancer in humans, chiefly colorectal cancer. But the actual risk is quite modest and far, far smaller than the cancer risks from smoking. According to the World Health Organization, processed meat has been classified in the same category as causes of cancer such as tobacco smoking and asbestos... but this does NOT mean that they are all equally dangerous.

In The Magic Pill, Australian chef Pete Evans claims that the popular keto diet can treat type 2 diabetes, cancer and autism. Michael Gannon, then president of the Australian Medical Association (AMA), called The Magic Pill hurtful, harmful and mean and compared it to the controversial film, Vaxxed, telling the West Australian in 2017 that both films were competing in the awards for the films least likely to contribute to public health.

In 2018, the current AMA president, Tony Bartone, MD, shared his own opinion about The Magic Pill, telling the Sydney Morning Herald: All forms of media have to take a responsible attitude when trying to spread a message of wellness. Netflix should do the responsible thing. They shouldn't screen it. The risk of misinformation... is too great.

While noting that Netflix has some incredible documentaries, HuffPosts Todd Van Luling (HuffPost and Yahoo are owned by the same parent company, Verizon Media) writes that many of the documentaries the streaming service adds each month make dubious claims that wouldnt withstand scrutiny from a fact-checker.

But in at least one case, Netflix appears to have listened to critics by pulling the documentary, Root Cause, in March 2019, which came under fire after several medical organizations, including the American Dental Association, said the film falsely links the root canal procedure to breast cancer and heart disease, employing baseless claims gleaned from discredited 1920s research, according to the Philadelphia Inquirer.

Yahoo Lifestyle reached out to Netflix for comment but has not yet heard back.

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'The Goop Lab' and other controversial documentaries: Why Netflix is facing criticism for promoting 'pseudoscience' - Yahoo Lifestyle

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Clitoris – Wikipedia

The clitoris ((listen) or (listen)) is a female sex organ present in mammals, ostriches and a limited number of other animals. In humans, the visible portion - the glans - is at the front junction of the labia minora (inner lips), above the opening of the urethra. Unlike the penis, the male homologue (equivalent) to the clitoris, it usually does not contain the distal portion (or opening) of the urethra and is therefore not used for urination. The clitoris also usually lacks a reproductive function. While few animals urinate through the clitoris or use it reproductively, the spotted hyena, which has an especially large clitoris, urinates, mates, and gives birth via the organ. Some other mammals, such as lemurs and spider monkeys, also have a large clitoris.[1]

The clitoris is the human female's most sensitive erogenous zone and generally the primary anatomical source of human female sexual pleasure.[2] In humans and other mammals, it develops from an outgrowth in the embryo called the genital tubercle. Initially undifferentiated, the tubercle develops into either a penis or a clitoris, depending on the presence or absence of the protein tdf, which is codified by a single gene on the Y chromosome. The clitoris is a complex structure, and its size and sensitivity can vary. The glans (head) of the human clitoris is roughly the size and shape of a pea, and is estimated to have about 8,000 sensory nerve endings.[3]

Sexological, medical, and psychological debate have focused on the clitoris,[4] and it has been subject to social constructionist analyses and studies.[5] Such discussions range from anatomical accuracy, gender inequality, female genital mutilation, and orgasmic factors and their physiological explanation for the G-spot.[6] Although, in humans, the only known purpose of the clitoris is to provide sexual pleasure, whether the clitoris is vestigial, an adaptation, or serves a reproductive function has been debated.[7] Social perceptions of the clitoris include the significance of its role in female sexual pleasure, assumptions about its true size and depth, and varying beliefs regarding genital modification such as clitoris enlargement, clitoris piercing and clitoridectomy.[8] Genital modification may be for aesthetic, medical or cultural reasons.[8]

Knowledge of the clitoris is significantly impacted by cultural perceptions of the organ. Studies suggest that knowledge of its existence and anatomy is scant in comparison with that of other sexual organs, and that more education about it could help alleviate social stigmas associated with the female body and female sexual pleasure; for example, that the clitoris and vulva in general are visually unappealing, that female masturbation is taboo, or that men should be expected to master and control women's orgasms.[9]

The Oxford English Dictionary states that the word clitoris likely has its origin in the Ancient Greek , kleitoris, perhaps derived from the verb , kleiein, "to shut".[10] Clitoris is also Greek for the word key, "indicating that the ancient anatomists considered it the key" to female sexuality.[11][12] In addition to key, the Online Etymology Dictionary suggests other Greek candidates for the word's etymology include a noun meaning "latch" or "hook"; a verb meaning "to touch or titillate lasciviously", "to tickle" (one German synonym for the clitoris is der Kitzler, "the tickler"), although this verb is more likely derived from "clitoris"; and a word meaning "side of a hill", from the same root as "climax".[13] The Oxford English Dictionary also states that the shortened form "clit", the first occurrence of which was noted in the United States, has been used in print since 1958: until then, the common abbreviation was "clitty".[10]

The plural forms are clitorises in English and clitorides in Latin. The Latin genitive is clitoridis, as in "glans clitoridis". In medical and sexological literature, the clitoris is sometimes referred to as "the female penis" or pseudo-penis,[14] and the term clitoris is commonly used to refer to the glans alone;[15] partially because of this, there have been various terms for the organ that have historically confused its anatomy.

In mammals, sexual differentiation is determined by the sperm that carries either an X or a Y (male) chromosome.[16] The Y chromosome contains a sex-determining gene (SRY) that encodes a transcription factor for the protein tdf (testis determining factor) and triggers the creation of testosterone and Anti-Mllerian hormone for the embryo's development into a male.[17][18] This differentiation begins about eight or nine weeks after conception.[17] Some sources state that it continues until the twelfth week,[19] while others state that it is clearly evident by the thirteenth week and that the sex organs are fully developed by the sixteenth week.[20]

The clitoris develops from a phallic outgrowth in the embryo called the genital tubercle. Initially undifferentiated, the tubercle develops into either a clitoris or penis during development of the reproductive system depending on exposure to androgens (primarily male hormones). The clitoris forms from the same tissues that become the glans and shaft of the penis, and this shared embryonic origin makes these two organs homologous (different versions of the same structure).[21]

If exposed to testosterone, the genital tubercle elongates to form the penis. By fusion of the urogenital folds elongated spindle-shaped structures that contribute to the formation of the urethral groove on the belly aspect of the genital tubercle the urogenital sinus closes completely and forms the spongy urethra, and the labioscrotal swellings unite to form the scrotum.[21] In the absence of testosterone, the genital tubercle allows for formation of the clitoris; the initially rapid growth of the phallus gradually slows and the clitoris is formed. The urogenital sinus persists as the vestibule of the vagina, the two urogenital folds form the labia minora, and the labioscrotal swellings enlarge to form the labia majora, completing the female genitalia.[21] A rare condition that can develop from higher than average androgen exposure is clitoromegaly.[22]

The clitoris contains external and internal components. It consists of the glans, the body (which is composed of two erectile structures known as the corpora cavernosa), and two crura ("legs"). It has a hood formed by the labia minora (inner lips). It also has vestibular or clitoral bulbs. The frenulum of clitoris is a frenulum on the under-surface of the glans and is created by the two medial parts of the labia minora.[23] The clitoral body may be referred to as the shaft (or internal shaft), while the length of the clitoris between the glans and the body may also be referred to as the shaft. The shaft supports the glans, and its shape can be seen and felt through the clitoral hood.[24]

Research indicates that clitoral tissue extends into the vagina's anterior wall.[25] enayl et al. said that the histological evaluation of the clitoris, "especially of the corpora cavernosa, is incomplete because for many years the clitoris was considered a rudimentary and nonfunctional organ." They added that Baskin and colleagues examined the clitoris's masculinization after dissection and, using imaging software after Masson chrome staining, put the serial dissected specimens together; this revealed that the nerves of the clitoris surround the whole clitoral body (corpus).[26]

The clitoris, vestibular bulbs, labia minora, and urethra involve two histologically distinct types of vascular tissue (tissue related to blood vessels), the first of which is trabeculated, erectile tissue innervated by the cavernous nerves. The trabeculated tissue has a spongy appearance; along with blood, it fills the large, dilated vascular spaces of the clitoris and the bulbs. Beneath the epithelium of the vascular areas is smooth muscle.[27] As indicated by Yang et al.'s research, it may also be that the urethral lumen (the inner open space or cavity of the urethra), which is surrounded by spongy tissue, has tissue that "is grossly distinct from the vascular tissue of the clitoris and bulbs, and on macroscopic observation, is paler than the dark tissue" of the clitoris and bulbs.[28] The second type of vascular tissue is non-erectile, which may consist of blood vessels that are dispersed within a fibrous matrix and have only a minimal amount of smooth muscle.[27]

Highly innervated, the glans exists at the tip of the clitoral body as a fibro-vascular cap,[27] and is usually the size and shape of a pea, although it is sometimes much larger or smaller. The clitoral glans, or the entire clitoris, is estimated to have about 8,000 sensory nerve endings.[3] Research conflicts on whether or not the glans is composed of erectile or non-erectile tissue. Although the clitoral body becomes engorged with blood upon sexual arousal, erecting the clitoral glans, some sources describe the clitoral glans and labia minora as composed of non-erectile tissue; this is especially the case for the glans.[15][27] They state that the clitoral glans and labia minora have blood vessels that are dispersed within a fibrous matrix and have only a minimal amount of smooth muscle,[27] or that the clitoral glans is "a midline, densely neural, non-erectile structure".[15]

Other descriptions of the glans assert that it is composed of erectile tissue and that erectile tissue is present within the labia minora.[29] The glans may be noted as having glanular vascular spaces that are not as prominent as those in the clitoral body, with the spaces being separated more by smooth muscle than in the body and crura.[28] Adipose tissue is absent in the labia minora, but the organ may be described as being made up of dense connective tissue, erectile tissue and elastic fibers.[29]

The clitoral body forms a wishbone-shaped structure containing the corpora cavernosa a pair of sponge-like regions of erectile tissue which contain most of the blood in the clitoris during clitoral erection. The two corpora forming the clitoral body are surrounded by thick fibro-elastic tunica albuginea, literally meaning "white covering", connective tissue. These corpora are separated incompletely from each other in the midline by a fibrous pectiniform septum a comblike band of connective tissue extending between the corpora cavernosa.[26][27]

The clitoral body extends up to several centimeters before reversing direction and branching, resulting in an inverted "V" shape that extends as a pair of crura ("legs").[30] The crura are the proximal portions of the arms of the wishbone. Ending at the glans of the clitoris, the tip of the body bends anteriorly away from the pubis.[28] Each crus (singular form of crura) is attached to the corresponding ischial ramus extensions of the copora beneath the descending pubic rami.[26][27] Concealed behind the labia minora, the crura end with attachment at or just below the middle of the pubic arch.[N 1][32] Associated are the urethral sponge, perineal sponge, a network of nerves and blood vessels, the suspensory ligament of the clitoris, muscles and the pelvic floor.[27][33]

There is no identified correlation between the size of the clitoral glans, or clitoris as a whole, and a woman's age, height, weight, use of hormonal contraception, or being post-menopausal, although women who have given birth may have significantly larger clitoral measurements.[34] Centimeter (cm) and millimeter (mm) measurements of the clitoris show variations in its size. The clitoral glans has been cited as typically varying from 2mm to 1cm and usually being estimated at 4 to 5mm in both the transverse and longitudinal planes.[35]

A 1992 study concluded that the total clitoral length, including glans and body, is 16.04.3mm (0.630.17in), where 16mm is the mean and 4.3mm is the standard deviation.[36] Concerning other studies, researchers from the Elizabeth Garrett Anderson and Obstetric Hospital in London measured the labia and other genital structures of 50 women from the age of 18 to 50, with a mean age of 35.6., from 2003 to 2004, and the results given for the clitoral glans were 310mm for the range and 5.5 [1.7] mm for the mean.[37] Other research indicates that the clitoral body can measure 57 centimetres (2.02.8in) in length, while the clitoral body and crura together can be 10 centimetres (3.9in) or more in length.[27]

The clitoral hood projects at the front of the labia commissure, where the edges of the labia majora (outer lips) meet at the base of the pubic mound; it is partially formed by fusion of the upper part of the external folds of the labia minora (inner lips) and covers the glans and external shaft.[38] There is considerable variation in how much of the glans protrudes from the hood and how much is covered by it, ranging from completely covered to fully exposed,[36] and tissue of the labia minora also encircles the base of the glans.[39]

The vestibular bulbs are more closely related to the clitoris than the vestibule because of the similarity of the trabecular and erectile tissue within the clitoris and bulbs, and the absence of trabecular tissue in other genital organs, with the erectile tissue's trabecular nature allowing engorgement and expansion during sexual arousal.[27][39] The vestibular bulbs are typically described as lying close to the crura on either side of the vaginal opening; internally, they are beneath the labia majora. When engorged with blood, they cuff the vaginal opening and cause the vulva to expand outward.[27] Although a number of texts state that they surround the vaginal opening, Ginger et al. state that this does not appear to be the case and tunica albuginea does not envelop the erectile tissue of the bulbs.[27] In Yang et al.'s assessment of the bulbs' anatomy, they conclude that the bulbs "arch over the distal urethra, outlining what might be appropriately called the 'bulbar urethra' in women."[28]

The clitoris and penis are generally the same anatomical structure, although the distal portion (or opening) of the urethra is absent in the clitoris of humans and most other animals. The idea that males have clitorises was suggested in 1987 by researcher Josephine Lowndes Sevely, who theorized that the male corpora cavernosa (a pair of sponge-like regions of erectile tissue which contain most of the blood in the penis during penile erection) are the true counterpart of the clitoris. She argued that "the male clitoris" is directly beneath the rim of the glans penis, where the frenulum of prepuce of the penis (a fold of the prepuce) is located, and proposed that this area be called the "Lownde's crown." Her theory and proposal, though acknowledged in anatomical literature, did not materialize in anatomy books.[40] Modern anatomical texts show that the clitoris displays a hood that is the equivalent of the penis's foreskin, which covers the glans. It also has a shaft that is attached to the glans. The male corpora cavernosa are homologous to the corpus cavernosum clitoridis (the female cavernosa), the bulb of penis (also known as the bulb of the corpus spongiosum penis) is homologous to the vestibular bulbs beneath the labia minora, and the scrotum is homologous to the labia minora and labia majora.[41]

Upon anatomical study, the penis can be described as a clitoris that has been mostly pulled out of the body and grafted on top of a significantly smaller piece of spongiosum containing the urethra.[41] With regard to nerve endings, the human clitoris's estimated 8,000 or more (for its glans or clitoral body as a whole) is commonly cited as being twice as many as the nerve endings found in the human penis (for its glans or body as a whole), and as more than any other part of the human body.[3] These reports sometimes conflict with other sources on clitoral anatomy or those concerning the nerve endings in the human penis. For example, while some sources estimate that the human penis has 4,000 nerve endings,[3] other sources state that the glans or the entire penile structure have the same amount of nerve endings as the clitoral glans,[42] or discuss whether the uncircumcised penis has thousands more than the circumcised penis or is generally more sensitive.[43][44]

Some sources state that in contrast to the glans penis, the clitoral glans lacks smooth muscle within its fibrovascular cap and is thus differentiated from the erectile tissues of the clitoris and bulbs; additionally, bulb size varies and may be dependent on age and estrogenization.[27] While the bulbs are considered the equivalent of the male spongiosum, they do not completely encircle the urethra.[27]

The thin corpus spongiosum of the penis runs along the underside of the penile shaft, enveloping the urethra, and expands at the end to form the glans. It partially contributes to erection, which are primarily caused by the two corpora cavernosa that comprise the bulk of the shaft; like the female cavernosa, the male cavernosa soak up blood and become erect when sexually excited.[45] The male corpora cavernosa taper off internally on reaching the spongiosum head.[45] With regard to the Y-shape of the cavernosa crown, body, and legs the body accounts for much more of the structure in men, and the legs are stubbier; typically, the cavernosa are longer and thicker in males than in females.[28][46]

The clitoris has an abundance of nerve endings, and is the human female's most sensitive erogenous zone and generally the primary anatomical source of human female sexual pleasure.[2] When sexually stimulated, it may incite female sexual arousal. Sexual stimulation, including arousal, may result from mental stimulation, foreplay with a sexual partner, or masturbation, and may lead to orgasm.[47] The most effective sexual stimulation of the organ is usually manually or orally (cunnilingus), which is often referred to as direct clitoral stimulation; in cases involving sexual penetration, these activities may also be referred to as additional or assisted clitoral stimulation.[48]

Direct clitoral stimulation involves physical stimulation to the external anatomy of the clitoris glans, hood and the external shaft.[49] Stimulation of the labia minora (inner lips), due to its external connection with the glans and hood, may have the same effect as direct clitoral stimulation.[50] Though these areas may also receive indirect physical stimulation during sexual activity, such as when in friction with the labia majora (outer lips),[51] indirect clitoral stimulation is more commonly attributed to penile-vaginal penetration.[52][53] Penile-anal penetration may also indirectly stimulate the clitoris by the shared sensory nerves (especially the pudendal nerve, which gives off the inferior anal nerves and divides into two terminal branches: the perineal nerve and the dorsal nerve of the clitoris).[54]

Due to the glans's high sensitivity, direct stimulation to it is not always pleasurable; instead, direct stimulation to the hood or the areas near the glans are often more pleasurable, with the majority of women preferring to use the hood to stimulate the glans, or to have the glans rolled between the lips of the labia, for indirect touch.[55] It is also common for women to enjoy the shaft of the clitoris being softly caressed in concert with occasional circling of the clitoral glans. This might be with or without manual penetration of the vagina, while other women enjoy having the entire area of the vulva caressed.[56] As opposed to use of dry fingers, stimulation from fingers that have been well-lubricated, either by vaginal lubrication or a personal lubricant, is usually more pleasurable for the external anatomy of the clitoris.[57][58]

As the clitoris's external location does not allow for direct stimulation by sexual penetration, any external clitoral stimulation while in the missionary position usually results from the pubic bone area, the movement of the groins when in contact. As such, some couples may engage in the woman-on-top position or the coital alignment technique, a sex position combining the "riding high" variation of the missionary position with pressure-counterpressure movements performed by each partner in rhythm with sexual penetration, to maximize clitoral stimulation.[59][60] Lesbian couples may engage in tribadism for ample clitoral stimulation or for mutual clitoral stimulation during whole-body contact.[N 2][62][63] Pressing the penis in a gliding or circular motion against the clitoris (intercrural sex), or stimulating it by movement against another body part, may also be practiced.[64][65] A vibrator (such as a clitoral vibrator), dildo or other sex toy may be used.[64][66] Other women stimulate the clitoris by use of a pillow or other inanimate object, by a jet of water from the faucet of a bathtub or shower, or by closing their legs and rocking.[67][68][69]

During sexual arousal, the clitoris and the whole of the genitalia engorge and change color as the erectile tissues fill with blood (vasocongestion), and the individual experiences vaginal contractions.[70] The ischiocavernosus and bulbocavernosus muscles, which insert into the corpora cavernosa, contract and compress the dorsal vein of the clitoris (the only vein that drains the blood from the spaces in the corpora cavernosa) and the arterial blood continues a steady flow and, having no way to drain out, fills the venous spaces until they become turgid and engorged with blood. This is what leads to clitoral erection.[11][71]

The clitoral glans doubles in diameter upon arousal, and, upon further stimulation, it becomes less visible as it is covered by the swelling of tissues of the clitoral hood.[70][72] The swelling protects the glans from direct contact, as direct contact at this stage can be more irritating than pleasurable.[72][73] Vasocongestion eventually triggers a muscular reflex, which expels the blood that was trapped in surrounding tissues, and leads to an orgasm.[74] A short time after stimulation has stopped, especially if orgasm has been achieved, the glans becomes visible again and returns to its normal state,[75] with a few seconds (usually 510) to return to its normal position and 510 minutes to return to its original size.[N 3][72][77] If orgasm is not achieved, the clitoris may remain engorged for a few hours, which women often find uncomfortable.[59] Additionally, the clitoris is very sensitive after orgasm, making further stimulation initially painful for some women.[78]

General statistics indicate that 7080 percent of women require direct clitoral stimulation (consistent manual, oral or other concentrated friction against the external parts of the clitoris) to reach orgasm.[N 4][N 5][N 6][82] Indirect clitoral stimulation (for example, via vaginal penetration) may also be sufficient for female orgasm.[N 7][15][84] The area near the entrance of the vagina (the lower third) contains nearly 90percent of the vaginal nerve endings, and there are areas in the anterior vaginal wall and between the top junction of the labia minora and the urethra that are especially sensitive, but intense sexual pleasure, including orgasm, solely from vaginal stimulation is occasional or otherwise absent because the vagina has significantly fewer nerve endings than the clitoris.[85]

Prominent debate over the quantity of vaginal nerve endings began with Alfred Kinsey. Although Sigmund Freud's theory that clitoral orgasms are a prepubertal or adolescent phenomenon and that vaginal (or G-spot) orgasms are something that only physically mature females experience had been criticized before, Kinsey was the first researcher to harshly criticize the theory.[86][87] Through his observations of female masturbation and interviews with thousands of women,[88] Kinsey found that most of the women he observed and surveyed could not have vaginal orgasms,[89] a finding that was also supported by his knowledge of sex organ anatomy.[90] Scholar Janice M. Irvine stated that he "criticized Freud and other theorists for projecting male constructs of sexuality onto women" and "viewed the clitoris as the main center of sexual response". He considered the vagina to be "relatively unimportant" for sexual satisfaction, relaying that "few women inserted fingers or objects into their vaginas when they masturbated". Believing that vaginal orgasms are "a physiological impossibility" because the vagina has insufficient nerve endings for sexual pleasure or climax, he "concluded that satisfaction from penile penetration [is] mainly psychological or perhaps the result of referred sensation".[91]

Masters and Johnson's research, as well as Shere Hite's, generally supported Kinsey's findings about the female orgasm.[92] Masters and Johnson were the first researchers to determine that the clitoral structures surround and extend along and within the labia. They observed that both clitoral and vaginal orgasms have the same stages of physical response, and found that the majority of their subjects could only achieve clitoral orgasms, while a minority achieved vaginal orgasms. On that basis, they argued that clitoral stimulation is the source of both kinds of orgasms,[93] reasoning that the clitoris is stimulated during penetration by friction against its hood.[94] The research came at the time of the second-wave feminist movement, which inspired feminists to reject the distinction made between clitoral and vaginal orgasms.[86][95] Feminist Anne Koedt argued that because men "have orgasms essentially by friction with the vagina" and not the clitoral area, this is why women's biology had not been properly analyzed. "Today, with extensive knowledge of anatomy, with [C. Lombard Kelly], Kinsey, and Masters and Johnson, to mention just a few sources, there is no ignorance on the subject [of the female orgasm]," she stated in her 1970 article The Myth of the Vaginal Orgasm. She added, "There are, however, social reasons why this knowledge has not been popularized. We are living in a male society which has not sought change in women's role."[86]

Supporting an anatomical relationship between the clitoris and vagina is a study published in 2005, which investigated the size of the clitoris; Australian urologist Helen O'Connell, described as having initiated discourse among mainstream medical professionals to refocus on and redefine the clitoris, noted a direct relationship between the legs or roots of the clitoris and the erectile tissue of the clitoral bulbs and corpora, and the distal urethra and vagina while using magnetic resonance imaging (MRI) technology.[96][97] While some studies, using ultrasound, have found physiological evidence of the G-spot in women who report having orgasms during vaginal intercourse,[84] O'Connell argues that this interconnected relationship is the physiological explanation for the conjectured G-Spot and experience of vaginal orgasms, taking into account the stimulation of the internal parts of the clitoris during vaginal penetration. "The vaginal wall is, in fact, the clitoris," she said. "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."[15] O'Connell et al., having performed dissections on the female genitals of cadavers and used photography to map the structure of nerves in the clitoris, made the assertion in 1998 that there is more erectile tissue associated with the clitoris than is generally described in anatomical textbooks, and were thus already aware that the clitoris is more than just its glans.[98] They concluded that some females have more extensive clitoral tissues and nerves than others, especially having observed this in young cadavers compared to elderly ones,[98] and therefore whereas the majority of females can only achieve orgasm by direct stimulation of the external parts of the clitoris, the stimulation of the more generalized tissues of the clitoris via vaginal intercourse may be sufficient for others.[15]

French researchers Odile Buisson and Pierre Folds reported similar findings to that of O'Connell's. In 2008, they published the first complete 3D sonography of the stimulated clitoris, and republished it in 2009 with new research, demonstrating the ways in which erectile tissue of the clitoris engorges and surrounds the vagina. On the basis of their findings, they argued that women may be able to achieve vaginal orgasm via stimulation of the G-spot, because the highly innervated clitoris is pulled closely to the anterior wall of the vagina when the woman is sexually aroused and during vaginal penetration. They assert that since the front wall of the vagina is inextricably linked with the internal parts of the clitoris, stimulating the vagina without activating the clitoris may be next to impossible. In their 2009 published study, the "coronal planes during perineal contraction and finger penetration demonstrated a close relationship between the root of the clitoris and the anterior vaginal wall". Buisson and Folds suggested "that the special sensitivity of the lower anterior vaginal wall could be explained by pressure and movement of clitoris's root during a vaginal penetration and subsequent perineal contraction".[99][100]

Researcher Vincenzo Puppo, who, while agreeing that the clitoris is the center of female sexual pleasure and believing that there is no anatomical evidence of the vaginal orgasm, disagrees with O'Connell and other researchers' terminological and anatomical descriptions of the clitoris (such as referring to the vestibular bulbs as the "clitoral bulbs") and states that "the inner clitoris" does not exist because the penis cannot come in contact with the congregation of multiple nerves/veins situated until the angle of the clitoris, detailed by Kobelt, or with the roots of the clitoris, which do not have sensory receptors or erogenous sensitivity, during vaginal intercourse.[14] Puppo's belief contrasts the general belief among researchers that vaginal orgasms are the result of clitoral stimulation; they reaffirm that clitoral tissue extends, or is at least stimulated by its bulbs, even in the area most commonly reported to be the G-spot.[101]

The G-spot being analogous to the base of the male penis has additionally been theorized, with sentiment from researcher Amichai Kilchevsky that because female fetal development is the "default" state in the absence of substantial exposure to male hormones and therefore the penis is essentially a clitoris enlarged by such hormones, there is no evolutionary reason why females would have an entity in addition to the clitoris that can produce orgasms.[102] The general difficulty of achieving orgasms vaginally, which is a predicament that is likely due to nature easing the process of child bearing by drastically reducing the number of vaginal nerve endings,[103] challenge arguments that vaginal orgasms help encourage sexual intercourse in order to facilitate reproduction.[104][105] Supporting a distinct G-spot, however, is a study by Rutgers University, published in 2011, which was the first to map the female genitals onto the sensory portion of the brain; the scans indicated that the brain registered distinct feelings between stimulating the clitoris, the cervix and the vaginal wall where the G-spot is reported to be when several women stimulated themselves in a functional magnetic resonance (fMRI) machine.[100][106] Barry Komisaruk, head of the research findings, stated that he feels that "the bulk of the evidence shows that the G-spot is not a particular thing" and that it is "a region, it's a convergence of many different structures".[104]

Whether the clitoris is vestigial, an adaptation, or serves a reproductive function has also been debated.[107][108] Geoffrey Miller stated that Helen Fisher, Meredith Small and Sarah Blaffer Hrdy "have viewed the clitoral orgasm as a legitimate adaptation in its own right, with major implications for female sexual behavior and sexual evolution".[109] Like Lynn Margulis and Natalie Angier, Miller believes, "The human clitoris shows no apparent signs of having evolved directly through male mate choice. It is not especially large, brightly colored, specifically shaped or selectively displayed during courtship." He contrasts this with other female species such as spider monkeys and spotted hyenas that have clitorises as long as their male counterparts. He said the human clitoris "could have evolved to be much more conspicuous if males had preferred sexual partners with larger brighter clitorises" and that "its inconspicuous design combined with its exquisite sensitivity suggests that the clitoris is important not as an object of male mate choice, but as a mechanism of female choice."[109]

While Miller stated that male scientists such as Stephen Jay Gould and Donald Symons "have viewed the female clitoral orgasm as an evolutionary side-effect of the male capacity for penile orgasm" and that they "suggested that clitoral orgasm cannot be an adaptation because it is too hard to achieve",[109] Gould acknowledged that "most female orgasms emanate from a clitoral, rather than vaginal (or some other), site" and that his nonadaptive belief "has been widely misunderstood as a denial of either the adaptive value of female orgasm in general, or even as a claim that female orgasms lack significance in some broader sense". He said that although he accepts that "clitoral orgasm plays a pleasurable and central role in female sexuality and its joys," "[a]ll these favorable attributes, however, emerge just as clearly and just as easily, whether the clitoral site of orgasm arose as a spandrel or an adaptation". He added that the "male biologists who fretted over [the adaptionist questions] simply assumed that a deeply vaginal site, nearer the region of fertilization, would offer greater selective benefit" due to their Darwinian, summum bonum beliefs about enhanced reproductive success.[110]

Similar to Gould's beliefs about adaptionist views and that "females grow nipples as adaptations for suckling, and males grow smaller unused nipples as a spandrel based upon the value of single development channels",[110] Elisabeth Lloyd suggested that there is little evidence to support an adaptionist account of female orgasm.[105][108] Meredith L. Chivers stated that "Lloyd views female orgasm as an ontogenetic leftover; women have orgasms because the urogenital neurophysiology for orgasm is so strongly selected for in males that this developmental blueprint gets expressed in females without affecting fitness" and this is similar to "males hav[ing] nipples that serve no fitness-related function."[108]

At the 2002 conference for Canadian Society of Women in Philosophy, Nancy Tuana argued that the clitoris is unnecessary in reproduction; she stated that it has been ignored because of "a fear of pleasure. It is pleasure separated from reproduction. That's the fear." She reasoned that this fear causes ignorance, which veils female sexuality.[111] O'Connell stated, "It boils down to rivalry between the sexes: the idea that one sex is sexual and the other reproductive. The truth is that both are sexual and both are reproductive." She reiterated that the vestibular bulbs appear to be part of the clitoris and that the distal urethra and vagina are intimately related structures, although they are not erectile in character, forming a tissue cluster with the clitoris that appears to be the location of female sexual function and orgasm.[15][28]

Modifications to the clitoris can be intentional or unintentional. They include female genital mutilation (FGM), sex reassignment surgery (for trans men as part transitioning, which may also include clitoris enlargement), intersex surgery, and genital piercings.[26][112][113] Use of anabolic steroids by bodybuilders and other athletes can result in significant enlargement of the clitoris in concert with other masculinizing effects on their bodies.[114][115] Abnormal enlargement of the clitoris may also be referred to as clitoromegaly, but clitoromegaly is more commonly seen as a congenital anomaly of the genitalia.[22]

Those taking hormones or other medications as part of a transgender transition usually experience dramatic clitoral growth; individual desires and the difficulties of phalloplasty (construction of a penis) often result in the retention of the original genitalia with the enlarged clitoris as a penis analogue (metoidioplasty).[26][113] However, the clitoris cannot reach the size of the penis through hormones.[113] A surgery to add function to the clitoris, such as metoidioplasty, is an alternative to phalloplasty that permits retention of sexual sensation in the clitoris.[113]

In clitoridectomy, the clitoris may be removed as part of a radical vulvectomy to treat cancer such as vulvar intraepithelial neoplasia; however, modern treatments favor more conservative approaches, as invasive surgery can have psychosexual consequences.[116] Clitoridectomy more often involves parts of the clitoris being partially or completely removed during FGM, which may be additionally known as female circumcision or female genital cutting (FGC).[117][118] Removing the glans of the clitoris does not mean that the whole structure is lost, since the clitoris reaches deep into the genitals.[15]

In reduction clitoroplasty, a common intersex surgery, the glans is preserved and parts of the erectile bodies are excised.[26] Problems with this technique include loss of sensation, sexual function, and sloughing of the glans.[26] One way to preserve the clitoris with its innervations and function is to imbricate and bury the clitoral glans; however, enayl et al. state that "pain during stimulus because of trapped tissue under the scarring is nearly routine. In another method, 50percent of the ventral clitoris is removed through the level base of the clitoral shaft, and it is reported that good sensation and clitoral function are observed in follow up"; additionally, it has "been reported that the complications are from the same as those in the older procedures for this method".[26]

With regard to females who have the condition congenital adrenal hyperplasia, the largest group requiring surgical genital correction, researcher Atilla enayl stated, "The main expectations for the operations are to create a normal female anatomy, with minimal complications and improvement of life quality." enayl added that "[c]osmesis, structural integrity, and coital capacity of the vagina, and absence of pain during sexual activity are the parameters to be judged by the surgeon." (Cosmesis usually refers to the surgical correction of a disfiguring defect.) He stated that although "expectations can be standardized within these few parameters, operative techniques have not yet become homogeneous. Investigators have preferred different operations for different ages of patients".[26]

Gender assessment and surgical treatment are the two main steps in intersex operations. "The first treatments for clitoromegaly were simply resection of the clitoris. Later, it was understood that the clitoris glans and sensory input are important to facilitate orgasm," stated Atilla. The clitoral glans's epithelium "has high cutaneous sensitivity, which is important in sexual responses" and it is because of this that "recession clitoroplasty was later devised as an alternative, but reduction clitoroplasty is the method currently performed."[26]

What is often referred to as "clit piercing" is the more common (and significantly less complicated) clitoral hood piercing. Since clitoral piercing is difficult and very painful, piercing of the clitoral hood is more common than piercing the clitoral shaft, owing to the small percentage of people who are anatomically suited for it.[112] Clitoral hood piercings are usually channeled in the form of vertical piercings, and, to a lesser extent, horizontal piercings. The triangle piercing is a very deep horizontal hood piercing, and is done behind the clitoris as opposed to in front of it. For styles such as the Isabella, which pass through the clitoral shaft but are placed deep at the base, they provide unique stimulation and still require the proper genital build; the Isabella starts between the clitoral glans and the urethra, exiting at the top of the clitoral hood; this piercing is highly risky with regard to damage that may occur because of intersecting nerves.[112]

Persistent genital arousal disorder (PGAD) results in a spontaneous, persistent, and uncontrollable genital arousal in women, unrelated to any feelings of sexual desire.[119] Clitoral priapism, also known as clitorism, is a rare, potentially painful medical condition and is sometimes described as an aspect of PGAD.[119] With PGAD, arousal lasts for an unusually extended period of time (ranging from hours to days);[120] it can also be associated with morphometric and vascular modifications of the clitoris.[121]

Drugs may cause or affect clitoral priapism. The drug trazodone is known to cause male priapism as a side effect, but there is only one documented report that it may have caused clitoral priapism, in which case discontinuing the medication may be a remedy.[122] Additionally, nefazodone is documented to have caused clitoral engorgement, as distinct from clitoral priapism, in one case,[122] and clitoral priapism can sometimes start as a result of, or only after, the discontinuation of antipsychotics or selective serotonin reuptake inhibitors (SSRIs).[123]

Because PGAD is relatively rare and, as its own concept apart from clitoral priapism, has only been researched since 2001, there is little research into what may cure or remedy the disorder.[119] In some recorded cases, PGAD was caused by, or caused, a pelvic arterial-venous malformation with arterial branches to the clitoris; surgical treatment was effective in these cases.[124]

With regard to historical and modern perceptions of the clitoris and associated sexual stimulation, for more than 2,500 years there were scholars who considered the clitoris and the penis equivalent in all respects except their arrangement.[125] The clitoris was, however, subject to "discovery" and "rediscovery" through empirical documentation by male scholars, due to it being frequently omitted from, or misrepresented, in historical and contemporary anatomical texts.[126] The ancient Greeks, ancient Romans, and Greek and Roman generations up to and throughout the Renaissance, were aware that male and female sex organs are anatomically similar,[127][128] but prominent anatomists, notably Galen (129 c. 200 AD) and Vesalius (15141564), regarded the vagina as the structural equivalent of the penis, except for being inverted; Vesalius argued against the existence of the clitoris in normal women, and his anatomical model described how the penis corresponds with the vagina, without a role for the clitoris.[129]

Ancient Greek and Roman sexuality additionally designated penetration as "male-defined" sexuality. The term tribas, or tribade, was used to refer to a woman or intersex individual who actively penetrated another person (male or female) through use of the clitoris or a dildo. As any sexual act was believed to require that one of the partners be "phallic" and that therefore sexual activity between women was impossible without this feature, mythology popularly associated lesbians with either having enlarged clitorises or as incapable of enjoying sexual activity without the substitution of a phallus.[130][131]

In 1545, Charles Estienne was the first writer to identify the clitoris in a work based on dissection, but he concluded that it had a urinary function.[15] Following this study, Realdo Colombo (also known as Matteo Renaldo Colombo), a lecturer in surgery at the University of Padua, Italy, published a book called De re anatomica in 1559, in which he describes the "seat of woman's delight".[132] In his role as researcher, Colombo concluded, "Since no one has discerned these projections and their workings, if it is permissible to give names to things discovered by me, it should be called the love or sweetness of Venus.", in reference to the mythological Venus, goddess of erotic love.[133][134] Colombo's claim was disputed by his successor at Padua, Gabriele Falloppio (discoverer of the fallopian tube), who claimed that he was the first to discover the clitoris. In 1561, Falloppio stated, "Modern anatomists have entirely neglected it... and do not say a word about it... and if others have spoken of it, know that they have taken it from me or my students." This caused an upset in the European medical community, and, having read Colombo's and Falloppio's detailed descriptions of the clitoris, Vesalius stated, "It is unreasonable to blame others for incompetence on the basis of some sport of nature you have observed in some women and you can hardly ascribe this new and useless part, as if it were an organ, to healthy women." He concluded, "I think that such a structure appears in hermaphrodites who otherwise have well formed genitals, as Paul of Aegina describes, but I have never once seen in any woman a penis (which Avicenna called albaratha and the Greeks called an enlarged nympha and classed as an illness) or even the rudiments of a tiny phallus."[135]

The average anatomist had difficulty challenging Galen's or Vesalius's research; Galen was the most famous physician of the Greek era and his works were considered the standard of medical understanding up to and throughout the Renaissance (i.e. for almost two thousand years),[128][129] and various terms being used to describe the clitoris seemed to have further confused the issue of its structure. In addition to Avicenna's naming it the albaratha or virga ("rod") and Colombo's calling it sweetness of Venus, Hippocrates used the term columella ("little pillar'"), and Albucasis, an Arabic medical authority, named it tentigo ("tension"). The names indicated that each description of the structures was about the body and glans of the clitoris, but usually the glans.[15] It was additionally known to the Romans, who named it (vulgar slang) landica.[136] However, Albertus Magnus, one of the most prolific writers of the Middle Ages, felt that it was important to highlight "homologies between male and female structures and function" by adding "a psychology of sexual arousal" that Aristotle had not used to detail the clitoris. While in Constantine's treatise Liber de coitu, the clitoris is referred to a few times, Magnus gave an equal amount of attention to male and female organs.[15]

Like Avicenna, Magnus also used the word virga for the clitoris, but employed it for the male and female genitals; despite his efforts to give equal ground to the clitoris, the cycle of suppression and rediscovery of the organ continued, and a 16th-century justification for clitoridectomy appears to have been confused by hermaphroditism and the imprecision created by the word nymphae substituted for the word clitoris. Nymphotomia was a medical operation to excise an unusually large clitoris, but what was considered "unusually large" was often a matter of perception.[15] The procedure was routinely performed on Egyptian women,[137][138] due to physicians such as Jacques Dalchamps who believed that this version of the clitoris was "an unusual feature that occurred in almost all Egyptian women [and] some of ours, so that when they find themselves in the company of other women, or their clothes rub them while they walk or their husbands wish to approach them, it erects like a male penis and indeed they use it to play with other women, as their husbands would do... Thus the parts are cut".[15]

Caspar Bartholin, a 17th-century Danish anatomist, dismissed Colombo's and Falloppio's claims that they discovered the clitoris, arguing that the clitoris had been widely known to medical science since the second century.[139] Although 17th-century midwives recommended to men and women that women should aspire to achieve orgasms to help them get pregnant for general health and well-being and to keep their relationships healthy,[128] debate about the importance of the clitoris persisted, notably in the work of Regnier de Graaf in the 17th century[39][140] and Georg Ludwig Kobelt in the 19th.[15]

Like Falloppio and Bartholin, De Graaf criticized Colombo's claim of having discovered the clitoris; his work appears to have provided the first comprehensive account of clitoral anatomy.[141] "We are extremely surprised that some anatomists make no more mention of this part than if it did not exist at all in the universe of nature," he stated. "In every cadaver we have so far dissected we have found it quite perceptible to sight and touch." De Graaf stressed the need to distinguish nympha from clitoris, choosing to "always give [the clitoris] the name clitoris" to avoid confusion; this resulted in frequent use of the correct name for the organ among anatomists, but considering that nympha was also varied in its use and eventually became the term specific to the labia minora, more confusion ensued.[15] Debate about whether orgasm was even necessary for women began in the Victorian era, and Freud's 1905 theory about the immaturity of clitoral orgasms (see above) negatively affected women's sexuality throughout most of the 20th century.[128][142]

Towards the end of World War I, a maverick British MP named Noel Pemberton Billing published an article entitled "The Cult of the Clitoris", furthering his conspiracy theories and attacking the actress Maud Allan and Margot Asquith, wife of the prime minister. The accusations led to a sensational libel trial, which Billing eventually won; Philip Hoare reports that Billing argued that "as a medical term, 'clitoris' would only be known to the 'initiated', and was incapable of corrupting moral minds".[143] Jodie Medd argues in regard to "The Cult of the Clitoris" that "the female nonreproductive but desiring body [...] simultaneously demands and refuses interpretative attention, inciting scandal through its very resistance to representation."[144]

From the 18th 20th century, especially during the 20th, details of the clitoris from various genital diagrams presented in earlier centuries were omitted from later texts.[128][145] The full extent of the clitoris was alluded to by Masters and Johnson in 1966, but in such a muddled fashion that the significance of their description became obscured; in 1981, the Federation of Feminist Women's Health Clinics (FFWHC) continued this process with anatomically precise illustrations identifying 18 structures of the clitoris.[56][128] Despite the FFWHC's illustrations, Josephine Lowndes Sevely, in 1987, described the vagina as more of the counterpart of the penis.[146]

Concerning other beliefs about the clitoris, Hite (1976 and 1981) found that, during sexual intimacy with a partner, clitoral stimulation was more often described by women as foreplay than as a primary method of sexual activity, including orgasm.[147] Further, although the FFWHC's work significantly propelled feminist reformation of anatomical texts, it did not have a general impact.[97][148] Helen O'Connell's late 1990s research motivated the medical community to start changing the way the clitoris is anatomically defined.[97] O'Connell describes typical textbook descriptions of the clitoris as lacking detail and including inaccuracies, such as older and modern anatomical descriptions of the female human urethral and genital anatomy having been based on dissections performed on elderly cadavers whose erectile (clitoral) tissue had shrunk.[98] She instead credits the work of Georg Ludwig Kobelt as the most comprehensive and accurate description of clitoral anatomy.[15] MRI measurements, which provide a live and multi-planar method of examination, now complement the FFWHC's, as well as O'Connell's, research efforts regarding the clitoris, showing that the volume of clitoral erectile tissue is ten times that which is shown in doctors' offices and in anatomy text books.[39][97]

In Bruce Bagemihl's survey of The Zoological Record (19781997) which contains over a million documents from over 6,000 scientific journals 539 articles focusing on the penis were found, while 7 were found focusing on the clitoris.[149] In 2000, researchers Shirley Ogletree and Harvey Ginsberg concluded that there is a general neglect of the word clitoris in common vernacular. They looked at the terms used to describe genitalia in the PsycINFO database from 1887 to 2000 and found that penis was used in 1,482 sources, vagina in 409, while clitoris was only mentioned in 83. They additionally analyzed 57 books listed in a computer database for sex instruction. In the majority of the books, penis was the most commonly discussed body part mentioned more than clitoris, vagina, and uterus put together. They last investigated terminology used by college students, ranging from Euro-American (76%/76%), Hispanic (18%/14%), and African American (4%/7%), regarding the students' beliefs about sexuality and knowledge on the subject. The students were overwhelmingly educated to believe that the vagina is the female counterpart of the penis. The authors found that the students' belief that the inner portion of the vagina is the most sexually sensitive part of the female body correlated with negative attitudes toward masturbation and strong support for sexual myths.[150][151]

A 2005 study reported that, among a sample of undergraduate students, the most frequently cited sources for knowledge about the clitoris were school and friends, and that this was associated with the least amount of tested knowledge. Knowledge of the clitoris by self-exploration was the least cited, but "respondents correctly answered, on average, three of the five clitoral knowledge measures". The authors stated that "[k]nowledge correlated significantly with the frequency of women's orgasm in masturbation but not partnered sex" and that their "results are discussed in light of gender inequality and a social construction of sexuality, endorsed by both men and women, that privileges men's sexual pleasure over women's, such that orgasm for women is pleasing, but ultimately incidental." They concluded that part of the solution to remedying "this problem" requires that males and females are taught more about the clitoris than is currently practiced.[152]

In May 2013, humanitarian group Clitoraid launched the first annual International Clitoris Awareness Week, from May 6 to May 12. Clitoraid spokesperson Nadine Gary stated that the group's mission is to raise public awareness about the clitoris because it has "been ignored, vilified, made taboo, and considered sinful and shameful for centuries".[153][154]

In 2016, Odile Fillod created a 3D printable, open source, full-size model of the clitoris, for use in a set of sex education videos she had been commissioned to produce. This model, first designed with Sculpteo,[155] was subsequently exhibited at the Cit des Sciences et de l'Industrie, the largest science museum in Europe.[156] Fillod was interviewed by Stephanie Theobald, whose article in The Guardian stated that the 3D model would be used in French primary and secondary schools;[157] this was never the case, but the story went viral across the world, demonstrating, according to Fillod, the public's hunger for information about the clitoris.[158]

In 2012, New York artist Sophia Wallace started work on a multimedia project to challenge misconceptions about the clitoris. Based on O'Connell's 1998 research, Wallace's work emphasizes the sheer scope and size of the human clitoris. She says that ignorance of this still seems to be pervasive in modern society. "It is a curious dilemma to observe the paradox that on the one hand the female body is the primary metaphor for sexuality, its use saturates advertising, art and the mainstream erotic imaginary," she said. "Yet, the clitoris, the true female sexual organ, is virtually invisible." The project is called Cliteracy and it includes a "clit rodeo", which is an interactive, climb-on model of a giant golden clitoris, including its inner parts, produced with the help of sculptor Kenneth Thomas. "It's been a showstopper wherever it's been shown. People are hungry to be able to talk about this," Wallace said. "I love seeing men standing up for the clit [...] Cliteracy is about not having one's body controlled or legislated [...] Not having access to the pleasure that is your birthright is a deeply political act."[159]

In 2016, another project started in New York, street art that has since spread to almost 100 cities: Clitorosity, a "community-driven effort to celebrate the full structure of the clitoris", combining chalk drawings and words to spark interaction and conversation with passers-by, which the team documents on social media.[160][161]

Other projects listed by the BBC include Clito Clito, body-positive jewellery made in Berlin; Clitorissima, a documentary intended to normalize mother-daughter conversations about the clitoris; and a ClitArt festival in London, encompassing spoken word performances as well as visual art.[161] French art collective Les Infemmes (a pun on "infamous" and "women") published a fanzine whose title can be translated as "The Clit Cheatsheet".[156]

Significant controversy surrounds female genital mutilation (FGM),[117][118] with the World Health Organization (WHO) being one of many health organizations that have campaigned against the procedures on behalf of human rights, stating that "FGM has no health benefits" and that it is "a violation of the human rights of girls and women" and "reflects deep-rooted inequality between the sexes".[118] The practice has existed at one point or another in almost all human civilizations,[137] most commonly to exert control over the sexual behavior, including masturbation, of girls and women, but also to change the clitoris's appearance.[118][138][162] Custom and tradition are the most frequently cited reasons for FGM, with some cultures believing that not performing it has the possibility of disrupting the cohesiveness of their social and political systems, such as FGM also being a part of a girl's initiation into adulthood. Often, a girl is not considered an adult in a FGM-practicing society unless she has undergone FGM,[118][138] and the "removal of the clitoris and labia viewed by some as the male parts of a woman's body is thought to enhance the girl's femininity, often synonymous with docility and obedience".[138]

Female genital mutilation is carried out in several societies, especially in Africa, with 85 percent of genital mutilations performed in Africa consisting of clitoridectomy or excision,[138][163] and to a lesser extent in other parts of the Middle East and Southeast Asia, on girls from a few days old to mid-adolescent, often to reduce sexual desire in an effort to preserve vaginal virginity.[118][138][162] The practice of FGM has spread globally, as immigrants from Asia, Africa, and the Middle East bring the custom with them.[164] In the United States, it is sometimes practiced on girls born with a clitoris that is larger than usual.[117] Comfort Momoh, who specializes in the topic of FGM, states that FGM might have been "practiced in ancient Egypt as a sign of distinction among the aristocracy"; there are reports that traces of infibulation are on Egyptian mummies.[137] FGM is still routinely practiced in Egypt.[138][165] Greenberg et al. report that "one study found that 97% of married women in Egypt had had some form of genital mutilation performed."[165] Amnesty International estimated in 1997 that more than two million FGM procedures are performed every year.[138]

Although the clitoris exists in all mammal species,[149] few detailed studies of the anatomy of the clitoris in non-humans exist.[166] The clitoris is especially developed in fossas,[167] apes, lemurs, and, like the penis, often contains a small bone, the os clitoridis.[168] The clitoris exists in turtles,[169] ostriches,[170] crocodiles,[169] and in species of birds in which the male counterpart has a penis.[169] The clitoris erects in squirrel monkeys during dominance displays, which indirectly influences the squirrel monkeys' reproductive success.[171] In female galagos (bush babies), the clitoris is long and pendulous with a urethra extending through the tip for urination.[172][173] Some intersex female bears mate and give birth through the tip of the clitoris; these species are grizzly bears, brown bears, American black bears and polar bears. Although the bears have been described as having "a birth canal that runs through the clitoris rather than forming a separate vagina" (a feature that is estimated to make up 10 to 20 percent of the bears' population),[174] scientists state that female spotted hyenas are the only non-hermaphroditic female mammals devoid of an external vaginal opening, and whose sexual anatomy is distinct from usual intersex cases.[175] There are also several mole species with a peniform clitoris.[176][177]

In spider monkeys, the clitoris is especially developed and has an interior passage, or urethra, that makes it almost identical to the penis, and it retains and distributes urine droplets as the female spider monkey moves around. Scholar Alan F. Dixson stated that this urine "is voided at the bases of the clitoris, flows down the shallow groove on its perineal surface, and is held by the skin folds on each side of the groove".[178] Because spider monkeys of South America have pendulous and erectile clitorises long enough to be mistaken for a penis, researchers and observers of the species look for a scrotum to determine the animal's sex; a similar approach is to identify scent-marking glands that may also be present on the clitoris.[173]

The clitoris of bonobos is larger and more externalized than in most mammals;[179] Natalie Angier said that a young adolescent "female bonobo is maybe half the weight of a human teenager, but her clitoris is three times bigger than the human equivalent, and visible enough to waggle unmistakably as she walks".[180] Female bonobos often engage in the practice of genital-genital (GG) rubbing, which is the non-human form of tribadism that human females engage in. Ethologist Jonathan Balcombe stated that female bonobos rub their clitorises together rapidly for ten to twenty seconds, and this behavior, "which may be repeated in rapid succession, is usually accompanied by grinding, shrieking, and clitoral engorgement"; he added that, on average, they engage in this practice "about once every two hours", and as bonobos sometimes mate face-to-face, "evolutionary biologist Marlene Zuk has suggested that the position of the clitoris in bonobos and some other primates has evolved to maximize stimulation during sexual intercourse".[179]

While female spotted hyenas are sometimes referred to as hermaphrodites or as intersex,[173] and scientists of ancient and later historical times believed that they were hermaphrodites,[173][175][181] modern scientists do not refer to them as such.[175][182] That designation is typically reserved for those who simultaneously exhibit features of both sexes;[182] the genetic makeup of female spotted hyenas "are clearly distinct" from male spotted hyenas.[175][182]

Female spotted hyenas have a clitoris 90percent as long and the same diameter as a male penis (171 millimeters long and 22 millimeters in diameter),[173] and this pseudo-penis's formation seems largely androgen-independent because it appears in the female fetus before differentiation of the fetal ovary and adrenal gland.[175] The spotted hyenas have a highly erectile clitoris, complete with a false scrotum; author John C. Wingfield stated that "the resemblance to male genitalia is so close that sex can be determined with confidence only by palpation of the scrotum".[171] The pseudo-penis can also be distinguished from the males' genitalia by its greater thickness and more rounded glans.[175] The female possesses no external vagina, as the labia are fused to form a pseudo-scrotum. In the females, this scrotum consists of soft adipose tissue.[171][175][183] Like male spotted hyenas with regard to their penises, the female spotted hyenas have small penile spines on the head of their clitorises, which scholar Catherine Blackledge said makes "the clitoris tip feel like soft sandpaper". She added that the clitoris "extends away from the body in a sleek and slender arc, measuring, on average, over 17 cm from root to tip. Just like a penis, [it] is fully erectile, raising its head in hyena greeting ceremonies, social displays, games of rough and tumble or when sniffing out peers".[184]

Due to their higher levels of androgen exposure, the female hyenas are significantly more muscular and aggressive than their male counterparts; social-wise, they are of higher rank than the males, being dominant or dominant and alpha, and the females who have been exposed to higher levels of androgen than average become higher-ranking than their female peers. Subordinate females lick the clitorises of higher-ranked females as a sign of submission and obedience, but females also lick each other's clitorises as a greeting or to strengthen social bonds; in contrast, while all males lick the clitorises of dominant females, the females will not lick the penises of males because males are considered to be of lowest rank.[183][186]

The urethra and vagina of the female spotted hyena exit through the clitoris, allowing the females to urinate, copulate and give birth through this organ.[171][175][184][187] This trait makes mating more laborious for the male than in other mammals, and also makes attempts to sexually coerce (physically force sexual activity on) females futile.[183] Joan Roughgarden, an ecologist and evolutionary biologist, said that because the hyena's clitoris is higher on the belly than the vagina in most mammals, the male hyena "must slide his rear under the female when mating so that his penis lines up with [her clitoris]". In an action similar to pushing up a shirtsleeve, the "female retracts the [pseudo-penis] on itself, and creates an opening into which the male inserts his own penis".[173] The male must practice this act, which can take a couple of months to successfully perform.[186] Female spotted hyenas exposed to larger doses of androgen have significantly damaged ovaries, making it difficult to conceive.[186] After giving birth, the pseudo-penis is stretched and loses much of its original aspects; it becomes a slack-walled and reduced prepuce with an enlarged orifice with split lips.[188] Approximately 15% of the females die during their first time giving birth, and over 60% of their species' firstborn young die.[173]

A 2006 Baskin et al. study concluded, "The basic anatomical structures of the corporeal bodies in both sexes of humans and spotted hyenas were similar. As in humans, the dorsal nerve distribution was unique in being devoid of nerves at the 12 o'clock position in the penis and clitoris of the spotted hyena" and that "[d]orsal nerves of the penis/clitoris in humans and male spotted hyenas tracked along both sides of the corporeal body to the corpus spongiosum at the 5 and 7 o'clock positions. The dorsal nerves penetrated the corporeal body and distally the glans in the hyena" and, in female hyenas, "the dorsal nerves fanned out laterally on the clitoral body. Glans morphology was different in appearance in both sexes, being wide and blunt in the female and tapered in the male".[187]

Researchers studying the peripheral and central afferent pathways from the feline clitoris concluded that "afferent neurons projecting to the clitoris of the cat were identified by WGA-HRP tracing in the S1 and S2 dorsal root ganglia. An average of 433 cells were identified on each side of the animal. 85percent and 15percent of the labeled cells were located in the S1 and S2 dorsal root ganglia, respectively. The average cross sectional area of clitoral afferent neuron profiles was 1.479627 m2." They also stated that light "constant pressure on the clitoris produced an initial burst of single unit firing (maximum frequencies 170255 Hz) followed by rapid adaptation and a sustained firing (maximum 40 Hz), which was maintained during the stimulation" and that further examination of tonic firing "indicate that the clitoris is innervated by mechano-sensitive myelinated afferent fibers in the pudental nerve which project centrally to the region of the dorsal commissure in the L7-S1 spinal cord".[189]

The external phenotype and reproductive behavior of 21 freemartin sheep and two male pseudohermaphrodite sheep were recorded with the aim of identifying any characteristics that could predict a failure to breed. The vagina's length and the size and shape of the vulva and clitoris were among the aspects analyzed. While the study reported that "a number of physical and behavioural abnormalities were detected," it also concluded that "the only consistent finding in all 23 animals was a short vagina which varied in length from 3.1 to 7.0 cm, compared with 10 to 14 cm in normal animals."[190]

In a study concerning the clitoral structure of mice, the mouse perineal urethra was documented as being surrounded by erectile tissue forming the bulbs of the clitoris.[166] The researchers stated, "In the mouse, as in human females, tissue organization in the corpora cavernosa of the clitoris is essentially similar to that of the penis except for the absence of a subalbugineal layer interposed between the tunica albuginea and the erectile tissue."[166]

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Cindi Pearce

Cindi Pearce is a graduate of Ohio University, where she received her bachelors degree in journalism. She completed both the undergraduate and graduate courses offered by the Institute of Childrens Literature. Pearce has been writing professionally for over 30 years.

Low testosterone levels affect women as well as men. Women may experience loss of sex drive, weaker orgasms, lethargy, loss of energy and endurance, and brittle bones. Men may suffer from infertility, diminished libido, erectile dysfunction, changes in body composition, reduction in facial and body hair, osteoporosis, impaired masculization, fatigue, depression, anger and confusion. While pharmaceuticals are often used to combat low levels of testosterone, many people prefer to use the natural approaches that are also available to increase their testosterone levels.

To replace testosterone naturally, consider one of two kinds of herbal supplements: non-estrogenic herbs and phytoestrogenic herbs. According to Vitamins.lovetoknow.com, non-estrogenic herbs work best to restore your hormone balance. According to Menopause-herbsfemhealth.com, non-estrogenic herbs do not contain any chemical structures similar to estrogen, but nevertheless they feed the endocrine system and balance hormones as a result. The non-estrogenic herb Macafem does a good job of maintaining hormonal balance. Macafem is grown in Peru and is a hardy perennial. This herb has an effect on the pituitary and endocrine glands, stimulating hormone production and helping you make your own natural hormones.

Foods that will naturally introduce testosterone into your system include radishes, cabbage, turnips, beef, broccoli, Brussels sprouts, garlic, oysters, eggs and cauliflower. Try to eat some or all of these items on a regular basis to increase your testosterone level.

Another approach to naturally increasing testosterone is to take an herbal supplement called tribulus terrestris. According to Bodybuildingforyou.com, tribulus terrestris increases testosterone by increasing the levels of luteinizing hormones in men and women. After the luteinizing hormones are increased, the secretion of sex steroids in males and females is stimulated. The luteinizing hormones bind to the receptors, stimulating synthesis and secretion of testosterone. In women, the cells of the ovary are stimulated.

Essential fatty acids will improve your testosterone levels, so make sure to eat peanuts, avocados, canola oil, olive oil, flaxseed oil and fish. If you are deficient in essential fats, your body can't produce the needed amount of testosterone. Testosterone is made from cholesterol, according to Vitaminslovetoknow.com. The best diet for increasing testosterone is made up of high protein, moderate fat and low carbohydrates.

The primary function of phytoestrogenic herbs is to relieve symptoms of menopause, according to Menopause-herbsfemhealth.net Many of these symptoms are caused by low levels of estrogen, the female hormone. The best phytoestrogenic herbs include black cohosh, gingko biloba, dong quai and red clover. There are, however, some medical concerns about phytoestrogenic herbs because they add hormones to the body, which could conceivably produce bad results, including breast cancer.

As men grow older, their bodies begin to manufacture less of the hormone testosterone. When testosterone levels drop, less sperm is produced...

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