L’anatomie du clitoris, un objet récurrent de controverses

Résumé Fr En

Organe exclusivement féminin, et exclusivement dévolu à la fonction érotique, le clitoris s’entoure pour beaucoup d’une aura fuligineuse qui a conduit certains systèmes de pensée au discrédit de son usage, certaines sectes et sociétés à son amputation systématique. Hostilité qui a longtemps prévalu sur toutes autres considérations, s’opposant à toute étude objective. Il pâtit aussi du tabou de la représentation de la vulve dans l’art figuratif et la statuaire occidentaux. Comme celle de son rôle physiologique, la description de son anatomie fut ainsi entachée de bien des erreurs. Après un consensus scientifique établi vers le milieu du XXe siècle cette anatomie est remise en cause depuis 1998 par des publications basées sur la résonance magnétique. Elles ont suscité une médiatisation approbative considérable qui est pour le moins prématurée. À l’aide de documents anatomiques inédits, le présent article s’efforce de mettre en doute cette nouvelle anatomie, et de relativiser le débat, dans le contexte des diverses controverses suscitées par le clitoris.Exclusively feminine organ, and exclusively devoted to the erotic function, the clitoris surrounds itself for many with a fuliginous aura that has led certain systems of thought to discredit its use, and certain sects and societies to its systematic amputation. Hostility, which has long prevailed over all other considerations, opposing any objective study. It also suffers from the taboo of the representation of the vulva in Western figurative art and statuary. Like the description of its physiological role, the description of its anatomy was thus marred by many errors. After a scientific consensus established in the middle of 20th century, this anatomy has been questioned since 1998 by publications based on magnetic resonance. They have attracted considerable media attention, which is premature to say the least. With the help of unpublished anatomical documents, this article attempts to cast doubt on this new anatomy, and to put the debate into perspective, in the context of the various controversies surrounding the clitoris.

Numerous studies have examined the negative impact of medically assisted reproduction (MAR) on patients’ sex lives. It appears necessary to question patients and sometimes to counsel them about management for their sexual and reproductive health. In this study prospective, quantitative, multicenter trial conducted from December 2018 through February 2019, we contacted the offices of all clinical MAR centers registered with the Agence de la Biomedecine (Biomedical Agency) to obtain a list of email addresses of the doctors working there and sent them questionnaires. We received 171 responses. The respondents were very predominantly women (89%), and their median age was 34 years (range: 28–64). Overall, 56% always discussed sexual function during their first consultation, 30% often, and 14% sometimes. We compared two groups: the “regular discussion” (RD) group, which included the doctors ( n=147) who responded “always” and “often”. The “occasional discussion” (OD) group included those ( n=24) who responded “sometimes”. The RD group discussed scheduling sexual relations less often than the OD group ( P=0.029). The RD and OD groups differed significantly in their rates of questions about the frequency of sexual relations ( P=0.04) and about problems of penetration ( P=0.025) and desire ( P=0.041); the RD group asked more often about all of these topics. In the RD group, 37% of the respondents had a sex therapist working at their center, and in the OD group, 21%, while respectively 9% and 17% did not know to whom or where to refer these patients, and 93% and 75% thought a sex therapist with expertise in MAR would be useful at their center. This study shows deficiencies in the management of sexual dysfunctions in MAR patients. Some actions that might improve the situation include: the creation of a directory of sex therapists, the creation of job lines at MAR centers for sex therapists specialized in this field, and the development of patient brochures and questionnaires.