I'm a fifteen-year-old girl, and I have a pretty great relationship with my parents, but I'm nervous to tell them that I have an enlarged clit. I know this is a medical problem, but I'm seeking relationship advice with my parents. Should I trust them enough to ask them to see a Gyno? In the past, they've seemed reluctant to talk about it. The internet seems to think that it could be caused by an excess of testosterone. Is that why I seem so much more sexually inclined than the other girls my age? Is this weird? I've been making excuses not to have [safe, of course] sex with boys, not because I don't want to, but rather because I'm scared they'll think I'm a freak.

Concerned Like Intensely Terrified

I passed this question along to regular "Savage Love" guest expert and friend-of-Slog superstar Alice Dreger, a member of the Medical Humanities and Bioethics program at Northwestern University's Feinberg School of Medicine and a patient advocate for people born with "different-than-average sex anatomies." Dreger responded at length to CLIT's letter, fisking-style, and you can read Alice's brilliant advice after the jump.

I'm a fifteen-year-old girl, and I have a pretty great relationship with my parents, but I'm nervous to tell them that I have an enlarged clit. I know this is a medical problem,

A big clit is NOT a medical problem unless you are going around accidentally poking somebody's eye out with it. (And then it is that person's medical problem, not yours, though I guess you might be liable.)

A big clit CAN indicate an underlying medical problem. In that sense, it can be a symptom of something that needs treatment, but don't confuse the two. It can indicate that you have a hormonal imbalance which may need treatment for you to stay healthy.

but I'm seeking relationship advice with my parents. Should I trust them enough to ask them to see a Gyno? In the past, they've seemed reluctant to talk about it.

Your parents are probably dealing with their own issues of confusion, shame, and fear. The best thing to do would be to find a trusted adult (ideally someone who is a social worker, psychologist, or some other kind of counselor who works positively with families) who can sit with you and your parents and talk about all of this. The problem is, I know of only about three people, truly qualified to do this, in North America. I mean that's how many people are qualified to understand the biology, the sexuality issues, and family dynamics in a way that is sex positive and loving.

Most docs don't know diddly about sex variations like yours and they will fumble and freak out. That's not going to help you. You want a doc who is sex positive, who treats you as a young adult, and who understands the difference between a big clit and a medical issue. Contact me and tell me where you're located, and we'll try to find you a good doc. Or, if you have a good family doc, use that person and have him or her contact me so I can put that person in touch with the experts so that you combine decent, humane care with biological expertise.

It's most likely, by the way, that you'll end up with a pediatric endocrinologist, so you might just start there. But again, you want someone who is decent to you and doesn't confuse your big clit with a medical problem.

I'm afraid for you. Too many docs in this country will still treat you in a way that is backwards, against the evidence, and sex-negative. They'll parade in a bunch of medical students and residents to look at the specimen. They'll offer you surgery you don't need, implying there's something wrong with your genitals when there isn't. They'll worry your parents and make them feel unnecessarily guilty.

The internet seems to think that it could be caused by an excess of testosterone.

Excess of androgens, actually (testosterone is one kind of androgen).

Is that why I seem so much more sexually inclined than the other girls my age?

Could be, yes. Or maybe you're just ahead of the curve.

Is this weird?

It's statistically less common than the more boring kind of clit, but I would do what most women with big clits do: think of it as NORMAL FOR YOU. It is normal for you. A word of advice: A lot of girls find their genitals strange, even when they have the kind that looks more like the gyn's wall diagram. I'm trying to avoid references to canned ham, here, while making the point to you that you're not alone in feeling some anxiety about your genitals. The difference is that you have something that stands out, so to speak, and I don't want to minimize that (rhetorically or surgically).

I've been making excuses not to have [safe, of course] sex with boys, not because I don't want to, but rather because I'm scared they'll think I'm a freak.

You need to understand your own situation before you have sex with boys, so that you can explain to them what's up in a way that indicates some level of comfort and confidence. Practicing talking about it with a sex therapist playing the role of a boy would be good. And then try to find boys who are decent enough to get that variations in sex anatomy can be fun. (God knows a lot of teenage boys would be helped by a clit big enough to find easily.) Not all guys like giant boobs, not all like small boobs. Many guys are perfectly comfortable with variations on boob size. They can be educated about the fact that clit sizes vary.

And by the way, the only reason people DON'T commonly know that clit sizes vary is that most women who were born with big clits unfortunately had some surgeon who cut most of it off when they were babies. The docs feared exactly the situation you're in—having to deal with the social awkwardness of a size that doesn't meet typical expectations. Believe me, you are fortunate to still have yours—I'll bet it works. The surgery often leaves people with diminished sexual sensation (you still have the urge, but you can't get off), with scar tissue (try explaining THAT to a new lover), and with a permanent sense of shame. A study of adult women who had their clits reduced when they were adults found that they did not benefit in the ways they wanted; that is, the surgical reduction didn't reduce their fears and concerns. It just left them with all the "side effects" of surgery.

Finally, beware fetishists. These are guys who are into your clit, but not into you. You want a guy who is into all of you.

How to find a sex therapist: http://www.aasect.org/
How to find a pediatric and adolescent gynecologist (much more likely to understand these variations than the average gynecologist): http://www.naspag.org/

Alice