Webmaster's Note: This Q&A was originally in Spanish and has been translated into English.
Question: You know, I have a big problem: I have a 6 year old daughter, right now we are doing research because the doctor says her clitoris is perhaps larger than normal. I am confused, it could be a case of hermaphroditism and I would like you to help me as soon as possible. Please send me all the information you have on this subject, including genetics, heritage, etc. Everything that is related.
This is very new and unknown to me. I have been looking for information on the web, but unfortunately there is a great lack of information regarding this matter. I am very interested in this subject and I want to investigate cases, illnesses, development, etc. Can you help?
Answer: There is information on the website that addresses this subject. Some of the material has been translated into Spanish.
In Spanish: The-Clitoris.com
In English: Clitoral and Labial Size
A large clitoris in not always an indication of hermaphroditism, an intersexed individual. There are normal and healthy girls and women who have a clitoris that measure up to 6 cm (2.5 inches) in length, though most are much smaller, even when above average in size. Having a large clitoris is likely no different than having a large nose or ears.
There are several potential causes for a girl to have a large clitoris. It may be a physical family trait passed down from generation to generation. She could have been exposed to increased levels of androgens while still the womb, as the result of elevated hormone levels in her mother's body. Her mother's body could have produced these hormones, or they could have come from medications she was prescribed during pregnancy. Her clitoris could be a normal random variation, which occur in one form or another, in all people. All girls and women have genitals that are uniquely shaped and colored, your daughter is no different in that respect.
Your daughter could have a genetic condition that has resulted in her being intersexed. If she is intersexed, surgery would never change this. Surgery can make cosmetic changes, but her genetic and psychological sex can't be changed. She may choose or believe she is one sex or the other, but her physical appearance may have no bearing on this.
A large clitoris may look like a small penis. This is because the clitoris and penis develop from the same tissues during early fetal development. Since the clitoris and penis are created from the same tissues, they function much the same. If you daughter's clitoris happens to look like a penis, it is still just a clitoris. A penis is merely a fully developed clitoris, they are one and the same.
A former co-worker's six-year-old daughter had an unusually large and prominent clitoris. It was clearly visible even when she was walking about while undressed. My co-worker was not overly concerned about this, even though she knew it was a bit unique. Her daughter did like to examine and touch her clitoris, which is normal for many girls, regardless of the size of their clitoris.
Be a little careful of the doctors, they may unintentionally traumatize your daughter, and make her feel abnormal. They may abuse her in the process of doing examinations and tests, trying to determine if she is healthy. Do not allow your daughter to be treated like she is an object for the doctors to test and dissect. Some women who were born with unique genitals have felt very traumatized by what the doctors did to them, when they were younger. If your daughter does not want to be examined, or have tests performed on her, then do not force her. Limit the number of doctors who examine her to as few as possible. If there are no indications of a medical problem, it is perhaps best to just let her be.
Here is a link to an article that has recommendations on how to treat children with ambiguous genitals.
Management of Intersexuality: Guidelines for dealing with individuals with ambiguous genitalia
There are some doctors who recommend cutting off or reducing a clitoris that is above average in size. My personal recommendation is that you not allow this to occur. This may cause more harm than good. It may lead her to believe there was something wrong with her, that she was somehow defective. She may feel she has something to keep hidden. The doctors may tell you that if you trim or remove her clitoris, she will grow up to be a normal woman, which is a potentially false statement to make. It may adversely affect her sexuality later in life, and there is no way to know for sure beforehand. This surgery may make it harder for her to experience sexual pleasure, if the nerves to her clitoris are altered or damaged. Look at it this way, if your daughter developed large breasts during puberty, would you force her to have them reduced or removed?
You can find some information in medical journals, at least those published in English. You can find many of them listed on the Internet. Search the medical journals at the website linked to below. Many if not most of the medical journals are about surgical management of ambiguous genitals, unfortunately.
U.S. National Library of Medicine
There are also websites for people who are intersexed. Keep in mind that male and female are actually slightly different versions of the same thing, not two distinctly different sexes, as many believe.
Intersex Society of North America (ISNA)
I hope this information is of help. If you have any questions please feel free to ask.
