A neoclitoris is a surgically constructed organ designed to provide sensation for individuals assigned female at birth undergoing gender-affirming surgery. This procedure creates a clitoris-like structure that aims to replicate the tactile and erogenous sensitivity of a natal clitoris. It is a component of certain gender-affirming surgical pathways, supporting anatomical reconstruction and an individual’s physical well-being.
How the Neoclitoris is Formed
A neoclitoris is formed through distinct surgical techniques: metoidioplasty and phalloplasty. Both utilize existing tissues.
In metoidioplasty, the surgeon works with the clitoris, which has often been enlarged by testosterone hormone therapy for one to two years prior to surgery. Ligaments attaching the clitoris to the pubic bone are carefully severed, allowing it to be released and repositioned to form a larger, more prominent clitoris-like structure. Surrounding local tissues, such as the labia minora, are used to add girth and support.
For phalloplasty, a new phallus is constructed using tissue flaps from other body areas like the forearm, thigh, or back. A neoclitoris can be created by incorporating or repositioning the natal clitoris, or by forming a new clitoral structure adjacent to the new phallus. Some phalloplasty techniques use specific tissues, such as the glans penis and inner foreskin, to fashion the neoclitoris and its prepuce.
Sensation and Purpose
The neoclitoris is designed to provide tactile and erogenous sensation. It retains its original nerve supply, specifically the dorsal clitoral nerves, which are preserved during surgery. This nerve preservation is important for maintaining sensitivity, as these nerves transmit sensations of touch, pressure, and sexual pleasure.
The human clitoris contains over 10,000 nerve fibers, highlighting the importance of nerve integrity for sensation. After surgery, individuals experience various types of sensation, including touch and pressure, with many reporting the ability to achieve orgasm. The degree and type of sensation can vary, but studies show the neoclitoris provides long-term erogenous sensitivity.
Post-Surgical Recovery and Appearance
The initial recovery period after neoclitoris formation involves swelling and a healing phase. Labial swelling resolves gradually over six to eight weeks after the procedure. Applying ice to the perineum during the first week can help mitigate swelling.
The appearance of a neoclitoris varies depending on the surgical technique. In metoidioplasty, the neoclitoris is larger and more prominent. In some phalloplasty techniques, it appears less distinct or more integrated into the overall penile construction. The final size and shape of the neoclitoris take several months to fully develop as swelling subsides and tissues settle.