How Melbourne urologist Helen O'Connell redefined research around the clitoris. - Brisbane Times


You can trace Professor Helen O'Connell's discovery of the full clitoris – and the rewriting of the world's anatomy texts – to two books: one that angered her and another that inspired. The first book, Last's Anatomy, she couldn't seem to escape. The 1985 edition was the set text for her surgical exam and – to her "utter disbelief" as a classic overachiever – she failed the test three times. She calls this the "ridiculous book"; it had almost no mention of the clitoris, and certainly no illustrations, yet there were two pages on the penis. To top it off, aspects of female genitals were described as a "failure" of male genital formation (O'Connell still has the book, the word "failure" underlined in blue pen).

"I knew at some point," she says, "that I was going to have to tackle that."

She came across the second book – a University of Melbourne social scientist showed it to her – a few months after finally passing her surgical exam, in 1989. It was called A New View of a Woman's Body and was published by the US Federation of Feminist Women's Health Centres. It's full of detailed drawings of vulvas. For the clitoris chapter, the female researchers took off their pants and compared themselves with illustrations in respected anatomy texts. Then they masturbated, observed each other and took notes of the many parts of the internal and external clitoris that were changed by, or contributed to, sexual pleasure or orgasm. Young Helen O'Connell, aged 27, found it "really cool" and the women's observations – though not scientific – "valid".

When she first tells me about this book in her consulting rooms in The Royal Melbourne Hospital's private wing, it's obvious she's still fascinated by these women and the way they watched and mapped each other's sexual responses. "Amazing methodology!" she laughs. "Don't you think? Just. Amazing." In the book, the researchers said they had no access to dead bodies or dissection rooms, so had to partially rely on old anatomy texts. And that was a lightbulb moment for O'Connell: she had access to dead bodies and dissection rooms at the University of Melbourne, where she was studying her master's of medicine in women's health. "We just needed to do good science and work it out from the cadavers," she says. And that, really, is how Helen O'Connell came to change the world of female anatomy forever.

I find myself sitting in O'Connell's office because, rather strangely, of Netflix. A few months ago I was watching a series called Explained, a show that packages the modern world – The Stock Market, Designer DNA, Cryptocurrency – into snappy 15- to 20-minute documentaries. On this particular night, the episode to load on my television was on the female orgasm. Around the eight-minute mark, the narrator said that in 1998 "the Australian urologist Helen O'Connell and her team discovered that the clitoris was way more powerful than we'd known". I sat up straight: a memory came flashing back to me.

It was 1998 and I was a young journalist at The Age, reading the day's news list. O'Connell had found that modern medical science was mistaken about the clitoris: the small button – or glans – that you can see is just the tip of the iceberg. Under the pubic bone, the organ looks like a wishbone with a body up to four centimetres long. Coming out of the body are legs, or crura, up to nine centimetres long, and also eggplant-shaped bulbs up to seven centimetres long. All these bits, O'Connell confirmed, are sensitive areas made of spongy tissue and become erect, just like the penis. A Melbourne doctor rewriting the anatomy books: this yarn, I thought, was a guaranteed front-pager.

But when I picked up the paper the next day, the lead front-page story was about a parasite that had shut down Sydney's water supply. Victorian premier Jeff Kennett was calling for states to have the power to veto potential hikes in the incoming GST, and visiting US Secretary of State Madeleine Albright had urged action on climate change. The clitoris story ended up on page six, squeezed between the paper's fold and a story about an American donation of wheat to Indonesia. Even in this, its moment of glory, the clitoris was treated as it had ever been: downgraded and difficult to find.

Sitting on my couch watching Netflix, it was O'Connell who fascinated me. It's been 20 years since that ground-breaking scientific paper: where was she now? What new mysteries of female sexuality had she solved? Had someone given this woman an Order of Australia? O'Connell's discovery was important for practical reasons: it gave surgeons a map of the key nerves, blood vessels and connecting parts of the clitoris so they could try to avoid destroying sexual sensitivity during any pelvic-area operation. O'Connell had witnessed many penis-related surgeries where great care was taken to avoid any loss of sexual function, but no one knew enough about the female anatomy to do the same for women.

Her work also inspired a generation of sex educators, therapists, artists and academics who use her research to answer some fundamental and persistent questions about sex. The clitoral v vaginal orgasm debate, the orgasm gap between heterosexual women and their male partners, small penises and "loose" vaginas, the so-called G-spot: all these things, sex therapists and researchers say, could be better understood if men and women knew more about the clitoris, and therefore female arousal. British writer Jessica Berens once said that without a proper map of the female bits, it's as if everyone's been driving around for ages and still not found where they want to go: a bit like Canberra. It's been 20 years since we've had a proper map, but are we, I wondered, there yet?

How Melbourne urologist Helen O'Connell redefined research around the clitoris. - Brisbane Times

Helen O'Connell is not a sex guru. She is not Bettina Arndt or the eccentric sex therapist played by Barbra Streisand in the 2004 film "Meet the Fockers".Credit:Kristoffer Paulsen

I'm only three minutes late to meet O'Connell, but her medical secretary is phoning, checking my whereabouts. Every single minute is crucial to O'Connell, 56, because being a clitoris guru is just a sideline.

Australia's first female urologist, O'Connell is a surgeon who treats patients with lower urinary tract problems such as incontinence and obstruction. A gifted endoscopic surgeon, she fixes or removes things within the tiny spaces of the urinary tract using a small telescope. She's also Director of Surgery and Head of Urology at Western Health, a sprawling health network servicing 900,000 people in Melbourne's west. In her rather limited spare time – and for no payment – she chips away on her female anatomy research, publishing a paper only last year on her search for the elusive but famous G-spot. More on that later.

When I get up to her third-floor consulting rooms, O'Connell, assured and professional, welcomes me into her office. She's wearing a dark pants suit and cat's-eye maroon glasses, blonde hair to her shoulders. We start awkwardly: I thought the meeting was to merely discuss the prospect of a profile, but she's like, "I've got one hour now, begin!"

In one of her research papers – which, with a tangle of keys, she unlocks from a white cupboard – O'Connell details the history of the clitoris in anatomy. In the 16th century, Italian anatomist Realdo Colombo (who called it a "seat of lust") and his contemporary Gabriele Falloppio (he of Fallopian tubes fame) feuded over who found the clitoris first. Dutch anatomist Regnier de Graaf did a comprehensive job of describing it in the 17th century, even discussing the crucial clitoral bulbs. And in the 1840s, German anatomist Georg Kobelt published an extensive account of the female genitals, their spongy tissues, muscles, nerves and blood supply.

His black-ink drawings are like a landscape of rivers, lakes and tree roots. "Really beautiful," notes O'Connell, who says she simply used modern science to confirm much of his work.

How Melbourne urologist Helen O'Connell redefined research around the clitoris. - Brisbane Times

Helen O'Connell's work built on the groundbreaking 1840s anatomy and "really beautiful" drawings of Georg Kobelt. Credit:Georg Ludwig Kobelt

But unlike O'Connell, Kobelt failed to connect all the internal bits as one structure, the clitoris, fed by the one nerve complex and blood supply. His work also left unexamined the relationship between the urethra, vagina and clitoris. Kobelt was soon forgotten anyway, as the clitoris fell out of fashion. That was the fault of Sigmund Freud, the bearded father of psychoanalysis, who declared in the early 1900s that clitoral orgasms were immature and "vaginal orgasms" mature. In 1948, the 25th edition of the seminal Gray's Anatomy removed the clitoris completely. While the clitoris made a comeback in later editions, only the part you can see – the glans – was noted.

O'Connell and her team took 10 cadavers and removed the pubic bone to expose the internal clitoris. They photographed what they saw and did laboratory tests on the tissues. At the time, anatomy texts often failed to mention the clitoral bulbs, which become engorged when aroused. Sometimes they were drawn half their size or put in the wrong place and were named "bulbs of the vestibule". A vestibule is a lobby or entrance hall, presumably to the vagina itself. "What the hell is the vestibule?" asks O'Connell, and we laugh, giving me the first glimpse of a lovely sense of humour behind the serious facade.

Anatomy books also connected the bulbs to the inner parts of the vulva. But O'Connell found this to be incorrect: they were joined to the clitoris body. Meanwhile, there was a whole bit of anatomy – the Bartholin's glands – that O'Connell couldn't find: they simply weren't where the anatomy books said. The standard texts also showed the clitoris flat against the pubic bone, but in reality, O'Connell found, it exists in three planes; with bits going everywhere. The 1995 edition of Gray's Anatomy said the clitoris's major nerve supply was "very small". But the nerves were actually "noticeably large", greater

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