The history of the term pudendum: Opening the discussion on anatomical sex inequality.

The anatomical terminology for the female external genitalia, "pudendum," was removed from the second edition of the Terminologia Anatomica (2019) in response to opposition of the Latin root of the word (pudēre meaning "to be ashamed"). This recent revision provides an opportunity to discuss sex inequality within the history of anatomy. This viewpoint article compares the evolution of modern anatomical terminology toward clarity and precision to the stagnant non-descriptive naming of the "pudendum" to illuminate a long timeline of the societal misperception of women. Claudius Galen (129-216 BC) used the Greek αιδοίον/aidoion (from αἰδώς/aidos meaning shame, respect, or modesty) to describe both the male and female external genitalia, as he believed that men and women were isomorphic, the difference lying only in the positioning of the reproductive organs. Galen, however, was not always impartial in his comparisons, repeatedly describing the female as inferior to the male. Andreas Vesalius (1543), whose illustrations greatly influenced the study of anatomy, later drew the female genitalia as Galen described them, as internal equivalents of male genitalia, codifying female shame within anatomical terminology. While renaming "pudendum" is a noble step in support of women, changing one word will not undo generations of implicit bias and institutional oppression. We can, however, work to create culturally and psychosocially competent future physicians through the integrative study of sex and gender issues and anatomy. Through an understanding of historical context, physicians can refocus their actions on providing care in a way that leaves the patient feeling proud, not ashamed.