Prominent doctor at the American Academy of Pediatrics proposes renaming penises ‘outies’, vaginas ‘front holes’ and clitorises ‘d*cklets’

A top pediatrician has called for child doctors to start calling the vagina a ‘front hole’ and the penis an ‘outie.’

Dr Ilana Sherer, a pediatrician in Dublin, California,  gave a presentation Sunday at the American Academy of Pediatrics (AAP) National Conference and Exhibition and called for more gender neutral terminology for body parts. 

Her proposals, given during a workshop entitled ‘Discussing Gender and Sexuality in the Primary Care Office,’ included referring to the vagina as an ‘innie,’ ‘front hole,’ or ‘T-penis’ and the clitoris as ‘d*ck’ or ‘d*cklet.’ 

She also proposed calling breasts ‘chest’ or ‘chesticles.’ For male anatomy, Dr Sherer recommended pediatricians call the penis ‘outie,’ ‘junk,’ ‘strapless,’ or ‘bits.’ 

Dr Sherer is a general pediatrician at Palo Alto Medical Foundation/Sutter Health.

She is board certified by the AAP, an organization to advance child health and well-being, as well as the profession of pediatrics, and serves on the organization’s Executive Committee for LGBTQ Health and Wellness.

Some in the medical community have been calling for gender-neutral body terminology for years, recommending ‘upper body’ for breasts, ‘erectile tissue’ for penis and ‘internal gonads’ for ovaries. 

They argue it creates a more inclusive space for people who may not identify as one gender or sex and are not comfortable using gender-specific terminology.

But doctors have previously warned against politicizing medical language because it could confuse public health messaging, especially for people for whom English is not their first language. 

Dr Leonora Regenstreif, a family physician and assistant clinical professor of family medicine at McMaster University, told DailyMail.com: ‘Health providers don’t need to be “cool.” We can just politely and respectfully use clinical, anatomical language.

‘Kids might giggle or snicker but they will likely be even more put off if we try to “match” their word choices, which may be based on pornographic or inappropriate online resources.’

The physician said a few questions, modified for the age of the patient, like ‘are you sexually active?’ and ‘Have you had intercourse with someone with a penis?’ are adequate.

She added: ‘Any more detail than this – like suggesting novel words like “front-hole” or “dicklet” – are unnecessary and prurient.’

During her presentation at the AAP Conference, Dr Sherer was not speaking on behalf of the organization and her recommendations have not been adopted or implemented by the medical organization. The AAP has not commented on Dr Sherer’s presentation. 

When it comes to LGBTQ care, in 2021, the AAP advised doctors treating patients identifying as transgender to ask them what words they would like used when referring to various body parts.

Guidance from July 2022 instructs parents to use ‘correct names for body parts’ when talking to young children and discussing body development and sexuality. 

In August, the AAP voted to stand by its 2018 guidance that supports LGBTQ access to counseling, hormone therapy, puberty blockers and, occasionally, surgery for minors under 18 years old. 

Any guidance from the AAP is not binding for doctors, but advice announced by a prominent medical advisory body is often implemented by healthcare providers as best practices. 

In trans girls, options include tucking male genital with medical tape or specialized underwear and padding with breast forms of silicone gel, padded bras and padded underwear to accentuate the hips and butt. Additional options include vocal training, makeup tutorials and wigs. 

In trans boys, options include binders like compression garments, and ‘packing,’ which includes a penile prosthesis and a ‘stand to pee device.’

A medical option includes prescribing birth control to patients who are menstruating, which will stop them from their getting periods. 

Other points of Dr Sherer’s presentation outlined potential ‘non pharmacologic treatment for body dysphoria’ for trans girls and trans boys.

Dr Sherer’s presentation also outlined how to ask patients about gender, including asking their preferred pronouns, gender identity and sexual orientation, and if they identify as male or female, or neither. 

To get more information on a child’s sexual orientation, Dr Sherer said doctors should ask patients if they are in an intimate relationship and what ‘parts of your body do you use/have you used for sexual pleasure?

Other questions relate to monogamous relationships, previous and ‘side’ partners, the genders of a patient’s partners and what body parts they use for sexual pleasure. 

The California pediatrician’s workshop also recommended doctors ‘think about your office’ and said they should display affirming signs and posters, ensure staff have adequate inclusivity training, hire a diverse staff that represents patient identities, have all-gender bathrooms, inclusive medical forms, include preferred pronouns on patient charts and display pronoun stickers on staff ID badges. 

Similar recommendations were released by the AAP in June 2021.  

The mission of the AAP is to ‘attain optimal physical, mental, and social health and well-being for all infants, children, adolescents, and young adults.’

The mission continues: ‘Children have optimal health and well-being and are valued by society. Academy members practice the highest quality health care and experience professional satisfaction and personal well-being.’

The medical care of trans patients has been politicized into a hot-button issue and is becoming a key political battleground heading into the 2024 Presidential Election.

Local and national politicians have been fighting and enacting legislation that limits and even outlaws gender-affirming care for trans children, which can include hormone therapy, puberty blockers and genital reconstruction. 

Up until the wave of state bans began in 2020 and 2021, there were no restrictions at the federal level for access to these treatments, which in some cases are irreversible. 

However, as of May 2023, 20 states have enacted legislation, executive actions, or other policies that restrict or ban healthcare for transgender youths, and more than 100 additional bills are under consideration.

All of the states are Republican or Republican-leaning, and all but one voted for former President Donald Trump in the 2020 election. 

Much of the political debate in recent years has been amid concerns that minors who get gender-affirming care are too young to make such a life-changing decision and are not fully aware of the risks.

For example, studies suggest those who are transgender are six times more likely to suffer from autism, and up to 70 percent of trans youths are depressed.

Other studies, including one by the National Institutes of Health, suggest patients are happier after the surgery, further complicating the issue.

There are concerns among Republican lawmakers about the lack of long-term safety data on puberty blockers and hormone drugs, which have seen other countries like the UK and Scandinavia restrict access in minors.

The Food and Drug Administration approved puberty blockers 30 years ago to treat children with precocious puberty – a condition that causes sexual development to begin much earlier than usual.

Sex hormones – synthetic forms of estrogen and testosterone – were approved decades ago to treat hormone disorders or as birth control pills.

The FDA has not approved the medications specifically to treat gender-questioning youth, but they have been used for many years for that purpose ‘off label.’

Doctors who treat transgender patients say those decades of use are proof the treatments are not experimental.

Dr Sherer and the AAP could not be reached for comment.