Before deciding whether to operate, Salgado studied the literature to find out if a larger clitoris led to increased sexual pleasure. He found a 2014 study in the Journal of Sexual Medicine that showed a correlation between women with larger clitorises and the ability to orgasm. But the study was small, with only 30 participants, and it did not prove that a large clitoris could cause women to orgasm. 

Other more recent studies also showed little consensus. A 2020 study in the Turkish Journal of Obstetrics and Gynecology found that clitoral size was not correlated with greater orgasm, while a 2020 study in the Journal of Surgery and Medicine found that surgeries “to increase clitoral glans visibility can facilitate sexual satisfaction and/or increase orgasm intensity [and that] clitoral glans visibility is more important than clitoral size for sexual stimulation.” Leah Millheiser, an OB-GYN and clinical professor at Stanford University who specializes in sexual health, told BuzzFeed News that “enlarging your clitoris has never been shown to increase sensitivity in women who have a normal size clitoris.” 

Salgado told Ana he’d never done this surgery before and that she could possibly lose sensitivity in the area. Ana was worried about the possibility, but she hoped the surgery would bring her stronger orgasms. “I wanted the surgery as soon as possible,” she said. But Salgado was booked for three months, and he also required her to have a psychological evaluation before the surgery, where they asked her about her gender identity (she is cisgender) and whether her husband was coercing her to get the surgery (she said he wasn’t). 

She passed the evaluation and underwent surgery in August 2018. It took about three hours and went smoothly. Her insurance didn’t cover the surgery, which Salgado says usually costs between $6,000 and $15,000. 

After Ana healed, her clitoral glans (the visible part of the clitoris) grew a half inch to a length of 2 inches, nearly double the size of an average woman’s clit. And it became even larger when aroused. She noticed a difference in sexual response immediately; her orgasms were more intense. “The sensation is different,” she said. “It’s not like multiorgasms. It keeps going, keeps going, keeps going. It’s nonstop.” She said during oral sex, “my husband has to keep his mouth [on my clit] until my soul comes back to my body.” But her inner labia were covering much of her clit, and she wanted more of it exposed. “I told [Salgado] I want to do something with my small labia. So he wrapped the labia [minora] around the clitoris, so that it looks like a small penis without circumcision.” 

“I don’t know why all women haven’t done this,” Salgado recalled her telling him.

One day, while her husband was performing oral sex, she said she had an orgasm that lasted eight minutes (her husband timed it). “It really changed my life,” she said. Her orgasms went on to become even more intense. In 2020, she had one that was “so strong that it completely locked my muscle on my back,” she said. Her physician said it was the first time he’d seen an orgasm cause back issues. 

She is now taking testosterone prescribed by a doctor to increase her clitoris size, and she uses a nipple pumping cylinder, which creates a vacuum around the clitoris and enhances blood flow. Ana said it increases the length of her clitoris to 4 inches. When she goes to the beach, sometimes people stare at her crotch, but she’s OK with it. “You have to be happy with yourself. [If] you want to explore your body, if you want to feel different, do it,” she said. 

When she told friends about the surgery, they were skeptical, but she assured them that the improvement in her sex life was worth it. 

After Salgado published an academic article on Ana’s surgery in 2020, other cis women started reaching out to him. They were looking to improve “not just the function, but also the aesthetic appearance,” he said. He has since performed this surgery on four additional women. 

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