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disclaimer: i am not a doctor or any kind of medical professional! i cannot diagnose you with anything, including as intersex. i only share what i understand to be true, based on what i have read, heard from others, and my own lived experiences, in order to help people learn about their bodies & come to their own conclusions about what makes sense for them. this is not medical advice!

What is vulvar hypospadias?

Hypospadias describes when someone's urethra is lower than typical. Vulvar hypospadias is when this happens on a body with a vulva, or genitalia that is close to a vulva.

Vulvar hypospadias is considered by the medical field to be "extremely rare." I personally do not believe this is true. Penile hypospadias is the second most common sex variation for those born with penises, at 1 in every 100 to 250 births. Many people have been told by their doctors that it is impossible for someone with a vulva to have hypospadias. Even when it is acknowledged, it's generally under the name "persistent urogenital sinus" where it is only considered to "count" if the urethra is inside the vaginal canal.

My preferred way of categorizing vulvar hypospadias comes from a Russian paper from 2021. You can use this diagram as a general guide (English text added by me, illustrations from the paper):

Some people with vulvar hypospadias have no associated issues. However, it is very common for people to deal with some or all of the following:

Discomfort or pain during vaginal penetration (whether during sex, a medical exam, or inserting a menstrual product) or the inability to do vaginal penetration at all due to pain (often described as "burning" or "tearing" and does not change based on arousal, lube, prep/foreplay, or muscle relaxation)

Chronic urinary tract infections and chronic urinary pain, especially after vaginal penetration

Urinary retention (being unable to fully empty the bladder, or needing to do extra steps in order to do so)

Episodes of urinary incontinence or near-incontinence (not fully losing control, but having issues nonetheless)

Anterior deflected urinary stream (urine comes out forward instead of straight down)

When giving a urine sample while menstruating, being unable to keep from getting blood in the sample, or finding it extremely hard to do so

Being unable to urinate with an internal menstrual product in, and needing to take it out early as a result

When using an internal menstrual product, constantly being aware of its presence, having to remove it early due to discomfort/pain, or feeling that you are "using it wrong" despite trying multiple different ways and sizes

Difficulty using a stand-to-pee device

Less sexual sensation on the genitals than expected, or none at all (it may feel "ticklish" or like rubbing an arm, rather than pleasurable)

It is very normal for people with vulvar hypospadias to go undiagnosed for years, even if they have had multiple gynecological exams. Most people do not get formally diagnosed. A decent amount of people with vulvar hypospadias also seem to have hypermobility.

Epispadias is when the urethra is higher than typical (this can split the clitoris, or even be above the clitoris!). Urethral duplication is when there are two urethras; there can also be more than two. Mesospadias (link) is when someone's urethral location isn't peritypical but doesn't fall neatly into epispadias or hypospadias alone, such as with people who have a vulva and a penis.

How can I tell if I have vulvar hypospadias? How do I locate my urethra? How do I measure the distance?

Because of how understudied it is, it is hard to find solid information on what counts. There is not much research on urethral-vaginal distance in general!

If you are questioning if you have hypospadias, I would focus on these three signs:

Symptoms (pain during sex, chronic UTIs, urinary retention, pain using tampons/cups/discs, etc.)

Distance (measurement between urethra/vagina and urethra/clitoris)

Urethral displacement (the urethra being pulled into the vagina during vaginal penetration)

This study (link) looked at a group of cis women, of various ages, who had reoccurring UTIs after sex, and measured their U-V distances. They compared those with measurments of a similar group of women who had no history of UTI. They found that the control group had a median U-V distance of ~2 centimeters, while the rUTI group had a median distance of ~1.5 centimeters. Amongst the community on Tumblr, the rule of thumb is that a distance of 1 to 0.5 cm is hypospadias territory. Based on the study mentioned above, ~0.2-0.3 centimeters is considered the criterai for subtotal or vestibulovaginal hypospadias.

The urethra is often tricky for even entirely typical people to find. Some people's urethral holes (the "meatus") are large and obvious, but many are smaller. The most direct way to locate your urethra is to watch yourself urinating, as this is when the urethra is most open and you can see where the stream comes from. You can try using a mirror or recording yourself while on the toilet or in the shower. You can also try urinating while in the shower, while feeling your vulva with your hand to locate where the stream comes from. The urethra is typically somewhat uncomfortable to touch, but some people with hypospadias may have decreased sensation in their genitals, which may make that method of finding the urethra difficult.

There is also not official criteria for measurements. Many people with hypospadias also have thick hymens that extend beyond the vagina, which can make it hard to tell where different parts of the vulva stop and start. The most important thing to keep in mind is that measurements are about getting a general picture, not an exact number. It is fine if you get slightly different numbers depending on if your vulva is stretched or not, or if you are not 100% sure of the exact measurement.

If you have total vaginal hypospadias, you do not really need to measure (although you may want to know how high up your urethra is). So the following advice assumes the urethra is outside the canal.

Some general tips for measuring:

I find the easiest way to look at the vulva is by placing a mirror on the floor and crouching above it, using your heels to help spread the labia. I do this in my bathtub because there is an overhead light directly above it. Whatever positions works best for you, works best for you. Ideally, you should be able to watch yourself in a mirror or phone camera and have at least one hand free. I personally recommend investing in some sterile gloves to use while doing this, as well as lubricant.

The urethral meatus emerges on top of what I am currently calling the "urethral mound" (also "urethral glans"; not an official medical term). However, the mound can look differently for different people. For some, it's a clear globe; for others, it's more triangular of square. Less often, it may have a ruffle around it. The mound also varies in size and can be very clear or appear non-existent Some people with hypospadias may have a "split" mound, which is thin and extends upwards towards the clitoris, ending in a V-shaped divot. You can see illustrations of what the urethral mound can look like here (link)

The urethral mound may stop a bit before the vaginal opening begins, or they may be very close. When measuring, I suggest measuring from the meatus (the hole) to the start of the introitus (the vaginal opening itself). If you can't tell where your introitus starts, I suggest gently inserting a finger slightly into the vagina. Press up gently (pushing against any hymen that might be there), and then slide upwards until your finger begins to leave the vagina and go towards the urethra. You can also do this in reverse (placing your finger near the urethra, pressing down gently, and sliding down until you feel your finger dip into the vagina). This is roughly where your introitus begins.

You can also measure the distance between your urethra and your clitoris. Typically this is around ~2 cm, but people with hypospadias can have 3 cm or more. If you have gone on testosterone or have clitoromegaly naturally, the size of yours may lower the distance between the clitoris/phallus and the urethra, which should be considered when measuring.

Another important test (the O'Donnell-Hirschhor test) is seeing what happens to the urethra during penetration. With partial or subtotal hypospadias, when a penis or phallic object enters the vaginal canal, the urethral meatus may get "sucked in" partially or fully. This contributes to the discomfort during sex and post-coital irritation. This can be harder to measure as it is hard to get a good view of the vulva during vaginal penetration. If your urethra is getting sucked in, that is a sign of hypospadias.

You can measure using any tool that you can safely and comfortably put against your vulva. The easiest way is by measuring your finger first, marking for 0.5 cm / 1 cm / 2 cm, and then placing your finger along your vulva.

Remember, the urethra isn't just the visible hole, it's an entire tube. Vulvar hypospadias isn't just about the location of the opening, but the fact that the walls between the vaginal canal and the urethra are very close or combined. This is why also considering issues like dyspareunia and menstrual product discomfort is important, as in people with hypospadias these can be partially or fully explained by the urethra being pressed against through the vaginal wall.

The vulva is a sensitive area, and people with hypospadias can be even more sensitive to rough touching. It is best to go slowly, use lubrication to keep things moist, and take breaks when necessary. I also suggest reading this post (link) about being gentle with your body while you are questioning, as it can be a very emotionally fraught process!

Other relevant resources to the process of questioning (all following bullet points are links):

What does a sleeve / redundant hymen look like?

Dropbox folder of illustrated vulva diagrams (mostly typical, but also some depicting variations)

Gynodiversity's vestibule panels (cw for IRL photographs of vulvas)

Wikimedia Common's category "Human surface anatomy of the vulva" (cw for IRL photographs of vulvas)

The Vulva Gallery's anatomy page

Does vulvar hypospadias count as intersex?

Identifying as intersex is a personal decision. Not everyone with vulvar hypospadias identifies as intersex, or even if they do, does so because of their hypospadias. But many people with hypospadias do, both vulvar and penile!

Being intersex isn't just about being "between male and female" or "having both," although some intersex people do describe themselves like that. The perisex (non-intersex) medical field has historically tried to control bodies that varied from the norm to assert control over people, especially people who's natural development threatened the sex binary. The medical definition of "intersex" tends to be a lot more strict & controlled than the community definition.

Here is how I personally define "intersex" (other definitions in the links directly below): "An umbrella term for congenital variations in sex characteristics that are outside of what is considered typical for "male" or "female" bodies. This includes variations that were present at birth and ones that developed naturally later in life, such as during puberty. This includes variations of the genitals, hormones, gonads, or chromosomes." You cannot transition into being intersex, and you also don't stop being intersex if you have had surgery, been on hormones, or done anything/had anything done to you that changed your variation to be more typical. Being intersex is about naturally being outside of what is typical for sex characteristics.

For more on vulvar hypospadias and intersexuality and why people may identify that way, see these posts (each following bullet point is a link):

VH & the intermisogyny behind "it's normal, shut up"

Erasure & lit review

Defining intersex & how hypospadias fits in (One)

Defining intersex & how hypospadias fits in (Two)

Where can I read more about vulvar hypospadias?

Unfortunately, information is very limited, and what exists tends to be extremely fixated on surgical procedures and often focus on young children.

If you are interested in exploring medical research on/related to vulvar hypospadias on your own, I can't recommend enough this literature review (link) by @intersexcat-tboy who i credit for helping me when i was questioning my own hypospadias :)

If you have or suspect you have vulvar hypospadias, you can also take this survey (link) I am running to get some information on our common experiences. The data will be shared sometime in February 2026 (no personal/identifying information from the survey will be shared).

Where can I learn more about being intersex, intersexism, the intersex community, etc.?

Intersex.wiki (link) is a by-intersex-for-intersex wiki with a lot of good person-centered information You can check out the page on hypospadias here (link)

InterACT (link) is a great youth-orientated intersex advocacy group, with a ton of resources.

This Is Intersex (link) has a lot of approachable resources that explain intersex terminology and intersex activism.

OII Europe (link) is a European intersex advocacy group which also has a vast amount of resources & information of intersex activism around Europe.

Intersex activist Hans Lindhal's YouTube channel (link) which, while not super active, has many insightful videos for you to check out

Right here, on Tumblr! This post (link) and the blog its on are a great place to start; it includes a lot of good information as well as some other blogs to check out.

What are "vulvicryptic variations"?

VCVs are congenital variations in vulvovaginal genitalia, outside of what is considered typical for a body with a vulva, yet are profoundly under-researched, under-diagnosed, or entirely unknown / undescribed. These variations are very hard to find information on, and what exists tends to be focused on young children and surgical procedures. Doctors may have never heard of these variations, and different doctors may see and approach these variations wildly differently because of the lack of consensus. This is often due to intermisogyny / intersexist medical misogyny (IMM).

The term "vulvicryptic variation" was coined by an anonymous community member going by the name Kallie. Thank you Kallie :)

All VCVs can fall under the intersex umbrella, but people with VCVs can identify in any way.

Vulvar hypospadias is a VCV. Others include:

Sleeve / redundant hymen (thick, protruding, possibly inflexible hymen) as well as other atypical hymen variations like microperforate and septate

Labial fusion (either the minora or (less often) the majora are fused together; this can be anywhere from covering the bottom half of the vaginal opening, to covering up most or all of the vulva)

Labial hypertrophy (larger than typical labia)

Labial hypoplasia (smaller than typical labia)

Clitoral hypoplasia / atresia (smaller than typical clitoris or no clitoris (also called aphallia))

Vaginal hypoplasia (smaller than typical vaginal canal)

Many other variations that don't have specific names (such as what is tentatively being called "split-type urethral mound," or an external urethral tube)

What is hypospadiac vulvicryptic variation (H-VCV)?

H-VCV is a constellation of VCV variations that has been noticed by people with vulvar hypospadias. The key traits are vulvar hypospadias and a sleeve / redundant hymen, but other known / suspected common traits include:

Labial fusion

Vaginal hypoplasia

Labial hypoplasia or hypertrophy

Clitoromegaly

Hyperandrogenism

Another potential name for H-VCV is "urethral-hymenal fusion," explained here (link). Why these traits often go together is unknown.

So what's your deal, Ippolyta????

not much :) i'm a young adult, i'm in college (social sciences), i have H-VCV (partial hypospadias, sleeve hymen, possible vaginal hypoplasia) & likely some other stuff, fibro, and autism, i like star trek TNG, warrior cats, immersive daydreaming & nonfiction writing :) my gender is intermaverine (link) & i'm bisexual aroallo and interintimate (link). i have a few intersex ocs and i love talking about them; you can see some art of one of them here (link)!