In a 1921 article discussing sexual “degenerates,” Perry M. Lichtenstein, a physician with the New York City prison system, noted that “both white and colored women indulge in the practice” of obtaining “sexual satisfaction from association with other females.” Lichtenstein noted that, upon examining such women, “in practically every instance” one would find “an abnormally prominent clitoris, … particularly so in colored women.” While according to Lichtenstein an atypically large clitoris was common in women who had sex with other women regardless of race, his belief that this was especially true of women of color was based not just on their sexual relationships with other women: as E. Heinrich Kisch wrote in his 1910 book, The Sexual Life of Woman, the “congenital enlargement of the clitoris” was commonly found to exist in “certain African races” to such a degree the organ was “an obstacle to coitus” with men. African American women, according to some American medical authorities, were inherently hypersexual, with the physical evidence found in their supposedly enlarged clitorises.

Physicians recognized the clitoris as homologous to the penis. Therefore, as Margaret Gibson pointed out in her essay on medical constructions of female homosexuality in the late nineteenth century, if the penis and clitoris were mostly differentiated by size, an enlarged clitoris illustrated sexual activity and thus masculinity to physicians. It illustrated, then, a feminine body that was other than a normative feminine body, for a woman who possessed a clitoris deemed overly large was labeled by many medical practitioners as acting in ways that were, if not masculine, at the very least as not appropriately feminine. Women who had sex with other women or women who were overly sexually active with men or with themselves were often regarded as hypersexual. And some physicians looked for physiological manifestations of these nonnormative sexual behaviors by looking at the size of the clitoris. But though many physicians believed all women's bodies held evidence of their nonnormative sexual behaviors in the form of an enlarged clitoris, it was in particular women of color and lesbians regardless of color who were most often regarded as inherently hypersexual. They were often seen as inherently sexually nonnormative, degenerate, or sexually underdeveloped, beliefs that were reflected in the perception that these women “commonly” had an enlarged clitoris.