As far as the child identifying it as "pain" when the clitoris engorges, well that just may well be what it is, pain. Never assume when they tell you they are in pain or it hurts that it is just a "sensation". In some cases it could very well be but you know your child and how they describe their own feelings. Some may have felt it as a "sensation" but others may have felt it as true pain. Remember there are different prader numbers as they say or degrees the clitoris is affected. So what one thinks is normal, one may feel as pain. So please, don’t fluff them off when they are telling you their clitoris hurts. See what the urologist or your pediatrician suggests. You know their clitoris is a clitoris not a penis. So since it isn’t one I would assume it wouldn’t function as one in turn causing some kind of interupption down there that I imagine could be painful when it does become engorged. Just my thought. I am not a doc. But the bottom line is, don’t fluff off your child’s pain.