The American Journal of Bioethics 3.2 (2003) 65-66
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Cutting History, Cutting Culture:
Female Circumcision in the United States
University of Nebraska Medical Center Toby Schonfeld, University of Nebraska Medical Center
Michael Benatar and David Benatar (2003) argue that cultural influences account for the differing intuitions we have regarding male and female circumcision and that focusing exclusively on the medical implications of the procedures will show them to be analogous. However, by focusing only on selected African practices of female circumcision where the procedure involves more than the removal of the clitoral prepuce, the authors obfuscate the fact that the clinically analogous procedure—prepuce removal for "medical" reasons—has existed for females in the United States since at least the nineteenth century. Because of the historical differences in how female circumcision has been practiced in the United States, it is not equivalent to male circumcision and hence cultural and historical considerations cannot be dismissed in the moral evaluation of these practices.
Female circumcision has been practiced in the United States since at least the nineteenth century. Cases of its use in the late-nineteenth through the early-twentieth century were for the treatment of masturbation (by both women and girls) and nymphomania—a term used interchangeably with masturbation and with what was regarded as excessive amounts of sex. Both of these phenomena were considered abnormal sexual behavior. Willard, in his 1910 textbook on the surgery of childhood, noted that an irritated clitoris—one whose hood bound it down too tightly and therefore caused irritating adhesions to remain trapped—could cause a woman or girl to masturbate in order to quell the discomfort. Willard stated that "an adherent prepuce should be stripped or circumcised." Hale (1896) likewise believed that "an abnormal condition of the clitoris" caused masturbation, and he removed the foreskin of a fourteen-year-old girl who had begun to show signs of "hysterical manifestation." The acts were regarded as socially fundamentally improper as well as physically unhealthy because they directed sexual energy to the self and away from productive, constructive heterosexual sex with the husband (Laqueur 1990).
To prevent or cure women of masturbating, however, was not the only medical reason for the removal of the clitoral foreskin. Beginning in the late-nineteenth century and extending into the 1970s, American women who engaged in what was considered normal sexual behavior, sex with their husbands, but who lacked an orgasmic response from missionary sex with their spouse were also considered abnormal in their behavior and were candidates for surgery. In 1904 Abbott noted the beneficial results achieved through circumcision on a married woman who "had failed, during two years of married life, to respond to the marital embrace, though her desire was ardent." Abbott found the clitoris to be hooded, a problem he remedied with a "slight operation under cocaine anesthesia." Seventy-two years later, two other doctors also recommended circumcision to women who had trouble reaching orgasm and for the same reason—a tight clitoral hood. Elting and Isenberg (1976) noted that up to 10% of women "find relief in female circumcision."
That the same procedure was used to fulfill two very [End Page 65] different results—one to curb sexual activity and response, the other to promote it—might seem odd until one looks at the underlying reason for the procedure. Female circumcision, whether used to suppress sexual behavior or to promote it, was an operation used to direct female sexual desire toward sex with a man, namely her husband. The history of female circumcision in the United States is the history of an operation used to direct female sexuality into culturally and medically appropriate behavior: missionary-position heterosexual sex with the husband. And though women were never circumcised in the United States to the extent that infant males were and are, the operation as performed on women reflects cultural fears, apprehension, and lack of understanding of female sexuality.
This demonstrates the major differentiation between the history of female circumcision and male circumcision. Circumcision surgically directed women's sexual behavior. Sexual...