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  • Female Circumcision and Clitoridectomy in the United States: A History of a Medical Treatment by Sarah B. Rodriguez
  • Madeleine Pape
Keywords

female sexuality, clitoris, vaginal orgasm, sexual surgery, heteronormativity

Sarah B. Rodriguez. Female Circumcision and Clitoridectomy in the United States: A History of a Medical Treatment. Rochester, New York, University of Rochester Press, 2014. xi, 280 pp., illus. $70.00.

Sarah Rodriguez’s cultural history of clitoral surgeries in the United States describes the construction of sexual deviancy in women and efforts [End Page 671] to conform their bodies to heterosexual norms from the mid-nineteenth century until the 1980s. Framing her account is the claim that interventions on the clitoris were fundamentally shaped by gendered expectations surrounding female sexuality and the female body. Surgeries on the clitoris during this period were thus a product of the enduring dominance of heterosexual and penetrative sex in American society as the legitimate model for women’s sexual pleasure, and reflected the attempts of physicians, family members, partners, and women themselves to conform their bodies to such a model.

Drawing on anatomy and gynecology texts, medical publications, and other communications by physicians over this 150-year period, Rodriguez identifies a spectrum of four clitoral surgeries: cleansing to remove smegma, the separation of adhesions between the clitoris and the clitoral hood, removal of the clitoral hood (circumcision), and the full excision of the clitoris (clitoridectomy). In line with her goal of framing the perspective of physicians within “a larger cultural history of the changing perceptions of female sexuality” (10), Rodriguez also references popular and psychoanalytic literature on marriage, sexuality and pleasure, and devotes a chapter of the book to describing the popular and feminist politics of the clitoris during the 1960s and 1970s. Thus while the primary sources for the book are presented in an exhaustive account of the published and public views of physicians on clitoral surgery, this medical history is embedded within a broader cultural framing that emphasizes the dynamic interaction between cultural, medical, and other expert knowledge of women’s bodies.

The pervasiveness of culture is rendered stark by the contradictory use of clitoral surgery to both “treat” masturbation and to enhance the sexual pleasure of women. With the exception of clitoridectomy, physicians performed the three remaining clitoral surgeries on women diagnosed as pathological masturbators and on women who struggled to reach orgasm in heterosexual intercourse. In both cases, however, the surgeries are consistent with a cultural context in which women’s bodies were required to conform to the model of penetrative sex, reflecting a heteronormative (and male-dominated) culture and the demands it made of women’s sexuality.

Yet Rodriguez is careful to capture the heterogeneity of opinion expressed by physicians throughout this historical period. Indeed all forms of clitoral surgery were contested and at no stage were they widely supported by physicians. Instead there were individual practicing physicians, contested medical opinions, and change over time in textbook accounts of the clitoris and the female orgasm. Thus Rodriguez provides an important counter-perspective to the 1980s feminist framing of medicine as a monolithic patriarchal institution, represented as it were in the work of lone physicians like Isaac Baker Brown. [End Page 672]

The heterogeneity of opinion among physicians also challenges the claim that the rise of the vaginal orgasm led to the disappearance of the clitoris from medical practice. While the book traces the vaginal orgasm from its origins in Freudian psychoanalytic theory to its pervasiveness in popular (heteronormative) culture in the early to mid-1900s, Rodriguez also deploys her sources to demonstrate that by no means did the clitoris “disappear” from medical discourse only to be rediscovered by feminist activists decades later. Throughout this era supposedly devoid of the clitoris, physicians continued to perform surgeries with the purpose of increasing stimulation of the clitoris during penetrative sex. While some physicians posited the vaginal orgasm as preferable, or in the extreme as the only healthy way for women to experience sexual pleasure, many did not ignore or forget the importance of the clitoris to women’s sexual pleasure. Rodriguez demonstrates that the existence of the vaginal orgasm remained contested, even within psychoanalysis, and was never...

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