Female Circumcision and Clitoridectomy in the United States: A History of a Medical Treatment by Sarah B. Rodriguez (review)

For Americans who think that female genital cutting is a barbarity confined to darkest Africa and parts of the Islamic world, Sarah Rodriguez’s detailed history of female circumcision in the United States will come as a revelation and perhaps a shock. In her impressively researched study the author considers the social rationale of such practices and their relationship with changing theories of anatomy, physiology, sexual behaviour and gender relations. In pursuit of these themes four types of circumcision are examined in detail: clitoridectomy; excision of all or part of the clitoral hood (female prepuce); removal of accumulated smegma beneath the hood; and breaking down the adhesions between the hood and the clitoris. These procedures were performed for three basic reasons: to discourage masturbation; to correct homosexuality or “hypersexuality”; or to enhance the capacity for orgasm during intercourse. Introduced in the late nineteenth century at the height of the childhood masturbation scare, clitoridectomy had a brief and limited respectability, usually performed on girls at the behest of worried parents, though occasionally at the request of adult women. There is not much evidence that clitoridectomy was widely employed to treat lesbianism or hypersexuality, though there are certainly cases of parents wanting the “large” clitorises of their daughters trimmed down to a “normal” size. Among professionals, there was much indecisive debate about whether lesbians and African women had abnormally large genitals (i.e. larger than those of white middle class Americans), but the conclusion of the gynaecologist whom Rodriguez regards as the most reliable authority on such questions (Robert Dickinson) seems to have been that there was wide variation among women of all races and that no firm standards could be set.

While circumcision (of any type) to control female masturbation or deviance was never more than a marginal practice, Rodriguez’s really explosive finding is the extent to which circumcision for the purpose of enhancing female sexual pleasure became established in both the medical repertoire and popular culture. While she has no precise figures, it is apparent that from the 1920s onwards tens of thousands of women sought or agreed to have their clitoral hood removed in the belief that this would allow more direct stimulation of the clitoris and thus make it easier for them to achieve orgasm. Rodriguez makes no judgement on how often the intended result was achieved, though she quotes a number of women who were so pleased that they used the pages of popular magazines to urge the operation on others. Many surveys revealed that a high proportion married women rarely experienced sexual pleasure during intercourse, and were therefore keen to try surgeries that promised to improve matters. The dark side of this natural desire was that they could fall victim to surgical entrepreneurs such as James Burt, who devised an operation far more extensive than clitoral hood removal to comprehensively re-engineer the genitals, and performed it routinely after childbirth without obtaining informed consent. That it took twenty years to bring his dubious and often harmful practices to an end highlights the difficulty of controlling rogue doctors in societies where medical services are supplied on the free enterprise model. Rodriguez does not consider the possibility that the problem faced by the unsatisfied wives might have been related to the likely circumcised penis of their husbands.

Female Circumcision is more a collection of essays on related topics than a single coherent narrative, and the author is more concerned to describe what happened than to analyse why or to place the phenomena into historical contexts. Much of the book is not directly about genital cutting, but rather the evolution of knowledge (or what passed for knowledge) about the female genitals and how they contributed to female sexual enjoyment. It is apparent that this knowledge was never unitary or secure, but always full of contention and uncertainty. While the medical establishment consistently held to...