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Most Americans associate female circumcision and clitoridectomy with cultural practices in far away countries. Yet, Sarah Rodriguez’s impressive history of female circumcision and clitoridectomy in the United States shows that these surgical procedures are much closer to home. Both practices, Rodriguez writes, “were and remain intimately part of American culture” (p. 11). While other historical work has focused on specific surgical excesses, such as the case of British surgeon Isaac Baker Brown, or the presumed lack of knowledge of the clitoris as sexual organ, Female Circumcision explores 150 years of genital surgery as medical treatment in the United States. Using a vast selection of anatomy and gynecology texts as well as numerous medical case studies, Rodriguez shows that medical experts absolutely “knew the clitoris to be a unique and powerfully sensitive sexual organ, the ‘electric bell’ of female sexual instinct” (p. 30). Its presumed role in women’s sex life was, however, deeply shaped by medical conceptions of (sexual) health and by cultural notions of women’s roles and duties. By showing how physicians made sense of clitoral physiology and how they defined what constituted a normative and healthy clitoris within their specific clinical and cultural context, Rodriguez sheds light on multiple interpretations of appropriate female sexuality and its consequences from the mid-nineteenth century to today. Female Circumcision is [End Page 816] organized around the reasons for the prescription of the four procedures the author examines (female circumcision, clitoridectomy, the removal of smegma, and the breaking up of clitoral adhesions): to stop masturbation, to combat homosexuality or hypersexuality, and to enhance the female capacity for orgasm. Since the late nineteenth century, masturbation has been one of the primary reasons for clitoral surgeries. Physicians thought that an unhealthy (i.e., irritated) clitoris provoked women to obsessive masturbation; the prescribed treatment was clitoral surgery to remove what caused these irritations. The medical concern was one of restoring health, and yet it was underwritten by the conviction that these treatments directed patients toward “proper,” socially desired sexual relations with their husbands. In addition to sexual ill health, sexual deviance and racial otherness were read onto the body. An atypically large clitoris was considered a sign of hypersexuality or lesbianism, though doctors were unsure whether the size of the organ was the cause or the effect of these sexual practices. It was also considered a marker of racial difference in African American women.
The “electric bell” (p. 30) of female sexuality was not only at fault in cases of inappropriate sexual behavior (masturbation, homosexuality, and hypersexuality), it was also considered the cause for a lack of sexual response. In the second part of her book, Rodriguez trails the fascinating and paradoxical usage of female circumcision (the removal of the clitoral foreskin) to increase women’s response to marital heterosexual intercourse. Female circumcision was performed to promote clitoral orgasm until the mid-twentieth century and to enhance the proper Freudian vaginal orgasm from the mid 1940s to the 1960s. Similar paradoxes seem to emerge in the 1960s and 1970s. The feminist health movement celebrated the clitoris as an organ of female sexual independence and some physicians now promoted masturbation as a healthy sexual outlet. At the same time, popular articles in magazines such as Playgirl endorsed the “surgery to liberate the liberating organ” (p. 139) as an enhancement of female sexual response during penetrative sex. The medical definition of the role and health of the clitoris was shaped by changing social and cultural attitudes about sex and gender.
In itself, this is not the most surprising conclusion, but Female Circumcision’s strength lies in its scope and the analytical thoroughness in which it follows various medical prescriptions of clitoral surgery. Rodriguez’s perspective as a medical historian provides a careful balance between how (and in what context) physicians made sense of clitoral physiology and pathology and the socio-cultural matrix in which these medical theories were formulated. Health circulated as the...