Clio Reads: Female Circumcision and Clitoridectomy in the United States: A History of a Medical Treatment

Many Americans think of female circumcision and clitoridectomy as cultural or religious practices that have taken place primarily in other parts of the world — not as medical procedures performed by doctors in the United States for the past 150 years. And though scholars of gender, sex, and medicine have noted the significance of clitoral surgeries, we have been missing a historical monograph on the subject.[1] Sarah B. Rodriguez’s new book, Female Circumcision and Clitoridectomy in the United States: A History of a Medical Treatment, fills this gap in the scholarship and, more importantly, explores the relationships between clitoral surgeries, social prescriptions for female behavior, and cultural approaches to sexuality and marriage. It’s an important book, and many Nursing Clio readers will find it fascinating.

Rodriguez argues that we cannot understand the history of female circumcision and clitoridectomy without also understanding medical, social, and cultural ideas about healthy female bodies, normal female sexuality, and the proper position of women in American life. It’s a deceptively simple argument that struck me, somehow, as both completely obvious and incredibly difficult to examine in sufficient depth. American attitudes toward gender and sex have changed a great deal over time, and “normal,” “healthy,” and “proper” have always been contested terms. Having written my own dissertation on women’s roles in shaping medical views of female anatomy and physiology, I know just how slippery these issues can be. In the nineteenth century, for example, many doctors (and members of the general public) believed that female masturbation was not just inappropriate but also abnormal and unhealthy; one hundred years later, many doctors and feminists were promoting masturbation as a normal, healthy, and potentially empowering expression of female sexuality. Placing medical approaches to the clitoris in the context of these evolving social and cultural attitudes about sex and gender is certainly challenging, and Rodriguez has to make sense of a tremendous variety of cases, including a teenage girl whose parents requested a clitoridectomy to curb her habitual masturbation, a woman who underwent clitoral surgery to restore her sexual passion for her husband, and a syphilitic and supposedly hypersexual woman of color who was “cured” when a physician removed her clitoris. Nevertheless, Rodriguez clearly explains the most common uses of clitoral surgery – to curtail female masturbation, to enhance female sexual pleasure during penetrative sex, and to treat homosexuality and hypersexuality – and persuasively demonstrates that “far from being examples of misogyny or aberrations in medical practice, female circumcision and clitoridectomy were and remain intimately part of American culture.”

Rodriguez argues that we cannot understand the history of female circumcision and clitoridectomy without also understanding medical, social, and cultural ideas about healthy female bodies, normal female sexuality, and the proper position of women in American life.

Rather than moving through the history of clitoral surgery in a purely chronological fashion, Rodriguez has organized her chapters around the reasons that female circumcision and clitoridectomy were performed. The first two chapters, for example, address clitoral surgery as a treatment for masturbation, first in adult women and then in female children. These surgeries were often requested by family members or by the patients themselves, and Rodriguez perceptively notes the importance of race and class in this history — clitoral surgery was employed, in many of these cases, to eliminate any expression of female sexuality that transgressed the boundaries of appropriate white, middle-class women’s behavior. Similarly, a chapter on surgeries to treat enlarged or “abnormal” clitorises connects this purportedly medical problem with social and cultural concerns — large clitorises were seen as more common in both lesbians and women of color, who were perceived as hypersexual. Though the chapters on female circumcision as a means of enhancing female pleasure during penetrative marital intercourse are a bit denser and not quite as clearly argued, they also make important contributions to the scholarship, detailing the connections between clitoral surgery, the so-called “vaginal orgasm,” and evolving social and cultural ideas about female sexual pleasure.

Readers of Nursing Clio may be especially interested in the ways that Rodriguez connects these surgeries both to contemporary plastic surgeries like “vaginal rejuvenation” and to political debates about female genital mutilation (FGM), which typically envision clitoral cutting as both foreign and non-medical. Sometimes historical monographs place more current events in their introductions and epilogues as a sort of false-feeling proof of relevance, but in this case, it absolutely makes sense. Rodriguez is, in fact, exploring the historical backdrop of these phenomena and revealing the persistent connections between medical approaches to female bodies and social and cultural prescriptions about women’s lives. This history is relevant to our understanding of gender, sexuality, and medicine in the twenty-first-century United States.

Though I often wished for a more narrative approach — the book is at its most fascinating when Rodriguez discusses specific case histories, and I wanted more of those — I do recommend Female Circumcision and Clitoridectomy in the United States to readers who want to know more about clitoral surgeries in the American context. The book would also make an excellent teaching tool; it would fit well on syllabi for women’s history, the history of medicine, or the history of sex.

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Notes

[1] See G. J. Barker-Benfield, The Horrors of the Half-Known Life (New York: Harper, 1976); Ann Dally, Women under the Knife: A History of Surgery (New York: Routledge, 1992); John Duffy, “Masturbation and Clitoridectomy: A Nineteenth-Century View,” Journal of the American Medical Association 19 (October 1963), 246-248; Elizabeth Reis, Bodies in Doubt: An American History of Intersex (Baltimore: Johns Hopkins University Press, 2009).

For Further Reading

Barker-Benfield, G.J. The Horrors of the Half-Known Life. New York: Harper, 1976.

Groneman, Carol. Nymphomania: A History. New York: W.W. Norton, 2000.

Laqueur, Thomas. Solitary Sex: A Cultural History of Masturbation. New York: Zone Books, 2003.

Lewis, Carolyn Herbst. Prescriptions for Heterosexuality: Sexual Citizenship in the Cold War. Chapel Hill: University of North Carolina Press, 2010.

Roy, Judith M. “Surgical Gynecology.” In Women, Health, and Medicine in America: A Historical Handbook, edited by Rima D. Apple, 173-95. New Brunswick: Rutgers University Press, 1992.