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When Detroit doctor Jumana Nagarwala was arrested on April 17, 2017, for female genital mutilation (FGM), many people were shocked to learn that the practice was still happening in the U.S.

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According to the sex researcher Elizabeth Sheehan, “Westerners… view [female circumcision] as being rooted in ideologies totally foreign to those in the West.” Sheehan explains in the Medical Anthropology Newsletter that such surgeries were performed in the U.S. and the U.K. from the 1800s all the way through to the 1970s. As Nagarwala’s arrest (and the subsequent arrest of another doctor) demonstrates, forms of it continue to this day.

“Female genital cutting/mutilation/circumcision has been discussed by Westerners for centuries, often as a bizarre and cruel practice far away in Africa,” wrote sex researchers Sara Johnsdotter and Birgitta Essén in their article on “the politics of genital modifications.” Yet it wasn’t until the 1970s, when radical feminist Fran P. Hosken brought attention to the practice, that the Western public became aware of it. At the time it was called “female circumcision,” but Hosken decided to change the term to the much more evocative “female genital mutilation.”

FGM is an umbrella term that encompasses everything from extreme practices—the complete removal of the clitoris and labia and sewing shut of most of the vaginal opening—to a symbolic pricking of the clitoris to draw blood. FGM also includes the removal of the clitoral hood, which is roughly analogous to removing the foreskin of a penis (male circumcision).

But the FGM label is not without controversy. “Many NGOS have abandoned the term FGM in favour of the more neutral ‘female genital cutting’” because “‘FGM’ is… too offensive,” according to Johnsdotter and Essén.

Removing the clitoral hood (clitoral circumcision), clitoridectomy (removal of the visible part of the clitoris), and removal of adhesions of the clitoris to its hood, were performed in America and England in the mid-1800s. The most famous practitioner was an “eminent obstetrical surgeon” from London named v, who co-founded St. Mary’s Hospital. In his 1866 book, On The Curability of Certain Forms of Insanity, Epilepsy, Catalepsy, and Hysteria in Females “Brown proposed that all of the feminine weaknesses referred to in the title could be cured by excision of the clitoris,” Sheehan wrote. Brown was only one of many surgeons who believed clitoridectomy could cure women’s “diseases.” However, soon after Brown’s book was published, the British medical establishment publicly condemned clitoridectomy.

Yet clitoredectomy and female circumcision continued in both England and the United States because doctors persisted in believing that many women’s health problems, particularly psychological ones, originated in their genitals.

It was masturbation that doctors claimed to be most concerned about. In the late 19th century, American physicians believed that female masturbation was caused by “excessive nervous stimulation,” writes Northwester University’s Sarah B. Rodriguez in her history of clitoredectomy in the U.S. Some doctors thought that women and girls masturbated because their clitorises were “irritated” and they rubbed their clitorises “to quell the irritation.” Performing clitoral surgeries was thought to “cure” masturbation. The height of clitoral surgeries in the U.S. was the turn of the 19th century, and by 1920 they became “routine.”

By the 1940s, many doctors no longer believed that masturbation was a disease and clitoral surgeries became less common. Yet not all doctors and parents thought that masturbation was safe. Throughout the 1960s, women and girls continued to be subjected to clitoral circumcision as an anti-masturbation measure.

But it wasn’t only girls who were getting circumcised. Driven by the publication of Masters and Johnson’s research showing that all female orgasms originated in the clitoris (not the vagina), some doctors and women’s magazines began touting circumcision as a way to improve clitoral stimulation during sex. Circumcision was promoted as empowering, and it became so common that, by 1977, “The Blue Shield Association recommended that its individual plans stop routine payment for… ‘the removal of the clitoral hood.’”

A few years after FGM was outlawed, in the early 2000s, clitoral surgeries came back into vogue. Some women in the U.S. and U.K. felt self-conscious about their genitals and demanded cosmetic surgery to get their clitorises reduced in size (“clitoris lifts”),  clitoral hoods removed, or labia reduced.

According to Marge Berer, the founding editor of Reproductive Health Matters, these cosmetic procedures are the equivalent of FGM and yet they are legal in Britain and the U.S. “If a woman (probably of African descent) asks a medical practitioner in Britain for her own or her daughter’s genitals to be partially or fully excised for traditional or cultural reasons, she will be told it is a criminal offense,” Berer writes. “Yet if any woman perceives her own genitals to be an abnormal shape or size, even though they are perfectly normal… the surgery is considered legal.”

As Nagarwala’s case demonstrates, although female circumcision is centuries old, it is not a thing of the past.


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Medical Anthropology Newsletter, Vol. 12, No. 4 (Aug., 1981), pp. 9-15
American Anthropological Association
Reproductive Health Matters, Vol. 18, No. 35, Cosmetic surgery, body image and sexuality (May 2010), pp. 29-37
Reproductive Health Matters (RHM)
Reproductive Health Matters, Vol. 18, No. 35, Cosmetic surgery, body image and sexuality (May 2010), pp. 106-110
Reproductive Health Matters (RHM)