Female Circumcision



Last updated: 22 March 2014, 10:41 UTC



As a preamble to this section of CIRCLIST, it is necessary to define our use of the terms "Female Circumcision" and "Female Genital Mutilation". These phrases should not be regarded as interchangeable. Within this website, by definition, the following distinction is made:

Female Circumcision ("Femcirc"): Surgery that modifies the female genitalia in ways likely to be accepted by a neutral observer as enhancing the quality of a woman’s sexual experience.

Female Genital Mutilation ("FGM"): Surgery that modifies the female genitalia in ways likely to be accepted by a neutral observer as reducing the quality of a woman’s sexual experience. Further detail of the more drastic procedures of FGM can be found here.

On this page we consider three forms of female genital surgery all falling into the category of Female Circumcision. Firstly the "unhooding" of the clitoris (the true equivalent of male circumcision), then frenectomy and lastly labiaplasty, the surgical reduction of pendulous labia using a procedure sometimes called the Toronto Trim. Although all three procedures are of a minor nature, none should be attempted on a do-it-yourself basis. Readers should note that in a few jurisdictions (the UK in particular) the legality of these surgeries is in doubt due to the catch-all wording of legislation against Female Genital Mutilation.



Unhooding of the clitoris

Drawing of clitoral hood with smegma (6804 bytes)
The clitoris, like the penis, has a hood or foreskin that produces a oily, lubricating fluid. This fluid allows the hood to move back and forth over the smooth and healthy clitoris. However, if the sex organs are not properly cleaned, it will accumulate and turn into a cheese-like substance called smegma. This smegma can dry out and irritate the clitoris. The irritation can be relatively mild or lead to a persistent inflammaton and cause severe pain. Indeed, over time, an accumulation of smegma may cause the foreskin to adhere to the glans and body of the clitoris. Because of these adhesions, the foreskin can no longer be moved back and forth over the glans, and this, in turn, can make sexual activity painful. The condition may also be responsible for a lack of orgasm in some women.

"Hoodectomy" provides a remedy for such problems. It is the true female equivalent of male circumcision.

As is the case with male circumcision, attempts have been made to devise clamping devices to guide the scalpel and protect delicate tissue that is not scheduled for removal. CIRCLIST has only been able to document of one such device, the Rathmann Clamp. Readers with an engineering background will recognise the device as a set of modified Mole Grips.

1 - Smegma
2 - Clitoral hood
3 - Clitoris
4 - Labia Minora

Shading denotes potential areas of
inflammation and
irritation when
smegma is present.

Image copyright © 2009 Humboldt-Universität, Berlin.


Frenectomy

Some women, especially those possessing a prominent clitoris, have a frenulum that tends to pull the organ downwards when it is erect in consequence of sexual arousal. This interferes with sexual performance in much the same way as is the case with a man suffering from Frenulum Breve. Frenectomy, the cutting away of this web of skin so as to allow the clitoris greater freedom of movement, is reported to enhance the sexual pleasure of women with this rare condition.



Labiaplasty

Over time, a woman’s inner labia can become inconveniently long, protruding way beyond the outer labia and becoming unsightly. Discomfort can also arise if, for example, they get snagged by knicker elastic. Prolonged tugging by way of masturbation has been suggested as one possible cause of such distension, but let’s not be judgemental about that. The procedure came to prominence following publication of an article in the North American edition of Cosmopolitan magazine, quoted in the Toronto Globe and Mail Tuesday, 10 November 1998 ("New hot cosmetic surgery for women" by Krista Foss, Health Reporter). This article seems to be the original published occurrence of the slang term that describes labiaplasty as the "Toronto Trim".


Before-and-after photographs of labiaplasty
Before labiaplasty, Patient 2 (59618 bytes) After labiaplasty, Patient 2 (60509 bytes)
Image pair copyright © 1996 Dr. Robert H. Stubbs MD, FRCSC, FACS
Before labiaplasty, Patient 3 (55794 bytes) After labiaplasty, Patient 3 (35028 bytes)
Image pair copyright © 2009 Ashirwad Hospital, Dehradun, India
Further images images and a list of practitioners performing 'hoodectomy' in the USA can be found here:
http://clitoralunhooding.com/clitoral-unhooding-photos.html.




amber alert (3308 bytes)
Legal uncertainties in the United Kingdom

UK law relating to modification of the female genitalia is contained in the Female Genital Mutilation Act 2003 (for Scotland, an Act of the same name dated 2005). Until March 2014 the position appeared to be relatively straightforward, prohibiting (for example) cosmetic labiaplasty. Apart from certain closely-defined exceptions relevant only to doctors, midwives and those training to become doctors or midwives "a person is guilty of an offence if he excises, infibulates or otherwise mutilates the whole or any part of a girl’s labia majora, labia minora or clitoris." The wording of the exception at first sight appears intended [a] to avoid ambiguity regarding episiotomy and [b] to allow for professional opening and re-closure of a pre-existing infibulation at childbirth. The latter assumption now seems to be in doubt. When, in March 2014, the UK’s first prosecution for FGM was announced, it soon became clear that the circumstances of the case relate to re-closure after childbirth.

The legislation has overseas application and applies to adult females as well as minors, despite the use of the term "girl" in the main parts of the Act. It does seem that, in a rush to protect the daughters of immigrants from the excesses of clitoridectomy and infibulation, some over-zealous legislation has found its way onto the Statute Book. Quite what a maternity unit is now expected to do when a woman with a pre-existing infibulation goes into labour is something of a legal mystery. One answer appears to be to stream all such cases for caesarian delivery.

Both doctors and patients should continue checking the latest legal situation before engaging in any of the procedures described above.



Acknowledgements

The following resources were used in the preparation of this web page:
German flag (193 bytes) Berlin flag (1435 bytes) Logo of Humboldt-Universität, Berlin. (12122 bytes) Website of Humboldt-Universität, Berlin.
Indian flag (1316 bytes) Website of the Department of Cosmetic Surgery, Ashirwad Hospital, Dehradun, India.
Canadian flag (1361 bytes) Ontario flag (1697 bytes) Logo of Dr. Stubbs (5920 bytes) Website of Dr. Robert H. Stubbs MD, FRCSC, FACS of Toronto, Ontario, Canada.
Canadian flag (1361 bytes) Logo of the Toronto Globe and Mail (38513 bytes) Toronto Globe and Mail, 10 November 1998.
UK flag (1361 bytes) Website of the UK Government’s Office of Public Service Information.
UK flag BBC logo BBC News website 21.March.2014.




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