Sarah B. Rodriguez teaches in the Medical Humanities and Bioethics Program and in the Global Health Studies Program at Northwestern University. Global Health Portal blogger Lajja Patel recently spoke with Sarah about her new book Female Circumcision and Clitoridectomy in the United States: A History of a Medical Treatment. Here is an excerpt from the interview.
About the book (from the publisher):
In the nineteenth through the mid-twentieth centuries, American physicians treated women and girls for masturbation by removing the clitoris (clitoridectomy) or clitoral hood (female circumcision). During this same time, and continuing to today, physicians also performed female circumcision to enable women to reach orgasm. While the opposite purposes of these clitoral surgeries (to either contain a perceived excessive sexuality or to remedy a perceived lack of sexual responsiveness) may seem paradoxical, their use reflects a consistent medical conception of the clitoris as a sexual organ. In recent years both the popular media and academics have commented on the rising popularity in the United States of female genital cosmetic surgeries, including female circumcision, yet these discussions often assume such surgeries are new. In Female Circumcision and Clitoridectomy in the United States: A History of a Medical Treatment, Sarah Rodriguez presents an engaging and surprising history of surgeries on the clitoris, revealing what the therapeutic use of clitoridectomy and female circumcision tells us about changing (and not so changing) medical ideas concerning the female body and female sexuality.
Can you tell us a little bit about your background, and your research interests?
My background is in the history of American medicine and my research area of interest is in women’s reproductive and sexual health since the late 19th century. I’m interested in history for history’s sake but I’m also interested in how history frames how we think about current medical debates and issues. I came to be interested in global health via my work on the topic of this book. Almost everyone conceives these methods as nonmedical procedures that don’t occur in the U.S. unless it’s by immigrants, but this is not the full picture. Historically, in the United States, female circumcision and clitoridectomy were done on white, native-born women as medical therapy.
Can you tell us about some of the history on female circumcision and clitoridectomy as discussed in your book?
To give you a little bit of a background, clitoridectomy is the removal of the external clitoris, while circumcision is the removal of the clitoral hood. Some physicians in the U.S. started using these procedures (at least based on published documentation) in the mid 19th century. At that time, physicians were using it to treat masturbation in women and girls. Physicians believed that there were poor physiological outcomes from masturbation – poor outcomes not in the moral sense but in the sense that people would become ill. Some physicians used clitoridectomy as a therapy for masturbation until at least the 1960’s – that’s the last published reference I found. Physicians also used female circumcision to treat masturbation and they used that therapy until at least the 1960s as well.
In addition to using female circumcision as a therapy for masturbation, however, beginning in the 1890’s physicians published reports of using female circumcision to enhance female orgasms. When I first discovered this use of the procedure, I didn’t think it made sense because physicians were (seemingly) performing female circumcision for polar opposite reasons: to enhance orgasms and to stop masturbation. After further research, I realized that both were being used for a similar goal: to treat culturally non-normative sexual behavior. Whether a woman was masturbating or not having an orgasm with her husband during sex, both behaviors were regarded as culturally inappropriate. If a woman was not having orgasms in the “appropriate” heterosexual manner with her husband, then the clitoris was seen to be at fault. The only “culturally appropriate” and “medically healthy” sexual behavior would have been to have orgasms with one’s husband. Female circumcision and clitoridectomy were medical therapies used to reinforce culturally normative sexual behavior.
While there is no evidence to suggest these procedures were frequently used, they were also not anomalies. They were commonly known enough to end up in some pediatric and gynecology textbooks, for example. And the reason why practitioners were performing these procedures was very much embedded in cultural ideas (and ideals) of normative female heterosexual behavior.
While you were writing this book, which populations were you hoping would read your book?
Definitely other historians and medical anthropologists. But I hope that people who work on policy/outreach/ education surrounding the issue of FGM also read it. And I’d love for people more broadly interested in women’s health and women’s history to read it.
Do you recall some challenges you had while writing this book?
One challenge was finding sources – you have to work with whatever documents are left. The majority of my sources are the published reports of physicians, but then all of these documents are from the perspective of the physician. Women’s voices don’t appear until really the 1970s when a few women began publishing about their experiences.
How long did it take you to write this book?
I initially started exploring this topic while an undergraduate for my honors thesis. I took it up again for my dissertation, but then moved to other topics for a bit. I then wrote one article and again let it sit. So, you can say, I’ve had an on again, off again relationship with this project for a long time. The short answer is, it’s taken me several years.
If you had this on and off- relationship what finally inspired you to go ahead and write this book?
I felt the need to give a more full accounting of the history of these practices than what I was able to do in an article. Also, I suppose I did it for the challenge of it – others told me that I’d never have enough material for a book and I thought otherwise.