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Female Genital Surgical Mods Overview

While some women are adding metal to their genitalia to enhance pleasure and/or adorn their bodies, others are removing flesh from their genitalia to achieve the same objective. Female circumcision is a very controversial issue, for while some organisations campaign against girls having their genitals removed against their will, there are other groups dedicated to performing modifications on the genitals of consenting adult women. The vast majority of these will be for cosmetic reasons, some will be for medical conditions, and some will be to enhance pleasure.

Personal comments

It is strange how men seem to go for genital enlargement ops, while women go for genital reduction ops! Having come into contact with 3 women who underwent some form of genital modification for whatever reason, I research this topic from time to time. I apologise in advance for not providing references, though I have ploughed through as many books as I could that had something to say on the subject.

Female Circumcision Terminology

It is difficult defining exactly what female circumcision is. The word 'circumcise' means to 'cut around', and when applied to male circumcision is the removal of the foreskin or prepuce of the penis to expose the glans. A cursory glance at embryology, to study genital development in both sexes, reveals that the male penis and female clitoris both develop from the same embryonic tissue. Both organs have a glans, shaft and prepuce.

'True' female circumcision

As a direct analogue of male circumcision, this would mean the removal of the female foreskin, the prepuce, or hood of the clitoris, leaving the glans permanently exposed. This is what I personally regard as female circumcision (this is only my opinion). An upside down U shaped incision is made in the hood of the clitoris around the glans. The remnant of the underside of the hood and its external remainder are stitched together.

Partial Circumcision

This is a term I use derived from its male counterpart to describe the removal of part of the hood of the clitoris. This can be thought of as Hood Trimming for want of a better phrase. There will be a blurring with circumcision and hood slitting. Hood trimming is usually performed on women where the clitoris is covered by a large fleshy hood that protrudes and/or is long and difficult to retract thus making the glans inaccessible. The procedure may also be referred to as a clitoridotomy.

Hood Slitting

This can take several forms as there is some degree of overlap with circumcision and hood trimming. Normally, a vertical incision is made from the tip of the hood to above the glans. Sometimes a narrow triangular wedge of skin is removed. This is performed on women who want to make the glans of the clitoris more accessible without removing the hood, so keeping the glans covered and protected.

Clitoridectomy

The removal of the entire clitoris. The hood, glans and shaft of the clitoris are excised and the remaining wound is stitched up. There is the very real possibility of death through Hemorrhaging, since the dorsal artery of the clitoris is severed as well as the corpora that makes up the shaft of the clitoris.

Sunna Circumcision

The procedure includes all of the above procedures from hood trimming, in its mildest form, right through to clitoridectomy at its most extreme. Sunna means 'blessing' and is usually used to describe the removal of the prepuce of the clitoris as practiced by female adherents of Islam. It is also sometimes performed on women who convert to Islam or marry moslem men. In Islamic countries this operation is sometimes called K'hita or K'hafd.

Clitoridopexy

A form of female circumcision developed by Dr James C Burt to enhance the ability to experience orgasm. Dr Burt claimed that reconstructing the vulva to make the clitoris more accessible to direct stimulation enables women to have more frequent and intense orgasms. He even performed the operation on his wife to prove that Clitoridopexy worked. He claimed that his wife was only mildly orgasmic before the operation, but since has found it easier to reach orgasm and reaches it quicker and nearly all the time! He had performed this operation in all stages of evolution on over 4000 women by the time that Thomas Szasz cited this case report in Medical World News 17 April 1978.

Excision

The removal of the entire clitoris, labia minora and in some cases the labia majora also. In a milder form, Excision may mean the removal of part of the clitoris or labia minora, more like a trimming of excess flesh, rather than the removal of organs. In its severest form is referred to as a Vulvectomy, Pharonic Circumcision, or Female Nullification.

Infibulation

The stiching together of either the outer or inner labia (or remains of). This is usually perfomed immediately after an excision. Infibulation can take place without the removal of organs, for Roman men undergoing prolonged separation from their wives sometimes had them infibulated to ensure chastity. Today some women are infibulated by having multiple piercings in their labia minora or labia majora.

Clitoral Reduction

An upside down V shaped incision is made in the hood of the clitoris to expose the glans and two corpora that make up the shaft of the clitoris. Excess flesh from the hood is removed. The glans of the clitoris is then separated from the two corpora, and the excess part of the corpora is excised. The glans is then relocated and stitched back onto the remainder of the shaft. The remnant of the hood is then stitched to form a new hood to cover the reduced clitoris.

Labia Trimming

The tips of the labia minora are removed. Each lip of the labia minora is taken separately, the excess flesh is then excised. The sides of remaining part of the lip are then stitched together. The surgeon repeats the procedure on the other lip. Great care must be taken to ensure that the results aren't lop sided where one lip is noticeably longer than the other. The operation can take about an hour to perform, and costs about œ2000 plus in the UK.

Labia trimming is often performed on women who have protruding labia minora and wish to look 'more normal' like their friends. Other women have one lip significantly larger than the other and wish to have this 'corrected', in which case, only the larger lip will be operated on.

Vulva Tidy/Repair

One of the largest growth areas in cosmetic surgery is vulva modification. This covers a variety of procedures already mentioned, and is often requested by women who believe that their genitals are ugly, abnormal, or deformed in some way. The most common procedure is labia trimming, though this is also performed in conjunction with a hood trimming or in some cases circumcision.

For a significant number of women the vulva is damaged or deformed by the stretching of their genitals during childbirth. The obstetrician may also contribute to or cause this, either when performing an episiotomy on the woman, or stitching up the episiotomy after the birth. Many affected women seek vulva repair ops to restore the damage or modify the appearance of their genitals so that they look more aesthetic for themselves and/or their partners.

Modification or Mutilation?

All we ever hear from the media is that female genital modifications of any kind are always mutilating experiences performed on girls and women without their consent to control their sexual desires, in the name of religion, ethnic identity, or tradition. We never hear any positive things. Anti FGM organisations never differentiate between the removal of the female foreskin by a consenting adult to better enjoy the pleasures of sex, and the removal of the external genitals of young girls without their consent or anaesthetics for that matter.

Just to show part of the other side of the fence, here is an extract from a letter sent by the husband of a circumcised woman to an Anti FGM organisation.

"My own partner has enjoyed unimaginable pleasure after the removal of an excessively large clitoral hood in 1976, but remains embarrassed by being made to feel odd when undergoing medical examinations."

Does this describe modification or mutilation? You decide!

Experiences of women I have known

In the past I have encountered 3 women who underwent some form of genital modification:

A woman I worked for was circumcised on medical grounds. A cousin had a vulva tidy op after childbirth. An ex girlfriend was circumcised to enhance sexual pleasure

The first 2 accounts are brief with vague details, but the last is obviously very personal and more detailed. I therefore apologise in advance for this indirect account from memory.

Medical Reasons

In 1981 when I was 16, I worked for Rita, a large woman with teenage children. I don't know how the subject came up but she told me that she had been circumcised. I didn't know what or where a clitoris was, so had no idea what it really meant. Rita offered to show me, and being a teenager thought all my birthdays had come at once because I was going to see a full grown woman's vulva!

She had black knickers on and pulled the gusset to one side to reveal a mess of gingerish pubic hair. I was initially disappointed that her slit was not in proportion to her build, and didn't really pay much attention when she spread her outer lips to show me. I can only remember her point to a bead type of thing and call it the clitoris. Rita had mentioned getting infections and the skin sticking, and that being circumcised cured it. This seemed familiar because as a child I had similar problems and was very close to being circumcised at 13. In hind sight Rita had probably suffered from Balanitis due to adhesions between the glans of the clitoris and the underside of the hood.

Vulva Tidy op after childbirth

This account is second hand from an aunt and my mum. Back in the early 80's, a cousin had a difficult birth with her first baby and had an episiotomy. Once the baby was born, surgeon said he was going to tidy her up. Being a nurse she took that to mean that he was going to stitch up her episiotomy. When she got a proper look at herself she saw that the surgeon had performed a vulva tidy up. The protruding parts of her labia minora had been removed and the hood of her clitoris had been trimmed back to expose the tip of the glans. She was angry that this had been done without her knowledge and consent but mellowed out once she was healed up.

Hoodless Ex

Karen had a well endowed vulva, with a very large, fleshy clitoral hood that protruded significantly from between her outer lips. She also had large, pendulous 'labia minora' to match. Although Karen had no difficulty pulling her hood back, she wished it would stay back without needing to be held. She enjoyed foreplay, masturbation and oral sex, but felt frustrated by her hood getting in the way of the fun.

While at Uni we shared a house with Lau who was a complete contrast to Karen. Lau's outer lips closed up to form a slit, and her small clitoris had a very short hood leaving the glans exposed. Karen envied Lau's clitoris. Over the summer vacation Karen went to see a gynaecologist, without my knowledge, and was circumcised. I finally saw Karen after a couple of months just before going back for our final year.

To begin with she was very self conscious about herself but she eventually showed me. Most of her hood had been removed leaving the glans permanently exposed. It was the first time that I saw the whole glans of Karen's clitoris. When I asked what had made her do it, she replied that Lau had jokingly offered to circumcise her during one of their mutual teasing sessions, and that's what gave her the idea.

When she was fully healed, she had to get used to the new sensations and learn how to get pleasure from her modified clitoris. We had to alter our arousal techniques and the way we made love as a result of her mods. On a personal note, I initially missed her hood, but this soon passed when I saw Karen begin to experience a new dimension in sexual pleasure. There were also times when I felt I left out when she was having such intense orgasms.

Based on Karen's experiences I have attempted to summarise some pros and cons as follows:

Pleasures of female circumcision:

The glans of the clitoris is exposed and more accessible to direct stimulation. This proved to be highly pleasurable in Karen's case. She described it as like having an extra dimension added to the pleasure she experienced. The sensations felt in the clitoris with its glans exposed were greater than when previously covered with a hood. This is very subjective, but after circumcision Karen generally seemed to be out of control with pleasure and developed a craving for oral sex! Karen said it was like having sensations amplified.

Karen loved the appearance of her circumcised clitoris. I must confess that I found her clitoris very erotic and enjoyed giving her oral sex. Karen was all for this too, but there were occasions when I thought that the face hugger from Alien had got me!!!!

With seemingly ordinary activities like walking, friction, generated by her knickers rubbing against her exposed glans, caused highly pleasurable sensations. She found horse riding became far more pleasurable too!

The clitoris is easy to keep clean. No more smegma build ups under the hood. Karen found it easy to orgasm using the shower jet aimed at her clitoris so that 'coming clean' took on a whole new meaning for her.

Pains of female circumcision:

There is a strong risk of hemorrhaging during surgery, especially if the dorsal artery of the clitoris is accidentally severed.

There is the risk of clitoral nerves being accidentally severed, leaving the woman unable to feel any sensations in the clitoris.

There is the possibility of the surgeon accidentally amputating all or part of the clitoris. It is well known that accidental amputations have occurred during the circumcision of male infants.

The surgeon may remove too much or too little of the hood. While not dangerous, this may have adverse psychological effects. The woman may feel mutilated if too much is removed, or that it was a waste of time if not enough is removed. Ask the surgeon exactly what s/he means when they say they will only remove a 'little' bit of skin!

Allied with the previous four points, is the possibility of requiring further surgery should things not go to plan.

Post op pain. Circumcision hurts for a few weeks. Especially when going for a pee, when urine makes contact with the wound. Karen needed to have a local anaesthetic before her stitches were removed.

For the first few months the clitoris will be hyper sensitive to direct stimulation, compared with pre-surgical sensations. Oral sex may be the only means of prolonged contact before things become too much to take.

A few months later, the glans may became callused and slightly de-sensitised. This is similar to what women with an uncircumcised short hood and exposed glans often find.

Previous love making positions and stimulation techniques will need to be modified to account for changes in anatomy and take advantage of the new sensations.

Wearing tight clothing may prove very uncomfortable sometimes, especially as the crotch seam of jeans cuts into the clitoris. This may mean a drastic change of image so be warned.

Sometimes the friction caused by knickers rubbing against the exposed glans becomes too pleasurable, bordering on the threshold of pain.

The medical profession take a keen interest when going for medical exams. Karen's clitoris was inspected by 5 different doctors when she went for a medical before doing teacher training. When she went for a medical to do nursing she became the focus of attention for a load of student doctors.

There is the remote possibility that the circumcision may tear during childbirth.

Other potential dangers

On a more lighthearted note, vibrations and friction, while intensely pleasurable, come with their own dangers, especially when riding a horse or motorbike. Some women derive incredible pleasure from the vibration of a motorbike engine, or the rhythmic friction between the saddle and the clitoral region while riding a horse. It would be so easy to lose control at the height of pleasure. A cracked collar bone is not to be sneered at when falling from a cantering horse. Worse still a fatal traffic accident!

With hind sight Karen that she wished she'd had it done earlier and can't thank the surgeon enough for turning a frustrating sex life into an incredible one.

Finally a few words of caution regarding any form of body mod be it surgical, non-surgical, piercings etc:

As with all cosmetic surgery, there is no 100% guarantee of success. What works for one person may not work for others. Many body mods for women are anatomy dependent. Be very specific about what you want, that way you are more likely to get what you want and less likely to be disappointed when things didn't turn out as expected. Only let a fully qualified operator that you can trust perform the mod. It's too late to discover that you were a guinea pig for an inexperienced operator when something goes wrong. The modification you require may be illegal in your country/state, so you may have to travel abroad for some procedures. In 1993 the British Medical Association struck off a doctor who had agreeing to perform an excision on an African woman. The woman in question turned out to be an undercover journalist working for a major British newspaper.

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submitted by: Anonymous
on: 23 Nov. 1997
in Female Genital Surgery

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