Something else? Ask Aunt Vadge – bottom left of your screen!
Female genital modification involves practices that are not considered to be detrimental to health or wellbeing, such as clitoral piercings or tattoos.
Female genital mutilation (FGM) or ‘cutting’ involves cultural surgeries to remove or fuse parts of the genitals. Cutting is performed ritualistically in some areas and communities.
Whether a practice is considered ‘mutilation’ or ‘modification’ seems to depend on who you speak to1, but the World Health Organisation has guidelines this article is informed by. Informed consent is usually the parameter, along with ongoing damage to the body (especially using violence).
Medical practices
Clitoridectomy (removing the clitoris) – FGM and medical surgery
A clitoridectomy is the partial or complete removal of the clitoris, and outside of FGM, may be performed medically because of disease or an enlarged clitoris. Clitoridectomy is also known as female ‘circumcision’, which is a misnomer, since it is not anywhere near the male equivalent of removing a small piece of skin from the end of the penis.
Removal of the clitoris is common in some African, Middle Eastern and Southeast Asian countries in girls aged from just a few days up to age 15. Amnesty International sets the annual figure at over two million clitoridectomies.
The human body has many ways and wiles, and cutting off the clitoral glans may not stop a person from being able to be sexually fulfilled and reach orgasm. But it can be damaging to a person’s sexual expression and function, which appears to be the point.
Labiaplasty, elective genitoplasty – cosmetic and medical surgery
The advent of the ‘designer vagina’ is a set of vagina modifications that tend to reduce labia minora size, remove part of the clitoral hood, or otherwise adjust the size and shape of the vulva. (Read about the labiaplasty operation and the discussion.)
Female genital mutilation (FGM) practices
Infibulation (removal of the vulva and closing of the vagina)
Infibulation is the most extreme form of cutting (Type III), and involves removing the entire vulva (inner and outer labia and clitoris), and closing the vagina up almost completely, leaving just a small hole for urine and menstrual blood.
The vagina is opened after the girl’s wedding for sex and childbirth. This practice is most commonly undertaken in Djibouti, Eritrea, Somalia, and Sudan. Despite efforts by the WHO, the practice is important for some African communities and shows no signs of abating.2
Gishiri cutting
Gishiri cutting is only performed in certain parts of Niger and Nigeria and involves incisions down the back wall of the vagina to the perineum, to ‘treat’ various reproductive disorders. There is no evidence that it helps any of the listed conditions.
Genital modifications
Clitoral piercing
Piercing of the actual clitoral shaft is rare, but not unheard of, since not many actually have enough clitoris sticking out to pierce. The Isabella piercing aims deep at the base of the clitoris, but again requires enough clitoris out to pierce.
Most genital piercings around the clitoris are actually the hood, which is a piece of skin. There is a risk of infection and other nerve pains from these types of piercings; however, there is also often an increase in sexual stimulation.
Genital tattoos
Genital tattooing doesn’t have any sexual or health benefits and is done purely for aesthetic reasons.
Labial stretching
Some African women practice labia pulling to elongate the labia for perceived improvements in sexual pleasure and to enhance female ejaculation.
Anabolic steroids and testosterone to increase clitoris size
Bodybuilders and some other athletes sometimes use anabolic steroids to improve their physical performance. In women, these substances cause enlargement of the clitoris, called clitoromegaly. Some may use a clitoral pump to increase the size and sensation of the clitoris.
Medical procedures
Gender affirming surgery
For transgender people taking female-to-male hormone treatments (high-dose testosterone), the clitoris is likely to enlarge significantly (clitoromegaly). The clitoris doesn’t reach the size of a typical penis.
A metoidioplasty (clitoral release) can be performed in place of a phalloplasty (the creation of a penis), allowing one to maintain sexual sensation in the clitoris.
Gender reassignment surgery supports the ‘person on the inside’ to be more in line with the body on the outside. Not all transgender people undergo gender-affirming surgery.
Surgery on ambiguous genitals or genitally injured children
A child born intersex or with variations in genitals (or having suffered an accident) may undergo surgery to ‘normalise’ them aesthetically, despite function being present most of the time.
These surgeries are often damaging to the child sexually and may render them infertile. In times gone by, a boy with a micropenis may have had his penis removed and been ‘reassigned’ as a girl. This practice is no longer common in Western countries due to its known risks.3
Self-inflicted damage: Skoptic syndrome
A person may self-inflict any variation of genital wounds, including the removal of tissue. This can be due to Skoptic syndrome, a mental illness associated with gender identity crisis, body dysmorphia and obsessive compulsive behaviour.4
Hymenorrhaphy (altering the hymen)
A hymenorrhaphy (hymenoplasty) includes recreating or thickening the hymen. Sometimes, the procedure may include implanting a liquid-filled capsule with red dye so that when the newly-married woman is penetrated by her husband, she bleeds, there is some resistance to the penis, and her ‘virginity’ can be determined (rightly or wrongly) as being ‘intact’.5
People who do not have an intact hymen for whatever reason may choose this surgery to avoid shaming and punishment in areas where ‘proving virginity’ is deemed important.
References
- 1.Kelly B, Foster C. Should female genital cosmetic surgery and genital piercing be regarded ethically and legally as female genital mutilation? BJOG. Published online January 25, 2012:389-392. doi:10.1111/j.1471-0528.2011.03260.x
- 2.Hemmeda L, Anwer L, Abbas M, et al. The unbroken chain of female genital mutilation: a qualitative assessment of high school girls’ perspectives. BMC Women’s Health. Published online January 3, 2024. doi:10.1186/s12905-023-02843-w
- 3.Göllü G, Yıldız RV, Bingol-Kologlu M, et al. Ambiguous genitalia: an overview of 17 years’ experience. Journal of Pediatric Surgery. Published online May 2007:840-844. doi:10.1016/j.jpedsurg.2006.12.036
- 4.Money J. Body-Image Syndromes in Sexology: Journal of Health & Social Policy. Published online May 11, 1995:59-76. doi:10.1300/j045v06n03_04
- 5.Wei S, Li Q, Li S, Zhou C, Li F, Zhou Y. A new surgical technique of hymenoplasty. Intl J Gynecology & Obste. Published online February 28, 2015:14-18. doi:10.1016/j.ijgo.2014.12.009
