and health data in general is often inaccurate in areas underserved by health care systems, all existing maps (including Map 1) must be understood as crude approximations of the pattern of prevalence; they do not reflect the increases or decreases in incidence (rate of new circumcisions in age groups at risk) that may or may not be occurring because of public health efforts and cultural change.
Clitoridectomy in the West
Damaging female genital surgeries are not limited to just a few countries of the world, nor have they always been linked to cultural traditions. A few years ago one of my European-American students told me that her grandmother had been circumcised as a child, growing up in the American South. She was not alone.
In a surgery performed in Berlin in 1822 (reported in The Lancet in 1825), a fourteen-year-old “idiotic” patient was said to have been cured of her “excessive masturbation and nymphomania” after being “declitorized” (Huelsman 1976:127). Not only did she discontinue “selfpollution,” but the “intellectual faculties of the patient began to develop themselves, and her education could now be commenced,” allowing her to begin to “talk, read, reckon, execute several kinds of needle-work, and a few easy pieces on the piano forte” (quoted in Huelsman 1976:127–28). According to Huelsman, the first four decades that The Lancet was in publication (i.e., after 1825), there were numerous case histories of patients “declitorized for a variety of medical reasons,” including hypertrophy, tumors, and “infantile, adolescent or adult masturbation regarded as excessive” (1976:128).
Elizabeth A. Sheehan offers a fascinating account of one of the European medical advocates of selective female genital cutting in the mid-nineteenth century, Isaac Baker Brown (Sheehan 1997), who was active during the period of greatest popularity of biomedical declitorization in England during the 1860s (Huelsman 1976:29). Although removal of clitorises in cases of disease was known in European medicine for centuries, Brown’s ideas emerged in an era of debate over whether the clitoris had any role at all in the female enjoyment of sex; some came to consider its removal as a “harmless operative procedure” (a phrase that was used in 1866, see Sheehan 1997: 328). An expert in various operations on the female sexual organs, Brown had founded the London Surgical Home for Women. From the observation that many of the female epileptics in his institution masturbated, Isaac Baker Brown developed a theory of causality that masturbation led to a progression of stages from “hysteria” to epilepsy and eventually “idiocy or death.” Particularly frightening in the long history of European understanding of women’s psychology is Brown’s assertion that danger signs of such possible degeneration might include becoming “restless and excited, or melancholy and retiring, listless, and indifferent to the social influences of domestic life.” “Often a great disposition for novelties is exhibited, the patient desiring to escape from home, fond of becoming a nurse in hospitals … To these symptoms in the single female will be added, in the married, distaste for marital intercourse” (Brown 1866, quoted in Sheehan 1997: 327).
Map 1. Types of Female Genital Cutting in Africa and Arabian Peninsula. Shaded areas indicate prevalence of some form of “female circumcision.” Darker shading indicates prevalence of infibulation. See Map Key on facing page.
Key for Map 1
COUNTRY
1 Benin
2 Burkina Faso
3 Cameroon
4 Central African Republic
5 Chad
6 Côte d’Ivoire
7 Democratic Republic of Congo
8 Djibouti
9 Egypt
10 Eritrea
11 Ethiopia
12 Gambia
13 Ghana
14 Guinea
15 Guinea-Bissau
16 Kenya
17 Liberia
18 Mali
19 Mauritania
20 Niger
21 Nigeria
22 Senegal
23 Sierra Leone
24 Somalia
25 Sudan
26 Tanzania
27 Togo
28 Uganda
29 Yemen
30 Oman
31 United Arab Emirates
Brown’s cure for such “feminine weaknesses” was removal of the clitoris. Recommending chloroform and scissors rather than a knife for the removal, Brown described cases of immediate improvement of his patients. There was widespread acceptance of his theories and some acceptance of his surgeries, both in Britain and North America. In modern times, even as late as the 1940s, biomedical physicians in England and the United States have done clitoridectomies for the treatment and prevention of masturbation and other “deviant” behaviors and psychological conditions such as “hysteria,” particularly for mental patients (Ehrenreich and English, 1973:34).
Ethnographic Research
Although this book is intended to offer breadth on the practices in their variant forms, I also offer data from my ethnographic research on rural women in communities in Sudan. This northeast African country is a valuable case because the most severe form of the surgeries—infibulation—is widely practiced there.
Over a period of more than two decades, I was able to spend about five and a half years in Sudan, which afforded me the opportunity to reflect on, and conduct ethnographic research on, female circumcision (see Map 2 for specific locations). My first trip to Sudan began in 1974, when my husband and I took teaching jobs at the University of Khartoum. The language of instruction at the university was English, but to delve into the society we studied Arabic and gradually became more proficient at speaking Sudanese Arabic. During the next several years, we lived in two urban contexts that afforded ample opportunities for participant observation: Khartoum, the capital city, and Wad Medani, the capital of Gezira Province, where my husband, Jay O’Brien, worked for a year at the University of Gezira. Some of my observations are drawn from these urban experiences, but I was fortunate to have opportunities for rural research in several parts of the country. (See Map 2, page 145.)
In 1975–76, I worked with the Economic and Social Research Council of the National Council for Research on the Jonglei Research Team that focused on the region in southern Sudan where the ill-fated Jonglei Canal was planned. Our multidisciplinary team collected data to enable us to analyze political, economic, and cultural patterns, local interest in development projects, and existing environmental adaptations and migration patterns of local herding, agricultural, hunting, and fishing practices. There I interviewed (with an interpreter) eighty women of the noncircumcising Nuer ethnic
