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Cited by 63Female Genital Mutilation/Cutting IssuesGenital Health and DiseaseSexual function and dysfunction studies

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Clitoral Reconstruction After Female Genital Mutilation/Cutting: A Review of Surgical Techniques and Ethical Debate

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Sharif Mohamed, Fatima, Wild, Verina, Earp, Brian D., Johnson-Agbakwu, Crista, Abdulcadir, Jasmine·2020·The Journal of Sexual Medicine
DOI 10.1016/j.jsxm.2019.12.004
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Abstract

Introduction: Clitoral reconstruction (CR) is a controversial surgical procedure performed for women who have undergone medically unnecessary, often ritualistic genital cutting involving the clitoris. Such cutting is known by several terms; we will use female genital mutilation/cutting (FGM/C). Treatments offered to women affected by complications of FGM/C include defibulation (releasing the scar of infibulation to allow penetrative intercourse, urinary flow, physiological delivery, and menstruation) and CR to decrease pain, improve sexual response, and create a pre-FGM/C genital appearance. Aim: In this study, our aim is to summarize the medical literature regarding CR techniques and outcomes, and stimulate ethical discussion surrounding potential adverse impacts on women who undergo the procedure. Methods: A broad literature review was carried out to search any previous peer-reviewed publications regarding the techniques and ethical considerations for CR. Main Outcome Measure: The main outcome measure includes benefits, risks, and ethical analysis of CR. Results: While we discuss the limited evidence regarding the risks and efficacy of CR, we did not find any peer-reviewed reports focused on ethical implications to date. Clinical Implications: CR can be indicated as a treatment for pain and potential improvement of associated sexual dysfunction when these have not responded to more conservative measures. Women must be appropriately informed about the risks of CR and the lack of strong evidence regarding potential benefits. They must be educated about their genital anatomy and disabused of any myths surrounding female sexual function as well as assessed and treated in accordance with the current scientific evidence and best clinical practices. Strength & Limitations: This is the first formal ethical discussion surrounding CR. This is not a systematic review, and the ethical discussion of CR has only just begun. Conclusion: We present a preliminary ethical analysis of the procedure and its potential impact on women with FGM/C.

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Metadata

Authors
Sharif Mohamed, F., Wild, V., Earp, B. D., Johnson-Agbakwu, C., & Abdulcadir, J.
Affiliations
  • Department of Obstetrics and Gynecology , Phoenix, AZ , USA
  • Institut für Ethik, Geschichte und Theorie der Medizin (DE)
  • Hastings Center (US)
  • University of Geneva (CH)
Corresponding author
Abdulcadir, Jasmine
ORCID
Venue
The Journal of Sexual Medicine
Publisher
Oxford University Press (OUP)
Published
2020-01-13
Volume
17
Issue
3
Pages
531-542
ISSN
  • 1743-6095 (ISSN-L)
  • 1743-6109
DOI
10.1016/j.jsxm.2019.12.004
OpenAlex
W2999642081
Cited by
63
References
63
Citations by year
2026: 4 · 2025: 6 · 2024: 7 · 2023: 11 · 2022: 13 · 2021: 18 · 2020: 4
FWCI
1.93
Type
journal article
Language
en
Open access
Licence
Locations
  • The Journal of Sexual Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Archive ouverte UNIGE (University of Geneva) (acceptedVersion, other-oa)
  • OPUS (Augsburg University) (submittedVersion, cc-by-nc-nd)
  • Archive ouverte UNIGE (University of Geneva) (submittedVersion, cc-by-nc-nd)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Female Genital Mutilation/Cutting Issues
  • Health Sciences › Medicine › Surgery › Genital Health and Disease
  • Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
Keywords
clitoral reconstruction, female genital mutilation, infibulation, surgical technique, sexual dysfunction, analgesia, informed consent
MeSH terms
Adult, Clitoris, Female, Humans, Pain, Sexual Dysfunction, Physiological, Circumcision, Female, Plastic Surgery Procedures

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