Clitoridectomy is a medical procedure that involves surgical removal of part of the vulvar tissue, especially the clitoris or its foreskin. In modern medicine, this type of surgery is not limited to "female circumcision" in traditional social or cultural customs. It is also included in clinical treatment plans under specific medical or psychological conditions. However, the medical community is extremely cautious about the scope of application of clitoridectomy, and its indications must be based on adequate diagnosis, ethical assessment and informed consent of the patient.
1. Definition and classification of clitoridectomy
Clitoridectomy can be divided into several categories based on the extent of the removal:
Clitoral hoodectomy : Only the skin tissue covering the clitoris is removed, leaving the clitoris itself intact. It is often used to treat clitoral adhesions or improve clitoral stimulation disorders.
Partial clitoridectomy : Removal of part of the clitoral body tissue while retaining the main nerve distribution area.
Total clitoridectomy : Removal of the entire clitoral body and foreskin, common in traditional "female circumcision", but rarely used in medicine.
2. Medical indications for clitoridectomy
The clinical situations in which clitoridectomy is performed are very limited, mainly including the following situations:
1. Malignant tumor or suspected cancer
When rare primary malignant tumors (such as squamous cell carcinoma, melanoma) or other highly suspicious lesions occur in the clitoral area, local or radical resection can be performed according to the degree of tumor invasion to control the spread of the lesion and prolong survival. After pathological confirmation, further radiotherapy or chemotherapy is required.
2. Chronic clitoritis or structural lesions
For those who suffer from recurrent clitoral hood adhesions, local cysts , chronic pain, etc., and who do not respond to conservative treatment, clitoral hood excision can be performed. This type of surgery helps expose the clitoris, relieve pain or itching, and improve quality of life.
3. Clitoral hypertrophy caused by congenital or hormonal factors
Some patients suffer from congenital adrenal hyperplasia (CAH) or exposure to exogenous androgens, which causes significant clitoral hypertrophy, affecting their appearance and mental health. On the premise that the cause is clear and hormone levels are stable, plastic clitoridectomy can be considered to preserve sensory nerves to maintain sexual function.
4. Part of gender confirmation surgery
In transgender surgery for female-to-male (FTM) transitions, some patients choose to remove the clitoris or reshape it into part of the penis. This type of surgery usually includes clitoral lengthening, foreskin reconstruction, or overall sexual organ reconstruction and must be performed under the guidance of a multidisciplinary team.
3. Ethical and Legal Considerations
In medical practice, forced or involuntary clitoridectomy is considered a violation of human rights by international organizations. The World Health Organization (WHO) explicitly opposes any non-medically necessary female genital mutilation. The implementation of such surgery must strictly follow the following ethical requirements:
Fully informed consent : The patient must be of legal age, have full capacity for conduct, and fully understand the risks and possible consequences of the surgery.
Medical necessity : Surgery should be performed for therapeutic purposes and not for cultural, religious, aesthetic, or familial pressures.
Psychological assessment support : Particularly in the context of gender confirmation or psychological distress, a full assessment and written opinion from a psychologist is required.
4. Surgical Risks and Complications
Any form of clitoridectomy carries risks, common complications include:
Postoperative infection and bleeding : Especially since local tissues are rich in blood supply, improper operation can easily cause bleeding.
Nerve damage : The clitoris is a highly nerve-dense area, and surgery may lead to decreased or permanent loss of sexual pleasure .
Scars and pain : Fibrous scars may form after surgery, leading to chronic pain, discomfort during sexual intercourse, etc.
Psychological trauma : Some patients experience gender identity confusion, anxiety or depression after surgery and require continuous psychological intervention.
5. Postoperative Care and Psychological Intervention
After the operation, attention should be paid to local cleaning and disinfection to prevent infection. Physicians need to guide patients to gradually restore their sexual function cognition and, if necessary, guide them into the sexual therapy consultation process. In addition, a long-term follow-up mechanism needs to be established to monitor the recovery of the surgical area, scar status and psychological adjustment.
6. Alternatives and non-surgical treatments
For clitoral area lesions or sexual dysfunction, the following nonsurgical options should be tried before considering surgery:
Local medication : such as hormone ointments are used to relieve foreskin adhesions or chronic inflammation.
Physical rehabilitation therapy : including biofeedback training and electrical stimulation therapy, suitable for some sexual dysfunctions.
Psychological treatment : Psychological support and cognitive behavioral therapy should be given priority, especially for those with gender dysphoria or clitoral morphology concerns.
Beauty Encyclopedia Tips:
Clitoridectomy is not a universal or routine cosmetic surgery item and its applicability is extremely limited. It should never be attempted rashly unless there is a definite medical need. Any surgical decision involving the female reproductive organs should be based on a multi-dimensional evaluation under the guidance of a professional doctor . It is strictly forbidden to be influenced by cultural bias, partner pressure or social customs. Protecting women's bodily autonomy and integrity is the foundation of modern medical ethics.