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On Clitoral Restoration in Survivors’ Words
Tobe Levin Freifrau von Gleichen
‘What would happen if one woman told the truth about her life? The world would split open.’
Muriel Rukeyser
On 5 September 2014, three women in a taxi glide through the Parisian dawn toward St Germain-en-Laye, the suburb where Dr Pierre Foldes plies his trade. Their mission? Neneh would be operated on; the clitoris she lost to the blade in The Gambia would be excavated from under the scar. Jeanie would report, and Tobe had come along to monitor the restoration operation sponsored by UnCUT/VOICES Press.
1 In 2009, the author founded UnCUT/VOICES Press upon learning that Khady’s memoir Mutilée, translated within four months of publication in 2005 into twelve foreign languages, had not attracted the interest of a single anglophone publisher. She phoned the Parisian publisher that owned the rights to Mutilée every six months for four years, asking whether rights to an English translation had been sold. When in 2009 the book had still not become available in English, she founded a publishing house to bring it out. The mandate of UnCUT/VOICES Press has remained to print books on FGM (the author’s preferred term). Would Neneh emerge with an organ restored? Would Pierre’s skill help others? Would the excised hear about Dr Dan mon O’Dey, the talented German plastic surgeon who refashions the entire vulva? Might Dr Marci Bowers in California be consulted? Or Dr Percec in Pennsylvania? There are also clinicians trained by these pioneers, and many more, who, newly aware of reversal options, yearn to learn. So, it appears that, yes, hundreds of excised women want their birth anatomy restored – despite risks to family relations, reputations, and ethnic solidarity, for, when they were cut, community consensus held that genital wounding was not only the right choice but also the only one.
These emboldened candidates for reconstruction downplay the scepticism among medical professionals. After all, some clinicians ask, what about controlled trials? And how do we know that an unearthed clitoris really works? Indeed, a scarcity of evidence calls for caution. As Belluck and McGarvey (2019) wrote on the medical options available for women living with FGM, some surgeons have expressed reservations.
2 Belluck and McGarvey (2019). Pam Belluck and Maddie McGarvey, ‘The Medical Solutions for Women Living with Female Genital Mutilation’, The Irish Times, Ireland, 6 June. https://www.irishtimes.com/life-and-style/health-family/the-medical-solutions-for-women-living-with-female-genital-mutilation-1.3908340 [Accessed 10 July 2025]. These authors quote Dr Jasmine Abdulcadir, an obstetrician-gynaecologist at Geneva University Hospitals, Switzerland. Although Abdulcadir had been a student of Pierre Foldes, she contends that ‘unless women are in pain’, they require a three-month wait and psychosexual counselling before restoration. In fact, ample briefings prior to surgery appear to have become routine. No positive outcome is assured, but even while lacking certainty, thousands of women choose to grapple with the hurt and flashbacks to undo the theft by blade.
To illustrate the motivating factors for women seeking reconstructive surgery, in the early 1990s, at Goethe Universität, Frankfurt am Main, I taught a class featuring videos about FGM. For six weeks, Senait, twenty-one, from Ethiopia, took her seat in my living room and watched one movie after another. At that time, although international advocacy was still in its baby shoes, my video library already shelved dozens of shows from independent filmmakers as well as from the BBC and German, Austrian, French, Dutch, and Spanish television stations. ‘I’m looking for something’, Senait told me. ‘But I can’t say exactly what.’ Finally, though, insight came. ‘Now I understand’, she said. ‘What’s missing is my clitoris. Because I was only two, I don’t remember being cut, but ever since, I’ve felt like something isn’t there that should be …’
3 Senait and the author were speaking German. All translations from German and French are by the author unless otherwise noted.As van der Kolk (2014) has written, ‘the body keeps the score’. He found that ‘trauma’s impact is not only mental, emotional, and neurological, but also physiological: trauma rewires the brain to put people in a constant state of stress or numbness, leading to a host of physical problems’ (book cover blurb). Senait’s sense of something amiss, and missing, aligns with van der Kolk’s description. It also dovetails with testimony collected by Marie-Noël Arras (2008:39): ‘J’ai toujours senti qu’il me manquait quelque chose … toujours!’ [‘I’ve always felt I lacked something.’]
At the University of Toronto, Gillian Einstein connects the dots. Her research links the clitoris to the body as a whole. In 2008, Einstein found remarkable similarities when comparing cerebral alterations in clitoral cancer amputees to brain configurations in ritually (i.e. deliberately, not accidentally) excised women. ‘Cutting neural innervation to the vulva’, Einstein notes, causes the brain and spinal cord to respond in a manner similar to ‘any loss of neural targets or inputs’ (Einstein 2008:84). Einstein’s work took place when the dearth of holistic studies acknowledging FGM’s effects on ‘the entire body via neural rewiring’ (ibid.:85) was startling, especially when one considers the vulva’s high innervation ‘by both sensory and motor nerves. Cutting the vulva must include cutting nerve and muscle, components of the nervous system’ (ibid.:88). The gratuitous injury becomes all the more chilling considering that ‘loss of targets may lead to further retrograde degeneration in the brain’ (ibid.:93), a known result of ablating these organs if diseased or lost in multiple sclerosis patients. When Einstein was preparing to write, she found ‘no information about how the breasts, legs, corpus cavernosum of the clitoris, and pelvic representations are related to the external genitals in female somatosensory space or how they map in relation to each other’ (quoted in Levin 2011:240).
Dr Pierre Foldes, pioneer of clitoral reconstruction surgery, encountered a similar disinterested ignorance. Even the Royal Academy of Medicine in London, sponsoring a colloquium on 4 July 2007 on ‘circumcision’ and excision, devoted five of six lectures to the penis and only one, by Efua Dorkenoo,
4 In 1983, Efua Dorkenoo (1947–2014), a nurse from Ghana residing in London, founded FORWARD (Foundation for Women’s Health Research and Development). It was among the first organisations to oppose FGM, and is now the largest such charity in the UK. to the clitoris. Despite countless articles detailing reconstruction of the male organ, for the clitoris Foldes found next to nothing. It was as though ‘surgeons had never operated on it and anatomists had barely noticed it. … Certain sexologists’ wild imaginings notwithstanding, it appears that physiology considers the circuitry of pleasure simply too blurry to capture’, Hubert Prolongeau remarks in
Undoing FGM (2011:93). It was as if the world conspired in disdain: the clitoris is a sexual organ, no more, and ‘that simple function was insufficient to make it as interesting as other organs’ (ibid.).
Yet Pierre had discovered a means to reverse the damage, offering his patients renewed genital health and pleasure. How? Let’s keep in mind that the trauma proceeded not only from atrocious pain but also from the perceived betrayal of a normally protective mother, hence wounding from both physical and emotional assaults.