The main argument in favor of hoodectomy is that it increases or enhances erotic
responsiveness. But other medical information shows the same variety of medical and hygiene
problems apply to the clitoris as to the penis, where male circumcision is generally regarded as the
best preventative and only permanent cure. So one finds, in the Campbell-Walsh Urology--the
most authoritative work in the field--discussions of various maladies associated with the hooded
clitoris, such as phimosis and balanitis, resulting from a number of possible causes, from fungal
infections, herpes virus, infected sebaceous cysts, "smegma-like debris," lichen sclerosus, and
lichen planus. "Conservative treatments" for these maladies involve estrogen or testosterone
creams to try to make the prepuce more elastic and retractile, as well as topical anti-fungal
medicines or acylovir (for herpes virus). However, from infections by lichen sclerosus, "phimosis
and fusion of prepuce is a likely sequel," and lichen planus infections may lead to scarring of the
clitoral glans. The authors add, "If conservative treatment fails due to the phimotic prepuce,
surgical management by dorsal slit procedure should be considered" (p. 883). (A dorsal slit
uncovers the glans of the clitoris, but does not remove the remaining split halves of the prepuce,
which simply gather to each side of the glans. Plainly, hoodectomy would have not only the
same hygienic effects, but would leave a more cosmetic result, as well. The same procedure,
moreover, would obviously be the most effective preventative measure.)
However, actual studies of hoodectomy have focused on erotic benefits. A few recent published
studies of patient satisfaction with hoodectomy are now available, and these confirm the
unanimous favorable reports of earlier and smaller studies. The three most recent published
medical studies are these:
1. A national study of outcomes of various forms of female genital cosmetic surgery has recently
beeen published in the Journal of Sexual Medicine. Extremely favorable results (97.2%) are
reported for women who had labiaplasty and clitoral hood reduction. The report from this study
is available here.
2. Dr. Gary Alter published an article in Plastic and Reconstructive Surgery 2008 Dec. 122(6),
1780-9 reporting follow-up study of his own patients who had undergone labiaplasty (many with
clitoral hood removal). Here is a quote from the abstract:
"The total number of patients undergoing reoperation was 12 of 407 (2.9 percent). Patients
responding to the questionnaire (166 of 407) were pleased with the surgery by an average score
of 9.2 of 10 (where 10 = most pleased). Improvement in self-esteem (93 percent), sex life (71
percent), and discomfort (95 percent) was reported with a low significant complication rate (4
percent); 163 of the respondents (98 percent) would undergo the surgery again. CONCLUSION:
Central wedge reduction with lateral clitoral hood reduction is a safe, effective procedure with few
complications and high patient satisfaction."
I assume the positive response regarding sex life might have been increased had Alter questioned
only those who had clitoral hood removal done. Some of the respondents may have had only
labiaplasties.
The complete abstract for this publication may be found here.
3. A report in Scientific American in October, 2000 indicates that as many as ¼ of the women
who have some sexual dysfunction suffer from clitoral phimosis, for which hoodectomy is the
obvious and most effective permanent cure.
4. Although it counts as only indirect evidence, a recent study published in the Asia Pacific
Journal of Public Health 20.4 (2008), "Orgasmic Dysfunction Among Women at a Primary Care
Setting in Malaysia," by Hatta Sidi, and Marhani Midin, and Sharifah Ezat Wan Puteh, and Norni
Abdullah, (abstract and bibliography is available at http://myais.fsktm.um.edu.my/4480/) showed
that the Malay women in the study experienced less orgasmic dysfunction than the non-Malay
women. This is significant because Malay girls generally undergo hoodectomy in infancy,
whereas non-Malay women are much less likely to have had hoodectomies.
These latest studies strongly confirm earlier ones, including:
5. Dawson, Benjamin E., “Circumcision in the Female: Its Necessity and How to Perform It.”
American Journal of Clinical Medicine 22.6 (June 1915), 520-523.
A very early medical report of hood removal, claiming all kinds of clinical (and psychological)
benefits. This article can be found at an anti-circumcision website.
6. Morris, Dr. R. O. Fifty Years a Surgeon. (London?), 1935.
Surgically removed many clitoral hoods to treat “preputial adhesions.” Dr. Morris noted a
“frequent finding” of the clitoral glans “undeveloped and buried beneath an adherent prepuce. I
investigated and found that because of the irritation caused by preputial adhesions, both boys and
girls require circumcision in equal numbers” (160).
7. McDonald, C. F. “Circumcision of the Female.” General Practitioner 18.3 (September,
1958). 98-99.
Claims to have performed “circumcision” on “perhaps 40 patients,” including some adult women.
Among the adult women who underwent the procedure, “Very thankful patients were the reward.
For the first time in their lives, sex ambition became normally satisfied” (98). However,
McDonald’s procedure actually does not remove the hood, but instead stretches it to the point
where “It is seldom that the prepuce will overgrow again once it has been opened” (98). In other
words, the effect of McDonald’s stretching technique is essentially the same as removing the
hood. This article may now be found online at an anti-circumcision website.
8. Rathmann, W. G. “Female Circumcision, Indications and a New Technique.” General
Practitioner 20.3 (September, 1959). 115-120. This article is now available online at a pro-
circumcision website, and also at an anti-circumcision website. Sent out a questionnaire to
women whose hoods he had removed, and received 112 replies. Of the 72 women who reported
having never experienced an orgasm prior to the surgery, 9 [12.4%] reported continued failure to
achieve orgasm; 64 [87.6%] reported successful achievement of orgasm after the surgery. Of the
39 who reported achieving orgasm only with difficulty prior to the surgery, 5 [12.5%] reported no
improvement; 34 [87.5%] reported improvement after the surgery. Rathmann provides a number
of indications and contraindications for the surgery, and invented a new clamp for the procedure.
9. Wollman, Leo. “Hooded Clitoris: Preliminary Report.” The Journal of the American Society of
Psychosomatic Dentistry and Medicine 20.1 (1973), 3-4.
Provides a “Statistical analysis of one hundred cases.” Not clear whether the statistics Wollman
reports include all one hundred women (32 of whom did not receive the surgery—see below) or a
statistical report of those who were clitoridotomised. In this study, he reports the frequency of
sexual intercourse before treatment as 3 times per week on average; after treatment as 5 times per
week on average. 49 women were able to attain orgasm prior to treatment; 92 after. 92
subjectively report improvement in intensity of sexual response, rapidity of sexual response,
and/or greater number of orgasms; 7 subjectively report no change, and 1 subjectively reports
being worse off. The longest time since treatment was 20 years; 64 patients were followed up
after 5 years since treatment. The treatment occurred in Wollman’s office 98 times; in the
hospital (at patient’s request) 2 times.
10. Wollman, Leo. “Female Circumcision.” The Journal of the American Society of
Psychosomatic Dentistry and Medicine 20.4 (1973), 130-131.
Reports on one hundred consecutive patients referred to him by psychoanalysts and clinical
psychologists. “Sixty eight benefited by surgical female circumcision: of the remaining thirty-two,
twenty-eight showed no need for this procedure; four refused to be treated by this technique.”
11. Crist, Takey. “Female Circumcision.” Medical Aspects of Human Sexuality 11.8 (August,
1977), 77.
Reports on Crist’s hood removals on of fifteen women, and provides a list of four conditions for
when the surgery would be indicated: “a) they could achieve orgasm only by masturbation and/or
oral sex, b) they could have orgasm in the lateral or female-superior positions only, c) they stated,
“it feels good, I get there, but suddenly it’s over.” d) they had a positive cotton-tip test, where
patients felt a distinct difference when a cotton-tipped applicator was applied directly to the
clitoris when the foreskin was retracted as opposed to application to the foreskin” [77]. Crist’s
study concludes, “Patients who have undergone this procedure have generally commented that
they have enhanced sexual response.”
12. David Haldane, “Clitoral Circumcision.” Forum (UK), 1990 (?), 41-43, 49.
Haldane interviews several women who had their hoods removed, and several doctors about the
procedure. Those who have actually undertaken studies (as opposed to simply expressing
opinions) include the following:
Dr. Stanley Daniels, who had performed hundreds of these surgeries. Daniels says that the
surgery isn’t for everyone, and refuses to perform it on about half of those who request it. In
those he does agree to perform the surgery on, however, Daniels claims that “a large percentage
report a ‘significant increase’ in the level of sensation and satisfaction in their sex lives after the
operation” (42).
Dr. W. G. Rathmann (see [7], above), who repeats his results and recommendations from his
published article.
Dr. Leo Wollman (see [8] and [9], above), whose articles are cited and whose results are reported.
Constance Knowles, a marriage and family counselor, whose interest in the procedure began with
her own hood removal in 1972 (for which, see the Print section). Knowles was undertaking a
long-term study of women who had the surgery and reported 75% as saying that the results were
“significant and lasting improvement in their sex lives,” and “25% [who] reported no long term
positive effects.”
It is interesting to note that Haldane quotes one critic of the surgery, Dr. Leon Zussman, who
claims that removal of the clitoral hood is not necessary because women get all the sensation they
need from “the motion […] transmitted through the labia to the hood and then from the hood to
the clitoris” (42). Zussman seems oblivious to the fact that many women find this form of
indirect stimulation inadequate and unsatisfying. Zussman goes on to warn that “Theoretically it
[hood removal] could even be detrimental to sexual response,” but honesty requires him to add,
“I am not willing to say that I’ve seen cases in which it [hood removal] has been [detrimental to
sexual response]” (42). He does claim, “we have seen many women who have undergone the
procedure and most of them admitted that it just doesn’t do much” [42]. Given the abundance of
personal and medical reports to the contrary (which this web site is dedicated to making more
readily available), one wonders how accurate Zussman’s impressions of what “most” women
who had their hoods removed have to say about the results they have achieved from the surgery.
13. Krista Foss, “New Hot Cosmetic Surgery for Women,” Toronto Globe and Mail, Tuesday,
November 10, 1998.
Foss reports on a Toronto surgeon named Dr. Robert H. Stubbs, who performs various kinds of
sexual enhancement surgery. Most of the article is about labiaplasty, but it is clear that Dr. Stubbs
also performs hood removals. Dr. Stubbs is reported as saying, "Some women report to me they
have had an orgasm for the first time after I have unhooded the clitoris.”
There is a website for Dr. Stubbs’s practice. On the Web page, Dr. Stubbs shows some
examples of his surgeries:
Before and after pictures of a “clitoral unhooding” (which seems also to have included a
labiaplasty).
Before and after pictures of a “genital enhancement” (which seems to have included both a
labiaplasty and at least a partial removal of the clitoral hood.
14. Dr. Irene Anderson contributed a report of her own hood removal to this website, and also
reported the following results of nearly a hundred hood removals she performed in her surgical
practice in Mexico:
I had it [her own hood removal] in November 1991. The reason was that I never had a vaginal
orgasm, so I wanted to improve the sensitivity of my clitoris, releasing it from the hood. The
result is great. Regarding my patients, the success rate was very high. I had nearly one hundred
surgeries of that type, and only three patients were not satisfied by the result. I recommend the
procedure to every woman, especially those who are not able to have vaginal orgasm.
Comparison of the Glans of the Clitoris with the Glans of the Penis
15. Scott, F. Brantley. “Nerve Endings in Glans Clitoris vs. Glans Penis.” Medical Aspects of
Human Sexuality. 15.7 (July, 1981), 88.
Several arguments—some by famous sexologists (see, e.g. W. H. Masters, V. E. Johnson, and R.
C. Kolodny, Masters and Johnson on Sex and Human Loving, 1986, 32-3)—have been
published over the years claiming that the removal of the clitoral hood should not be compared to
the removal of the male foreskin, on the ground that the clitoral glans was much more sensitive to
stimulation than the male glans. This claim is repeated as fact by several self-identified “experts.”
Scott’s brief answer to a question sent to the journal would appear to count against any such
claim: “Anatomic studies have shown that on a per centimeter surface area, the number of nerve
endings in the glans clitoris is equal to that in the same surface area of the glans penis” (88). The
same evidence would seem to support the surgical removal of the clitoral hood for women who
find its presence has the effect of dampening stimulation on the simple ground that the clitoral
glans is so much smaller, and thus offers less opportunity for stimulation than does the male glans.