Cosmetic clitoridectomy in a 33-year-old woman.

The Female Genital Mutilation Act (2003) in England allows for mental health exceptions for cosmetic surgery resulting from perceived abnormality. Similar legislation exists in other countries. There are no reported cases of clitoridectomy for cosmetic reasons or any discussion in the literature of mental health exceptions to the Act. This is a single case report on a 33-year-old married, heterosexual woman who had already had a cosmetic labiaplasty and was seeking a clitoridectomy for aesthetic reasons. At assessment, there were no psychiatric contra-indications or unrealistic expectations and the patient proceeded with a clitoridectomy. At 9 and 22 months follow-up, she was reassessed and was very pleased with the outcome. There were improvements in the satisfaction with her genital appearance, sexual satisfaction, and quality of life related to body image. Assessments for cosmetic clitoridectomy will continue to be rare, but this case may provide some guidance for practitioners who are confronted with such requests for body modification. However there remains only limited understanding of the motivation for such a request.