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Psychological and Sexual Restoration Following Clitoral Reconstructive Surgery After Female Genital Cutting: A Case Report

Naveed H, Shqair L, Bowers M, Lieb W · 24 Jun 2026

Abstract

Abstract Background Female genital mutilation/cutting affects over 230 million women and girls globally, with growing numbers of affected individuals now residing in the United States. Despite this, clinical awareness and physician training in restorative procedures, such as defibulation and clitoral reconstructive surgery remain limited. While clitoral reconstructive surgery (CRS), particularly via the Foldès technique, has shown promise in restoring clitoral function and improving psychosocial outcomes, concerns over limited outcome data and ethical implications continue to fuel debate. This case report aims to expand the limited U.S.-based literature on CRS for individuals affected by female genital mutilation/cutting and introduces a new counseling framework that incorporates peer-to-peer support as a component of the preoperative decision-making process. Case Presentation: We present the case of a 35-year-old cisgender female with Type IIb FGM/C who presented with chronic pelvic pain, dyspareunia, anorgasmia, and significant psychosocial distress. After evaluation, the patient was deemed a candidate for CRS. As part of the counseling process, the patient was connected with a prior CRS patient who shared her postoperative experience. Post-surgical outcomes were monitored at 1 week, 1 month, 4 months, and 1 year following the procedure. The patient’s postoperative course was uncomplicated. Pain resolved within 48 hours, with minimal discharge reported at early follow-up intervals. One month post-op, the reconstructed clitoris was visible. At one-year follow-up, the patient reported achieving orgasm for the first time and expressed substantial psychological improvement. No complications were noted, and the patient’s satisfaction with surgical and psychological outcomes was high. This case stresses the impact of including culturally sensitive, peer-based counseling in improving surgical confidence and shared decision-making. Conclusions While ongoing ethical concerns warrant careful consideration, CRS can give meaningful restoration for patients suffering from chronic pain, sexual dysfunction, and trauma. Integrating peer-to-peer counseling into the preoperative process provides a new and culturally resonant strategy to support informed decision-making and manage expectations. As the prevalence of FGM/C in the United States increases, there is an urgent need to expand physician education, increase research relating to FGM/C, and create national guidelines to standardize care and counseling for this underserved population.