The origins of the practice are unknown. Its east-west, north-south distribution in Africa meets in Sudan, leading Gerry Mackie to speculate that infibulation originated with the Meroite civilization and imperial polygyny, before the rise of Islam, to increase confidence in paternity.
The philosopher Philo of Alexandria (c. 20 BCE – 50 CE) also made reference to it: "the Egyptians by the custom of their country circumcise the marriageable youth and maid in the fourteenth (year) of their age, when the male begins to get seed, and the female to have a menstrual flow."
Gynaecologists in 19th-century Europe and the United States removed the clitoris to treat insanity and masturbation. British doctor Robert Thomas suggested clitoridectomy as a cure for nymphomania in 1813. The first reported clitoridectomy in the West, described in The Lancet in 1825, was performed in 1822 in Berlin by Karl Ferdinand von Graefe on a 15-year-old girl who was masturbating excessively.
