During a December 1893 speech before the Cleveland Medical Society, physician Alvin Eyer stated that the only cure for masturbation was either marriage or amputation of the clitoris. Eyer then described his removal of the clitoris of a seven-year-old girl, referred to by the initials M.E.H., who had been adopted the previous year. The mother told Eyer how she caught her daughter “gratifying her passions as often as four or fisve times a day” and that the child confessed to masturbating in the orphanage. Upon examination, the doctor found her clitoris “much developed for one her age” and then proceeded to bury the clitoris within the folds of the child's labia to hide it from her touch. M.E.H, however, would not be so thwarted, and Eyer decided to remove the organ entirely. Nearly six weeks after the operation, the mother reported that her daughter confessed to trying to masturbate again but had told her mother: “you know there is nothing there now, so, of course, I could do nothing.”

M.E.H.'s mother was concerned about her daughter's health as a result of masturbation, and her view of the physical problems masturbation wrought on children were reflected in the medical literature at the turn of the twentieth century. According to a 1905 pediatric textbook, masturbation made children “languid,” and they suffered from headaches, “palpitations, mental and physical relaxation, anemia, emaciation, and a change in demeanor.” Moreover, masturbating children became “bashful,” and “shy” as well as potentially “hysterical.” Fears of such immediate health repercussions often prompted parents to seek medical attention—indeed, one physician recommended in his 1923 Nursery Guide for Mothers and Nurses that parents inform their physician as soon as they discovered their child masturbating. Though M.E.H.'s mother was concerned enough she sought medical treatment, she, along with Eyer and the other physicians who treated girls with one of the four clitoral surgeries, also regarded masturbation as an abnormal and unhealthy sexual behavior, a behavior that could manifest itself into a variety of physical and mental health problems. But among physicians this early abnormal sexual behavior was believed to impact the child's future sexual health as well.

Physicians removed smegma, broke up adhesions, circumcised the clitoris, and, at the most extreme, removed the clitoris of women to surgically redirect sexual instinct to what was considered physically healthy and socially acceptable: vaginal sex, prompted by a husband.