In the early fall of 1896, John O. Polak, a doctor in Brooklyn, New York, examined Lizzie B., a twenty-nine-year-old single woman, who, until her nineteenth birthday, appeared to her family to be in exceptionally good health. Around this time, however, the young woman became morose and spent much of her time alone. She would, reported the doctor, “sit alone for hours masturbating,” though she also masturbated “in the presence of friends and relatives.” When Lizzie's father finally took his daughter to see Polak, the doctor described Lizzie as “pale and emaciated,” and he learned she masturbated from twenty to forty times a day. Polak's physical examination of Lizzie revealed a somewhat larger than normal clitoris. Though Polak tried to explain to the distraught father that surgical intervention might not help his daughter, the father “insisted that something radical must be done, and assumed all responsibility.” Polak reluctantly consented to operate, and, nearly two weeks after first examining Lizzie, he performed a clitoridectomy. The doctor concluded his report by writing that three months after the operation, Lizzie “has shown no desire to return to her former habits; she seems happier, and her mental condition clearer.” He believed his removal of her clitoris cured her of masturbating.

Contrary to prior accounts of female circumcision or clitoridectomy, Polak's and other physicians’ approach to clitoral surgery, at least as revealed in published medical works, represented a cautious one that respected the importance of clitoral stimulation for healthy sexuality while simultaneously recognizing its role as cause and symptom in cases of insanity and ill health that were tied to masturbation. In addition to removing the foreskin or the entire organ, doctors during the late nineteenth century through the early twentieth century removed smegma and separated adhesions between the clitoral hood and the clitoris as therapies for masturbation. Physicians who performed these surgeries did so with the belief that the removal of all or parts of the clitoris corrected an unhealthy organ and thereby prevented the further deterioration of their patient's health from the vile effects of masturbation. Physicians who practiced circumcision or clitoridectomy, or who removed smegma or broke up adhesions, linked their patients’ ill health to a nervous irritability, the origin of which was an irritated, abnormal clitoris. The irritated, abnormal clitoris was believed to provoke women into what was considered the medically and socially unhealthy behavior of masturbation.