“They come to us seeking solutions that will optimize their health — both physical and psychosexual,” said Dr. Nawal M. Nour, an obstetrician-gynecologist who directs the African Women’s Health Center at Brigham and Women’s Hospital in Boston. “Presently, we are failing them because we lack the research that can guarantee their best outcome.”

With Ms. Sillah’s operation in 2016, Dr. Percec joined a small but growing number of doctors worldwide performing such surgeries.

The procedure, often called clitoral reconstruction or restoration, is viewed with caution and skepticism by some medical experts. The World Health Organization says that while there are some promising reports that the operation may relieve pain , there is not yet enough evidence of safety and effectiveness. The organization advises against raising unrealistic expectations, especially for women seeking sexual improvement.

Still, demand for such operations is growing in the United States and other Western nations as more women who have been genitally cut move to countries where medical techniques are advanced, insurance often covers surgery, and women can make decisions about their bodies.

Over the past two years, four women — a health professional, a hairstylist , a bus driver and Ms. Sillah, the hospital pharmacist — shared intimate details of their experiences, and one allowed me to be in the operating room during her surgery. They described physical and emotional traumas, struggles with ruined relationships and feelings of shame that they were not “normal.”