A nondescript suburb on the outskirts of San Francisco. A plain brick building. Seven nervous women wait in the sunlight. They are here for surgery, which perhaps has as much claim as any other to describe itself as "miraculous."

The little building doesn't shout its purpose, for many reasons. First, this surgery is about female sexuality. Second, it is contrary to the beliefs and traditions of millions of families worldwide — brutal beliefs and traditions. And then there's the delightful surreality of the pair behind the procedure: the tall, blonde female surgeon — one of the best in the United States — who happens to have been born male, and the cheerful French counselor who follows the bizarre 1970s Raelian sect, which believes humans were created by extra-terrestrials for the purpose of unalloyed joy.

Soon afterward one of the first patients, Zaria, 24, is under anaesthetic. "This one's pretty bad," says the surgeon, glancing at me from the stool where she sits between the legs of her patients, scalpel poised.