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There have been a few stories in the press recently which have put the issue of female genital mutilation back on the agenda. Female genital mutilation (sometimes referred to as female circumcision or female genital cutting) is the practice of removing parts or all of a young girl’s external genitalia for non-health reasons, but for religious or cultural justifications.

Recently the American Academy of Pediatrics (AAP) issued their policy position on FGM, which went far too close to finding a compromise position on the practice than activists could stand. While the AAP’s position did state that they “oppose all forms of FGC that pose risks of physical or psychological harm”, in the original position they stated:

“Most forms of FGC are decidedly harmful, and pediatricians should decline to perform them, even in the absence of any legal constraints. However, the ritual nick suggested by some pediatricians is not physically harmful and is much less extensive than routine newborn male genital cutting. There is reason to believe that offering such a compromise may build trust between hospitals and immigrant communities, save some girls from undergoing disfiguring and life-threatening procedures in their native countries, and play a role in the eventual eradication of FGC. It might be more effective if federal and state laws enabled pediatricians to reach out to families by offering a ritual nick as a possible compromise to avoid greater harm.”

They compared the ‘ritual nick’ of a girl’s genitalia to ear piercing.

After an outcry, the AAP retracted their statement, saying;

“We retracted the policy because it is important that the world health community understands the AAP is totally opposed to all forms of female genital cutting, both here in the U.S. and anywhere else in the world,” said AAP President Judith S. Palfrey

Now, where to start with the problems with this? Firstly, the language used in the document is upsettingly subversive. Changing the term ‘female genital mutilation’ to ‘female genital cutting’ is a down-playing of this offensive act of violence towards girls. Similarly, they were keen to stress that they are against ‘cutting’ which “pose risks of physical or psychological harm” leaving the door open for less ‘risky’ cutting, quaintly called a ‘ritual nick’, to be condoned by the organisation.

Most importantly they put community sensitivities and the desire “to build trust” with those who promote this practice, above the rights of the girls who do not and cannot give their consent to a human rights violation being performed on them. This not only affects the individual girls physically, but feeds into their status within their family and community and more broadly the hyper-negative view of female sexuality and genitalia.

This is not to underplay the massive task of eradicating FGM in the developing world. Locally based organisations need to work long-term to change attitudes and address the various different justifications that are given to this practice. Using human rights language in these contexts would often be counter-productive. However, within the context of the AAP’s position, we are dealing with a developed country with immigrant communities and the evidence that ‘compromise’ positions need to be sought does not seem to exist – as actually admitted by the AAP in their paper:

“In some countries in which FGC is common, some progress toward eradication or amelioration has been made by substituting ritual “nicks” for more severe forms. In contrast, there is also evidence that medicalizing FGC can prolong the custom among middle-class families (eg, in Egypt). Many anti-FGC activists in the West, including women from African countries, strongly oppose any compromise that would legitimize even the most minimal procedure. There is also some evidence (eg, in Scandinavia) that a criminalization of the practice, with the attendant risk of losing custody of one’s children, is one of the factors that led to abandonment of this tradition among Somali immigrants.”

(links are to the statement’s original references)

So there is good evidence against this position and a complete failure to address structural and cultural discrimination against women and girls.

There has also been scathing coverage of the research of Dr Dix Poppas at Cornell University where he was performing clitoroplasty, the removal of part of a clitoris that was deemed “too big”, on young girls. There is other information that these procedures were specifically being performed on ‘intersex’ children, which is still highly controversial. Given that the details of this research remain unclear, I will return to it when I have more information. In the meantime, this article from Alice Dreger and Ellen K. Feder goes into the ethics of the use of vibrators on the girls/intersex children undergoing this surgery. Details on contacting Cornell University here. Jolene has also covered this story here.