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Doctors Face Difficult Dilemma Over Female Genital Cutting
Filed under: In The News
Is it OK to inflict a little bit of harm in order to avert serious physical damage? That's a question pediatricians in America are grappling with, and the answer is far from clear cut.
At issue is the practice of female genital cutting (FGC), a procedure sometimes referred to colloquially as female circumcision, which ranges from the partial removal of a girl's external labia to the complete removal of the clitoris and all labia. In the most extreme cases, the vagina will be sewn shut. The practice dates back to the Pharaohs in Egypt and is widely practiced in parts of Africa and of Asia. It is not associated with any particular religious belief.
The World Health Organization and other groups have been working for years to abolish FGC, which was banned in the United States in 1996. The practice is seen as such an essential rite of passage by many parents, though, that they ask their doctors here to cut their daughters anyway. Those who cannot find someone to perform the procedure in the United States often send their daughters abroad to have it done -- often in unsterile environments without any anesthesia. The WHO estimates that between 100 and 140 million women worldwide have been subjected to a cutting procedure.
All this leaves doctors in a moral quandary: They know that by declining the parents' requests, they could be ultimately subjecting the girls to far more harm. To counter that, the American Academy of Pediatrics recently revised its guidelines to allow for "a ritual nick" that "would not cause physical harm." The thought was that by inflicting a small, symbolic cut -- much less severe than male circumcision -- doctors in the United States could prevent more drastic damage.
"When you're dealing with religious or cultural beliefs, saying no is sometimes not sufficient for people, and it will not necessarily eliminate the practice," Dr. Doug Diekema, a pediatrician at Seattle Children's Hospital and a member of the AAP's ethics committee who advocated for the new guideline, tells ABC News. "The cut itself would be tiny, really just like a poke with a needle, so there might be a drop of blood."
Well-intentioned though the changes may have been, women's rights groups, victims of FGC and other organizations were swift and strident in their opposition.
"The reality is that what (that) statement does is perpetuate female genital mutilation," Taine Bien-Aime, president of Equality Now, tells ABC News. "There is no other way around it."
After the onslaught of outraged opposition, the AAP withdrew the policy modification, saying it had caused too much confusion.
"The AAP is totally opposed to all forms of female genital cutting, both here in the U.S. and anywhere else in the world," AAP President Dr. Judith Palfrey says in a statement. "One good thing to emerge is that this discussion has shone a bright light on this issue and raised the world's awareness about this harm to young women."
Related: Cameroon Moms Iron Daughters' Breasts in Little-Known Mutilation Practice
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ReaderComments (Page 1 of 1)
6-16-2010 @ 4:30PM
Heather said...The article says that in Africa and Asia, where this is still common practice, that it is not associated with any particular religious belief. So why, WHY on earth would they do such a barbaric, PAINFUL thing to these girls?
I've heard of this before, but I've never heard why this is done. Some girls are subjected to this "procedure" when they hit puberty. They are given a stick to put between their teeth, their mothers sit behind them and hold their heads in their lap while some midwife-type practitioner cuts away their clitoris with a dirty knife and no anesthesia. I can't even begin to fathom the pain that this causes, let alone subsequent infections. Any why would they sew them shut? What happens when they get their periods?
Something has GOT to be done to protect these girls and stop this from happening! It's not like having a foreskin, or wisdom teeth, or an appendix removed. Foreskins can cause infections in young boys, wisdom teeth crowd the mouth and appendixes become easily infected and can rupture, sometimes causing death. Why a clitoris needs to be removed (and in such a way) just baffles me. I can only assume it's because it's the only body part that serves no function whatsoever other than to give pleasure. I guess they figure that that's "dirty and shameful" and the girls are better off without it.
Sick people.
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6-16-2010 @ 11:25PM
Mark Lyndon said...It's illegal to cut off a girl's prepuce, or to make any incision on a girl's genitals, even if no tissue is removed. Why don't boys get the same protection? Everyone should be able to decide for themselves whether they want parts of their genitals cut off.
Female and male circumcision are more comparable than some people think. Firstly, in countries where female circumcision is done under unhygienic conditions, male circumcision is too (razor blades, no anesthesia, etc). Many boys die each year in Africa from tribal circumcisions – 79 young men died last year in just one province of South Africa. In some countries though female circumcision only involves the tiniest of nicks, or the removal of the clitoral hood - the anatomical equivalent of the foreskin - and is done to babies in sterile conditions, even with pain relief. Check out how it's done in Egypt, Malaysia or Brunei, for example. Circumcised women choose to have their daughters circumcised, citing how it's cleaner, good sexually, reduces secretions and smegma and is generally hygienic, and also mentioning studies showing circumcised women have lower infection rates. Basically the same reasons that people use to defend male circumcision. It's just a cultural difference.
Don't get me wrong. I'm totally against female circumcision, and I probably spend a lot more time and money trying to stop it than most people. If people are serious about stopping female circumcision though, they also have to be against male circumcision. Even if you see a fundamental difference, the people that cut girls don't (and they get furious if you call it "mutilation"). There are intelligent, educated, articulate women who will passionately defend it, and as well as using the exact same reasons that are used to defend male circumcision in the US, they will also point to male circumcision itself (as well as labiaplasty and breast operations), as evidence of western hypocrisy regarding female circumcision. The sooner boys are protected from genital mutilation in the west, the sooner those peoples that practice FGM will interpret western objections as something more than cultural imperialism.
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6-17-2010 @ 1:00AM
LCason6880 said...When the parent asks for this proceedure, or when a health care professional finds that it has been done, arrest the parents on the spot and remove the children from their care. period
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6-17-2010 @ 8:26AM
Heidi said...I don't see much difference between female genital mutilation and circumcision for boys. Notice though the difference in what we call it - implying that mutilating girls is bad but it's ok for boys? Both times I was pregnant I prayed for girls. If I'd had boys there would have been an all out family battle over circumcision. It's barbaric and unnecessary
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6-17-2010 @ 8:16PM
Janice said...There is absolutely no similarity between male circumcision and "female circumcision." I don't want to seem impolite, but if anyone thinks the two have anything in common, they should educate themselves on the matter. Read. Read the first comment after the article to begin, then google it and read some more. I hope everyone who takes my advice has a strong stomach, because you will feel sickened by what mothers do to their daughters for no good reason. As far as I can tell, female genital mutilation continues into this millenium because
1. The mothers did it to their daughters, so the daughters do it to their own. Generation after generation torture, and even kill (by infection), their own girls because that's what their mothers taught them to do.
2. The men expect it to be done. Again, for no other reason than because it's what men have expected for generations.
I think the docs who want to do a minimal procedure to prevent catastrophe have their hearts in the right place. It probably is the best thing to do for these individual girls who are their patients. But this isn't going to go away until the women who want it done get the education and the nerve to stop it themselves.
6-17-2010 @ 9:49AM
k said...I have dated men who were and men who were not circumcised and the majority of the uncircumcised, men wished their parents had gotten them circumcised.I believe it is societal for them to feel that way. However evidence was not overwhelming enough for me to feel it was a necessary procedure for my son, so he did not get it. On the opposite end of the spectrum I do not feel that circumcision is terribly bad either. Neither circumcision nor the lack thereof interferes with a man's sexual pleasure. The difference is that the savages who do that to a female are making sure that a woman's sexual pleasure is interfered with or destroyed and THAT is why the procedure is wrong.
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6-17-2010 @ 11:18PM
Hugh said...@Janice: When you compare apples with apples, tribal with tribal, the difference between the two practices is much less. 91 boys died in one province of South Africa last year from tribal circumcision, and 13 more in the last 12 days. Three are now in hospital with gangrene, and nine other penile amputations have come to light.
Now compare surgical with surgical: this loving Malaysian mother’s blog – search on aandes zahra – with this American mother’s – search on mak'n changes obi . If anything the little girl seems to have got off more lightly than the little boy.
It is as human rights abuses that they are absolutely on all fours. How dare anyone go cutting any healthy, normal, functional, non-renewable part (and it would be of the genitals, wouldn’t it?) off another human being, regardless of their age or sex, without their informed consent? If it weren’t so customary and entrenched, this would be instantly apparent to anyone.
@k: Your sample was far too small. The VAST majority of intact men (more than 2/3 of the men in the world) greatly enjoy their foreskins and would do you violence if you tried to remove them. The foreskin contains ~20,000 specialised nerves, like those of the fingertips or the lips (a kiss on the hand can be quite Continental, but one on the lips is distinctly more erotic, for that reason). They are in a unique mobile structure, strategically placed, and if it's not for sexual pleasure, what was God/evolution thinking?
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