A very long time ago when I was a college student, I was tapped to participate in an elite honors zoology seminar. If I remember correctly, there were ten students and two professors. We were each assigned a semester-long research project culminating in a paper and oral presentation/defense of our research. It was a fantastic opportunity for an undergrad, and I learned a great deal. We would meet weekly to discuss our progress, ask questions, and help each other work through problems. The topic I drew was Female Genital Mutilation (FGM).
This research was my first exposure to FGM, and the practice turned out to be much more horrible than I imagined. Although I think (
here,
here and
here) there is a legitimate debate about the medical benefits vs. risks of male infant circumcision, FGM is unequivocally a horrific disfiguring and dangerous rite. The scope of disfigurement is appalling, as you will see in the video below.
Skepchick's Rebecca Waston has a great informative video podcast about FGM. (If you have read my links above, you already know that I disagree with her claim that there are no medical benefits of male circumcision):
Aside from the scope of the procedure, several other aspects of FGM are particularly disturbing:
1. It is often performed on girls old enough to remember the terror and pain
2. Without anesthesia
3. In the dirt
4. With a sharp piece of glass or tin
5. By a man who is not a doctor
6. To cut away any possibility of sexual pleasure
7. So that a child bride's husband has to literally cut through scar tissue with a knife in order to rape her
8. After which he sews her closed again until the next rape
Everything about FGM is abominable.
During the discussion of my FGM research, we all tried to come up with various ways to end the practice, and we were all fairly stymied. How do you stop something that is so culturally ingrained? What about the girls who want FGM in order to be marriageable--a matter of life an death in their culture? What about the slippery slope of
ethnocentrism--what other cultural institutions do we have a right to condemn and undermine?
Facing an increasing number of immigrant patients from countries where FGM is common, pediatricians in the US recently tried to address these questions. The
American Academy of Pediatrics is wholeheartedly against FGM. However, many doctors were watching their patients' parents send girls out of country or to a lay "practitioner" to receive FGM. In the cases where parent education failed, and the girls were in immediate danger of rusty-knife-style complete FGM, the AAP came up with a
last-resort alternative. They suggested doctors offer a ritual "nick" of the clitoris, under sterile conditions and with a local anesthetic. This "nick" would be far less damaging than male infant circumcision, even less than ear piercing, and would heal up nicely. Very smart people lost their bloody minds over this, and a month or so later the AAP
retracted this recommendation.
I can well understand a reluctance to participate in or to condone FGM to any degree. I know it needs to be ended entirely, but how? It's illegal in the US, but that doesn't stop the practice. The AAP's original policy statement seems well-reasoned to me, and might be very useful as a stop-gap, last-resort measure to begin to change the culture of FGM. If a physician has tried repeatedly to talk a girl's parents out of subjecting their daughter to FGM and can perform a small nick to save a child from being sent to some backwater so a priest can carve her up with the lid from a steel can, I think the nick in the doctor's office is the better alternative.
I can also see the slippery-slope argument from opponents. If we are willing to allow a nick in this case, how far are we willing to go? Will the nicking alternative serve to prolong the practice of FGM, when it might otherwise have eventually died out here in the US? As in my zoology seminar discussion, I don't know. These are challenging questions for society to consider. I do think we need to keep talking about this and about ways to end the practice once and for all.
In the interim, how do we protect girls whose parents insist on some form of FGM? My provisional opinion on the topic allies most closely with Dr. Amy Tuteur, who wrote an article called
Who is Helped by Opposition to Female "Nicking"?
No doubt the commentators feel justified in their self-righteous condemnation of any attempt at compromise, but they've failed to ask the most important question: Is there anything we can do to protect girls whose parents will not forgo FMG? That question can only be addressed with empirical answers, not moral arguments.
Will offering to mimic the procedure with a ritual "nicking" reduce the incidence of traditional FMG and the health problems that go with it? Research suggests that the answer is not clear. Data from the World Health Organization shows that substituting ritual nicking has reduced the incidence of traditional FMG in countries where it is commonly practiced. On the other hand, evidence from Scandinavia has shown that harsh penalties (including the threat of loss of child custody) is also effective at reducing FGM.
It is all well and good for FGM activists to proclaim that compromise is unacceptable, but does that position help the girls it is intended to protect? At the moment, the response of activists appears to little more than flaunting a sense of moral superiority, but that moral superiority, no matter how admirable, does nothing for the girls facing some form of FGM.
Obviously, as the AAP strenuously insists, the ideal is to prevent any form of FGM, ritualized or otherwise. But if that goal cannot be reached is it morally unacceptable to offer a medically harmless compromise? It is difficult to make a compelling moral argument against anything that will reduce the overall incidence of real FGM.
Let's not lose sight of the real question asked by the AAP. The question is not whether we should oppose FGM. We should and the AAP strongly opposes it. The question is whether anything can be done to prevent the serious health and psychological problems due to FGM by replacing it with a ritually acceptable, but medically harmless compromise. It is a reasonable question, and the AAP's response deserves serious consideration.
Nikki Stern
Greg Correll
Amanda Gulledge
marytkelly
Indiana_Joe
Lainey
Salon.com
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