Female Genital Mutilation: It's Not Your Father's Circumcision

By Kit-Bacon Gressitt

There is a practice common in some Asian and African countries in which girls, typically between infancy and adolescence, are subject to the removal of some or all of their external genitalia. This is done with a knife or scissors or a piece of broken glass or whatever the ritual performers have at hand.

Some folks refer to this cultural tradition as “female circumcision,” which is a questionable reference, but, since folks like to compare things to penises, let’s go with that.

In what Westerners think of as circumcision, some or all of the penis foreskin is removed, leaving the rest of the penis intact. However, this practice is under increasing scrutiny, because it is not medically necessary, although it is thought by some to reduce the likelihood of infection. (Please note that infection is something a little soap and water—and maybe some fun—can prevent.)

Those who liken the female practice to male circumcision are, I suspect, desperately attempting to dismiss it as inconsequential to our spiffy culture (a culture that assures I can amble into the local grocery store and purchase 27 different sizes and styles of menstrual cycle absorbent thingies, four distinct brands of end-o female odor products and seven brands of cramp-, bloat- and get-away-from-me-you-irritating-pissant pills.) What these folks fail to comprehend, though, is that what is being done to female genitalia is not reasonably comparable to male circumcision.

What’s being done to females is more like lopping off the penis.

Imagine that—and I am serious. Imagine a young boy held down by a group of adults, his legs forcibly spread, and his penis cut off. The raw edges of skin are then pulled from either side of the boy’s wound and stitched together, leaving just enough of a hole for urination.

Types of Female Genital Mutilation

Now, if we hold true to the comparison, the range of excising done on females—from the entire clitoris and labia minora to clitoris and some of the labia to only part of the clitoris—means it’s possible that the hypothetical male ritual might demand the boy’s entire penis or maybe half of the penis or perhaps only a quarter of the boy’s penis. But anywhere you cut, that’s still gotta really hurt—in more ways than one.

Regardless, if the child survives the shock and pain, the likely infections, and all the other dire consequences, he grows into adulthood with his manhood butchered.

And if this were actually happening to boys in Egypt or Indonesia or Ethiopia or Iraq, we’d be horrified, right? And what if people wanted to do it here, in the United States? No way, right?

Thankfully, boys’ genitalia are not commonly mutilated in this particular way, and the United States has made the practice on females illegal, regardless of their families’ cultural traditions. In fact, just about every single mainstream U.S. and international medical organization involved in girls’ and/or women’s health is adamantly opposed to the practice in any of its forms, and they call it what, to most Western ears, sounds about right—female genital mutilation.

Every organization, that is, except the American Academy of Pediatrics (AAP). AAP called it “female genital mutilation” (FGM) in their 1998 policy statement on the practice. But then its Committee on Bioethics released an updated FGM policy in April 2010 that declared “female genital cutting” is really a much nicer term for this thing that adults do with sharp objects to girls’ genitalia. “Mutilation,” the Committee on Bioethics determined, is an inflammatory word, and they surely don’t want to offend!

I wonder if they considered the sensibilities of the subjects of FGM in their deliberations.

Now, I have to bring us back to the penis scenario for just a moment, because I believe most reasonable folks would agree that, if the practice were perpetrated on boys’ penises, they would not hesitate to call it mutilation. This makes me wonder why the committee—or anyone else—would shrink from the word when it is the female clitoris that’s being cut off?

"Female genital cutting" is a coddling euphemism for the violence that is being done to female bodies.

The AAP Committee on Bioethics dropped another bomb in its updated policy: The committee suggested that U.S. law prohibiting FGM might be changed to allow U.S. physicians to demonstrate their great capacity for cultural sensitivity by performing a “minor” form of the practice. The committee’s suggested alternative procedure was a ritual “pricking or incising [of] the clitoral skin.” They opined that this would accommodate cultural requirements for a girl’s initiation into her ethnic community, while serving as a deterrent to immigrant parents who might otherwise ship their girls back home to offer up the whole shebang down there to male-dominated cultural tradition.

After an onslaught of letters from peers and laypeople, the policy statement was swiftly retracted. But consider for a moment the committee’s originally proposed accommodation of this particular cultural tradition. It smacks of the feminist debate over the practice in the context of cultural relativism.

Calling it “cutting” rather than “mutilation” and suggesting a culturally sensitive “pricking or incising” are akin to recommending that we be sensitive to the cultural tradition of stoning women for adultery by allowing the offended man to throw, say, only one medium-size rock at his wife’s or daughter’s or sister’s or mother’s head. And I suppose we could consider whacking only one finger off a thief, instead of a whole hand. That might be a nice culturally sensitive compromise. Now, what sort of sensitivity might we demonstrate toward the cultural tradition of killing the victims of rape?

Okay, okay, ridiculous considerations, all—as are the AAP’s suggestions, which makes it awfully tempting to urge the 2010 committee members to be the first to spread their legs for some culturally sensitive ritual nicks. But at the core of this controversy, it is much more frightening than it is ridiculous.

In the United States of America, we have a group of esteemed, medical professional women and men who talked themselves into believing that it might be okay to cut girls’ genitalia a little as a demonstration of cultural sensitivity and a deterrent to cutting girls’ genitalia a lot.

We can only hope this is not indicative of females’ standing in U.S. culture.

Except this happened here.

Love, K-B

NOTE: The Girls Protection Act of 2010, HR 5137, sponsored by Reps. Joseph Crowley (D-N.Y.) and Mary Bono Mack (R-Calif.), would make it illegal to transport minors out of the United States for purposes of female genital mutilation. You might like to write a letter of support to your elected representatives.

UPDATE from Medscape Medical News:
AAP Retracts Controversial Policy on Female Genital Cutting
By Kathleen Louden

June 2, 2010 — The American Academy of Pediatrics (AAP) is again changing its policy on ritual female genital cutting (FGC) after advocacy groups protested the academy's recently revised policy statement regarding the excision of girls' external genitalia, which some African, Middle Eastern, and Asian cultures perform as a rite of passage.

The AAP board of directors voted on May 22 to retire the new policy, published in the May issue of the journal Pediatrics, and to immediately revise it because of the confusion it generated, AAP President Judith Palfrey, MD, told Medscape Pediatrics.

That policy statement expressed concern that girls from cultures that practice FGC who now live in the United States may be sent by their parents back to their native countries for a genital-altering procedure that can be harmful and even life-threatening. In the statement, which revised the academy's 1998 policy, the AAP's Committee on Bioethics wrote, "It might be more effective if federal and state laws enabled pediatricians to reach out to families by offering a ritual [clitoral] nick as a possible compromise to avoid greater harm."

Opposes "All Forms" of FGC

In an official statement that the AAP released to Medscape Pediatrics, the board writes: "The AAP does not endorse the practice of offering a 'clitoral nick.' This minimal pinprick is forbidden under federal law and the AAP does not recommend it to its members."

"The ethics committee will do a rewrite, which will reassert the AAP opposition to all forms of female genital cutting," stated Dr. Palfrey, a pediatrician at Children's Hospital Boston.

During a telephone interview with Medscape Pediatrics, Dr. Palfrey said the original comment about performing a medically unnecessary nick represented an academic discussion of options to stop this "awful" practice.

"This was never a recommendation," she stressed. "Obviously, having a discussion inside a policy statement is confusing. We regret this."

The new policy revision will appear in the July print issue of Pediatrics.

Committee members will explore noncutting options in working to eliminate all forms of FGC, Dr. Palfrey said. ...

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