AAP on Female Genital Mutilation: Let's Not and Say We Did

The American Academy of Pediatrics is under fire for revising its guidelines on female genital mutilation (FGM). U.S. federal law bans all forms of female genital cutting for minors. However, the bioethics division of the AAP wants the law changed to allow doctors to ceremonially nick the clitoris at the parents' request. The process AAP reluctantly endorses has been compared to a pinprick--just enough to raise a drop of blood. It's essentially a medicalized ritual that evokes FGM without actually harming the child.


Many of my fellow feminists are outraged by the AAP's proposal. Personally, I think the change might be a good idea, or at least a proposal worth studying.

The overriding goal should  to maximize the number of intact clitorises. I'm all in favor of repudiating FGM and all its pomps, but outrage has to take a back seat to child protection. The AAP thinks that it's better to give parents the option of a medically harmless symbolic version of the procedure in order to dissuade them from sending their girls back to their ancestral homelands to get their clitorises cut off for real.

SarahMC of Pursuit of Harpyness writes:

The AAP is supporting a form of ritualistic mutilation on girls in an attempt to prevent potential further harm. But will parents who request FGC be satisfied with–or fooled by–the so-called compromise of a "nick?" I am sympathetic to this complex predicament. However, if doctors suspect that their patients’ parents will sexually mutilate them, they could contact child protective services. What is best for the girls? [Emphasis added]

It's not a question of fooling or satisfying anyone who's gunning for clitoridectomy or infibulation. If parents are really invested in mutilating their daughters, they won't be satisfied with a ritual nick.

However, there are probably parents out there would would prefer to keep their daughters intact, but who don't want to be seen as rejecting the tradition. Now, you might be thinking: What kind of horrible person would go along with something like this just for the sake of tradition?

Well, some secular Jewish parents face a similar conundrum. It's difficult to justify cutting off part of an infant's penis because a very old book says that a God you don't believe in prefers boys that way. Some couples I know are deeply divided on this question. I wouldn't want my son cut, but I know this decision would ruffle some feathers even within my liberal family. (I don't want to equate the horrors of FGM with routine foreskin docking. FGM is infinitely worse in terms of health impact and symbolism. Foreskin docking is perfectly compatible with a healthy sex life. The symbolism of FGM: Your genitals are dirty and if they work correctly you will become a filthy slut, so we're preemptively hobbling you. The symbolism of male circumcision within Judaism: You are special, welcome to this awesome club!)

Opting out of a major ritual will be seen as provocative, even rebellious. Other people will interpret it as a criticism of them, of their bodies, of their decisions about their own children--whether you meant it that way or not. Some people relish the opportunity to Make A Statement with their child-rearing decisions, but other people would rather just avoid the static. It's so much easier to cave to social pressure. You can reassure yourself everyone does it and life goes on and it's no big deal. It's easy to justify what everyone around you accepts as normal, even in the face of your own qualms.

If you could opt for a ceremonial blood-drawing, you could tell your family, "Oh, yeah, we took care of that at the hospital." It's not like they're going to check.

The harm reduction approach to FGM prevention could backfire. The AAP acknowledges that possibility in the position statement. There's some research that suggests that ritualizing the procedure legitimizes the procedure and keeps the custom alive longer than it otherwise would have. I would like to see the law changed to allow for some randomized prospective studies of harm reduction vs. outright denunciation. We should go with whatever approach gets the most girls to adulthood with their genitals intact.

Photo credit: flickr user geoftheref licensed under Creative Commons.

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