May 07 2010
FGM Compromise?
Africa Rising: The Grassroots Movement to End Female Genital Mutilation is a short film about the grassroots movement in Africa working to end the practice of Female Genital Mutilation (FGM):
Meanwhile, blogger Andrew Sullivan, among others, is horrified to learn that the American Academy of Pediatrics (AAP) has endorsed a ‘kinder gentler’ form of FGM:
NEW YORK, May 5 /PRNewswire-USNewswire/ — International human rights organization Equality Now is stunned by a new policy statement issued by the American Academy of Pediatrics (AAP), which essentially promotes female genital mutilation (FGM) and advocates for “federal and state laws [to] enable pediatricians to reach out to families by offering a ‘ritual nick’,” such as pricking or minor incisions of girls’ clitorises. The Policy Statement “Ritual Genital Cutting of Female Minors”, issued by the AAP on April 26, 2010, is a significant set-back to the Academy’s own prior statements on the issue of FGM and is antithetical to decades of noteworthy advancement across Africa and around the world in combating this human rights violation against women and girls. It is ironic that the AAP issued its statement the very same day that Congressman Joseph Crowley (D-NY) and Congresswoman Mary Bono Mack (R-CA) announced the introduction of new bipartisan legislation, The Girls Protection Act (H.R. 5137), to close the loophole in the federal law prohibiting FGM by making it illegal to transport a minor girl living in the U.S. out of the country for the purpose of FGM.
…and The Debate Continues
2 responses so far
Equally horrified by this statement, which I also blogged about recently on my website. My medical adviser in the UK also submitted this letter to the British Medical Journal, which makes their stance as doctors unambiguous:
American Academy of Pediatrics – female genital mutilation
The BMJ news summary errs. (1) Close reading of the American Academy of Paediatrics (AAP) Bioethics Committee statement (2) shows that, despite sensitively explaining the cultural meanings, procedures, consequences and illegality, the 1998 stance (3) has been modified; proposing legal change in the USA to enable paediatricians to “reach out to families by offering a ritual nick as a possible compromise”. FGC is not a treatment in the child’s best medical interests. (4) Cultural rituals, rites of passage, adult female sexual pleasure and marriageability are not within the scope of appropriate, expert paediatric practice. A girl without a problem is not a patient; the doctor becomes a stranger with no indication to expose, touch or cut the genitalia. Different approaches, including moratoriums on non-medically indicated genital alteration, have been suggested until adolescents or adults can make the decision themselves, e.g. in children with disorders of sex development (5,6) and circumcised boys. (7) Girls could accuse the AAP of disregarding unconsented damage to their sexual lives and betraying the trust vested in the medical profession. If parents or associates perform the “nick” they take responsibility for any consequences. If doctors charge a fee-for-service, they have an interest in creating a veneer of ‘medical respectability’. The coy presentation of laceration as harm limitation condones FGC and will have worldwide repercussions. The AAP must be condemned for giving ideological succour to medical involvement in ritual FGC. However minor, assaults on children should be named and requests met with a gentle but firm ‘no’.
Susan Bewley MD FRCOG MA Consultant Obstetrician, Kings Health Partners, London
Janice Rymer MD FRCOG FRANZCOG FHEA Professor of Obstetrics and Gynaecology, Kings College London
Sarah Creighton MD FRCOG Consultant Gynaecologist, University College Hospital, London
(1) In brief. US paediatricians condemn ritual female genital cutting. BMJ 2010;240:942
(2) American Academy of Pediatrics. Policy statement – ritual genital cutting of female minors. Pediatrics http://pediatrics.aappublications.org/cgi/content/abstract/peds.2010- 0187v1 published online April 26, 2010 accessed 2/5/2010
(3) American Academy of Pediatrics. Committee on Bioethics. Female Genital Mutilation. Pediatrics 1998;102;153-156
(4) World Health Organisation. Female genital mutilation. http://www.who.int/mediacentre/factsheets/fs241/en/ accessed 2/5/2010
(5) Creighton SM, Liao L-M. Changing attitudes to sex assignment in intersex. BJU International. 2004;93:659-664
(6) Kipnis, K. & Diamond, M: Pediatric Ethics and the Surgical Assignment of Sex. J. Clin. Ethics 1998;9 (4) 398–410
(7) Circumcision information and resource pages http://www.cirp.org/library/statements/ accessed 2/5/2010
Competing interests: None declared
[...] author, and former member of The Netherlands parliament, Ayaan Hirsi Ali, has weighed in on the proposed compromise on Female Genital Mutilation [...]