AAP Reverses Policy on Female Genital Cutting

This story didn't get much prominence in the news with all the other things that are going on, but I think it's an interesting development and relevant to topics we discuss here. Amnesty International estimates that 130,000,000 women in the world have undergone the procedure known variously as female circumcision, female mutilation, or female genital cutting. The procedure is mostly practiced in Asian and African countries, and though it varies, female genital mutilation generally consists in removal of the external female genitalia, especially the clitoris and clitoral hood.

The American Academy of Pediatrics recently passed a new rule allowing doctors to perform a "ceremonial pinprick, or small nick," in situations where families wanted this done to their daughters. After an outcry, the AAP rescinded the rule.

One thing should be made clear from the start: female circumcision is nothing like male circumcision. Guys might argue about whether there sexual pleasure is greater or less with a foreskin, but there is no objective measure that shows any significant difference one way or the other. There may be health issues that are affected by the presence or absence of the male foreskin, but basically it is a sheath of skin with no function. (I know there are people who are adamantly opposed to circumcision, I don't care to argue with you here. The point is, the penis functions just fine either way.)

There are four levels of female circumcision, and even the lowest level involves removal of the clitoris. You will find that newspapers don't like to publish the word clitoris, you can read entire articles on this subject that do not use the word, and we may see this as a not-so-subtle expression of profound sexism. The clitoris does have a function: it is the key to orgasm for women. The only reason to remove it would be to reduce the pleasure that a woman experiences in sex. And why would you want to do that? There is no answer that does not lead to a conclusion of oppressive patriarchal sexism.

The American Academy of Pediatrics published a policy statement that has been removed from their web site (even though their home page still has a link to it). I will quote from Psychology Today blogger Paul Raeburn, who seems to have some involvement in the issue and had access to the original documents.

The American Academy of Pediatrics was suggesting that a less damaging "clitoral nick" might be a reasonable alternative to the more dangerous and disfiguring genital cutting practiced by a variety of cultures around the world.

"There is reason to believe," the AAP said in its statement, "that offering such a compromise may build trust between hospitals and immigrant communities, save some girls from undergoing disfiguring and life-threatening procedures in their native countries, and play a role in the eventual eradication of FGC [female genital cutting]."

The idea was that pediatricians who were asked to perform a genital cut would, as an alternative, propose a "clitoral nick," a very small cut, that might satisfy the cultural imperative without harming the child. AAP sputters, then retracts policy on female genital cutting

So you as a doctor would wheel the girl into the operating room, assemble a surgical team, shut the doors and take your sterile scalpel out, make a meaningless incision somewhere in her genital region, wheel her to recovery, and parade out to the waiting room to tell the proud parents -- almost certainly of African or Asian heritage -- that the procedure had been done. I can see why the AAP would think this was okay, you can make the family happy without doing the damage that the actual mutilation technique does.

Except -- this is America, and we don't do that here. We do not think it's okay to surgically alter women's bodies to make it harder for them to have orgasms. The Psychology Today piece continues:

Apparently the pediatricians were having their own problems restraining their views. I just received an email saying that the AAP "reaffirms it's strong opposition to FGC and counsels its members not to perform such procedures. As typically practiced, FGC can be life-threatening. Little girls who escape death are still vulnerable to sterility, infection, and psychological trauma."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."

Here's how CNN presented the AAP's turnabout:

The American Academy of Pediatrics has rescinded a controversial policy statement raising the idea that doctors in some communities should be able to substitute demands for female genital cutting with a harmless clitoral "pricking" procedure.

"We retracted the policy because it is important that the world health community understands the AAP is totally opposed to all forms of female genital cutting, both here in the U.S. and anywhere else in the world," said AAP President Judith S. Palfrey.

The contentious policy statement, issued in April, had condemned the practice of female genital cutting overall. But a small portion of statement suggesting the pricking procedure riled U.S. advocacy groups and survivors of female genital cutting.

In the April statement, the group raised the idea that some physicians should be able to prick or nick a girl's clitoral skin in order to "satisfy cultural requirements." The group likened the nick to an ear piercing.

On Thursday the AAP stated the group will not condone doctors to provide any kind of "clitoral nick." The AAP also clarified nicking a girl or woman's genitals is forbidden under a 1996 federal law banning female genital mutilation. Pediatricians now reject all female genital cutting

It is notable here that female genital mutilation has no religious rationale. Neither the Muslim nor Coptic faiths require it or endorse it, in fact, fatwas have been issued against it. It is a practice that goes back at least to the days of the Pharaohs.

The USA has always been a haven for immigrants, and when they come here they bring customs from their homelands -- and they give some up. There are some things we don't eat, for instance, monkeys and cats and dogs, lots of things. There are kinds of marriage practices that are fine where you came from, but you won't do that here. Some countries are banning burqas, we haven't gone that far but it could happen. And one thing we are not going to do in this country is let you cut up women's genitals to diminish their sexual response.

The AAP may have thought they had a clever way to make everybody happy, but unh-uh, it's not going to happen here.