May 11, 2010
By Julia Lalla-Maharajh -Enf FGM now
This article was submitted for publication in the Huffington Post on 30 April 2010
So, I’m sitting here in London, getting ready for the World Economic Forum meeting next week in Tanzania. It’s a time of reflection as I think about how to address female genital mutilation with African leaders.
Twitter is with me on my laptop and a sideways glance shows me that on 26 April, the American Academy of Pediatrics released updated guidance on what it now calls “Ritual Genital Cutting of Female Minors.”
What strikes me on first reading, is that this is no guidance at all.
It shows its own interior confusion: on one hand, a strong document that invokes the links between human rights and FGM, discusses the terror felt when girls go through FGM and noting that it is illegal and constitutes child abuse in the US.
On the other hand, the final page suddenly states:
“The ritual nick (pricking or incising the clitoral skin) is no more of an alteration than ear piercing.”
I am not a doctor, yet as a woman, I distinctly know that my clitoris is entirely different from my ear lobe. It goes on to state:
“Offering a ritual nick is a possible compromise to avoid greater harm.”
Yet nowhere is this sourced, nowhere is it stated why such a Faustian compromise should be allowed to take place. There is no evidence that medical involvement is a form of “harm limitation” as is claimed. The group Equality Now also point to the contradictions in the statement, saying:
“A reduction in the severity of a human rights violation does not minimize the gravity of such a violation.”
How does this constitute medical guidance? When I ask for thoughts from a doctor friend, she says:
“The key thing is that it is not within the scope of the work or duties of doctors to be involved in cultural rituals or rites of passage … just as there is no medical indication to expose a child’s genitalia to a stranger (which the doctor is, as the child is not a patient with a problem) and same for breaching the skin — whether a small nick or actual cut.”
So why this sudden lunge in a different direction? Why has the AAP “updated” its guidance in such a distinct way? The answer comes in the next paragraph, which states that the “ritual nick is … much less extensive than routine newborn male cutting.” Ah. Revealed for what it is. This is a way of trying to tread carefully through a highly complex debate of why, in the US, it’s considered right to circumcise boys to the extent that they are.
When I first had my eyes opened to the enormity of female genital mutilation, I lived in Ethiopia. Back home, I started educating myself about it. The scale is remarkable — over 140 million women live with horrendous health and psychological consequences as a result of their genitals being forcibly removed when they were children.
I was also shocked at how, primarily in the US, the main discourse around female genital mutilation is not as an issue in its own right, but as a comparator for the anti-male circumcision lobby. It’s only more recently through reading that I’ve begun to understand how much more invasive the form of male circumcision is in the US, where in many cases, the whole foreskin is removed. This is extremely unusual in Europe where only the tip of the foreskin is removed.
This new guidance is a severe compromise of medical principles and a shocking one. As Naana Ooto-Oyortey, Executive Director from the well respected organisation FORWARD commented today:
“FGM carried out by medical professionals gives a legitimate and acceptable face to a practice which damages women’s and girls’ reproductive, sexual and psychological health.”
Equality Now are very clear too that they wish to see a retraction of part of the statement that, “In effect promotes changes in US federal and state laws to enable physicians to ‘nick’ girls’ genitalia.”
I am still so shocked that a bioethics committee are making this distinction and suggesting a change in US federal and state law — and that the best comparison they can come up with is that pricking the clitoris is of the same magnitude as ear-piercing. I wonder if a small girl, perhaps the age of four or five would think the same?
I think my visit to Tanzania will be much more straightforward – at least many African countries are striving to educate their communities about the harm done through FGM. The US on the other hand are making a mockery of their own “guidance” which is in fact opaque and a way of fudging the issue even further.
Like FORWARD, I would call on the AAP to revert to its earlier, caveat free 1998 policy statement that ‘opposes all forms of female genital mutilation’. It was a hard-fought battle to get to that place — let’s please not take a regressive step.
