# How Long Until American Pediatricians Are Cutting Off Clitorises? **URL:** \ **Category:** Great Debates\ **Created:** [May 15, 2010, 2:04pm UTC](https://boards.straightdope.com/t/how-long-until-american-pediatricians-are-cutting-off-clitorises/539541 "2010-05-15T14:04:08Z")\ **Posts on this page:** 20\ **Page:** 3
**Author:** ![Kimstu](https://avatars.discourse-cdn.com/v4/letter/k/ecd19e/32.png) [@Kimstu](https://boards.straightdope.com/u/Kimstu)\ **Post date:** [May 16, 2010, 2:54am UTC](https://boards.straightdope.com/t/how-long-until-american-pediatricians-are-cutting-off-clitorises/539541/41 "2010-05-16T02:54:30Z")
> [@Napier](#): > > It may be less harmful to do a clitoridectomy using modern techniques than letting it happen in a mud hut somewhere. > > But that is not at all the same as concluding that western doctors could ethically offer the procedure. After all, intentionally administering too much anaesthetic to cause an injured person to die to prevent them eventually returning to the street as a violent criminal may be less harmful than fulfilling the traditional function of healing all the people possible. It’s still failing to live up to an oath to do no harm. Whoa, whoa, whoa, whoa. Nobody’s suggesting for a minute that western doctors ethically could offer to perform clitoridectomies, or should give even the remotest consideration to doing so. What’s being debated here is whether doctors should consider offering to perform a **different** ritual procedure **instead** of a clitoridectomy: i.e., a very minor nick or prick to the genitals that does **not** actually harm them. ---
**Author:** ![Kimstu](https://avatars.discourse-cdn.com/v4/letter/k/ecd19e/32.png) [@Kimstu](https://boards.straightdope.com/u/Kimstu)\ **Post date:** [May 16, 2010, 3:03am UTC](https://boards.straightdope.com/t/how-long-until-american-pediatricians-are-cutting-off-clitorises/539541/42 "2010-05-16T03:03:59Z")
> [@DSeid](#): > > And the “simple nick” performed in the conditions found more often in the native lands, is still a procedure of great potential risk and harm. True, but so is circumcision performed in the conditions found more often in the native lands. [For instance:](http://www.ncbi.nlm.nih.gov/pubmed/1222463) > [@](#): > > Male and female circumcision is still widely practiced in most North-West African countries; unfortunately, these procedures are done mostly in totally unsanitary conditions, and at the hands of inexperienced people. Among the complications observed in this series there were, for male circumcision, 1 case of hemorrhage, 4 cases of partial or total amputation of the penis, 1 case of tetanus, 5 cases of urethral fistula, 1 deformation of the glans, and 3 cases of lymphoedema of the penis. By your logic, we ought to be promoting bloodless alternatives to ritual circumcision too, in order to lessen the widespread acceptance of circumcision in situations far removed from modern medicine where it becomes much more risky. ---
**Author:** ![MichaelQReilly](https://avatars.discourse-cdn.com/v4/letter/m/df705f/32.png) [@MichaelQReilly](https://boards.straightdope.com/u/MichaelQReilly)\ **Post date:** [May 16, 2010, 3:23am UTC](https://boards.straightdope.com/t/how-long-until-american-pediatricians-are-cutting-off-clitorises/539541/43 "2010-05-16T03:23:20Z")
> [@Angry Lurker](#): > > I’m not asserting circumcision is as bad as genocide, I’m asserting it’s self evidently awful. As, obviously, is messing around with babies’ clitorises and there is no way paediatricians should be getting involved with either, for exactly the same reason that doctors don’t participate in lethal injections. Your assertions are to the contrary of the scientific evidence: [http://www.guardian.co.uk/lifeandstyle/2009/jul/05/circumcicision-health-children](http://www.guardian.co.uk/lifeandstyle/2009/jul/05/circumcicision-health-children) > [@](#): > > Quite simply, circumcised men are around 60% less likely to contract HIV and other sexually transmitted diseases. And of course, they are less likely to pass them on - and that has a huge effect on STD rates in women. Studies suggest that women whose long-term partners are circumcised are two to three times less likely to develop cervical cancer. ---
**Author:** ![Peremensoe](https://avatars.discourse-cdn.com/v4/letter/p/ce7236/32.png) [@Peremensoe](https://boards.straightdope.com/u/Peremensoe)\ **Post date:** [May 16, 2010, 3:38am UTC](https://boards.straightdope.com/t/how-long-until-american-pediatricians-are-cutting-off-clitorises/539541/44 "2010-05-16T03:38:58Z")
> [@DSeid](#): > > there is no risk that American pediatricians are going to slip into doing clitorectomies. Ten years ago, did you think the “simple nick” would be endorsed? Actually, though, the slope I envisioned wasn’t so much one of official medical practices, but of cultural expectations. > [@DSeid](#): > > Medicalizing the procedure may reduce infections in some but still ends up endorsing the practice overall, and may actually inadvertently encourage more severe forms of the procedure in the native lands as those are easier to perform on a sedated or anesthetized child. Or, maybe, more severe forms of the procedure here in the West, in less-than-official or less-than-medical contexts. > [@DSeid](#): > > The most successful method for reducing the frequency of clitorectomies and infibulation is grassroots education to voluntarily accept _bloodless_ alternatives; by _promoting_ a less severe _surgical_ alternative instead, the AAP undermines those efforts. Exactly. > [@Kimstu](#): > > By your logic, we ought to be promoting bloodless alternatives to ritual circumcision too, in order to lessen the widespread acceptance of circumcision in situations far removed from modern medicine where it becomes much more risky. That might not be a bad idea. But see, here’s the other difference. Male circumcision is _already_ an established and relatively accepted (though I understand now declining) procedure in our societies of the West. _No form_ of FGM, even the mildest, has previously received _any_ official tolerance. We’re not talking about establishing brand-new, logically coherent rules for a hypothetical society; we’re talking about shifts in the existing expectations and tolerances of existing societies–specifically, an _increasing_ tolerance for cutting baby girls. I agree that, _abstractly_, there’s something of a logic gap in the attitudes toward the two different practices (male/female). I don’t agree that, in real life, it is helping anyone to partially close this gap by endorsing more cutting on the girls. ---
**Author:** ![astorian](https://avatars.discourse-cdn.com/v4/letter/a/ad7895/32.png) [@astorian](https://boards.straightdope.com/u/astorian)\ **Post date:** [May 16, 2010, 3:42am UTC](https://boards.straightdope.com/t/how-long-until-american-pediatricians-are-cutting-off-clitorises/539541/45 "2010-05-16T03:42:27Z")
I am not inferring a slippery slope where none exists. The doctors themselves have already pushed the issue to the edge of a slope. I’m merely pointing out what they’re doing. The doctors themselves are now saying, “Maybe we can kind of sort of accommodate people who WANT us to do something we’ve been calling barbaric for a long time.” That is a HUGE leap in the wrong direction. And the logic they’re employing to justify a nick will just as easily justify going all the way. ---
**Author:** ![Kimstu](https://avatars.discourse-cdn.com/v4/letter/k/ecd19e/32.png) [@Kimstu](https://boards.straightdope.com/u/Kimstu)\ **Post date:** [May 16, 2010, 4:15am UTC](https://boards.straightdope.com/t/how-long-until-american-pediatricians-are-cutting-off-clitorises/539541/46 "2010-05-16T04:15:22Z")
> [@spark240](#): > > No form of FGM, even the mildest, has previously received any official tolerance. > > We’re not talking about establishing brand-new, logically coherent rules for a hypothetical society; we’re talking about shifts in the existing expectations and tolerances of existing societies […] But the chief reason that not even the mildest form of FGM has previously received any official tolerance is not that we consider it injurious; clearly, FGM in its mildest form is even less injurious than other “mutilation” procedures that we routinely perform, like circumcision and ear piercing. Rather, we haven’t previously tolerated mild and harmless forms of FGM primarily because they just haven’t been part of our cultural heritage. If a particular ritual practice is not harmful in and of itself, and if comparable practices are already legally and culturally tolerated for other groups of people in our society, then I don’t think we’ve got a valid justification for refusing to tolerate the new ritual practice simply on the grounds that it’s new to us. > [@spark240](#): > > I agree that, abstractly, there’s something of a logic gap in the attitudes toward the two different practices (male/female). Yup. And while you’re right that an abstract logic gap is not automatically a pragmatic justification for making a policy logically consistent, the pragmatic reality is that today’s abstract logic gap is tomorrow’s lawsuit. ---
**Author:** ![Kimstu](https://avatars.discourse-cdn.com/v4/letter/k/ecd19e/32.png) [@Kimstu](https://boards.straightdope.com/u/Kimstu)\ **Post date:** [May 16, 2010, 4:30am UTC](https://boards.straightdope.com/t/how-long-until-american-pediatricians-are-cutting-off-clitorises/539541/47 "2010-05-16T04:30:01Z")
> [@astorian](#): > > And the logic they’re employing to justify a nick will just as easily justify going all the way. Sorry, but that’s total bullshit. I agree that there are some valid reasons to be concerned about acceptance of clitoral-hood nicking, but it’s simply not true that acceptance of slight clitoral-hood nicking can be logically used to justify acceptance of clitoridectomy. One is a harmless minor skin puncture posing no realistic threat to health or genital functioning, and the other is _permanent amputation of a sex organ._ There’s no way that a rational person could imagine that justifying the one makes it just as easy to justify the other. ---
**Author:** ![kidchameleon](https://avatars.discourse-cdn.com/v4/letter/k/898d66/32.png) [@kidchameleon](https://boards.straightdope.com/u/kidchameleon)\ **Post date:** [May 16, 2010, 4:39am UTC](https://boards.straightdope.com/t/how-long-until-american-pediatricians-are-cutting-off-clitorises/539541/48 "2010-05-16T04:39:12Z")
> [@levdrakon](#): > > The clitoris serves no useful purpose, why not cut it off? It can make a handy coat rack. ---
**Author:** ![Otara](https://avatars.discourse-cdn.com/v4/letter/o/a88e4f/32.png) [@Otara](https://boards.straightdope.com/u/Otara)\ **Post date:** [May 16, 2010, 4:49am UTC](https://boards.straightdope.com/t/how-long-until-american-pediatricians-are-cutting-off-clitorises/539541/49 "2010-05-16T04:49:30Z")
Could we get some actual information about what this ‘nick’ actually involves? If its similar to a circumcision where theres no direct effect on nerve endings I can see the hypocrisy aspect, even though Im against both personally. As in it should be all in or all out, with my personal preference of course being all out. Id also want information about these other countries where it was tried and what the outcomes were, so the pragmatic as well as the principled aspects could be examined. Otara ---
**Author:** ![Kimstu](https://avatars.discourse-cdn.com/v4/letter/k/ecd19e/32.png) [@Kimstu](https://boards.straightdope.com/u/Kimstu)\ **Post date:** [May 16, 2010, 5:08am UTC](https://boards.straightdope.com/t/how-long-until-american-pediatricians-are-cutting-off-clitorises/539541/50 "2010-05-16T05:08:12Z")
> [@Otara](#): > > Could we get some actual information about what this ‘nick’ actually involves? AFAICT, the procedure varies widely from culture to culture; all types of FGM, mild or otherwise, that don’t involve actually cutting off the clitoral hood, cutting off the clitoris, or any labial mutilation seem to be [classified by the World Health Organization as Type IV FGC](http://en.wikipedia.org/wiki/Female_genital_cutting#Type_IV:_Other_types). [Here’s some info on various Type IV procedures among groups in Indonesia:](http://www.lonelyplanet.com/thorntree/thread.jspa?threadID=1546248) > [@](#): > > Studies have shown that in some parts of Indonesia, female circumcision is more ritualistic — a rite of passage meant to purify the genitals and bestow gender identity on a female child — with a practitioner rubbing turmeric on the genitals or pricking the clitoris once with a needle to draw a symbolic drop of blood. In other instances, the procedure is more invasive, involving what WHO classifies as “Type I” female genital mutilation, defined as excision of the clitoral hood, called the prepuce, with or without incision of the clitoris itself. The Population Council’s 2003 study said that 82 percent of Indonesian mothers who witnessed their daughters’ circumcision reported that it involved “cutting.” The women most often identified the clitoris as the affected body part. The amount of flesh removed, if any, was alternately described by circumcisers as being the size of a quarter-grain of rice, a guava seed, a bean, the tip of a leaf, the head of a needle. I certainly don’t think that American doctors should be doing anything more drastic than a symbolic prick or nick that doesn’t permanently damage the genitals. Although if we get into health-impact questions, since studies have shown that male circumcision reduces HIV infections by keratinizing the skin of the penis head, and the clitoral hood or prepuce is anatomically the female equivalent of the foreskin, I wonder if FGM advocates will start arguing that we ought to remove the clitoral hood as an anti-AIDS approach. ---
**Author:** ![straight\_man](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/straight_man/32/3027_2.png) [@straight\_man](https://boards.straightdope.com/u/straight_man)\ **Post date:** [May 16, 2010, 5:13am UTC](https://boards.straightdope.com/t/how-long-until-american-pediatricians-are-cutting-off-clitorises/539541/51 "2010-05-16T05:13:19Z")
> [@astorian](#): > > I am not inferring a slippery slope where none exists. The doctors themselves have already pushed the issue to the edge of a slope. I’m merely pointing out what they’re doing. > > The doctors themselves are now saying, “Maybe we can kind of sort of accommodate people who WANT us to do something we’ve been calling barbaric for a long time.” > > That is a HUGE leap in the wrong direction. And the logic they’re employing to justify a nick will just as easily justify going all the way. No, it won’t. The doctors would be “pushing the issue to the edge of a slope” if and only if they were agreeing to perform an injurious procedure. The ethical barrier to FGM procedures is the principle of non-maleficence, one that is _in no way_ violated by a pin-prick. The problem is not that the practice of FGM is “barbaric”, but that it is harmful. The logic employed to justify a harmless procedure (e.g. a pin-prick) cannot be used to justify a harmful one (clitoral incision). ---
**Author:** ![Curious\_About\_Stuff](https://avatars.discourse-cdn.com/v4/letter/c/a8b319/32.png) [@Curious\_About\_Stuff](https://boards.straightdope.com/u/Curious_About_Stuff)\ **Post date:** [May 16, 2010, 5:24am UTC](https://boards.straightdope.com/t/how-long-until-american-pediatricians-are-cutting-off-clitorises/539541/52 "2010-05-16T05:24:20Z")
It’s only prevalent in parts of Africa, not in the Middle East or in Asia. It’s not an issue at all in Central or South America, and Latinos will be the majority in 50 years or less. Plus, the African American culture in America would never accept this practice. Clitorectomies are not Islamic in nature at all, and is extremely rare even in the Middle East. Overall, this horrible practice is on the decline, and it will never be common here in the US. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [May 16, 2010, 9:30am UTC](https://boards.straightdope.com/t/how-long-until-american-pediatricians-are-cutting-off-clitorises/539541/53 "2010-05-16T09:30:03Z")
> [@spark240](#): > > Ten years ago, did you think the “simple nick” would be endorsed? “Endorsed”? No. But did I always have a problem with our cultural imperialism that condemned all Female Genital Cutting and that lumped all sorts from infibulation to the symbolic prick of the clitoral prepuce together? Yes. **Kimstu** references that there have been complication of male circumcision in Africa. With a study that shows 15 complications in over 2 1/2 years, some of them fairly benign. Sorry **Kimstu** that rare rate of serious complications is not comparable to the harm intrinsic to Female Genital Cutting greater than the prick of the clitoral hood. I will withdraw the comment regarding risk of infection from the “nick” procedure in native lands as I have no documentation that such is true, but I remain concerned that endorsing it, if that was what the AAP was doing, would undermine the current extant and successful efforts of grassroots organizers. Again there is a big difference between tolerating something and endorsing it. In my mind prohibiting something places the burden of proof of significant overall harm on us. If we are unable to make that case, the case that doing the procedure causes significant harm, then we should tolerate a cultural difference with respect. OTOH endorsing something, reaching out and suggesting something, comes with a different burden of proof. In that case we need to be quite confident that doing that is doing significantly more good than harm and that less harmful alternatives do not exist. Of course it may be useful to look at the [actual AAP statement](http://pediatrics.aappublications.org/cgi/content/full/pediatrics;125/5/1088), rather than quotes by some about it. Turns out that they are not really endorsing it. > [@](#): > > The American Academy of Pediatrics opposes all types of female genital cutting that pose risks of physical or psychological harm, counsels its members not to perform such procedures, recommends that its members actively seek to dissuade families from carrying out harmful forms of FGC, and urges its members to provide patients and their parents with compassionate education about the harms of FGC while remaining sensitive to the cultural and religious reasons that motivate parents to seek this procedure for their daughters. … > > … The physical burdens and potential psychological harms associated with FGC violate the principle of nonmaleficence (a commitment to avoid doing harm) and disrupt the accepted norms inherent in the patient-physician relationship, such as trust and the promotion of good health. More recently, FGC has been characterized as a practice that violates the right of infants and children to good health and well-being, part of a universal standard of basic human rights.24 > > Protection of the physical and mental health of girls should be the overriding concern of the health care community. Although physicians should understand that most parents who request FGC do so out of good motives, physicians must decline to perform procedures that cause unnecessary pain or that pose dangers to their patients’ well-being. … > > … An educational program about FGC requires, above all, sensitivity to the cultural background of the patient and her parents and an appreciation of the significance of this custom in their tradition.5 Objective information should include a detailed explanation of female genital anatomy and function, as well as a thorough review of the lifelong physical harms and psychological suffering associated with most forms of FGC. It should be emphasized that many countries in Africa have supported efforts to educate the public about the serious negative health effects of FGC and that prominent physicians from Africa are advocates for the elimination of these practices because of their adverse consequences. Pediatricians and pediatric surgical specialists who care for patients from populations known to practice FGC commonly, such as Somalian, Ethiopian, Eritrean, and Sudanese communities, should be aware of local counseling centers. Successful educational programs typically require the active involvement and leadership of immigrant women, whose experience and knowledge can address the health, social status, and legal aspects of FGC. Health educators must also be prepared to explain to parents from outside North America why male genital alteration is routinely practiced here but female genital alteration is routinely condemned.31 > > Some physicians, including pediatricians who work closely with immigrant populations in which FGC is the norm, have voiced concern about the adverse effects of criminalization of the practice on educational efforts.32 These physicians emphasize the significance of a ceremonial ritual in the initiation of the girl or adolescent as a community member and advocate only pricking or incising the clitoral skin as sufficient to satisfy cultural requirements. This is no more of an alteration than ear piercing. A legitimate concern is that parents who are denied the cooperation of a physician will send their girls back to their home country for a much more severe and dangerous procedure or use the services of a non–medically trained person in North America.33,34 In some countries in which FGC is common, some progress toward eradication or amelioration has been made by substituting ritual “nicks” for more severe forms.2 In contrast, there is also evidence that medicalizing FGC can prolong the custom among middle-class families (eg, in Egypt).35 Many anti-FGC activists in the West, including women from African countries, strongly oppose any compromise that would legitimize even the most minimal procedure.4 There is also some evidence (eg, in Scandinavia) that a criminalization of the practice, with the attendant risk of losing custody of one’s children, is one of the factors that led to abandonment of this tradition among Somali immigrants.36 The World Health Organization and other international health organizations are silent on the pros and cons of pricking or minor incisions. The option of offering a “ritual nick” is currently precluded by US federal law, which makes criminal any nonmedical procedure performed on the genitals of a female minor. > > The American Academy of Pediatrics policy statement on newborn male circumcision expresses respect for parental decision-making and acknowledges the legitimacy of including cultural, religious, and ethnic traditions when making the choice of whether to surgically alter a male infant’s genitals. Of course, parental decision-making is not without limits, and pediatricians must always resist decisions that are likely to cause harm to children. Most forms of FGC are decidedly harmful, and pediatricians should decline to perform them, even in the absence of any legal constraints. However, the ritual nick suggested by some pediatricians is not physically harmful and is much less extensive than routine newborn male genital cutting. There is reason to believe 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. It might be more effective if federal and state laws enabled pediatricians to reach out to families by offering a ritual nick as a possible compromise to avoid greater harm. > > Efforts should be made to use all available educational and counseling resources to dissuade parents from seeking a ritual genital procedure for their daughter. For circumstances in which an infant, child, or adolescent seems to be at risk of FGC, the American Academy of Pediatrics recommends that its members educate and counsel the family about the detrimental health effects of FGC. Parents should be reminded that performing FGC is illegal and constitutes child abuse in the United States. … So as it turns out the AAP has it more right than wrong this time after all. The focus of this statement is to encourage pediatricians to discourage female genital cutting without cultural imperialism. I would like to see more discussion in the statement about the success in some of the native lands of substituting not with a ritual nick but with a bloodless alternative and the option of working with the at-risk American subcultures to encourage that, but the emphasis of the statement is still where it belongs - dissuade with compassionate and culturally sensitive education. ---
**Author:** ![Chief\_Pedant](https://avatars.discourse-cdn.com/v4/letter/c/a6a055/32.png) [@Chief\_Pedant](https://boards.straightdope.com/u/Chief_Pedant)\ **Post date:** [May 16, 2010, 11:50am UTC](https://boards.straightdope.com/t/how-long-until-american-pediatricians-are-cutting-off-clitorises/539541/54 "2010-05-16T11:50:33Z")
There is generally a qualitative difference between male genital mutilation by circumcision and female genital mutilation, particularly in cultures where the procedures are done by the ignorant, incompetent and medically untrained. As **Kimstu** points out, there’s no moral logic that supports mutilating male children while condemning mutilations on females. What cannot be ignored at a practical level is the delayed physical consequence of any permanent mutilation. This seems minimal for ear piercing, probably minimal for circumcision and more significant for female genital manipulation. I am concerned that what seems to be being proposed is for a physician to do what amounts to a sham procedure because having physicians perform this role will elevate the parents’ impression that something anatomically significant is being performed, in the hope the parents will buy into an idea that some sort of ritual requirement has been satisfied. I find no solace in the argument that if we physicians don’t do a sham procedure in the US in an effort to satisfy cultures too ignorant to realize a sham procedure has been done, the child will be taken overseas to have a proper mutilation carried out. This amounts to hoping the parents are too stupid to realize they’ve been head-faked by the medical profession. While such parents may not be the brightest candles on the altar, it seems to me that asking the medical profession to fake them out crosses a line. If all that is actually being done is some trivial, substitutionary, harmless skin prick, let it be represented as exactly that. In such cases any individual with pretty minimal training could be licensed to do it, similar to ear piercing. If, on the other hand, parents know exactly what is going to be done (“We are going to nick the skin and leave a tiny scar that will have no consequence whatsoever”) then I agree with **Kimstu** wholeheartedly that one cannot distinguish morally between such a procedure on girls and circumsion on males. The fact that the underlying religious beliefs for either procedure are retarded is rather besides the point…we’ve already OK’d circumcision as a society. In short, as long as a procedure is truly trivial, and as long as the parents give truly informed consent about exactly what is being done, and as long as we allow mutilations of babies with circumcision and ear piercing, I see no difference in adding genital skin nicking to the list of things we permit. And if it’s that trivial, it’s fine to license a host of folks to do it. If the proposal is for physicians in particular to misrepresent something to the cognitively underserved in an effort to prevent them from performing more dangerous rituals on their own, I’m off the list of participants. ---
**Author:** ![Happy\_Poster](https://avatars.discourse-cdn.com/v4/letter/h/c89c15/32.png) [@Happy\_Poster](https://boards.straightdope.com/u/Happy_Poster)\ **Post date:** [May 16, 2010, 12:23pm UTC](https://boards.straightdope.com/t/how-long-until-american-pediatricians-are-cutting-off-clitorises/539541/55 "2010-05-16T12:23:26Z")
> [@MichaelQReilly](#): > > Your assertions are to the contrary of the scientific evidence How many sexually active babies do you know? This is not evidence of anything relevant. ---
**Author:** ![Rand\_Rover](https://avatars.discourse-cdn.com/v4/letter/r/db5fbb/32.png) [@Rand\_Rover](https://boards.straightdope.com/u/Rand_Rover)\ **Post date:** [May 16, 2010, 1:40pm UTC](https://boards.straightdope.com/t/how-long-until-american-pediatricians-are-cutting-off-clitorises/539541/56 "2010-05-16T13:40:47Z")
> [@astorian](#): > > I am not inferring a slippery slope where none exists. The doctors themselves have already pushed the issue to the edge of a slope. I’m merely pointing out what they’re doing. > > The doctors themselves are now saying, “Maybe we can kind of sort of accommodate people who WANT us to do something we’ve been calling barbaric for a long time.” > > That is a HUGE leap in the wrong direction. And the logic they’re employing to justify a nick will just as easily justify going all the way. This post doesn’t add anything that’s not in the OP. You are still simply displaying the classic slippery slope fallacy. ---
**Author:** ![Happy\_Poster](https://avatars.discourse-cdn.com/v4/letter/h/c89c15/32.png) [@Happy\_Poster](https://boards.straightdope.com/u/Happy_Poster)\ **Post date:** [May 16, 2010, 3:23pm UTC](https://boards.straightdope.com/t/how-long-until-american-pediatricians-are-cutting-off-clitorises/539541/57 "2010-05-16T15:23:21Z")
> [@Angry Lurker](#): > > How many sexually active babies do you know? > > This is not evidence of anything relevant. Actually I just had a bath and looking at my cock and, sadly, my developing moobs I came up with a rather wonderful analogy. The medical evidence is perfectly clear that giving women preventative masectomies would virtually eradicate breast cancer; I presume that this could be extrapolated to babies. Should we be giving babies masectomies? ---
**Author:** ![Oregon\_sunshine](https://avatars.discourse-cdn.com/v4/letter/o/50afbb/32.png) [@Oregon\_sunshine](https://boards.straightdope.com/u/Oregon_sunshine)\ **Post date:** [May 16, 2010, 4:06pm UTC](https://boards.straightdope.com/t/how-long-until-american-pediatricians-are-cutting-off-clitorises/539541/58 "2010-05-16T16:06:52Z")
American pediatricians are already performing genital mutilations - on intersexed children. [This is not necessarily optimal but until recently was the accepted treatment standard for children with intersex conditions.](http://www.isna.org/faq/concealment) ---
**Author:** ![flickster](https://avatars.discourse-cdn.com/v4/letter/f/7bcc69/32.png) [@flickster](https://boards.straightdope.com/u/flickster)\ **Post date:** [May 16, 2010, 4:51pm UTC](https://boards.straightdope.com/t/how-long-until-american-pediatricians-are-cutting-off-clitorises/539541/59 "2010-05-16T16:51:22Z")
> [@DSeid](#): > > So as it turns out the AAP has it more right than wrong this time after all. The focus of this statement is to encourage pediatricians to discourage female genital cutting without cultural imperialism. I would like to see more discussion in the statement about the success in some of the native lands of substituting not with a ritual nick but with a bloodless alternative and the option of working with the at-risk American subcultures to encourage that, but the emphasis of the statement is still where it belongs - dissuade with compassionate and culturally sensitive education. “Encouraging to discourage” still opens the door to allow FGM to take place, so I still disagree with the AAP’s stance. ---
**Author:** ![even\_sven](https://avatars.discourse-cdn.com/v4/letter/e/dfb087/32.png) [@even\_sven](https://boards.straightdope.com/u/even_sven)\ **Post date:** [May 16, 2010, 4:57pm UTC](https://boards.straightdope.com/t/how-long-until-american-pediatricians-are-cutting-off-clitorises/539541/60 "2010-05-16T16:57:56Z")
A couple of thoughts… I think in order to understand how to eliminate FGM, you need to understand it’s history. First off, although it tends to be more popular in Islamic communities, there is nothing in Islam that calls for it. It is absolutely a mistake to call this an Islamic practice. FGM is old. It goes back to the time of the Pharaohs. In much of west Africa, it has been a part of the coming-of-age process since times immemorial. I think it was usually performed along side male circumcision, and was considered the female equivalent. Often it was a part of a ritual process that would last for years. While to our eyes these practices may seem like “random backwards tribal stuff”, over in Africa people have a pretty good understanding of their history and culture and see this as a part of their culture as completely real and serious as Jewish people view male circumcision. These days, people really are beginning to recognize that this practice is out of place in the modern world. When I was in Mali, I was surprised to see lots of people wearing anti-FGM clothing and anti-FGM posters up in public places. There are dedicated local activists throughout Africa (don’t know much about the Middle East and other areas) who are working hard to end this practice. Change \*is \*coming from within the community. But it takes a while to undo thousands of years of tradition. For example, if anti male circumcision activists were to finally convince people that routine male circumcision is a bad thing, they would still probably not have an easy time covincing observant Jews to give up the practice. It’s just too big of a piece of their cultural identity. Once again, African cultures are as complex and cherished as any other culture. It’s not just random tribal superstition. This is part of a cultural heritage that goes back hundreds of years and is a part of people’s collective memory and identity. You aren’t going to succeed by just telling people “your traditions are stupid, you should stop them.” But you might be able to find a culturally acceptable substitute- something that fulfills the same ceremonial role and can provide the same sense of initiation, without permanent harm. Indeed, it appears that this approach does indeed work. It’s often the culture people want to preserve, not necessarily the practice itself. A final note, as odious as FGM is- and I say this as someone who is likely looking at gender and development as a career path- it does not always eliminate sexual pleasure. Even women who experience the most extreme forms still report sexual desire, pleasure and orgasm. This in no way means it’s okay, but if we are going to eliminate it, we should deal as much in facts and reality as we can. [Previous page](https://boards.straightdope.com/t/how-long-until-american-pediatricians-are-cutting-off-clitorises/539541.md?page=2) [Next page](https://boards.straightdope.com/t/how-long-until-american-pediatricians-are-cutting-off-clitorises/539541.md?page=4)