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.
True, but so is circumcision performed in the conditions found more often in the native lands. For instance:
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.
Your assertions are to the contrary of the scientific evidence: http://www.guardian.co.uk/lifeandstyle/2009/jul/05/circumcicision-health-children
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.
Or, maybe, more severe forms of the procedure here in the West, in less-than-official or less-than-medical contexts.
Exactly.
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.
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.
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.
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.
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.
It can make a handy coat rack.
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
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.
Here’s some info on various Type IV procedures among groups in Indonesia:
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.
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).
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.
“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, rather than quotes by some about it. Turns out that they are not really endorsing it.
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.
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.
How many sexually active babies do you know?
This is not evidence of anything relevant.
This post doesn’t add anything that’s not in the OP. You are still simply displaying the classic slippery slope fallacy.
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?
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.
“Encouraging to discourage” still opens the door to allow FGM to take place, so I still disagree with the AAP’s stance.
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.