The Hoohah Brouhaha.

Allow me to begin by stating the obvious.

Female Genital

Mutilation

is serious business.

Note that I'm perfectly willing to use the M word. I've read Infidel. I thought it was fantastic. I've read The Hidden Face of Eve. I get it. I do.

I also, unfortunately get that Female Genital Mutilation is still a serious problem, even in the good old US of A. Estimates place the number of girls at risk in the States at about ten thousand. As far as the population goes, this doesn't seem like much of a problem unless you stop thinking in big numbers.

It's a horrible, detestable, disgusting practice and it needs to be stopped. We've done a lot to attempt to end it and to make sure its practice doesn't increase on our shores. We've criminalized it. We've done some public education on it. But really, how much can we do?

Here's one thing we can do. We can permit American physicians, trained medical professionals, perform a similar procedure which would not remove any tissue in a sterile facility. It seems, immigrant families have been approaching their daughters' pediatricians asking for this procedure. No, I really don't think doctors should be providing any nutball procedure at whim to parents. But, in the case, I think we should think very seriously about it.

For the record, no one is suggesting we give pediatricians license to perform infibulations, so just stuff that idea right back where it came from. No one is "advocating" FGM. No one is "promoting" FGM. It's not happening.

There has been quite a movement against FGM over the last several years. And, it's my understanding that it's working. In many communities, people have been adopting a bloodletting ceremony involving something like a pin stick to replace the practice of FGM. Some have left the bloodletting behind entirely. This is great news, as is the Bris Shalom. But, its adoption has not been universal, and it would be helpful to families to provide a less harmful alternative while easing them into their new culture in this country.

I don't think, for an instant, that permitting doctors to prick an infant girl's labia at the pleading of her parents is an attractive idea. But I also don't think having this kind of procedure available is going to prompt new adopters of FGM. What is might do is give some immigrant parents an option to uphold their cultural beliefs in a way that does minimal harm to their daughters. What this might do is give doctors a tool to help persuade parents not to allow their skeevy great-uncle chop up their daughters with dirty kitchen shears while they flail on the living room floor. What it might do is help prevent families from sending their daughters back home to Somalia or Yemen or Saudi Arabia where someone else's skeevy uncle will slice into them with a razor of unknown origin and scrape off their labia where there may not even be clean water to wash the wound.

There is a reason pediatricians perform circumcisions. It's because, if they didn't, someone else would. I disagree with male infant circumcision. I know there are some issues that are best treated with this procedure, but routine application is not excusable. Unfortunately, it is still performed. But, fortunately, the American culture left FGM behind decades ago. Yes, we too performed Female Genital Mutilations. But, I don't believe we'll be shifting back. We aren't still having a culture war about male circumcision because it might actually be beneficial or because it was illegal and we started making religious exceptions. We're still haveing a culture war on circumcision because it was introduced as a way to control sexuality and excuses have been made since that it is somehow beneficial. It is, in the end, still about a cultural attachment to bygone practices. We've just managed to brainwash ourselves into thinking it isn't.

In no way would any AAP pronouncement mean that pediatricians would be hanging out GET YOUR FGM HERE! shingles. Nor is the number of physicians willing to do this (or, probably, already doing it) likely to change much. But what it might mean is that these physicians might be doing so at less professional cost to themselves. Having this option available isn't going to persuade families who are on the fence about FGM to do it. What it's going to do is draw some families away from it. So, when a family asks, and the doctor has explained the harm or this procedure. Then they've argued back and he's discussed the ethical problems, and he's pleaded with them to not do this procedure, before they storm out of his office and put her on the first plane to Somalia, he has one more option. "I can do this instead. It won't cause permanent harm and she can still go through a ritual." It just. might. work. And then, when this girl doesn't bring doom upon her house, her little sister won't be mutilated at all. When this girl's husband doesn't drop dead from touching her intact clitoris, maybe her cousins won't be mutilated at all. When this girl grows up, she won't consider doing something to her daughters that she obviously didn't need to make her desirable.

I think that it may be that permitting this modified practice along with a thorough discussion of the risks and harms of Female Genital Mutilation will help wean families from FGM and maybe end its practice within a generation. It may build an immigrant community able to innoculate newcomers against this practice, ending the need for the accomodation altogether.


Now, for the actual damn document.

Policy Statement
Ritual Genital Cutting of Female Minors, May 1, 2010.

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.

I would be completely satisfied if they didn't change their recommendations. There was a big stink about how they were considering whether to shift back to recommending routine male infant circumcision, and nothing came of that as far as I know. But I think this is an issue which deserves serious thought instead of the knee-jerk nonsense spreading around the internet, especially the Atheist corner. When half the comments are merely a string of obscenities, we're obviously not thinking rationally.

And, for the record, can we kill the canard about the Hippocratic Oath already? Nobody fucking uses it.