Female Circumcision or the “Nick”

Fgm-395 The American Academy of Pediatrics is
suggesting that American doctors be given permission to perform a
ceremonial pinprick or “nick” on girls who come from cultures that believe in female circumcision.

They argue that it won't hurt the girls at all, and it might prevent families from going abroad for the full operation.

Opponents say that American doctors should not be involved in any way in a barbaric practice that damages girls. It could lead to doctors being pressured to do more serious procedures on the girls.

I read this article over the weekend, and it stayed with me. I found myself in the opposing camp. I don't want any official endorsement of female circumcision, even a benign nick.

Some reactions from around the blogosphere. Andrew Sullivan is against it. So is PZ Myers and Melissa McEwan. But Amanda Marcotte thinks this might be a practical solution.

26 thoughts on “Female Circumcision or the “Nick”

  1. I think this is just about a first: I actually agree with Marcotte about something. We probably share loads of policy preferences, but I can’t remember ever nodding my head at her reasoning on cultural issues before. In this case though, I think she’s on to something: adapting traditions through formalistic performances of them is both reasonable and wise.
    There is also, however, I think one key point she misses. She writes:
    The argument against the ritual nicking is that mothers who’ve been defending their daughters against fathers who demand circumcision will now be forced to give in.
    I’m no authority, but from what I’ve read, in these very patriarchal immigrant communities it is usually the mothers who most strongly pressure their daughters to go along with tradition. Presumably one could roll out all sorts of arguments about false consciousness here and whatnot, but to oppose this adaptation because it disarms mothers’ arguments against fathers may not entirely fit the way these things are usually decided.

  2. Russell is right in his last paragraph. (I worked for the Center for Gender and Refugee Studies at UC Hastings for a bit and FGM was one of their big subject areas, so I had to learn a fair bit about it.)
    I think all of these rituals are nonsense and terrible and that people should get rid of them. But given that they won’t, we might ask what we can do. This approach, if it really doesn’t do any significant harm, seems plausible. People might also ask themselves if they feel very different about this type of thing and male circumcision. There are, apparently, pluses and minuses for that operation, but it’s hard for me to see how anyone who doesn’t at least have serious worries about male circumcision can categorically oppose this option. (The all-things-considered judgment on either one might come out any way, but most people should hesitate to make such a judgment, as they are unlikely to have informed views.)

  3. Here’s my question: are there members of some culture, who are currently residing in the US, who will actually take doctors up on this? A ritual nick in an American medical setting? Has anyone from any of these communities expressed interest in such an option? Maybe that’s in some way beside the point, but it seems like a relevant question to ask.

  4. “I think all of these rituals are nonsense and terrible and that people should get rid of them. But given that they won’t, we might ask what we can do.”
    I have to wonder how much interest there is going to be in this purely token bloodletting among members of communities where the point is to totally reconfigure the topography and functionality of female genitalia.

  5. In my opinion, this is very like male circumcision. In my childhood, our next door neighbor was a female, Jewish pediatrician who Did Not Approve of male circumcision.
    In this case, FGM is much more harmful than male circumcision. If a small nick will prevent the outright mutilation and removal of the genitalia, then it’s worth trying.

  6. “I have to wonder how much interest there is going to be in this purely token bloodletting among members of communities where the point is to totally reconfigure the topography and functionality of female genitalia.”
    You could be right. On the other hand, why let negative opinions of foreign practices prevent the attempt to preserve a child’s sexual organs? If there is no US alternative, many families apparently presently elect to return home for the procedure. If there is a ceremonial alternative, perhaps it could be acceptable for the family not to return home for FGM.
    There are any number of current practices we perform everyday which replace older practices we would not accept today. Christmas trees, for example. Some European cultures have transformed bride thefts into visits to local pubs, whereby the bridegroom must “ransom” the bride.

  7. I have to wonder how much interest there is going to be in this purely token bloodletting among members of communities where the point is to totally reconfigure the topography and functionality of female genitalia.
    My understanding–and again, I’m no authority here–is that a ritualistic nick is already practiced in some tribes (or, more probably, amongst certain urbanized and/or educated members of said tribe). That suggests there are people who would be satisfied by and find sufficient meaning in this formalistic practice, without going all the way towards some kind of horrible clitoridectomy.

  8. Re: RAFox’s comment above: do any of that group go back for the ritualized nick? If it’s an option already….
    I suppose the creation of a convenient, already sanctioned (in some groups) option might sway some. There would probably be still some traditionalists; ultimately, it sounds like the creation of a new culture (concerning the issue). I think there would be some push-back.
    I can’t decide on this topic, myself. It’d take a lot more research and thinking before I could formulate an opinion, other than general distress.

  9. I’m with you, lmc.
    I could make this a circumcision themed day. I just read an article about promoting male circumcision in Africa to prevent AIDs.

  10. I felt eeky about it, until someone pointed out that male circumcision is accepted in the US.
    Yes, there are those who object, but they’re not anywhere close to making it illegal in the US, and even if they were, there would probably be a clear exemption for religiously based male circumscriptions. So, I think this would be a fine option to offer, as long as the there are reasonable guarantees that the requested and performed procedure will not be harmful (and indeed, will be a “ceremonial nick”).
    I still feel a bit eeky, since the ritual we’re suggesting replacement for was/is, unlike male circumscription, designed to impact the function of female genitalia (that’s its very purpose, after all). But I can live with it being legal.

  11. PS: And, if we want to be more aggressive about it, we could make it illegal to transport a child outside of the United States to engage in the practice. Then, parents who wanted to do it would have to decide to leave the US.

  12. Male and female circumcision aren’t even in the same ballpark. In fact, female circumcision is genital mutilation. I’ve had two boys circumcised and their equipment works just fine.

  13. “BJ, that seems much worse. Would you do a check on all girls coming back into the U.S.?”
    Well, you could ask parents to sign a document saying that they haven’t engaged in the practice. If the information came out later, then, you could deport the parents. Basically, it’s a question of how seriously we take the mutilation.
    Laura — I am well aware that FGM is not at all comparable to male circumcision. But, I believe this “ceremonial” version must be — or it would be unacceptable. The ceremonial version has to be purely cosmetic, with no sexual or physical repercussions, for it to be comparable to circumcision. If it passes that test, though, then a country that allows male circumcision should allow the ceremonial version, too.

  14. It seems odd because in the case of male circumcision, the practice is meant to mark the child, as one of the tribe. The same for female circumcision, in a more convoluted way: it marks the girl as virginal because not interested in/incapable of sex. So to replace a marking procedure with a nick doesn’t seem as if it would work unless it was meant to scar a lot. Maybe they could replace it with a ring through the labia, or something like that. Which distresses me almost as much, but isn’t permanently disfiguring. But I’m only theorizing about what might be acceptable to a group for whom sexually disabling body modification is acceptable.

  15. If the information came out later, then, you could deport the parents.
    And then they can take their daughter back to the place where they cut-off genitalia?

  16. ” But I’m only theorizing about what might be acceptable to a group for whom sexually disabling body modification is acceptable. ”
    I’m presuming that this has been considered by the APA, and that they haven’t invented their own procedure.
    “And then they can take their daughter back to the place where they cut-off genitalia? ”
    Well, that’s not particularly worse than not being able to enter the US because you’re under threat of FGM. And, of course, one is hoping that the threat of deportation is sufficiently high that the parents would avail themselves of other options; otherwise, they could have just stayed in the country where they can cut off genitalia at will.
    I think the bigger issue is what other laws would we make it illegal for a naturalized American to violate while in another country (i.e. could a 19 year old be told he can’t drink alcohol in Britain, and then deported if he did?). The enterprise starts to resemble Lieberman’s plans, which I don’t support.

  17. I can’t say that I trust the AAP’s realism very much, given that they have suggested online shopping would be a good alternative to the dreadful danger of letting children ride in shopping carts.

  18. unlike male circumscription, designed to impact the function of female genitalia
    Male circumcision became common in the US in part because it was thought to prevent masturbation. And, while there are significant debates about possible benefits, those mostly apply in circumstances where regular washing isn’t easy. And the foreskin is the most sensitive part of the penis. I’m not sure that male circumcision is wrong, and it’s obviously a lot less serious than female circumcision, but from a physical point of view, the option discussed above seems _much less_ serious a form of genital mutilation than male circumcision. The fact that you’re used to it doesn’t change that. There are other factors to consider than the physical point of view, but surely that’s an important one.

  19. I had a comment eaten up earlier that would have been longer. What I wanted to say was, what makes us think that the more severe forms of FGM aren’t being performed in the US in medical settings? There certainly are already US medical practices that do virginity fixes and female genital plastic surgery. Also, isn’t there a even better case to be made for doing the more radical forms of FGM in the US under proper medical supervision, rather than in the 3rd world, by an illiterate operating with broken glass (or something along those lines)?

  20. “What I wanted to say was, what makes us think that the more severe forms of FGM aren’t being performed in the US in medical settings? ”
    Well, it was outlawed in 1996:
    18 U.S.C. § 116 : US Code – Section 116
    Interestingly, the law only applies to children (under the age of 18), and it details the medical procedure they opposed. So the cosmetic procedures Amy described would be allowed, as long as they weren’t on children. Presumably a >18 year old could consent to FGM under the law.
    I can’t be sure, but my guess would be that it would not be done frequently by licensed doctors in US medical settings, as long as it is illegal.
    The 1996 news reports also state that a “nick” procedure was being used by physicians in Seattle at the time, at the request of Somali parents.

  21. How dare we debate what unneccessary risks might be OK to expose a child to? Why should any child have to heal from a blood-letting while in a fouled diaper?
    In the 13 years FGM has been illegal in the US there has been only 1 prosecution (and that was botched, the mom framed the dad but he went to jail for 10 years).
    This AAP proposal is a poorly disguised bid to sell more cutting procedures, when they should instead by cowering in shame for the ones they perpetrate today (15% of US male infants are circumcised by AAP members at about $300 a pop).
    Follow the money. 2 million boys per year times 15% times $300 = 90 Million dollars.
    NOT ONE national medical association on earth (not even Israel’s) endorses routine circumcision.
    FGM is illegal for 94% of the world’s population with no religious or “nick” exception. Why does the US have to be the ones back-tracking on this?

  22. How dare we debate what unneccessary risks might be OK to expose a child to? Why should any child have to heal from a blood-letting while in a fouled diaper?
    Ron- are your campaigning to make male circumcision illegal as well? Because that’s really common in the US (though not as common as it was a few years ago) and fits your definition really well, perhaps even better than the sort of procedure being discussed for women here. Given your account, it seems like that should be your real target in the US. Do you have any more of an argument for people like Laura to convince them that they’ve done wrong?

  23. I skimmed through a couple books on FGM as an undergraduate, and I thought that FGM is often a coming-of-age ritual, so it’s not really an exact counterpart to male infant circumcision. The article Laura links talks about girls under 15.

  24. Yes- FGM is usually done to young girls, not babies. (It’s not completely clear why that matters, though it might.) In the past this was true of male circumcision, though, too, and still is in some places. (There’s a great scene in a movie by Kusturica of Muslim boys in Yugoslavia dreading being circumcised.) My recollection of the case mentioned by BJ above of Somali families was that they were willing to have this done on infants, but I might be wrong.

  25. “(It’s not completely clear why that matters, though it might.)”
    With a big child, there’s no diaper, so there isn’t the lengthy exposure to urine and feces that there would be with an infant. Old-school diaperless parenting might cause less irritation and be less risky infection-wise, although I have a hard time recommending it with a straight face, since (short of a post-apocalyptic scenario), I can’t imagine doing that myself. I wouldn’t circumcise a boy, either, not having any religious imperative to do so.
    One of my young male relatives had to be circumcised when he was 5 for some medical reason that I was too queasy and delicate to inquire into. Poor guy.

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