News

Laura MacDonald
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Anger from human rights campaigners as American paediatricians soften line on forced female genital cutting

Wednesday 12th May 2010
In a policy statement in its house journal Pediatrics, the American Academy of Pediatrics (AAP) has suggested doctors be allowed to perform a ritual nick to the clitoral hood of a female child, and calls for an end to use of the term female genital mutilation, which it describes as 'culturally insensitive.'

The statement, described as controversial by the New York Times, has aroused angry responses from medical professionals and campaigners, including NORM-UK, highlighting that this position contradicts the AAP stance on consent:

"…providers have legal and ethical duties to their child patients to render competent medical care based on what the patient needs, not what someone else expresses.."

The statement points out that some forms of female genital cutting are "less extensive than newborn male circumcision commonly performed in the West", and that many genitally altered women do not perceive themselves as mutilated. It rejects use of the term 'female circumcision' however, claiming that to use this term would assign the surgery the same 'respectability' as infant male circumcision.

The Academy suggests that allowing doctors to perform what it calls a 'non physically harmful' variant of female genital cutting would save patients from a more severe form which might be inflicted out of US jurisdiction. The statement is highly controversial - the latest interagency statement on FGM defines nicking or pricking of a girl's vulva as among 'other harmful procedures', and assigns it to the category of, 'type IV female genital mutilation'. In fact type IV FGC/M is little studied, but it would be reasonable to suggest that in incising a delicate and very nerve rich part of the body (the prepuce) it risks both scarring and sensory damage.

Under current federal law it is illegal to perform ANY non-medically indicated surgery on the genitals of a girl (although not a boy). This includes nicking of the clitoral foreskin (hood) and excising part or all of it (type Ia FGM/C). The latter is a common practice in Indonesia, and many other Muslim communities (it is considered obligatory under the Shafi'i school of Islam). The former is practised widely in Africa, the Middle East and South East Asia, but efforts have been made to eradicate it - for example in Israel - where it has been announced that the Bedouin community no longer practices incision.

As an indication of the strength of feeling against any FGM/C in the US, a recent US Appeal Court judgement which awarded asylum to an Indonesian couple and their children on the grounds of a risk of FGC/M, included the statement, "the attempt to parse the distinction between differing forms of female genital mutilation is not only a threat to the rights of women in a civilized society, but also runs counter to [established] precedent." The judges added, "there's no such thing as mild female genital mutilation."

Like other human rights groups NORM-UK wholeheartedly rejects the notion that a parent may hurt a child in the name of religious practice or cultural preference.

We refute the suggestion that incising a child's clitoral hood, causing pain, bleeding and potentially scarring and sensory damage, is "non physically harmful".

We refute the suggestion that forced non therapeutic circumcision of males is 'respectable' and beleive this wording aptly illustrates the cultural blindness which afflicts the AAP bioethics committee.

We believe that the Academy has chosen this moment to position forced female genital cutting as a valid parental choice, in order to prepare the ground for a new statement supporting forced male genital cutting. The Academy's position demonstrates our long held view that denying the rights of one group erodes the rights of all.

We urge the AAP to accept what most of the world accepts - that the healthy prepuce is a functional part of our male, female and intersex bodies - and doctors should refuse any parent's request to harm it.