Pediatricians Finally Reject All Female Genital Mutilation

The American Academy of Pediatrics (AAP) has finally come to its senses. In a previous statement made in April, they went head to head with the 1996 federal law that bans all types of female “circumcision” – or what we more aptly call “female genital mutilation” (FGM). A previous statement suggested that pediatricians should consider “pricking” the clitoris as a way to meet cultural requirements and appease immigrants whose cultures demand that they undergo FGM as a way to help prevent having these girls transported back to Somalia, Ethiopia, or wherever else this practice is condoned. This “clitoral nick” would require a tiny cut in the skin over the clitoris, which the statement compared to getting ears pierced. Now, they have retracted their statement in favor of one that opposes all types of genital cutting in girls.

Culturally Sensitive and serving my duty

I totally get where the AAP was coming from. As an OB/GYN who worked with Somali immigrants (all of whom were victims of FGM), I understand. In Somalia, almost all women undergo the most severe form of FGM — cutting off the labia and the clitoris and sewing everything closed so that only a matchstick sized hole can allow the egress of urine. These women believe that, if they don’t have this done, they will be unable to prove their chastity and no man will marry them. Girls have this done as a right of passage, usually around the ages of 9-12, often by other women with unsterile tools in non-medical settings.  While a girl heals from her severe wounds, she is attended by other girls and women who have already undergone the procedure. She is loved and nurtured, fed the best food, and honored by her community. When she heals, she is considered chaste and eligible for marriage, usually an arranged, often polygamous marriage.

As a doctor working with these women, I was challenged to be, at once, culturally sensitive and serving my duty to reform this practice and protect the baby girls I delivered from undergoing this same mutilating procedure. I went into their homes, ate out at the local Somali restaurant, interviewed them, and earned their trust. I learned that you can come out with the guns of reform blaring. You must accept them as they are and empower them to buck the system, to protect their bodies and those of their daughters, and to honor their bodies for the perfect way in which they were born.

What about male circumcision?

The minute you start talking to these women about FGM, they attack the circumcision of males (and I agree). They ask why we oppose the cutting of female genitals when so many American baby boys are subjected to unnecessary cutting of the penis. Since there is absolutely no medical reason to circumcise boys (and pediatricians all agree that this is purely cosmetic), why do we modify boy genitals? The women are right in thinking that we’re completely hypocritical to oppose pricking a clitoris when we routinely lop off the foreskin of baby boys.

I know, I know. Cutting off the foreskin of your baby boy is not the same as chopping off labia and removing a clitoris. Male circumcision is a mostly harmless, cosmetic procedure that runs along cultural lines. Almost all Jewish babies and many white American babies get circumcised. Few Hispanic babies or Asian babies do. Dads tend to say things like, “I just want my son to look like me, and I’m circumcised.”

As an OB/GYN, I was trained to do circumcisions — and I thought it was the worst thing I ever had to do (worse even than sticking your hand up someone’s bum to retrieve some lost object or pull out impacted feces). Take a baby, strap them onto a “baby board” that’s basically 4 point restraints, clamp, cut, baby screaming bloody murder because nobody at Northwestern believed in baby anesthesia. It was really awful. I refused to do them after I finished residency.

Loving ourselves just the way we are

What bothers me most about this whole issue is that there’s a pervasive notion that our bodies are not okay the way they’re created. If your ears stick out, you should get them surgically altered. If your boobs aren’t big enough, you should augment them. If you’re a wee bit pudgy, you should diet. I remember being 17 years old, about to go to my senior prom. I was wearing a strapless white taffeta gown, and my hair was done up just so with my blue eyeshadow gleaming. I was looking in the mirror, feeling pretty hot, and my mother was standing over my shoulder, beaming with what looked like pride.

Then she delivered the doozy. “Lissa, you’d be so beautiful if it weren’t for that nose.” Honestly, until that moment, I had never noticed my nose. But you can believe that I’ve thought about it ever since.

Let’s commit to loving ourselves just the way we are. Let’s protect our children from comments or procedures that suggest that they are not okay just the way they are.  Let’s be mindful of how our thoughts and actions affect those around us. And let’s reframe how we feel about the bodies we’re lucky enough to inhabit and those of the ones we love.

What do you think?   How do you feel about FGM? Did you circumcise your sons? How did you make your decision? If you had a baby, how would you feel about having their genitals cut now? What are your thoughts? Let’s talk about this rarely discussed topic.

[photo credit: photoxpress.com]