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:]


Jane H.
Jane H5 years ago

FGM is absolutely horrfic. I had 2 sons and 1 daughter. Both boys were circumsized and now I find that this is the healthier way to go. But NOT for girls.

Patricia H.
Patricia H.5 years ago

thanks for posting

Jean Bureau
Jean B5 years ago

Hey Charles W.: 99% of European men have their foreskin... That doesn't mean that they have dirty penises! Clean the damn thing! And stop that dreadful mutilation!

I am 53 and I have had my foreskin removed when I was 2 weeks old and have problems with all my sexual relations ever since!

And Thomas P., the American Academy of Pediatricians says that it is better for boys because they all get about $100.00 for each circumcision they do. Now do you understand why they recommend it?!!!

Rebecca S.
Rebecca S5 years ago

Unless there is a medical reason, there is no reason why a baby needs to undergo a surgical procedure such as circumcision.

Sandy Erickson
Sandy Erickson5 years ago

Curcumcision is a way of thaking away a good part of the pleasure of sex for the man. God gave this to the people that rejected Him. Think about it.

Alice O.
Alice O5 years ago

high time!!!! I never understood the absurdity of genital mutilation, be it on a boy or a girl. If "god" is all powerful, all knowing, almighty and so on, why the hell should he have made a mistake that we, inferior imperfect creatures, should correct for him? Why didn't he correct it on the first place before "making" us? This stupid nonsense to me is just an excuse to a terrible instance of violence and mutilation to children, also masked as "culture". Only a sick mind could defend it.

No B.
Nancy B5 years ago


Duane B.
.5 years ago

Thank you for sharing.

Teresa Wlosowicz
Teresa W5 years ago

So late?

Thomas P.
Thomas P5 years ago

I am thankful and most appreciative that the author has cast more light on this barbaric practice of FGM. I have been disgusted by it since I first learned of it 10 years ago (though it's been going on for centuries). The fact that much of the world has turned a blind eye to the practice of castrating girls (and in some cases young women) and likely irreversibly changed their course, because it is often referred to as a "cultural" practice is a stain on those who have done so, and they have almost as much blood on their hands as those who actually carry out this barbarism. In my view, whether this practice is or isn't cultural is completely irrelevant since it is so harmful to women. However, the author's comparison of FGM to male circumcision is not at all analogous, and her statement that "pediatricians all agree that" (circumcision) "is purely cosmetic" is false. In fact, in its latest guidelines published August 27, 2012, the American Academy of Pediatricians (AAP, ironically the same group the author sites in her discussion of FGM) says that the health benefits of circumcision outweigh the risks. The argument that FGM is the same as male circumcision is wrong on its face, primarily because of the end result. The end result of FGM is intrinsic in its name...a girl's (or in some cases a young woman's) clitoris is essentially mutilated (completely removed) and she will likely never experience orgasm, all done under the guise of keeping her chaste. This is NOT the ca