AAP advocating for U.S. pediatricians to perform certain types of FGM
I found this really disturbing.
Here's an intro:
NEW YORK, May 5-- International human rights organization Equality Now is stunned by a new policy statement issued by the American Academy of Pediatrics (AAP), which essentially promotes female genital mutilation (FGM) and advocates for "federal and state laws [to] enable pediatricians to reach out to families by offering a 'ritual nick'," such as pricking or minor incisions of girls' clitorises. The Policy Statement "Ritual Genital Cutting of Female Minors", issued by the AAP on April 26, 2010, is a significant set-back to the Academy's own prior statements on the issue of FGM and is antithetical to decades of noteworthy advancement across Africa and around the world in combating this human rights violation against women and girls. It is ironic that the AAP issued its statement the very same day that Congressman Joseph Crowley (D-NY) and Congresswoman Mary Bono Mack (R-CA) announced the introduction of new bipartisan legislation, The Girls Protection Act(H.R. 5137), to close the loophole in the federal law prohibiting FGM by making it illegal to transport a minor girl living in the U.S. out of the country for the purpose of FGM.
The rest of the article is here.
Re: AAP advocating for U.S. pediatricians to perform certain types of FGM
I couldn't find anything mentioning it on AAP's website. The closet thing I could find was this statement from their July 1998 policy
"Some physicians, including pediatricians, who work closely with immigrant populations in which FGM is endemic, have voicedconcern about the adverse effects of criminalization of the practiceon educational efforts.24 These physicians emphasize the significanceof a ceremonial ritual in the initiation of the girl or adolescentas a community member, and advocate a lesser procedure, such aspricking or incision of the clitoral skin, as often sufficientto satisfy cultural requirements. Pediatricians and pediatricsurgical and urologic surgeons who are contemplating performingsuch a procedure should consider their role in perpetuating thissocial practice with its cultural implications for the statusof women. It is also unclear whether performing such lesser procedureswould be exempt from federal criminal laws."
That policy was revised on May 1, 2010 with this:
POLICY STATEMENT
Published online May 1, 2010
PEDIATRICS Vol. 125 No. 5 May 2010, pp. 1088-1093 (doi:10.1542/peds.2010-0187)
FROM THE AMERICAN ACADEMY OF PEDIATRICS
Policy Statement
Ritual Genital Cutting of Female Minors
Committee on BioethicsThe traditional custom of ritual cutting and alteration of thegenitalia of female infants, children, and adolescents, referredto as female genital mutilation or female genital cutting (FGC),persists primarily in Africa and among certain communities inthe Middle East and Asia. Immigrants in the United States fromareas in which FGC is common may have daughters who have undergonea ritual genital procedure or may request that such a procedurebe performed by a physician. The American Academy of Pediatricsbelieves that pediatricians and pediatric surgical specialistsshould be aware that this practice has life-threatening healthrisks for children and women. The American Academy of Pediatricsopposes all types of female genital cutting that pose risksof physical or psychological harm, counsels its members notto perform such procedures, recommends that its members activelyseek to dissuade families from carrying out harmful forms ofFGC, and urges its members to provide patients and their parentswith compassionate education about the harms of FGC while remainingsensitive to the cultural and religious reasons that motivateparents to seek this procedure for their daughters.
j+k+m+e | running with needles
My unpopular opinion- how is a nick of the clit for ritual purposes worse or different than a circumcision for ritual/religious/aesthetic purposes?
And, I assume that the AAP wants peds to do them so that would be professionally done under sterile conditions with pain meds.
I heard this might have something to do with their position on circumcision. They get a lot of heat for being neutral on one and totally apposed to the other.
But it doesn't matter what their position is, FGM is illegal. No baby girl "nicks."
It's a real story. Here's the info on the AAP's website.
https://www.aap.org/advocacy/releases/apr2610studies.htm
The change is from "all forms of genital cutting" to "all forms of female genital cutting that pose a risk of physical or psychological harm".
I personally don't believe there is a form of genital cutting that DOESN'T cause harm, but you start to get into circ-type arguments at this point....and that's a flame waiting to happen.
Here is another quote from AAP on the subject:
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.
Here is the entire statement from the journal
"EDUCATION OF PATIENTS AND PARENTS
An educational program about FGC requires, above all, sensitivity to the
cultural background of the patient and her parents and an appreciation
of the significance of this custom in their tradition. 5 Objective information should include a detailed explanation of female genital anatomy and function, as well as a thorough review of the lifelong physical harms and psychological suffering associated with most forms of FGC. It should be emphasized that many countries in Africa have supported efforts to educate the public about the serious negative health effects of FGC and that prominent physicians from Africa are advocates for the elimination of these practices because of their adverse consequences. Pediatricians and pediatric surgical specialists who care for patients from populations known to practice FGC commonly, such as Somalian, Ethiopian, Eritrean, and Sudanese communities, should be
aware of local counseling centers. Successful educational programs
typically require the active involvement and leadership of immigrant
women, whose experience and knowledge can address the health,
social status, and legal aspects of FGC. Health educators must also be
prepared to explain to parents from outside North America why male genital alteration is routinely practiced here but female genital alteration is routinely condemned. 31 Some physicians, including pediatricians who work closely with immigrant populations in which FGC is the
norm, have voiced concern about the adverse effects of criminalization of the practice on educational efforts.32 These physicians emphasize the significance of a ceremonial ritual in the initiation of the girl or adolescent as a community member and advocate only
pricking or incising the clitoral skin as sufficient to satisfy cultural requirements. This is no more of an alteration than ear piercing. A legitimate concern is that parents who are denied the cooperation of a physician will send their girls back to their home country for a
much more severe and dangerous procedure or use the services of a non?medically trained person in North America.33,34 In some countries in which FGC is common, some progress toward eradication or amelioration has been made by substituting ritual ?nicks? for more severe forms.2 In contrast, there is also evidence that medicalizing FGC can prolong the custom among middle-class families (eg, in
Egypt).35 Many anti-FGC activists in the West, including women from African countries, strongly oppose any compromise that would legitimize even the most minimal procedure.4 There is also some evidence (eg, in Scandinavia) that a criminalization of the practice, with the attendant risk of losing custody of one?s children, is one of the factors that led to abandonment of this tradition among Somali immigrants.36 The World Health Organization and other international health organizations are silent on the pros and cons of pricking or minor incisions. The option
of offering a ?ritual nick? is currently precluded by US federal law, which
makes criminal any nonmedical procedure performed on the genitals of a female minor.
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 pedia-
tricians 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.
j+k+m+e | running with needles
I think they are both wrong. My personal thoughts are that ritual/religious reasons are not adequate justification for either practice. That being said, the history and reasoning behind FGM seems far more cruel to me. The "nick" is symbolic of a barbaric practice with serious social and political implications so that's where I see a difference.
I agree with you. I really didn't want DS circumcised but DH was adamant that it be done just so he fit in when he was older. I gave in but sometimes wish I hadn't. : (
ITA.
I don't disagree that neither is a good thing, and DS is intact. Honestly, I thought I was on 6-12 where you'd get the "OMG no it's so different ew foreskin and ladybits," (oops!) but I don't find myself more disturbed by this than circ, despite the history/associations. You've got to work within a culture, and if we get a ritual nick in a peds office rather than infibulation with a used scalpel by a non-professional, it's a big step in the direction I'd like to see things go.
I don't see the point in drawing a line between female and male genitals... nor do I see a point in picking and choosing which motivations to cut the genitals of children are noble and reasonable and which ones are barbaric, sexist and cruel. I find many of the accepted reasons for MGM to be just as unenlightened as the FGM reasons that most American people find so horrifying.
I don't agree with all of the AAP's statement here. I don't trust them one bit. But they do say on truth here- and that is that the FGM nick they propose is less invasive and less severe than the MGM they do all the time and do legally. Now the ethical response is, "So then we need to even this up by refusing to do MGM for any non-medical reason" the correct answer is not, "Because we already have granted ourselves permission to use our medical skills to violate males for non-medical purposes, why should we not also be sensitive to the factors that compel parents of females to circumcise them?"
The purpose of the nick (not that I agree) is to satisfy the parents in a sterile enviornment (that seems quite sure that in their hands- it's not going to be "mutilation" ) rather than refuse the parents and leave the child vulnerable to the other options, such as a circumcision holiday in the home country.
https://www.youtube.com/watch?v=qsqEyGdLh8I
This is a great video of interviews with Egyptian mothers. Other than the dirt street and head scarves- these women don't seem too different from any American woman... their feelings do not seem intent on causing their children harm or hurting them... they, like American mothers, only have their child's best interest in their heart- they need to conform with tradition, they think it's best, they want to protect her future chances for marriage and protect her from social stigma... it's just what is done- everyone does it! .... how is that different? Besides- they are circumcised and it's never caused them any harm! They KNOW it's normal... they know first hand it's not bad and they want their daughter to have all the good things that come from being circumcised just like they have! They don't look upset about it.
"According to Dr. Hassan Abdel Kader, general manager of Aswan's Teaching Hospital and a gynecologist, the practice has been banned from inside Aswan hospitals for approximately 20 years, with related operations performed strictly in cases of medical necessity, such as in the case of an infection."
https://www.almasryalyoum.com/en/news/fgm-pharaonic-rite-thats-hard-habit-break
Look at this quote! This Dr. says that inside the hospital they only circumcise the girls if there is a medical necissity... oh yeah... because we all know how often if happens. I wonder how many Egyptians know a girl or woman who had to be circumcised because they got infections down there? It would make sense for parents who care about their daughter's health to help her avoid that possibility don't you think?
https://aandes.blogspot.com/2010/04/circumcision.html
This mom just wrote (April 27) about her daughter's circumcision that day. She doesn't seem like such a bad lady... pretty "normal" if you ask me... and her daughter didn't even cry. It was just a tiny snip... see? You can hardly even see the little piece of her stuck on the scissor blade. Really- you can hardly even see it- how can you find fault with her actions or a doctor who would participate in this cultural custom? (rhetorical qustions of course!)