Friday, May 7, 2010

American Academy of Pediatrics on female genital mutilation

The American Academy of Pediatrics' policy statement on female genital mutilation can be found here. The statement is far more nuanced than was suggested by the original reports I read—what initially seemed blind obeisance to multiculturalism is actually an attempt to minimize harm:
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. 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.
The primary goal here seems not to be mere trust-building for its own sake, contrary to the way the policy has been publicized, but rather to find the most effective route to saving girls from having their genitals mutilated. The key worry is that mere illegalization of FGM, without offering the "ritual nick," will just result in families sending their girls back to their barbaric home countries to have the full procedure performed.

I understand why admirable groups like Equality Now are opposed to this policy, but I am not sure they are right. The danger of the AAP policy is that it may help to legitimize female genital mutilation. But the intent of the policy is to actually prevent female genital mutilation by offering a substitute which, while outrageous in itself, is far better than the alternative. It is not clear which effect is more probable. I think this is something that deserves to be tried, and carefully monitored, so we can determine empirically the fastest route to eliminating female genital mutilation.

*FGC refers to "female genital cutting"—a term which the AAP insists on using instead of the more accurate "female genital mutilation," because using the latter term is "inflammatory" and "culturally insensitive." This part, of course, really is blind obeisance to cultural relativism. Sometimes neutral terms do not accurately describe a practice.

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