By Ayaan Hirsi Ali – AMERICAN pediatricians must not perform any form of female circumcision.
THE American Academy of Pediatrics recently put forward a proposal on female genital mutilation. It would like American doctors to be given permission to perform a ceremonial pinprick or nick on girls born into communities that practise female genital mutilation.
Female circumcision is a custom in many African and Asian countries whereby the genitals of a girl child are cut. There are roughly four procedures.
First there is the ritual pinprick. This is what the American Academy of Pediatrics refers to as the nick option.
To give you an idea of what that means, visualise a pre-teen girl held down by adults. Her clitoris is tweaked so that the circumciser can hold it between their forefinger and thumb. Then they take a needle and pierce it, using enough force for it to go into the peak of the clitoris.
As soon as it bleeds, the parents and others attending the ceremony cheer, the girl is comforted and celebrations follow.
There is a more sinister meaning to the word nick if you consider the fact that in some cases it means to cut off the peak of the clitoris. Proponents compare nicking with the ritual of male circumcision. But in the case of boys, it is the foreskin that is entirely or partly removed and not a part of the penis head.
In the case of girls, the clitoris is mutilated.
Then there is the second method whereby a substantial part of the clitoris is removed and the opening of the vagina is sewn together (infibulation). The third variation adds to this the removal of the inner labia.
Finally, there is a procedure whereby as much of the clitoris as possible is removed along with the inner and outer labia. Then the inner walls of the vagina are scraped until they bleed and are bound with pins or thorns.
The tissue on either side grows together, forming a thick scar. Two small openings approximately equal to the diameter of a matchstick are left for urination and menstruation.
Often these operations are done without anaesthesia and with tools such as sharp rocks, razor blades, knives or scissors, depending on the location, family income and education.
It is thus more accurate to speak of female genital mutilation – as the World Health Organisation does – instead of using the obscure and positive-sounding term circumcision.
According to the American Congress of Obstetricians and Gynaecologists, more than 130 million women and girls worldwide have undergone some form of female genital cutting.
Some immigrant parents from Egypt, Sudan, Somalia and other countries where female genital mutilation is common, continue this practice in Europe and the US, even though they know it is criminal. Some of them sneak their daughters out of the country during the long school vacations in summer so that they can be subjected to one of these forms of genital mutilation.
Congressman Joseph Crowley of New York recently introduced a bill to toughen federal laws by making it a crime to take a girl overseas to be circumcised.
He argued, rightly, that female genital mutilation serves no medical purpose and is rightfully banned in the US.
While the American Academy of Pediatrics agrees that such a procedure serves no medical purpose, it argues that the existing federal law has had the unintended consequence of driving some families to take their daughters to other countries to undergo mutilation. It says “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”.
But is this plausible? I fear not.
I am familiar with this debate in two ways. First, I come from a culture where almost every woman has undergone genital cutting. I was five years old when my genitals were cut and sewn. Second, while serving as a member of parliament in The Netherlands, I was assigned the portfolio for the emancipation and integration of immigrant women. One of my missions was to combat practices such as female genital mutilation.
To understand this problem, we need to begin with parental motives. The nicking option is regarded as a necessary cleansing ritual. The clitoris is considered to be an impure part of the girl-child and bleeding it is believed to make her pure and free of evil spirits.
But the majority of girls are subjected to mutilation to ensure their virginity (hence the sewing up of the opening of the vagina) and to curb their libido to guarantee sexual fidelity after marriage (hence the effective removal of the clitoris and scraping of the labia). Think of it as a genital burka, designed to control female sexuality.
When the motive is to ensure chastity before marriage and to curb the female libido, then the nick option is not sufficient.
Moreover, the nick option does not address the main problem in Western liberal democracies where female genital mutilation is outlawed, which is that it can almost never be detected, so few perpetrators are brought to justice. Even if we were to consider tolerating it in its most limited form, how could we tell that parents who want to ensure their daughter will be a virgin on her wedding night will not have her (legally) nicked and then, a few months later, (illegally) infibulated? I applaud the compassion for children that inspires the pediatricians’ proposal, but they need to eliminate this risk for little girls.
Legislation is only a first step, and even with that there is no uniformity across the US. Some states have passed bills that define such mutilation in all its manifestations and punish it. Others place it under existing laws of child abuse. So Crowley’s next move should be to push for uniform enforcement of his bill.
But even if the legislative flaws are fixed, there remains the difficult question of detection.
For the law to have any meaningful effect in eradicating female genital mutilation in the US, we need to work out a way of knowing when a girl has been mutilated. As a legislator in The Netherlands, this was for me the thorniest issue. In the US, where civil liberties are even more jealously guarded, the thorns are likely to be sharper still.
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