Dr. Jim Henderson, medical director for Siloam Health Care Services, Inc., uses the terms “female circumcision” and female genital mutilation (FGM) interchangeably, responding to questions from The Tennessee Star about the state’s female FGM reporting law.
Except, “female circumcision” has been rejected as an accurate description of the barbaric FGM practice by the World Health Organization, UNICEF, the National Organization for Women, human rights organizations and perhaps most importantly, by anti-FGM activists who were mutilated in their home countries like Jaha Dukureh, founder of Safe Hands For Girls:
As an infant growing up in Gambia, I experienced Female Genital Mutilation. It took away a part of my femininity, my ownership to my body. Some girls, including my half-sister who died from complications from being cut, even lose their lives.
Siloam Health serves as the Statewide Refugee Screening Coordinator for Tennessee and a primary care provider for refugees:
As you may know, every refugee that’s resettled in Nashville passes through the doors of Siloam Health for his or her initial medical screening exams. Many of these refugees eventually become our primary care patients, and it is our privilege to get to know them over time as they become a vital part of the flourishing of our community.
Dr. Henderson cited Siloam’s reliance on Wellshare International’s reference guide Providing Culturally Appropriate Reproductive Health and Family Planning Services to Somali Immigrants and Refugees which mentions “female genital mutilation” and “female genital cutting” one time each, deferring instead to the term “female circumcision.”
Wellshare International, formerly known as the Minnesota International Health Volunteers is based in Minneapolis, Minnesota, a metro area and state ranked third by the Population Reference Bureau where women and girls are at greatest risk for being mutilated and where the largest Somali population in the U.S. is counted.
Critics of the term “female circumcision” say this is an effort by multicultural feminists to normalize what some cultures consider initiation rites. In 2007, the American Anthropological Association discussed the issue with a panel of African anthropologists living and teaching in the U.S. who have been cut and support allowing it to continue in the U.S.
A recent paper published in the Journal of Medical Ethics offers an newer, more neutral term – “female genital alteration” (FGA) that will help soften the stigma of FGM. The authors claim that criminalizing FGM hasn’t worked and eradication campaigns are “sensationalized, ethnocentric, racist, culturally insenstivie and simplistic.”
Along with a rebranding of FGM, OBGYNs Drs. Kavita Shah Arora and Dr. Allan Jacobs offer a “compromise solution” that would:
accommodate cultural beliefs while protecting the physical health of girls, we propose a compromise solution in which liberal states would legally permit de minimis FGA in recognition of its fulfillment of cultural and religious obligations…
The “de minimis” types of FGA for which the doctors advocate, include “a small nick in the vulvar skin” and procedures that create structural change without negatively impacting reproduction or sexual satisfaction likening it to “procedures resembling elective labiaplasty as performed in Western nations.”
The “compromise” offered by these doctors echoes an earlier recommendation by the American Academy of Pediatrics’ (AAP) to a softened approach to FGM. In 2010, the AAP Committee on Bioethics suggested that legally allowing pediatricians to offer a “ritual [clitoral] nick” as a compromise to accommodate imported FGM adherents might avoid potentially more extensive mutilation to young girls. After significant pushback and criticism the AAP was forced to retract the idea of the “ritual nick.”
Drs. Arora and Jacobs are explicit in their condemnation of anyone and any effort to oppose any form of FGM:
labelling these de minimis procedures as ‘mutilation’ is culturally insensitive and discriminatory towards women, and that they do not constitute a human rights violation
Even worse, the doctors assert:
[p]olicies that attempt to suppress all forms of FGA that alter female external genitalia are culturally supremacist.
The doctors likewise justify the need for FGM accommodation explaining how it has been embedded in cultures through “ties to historical tradition, tribal affiliation social status, marriageability and religion, but is most frequently associated with Muslim culture” arguing that:
many Muslim scholars classify FGA as ‘Sunnah’ or practice established by the prophet Muhammad. Though not prescribed explicitly in the Quran, the practice thus is religiously virtuous. In fact, the colloquial term for FGA procedures in Arabic refers to a ritual state or purity.
Culturally sensitive accommodation of FGM in the U.S. can be a slippery slope leading into the murky waters of religious and cultural prescriptions such as wife beating, child marriage and honor violence. U.S. courts have already been confronted with the “culture defense” in a variety of criminal and non-criminal cases involving immigrants.
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