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Taina Bien-Aime

Taina Bien-Aime

Posted: May 10, 2010 11:04 AM

First Do No Harm

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In 1994, a frightened 17 year old girl boarded a plane to flee an impending forced marriage to a much older man with three other wives. In a small room waiting for the groom, in Togo, West Africa, Fauziya Kassindja was also warned that a woman would soon arrive to excise her clitoris and other parts of her genitalia in preparation for her impending nuptials. From time immemorial, women in her community needed to be "clean" for their husbands and to gain acceptance into society. In honor of her father who had protected her until his sudden death, Fauziya refused that day to undergo the harmful practice of female genital mutilation, or FGM, and escaped. Thanks to her mother's savings, Fauziya wound up at Newark International Airport claiming political asylum. However, instead of receiving protection from the authorities, Fauziya was incarcerated for 16 months in New Jersey prisons because FGM was not yet established as persecution under United States' laws. That was about to change.

Fauziya's case generated the first massive campaign in the US that effectively broke the silence about FGM. The campaign led to a decision establishing that the threat of FGM could constitute persecution, which subsequently led to the enactment of the 1996 federal law and a handful of state laws prohibiting FGM. A number of medical associations also issued clear statements condemning FGM as a human rights violation, including the American Academy of Pediatrics (AAP). In its 1998 Policy Statement, the AAP clearly stated that it "oppose[d] all forms of FGM," counseling its members not to perform it as it would perpetuate the practice "with its cultural implications for the status of women."

Twelve years later, on 26 April 2010, the AAP has inexplicably retracted that position in its confused and ill-advised Policy Statement - Ritual Genital Cutting of Female Minors, not only downgrading the terminology to female genital "cutting," but also in effect promoting a form of FGM that would involve the "nicking" of a girl's clitoris, in order to remain sensitive to the cultural and religious backgrounds of their patients' parents.

The World Health Organization estimates that 140 million women and girls have undergone FGM, mostly in Africa, and in some countries in the Middle East, Asia and wherever FGM-practicing communities have emigrated, including the U.S. The organization classifies FGM into four types, ranging in severity, with Type IV as procedures to female genitalia for non-medical purposes, such as the "nicking" that the AAP is now suggesting US pediatricians contemplate performing on certain girls to satisfy their parents' traditional customs.

Harmful cultural practices against girls have brought us early marriage, foot binding, marriage through rape and abduction, and FGM, to name a few. Thanks to education, community outreach and political will, a few abuses have disappeared, but most persist because of efforts by conservative forces to perpetuate the status of girls as second class citizens. The revised AAP Policy Statement is at risk of mirroring this resistance to progress. Their Statement defies decades of efforts at the grassroots level across Africa and internationally to end FGM and the recognition that FGM is a form of violence and discrimination aimed at safeguarding a girl's virginity, controlling her sexuality and guaranteeing her marriageability.

Hundreds of African women - and men - have dedicated their lives to end FGM in their own communities through awareness-raising, education, and advocacy for legal and policy changes. While resistance to progress may be at times fierce, as in most social change movements, stories of girls and their families who are successfully rejecting the practice and mobilizing their communities and governments to eradicate FGM are proliferating. The AAP should honor those commitments and not seek to undermine such advances.

The international outrage to the revamped AAP Policy Statement is mounting. The Inter-African Committee on Traditional Practices and the European Network for the Prevention and Eradication of FGM are among the extensive networks that are denouncing the AAP Policy Statement and drawing their attention to the 61st World Health Assembly Resolution (WHA61.16), which urges medical personnel to protect girls from all forms of FGM. It is time for the AAP to retract their 2010 Statement.

Pediatricians must protect girls against FGM through culturally sensitive training about the unfounded myths surrounding FGM. Supporting community-based programs that could help families abandon the practice is also key. Contrary to many other countries, abysmally little has been done in the US to holistically address FGM since Fauziya was released from jail over a decade ago. Culture is fluid and dynamic and its harmful elements can also change with education, enlightenment, and the rule of law. The AAP must stand on the side of their patients. In lieu of calling for an amendment to federal and state laws that protect girls' bodily integrity, the AAP should join the movement to end FGM and ensure that pediatricians first do no harm to girls' physical and psychological well-being or jeopardize their inalienable, indivisible and universal rights to equality.

Taina Bien-Aimé is the Executive Director of Equality Now, an international human rights organization.

 
 
 
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08:06 PM on 05/24/2010
Freedom is a new charity that has been established to save the lives of vulnerable children in the UK who are at risk of, or are subjected to, Forced Marriage and dis-honour based violence. More information is available on the website at www.freedomcharity.org.uk
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Hdaryl01
09:40 AM on 05/14/2010
If men's genitals can legitimately be cut based on deference to cultural and religious mores, against their will, and without their consent, for no medically indicated reason, by extension based on equal treatment, so can women's genitals be cut. Duh.

The next ledge on the slippery slope you ladies may get to enjoy is having the accepted and entrenched cultural and religious practice institutionalized as a legitimate medical treatment a la male circumcision. Studies have shown that female circumcision offers profound health benefits......prevents any number of diseases and maladies.....and offers extraordinary benefits to its recipients.....Sound familiar?

Now, are you starting to grasp why, as I have been imploring, this debate and battle must be UNIVERSALLY about GENITAL CUTTING regardless of gender, regardless of reason, globally. Ladies, do you care to join us men in our civil and human rights battle now?

FIRST DO NO HARM has been abrogated for decades in the U.S. relative to men's genitals. Now, women get to enjoy their own just deserts....
09:21 AM on 05/12/2010
Male circumcision is more severe than removing the clitoral hood. You might want to check out this side by side comparison of attitudes toward female and male circumcision:

http://www.fgmnetwork.org/intro/mgmfgm.html

You can't be against one and not the other without being a hypocrite.
05:00 AM on 05/11/2010
HP posted some serious news, at last.
01:30 AM on 05/11/2010
FGM is abusive. Religion and "tradition" have no argument against child abuse and brutality. No parent has a right to harm their child. Allowing this to happen to their daughters is wrong. Please tell them to stop caving to peer pressure. We are living in the Dark Ages if this abuse is allowed to continue. Why would anyone think man could create a better body than God?

There is a reason our bodies have a clitoris, just like there is a reason for a penis. FGM is akin to cutting off a penis since they are the same organs in embryo. Whoever is condoning this cruelty must STOP ABUSING innocent children. The people who perform this procedure deserve to have the same thing done to them. If they can imagine having someone slicing off a piece of their genitalia, they would put an abrupt end to this morbid, sadistic, nasty business. Stay away from babies' vaginas. I can't believe this is even a discussion!!

Christine Cooney
02:29 PM on 05/10/2010
APA is pretty clean on the subject:

1. Opposes all forms of female genital mutilation (FGM).
2. Recommends that its members actively seek to dissuade families from carrying out FGM.
3. Recommends that its members provide patients and their parents with compassionate education about the physical harms and psychological risks of FGM.
4. Recommends that its members decline to perform any medically unnecessary procedure that alters the genitalia of female infants, girls, and adolescents.

http://pediatrics.aappublications.org/cgi/content/full/pediatrics;102/1/153
11:20 PM on 05/10/2010
That is the link to the old policy. Here is a link to the new revised Policy Statement:
http://aappolicy.aappublications.org/cgi/content/full/pediatrics;125/5/1088
11:33 PM on 05/10/2010
From you new link. The recommendations are still the same

The American Academy of Pediatrics:

1. Opposes all forms of FGC that pose risks of physical or psychological harm.
2. Encourages its members to become informed about FGC and its complications and to be able to recognize physical signs of FGC.
3. Recommends that its members actively seek to dissuade families from carrying out harmful forms of FGC.
4. Recommends that its members provide patients and their parents with compassionate education about the physical harms and psychological risks of FGC while remaining sensitive to the cultural and religious reasons that motivate parents to seek this procedure for their daughters.
Having said that, Bein-Aime is correct to say that AAP inserted some cowardly multi-culti nonsense.
I quote:" ... 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."
No it doesn't require that.
The female genital mutilation should be prohibited in all forms, as it is done in many civilized countries.
01:51 PM on 05/10/2010
To Frosty Grin
In my opinion, it is not OK to circumcise little boys, but you males can fight your own battles. A huge number of women would not choose to have their sons circumcised, but they have to give in to the males in their families who think that it is compulsory, and who make the decision.

Male circumcision is nothing like female circumcision, and is perpetuated for entirely different reasons.

The "equality" we women are talking about is to have the power to make our own informed decisions about our bodily integrity at an appropriate adult age, to have the recognised right to exercise our own choice about whom we will marry and under what conditions, and for men to understand that they have never had the right to own women, to arrange the future marriage partners of their daughters and to buy and sell women as if they were material goods. They have just assumed this right over generations going back so far that it has become the norm.

"Nicking" a little girls genitals is sexual abuse, an assault on the girlchild, and is a criminal offence. It is not medically necessary (any more than male circumcision is); and in fact may cause physical and psychological harm.

Please let us not have any more trite, flippant comments. This is a very serious matter.
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03:29 PM on 05/10/2010
"In my opinion, it is not OK to circumcise little boys, but you males can fight your own battles."

"You males"? Seriously?
We're all people, you know? Taina Bien-Aimé specifically mentioned "African women - and men" fighting FGM. More importantly, male _children_ can't fight their own battles. Are you seriously implying that females don't care about male children?

"Male circumcision is nothing like female circumcision, and is perpetuated for entirely different reasons."

It isn't true. The main reasons are the same:

1. Misguided notions of "cleanliness";
2. Conformist notions of "aesthetics";
3. Power and control (especially in religious rituals).

Also, it's a fact that male circumcision became popular in the US as a way to make masturbation less pleasurable.

The only major difference is that MGM is usually less invasive, and it has been "medicalized".
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Nance Cedar
Agitating for a better tomorrow.
01:50 PM on 05/10/2010
Here is the statement from the AAP. I don't see anything here suggesting that they approve FGM at any time.
http://pediatrics.aappublications.org/cgi/content/full/pediatrics;102/1/153
11:18 PM on 05/10/2010
Here is a link to the new revised Policy Statement:
http://aappolicy.aappublications.org/cgi/content/full/pediatrics;125/5/1088

The policy states: "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."
01:40 PM on 05/10/2010
This is just outrageous. Why do parents want to cut at their kids genitals?
02:34 PM on 05/10/2010
In some African and many Muslims cultures women are viewed as property to be disposed of as needed.
To them it is not much different from gelding their horses or fixing their pets.
Note that according to Sharia religious law, in certain cases, witness evidence of 4 ( !) women is equal to that of one man.
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01:14 PM on 05/10/2010
"their inalienable, indivisible and universal rights to equality"

Hey, if it's OK to circumcise little boys, why is it wrong to even "nick" a little girl's genitals? Doesn't sound like equality to me.
01:37 PM on 05/10/2010
At what point in this article did the author say it was alright to circumsize little boys?
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03:09 PM on 05/10/2010
She doesn't even mention it - even though the situation with MGM in the US is worse than with FGM. And she's a director of the organization called _Equality _Now.
04:37 PM on 05/11/2010
I agree with Frosty. This outrageous policy statement is simply an outgrowth of America's culturally entrenched disregard for children's genital integrity. This medical establishment in this country is so invested in defending the belief that a parent has the right to hire a physician to cut their child's genitals that it is only logical that they would sooner cave to expand the practice to baby girls than ever admit that infant genital cutting of any kind is a violation of human rights.