The ritual "nick": AAP statement on female genital mutilation

An article in The New York Times recently reported that the AAP supports legalizing the option of performing a "ritual nick" in order to prevent parents from taking their daughters overseas for more extensive genital cutting. I was curious to read the reasoning behind this position, so I looked up the AAP Policy Statement on Ritual Genital Cutting of Female Minors, recently revised in May 2010. Here is an excerpt concerned with legalizing a small "nick" or pinprick:

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. 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. In some countries in which FGC [female genital cutting] is common, some progress toward eradication or amelioration has been made by substituting ritual "nicks" for more severe forms. In contrast, there is also evidence that medicalizing FGC can prolong the custom among middle-class families (eg, in Egypt). Many anti-FGC activists in the West, including women from African countries, strongly oppose any compromise that would legitimize even the most minimal procedure. 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. 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 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.

Thoughts? Is it better to allow a "ritual nick" in order to theoretically prevent more extensive, and more dangerous, genital mutilation? Or is it ethically/morally wrong to support any form of FGM? How might these arguments apply to male genital mutilation (i.e., circumcision)?

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This is going to ruffle some feathers

Circumcision: I don’t get it. 

I’ve read through all the arguments for circumcising, and the more I read the less impressed I am. 

The very thought of cutting off a part of my newborn baby is physically repulsive to me. Even this post is difficult for me to write, because I am so upset that any mother would agree to circumcise her newborn son. How can our society condone this ritualized violence? 

I can’t write this post without letting emotion leak through. I just can’t. 

Babies need to be welcomed into this world with love and gentleness. Imagine what it must be like for a newborn: he’s been welcomed into his family with excitement and joy. He’s nursed at his mother’s breast. He’s gone to sleep on the warmth of her chest, hearing the familiar heartbeat. Then violence, and pain, and terror. And more pain. 

I can find no good reasons to cut off a beautiful, sensitive, and physiologically important part of a baby. 

I find the following justifications particularly repugnant:

• I don’t want my son to be teased. Simply put, this is utterly and completely lame. Do we give our daughters nose jobs or breast implants, because we think they might get teased? Do we supply our children with recreational drugs, because their peers would tease them if they said no?

• I think an intact penis looks “gross.” No matter what we think is aesthetically pleasing, routine infant circumcision is medically unnecessary cosmetic surgery, with its own set of risks, on an unconsenting baby. Parents would be arrested for cutting off any other part of their baby—nose, fingers, ears—simply for aesthetics.

• I want him to look like his father. My husband grew up in a mixed family. His father was intact, the 2 oldest boys were circumcised, and the 2 youngest were intact. It was never an issue. In addition, boys will look different from their fathers in many ways: body shape, vocal tone, body & pubic hair, eye color, and so on. Why is it so urgent to alter an infant’s penis? We don’t perform cosmetic surgery on baby girls to make them look like their mothers—why is okay for infant boys?

• Intact penises are dirty and smelly. That statement is incorrect. An intact penis is no harder to keep clean than any other part of the body.

• Infants are too young to remember it anyway. I am not even going to respond to this one because it is so callous.
  

I know women who feel that circumcision is wrong and barbaric, and who STILL do it to their sons. 

What lessons are we teaching our infants about the meaning of life and human nature when we tie them down and cut off parts of their bodies? This kind of trauma and violation has to leave some kind of imprint. We know that babies exposed to obstetric drugs and operative procedures have higher rates of drug addiction and suicide when they grow up. 

I started to read through this article about circumcision from Men’s Health Magazine (July/August 1998, so the US circumcision rate is lower today). I couldn’t finish it. The mother bear in me wanted to snatch that screaming, terrified baby away. I had to avert my eyes.

I just don’t get it.

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