The mists begin to clear on FGM statistics


Readers may recall that I have long been interested in trying to unpick the data on female genital mutilation in the UK. The general standard of debate on this topic is woefully uninformed by actual facts. News pieces and campaign materials have traditionally waved around (almost) meaningless statistics about the numbers of girls being at risk of FGM, without explaining what they mean by “at risk” or how severe that risk might be.

The numbers tend to be horrifying and this has at least two extremely serious consequences. The first is that the practice of FGM among migrant communities in the UK is used as a damning indictment of their failure to integrate, to accede to British law and custom, or more broadly as evidence the uncivilised, backwards ways of immigrants and especially Muslims.

Secondly, for many years there has been a clamorous call to demand explanations why nobody in the UK has been successfully prosecuted for conducting FGM. It has long been assumed (and not just among the spittle-flecked rabble of the Daily Mail comments section) that some sort of political correctness must be the reason why police, prosecutors, social services and child services have all been deliberately averting their gaze from the brutes who continue to cut up the genitals of little girls. But as I have written before, there is another possible explanation as to why these offences are never prosecuted – could it be because in fact these crimes very rarely happen in the UK?

This week the Health & Social Care Information Centre published their latest quarterly bulletin on FGM. This exercise (still described as ‘experimental’) collates reports from Health Trusts around the country which count the numbers of new cases that have come to light within the NHS. The vast majority of cases are adult women (mostly aged 18-39) and typically come to light during obstetrics & gynaecology care in pregnancy and childbirth.

As the headlines explained, this latest quarter found around 1200 new cases of FGM. For the first time, however, the data included some numbers for where the women and girls were born and where the FGM procedure had occurred.

Before I go any further let me stress that the statistics here are patchy and incomplete. We are only considering newly discovered cases, not the total, and there are huge holes in the data sets where the relevant information could not be or was not recorded. Nonetheless the numbers are revealing.

Of the 1242 cases, there were 532 where the country of birth was recorded. Of those, precisely 11 cases were of girls or women born in the UK. That means that 98% of cases of FGM in the UK (from this data set and where the info was logged) were on women born outside of the UK.

Even more usefully, there were 319 cases in which the data recorded where in the world the FGM was undertaken. Of those, seven were reportedly undertaken in the UK. Again, 98% of FGM procedures happened outside the UK.

These numbers 11 cases and 7 cases respectively) are so tiny we should be aware of the risks of data errors and statistical noise. For instance, genital piercings can be classified as Type 4 FGM (in some cases this is legitimate and accurate – piercings are sometimes inflicted upon girls as a form of FGM) but it does create obvious scope for confusion and miscategorisation.

There is one incredibly important question which the HSIC still fails to address or answer: How many of the 1242 new cases of FGM are women who were already resident in the UK before they were mutilated? If we had an answer to that question, everything would suddenly become a lot more meaningful. In the meantime, what is this data telling us? It looks to me like what we are seeing is that relatively large numbers of women who move to the UK from FGM-practising countries such as Nigeria, Kenya and Somalia have already been cut when they move here. This should be a clear and uncontroversial point. There is an obvious and serious need for health professionals to be aware of this and to have the expertise necessary to provide these women with the care and medical treatments they might require to heal the damage.

The other key takeaway from the data is that amongst girls who have been born in Britain, even to communities where it has been traditionally practised, FGM is exceptionally rare. For years we have been told that anything up to 120,000 girls in the UK are “at risk” of FGM, an estimate based on numbers of girls born in the UK to families from the relevant parts of the world. If the true numbers were anything even vaguely on this scale we would expect to see far, far more new cases coming to the attention of the authorities.

To be clear, we cannot be sure from this data that there aren’t lots of girls who are born elsewhere, brought intact to the UK as children, taken out of the country to be cut elsewhere and then brought back again, but this really seems something of a stretch to me. A more credible interpretation of the data would be that FGM remains a huge medical and human rights catastrophe in many parts of the world, but that when people move to the UK, with very few exceptions, they abandon the custom.

We still don’t have the statistics to speak about any of this with authority. As the academic cliché would have it, more research is necessary. If I had one wish on this front, however, it would be that when journalists, campaigners and politicians talk about the thousands of women in Britain who have suffered FGM they explain to people that the vast majority were living elsewhere when it happened. That little nugget of nugget of knowledge entirely transforms the debate and would do so in a much more constructive direction.

Comments

  1. sonofrojblake says

    seven were reportedly undertaken in the UK

    How many boys had their genitals mutilated legally over the same period? Prediction: more than seven.

  2. StillGjenganger says

    @so0nofrojblake.

    Politically, FGM and circumcision are almost exactly opposite.

    FGM is universally condemned, but there is immense ignorance about how common it is, who does it where, exactly which operation(s) we are talking about etc.

    With circumcision we know exactly what is involved, how common it is, and what happens. The disagreeement is about how we should judge it.

    Could we try to keep the two discussions separate?

  3. 123454321 says

    Brilliant article with one massive omission i.e. who (interpret, please, as which gender) is responsible for promoting, encouraging, maintaining and perpetuating this retarded and barbaric custom? Hint: the answer doesn’t align with what we’ve been told by Western Feminists over the last few decades, you know, the type who have consistently lied on the likes of Woman’s Hour and have now successfully indoctrinated millions of people with nonsense, baseless factoid FGM pseudoscience that has no intent other than to blame men.

    Well done, Ally, for pulling some meaningful stats together. Hopefully Woman’s hour researchers will tune in and start spewing their coffee! FGM is appalling but let’s hope the media have the decency to start reporting the facts and stop using stuff like this as a feminist weapon against western men!

  4. sonofrojblake says

    With circumcision we know exactly what is involved, how common it is, and what happens

    Really? Because it was relatively recently I found out some of the things that happen, and it turned my stomach.

    http://www.huffingtonpost.com/2014/08/05/jewish-mohels-banned_n_5650672.html

    And why, exactly, should the discussions of the deliberate unnecessary mutilation of the genitals of children by adults for spurious “cultural” reasons be kept separate on grounds of the gender of the children? Explain carefully.

  5. That Guy says

    @123454321

    ….what? I have never heard of FGM being used to blame/blamed on western men.

    90% of the time it is widely accepted that the practice is enforced by the matriarchs in the family, with only the literal cutting being done by (usually assumed to be non-western) doctors. And that’s only when the cutting takes place in a medical setting.

  6. StillGjenganger says

    @Sonofrojblake
    I could answer in kind: “Why should a harmless, cosmetic change like circumsicion, much like straightening teeth or removing adenoids, be confounded with something damaging and indeed crippling like FGM, just because both involve the genitals“? Because that is how I see it. But no matter how loud you shout it, there really is no use in just assuming that your way of seeing the world must be the basis for all debate. They are different activities. One is generally agred to be mutilation. One is widely (but not univerally) held to be harmless. I do not particularly want to debate circumcision – I have said all I had to say in other debates. But whatever we might disagree on, mixing up the two debates can bring nothing but confusion.

  7. sonofrojblake says

    That isn’t an answer in kind. My question was limited to factual assertions. Yours includes matters of opinion, such as the use of the word “harmless”. It is demonstrably not harmless – did you even read the link?

    The general principle in civilised countries is that irreversible cosmetic body modification (e.g. tattoos) is only permissible on adults who give informed consent. An exception is made for circumcision because reasons.

  8. That Guy says

    @StillGjenganger

    I agree that conflating FGM with male circumcision is not a Good Idea- as the two are as you point out, politically different phenomena. (for us).

    But I AM kind of revolted that you consider it a ‘harmless, cosmetic’ procedure. Not wishing to take the bait on this, but both procedures are probably considered “harmless” by the cultures that practice them. I will never forget hearing from US men and women that “I’d probably get my son circumcised because I wouldn’t want him to be different”.

    I’m sure you have (maybe valid) objections but like you said, this is a FGM thread.

  9. StillGjenganger says

    @SonOfRoj
    Not so, Roj. You use the loaded word ‘mutilation’, implying that the activity is horrible and damaging, and describe the reasons for doing it as ‘spurious’. That is your opinion, but it is no more factual than my calling it ‘harmless’.

    @ThatGuy.
    Fair enough. I am happy to leave it there.

  10. 123454321 says

    StillG, I’m slightly shocked to hear your views on MGM, coming from you, especially. Not a debate for here but you’d better stick to MGM facts otherwise I’m gonna slaughter your ‘opinion’ of MGM at a convenient and appropriate rendezvous sometime in the future. Can hardly wait.

  11. 123454321 says

    ThatGuy#5

    “….what? I have never heard of FGM being used to blame/blamed on western men…..90% of the time it is widely accepted that the practice is enforced by the matriarchs….”

    Now come on, let’s play straight. I’ve been around long enough to have seen the finger of blame pointed squarely at the patriarchy (which by definition includes western men) more times than you can shake a stick at. I can’t recall even once where I’ve heard anyone specifically blame women or the matriarchy. Your 90% figure is massively inaccurate and I’d suggest that the feminist narrative has seen that 90% of people have been brainwashed into believing everything is the fault of the patriarchy!

    I’ve just searched google and there are hundreds of links like this:

    http://www.theguardian.com/global-development/poverty-matters/2014/jul/24/patriarchy-child-marriage-female-genital-mutilation-fgm-feminism

    The last FGM debate I heard on Woman’s Hour persistently regurgitated the notion that patriarchal values that oppress women must be broken down in order to fight FGM.

  12. That Guy says

    @123454321 #11

    OK, so it’s clearly established that you don’t know what “patriarchy” means. Super. I’ll let you try and reason yourself out of your victim complex, since you’ve demonstrated that you’re smart enough to use google, that should be enough to get you started.

    Cheers!

  13. Holms says

    #3 1234
    Brilliant article with one massive omission i.e. who (interpret, please, as which gender) is responsible for promoting, encouraging, maintaining and perpetuating this retarded and barbaric custom?

    Omission? That implies your question wasn’t answered but should have been. But why would we expect this report to answer your question, or even attempt to ask it, when the nature of the stats gathered are unrelated to that question? You are trying to paint it as if there is an intentional hush-up, when it is simply natural that particular types of data can only shed light on particular questions.

    Also, see #5.

    #4 sonof
    And why, exactly, should the discussions of the deliberate unnecessary mutilation of the genitals of children by adults for spurious “cultural” reasons be kept separate on grounds of the gender of the children? Explain carefully.

    Some discussions are of multiple related topics. Other discussions are of only one topic. Why should all discussions should be broad, and none focused on just one. Explain carefully. (I think it is reasonable to sometimes discuss both, and other times only one.)

    #6 StillG
    I could answer in kind: “Why should a harmless, cosmetic change like circumsicion, much like straightening teeth or removing adenoids, be confounded with something damaging and indeed crippling like FGM, just because both involve the genitals“?

    Tooth straightening has a medical function. Adenoid removal has a medical function. The medical function justifies their use on a minor.

    Circumcision sometimes has a [note: nudity] medical function, and hence is sometimes medically justified for use on a minor. Cosmetic use on the other hand? Much like any other cosmetic surgery, this should be left at the discretion of the person once they have reached majority.

    #12 1234
    Now come on, let’s play straight. I’ve been around long enough to have seen the finger of blame pointed squarely at the patriarchy (which by definition includes western men) more times than you can shake a stick at.

    No it doesn’t. A patriarchal culture is simply one in which men of that culture are generally dominant, and the women of that culture generally subordinant. A tiny fringe of the more ridiculous tumblr feminists might claim that ‘the patriarchy’ is some sort of world spanning group that crosses all national and cultural boundaries, but that is as ridiculous as those MRAs that ascribe the same global nature to feminism. Don’t conflate the tiny minority with the mainstream.

  14. StillGjenganger says

    @Holms 15
    My argument was with assuming without argument that FGM and circumsicion are effectively the same thing, and with going off topic to discuss circumcision. You are not addressing my argument, you are simply going off topic to discuss circumcision. I could be tempted – I like a good scrap – but in the interest of the spectators, and out of respect for Ally I think we should stick to FGM for now.

  15. sonofrojblake says

    @StillG, 9:

    You use the loaded word ‘mutilation’, implying that the activity is horrible and damaging, and describe the reasons for doing it as ‘spurious’. That is your opinion, but it is no more factual than my calling it ‘harmless’.

    The word “mutilation” means “an act of physical injury that degrades the appearance or function of any living body”. This is a factually accurate description of circumcision. If you chose to infer “horrible”, well, perhaps you should think about why, but it is not “loaded” – it’s a factual description.

    And the word “spurious” means “based on false ideas”. If you’re here to argue that the religious and cultural so-called “reasons” for circumcision are true and accurate ideas, I think you might be in the wrong place.

    [FGM and circumcision] are as you point out, politically different phenomena

    Well yeah – one happens to women and girls, and Matters, the other happens to boys, and Doesn’t Matter And We Mustn’t Bring It Up.

    And there I’ll leave it.

  16. StillGjenganger says

    @SonOfRojBlake
    ‘Body modification’ means ‘an act that permanently changes the appearance or function of a living human body’. Factually that is identical to your definition of ‘mutilation’, except for the loaded words (‘injury’, ‘degrades’). In the same way ‘spic’ and ‘latino’ (or’hispanic’) refer to the same people, just with a different emotional load. There is an even more obvious example, but I have avoided that out of respect for US sensibilities – it starts with ‘N’.

    If you do not see the distinction you are being (deliberately) obtuse.

  17. StillGjenganger says

    @SonOfRojBlake
    Have you considered that gender reassignment surgery is ‘an act of physical injury that degrades the function of a living human body’? If you maintain that your definition of ‘mutilation’ is purely a matter of fact, you will have to agree that gender reassignment surgery is mutilation. Do you? Or can you see that this is not a purely factual question?

  18. H.E. Pennypacker says

    @Ally

    Nice work on the statistics – interestingly though I see the Guardian is running an article that specifically brings up the figure of 11 girls born in the UK to prove how many girls born in the UK are at risk. Strange logic.

    @sonofrojblake

    And the word “spurious” means “based on false ideas”. If you’re here to argue that the religious and cultural so-called “reasons” for circumcision are true and accurate ideas, I think you might be in the wrong place.

    Not meaning to pile on, but I have to agree with Gjenganger here. You seem to have made the common error of assuming that other groups have culture which blinds them from the truth, while you are culture-free and can see the facts. It’s like above where Ally says that “FGM remains a huge medical and human rights catastrophe” in much of the world. This is the point of view as expressed from his own culture – a more objective interpretation would be that the West has not managed to impose its customs and morals on this part of the world as much as many Westerner’s would like.

  19. That Guy says

    @StillG #19

    Trim it on the Transphobia. Gender Reassignment therapy is (contrary to what the internet armchair psychologists will tell you) a medical treatment for gender dysphoria. I understand that you’re probably only using this as a rhetorical device, but referring to SRS and gender reassignment in general as “mutilation” is a favoured tactic amongst those who want to degrade trans* people and deny them treatment. Contributing to this is not helpful.

    @ H.E #20 I’m not too sure I understand the latter part of your post- particularly

    It’s like above where Ally says that “FGM remains a huge medical and human rights catastrophe” in much of the world. This is the point of view as expressed from his own culture – a more objective interpretation would be that the West has not managed to impose its customs and morals on this part of the world as much as many Westerner’s would like.

    Are you saying that the revulsion at FGM is purely based on a form of cultural imperialism, and not because independent of culture, it is a horrific practice that causes demonstrable harm to the people it is done to, including complications in childbirth and denying people sexual pleasure?

    I would be interested if you could elaborate.

  20. 123454321 says

    ThatGuy,

    “OK, so it’s clearly established that you don’t know what “patriarchy” means.”

    Err, yes I do know what patriarchy means, thank you very much. I also know how much it has been relentlessly pinned with blame (particularly by feminists) for its ‘perceived’ association with negativity and problematic, social issues along with little else. Go ask anyone on the street what their perception of patriarchy means and they’ll come back with words like: dominance, overruling, MALE, power, oppressive, MEN, control, BOYS, commanding, supremacy etc. Then ask them why FGM exists and who is responsible and they’ll soon equate the two in an unremarkable feat of social conflation ignorance. Woman’s Hour has done it on many occasions (bravo), along with other countless debates held in the public media arena. Bravo for attracting all those listeners and then successfully indoctrinating them with bullshit.

    Even if there is such thing as a patriarchy, it certainly hasn’t done very well for the constituents who supposedly make up the group! I think you’ll find the new definition of patriarchy will include words like: protectors, providers, world-shapers, doers, risk takers, founders of politics and economy etc. Not the current bullshit taught in gender studies classes whereby the single-most fundamental goal is to write and teach around a syllabus that is designed to attract women and girls (and some men of course) who are, strangely for some reason, not attracted to the idea of becoming an Engineering Designer or forklift truck driver or working long, unsociable hours in a dirty and dangerous environment. Money? Supply and demand? See?

    Scapegoat and unadulterated ignorance based on a complete lack of flexible thinking springs to mind. Dear oh dear!

  21. StillGjenganger says

    @ ThatGuy 21
    Well, that is rather my argument. In cardboard cutout:
    1) By Rojs definintion, gender reassignment surgery would qualify as mutilation.
    2) (implicit) This is surely wrong, and I assume that Roj agrees.
    3) Therefore Rojs definition is wrong (and I hope he can see why).
    It sure was not intended to offend anybody – and we can hardly have a situation where certain opinions can not be stated, not even in order to disagree with them.

    On the other argument:
    All this cultural realtivism stuff is quite tangled. It is surely true that different cultures see things differently, that some African cultures see FGM as a good and justified thing, and that we have our own cutural biases and blindnesses. The question is how we should deal with it. We can not say that everybody is equally right. We may not be able to actually prove that our ideas are the right ones, but we do have to make judgements, and we are pretty much forced to make them based on our own values and thoughts. As I see it, the right reaction is to be a little less cocksure about how our own ideas are obviously true, to at least consider the possibility that the other side might be as right as we are, and to be a little humbler about it in the (quite common) cases where we end up forcing our values on everybody else.

    All I think HEP is saying is that if we suspend the discussion on which side is right we have a case where two in principle equal cultures see this practice differently. Which is true, and neutrally put. That does not necessarily mean that he thinks FGM is an acceptable practice or that we should let it pass, only that we should be aware that in so doing we are indeed imposing our values on other people who do not have to share them.

  22. 123454321 says

    Holms, I have no idea what you are trying to say in #15 but my question as to who is responsible is entirely justified if we want to seek the truth and potentially exonerate “the patriarchy” from incorrect assumptions as well as put an end to FGM.

    Pointing the finger at the patriarchy without factual evidence really isn’t helpful anymore. It really is that simple.

    I would like to see these barbaric lunatics who encourage and perpetuate FGM reeducated and prevented from operating. I respect what Ally has pulled out, but unfortunately it’s not enough.

    Part of breaking down the barriers when it comes to understanding FGM is to absolve current blame based on assumptions and perceptions that aren’t based around factual evidence. Then we start again, properly.

  23. sonofrojblake says

    @StillG, 18:

    ‘Body modification’ means ‘an act that permanently changes the appearance or function of a living human body’. Factually that is identical to your definition of ‘mutilation’, except for the loaded words (‘injury’, ‘degrades’).

    Fair enough. But this, from the NHS website: “There is no legal age restriction on most body piercings, but performing genital or female nipple piercing on someone under the age of 18 could be considered an offence.” Interesting, once again, that if you thus assault a woman/girl, that could be considered an offence, but if you want to stick a sharp object through the nipple of a boy of any age for no good medical reason, crack on.

    As a civilised culture we generally frown on (to the point of outlawing) making permanent changes to people’s bodies without their permission unless there’s a medical reason.

    @H.E.Pennypacker, 20:

    the West has not managed to impose its customs and morals on this part of the world as much as many Westerner’s would like

    There are a few things to unpack there.
    First – I don’t think it’s imperialist or arrogantly “culture-free” to adopt as a principle that cutting parts off the bodies of defenceless and non-consenting children is wrong unless there’s an immediate medical reason to do so.
    Second – apart from anything else, “the West” hasn’t adopted that principle, which is my problem. They’re quite happy to lambast the nasty brown people for cutting their girls, but heaven forbid we say anything about cutting boys because we might offend some other people we really, really mustn’t do anything to offend in any way, and besides they’re white and have had a simply awful time recently so here, let me sharpen that for you.
    Third – the West at this point is only slightly concerned with imposing its customs and morals on the disgusting holes where this practice is common. They’re more concerned with ensuring that immigrants to the West don’t bring their barbaric ways with them. And what Ally is pointing out is that, from the actual stats, it seems they don’t, much, at all. Which is a good thing… isn’t it?

    1) By Rojs definintion, gender reassignment surgery would qualify as mutilation.

    Indeed. My definition was, I’ll grant, incomplete, because I didn’t foresee anyone being so dense as to bring up such a disingenuous and easily-demolished objection. I took it for granted that immediate medical need was a blindingly obvious exception, otherwise tooth extraction, appendectomy and amputation would count as mutilation. I apologise for overestimating you and shall endeavour not to do it again.

  24. That Guy says

    @ StillG #23

    I assumed that was where you were driving, and thank you for clearing that up.
    Why I don’t necessarily buy 1), the issue I have is that a great many people vehemently disagree with 2) and use it as a political device. That is, they use the same argument to argue against trans* rights (almost word for word), and it isn’t immediately clear without making 2) explicit where you fall.

    I don’t mean to censor with my censure, rather that there are likely better ways of stating your argument or better metaphors to use that don’t contribute (inadvertently or otherwise) to the idea that trans* people should be denied treatment, particularly in this volatile time of bathroom bills.

    (as an aside, I disagree with your argument, but FGM thread…)

    I agree that discussions about these matters can become tangled, but I also feel that there are times when too much caution or too much timidity can be harmful. A common tactic in right wing spheres is the homogenisation of communities- every time there is a vaguely islamic atrocity there are cries of “speak out!” directed at a vague and ill-defined “muslim community”. This can cause problems for numerous reasons, not least that expecting everyone of a particular identity to conform to a “community” like a hive mind is a little bit racist.

    Similarly, SOME (#notallactivists) on the left, in distancing themselves from debates like this, homogenise members of “other cultures” into one group with selected spokespeople. This is not the best way of going about matters. It’s far more eloquently put here, and I would strongly recommend this article.

    http://www.theexmuslim.com/2016/03/28/regressiveleft/

    @ 123454321 #22

    ;0)

    xx

  25. StillGjenganger says

    @SonOfRojBlake
    There is no getting out of it. The operative statement would be (I think) that ‘body modification is a serious step and should not be done on minors unless there is good and sufficient reason for allowing it’. But what is a ‘good and sufficient reason’ is a value judgement. Jews think Gods command is a ‘good and sufficient reason’, and a number of Africans think tribal custom is a ‘good and sufficient reason’. Even medical need is not really a clear criterion. People’s bodies can function perfectly well with crooked teeth, harelips, very short stature (under 4 foot), exrtremely ugly noses, or mildly intersex genitals. So when is it ‘medical need’ to change this, and when is it ‘cosmetic surgery’, which should presumably wait till adult age? As for gender reassignment surgery, it is very much a matter of definition (and quite controversial too) whether that is a ‘medical need’, a life-enhancing service (like cosmetic surgery for a burn victim), or something much worse that I do not need to mention as neither of us would agree with it.

    Your value judgements are just one possible choice among many – they do not become impersonal facts just because you (or I) happen to believe them.

  26. Holms says

    #16 StillG
    My argument was with assuming without argument that FGM and circumsicion are effectively the same thing, and with going off topic to discuss circumcision.

    It baffles me that you regard them as being dissimilar. They are both surgical modifications to genitals, both for primarily cultural reasons (as opposed to medical), and both nearly exclusively performed on minors. Hence, they are both surgeries performed on people that have not given informed consent; something that is normally only considered ethical if the surgery is medically indicated.

    That’s pretty damn similar.

    #21 That Guy
    Trim it on the Transphobia. Gender Reassignment therapy is (contrary to what the internet armchair psychologists will tell you) a medical treatment for gender dysphoria.

    That’s pretty much the point he is illustrating: ‘mutilate’ is definitely an emotionally loaded term, as demonstrated by the fact that we don’t tolerate it as a description for SRS. sonofroj is the one claiming claiming that it is a totes neutral term, implying that he would use it as a descriptor for post-op trans people.

    #24 1234
    Holms, I have no idea what you are trying to say in #15 but my question as to who is responsible is entirely justified if we want to seek the truth and potentially exonerate “the patriarchy” from incorrect assumptions as well as put an end to FGM.

    And I’m pointing out that you are demanding this answer from a dataset that is not related to your question.

  27. StillGjenganger says

    @That Guy 26

    Too much timidity can indeed be harmful, but I cannot follow that person you linked to. Near as I can understand (it is hard to read without a PhD in a relevant subject) she is proposing Hijab wearing and ‘Guess culture’ (the practice that requests are hard to refuse, and that it is therefore very rude to make a request unless you are pretty sure it will be granted) as practices that are objectively wrong and that anyone should be against without too much worrying about understanding the culture they are part of. Essentially she seems to be defending her right to insist on her own interpretation of the world when – well basicallly whenever her own interpretation of the world deems it to be right. That is rather too much self-justification for my taste.

    As I see it, there are two perfectly good principles that sometimes conflict: 1) we should try to improve things for all people, not just for people who happen to share our own culture. 2) Other people and cultures have different perspectives that are in principle no worse than ours, and we have no right to impose our views on theirs. So, like a judge called on to mediate between conflicting paragraphs of the humen rights declartation, we need to decide which way to tilt in each individual case. My solution would be to impose my views, unashamedly, on occasion, but to require a higher threshold of (in)action before going against cultural difference. So, for FGM I would say that the harm is so serious and so obvious that it would override my respect for other cultures right to do things their way – whereas I think the balance goes the other way for circumcision. For ‘Guess’ v. ‘Tell’ cultures I would say that it s nobodys business how people prefer to interact. For Hijabs I would say that I am generally against, but that it is not up to me to decide how Muslims prefer to organise themselves. I would, however say, that the norms of my, European, society say that people should show their faces when they talk, so that even if people have the right to wear the niqab, I have the right to refuse to talk to them, or sell to them, while they do. I do not claim to be a philosopher, but I think this approach has two advantages: It drives the discussion towards the concrete and objective costs of any given practice, and it makes explicit the unavoidable fact that people (mostly majorities) will sometimes have to impose their views.

  28. StillGjenganger says

    @Holms 28
    FGM and circumcision are similar in many ways, different in others. The problem is that Roj did not argue that they should be treated the same, he just took it for granted that they were indistinguishable, so that the condemnation bestowed on one automatically belonged on the other as well. That is as far as I can go without getting off FGM altogether.

  29. That Guy says

    @StillG #29

    No, that’s not what was said. I didn’t find the article that hard to read, are you a non-native english speaker by chance?

    The Gist is – when we talk about “culture” we do so in a way that homogenises (=makes and treats everyone the same) and when we are timid and defer to ‘spokespeople’ from ‘other culture’ we (by we I mean left leaning activists) take for granted that what they say is uniformly true for all members of the group we have deemed part of the ‘other culture’.

    This is prone to issues, as the ‘spokespeople’ selected by the left, or who are in the ‘opportunity to put themselves forward’ are more than likely the privileged members of that ‘other culture’ group (hereafter referred to as OCG).

    Let’s take the example of the Hijab. So, to many in western european culture, the notion of covering the bodies of women in this way is alien, and to some, distressing. So, we select a Spokesperson from OCG. here are two possible outcomes (many are possible)

    1)OCG Spokesperson is a prominent religious figure, say an Imam or similar. This person downplays what are seen as regressive and oppressive elements of this practice, and we on the left west europe are soothed. HOWEVER, the religious figure has a vested interest in protecting his members from prejudice (understandably) or is part of the political establishment of a theocracy where veiling is a common practice. In this case, the Spokesperson’s views cannot be taken as that of the whole of OCG.

    2)OCG spokesperson is a veiled woman from western europe or similarlarly permissive area. They claim that veiling is ‘her choice’ and is simply a way of remaining modest in the sight of god. We are soothed as what at first appears patriarchal and oppressive is cast in a almost feminist light. HOWEVER, this person’s upbringing and freedoms are not the same as other members of OCG from insular communities or poorer members of OCG from an area where theocracy is the norm. In that case, her views ‘Choice’ cannot be extended to members of OCG where veiling is not a choice, either by family influence or the ‘morality’ police and veiling laws in some countries.

    In both cases, (and all realistic cases, I’d wager) the ‘spokesperson’ is a privileged member of that OCG, whose motivations or experiences are atypical of people in that OCG, particularly the most vulnerable in that OCG. Consider a similar scenario playing out in relation with the Hindu caste system- what caste is most likely to have the resources, upbringing and wherewithal to be able to engage with media organs which influence public opinion?

    The point amongst these points is that ‘cultures’ as we are describing them here are made up of many discrete (and most importantly) different individuals. In that case, and specifically FGM, the only opinion that matters are of the person being cut. and as a child, they often are not informed accurately about the risks, reasons or thinking of the procedure, which often causes (as said before) concrete, physical harm. Parents, medical staff, or whatever “community leaders” that are consulted in this all have motivations of their own, “it was done to me so it should be done to her”, “if this procedure is not done, she will become promiscuous and bring shame on our community etc).

    In this, I don’t think it’s inappropriate or culturally imperialist to suggest that procedures without medical benefit should not be performed on children, not lest ones that are aimed at controlling a child’s future sexuality or membership of faith.
    (on male circumcision, I agree maybe there’s room for debate on medical benefit, but I personally feel it falls into this category, FGM I would say definitely does, and “correcting” the genitals of intersex children I feel also falls into this category).

    Now. I am not saying that western nations should all tool up and invade countries where FGM is common practice and set up forcible re-education camps. This is neither practical nor particularly ethical. and I am also not saying that ‘western cultures’ are the ‘best cultures’. Open a newspaper. You will see we are far from flawless.
    What I AM saying is that fear of critically examining what people from ‘other culture’ groups are saying (and the position from which they say it) is not particularly smart, and ultimately lets down the people most in need perceived to be from those groups.

  30. StillGjenganger says

    @That Guy 31
    Yes, yours is a good account of her main point, wheras I concentrated on a minor point that I feel is more important and more relevant here. The main problem is not really which spokesman we choose to listen to. Once we have listend enough to get a balanced picture of the situation, the big problem remains: how do we deal with the conflict between wanting to get rid of something that we think is wrong (by our norms), and not wanting to impose our norms on other groups that do not share them. And her solution sounds uncomfortably like ‘listen to the people who agree with you and ignore the rest’. At the least it gives people full freedom to ignore the viewpoint of different cultures whenever they feel like it.

    I quite agree that we should critically examine what people from various groups are saying, and decide for ourselves whether we find their practices acceptable. I just think that once we have decided that we do not like this or that practice, we should ask a couple of additional questions: ‘How much damage does this actually do?’ ‘What would happen if I just left this alone, that would be worse than the (undoubted) cost of imposing myself over other people and taking away the (undoubted) subjective benefit they get from doing things their way’?

    When we are talking FGM the costs of letting things continue are obviously so serious that we need to take a stand. But with circumcisions, just how much actual suffering (as opposed to violation of abstract ideological principles) are caused by correctly executed circumcisions? Are we really intefering to prevent suffering, or mainly to affirm the superiority of our own ideology? As for the Hijab, I want rid of it too, but it seems clear to me that what is needed is a cultural change among Muslims. And that is something that can realistically be achieved only by people who are part of and identify with the Muslim community. It does not help for western (post)Christians or people who have explicltly rejected their Muslim upbringing (you can renounce your faith without renouncing your solidarity with your community) to wade in and tell Muslims how they (or their daughters) are allowed to dress.

  31. StillGjenganger says

    @That Guy 31

    I guess I am asking: “When should we decide that, even if we disapprove of some practice that some other culture has, we should still leave them alone to do thing their way“? If the answer is “never“, how is that different from the old cultural imperialism? If not, what criteria would you apply?

  32. H.E. Pennypacker says

    @sonofrojblake

    First – I don’t think it’s imperialist or arrogantly “culture-free” to adopt as a principle that cutting parts off the bodies of defenceless and non-consenting children is wrong unless there’s an immediate medical reason to do so.

    I agree that imperialist is rather a strong word which is why I didn’t use it myself. But here, the concepts you use to make the case against these practices are culture-free universals, but are culturally specific. For instance, the idea of “non-consenting children”: the notion of “consent” here is based on a specific idea of individual agency based on the exercise of free will which many cultures don’t share; “children” has also meant many things in many different times and places. Neither of these are objective categories. Again “medical reason”. Here you mean “Western medical reason”, but even that is a gross generalisation because two English doctors who work at the same hospital might disagree on whether a procedure was “medically necessary”, let alone an English and a Swedish doctor.

    Second – apart from anything else, “the West” hasn’t adopted that principle, which is my problem. They’re quite happy to lambast the nasty brown people for cutting their girls, but heaven forbid we say anything about cutting boys because we might offend some other people we really, really mustn’t do anything to offend in any way, and besides they’re white and have had a simply awful time recently so here, let me sharpen that for you.

    I agree on the level that, if I have children, I’m definitely not going to have them circumcised, whatever their gender. I guess I differ on how much I think my own view should be imposed on other people.

    Third – the West at this point is only slightly concerned with imposing its customs and morals on the disgusting holes where this practice is common. They’re more concerned with ensuring that immigrants to the West don’t bring their barbaric ways with them. And what Ally is pointing out is that, from the actual stats, it seems they don’t, much, at all. Which is a good thing… isn’t it?

    You speak of “disgusting holes” and “barbaric ways” and yet deny any cultural arrogance?

    I think the question of whether it’s a good thing that we try to stop them practicing their culture here is an interesting one. I have no problem with that, I just wish we’d be more honest about it. That’s what I admire about the French: they actually say “if you want to come here you have to learn to be more like us” (obviously they have a lot of problems with how they integrate the immigrant population and I’m not holding their model up as an example by any means, I just appreciate their honesty). We say we want to be multicultural, but we mean “only if you agree to jetison all the bits of your culture that we find disgusting, offensive, or morally wrong”.

    I remember when I was in school they told us to respect everyone’s religion, culture, gender, sexuality. There were psoters in every classroom, and we had assemblies about it. The thing was, many of the kids in my school came from cultures, or believed in religions, that didn’t respect people’s sexuality. The policy of the school, from what I could tell, whenever a kid brought up the fact that their religion was against homosexuality and that the teacher needed to respect their religion, was to claim with as much authority as you culd muster that their religion didn’t oppose homosexuality in any way. Luckily for the teachers, I never heard anyone able to drop any scriptures in support of their bigotry, but many religions are plainly opposed to homosexuality. Just to be clear, I fully support prioritising respecting people’s sexuality over respecting people’s religion in this situation.

    @thatguy

    Are you saying that the revulsion at FGM is purely based on a form of cultural imperialism, and not because independent of culture, it is a horrific practice that causes demonstrable harm to the people it is done to, including complications in childbirth and denying people sexual pleasure?
    I would be interested if you could elaborate.

    Well I think that “FGM” covers a very broad range of practices, carried out in a wide range of places by many different peoples for a huge number of reasons. I don’t think that anyone here is in any position whatsoever to claim that it is “a horrific practice that causes demonstrable harm to the people it is done to, including complications in childbirth and denying people sexual pleasure”. In fact, on a previous thread on this topic on the blog an academic who herself had been circumcised. She was very positive about her own experience and produced a study that seemd to show that it didn’t decrease sexual pleasure. I don’t deny that it has risks, but so do many of the things that people do. I’m not saying it is all roses and peaches everywhere, but nobody here knows enough about it to be able to condemn it outright as an objectively awful thing.

  33. StillGjenganger says

    I think the question of whether it’s a good thing that we try to stop them practicing their culture here is an interesting one. I have no problem with that, I just wish we’d be more honest about it. That’s what I admire about the French: they actually say “if you want to come here you have to learn to be more like us” […]. We say we want to be multicultural, but we mean “only if you agree to jetison all the bits of your culture that we find disgusting, offensive, or morally wrong”.

    Exactly so.

    Tolerance of diversity is seen as an absolute moral good, around here – except that we really treat our own basic principles as absolute moral goods as well, which the ‘diverse’ people have a moral duty to agree wth. The two principles are incompatible, and denying this leads not only to confusion, but to a lot of people selectively chosing whatever principle is most convenient in any given case, and claiming that they are absolutely morally right all the time. Paradoxically I think we might be sometimes more tolerant, and certainly easier to get along with, if we simply said “A society needs certain norms. These are ours, this is what we will accept, and this is what we will not.” You might be less eager to impose your norms all the time – be it on minorities or on bigots – if you acknowledged openly that this is what you are doing. Take trans* people for instance. The current debate is between two positions: Either you are really, totally only, a man if you say you feel you are, and you behaviour, history and body are irrelevant. Or you are really,only, the gender that matches your biology, and your feelings are irrelevant for how you should be treated. Would it not be nicer all around if we could ask “Whatever these people ‘really’ are, they want to be treated as (say) women. We have the right to decide, but what is the problem (case by case) in treating them as they want, whatever we may privately think?”

    on a previous thread on this topic on the blog an academic who herself had been circumcised. She was very positive about her own experience and produced a study that seemd to show that it didn’t decrease sexual pleasure.

    I read that too. It was persuasive – but it was not quite enough to convince me. I regard it as an accepted fact that FGM, as actually practiced, causes a lot of medical problems, sexual dysfunction etc., but it certainly possible that this is (mostly?) due to incompetence and lack of hygiene (much as the complications fo circumcision). And it is almost a given that some forms of what we call FGM (clitoral hood nicks?) could be done without risk. It is quite plausible that the reaction to FGM started as a matter of snick and ideology, and that the ‘facts’ we have are mainly propaganda. On the other hand (as That Guy says above) thiis is one spokespeson that has a vested interest in giving her side. It would take a larger wreght of evidence to convince me that the pracice can be done safely. My gut reaction would be to legalise some definitely innocous form, like the clitoral hood nick, and let them get on with it. But I do not know what that would do in practice to the efforts to stamp out the undoubtedly risky and damaging practices that happen today, and in my ignorance I should not barge in and overrule the people who do know about it.

  34. Lucy. says

    “the spittle-flecked rabble of the Daily Mail comments section) ”

    That’s a common accusation, but completely untrue. The DM comment sections are largely polite and civilised and often thought-provoking (unlike its articles). Commenters come from around the world and have a variety of political opinions.

    Spittle-flecked comment sections can be found on the Spectator, though this has marginally improved since they’ve enforced subscription. The Telegraph’s was soaked in spittle before it was closed. The New Statesman’s was moany. The Guardian is more depressing, perpetually-sniping dirge than spittle flecked.

    Heteronormative Patriarchy for Men: statistics-flecked.

  35. That Guy says

    @StillG & H.E.

    I don’t think we’ll ever meet on this. I understand your concerns- however, I simply cannot agree with your assessments. I actually find it quite insulting the way that the waters have been muddied in the most obtuse way. terms like ‘Children’ and ‘medically necessary’ are well understood in this context. The manner in which you approach this could be used to justify any number of social ills, including child marriage and sexual abuse.

    However, I won’t waste any more of our time trying to convince you.

    @ Lucy #36

    You are possibly the last person I would expect to defend the Daily mail comments section.

  36. StillGjenganger says

    @That Guy

    Look, you believe that your own value system is the right one. And you believe that we should base our society on things that can be proved, instead of on arbitrary assumptions. For what it is worth I pretty much agree with you on both counts. Unfortunately it is not possible to prove that one value system is superior to another – because you need to assume that your values are correct in order to prove that they are.That is a basic condition – I believe it can be reduced to a more general principle that you can not prove that a system is correct without going outside that system for your proof. So, like it or not – and I do not particularly like it – this is something we need to deal with.

    To take child marriage as an easy example. I agree with our current age limits (of course – they reflecct the culture I grew up in). But just try to prove them correct from first principles! Children are sexually functional from about 13-14, but the brain is not fully developed and settled down till the early twenties. How do you prove your choice of age limit is correct? Arranged marriages? Well, our society is organised as atomic individuals and nuclear families, and it is obvious that a decision like marriage is individual and should be taken alone and in maturity. Other societies are organised in families and clans, with close interaction between lots of people – and those societies have advatages as well as disadvantages. To someone grown up in such a society their ways would seem obviously superior. I may disagree, as may you, but how do you prove it objectively?

    If we lived in monocultural societies, we could all just maintain we were right and ignore everybody else. But with multiple cultures lliving together we are faced with the problem. If we cannot prove objectively who is right (and we cannot), how do we mediate between different (and incompatible) value systems? One extreme would be to say ‘we happen to be right and we have the power, so shut up and do as we tell you’. Not a particularly nice approach, as progressive people ought to agree – but is that not the approach that people like you take to e.g. circumcision? .The other extreme would be to say that every culture is equally right, and whatever they decide is riight for them, no matter what we think about it. That approach would lead to condoning child marriage and sexual abuse, as you point out.

    The best I can come up with is a compromise: We do enforce our values on occasion, but we try to limit it to times when the damage done by other people is clear, obvious, and preferably objective. Or where there can be only one rule for all, like the norms for what can be printed in a newspaper. So, we should generally prefer to let people do their own thing in peace, For e.g. FGM we would conclude that the damage (medical complications, sexual dysfunction) is clear obvious and objective, so we act. For circumcision I leave the question to you: It is an irreversible body modification on a minor, yes. You see no benefit from it, but other cultures do. So, before you ban the practice, how much actual, objective suffering does it cause (if correctly performed)?

    he two extremes would be that 1) we are right and ignore anybody who disagrees, 2) every culture is right adn nobody can say anything to anyvbody. INtellectully consistent, but neither is a good recipe for a funcioning society.

  37. StillGjenganger says

    @SilllGjenganger
    The last three lines of the last post should have been deleted before sumitting. Sorry.

  38. Marduk says

    I never thought it was going on here. I’m not aware of anyone complaining about a lack of prosecutions either. That said the numbers are really far too low to be at all credible. Rates of FGM in counties we have significant immigration from approach 100%. I suspect the issue here is a combination of the question of what a “new case” actually is, one cannot discount “Rotherham syndrome” and that these women while in the country and citizens in a legal sense are likely to be outside British society and its institutions anyway. I very much doubt they’ve been allowed to learn English, let alone have a private talk with a GP.

    “If the true numbers were anything even vaguely on this scale we would expect to see far, far more new cases coming to the attention of the authorities.”

    I wish I could be confident you are right about that.

    I find no relief in these numbers at all.

  39. Lucythoughts says

    H.E. Pennypacker ; Gjenganger
    ” In fact, on a previous thread on this topic on the blog an academic who herself had been circumcised. She was very positive about her own experience”

    Did you both find it persuasive? I must say I’m surprised because I read it (not at the time, but later) and found it very far from. The woman in question, as far as I remember, had been brought up in the UK and had chosen in her twenties, without any external pressure, to travel to her country of origin specifically to undergo FGM because she believed it would enhance her bond to her “home” culture and because she thought it would make her genitals more attractive. That is such a long way from a typical experience of FGM as to barely stand comparison. She was very pleased with the outcome yes, but is it surprising that someone actively choosing a body modification for cosmetic and emotional reasons is likely to be satisfied with the results? Does that in any way imply that someone else, having the same procedure forced upon them, is likely to be equally pleased? Her experience is hers, but it is irrelevant to the experience of a three year old who is held down while someone cuts parts of her genitals away for reasons she cannot possibly comprehend. Or a ten year old who is cut and sewn up and then given away in marriage before the wounds have had a chance to heal. Those are only two possible scenarios out of many but both are far more common than the experience of that academic who underwent FGM voluntarily.

    “I don’t think that anyone here is in any position whatsoever to claim that it is “a horrific practice that causes demonstrable harm to the people it is done to, including complications in childbirth and denying people sexual pleasure”.”

    There is very little research on the effects of FGM on sexual function and what exists is largely inconsistent, methodologically flawed and involves very small samples of atypical patients. Sexual experience is very individual and is as much or more dependent on psychological factors than physical ones. We just don’t know what effect is “typical” from different FGM types or how common significant loss of function, or acute pain during sex, are. And that isn’t all we don’t know, we also don’t know what proportion of FGMs result in such complications as infection, excessive bleeding, chronic pain, urinary problems, infertility, PTSD etc and it is no use saying we should quantify all of these things before adopting a position because it is damn near impossible to find out those numbers. We don’t even know how many girls die every year as a result of FGM. So the question becomes, how often does it have to go wrong before the suffering outweighs the “benefits”? From what we do know, I think it is fair to say that it goes wrong a hell of a lot more often than that.

    We have better data on obstetric complications. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(06)68805-3/abstract This is behind a paywall I’m afraid but the abstract gives some robust figures. It is a WHO study which looked at 28,383 births in hospitals in 6 African countries and assessed the incidents of complications in women with FGM types 1, 2 and 3 compared to non-FGM. Complications went up with the extensiveness of the FGM and included postpartum haemorrhage, stillbirth and neonatal death and others. Needless to say, the women giving birth in these hospitals were the lucky ones because access to any maternity care is very patchy in West and East African countries where FGM is widely practiced. WHO concluded “FGM is estimated to lead to an extra one to two perinatal deaths per 100 deliveries.” Nobody knows how many maternal deaths it causes.

    And this brings us back to culture. In the West we have come to see the primary function of the vaginal structures as being sexual pleasure, hence our horror at the idea of clitoridectomy. As far as evolution is concerned however, the primary function of the vagina is to facilitate childbirth. The more you cut it up, the more you compromise that function, and the result is pain, ill-health and death for mothers and babies. That is the bottom line, and respecting cultural practices strikes me as largely crap when those practices demonstrably result in loss of life and increase the risks of what is already the most dangerous time in a woman’s life.

  40. StillGjenganger says

    @Lucythoughts. Tht point I took away from that account that that it was at least possible that the operation in itself did not unavoidably cause the kind of medical complications and, especially, sexual dysfunction generally attributed to it – not that the overall experience would be positive for all, or even most, who underwent it. If proved that would in itself be a big change in current thinking – going against obvious reaction to the idea of ‘clitoridectomy’ is that the effect would be drastic and unavoidable, Which still does not prevent one from being against FGM for some of the other reasons you menstion. But, as I think I said, it was not enough to convince me. She did give a coherent and plausible account, which is new, but she is only one person with an obvious personal bias. And there is so much weight of evidence / opinion on the other side that it would take more than one account to convince even of the theoretical possibility of doing major kinds of FGM without heavy risk, It seems obvious to me that something like a clitoral hood nick could be done without significant medical risk – and I would in abstract terms look favourably on such an option – but, as I think I also said, I do not know enough about the sociology of the fight against FGM to push for changers in current policies. And FGM, as currently practices, does appear to cause a lot of avoidable suffering.

    In short, the treatment of FGM is not quite such a no-brainer as I had thought, but on the available evidence I would still stay with current policies. Can i get away with that?

  41. Anton Mates says

    I have to agree with Marduk @40; these numbers are way skewed, and mostly not in ways that are cause for relief. The fear of legal repercussions for your family and social repercussions for yourself is a strong deterrent against admitting that you underwent FGM in the UK. It’s far less risky to say that it was done in rural Africa by a distant relative that the British government can’t even locate, let alone prosecute.

    But the main issue is that, as Ally says, these reports are overwhelmingly about pregnant women at obstetric visits. This alone explains why most of the reported cases are adults; little girls aren’t being examined! (Especially not little girls from families that would have them undergo FGM in the first place.) These statistics pretty much have to have missed the vast majority of child FGM cases.

    The one “heartening” bias I can think of, is that they’ve probably also missed a lot of milder, Type 4 cases. That’s because those don’t leave obvious scars or other lasting damage, so there’s no reason a healthcare worker would notice them in the first place. The girls and women who’ve undergone Type 4 FGM are also unlikely to remember and report it, if it was done in infancy. Which probably explains why the majority of Type 4 cases reported here are body piercings. So I’m pretty sure these numbers overstate the proportion of FGM cases which are Type 1-3.

    But yeah, we’re just not seeing what happens to little girls on British soil. I’m not saying that the FGM rate among them is high; but these numbers give us no reason to be confident that it’s low, either.

  42. That Guy says

    @ Anton #43

    Just out of interest, what do you feel is the best way of improving these statistics?
    Mandatory checkups? Monitoring the travel of at-risk individuals?

    I can’t think of any solution that wouldn’t be draconian.

    I’m not convinced by your scepticism- I’m not sure that most FGM survivors who were mutilated in the UK would rather claim it was performed abroad- I just cannot see the motivation. Perhaps that’s a blindspot of mine, but in the absence of family pressure (in a one to one session with a midwife/GP) I wouldn’t see any reason to lie about where it took place.

  43. Marduk says

    44.

    That isn’t where the “family pressure” is.

    Lets assume you are fine with your mother or grandmother going to jail in a country where she may not even speak the language or even have much life experience outside the domestic sphere. There have been strides made recently that mean you won’t always have to personally testify or can testify with police protection but none the less.

    The issue is the risk of being ostracised by your immediate family, your extended family and your community. This amongst groups who place a lot more importance on the above than is typical. You are likely to be in the group in British society least likely to have qualifications, least likely to have a job (and even less likely to have a job outside your immediate community) and meretricious SJWing aside, yes, you are more likely to be discriminated against. You could end up being ejected from your family home into hostel (if you are lucky) with no obvious prospects for anything else completely alone in the world. No friends, no family, no assets, nothing…and for what, its already happened.

    Just because something like this has happened to them it doesn’t make people enemies of their families and communities which is basically what you’d be turning yourself into (or at least how some would see it).

    You have to remember that in situations like this ostracism is a very powerful force. I’ve (and perhaps you’ve) moved all round the country so I don’t think I really have community to be ostracised from at this point, this is the British 21st century disease perhaps. I have a small family who I love but I don’t see them every day or even every month. But for these women its a very, very serious thing. Indeed, it is the risk of ostracism that causes it to be done in the first place, its practiced by people who believe its a pre-condition for being married within that community, its the crux of the whole matter.

    The implicit problem and perhaps assumption in Ally’s post is the idea that people who would practice FGM are somehow in all other areas of life fully integrated into mainstream British society. I think its reasonable to suspect that isn’t the case.

  44. H.E. Pennypacker says

    @That Guy

    I actually find it quite insulting the way that the waters have been muddied in the most obtuse way.

    The waters are muddy, the real world is endlessly complicated, you don’t have a crystal clear understanding on this after having read a bit of anti-FGC activist literature and seen a documentary or two. Neither do I, but I’m not claiming to.

    @Lucythoughts

    Did you both find it persuasive?

    What do you mean by persuasive? I believed that it was an accurate description of her own experience. I can’t particularly say that it persuaded me because I already thought that there are many women and girls around the world who have been circumcised and feel positively about it.

    On the second point, you haven’t really disagreed with anything I’ve said. The figures you cite don’t show that it causes problems but that in some cases it may lead to them. Moreover, that WHO study is extremely contreversial and many people see it as an expensive exercise in confirming what you already believe. http://onlinelibrary.wiley.com/wol1/doi/10.1111/j.1548-1360.2012.01174.x/citedby is a reasonably balanced overview looking at the politics of knowledge production. I think it’s behind a paywall – the author interviewed many of the bureaucrats and researchers involved in the study as well as going to meeting’s etc. (basically she studied the study). Here are some relevant passages starting from meetings after research had been concluded and data analysed, when they were trying to draw conclusions and write the article that was to be published:

    As the meetings unfolded, the confidence in the prospect of a prestigious publication grew but so did confusion about the meanings of the study. As graph after graph of data analysis was presented and discussed, it seemed that the study that was supposed to provide clear answers produced questions instead. By the end of the meeting, the air was permeated by uncertainty and nobody was able to fully make sense of just what it was that the study showed. In other words, the data were analyzed but did not yield a “consensus narrative” (Lowe 2010). To the question “What is the take-home message?” there was no clear answer.

    If the WHO researchers were ideologically driven and interested in constructing cutting as a “killer of women and children” at the expense of scientific integrity, they did not reveal it. The discussions were dominated by sober, painstaking deliberations about data quality, rather than moralizing outcries against cutting

    […]

    As the study traveled toward publication, it acquired a new form and with it, a meaning, setting the stage for the narrative about deadly harm. I suggest that the very form of the Lancet article lead to the appearance of conclusive interpretations and produced cutting as a risk of death. Although the final article and the Geneva draft present almost the same data, they differ in how they frame their analyses and conclusions: the draft aims at objectivity and is shot through with uncertainty whereas the published article presents a confident argument (WHO Study Group on Female Genital Mutilation and Obstetric Outcome 2006).

    The rhetorical structure is transformed from a pendulum to an arrow—a straight line leading toward a conclusion that cutting leads to delivery complications. The article no longer aims at getting the facts straight but eliminates all “useless facts” (Latour 1987:7). Gone are most of the qualifications, modifiers, and swings between different kinds of evidence. Much like infibulation itself has an aesthetic valence and is meant to produce smooth lines, clean surfaces, and pure bodies (Boddy 1982), the scientific cutting of contradictory statements is also guided by aesthetic and formal considerations. The Lancet article tells a linear and streamlined story, without introducing counterevidence. The formal clarity of the published article does the double work of convincing and producing meaningful interpretations.

    […]

    Rather than waiting for the public to make sense of the study and be convinced by it, the WHO promoted the interpretation of the study as evidence of deadly harms, coding the study results in the alarmist discourse. The WHO was particularly skillful at constructing interpretations, as it not only sponsored and managed the production of knowledge, but also formulated its meanings. Embarking on a speedy campaign, they invited a scientific commentary written by doctors known for their activism against cutting, issued a press release, and sponsored a “study launch” at Dorkenoo’s NGO.

    So we move from an inconclusive study to one that demonstrates the deadly harms of this evil practice. This is how the knowledge that you have read about FGC is produced and this is why almost everyone here thinks it’s a cut-and-dried case of barbaric, ignorant people abusing their own children. This is not to say it’s a beautiful thing that always brings joy and happiness, but that reality is much more complicated. The water’s are muddy, and by pretending they’re not, you’re likely to end up doing more harm than good.

  45. Lucythoughts says

    #46
    I disagree that the study is inconclusive. What your quotes demonstrate is that they were doing large-scale primary research, which inevitably produces vast amounts of confusing data which has to be sifted through. I mean for God’s sake, you’re looking at data from over 28,000 births in 28 different centres, each with their own protocols, in six different countries. Then the women themselves come from different backgrounds, ethnicities, and have different medical histories. That is what primary research looks like, and why people who want a quick easy publication prefer to work with cell lines or mice. So what do the criticisms you quote actually boil down to? That they spread all this data out and were initially circumspect about what it might mean, then eventually published THE SAME DATA but had substantially firmed up their conclusions. They haven’t been accused of mishandling the data; they haven’t been accused of omitting confounding factors, all they have been accused of is turning a lot of raw data into a coherent narrative that a prestigious journal might want to publish. Well, that is how scientist get publications, what do you expect?

    In my opinion they have done a good job with a very difficult research project; they started with a big enough cohort that they had a good chance of finding a pattern under the noise, they analysed the data for confounding factors and adjusted for them and they found a pattern of increasing risk for mother and baby across several criteria of complications. The controversial bit is attempting more generally to quantify perinatal deaths per 1000 births attributable to FGM. The overall pattern of increased risk of complications was there to be found. I have now found a free copy http://www.who.int/reproductivehealth/publications/fgm/fgm-obstetric-study-en.pdf so anyone is welcome to read it and decide whether they agree. I have said my piece. If they don’t feel like devoting that much time, I include a taste of the discussion section so they can decide for themselves whether it seems over-stated or excessively crusading.

    “ Whether or not a woman undergoes FGM and the type of procedure done
    are determined culturally and socially. The women participating in the
    study were from more than 120 different ethnic groups. FGM is closely
    linked with ethnic group,(9,10) so, in this dataset, adjustment for ethnicity
    was neither appropriate nor practicable because of the likelihood of
    overadjustment. For example, 97% of Arab and 96% of Nubian women
    in the Sudan, 99% of Embu women in Kenya, and 98% of Bini women in
    Nigeria had undergone FGM, whereas 90% of Ouoloff women in Senegal
    and 88% of Frafra women in Ghana had not. FGM is also affected by
    social and demographic factors (table 2). The overall results were
    adjusted for many of these factors, including those regarded as likely
    to mediate potential relations between ethnicity and obstetric outcome,
    which were study centre, age, parity, height, education, socioeconomic
    status, rural or urban residence, time taken to get to hospital, and
    antenatal care. Although there is a theoretical possibility that the effects
    seen here are not directly attributable to FGM, but are a result of bias or
    residual confounding with ethnicity or some other factor, this adjustment,
    and the fact that the findings are statistically homogeneous across
    several study centres, and hence ethnic groups, makes this possibility
    unlikely. The gradual increase in risk of adverse outcomes associated
    with increasingly extensive FGM, with the greatest RRs in women with
    FGM II or III also suggests that the relation is causal. The absence of
    any association between FGM and birthweight and the strength of
    the relation between FGM and fresh stillbirth also lend support to this
    relation, suggesting that the findings are not due to an increased risk of
    general adverse reproductive outcomes in women with FGM, but rather
    to risks relating more specifically to difficulties at delivery.”

  46. Lucythoughts says

    #46 “barbaric, ignorant people abusing their own children. This is not to say it’s a beautiful thing that always brings joy and happiness, but that reality is much more complicated. The water’s are muddy, and by pretending they’re not, you’re likely to end up doing more harm than good.”

    I don’t believe I have used any of those words and I don’t particularly think that you are one of a tiny minority who recognizes that this is a complex issue either. I will however say, for the record, that I think that cutting off pieces of a girl’s clitoris and labia without anaesthetic is a form of abuse unless she is wholeheartedly willing to undertake the procedure. Some are, but many who are not are forced to undergo FGM anyway. Some are happy with the results; others are deeply traumatized and some suffer long-term pain and debility or death as a result. In general people are happy with body modifications which they have chosen to have, and content with ones they have no memory of and which have caused no lasting complications. They are deeply unhappy with ones which are forced upon then in the face of resistance or which cause them physical suffering or psychological damage.
    So the question is, I suppose, does a parent have a right to take that kind of risk with their child’s health and cause them so much unnecessary pain? You obviously think they do and I disagree. I think it is a violation of a position of utmost responsibility and trust. I also think there is something insidious about body modification memes in general, because they have a habit of spreading through a culture until the penalty for not complying becomes overwhelming. When this creates a situation in which parents feel compelled to hurt their own children, it is a terrible, terrible thing. It acts as a social force which demands that a parent makes a sacrifice of their child welfare on the altar of community cohesion, and yet, it is not essential to that cohesion; when they die out it doesn’t affect the rest of the culture much at all. It is an add-on; a pernicious weed growing in the fertile social soil. I will willingly admit that I would like to see FGM die out; I think its disappearance could only do good.

  47. Anton Mates says

    That Guy @44,

    Just out of interest, what do you feel is the best way of improving these statistics?
    Mandatory checkups? Monitoring the travel of at-risk individuals?

    Well, the most obvious improvement would be to have the health care providers report basic demographic information (anonymized, of course) on all the patients/clients they’re seeing, not just the FGM cases. Right now we don’t even know what proportion of their patients were identified as having FGM, let alone how that group compares demographically to the rest of their patients. That information is essential for generalizing the results to the UK population as a whole.

    Mind you, I’m sure the HSCIC is planning to do something like that in the future. Their statisticians are smarter than I am.

    I would personally be all for mandatory checkups, but I imagine providers are already expected to at least recommend periodic checkups for young patients? Again, simply getting demographic data on which families do or don’t agree to these would be very helpful.

    Perhaps that’s a blindspot of mine, but in the absence of family pressure (in a one to one session with a midwife/GP) I wouldn’t see any reason to lie about where it took place.

    Marduk explained why there would be family pressure anyway, but just to underscore: GPs and health trusts (the vast majority of FGM reports in this data set are from health trusts) are mandatory reporters of FGM. So women know that if they admit to a provider that they underwent FGM in the UK, that information is getting back to the government in some form or another. It would be entirely reasonable for them to fear that the next step would be a criminal investigation of their family.

  48. H.E. Pennypacker says

    @Lucythoughts

    One of the reasons I chose this article is because it’s a less polemical attack than others that were made on the WHO study. I think maybe I didn’t make it clear, but the article argues that the data was spun so that it seemed more conclusive than it really was, primarily due to the formal demands of science publishing rather than the ideological bias of those involved (so largely in agreement with you). That’s not really an argument for this study though, it’s an argument against other similarly large studies. One of the main points of contention is that the raw numbers showed identical outcomes for cut and uncut women, but after analysis it seemed that FGC caused a lot of problems. I’m not claiming that FGC is never a contributory factor in complications during childbirth, but that the conclusions that study draws are built on much shakier ground than you would guess by reading the article.

    “So the question is, I suppose, does a parent have a right to take that kind of risk with their child’s health and cause them so much unnecessary pain? You obviously think they do and I disagree.”

    One of my points is that framing this in terms of rights is a culturally specific way of looking at the issue. In the West we like to talk about these issues in terms of “rights” but this isn’t a universal way of understanding things, and it’s one that I think often obscures more than it illuminates. I don’t think it’s a matter of ascertaining who has what rights, and weighing one person’s rights against another’s, I don’t think this is a useful way to approach the problem of FGC. I think the important question is what you (in the general sense) are going to concretely do to bring about change and what specifically you are aiming for. And I am highly doubtful that this can be done in any useful way on the scale of FGC as a total phenomena but would have to be targeted at specific groups, and would necessarily involve learning a lot about these specific groups. Infibulating girls to control their sexuality is very different to removing their clitoris to mark their transition into full womanhood and I don’t believe it necessarily makes sense to approach them as a single phenomenon.

    My problem is not with people being against FGC or trying to change other people’s behaviour, it’s with the way people are against FGC and the ways they are trying to get rid of the practice.

    I’ve seen two documentaries (one on the BBC a year or so ago, one that was a bit older) about projects to rescue girls from FGC. In both, the method was to get them to run away from their families and communities to go and live in a centre for girls escaping FGC (it might even have been the same place, I saw the first one several years before the second). The girls seemed quite happy in their new Western-funded home, wearing Western clothes. That all seems well and good, some people might question how moral it is to go and convince children to run away from their parents but if you accept that FGC is a horrific human rights abuse it’s probably justifiable.

    The question I was interested though, is what happens next? What happens to these communities if half of the girls are convinced to run away from home to live in the relative comfort of a nice NGO compound? More importantly though, what happens to these girls? They can’t go home (unless they recant and decide to get cut). Can they go to the city and get some low-paid job as a maid or something? Are they going to live in the NGO compound forever?

    The alarmist discourses about human rights and medical catastrophes leads to a mentality of “we must take drastic action now”, and I am highly scepitcal that such an apporach will produce good results for anyone in the long run, except for the aid workers who continue to get paid (I try not to be quite as cynical as Mark Twain: “Extending the Blessings of Civilization to our Brother who Sits in Darkness has been a good trade and has paid well, on the whole; and there is money in it yet, if carefully worked”).

    Also, at one point you refer to body modification as a meme. Do you subscribe to the view that culture is made up of memes? If so, our understandings might be too different to avoid talking past eachother.

  49. Ally Fogg says

    Marduk ( & AntonMates)

    The implicit problem and perhaps assumption in Ally’s post is the idea that people who would practice FGM are somehow in all other areas of life fully integrated into mainstream British society. I think its reasonable to suspect that isn’t the case.

    I was fairly explicit in the OP that the stats produced by the HSCIC are patchy and have all sorts of holes in the data. But I have to say the sentences above really miss the point.

    I have never suggested for a moment that “people who would practice FGM are somehow in all other areas of life fully integrated into mainstream British society”

    However I am saying that with very few exceptions they do use the National Health Service. The fact that the NHS is finding 1200 new cases every quarter suggests that the consequences of FGM do show up sooner or later within the health system.

    If significant numbers of British (resident) girls were continuing to be subjected to FGM, we would expect to see a high proportion of them turning up in A&E (or the morgue) with complications like uncontrolled bleeding, septicaemia, suture failures etc etc etc – we know from other countries that FGM has high rates of complications. Those cases seem to be all but non-existent.

    I totally accept that there is motivation for women to be untruthful when asked about the details of their ‘ceremony’ and where it happened and who was involved. But when you are only talking about seven cases, that cannot be a convincing explanation for all the rest.

    I repeat, the research that I would really like to see conducted (and the HSCIC could do it) would be two simple questions:

    1. What age were you when the FGM ceremony took place?
    2. What age were you when you became a UK resident?

    That would largely get around the problem of people worrying about informing on their relatives and would be an incredibly informative exercise.

    I generally try not to be too cynical about the motivations of people involved in work like this, but I do find the reluctance to ask those questions rather puzzling.

  50. Lucythoughts says

    #50
    “That’s not really an argument for this study though, it’s an argument against other similarly large studies”

    It isn’t a criticism of “similar large studies”, it is a criticism of every piece of scientific research that has ever been published, and frankly the output of most academics is pure as the driven snow compared to the data published from clinical trials. This isn’t a new problem or one that only affects a subset of research; it’s endemic. It’s because publication in journals is a form of, well, journalism. Fortunately, we know that and that is why research papers should not just be read, they should be read critically. In that WHO paper the absolute numbers for complications are included in the data that’s presented, I didn’t miss them. The point of the data analysis is that you can’t directly compare data from middle class urban dwelling Sudanese women to poor women in rural Ghana and say “look, cutting makes no difference / a big difference” because they have different background rates of obstetric complications in the first place. That is why I prefer to trust the analysed data, where some effort has been made to control for those other factors. The controls aren’t perfect because humans don’t have perfect analogues but controlling for nothing tells you precisely nothing. Having put those controls in place, you see a statistically significant pattern of increasing complications with extent of FGM for seven different criteria for complications. I find that pretty convincing.

    “Also, at one point you refer to body modification as a meme. Do you subscribe to the view that culture is made up of memes?
    If so, our understandings might be too different to avoid talking past each other.”

    I don’t think that every aspect of culture is a meme. I think that most culture is a sort of diffuse, osmotically transmitted framework of norms for how people interact in different social contexts. However, I think that body modification blatantly shows memic behaviour; they arise almost spontaneously (although I think they usually start from interaction with another culture that already practices); they propagate through a population by various methods of transmission; when they reach a critical level of take-up within a given community they can make a switch, becoming “necessary” for full social standing within the community and are then enforced directly or indirectly. Sometimes they just seem to reach a tipping point and disappear again; sometimes this occurs after a period of becoming increasingly extreme, sometimes after other changes in society, sometimes when they are replaced by an alternative practice. They are about as memic as they come. Fashions in general show memic behaviours but it seems like ones which require a sacrifice in terms of pain or risk are the most persistent once they have established themselves.

    I would site two examples which seem to me to have arisen recently. One, here in the UK, is ear piercing. A couple of generations ago having pierced ears was in no way the norm, unless you were from a particular ethnic group. Now I doubt there are many girls who reach the age of ten without begging their Mum and Dad for permission to have it done. Why? For obscure reasons it took off and then propagated through what I would call child culture: little girls emulating older girls, big sisters etc. The second example is cosmetic circumcision in America. Why do so many non-Jewish / non-Muslim parents circumcise their baby sons in America now? When did it start to spread as a practice? Is it only local to certain areas or is it spreading across the country? I genuinely don’t know the answers to those questions, but I’d be interested. I’m fairly sure it is simply not a Thing in the UK.

  51. Anton Mates says

    Thanks for linking to that paper, Marduk. I’ll paste a couple of their conclusions:

    The majority of FGM seen in our series was WHO type 4, that is, the type with normal genital examination findings or a small genital scar. No child had WHO type 3 FGM (infibulation).

    In line with the international literature, this study identified the following trends: (i) FGM occurring at a younger age; (ii) increased prevalence of the less invasive types of FGM; and (iii) the medicalisation of FGM about which frontline professionals should be aware.

    I find two things particularly interesting about these results. First, they describe exactly the sorts of FGM cases that I think are undercounted in the HSCIC’s data: cases in young girls, and Type 4 cases without obvious scarring. If a single London clinic is recording around 10 child cases per year, and the HSCIC’s dataset contains only 30 child cases a quarter across all of England, I think it’s safe to say that the latter dataset is missing an awful lot of cut kids.

    Second, if it is generally true that FGM in the developed world is becoming more medicalized, less invasive, and conducted on younger children…well, that sounds a lot like it’s converging with male circumcision. Or, at least, certain cultural strains of it are. If that trend continues, it’ll be interesting to see how this affects the discourse on and government policies toward both practices.

    Ally @51,

    However I am saying that with very few exceptions they do use the National Health Service. The fact that the NHS is finding 1200 new cases every quarter suggests that the consequences of FGM do show up sooner or later within the health system.

    This seems a bit circular to me. How do we know that almost all of them use the National Health Service for gynecological/obstetric issues? 1200 new cases per quarter just tells you that the true number of cases is bigger than that; it doesn’t tell you how much bigger, so far as I can see.

    If significant numbers of British (resident) girls were continuing to be subjected to FGM, we would expect to see a high proportion of them turning up in A&E (or the morgue) with complications like uncontrolled bleeding, septicaemia, suture failures etc etc etc – we know from other countries that FGM has high rates of complications.

    Depends on the type of FGM and the tools and training used. If it’s Type 4 or on the “mild” end of Type 1, and sufficiently medicalized, then the acute complication rate is probably quite low. Furthermore, if girls are taken abroad to be cut, any acute complications would be dealt with before they return. (Or they wouldn’t return at all, though I’d hope the Home Office would notice if that happened often.)

    Speaking of which, have there been many verified cases of girls getting cut while on holiday abroad? Or…any verified cases at all? I did a little cursory googling but found nothing.

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