FGM prosecutions and the question nobody dares to ask


The acquittal of Dr Dhanuson Dharmasena yesterday means that more than 20 years after specific legislation was passed, there remains not one single British conviction for inflicting female genital mutilation (FGM).

The case against the obstetrician was always a strange one. His patient was a survivor of previous Type 3 (ie the most severe) form of FGM, and after saving her life with an emergency operation during labour, he stitched her up in such a way that appeared to restore her post-FGM state of mutilation, rather than reverse it. Dr Dharmasena always insisted that the suture was no more than necessary to stop her bleeding. The jury took less than 30 minutes to rule him (and his co-defendant) not guilty. All medically-trained observers who have followed the trial now seem to agree that the verdict was correct and the charges should never have been brought.

So why were the charges brought and pursued so vigorously? I can only presume it is a consequence of the enormous pressure being felt by the CPS and other agencies, including the police, to begin securing convictions for FGM offences. If anyone still believed that the powers-that-be are scared or shy of prosecuting FGM cases for fear of appearing culturally insensitive or racist or whatever else, the ill-judged prosecution of Dr Dharmasena should set them straight.

I’m something of a lone voice on this issue, because I have never been entirely convinced that political correctness and cultural relativism are the primary obstacle to identifying cases and securing convictions. Perhaps if we go back far enough – into the early years of New Labour and back through the 90s and 80s, there might have been a toxic combination of ignorance and political correctness that led some professionals to turn blind eyes, but for at least 15 years now every professional in health, social care, education and even the youth, voluntary and community sectors (where I worked for about a decade) has been inundated with instructions, policies, guidelines and rules for identifying or acting upon suspicions that a girl is at risk of FGM.

No one is now in any doubt that FGM represents a severe and horrfic form of child abuse and no one is unsure what steps to take if a case comes to light. Especially over the past five years, with the nation broadly horrified and stunned by the child grooming scandals in Bradford, Rotherham and elsewhere, the idea that significant numbers of professionals would routinely ignore cases of FGM for fear of appearing racist or out of respect for cultural differences is downright fanciful. I live and work in inner city Manchester, around large African and Asian communities, and I have friends who are teachers, doctors, youth workers and social workers. I would be astonished if any one of them would not act properly if they discovered a crime of FGM.

So what is the reason for the lack of prosecutions? I’d suggest there are two more credible explanations.
The first is an obvious one. it is a very, very difficult crime to detect. Victims are highly unlikely to cooperate with prosecutions because to do so would put their own loved ones (usually parents) in prison. Under such conditions, victims (or their carers) may avoid gynaecological checks and interventions because they know that to do so might trigger investigations. Unless there is a life-threatening emergency, a couple of decades could easily pass between a girl being cut and any medical professional having a look at her gynaecological condition. Even then, unless she is willing to testify, it would be impossible for investigators to establish how she came to be mutilated.

The second explanation is more controversial. As I have written before, the evidence as to the extent of FGM in Britain is far more tenuous than the mainstream debate normally allows. Campaigners, journalists and politicians hide behind such phrases as ” X thousands of girls are at risk of FGM every year” which are almost entirely meaningless. What is certain is that there are several thousand women in Britain who have survived FGM. Recent statistics confirmed this – at least 1700 women are currently known to be under treatment by NHS trusts. However, the key question which has not been answered is when these women were cut, and what their life circumstances were at the time. While there will always be complex individual circumstances, in broad terms there are three situations in which a girl in Britain might have been subjected to FGM.

1. She is born and raised in the UK, and subjected to FGM by someone in the UK.
2. She is born and raised in the UK and taken out of the country to be subjected to FGM in her country of heritage (or elsewhere) before returning.
3. She is born and raised in another country, subjected to FGM while there, then migrates to the UK at a later date.

Categories 1 and 2 above both involve a crime occurring under British law. Category 3 does not. While we know that there are thousands of women who have been subjected to FGM, we literally have no information, no data at all, as to how many of them belong in Categories 1, 2 or 3.

The possibility (which nobody seems willing to publicly acknowledge) is that the overwhelming majority of affected women in the UK belong in Category 3, which would mean that no crime had been committed under UK law. If this were the case, it would provide another very strong explanation as to why the authorities have failed to successfully prosecute people for FGM crimes. It would be because very few FGM crimes have occurred in this country in the first place.

Is this credible? Before discussing further let me reiterate that there certainly are some cases of British national or resident girls being cut, either in Britain or (more commonly) after being taken out of the country. I am not saying such cases do not exist – a couple of survivors are interviewed first hand here.

I am however suggesting that it is possible – not certain, but possible – that the numbers of such cases are far, far smaller than the popular debate and discussion generally allows. Beyond a handful of personal accounts, the evidence is dependent upon hearsay, rumour and assumption (as the article linked above demonstrates quite clearly.)

Let us suppose for a moment that a significant number of girls were either being mutilated in secret ceremonies here in the UK or taken out of the country during the school holidays, for instance. FGM, usually performed by untrained practitioners using non-sterile, non-clinical equipment and venues, carries a high risk of immediate and short term complications and sequelae. Here is an extract of a study on the attendees of an African Well Women clinic in London.

57 of the 66 women (86%) reported at least one acute complication, of which severe pain was experienced by 48 (73%), particularly among those in whom the procedure was carried out at an older age. Eight women (12%) remember requiring hospital admission for presumed septicaemia after the operation requiring intravenous antibiotic treatment (5/8), or severe haemorrhage requiring blood transfusion (3/8). Five other women (8%) had the procedure reversed because of acute urinary retention (2/5) or localised infection or abscess (3/5), and all five were re-infibulated (re-stitching of the vaginal orifice) a few weeks later.

Most of this is not the kind of condition that clears up with a couple of days in bed and an aspirin. If hundreds of British residents were being mutilated every year, we would expect to see a reasonably high proportion turning up in A&E soon after, with blood poisoning or uncontrolled bleeding, or if untreated, turning up in the morgues. Where are these cases? Is it credible that they are indeed happening but passing unnoticed, not leading to police involvement, investigations, prosecutions? It is possible, but as the years go by, it looks increasingly unlikely.

All calculations about the extent and risks of FGM carry a huge assumption – that people from communities which practise FGM in their lands of origin will continue to practise after migrating. As the website Full Fact notes here, even the authors of the reports which provide the statistics acknowledge that this is an entirely unsubstantiated assumption. Meanwhile, if you read the study of the African women above, it explains that even despite all the medical complications and horrors, almost 6% were seriously considering having their daughter undergo genital mutilation outside the United Kingdom. Another way of presenting these figures would be that 94% of African FGM survivors in London said they did not intend to inflict FGM on their daughters. That is a massively significant finding.

A few years ago the press got very excited about an FGM scandal in Sweden. As the Guardian explained:

When Norrköpings Tidningar reported that every single girl in a school class of 30 had turned out to be circumcised – with 28 of them having their clitorises and labia cut away and their vaginas sewn almost shut – it was picked up by the media across the world, including by UK broadsheets.

In fact the girls, aged 13-18, were part of a group of newly arrived immigrants from FGM high-risk countries brought together for an educational session as part of a new pilot project being launched in Norrköping. They had all been circumcised in their home countries.

How typical is this case, both in the nature of the abuse and the inaccuracy of the reporting? I honestly do not know, My suspicion is that it may be the norm, not the exception.

There may be a glimmer of light on the horizon here. The Office of National Statistics has begun collecting data on FGM cases in the NHS, as I quoted above. At the moment only the headline data is being reported, the data collection is still being described as a pilot exercise. We are promised that later this year, more detailed data will be made available. I very much hope that these data will include the following question:

  • Was the patient a UK resident before the point at which FGM was performed?

That question alone would be extremely instructive. I can see no ethical or practical reason why it should not be asked by NHS staff when taking a history. It would allow us to know whether resources being spent on attempting to police and prosecute FGM are being frittered away on a wild goose chase.

In many respects FGM is a perfect candidate for a classic moral panic. It involves secret, inaccessible facts which cannot easily be challenged. Many people have political motivations to push the agenda. This includes racists, Islamophobes and xenophobes who use it as a stick to beat immigrants or as supposed evidence of the failures of multiculturalism, but on the other side, progressives, feminists and liberals for whom it stands as an iconic symbol of patriarchal brutality and also (conversely) a demonstration of how unaffected they are by cultural relativism.

Nobody has anything to gain from challenging any statement about the extent and prevalence of FGM, even people from the communities involved know that to do so would have them marked out as apologists or defenders of the practice. Consequently the mainstream narrative on the issue is not a case of everyone pushing at an open door so much as everyone pushing at a revolving door, their collective momentum driving everyone on faster and faster, even if they are starting from entirely opposite directions.

This does not mean that everyone involved is wrong. It does mean it is a situation where everyone should be aware of the potential for sociological myths to emerge.

I repeat for the final time, I do not know for a fact what is going on. I am simply observing that nobody else really knows either. If my suspicions prove broadly correct, I would be very happy – not to be proven right, but because it would mean that there have been far fewer acts of horrific abuse committed on young British (or British-resident) women and girls than previously supposed. If I am wrong, I hope no efforts are spared in pursuing and prosecuting those who are committing these offences.

If, however, the question continues to go unasked, I could only conclude the reason is that nobody really wants to know the answer.

Comments

  1. says

    ‘… but for at least 15 years now every professional in health, social care, education and even the youth, voluntary and community sectors (where I worked for about a decade) has been inundated with instructions, policies, guidelines and rules for identifying or acting upon suspicions that a girl is at risk of FGM.’

    Didn’t this doctor claim not to have known this, though? Even when told by a nurse that what he’d done amounted to it?

  2. Ally Fogg says

    Julia

    The exact phrasing in the Guardian report was as follows:

    He told the court he had been given no training on FGM, either as a medical student or a postgraduate, or in his supervised training as a junior registrar at the Whittington. He said he had acted at all times in the woman’s best interests…. When Dharmasena sewed her up, a midwife warned him that what he had done was illegal. The doctor disputed this. But he was concerned about what he had done and asked a consultant on duty for advice, and the more senior doctor said it would be “painful and humiliating” to remove the stitch he had made, and told him to leave it in place.”

    I took that to mean he had been given no training in how to surgically treat an FGM patient in the midst of childbirth. As he was a registrar (ie not a specialist) that doesn’t seem especially surprising. But the fact that he immediately went to the consultant and asked would appear to support the case that he was making a medical decision at the time.

  3. 123454321 says

    Lots of good questions, Ally, but you don’t include the critical one I’d like to get to the bottom of, which relates to where the control lies, and thus where the reeducation focus is required:

    Who in the family unit is controlling and condoning this brutal act of barbarity by irresponsibly supporting the notion that these women should be sent to meet this most despicable fate? For example, I read from the interview extracts:

    “While in Somalia, Aisha’s grandmother thought that it was time for her to be “closed”.”

    “Some members of my extended family still support it…”

    “Other more traditional women want the husband, quite literally, to break them in.”

    “Whenever I have had arguments with women about FGM, the fall-back for my opponents is “But in our culture…”

    “and surveys of women in London and Bristol who have undergone FGM show that many of them saw it as a sunnah.”

    Have you ever thought that the problem may lie with taboos relating to certain demographics that daren’t be blamed for anything? Hmmm, how do we break down the barriers on that one? I’d really like to know what’s going on here. FGM is beyond barbaric. It’s inhumane, cruel, savage and primitive. Who the hell condones this for their children these days!!!

  4. karmacat says

    Except to remove a stitch is not painful or humiliating, so I wonder about the consultant. FGM is not a necessary medical procedure but a cultural one (as with MGM). I would have liked to have known more about the consultant and what he based his decision on. Again removing a stitch is not painful but the consequences of not doing so could cause more problems. I haven’t read too much about this issue in the UK, but I was wondering how much the government has worked with the community about this issue. Have any Muslim doctors spoken against this procedure? It takes time to change the culture, but in the meantime a lot of girls and women are suffering

  5. says

    I don’t know anything about the incidence of FGM in British born women. But I think you should edit your article to remove what I hope is just a poor choice of phrasing.

    “She is born and raised in the UK and taken out of the country to be subjected to FGM in her home country (or elsewhere) before returning.”

    If she is born and raised in the UK, the UK _is_ her home country; using “parents’ home country” or “parents’ country of origin” would be much better,

  6. Ally Fogg says

    Paul, no you are absolutely correct, thanks for pointing it out. I typed the opposite of what I meant, wholeheartedly apologise, and am now changing it.

  7. Anne Fenwick says

    I think you may be right about the incidence of FGM in Britain being low. Which means we should be very wary of attempts to encourage profiling of ethnic groups considered at risk in ways that interfere with their rights. At the same time, we should be vigilant because things can change fast. When communities reach a certain size, I think the tendency to maintain or reinstate their own practices increases. While there’s an influx of people from FGM practising regions, the anti-FGM campaign needs to be quite open and active, and public service workers need a plan of response to existing and potential new cases. There were multiple points of failure in this case, none of which amount to anything a reasonable person would call FGM.

  8. says

    “No one is now in any doubt that FGM represents a severe and horrific form of child abuse and no one is unsure what steps to take if a case comes to light.” This is a free thinking blog – one that invites it readers to engage in assumption questioning conversations. Surely the vast majority of women (including highly educated women) in at least seven East and West African countries (from Egypt to Sierra Leone) have their doubts. One place to start raising some doubts about the current moral panic (and media involvement in the scare) is to read the 2012 Hastings Center Report, a respected bioethics journal, titled “Seven Things to Know About Female Genital Surgeries in Africa”, which is available at this website: http://www.thehastingscenter.org/Publications/HCR/Detail.aspx?id=6059
    The abstract of that statement co-signed by 15 researchers and scholars from a variety of disciplines who study the practice (I am one of them) reads as follows: “Starting in the early 1980s, media coverage of customary African genital surgeries for females has been problematic and overly reliant on sources from within a global activist and advocacy movement opposed to the practice, variously described as female genital mutilation, female genital cutting, or female circumcision. Here, we use the more neutral expression female genital surgery. In their passion to end the practice, antimutilation advocacy organizations often make claims about female genital surgeries in Africa that are inaccurate or overgeneralized or that don’t apply to most cases. The aim of this article—which we offer as a public policy advisory statement from a group of concerned research scholars, physicians, and policy experts—is not to take a collective stance on the practice of genital surgeries for either females or males. Our main aim is to express our concern about the media coverage of female genital surgeries in Africa, to call for greater accuracy in cultural representations of little-known others, and to strive for evenhandedness and high standards of reason and evidence in any future public policy debates. In effect, the statement is an invitation to actually have that debate, with all sides of the story fairly represented.”

  9. says

    I have a suspicion that the registrar in this case was prosecuted as a means to an end in prosecuting the shadowy “Mr Mohammed” figure who was the co-defendant on trial for encouraging or procuring FGM.

    As there were witnesses to Dr Dharmasena replacing the stitch at the behest of Mr Mohammed, who was acting as translator for the patient, and the procedure was found by a jury to be FGM then the prosecution would have a cut and dried “encouraging or procuring” conviction.

    Although I agree with Ally that female genital mutilation procedures are probably rare in the UK, the problem arises when community leaders (TM) encourage and then act as procurers for a fee, transporting girls abroad. I believe that these people are the prosecution rightful targeting.

    Unfortunately in this case it was done ham fistedly and I feel sorry for the doctor who found himself in the middle of it.

  10. Peter D says

    This is the second case regarding FGM to be published in the last few weeks. The first, judgment was made by Sir James Munby in the family court. Here is a link:

    http://www.judiciary.gov.uk/wp-content/uploads/2015/01/BandG_2_.pdf

    In this case three separate “expert” witnesses gave evidence about a little girl that had been removed from her family. She was suspected by social workers of having undergone FGM. In para. 79 Sir James quotes one of the “experts”, Professor Creighton. Her clinic, at University College Hospital, happens to be the ONLY specialist Paediatric FGM unit in the country. She states:
    “There is a dearth of medical experts in this area, particularly in relation to FGM in young children. Specific training and education is highly desirable.”
    The paucity of expertise was clearly demonstrated in this case. This would suggest that FGM is in fact far less common than we have been led to believe.
    Sir James remarks regarding sir James remarks regarding male genital mutilation were also illuminating.

  11. Thil says

    “because it would mean that there have been far fewer acts of horrific abuse committed on young British (or British-resident) women and girls than previously supposed”

    I’d have thought you’d be saddened by the fact that this is going on anywhere, especially an anywhere where jurisdictional boundaries leave us powerless to deliver justice

  12. Seth says

    @ 9, Richard:

    “…Here, we use the more neutral expression female genital surgery…”

    Bullshit. Something is only considered surgery, especially in children who can’t reasonably consent, if it is medically necessary. Non-medically-necessary forms of body alteration are never called “surgery”–at best they’re “plastic” or “cosmetic” surgery.

    “Female genital surgery” is absolutely NOT a neutral term. It lends the practice the legitimacy of a necessary medical intervention, when it is anything but. Call it “non-consensual female genital modification” if you want a more (but still not entirely) neutral term. But don’t use “surgery” and expect to be taken seriously.

  13. says

    Seth
    One of the more important reviews of the literature on the medical consequences of [for the sake of this discussion I will call it] “the practice that can’t be named” is written by Carla Obermeyer, published in the Medical Anthropology Quarterly, and titled “Female Genital Surgeries: The Known, the Unknown and the Unknowable.” Whatever you think of the title it is well-worth reading. Here is the link:

    http://www.jstor.org/discover/10.2307/649659?sid=21105270550091&uid=3739656&uid=4&uid=2&uid=3739256

    There is a significant cosmetic or aesthetic element to the practice of genital modification in many East and West African societies, where the aim is not “mutilation” of the body but rather enhancement of the appearance of the genitals of both females and males. The very use of the expression “cosmetic surgery” implies that not all surgeries are medically necessary (including face lifts, breast enhancements, sex change operations, even the surgeries performed on children such as those designed to normalize the facial appearance of Down Syndrome children so they won’t be stigmatized or to remove the foreskins of eight day old Jewish children when done entirely as a mark of ethnic identity or religious commitment).

    The media coverage of female genital modifications in Africa has been scandalous since the early 1980s. Journalists in Europe and North America have seemed to believe there is no other side to the story and have been insufficiently conscientious when it comes to fact checking, which is one reason I pointed to the Hastings Center Report Advisory in my original comment. The “M” word has been used quite effectively by advocacy organization to block critical reasoning when it comes to the practice that can’t be named. If you have any interest at all in understanding female (and male) genital operations in Africa from the point of view of those who embrace them have a look at that advisory. A discussion of the aesthetic element (and other elements as well) can be found in my essay “The Goose and the Gander: The Genital Wars,” which is available Open Access at this website:

    http://www.tandfonline.com/doi/abs/10.1080/23269995.2013.811923#.VNQpmvnF9qU

  14. Jacob Schmidt says

    Except to remove a stitch is not painful or humiliating, so I wonder about the consultant. FGM is not a necessary medical procedure but a cultural one (as with MGM). I would have liked to have known more about the consultant and what he based his decision on. Again removing a stitch is not painful but the consequences of not doing so could cause more problems.

    Dr Dharmasena always insisted that the suture was no more than necessary to stop her bleeding.

    I took that to mean the stitches were medically necessary. That is, to not treat them brought risk, and their untreated state or potentially worsened state could have been humiliating and/or painful.

  15. says

    I’m afraid, Ally, the idea that a doctor that even the ‘Guardian’ tells us ‘began specialising in obstetrics and gynaecology in 2008’ hadn’t been trained in FGM is laughable.

    Unless he worked in the Cotswolds.

  16. says

    Anne Fenwick: “…we should be very wary of attempts to encourage profiling of ethnic groups considered at risk in ways that interfere with their rights. “

    Sounds a lot like what might have been said in Rotherham all those years ago.

    Screw their ‘rights’. We are a civilised country. We don’t permit this. Want to live here? Abide by our laws, or get out.

  17. Ally Fogg says

    Richard

    I’ve had a look at your links and it is the exact same logic of cultural exceptionalism that I’m often subjected to by advocates of male circumcision.

    It is bullshit when they come out with it and it is bullshit when you come out with it.

  18. StillGjenganger says

    @Ally 17
    Thanks for answering – I was really curious which way you would jump on this one.

    There are two different approaches in these debates:
    1) You find out what the facts are and try to understand the different points of view, and then if necessary, you adjust your conclusions to what you find out.
    2) You decide what the right conclusion is, and use that to decide which people to listen to and which facts to allow into the discussion.
    Normally you are remarkably consistent in choosing possibility 1). Circumcision seems to be one of the rare cases where you prefer 2).

  19. Ally Fogg says

    On the contrary, Gjenganger. The truth is literally the exact opposite to what you say.

    If you’d asked me 15 or 20 years ago what I thought of either FGM or ritual male circumcision, I would have told you that I thought FGM was an obscene violation of human rights and that male circumcision was no big deal, I had no issue with it if that was what parents wanted to do.

    Since then, in response to various arguments and evidence I have encountered, I have gone to look at the evidence, considered arguments from both sides, and my opinion about male circumcision has changed as a consequence.

    It is precisely because I have looked at the evidence and kept an open mind that I have arrived at the conclusion that all ritual, cultural and religious genital modification is an archaic violation of human rights.

    Perhaps if you followed your own advice you would follow a similar path.

  20. StillGjenganger says

    Perhaps if you followed your own advice you would follow a similar path.

    I really doubt it. Near as I can see, the argument against male circumcision is purely a matter of abstract ethics – the actual damage done certainly does not justify a ban, or even the heated rhetoric applied to it, IMHO.

    But fair enough – you have thought this through long enough, you have a firm conclusion, and you cannot be arsed to go through it again.

    From my purely selfish point of view it is just a lost opportunity to learn something (though it is of course not your job to teach me). Some of the points Richard Schwerder’s link made seemed rather appealing. You would expect that it is mainly women who control and maintain women’s initiation rites, like men maintain men’s. Would the practice really persist – against parents’ desire to see their children flourish – if it was as uniformly dangerous as we are sometimes led to think? You would expect that feminists explaining anything they do not like (from FGM to Mansplaining) as a direct effect of patriarchal dominance are quite likely wrong. It is surely true (if maybe irrelevant) that there is no correlation between the degree of patriarchy and the prevalence of FGM. And it sounds like the perfect set-up for a moral panic, with strong feelings, advocacy groups dominating the information flow, and opposing views finding it hard to be heard (how would the trafficking debate go, if the Poppy project was the unopposed news source)?

    Other points are much more dubious. Is it really as common, and as accepted as he says, across countries like Egypt? Just how innocuous can this really be (from the point of view of practical consequences), or is it just that the effects, while uniformly bad, are not quite as disastrous as the propaganda paints them? I still think that this practice, most likely, should be banned worldwide, but Richard Schwerder offered some new and unexpected arguments. A specific critique of those arguments would have allowed me to learn something, and might have advanced common understanding. Hearing that any kind of circumcision is totally unacceptable by your ethical principles tells me nothing I did not know already.

  21. Anne Fenwick says

    ” 16 – Screw their ‘rights’. We are a civilised country. We don’t permit this. Want to live here? Abide by our laws, or get out.

    Who is ‘them’, assuming you mean actual FGM practitioners how do you hope to find them, and since when have we practiced expulsion as the sole punishment for criminals?*

    *OK, Aussies, USians, I know there is a date for that one, although I think there was an (ahem) ‘back to work’ package included in the deal.

  22. says

    Dear Ally
    Thanks for taking the time to follow those links. Thanks too to StillGjenganger for the exchange that followed.
    The serious scientific and scholarly research literature on the practice of female genital modifications in Africa has been almost entirely ignored by journalists in Europe and North America, while hyperbolic, sensational and inaccurate claims about effects on sexuality and health promoted by advocacy organization are routinely published. African mothers, we are led to believe, are either monsters (“mutilators” of the daughters), uneducated fools (who don’t understand the consequences of their “harmful cultural practice”), slaves of a tradition they themselves would like to abandon if only given the chance, or victims of cruel African men who just love to deprive their wives and daughters of all sexual pleasure. It is a familiar “dark continent” image. Rarely heard are the voices of the many educated African women who are attached to their cultural traditions, find meaning in them and don’t view themselves as mutilated victims, but quite the contrary feel empowered, enhanced and even aesthetically appealing as a result of the procedure.

    One such voice is that of Dr. Fuambai Sia Ahmadu. Below is a link to an interview I conducted with her titled “Disputing the Myth of Sexual Dysfunction of Circumcised Women”, published in the journal Anthropology Today:

    http://www.uregina.ca/arts/anthropology/assets/docs/pdf/Londono%20on%20FGC%20in%20Anthropology%20Today%202009.pdf

    Fuambai Sia Ahmadu also has a website, which deserves to be widely known and invites engagement with anyone seriously interested in learning more about the practice that can’t be named (and how to judge it from a moral, legal and medical point of view). This at least is one way to have access to other sides of the story. Here is the link to her website:

    http://www.fuambaisiaahmadu.com/

  23. Allo V Psycho says

    @Dr Shweder
    I suspect that you and Ally might be at cross purposes, in a way helpfully brought out by Seth’s comment above, when he suggested the term “non-consensual female genital modification”. The issue at stake here is surely is that of consent. For this reason, ‘surgery’ is not a neutral term.
    If, in an assault, someone cuts my finger off, I would not call it surgery, even if the outcome is the same as that which might result from surgery to which I had consented for a good medical reason. Because of the lack of consent, I would describe the consequence of the assault as ‘mutiliation’.
    Of course, I might wish, as ‘cosmetic surgery’, to have a finger removed, if I were suffering from apotemnophilia, or Body Integrity Identity Disorder. In that case, with appropriate discussion as to competence and informed consent, a medical professional might consider the procedure (see Ryan CR. Out on a Limb: The Ethical Management of Body Integrity Identity Disorder. Neuroethics (2009) 2:21 – 33).

    If an adult woman chooses to have cosmetic surgery to her genitals, then again that is a choice for a competent and informed adult. Such surgery does occur, for instance, for cosmetic labial modification. If she did not choose to undergo such a procedure, then it would count as assault, and the term ‘mutilation’ would again be appropriate. The term FGM is used, not just by “advocacy organization to block critical reasoning”, but is also used by the WHO, for these reasons.

    The situation with clitoridectomy is different from straightforward cosmetic labial modification, in my view, in that it can represent a significant reduction in sexual pleasure. It therefore requires much more serious consideration, as in cases of Body Integrity Identity Disorder, or Body Dysmorphic Disorder. Other treatment options should be considered first, since clitoridectomy necessarily results in loss of function, in a way that labial cosmetic surgery does not. It is perhaps not as significant as, for instance, transgender operations, which also require careful consideration, but it is not trivial.
    Here, I think Ally and Seth are considering genital operative procedures carried out without consent, on children below the age of competence. Here, the WHO term of FGM seems quite appropriate. You seem to be talking about informed choices by competent adults, which is very different (although, as you can see, I think clitoridectomy is more complicated than less radical genital cosmetic surgery). Is this where the confusion is arising?

  24. says

    Dear Allo V Psycho
    I very much appreciate your deeply thoughtful observations. Most anthropologists who are experts on the topic do not favor the expression “mutilation” because a moral conclusion is inherent in the term and thus forecloses any critical reasoning about the nature of the practice – it is like starting a debate about abortion by labeling it the “murder of innocent life.” Among peoples who embrace the practice they label it in morally positive ways, using terms such as “purification” or “cleansing” and even view it as a “beautification.” Anthropologists don’t adopt that type of conclusion-tending language either, at least not as their primary descriptive term.

    Finding a neutral descriptive language so as to hold the normative judgment in abeyance while one informs oneself about the facts of the matter is a challenge of course. Genital cutting does not seem neutral to me (I doubt the New York Times would ever refer to Jewish circumcision as male genital cutting, and would certainly never describe a traditional Jewish bris as an occasion for male genital mutilation). Female genital modification is an expression adopted by some researchers, which does seem pretty neutral to me. I have no particular stake in the expression female genital surgery. I have even begun using the expression “the practice that can’t be named.” But when I do use the expression “surgery” I use it to refer to a procedures of a certain type – the type of procedures that might be used when a surgeon amputates the leg of a person who has been in a coma and has never given consent to the operation, or the type of procedure that might be used when a young child who is no position to give consent has their appendix removed.

    Nevertheless, it is fine with me if we give up both the “M” word and the “S” word as long as the aim is to actually educate ourselves about the facts of the matter and try to understand “the native point of view.” (By the way, the best evidence on sexuality, some of which is discussed in the essay I mentioned “The Goose and the Gander: The Genital Wars” is not as you think. You may also notice in that essay that the notion of a “Body Integrity Identity Disorder” is highly relevant for understanding the practice that can’t be named. Or least there is a local cultural variation on that theme in which bisexuality is viewed as a universal and identity confusing feature of childhood that should be overcome and the attainment of a normal gender identity for both girls and boys is achieved by means of a genital modification.

    Given that the consent issue looms large in these discussions I have tried to come to terms with the moral foundations of Jewish neonatal male circumcision (which is nonconsensual and I suppose would be viewed as a form of “mutilation” if one adopted your analysis). A link to my examination of the practice – titled “Shouting at the Hebrews: Imperial Liberalism v Liberal Pluralism and the Practice of Male Circumcision” and published in the journal Law, Culture and the Humanities – can be found at this website:

    https://humdev.uchicago.edu/sites/humdev.uchicago.edu/files/uploads/shweder/2009–Shouting%20at%20the%20Hebrews.pdf

  25. H.E. Pennypacker says

    @ Richard Shweder

    Thank you very much for the informative links. I was largely unaware of the academic work arguing this point of view. I staked out a similar position to yours in a previous thread on this blog that was about male circumcision (although I was somewhat less eloquent).

    At that time there was a visceral refusal to accept that damning the praxtices of other cultures ws essentially essentially amounted to claiming that we, as Westerners, ad access to universl morals that must be enforced upon less enlightened “others”. Even putting forward the point of view that we should be careful about forcing people to chnge their behaviour to fit Western ideals was deemed dangerous.

    Most of the opposition seemed to be based around the idea that Human Rights, as currently conceived by contemprry Western governments and international organisations, are universal moral truths rather than historically and culturally specific inventions.

  26. says

    Thanks for mentioning my website, Rick. If I may just interject here in the middle of this interesting discussion. As a circumcised African woman, I must say I do have a problem with the term “mutilation” because this implies loss of function and disfiguring and the definition alone has nothing to do with consent. The definition I just looked up is, “to injure, disfigure, or make imperfect by removing or irreparably damaging parts”. I would agree with Rick that many affected women do not consider the various types of “FGM” as disfiguring. For example, many women in my community in Sierra Leone do not view WHO Type II Excision (removal of external clitoral foreskin/glans and labia minorae) as an injury or disfigurement or an imperfection. On the contrary, the procedure in my culture is seen as cosmetic, as an aesthetic improvement over what is considered unsightly, excessive clitoral foreskin and inner labia. The result is a smoother appearance that is less fleshy and considered less cumbersome for women during sexual intercourse. (This procedure does not include the suturing together of the external labia, which is a much rarer procedure Type III that nonetheless receives all the attention in the global media).

    With respect to loss of function, the remarks by Allo V. Psycho are not supported by the evidence from many women who have experienced excision or clitoridectomy. I am always prepared to use myself as an example: I was a sexually experienced college student at the age of 21 who enjoyed orgasms from the first time I experienced this probably at age 19. Immediately after my excision, I was concerned that I would never experience orgasm again because I had bought into the western popular idea that I could only achieve this height of pleasure through external clitoral stimulation. I was very surprised when I resumed sexual relations with my boyfriend that I could still reach orgasm and that I enjoyed everything we did prior to my excision, including oral sex. This is probably because most of my clitoris (as with all women) is hidden within the body. The visible part is a very small fraction that contains the foreskin and glans. Excising this visible skin and tissue has not impaired (for me) the sensitivity of millions of nerves that run through the internal clitoris and other parts of the genitalia and my body. Every woman is different and has different preferences – I am still as sexually responsive as I was pre-op. The procedure has not affected my level of desire, my feeling during foreplay and sexual intercourse and has improved my overall sense of femininity as well as in my view, the external appearance of my vulva. I am confident sexually and have never had any sexual issues with men. My experience turned out to be very typical of the women I encountered when I conducted fieldwork in The Gambia for five years and is very much in line with the experiences and attitudes of the women I grew up with who are among the most sexually assertive women I have encountered through my very cosmopolitan, globe-trotting adult life. Even today, when I encounter circumcised women who are anti-FGM activists, most state that they enjoy sex and have orgasms. So, it’s been very important for me to help dispel these deeply ingrained myths about female circumcision and sexuality.

    If the concern is about children then we can discuss the rights of the child without using derogatory and insulting language. We can use terms like infibulation to refer to WHO Type III if we are uncomfortable with the term “surgery”. I have no problem for example with the term excision although I cringe at the sound of clitoridectomy, female genital cutting and certainly female genital mutilation. Whatever term we decided to use, it ought to be one that is also acceptable to the vast majority of affected women whose bodies are the topic of conversation.

    Thanks all, FSA

  27. says

    Dear H.E. Pennybacker

    Thank you very much for your comment. Journalists have for most part kept themselves innocent of the excellent academic research on the topic, much of which you will find referenced in the Hastings Center Report Advisory on “Seven Things to Know about Female Genital Surgeries in Africa”. The boilerplate harm claims now standardly repeated by the media (images of African parents routinely maiming and murdering their daughters and depriving them of their sexual capacity) are very hard to defend, once one moves away from advocacy research or research with very poor quality controls.

    With regard to human rights (for example, family privacy) there are many ironies in the way they are (or are not) applied and interpreted in the context of the global campaign. I have tried to examine the human rights argument against the practice that can’t be named in an essay titled “When Cultures Collide: Which Rights? Whose Tradition of Values?” published in an edited book on Global Justice and the Bulwarks of Localism, which can be accessed via this link:

    https://humdev.uchicago.edu/sites/humdev.uchicago.edu/files/uploads/shweder/When%20Cultures%20Collide.pdf

  28. Allo V Psycho says

    Thanks to both Richard and Fuambi. I will reply to Richard first, then I’m afraid life intervenes for a while! But I will reply to Fuambi as soon as I possibly can.

    Richard, you say:

    “Most anthropologists who are experts on the topic do not favor the expression “mutilation”.

    That’s interesting. Can you provide me with a source for the frequentist term?

    “Among peoples who embrace the practice they label it in morally positive ways, using terms such as “purification” or “cleansing” and even view it as a “beautification.”

    This is a slightly ambiguous phraseology – “Among peoples who embrace the practice….”. Is that all people within that culture? All women on whom the practice has been carried out? Those who embrace it will speak positively about it, those who do not embrace it will speak negatively about it – even within that culture we are no further forward in determining whether or not it is widely viewed as positive without further evidence.

    “Finding a neutral descriptive language so as to hold the normative judgment in abeyance while one informs oneself about the facts of the matter is a challenge of course”

    Perhaps fortunately for me, the NYT is not an arbiter of ethics or even social practice! Can we agree, then, on ‘non-consensual genital modification’? Or perhaps being even more specific: ‘non-consensual clitoridectomy’; ‘non-consensual labiectomy’; and ‘non-consensual infibulation’, as appropriate? Would you agree with these terms?
    (Incidentally, I don’t think the “practice that cannot be named” is a good choice in your terms, since its most recent popular cultural reference is to a representation of complete evil)!

    “When I do use the expression “surgery” I use it to refer to a procedures of a certain type – the type of procedures that might be used when a surgeon amputates the leg of a person who has been in a coma and has never given consent to the operation, or the type of procedure that might be used when a young child who is no position to give consent has their appendix removed”.

    These are not equivalent examples. In both cases, the situation must be life threatening, otherwise the intervention would not be considered. In both cases, as a result, normal requirements for consent are in abeyance. This does not apply to clitoridectomy, labiectomy or infibulation.

    “Nevertheless, it is fine with me if we give up both the “M” word and the “S” word as long as the aim is to actually educate ourselves about the facts of the matter and try to understand “the native point of view.”

    Oh, I’m not trying to reach a Hegelian synthesis of opposites, and understanding is not the same as ‘according with’. (I’m not very keen on the use of the rather loaded word ‘native’ in this context, incidentally).

    I’ll address sexuality in my reply to Fuambi.

    “You may also notice in that essay that the notion of a “Body Integrity Identity Disorder” is highly relevant for understanding the practice that can’t be named”.

    Indeed, as it applies to competent informed adults, as Ryan discusses.

    “Or least there is a local cultural variation on that theme in which bisexuality is viewed as a universal and identity confusing feature of childhood that should be overcome and the attainment of a normal gender identity for both girls and boys is achieved by means of a genital modification”.

    I didn’t quite follow all of this this sentence. However, we probably agree that some children are born with ambiguous genitalia, that surgical modification may be appropriate in these cases, and that such instances are both very rare and shed no light on non-consensual genital modification of normal children.

    As I will repeat to FSA, the central issue here is consent. If a competent and fully informed adult woman wishes to undergo these procedures for cultural, cosmetic or sexual reasons, then that is one thing. Carrying them out on non-consenting babies or children is different, and I believe meets the definition of assault.

    This hints at another issue which we haven’t discussed. Surgery on the genital area in women (and especially in infants) is complex and hazardous, due to the proximity of the urethra, and the complexity of the nerve and vascular supply to the region. The risk of negative side effects is high (and, indeed, may be a major factor in the WHO’s thinking). In my jurisdiction, NCGM is illegal, but in other jurisdictions it may not be. Do we agree, that as an initial safety measure in jurisdictions where it may currently be legal, that genital modification of infants and children should only be carried out in a sterile environment, by a practitioner holding a Primary Medical Qualification and with specialist experience?

  29. Mike W says

    I have been made aware belatedly of this discussion, and it is very refreshing to see that, in this forum, only a minority of the comments resort to an uncritical diatribe about “barbaric child abuse” which, regrettably, is the norm in similar situations. The more thoughtful and open-minded contributions make some very interesting points, on which I shall try to comment separately. Firstly, Comment 10 by Peter D, in particular the link to an earlier case:
    The judgement, although rather heavy going, is well worth reading and, in my opinion, is very sound with one exception to which I shall revert. A point worth noting is that one supposed expert witness was a prominent anti-FGM activist, frequently quoted in the UK media, about whom the judge wrote “I regret to have to say that XXXX merited all the harsh criticism expressed by YYYY and ZZZZ. …… Her inability in the witness box to provide explanations for matters that cried out for explanation was striking. Her report …. was a remarkably shoddy piece of work. A report that says, ……., is worse than useless. In my judgement her report and her oral evidence were well below the standard required of an expert witness. She was not a reliable witness. Her oral evidence was exceedingly unsatisfactory.”
    Peter D says that the judge’s later remarks about male circumcision are “illuminating”, however I find them very interesting, but untenable. The critical issue is whether a child suffers “significant harm”, and there is a long and contorted argument which seeks to demonstrate that male circumcision does NOT cause significant harm, whereas the presence of a very small scar on a girl’s clitoral hood DOES cause significant harm. The “get-out” which the judge appears to be desperately seeking, seems to be that “this is the opinion of society”. Using absolute, common-sense-based judgement, if one believes that either situation constitutes significant harm, it is obvious that male circumcision is the more significant. Another consideration, ignored in the judgement (possibly justifiably because the issue is interpretation of the law, rather than absolute right or wrong) is that the “opinion of society” is dominated by misinformation, ignorance, prejudice, arrogance, and other factors more reminiscent of a medieval witch-hunt than intelligent consideration of a sensitive issue in a multi-cultural society. However, leaving these matters aside for the moment, there is a very interesting corollary. If it is “the opinion of society” which is the deciding factor then, in societies which practice and favour female circumcision, it is entirely appropriate that this should be performed, and it should not be subject to criticism by those in other societies who live by different values.
    For the record, I am a strong proponent of male circumcision, having had it done at my own wish as an adult and, by direct comparison, having experienced the beneficial effects including, if anything, enhancement of sexual pleasure.

  30. Mike W says

    Continuing to Comment 18 by StillGjenganger:
    You are correct in that, with very few exceptions such as Richard Schweder, your “Approach 2)” is followed in almost all public debate and media coverage of female circumcision. Unfortunately I cannot immediately provide links for the following, but a Google search should lead those interested to the sources which provide a particularly striking example. There are now several studies in Africa which demonstrate a significant correlation between male circumcision and reduced probability of AIDS infection. There are also one or two studies which demonstrate a similar correlation for female circumcision. Reading one of these papers some time ago, I was struck by the fact that the authors, after carefully processing all their statistical data and concluding that female circumcision significantly reduced AIDS infection, then appeared to panic and try to invent all sorts of arguments as to why the result which they had just carefully demonstrated could not possibly be correct !

  31. Mike W says

    Comment 25 by H. E. Pennypacker.
    Constant citation of “Human Rights” is based on exactly the erroneous assumption which you describe. “Human Rights” are an artefact of the society which has invented them, and have no absolute, inherent global validity for all societies. To assert this is extreme cultural arrogance and imperialism. While the core principles are doubtless agreed by all societies, attempts to impose on others culturally-specific interpretations at a detailed personal level are misguided.
    Western society would benefit from adopting “rights” from some of the societies on which it attempts to impose its sometimes questionable values. How about a right for elderly people to continue living in a caring and supportive extended family environment, and to be respected for their experience and knowledge, instead of being consigned to a lonely institutional existence by children whose main concern is their expected inheritance ? Or, more abstractly, how about a right for every child to make up its own mind about its religious or non-religious beliefs, instead of being forcibly and absolutely non-consentingly indoctrinated into a particular religion long before reaching the age of reason ?

  32. StillGjenganger says

    @Mike W
    I think you go a bit too far, on two points.

    The general consensus is – massively – that some forms of FGM cause quite serious problems with sexual pleasure, medical complications etc. This may of course be wrong, but it does sound plausible, and it would take some solid medical evidence to change my mind, let alone the consensus. Some forms of FGM surely are no more harmful than (male) circumcision, and I would have no problems with those. But it is at least possible that banning these is a practical necessity for getting rid of the major problems that (we all think) are caused by the more serious forms. In short, a lot of the present attitude to FGM may be either ideologically driven or hysterical, but it might be right even so, and you have a lot of ground to make up to convince us all otherwise.

    Also, all morals are artefacts of the societies that made them. That does mean that we need some suitable humility when we consider imposing our values on others, and should let others live their way if at all reasonable. It does not mean that we are forced to accept whatever any society happens to favour, regardless of what we think of it. The Saudi approach to blasphemy and alcohol is their business, but I am allowed to maintain that their approach to gender relations is wrong, even if it is up to them, not us, to sort out. And if any society that championed slavery or crippling mutilation of children, we would be perfectly justified in using all available means including war to change their behaviour (as long, of course, as the suffering we caused was not even worse than the suffering we wanted to alleviate).

  33. says

    Dear Allo V Psycho and Mike W

    First of all thank you Mike W for entering the conversation and for keeping it going in such a constructive way. Perhaps the most rigorous and large scale study of the reproductive health consequences of female genital modifications is the Medical Research Council Study comparing “cut” and “uncut” women in the Gambia. After discovering that there were very few differences between the two groups (not much to support the hyperbolic harm claims of the activists) they still seemed to feel it was necessary to say something in support of the cause. Look at their data and then look the way they conclude their publication. Here is the link:
    http://onlinelibrary.wiley.com/doi/10.1046/j.1365-3156.2001.00749.x/pdf

    And thank you AVP for your follow up. Here I try to be responsive to your several questions and observations.

    With regard to the descriptive terminological preferences of anthropologists who are experts on the topic these are the titles of some of the most best known anthropological books or collections of essays on the topic: Female ‘Circumcision’ in Africa; Transcultural Bodies: Female Genital Cutting in Global Context; The Female Circumcision Controversy. (“Mutilation” is a politically motivated rhetorically loaded term which came into use in activist contexts in the early 1980s. It is about as far from “neutral” as one can get.)

    I don’t know of any study that has actually tallied up all the various terms that are used by anthropologists to refer to the customary practice; but based on my own familiarity with the literature female circumcision (often in quotes) and female genital cutting are frequently used as titles for publications by anthropologists who have direct experience with the practice. Other preferred labels include female genital operations, female genital surgeries and female genital modifications. (A list of key academic publications can be found in the Hastings Center Report Advisory mentioned in my earlier comments. Information about sexuality and health outcomes can be found there as well).

    Even in anthropology cultural critiques get developed, but ideally at the end of the day and only after one truly informs oneself about the unfamiliar customs of others. Most cultural anthropologists I know try to avoid rhetorical strategies where strong moral judgments get built into the very language used to describe customary practices. Not surprisingly anthropologists are trained to be cautious about the many hazards of ethnocentrism. (In my earlier comment I placed the expression “the native point of view” in quotation marks – it is a term of art in cultural anthropology meant to suggest the distinction between one’s own culturally shaped point of view and the point of view of the people one is studying.)

    Concerning the perceived ambiguity in the phrase “Among peoples who embrace the practice…” Let me illustrate my point about local support for the practice and try to be a bit more precise with the example of a UN conducted survey done in Northern and Central Sudan in 1989-1990. Out of 3805 women interviewed 89% were circumcised. Of the women who were circumcised 96% said they had or would circumcise their daughters. When asked whether they favored continuation of the practice 90% of circumcised women said they favored its continuation (see Williams and Sobieszczyk, 1997, Table 1, Attitudes Surrounding the Continuation of Female Circumcision in the Sudan: Passing the Tradition to the Next Generation. Journal of Marriage and the Family 59:966-981).

    Today there are at least seven countries in East and West Africa (including Egypt) where the prevalence rates for female and male genital modifications are in the 80% plus range and the pattern of favorability ratings by women are not unlike those described above. (I would note as well that where there are customary female genital modifications there are almost always male genital modifications too. There are very few cultures, if any, where genital operations are only customary for females – the practice is not an example of singling out or picking on females).

    With regard to the two examples I offered of operations that deserved to be called “surgeries” even without grants of consent my only point was to suggest that consent is not an essential semantic feature of the idea of a surgery. It seems to me the more apt semantic marker of a surgery is the aim of the particular procedures used (incisions, excisions, stitches, etc.), namely to perform the operation so as to enhance some aspect of a person’s (biological, psychological or social) well-being. Enhancement or the production of a benefit is typically the aim of customary genital operations for boys and girls in those ethnic groups where such operations or surgeries are customary.

    I am not surprised my invocation of your reference to “body integrity identity disorder” seemed cryptic. I probably should have said more. Your reference was helpful because despite the clinical use of that concept in Europe and North America that notion is actually potentially useful for understanding one of the reasons for male and female genital modifications in African ethnic groups. It is characteristic of circumcising ethnic traditions in East and West Africa that the distinction between being male or being female matters for ones sense of social and personal identity and for the functioning of society. In many ethnic groups in East and West Africa the foreskin is devalued by males precisely because its fleshy folded appearance reminds them of the look of an uncircumcised vagina. And similarly, the unconcealed part of the clitoris is devalued by women precisely because its protruding appearance reminds them of something male-like that has been pulled out of the body. In other words, all normal children prior to being “circumcised” are thought to be anatomically (and hazardously) bi-sexual and at risk of having (what clinicians in Europe and North America might call) a body integrity identity disorder, if they reach maturity without surgically removing the female element from the male body and the male element from the female body. That perception may (or may not) seem odd to Western eyes, but given that culturally heightened perception of human anatomy, customary African genital modifications amount to sculpting the naturally given body into what is locally viewed as a culturally improved form. From their point of view it is not an assault but rather an enhancement or a benefit. In other words, through customary means males become aesthetically more masculine by getting rid of an unbidden (and unwanted) female element (the foreskin) and females become aesthetically more feminine by trimming back an unbidden (and unwanted) male element (the exterior protrusions of the clitoris).

    Your proposed neutral alternative descriptor is “non-consensual female genital modifications”. That descriptor seems fine if it is only used descriptively (without normative implications) to identify the sub-set of cases where the custom is non-consensual. In South Korea for example, male circumcision rates are very high (higher than the USA) yet only about 10% are neonatal. There is a good deal of variation in the age and degree of consent involved (and many South Korean youths have the genital surgery in their preadolescent or even late teenage years. It would be very useful to actually know whether consent makes any difference for a girl’s or a boy’s degree of life satisfaction with their modified genitals.

    Nevertheless, if I understand your moral stance correctly, the insertion of the adjectival phrase “non-consensual” in the descriptor “non-consensual female genital modification” is designed to express your negative evaluation of the practice. If that is true then the expression is not really being used in a descriptively neutral way. And that seems problematic to me. It seems problematic in part because it presumes a bit too much about the moral implications of consent: a lack of self-determination in childhood is not a reliable measure of the immorality of a practice. (Notably most Jewish anti-fgm activists have probably circumcised their sons in infancy and given them no choice about what language will be spoken in the family, or whether to go to school or wear braces, and I suspect you yourself might find it strange or at least invidious to label the practice of inoculating children a “non-consensual public health measure). It also seems problematic because consent is not really the central issue for anti-fgm activists – they don’t want the operation done even if it can be done safely and with the consent of both the parents and the girl. (It is worth pointing out that the laws in many European countries define consent so narrowly that a highly educated adult woman of recent African descent (such as Fuambai Ahmadu) is not free to surgically modify her genitals (although she probably could have a sex change operation), and the prohibition applies most strongly if she explicitly wishes to carry on a long-standing cultural tradition which she finds personally meaningful, aesthetically appealing and identity-defining.)

    But then again it quite possible I have misread your position and you mean to use the expression “non-consensual female genital modification” in a non-evaluative sense and only in contexts where it serves some descriptive scientific purpose, which seems fine to me.

  34. H.E. Pennypacker says

    Just to add to what Richard Shweder was saying above about circumcision being about separating relatively undifferentiated children into clearly differentiated men and women where people move from an un-/bi-sexed natural homegeneity in their youth to clearly defined cultural genders in adulthood.

    This conception has always struck me as being close to a feminist theory of gender – gender is not natural but is created in culturally specific forms – with the obvious caveat that whilst most fwminists regard this as largely negative, whilst in the views of many circumcising African people it is positive.

    Actually for many groups it is not only positive but absolutely essential. Many people seem to labour under the illusion that certain cultural practices that could be abolished whilst doing relatively little damage to the rest of the culture ff the people who are being forced to change. Among many groups who practice both female and male circumcision (the Dogon spring to mind as a famous example) the differentiation from homogeneity into male and female parts is not just an ideal of human maturation but is the fundamental principle of their entire cosmology. Everything, the entire universe, was formed through the separation of an undifferentiated mass into male and female parts.

  35. Allo V Psycho says

    Dear Fuambi,

    Thanks for your reply. In passing, I may say do not find citation of dictionary definitions particularly helpful, since these may vary a great deal, and may not have been developed by reference to a particular debate.

    You indicate that my ‘remarks’; are not supported by various narratives. I would classify my understanding of the role of the external clitoris as a source of pleasure in female sexuality rather by reference to an extensive body of sexual science research and also by extensive narratives, rather than merely as ‘remarks’! But you will meet with no objection from me if you campaign for labiectomy for aesthetic reasons and clitoridectomy to enhance sexual pleasure, as voluntarily undergone by competent, fully informed women, and carried out with proper medical care by experienced practitioners. For me, this would fall into the same category as other voluntary body modifications.

    But would you agree with me that such procedures carried out on adult women without their consent would indeed be an assault (and a serious one)?

    And if that is the case, is it not also inappropriate to carry it out without consent on infants and children?

    And finally, that if despite this, it is still carried out, in view of the clinical hazards it represents, it is essential that it be carried out by medically qualified practitioners in appropriate environments?

    As for terminology, why do you cringe at the term ‘clitoridectomy’, which in this context is an accurate technical description? And would you object to the term ‘non-consensual’?

    While not strictly relevant to your points, I will add something about cultural relativism. I believe (or ‘I hold these truths to be self evident…’) that women are entitled to full equality and respect in law, the polity, the family, and society in general. This includes full autonomy over their body choices as competent informed adults. I believe that cultures which do not hold and act on these principles are indeed less perfect than those which do. Of course, no cultures are perfect! Nor is this unidirectional – for instance, the culture I live in has serious flaws in some directions (care for and respect for the elderly, for instance), and could benefit from learning from other cultures.

    However, cultural values are strong and pervasive, especially since children are indoctrinated into their own cultures at early stages. It is no surprise to me that individuals brought up within a culture will defend it, even when it contradicts other principles: that even if they have suffered harm, then they will continue to inflict harm on others as a result of the cultural lenses through which they see things.

    Best wishes,
    AvP

  36. says

    I couldn’t have stated this better H.E.Pennypacker. The Dogon are a Mande speaking group in West Africa. All Mande speaking peoples including my own the Kono in Sierra Leone practice male & female circumcision as important gender transitions to adulthood in initiation ceremonies. You are very correct in observing that in these societies both sex and gender are sociocultural constructs and not given in nature. The natural born human is considered androgynous possessing both male and female parts. Initiation/circumcision creates the single sex social being and at the same time grants adult status (which is not a feature of chronological age but of one’s ritual status). This is indeed something feminists should be all over to demonstrate that even what we in western society take as a biological given (sex) is socially constructed. This idea of refashioning genitalia to match cultural concepts of gender should also be attractive or meaningful to transgenders. In many Mande societies a woman can (and do) become men by undergoing male initiation especially to become chiefs (although it is not possible for men to ever go through female initiation to become women).

    AvP Great questions. Unfortunately I have to go out now but am looking forward to getting back to answer them this afternoon (I realize there’s a significant time difference)

  37. 123454321 says

    Strange. Even Jenny now poses the question on Woman’s hour as to why Mothers continue to enforce FGM on their daughters!

    12 mins 15 seconds in.
    http://www.bbc.co.uk/programmes/b0512h6m

    But I thought the patriarchy was responsible for FGM, or at least that’s what feminists have been telling me for years. How strange that this might not be true after all.

    I predict this could all become very awkward and many people will choose to remain quiet, which won’t be good for those girls still being subjected to this awful child abuse.

    The power of feminism, huh!

  38. says

    Dear 12345321
    This is what the Hastings Center Report Advisory titled “Seven Things To Know About Female Genital Surgeries in Africa” has to say about patriarchy and its purported connection to female genital modifications – their points 4, 5 and 6 seem relevant. As noted in an earlier comment the full report is available using this link:

    http://www.thehastingscenter.org/Publications/HCR/Detail.aspx?id=6059

    4. Customary genital surgeries are not restricted to females. In almost all societies where there are customary female genital surgeries, there are also customary male genital surgeries, at similar ages and for parallel reasons. In other words, there are few societ¬ies in the world, if any, in which fe¬male but not male genital surgeries are customary. As a broad generaliza¬tion, it seems fair to say that societ-ies for whom genital surgeries are normal and routine are not singling out females as targets of punishment, sexual deprivation, or humiliation. The frequency with which overheat¬ed, rhetorically loaded, and inappro¬priate analogies are invoked in the anti-mutilation literature (“female castration,” “sexual blinding of wom¬en,” and so on) is both a measure of the need for more balanced critical thinking and open debate about this topic and one of the reasons we are publishing this public policy advisory statement.

    5. The empirical association be¬tween patriarchy and genital surger¬ies is not well established. The vast majority of the world’s societies can be described as patriarchal, and most either do not modify the genitals of either sex or modify the genitals of males only. There are almost no patri¬archal societies with customary geni¬tal surgeries for females only. Across human societies there is a broad range of cultural attitudes concerning fe¬male sexuality—from societies that press for temperance, restraint, and the control of sexuality to those that are more permissive and encouraging of sexual adventures and experimen¬tation—but these differences do not correlate strongly with the presence or absence of female genital surger¬ies. In some societies where genital surgeries are customary for females and males (for example, in Northeast Africa), chastity and virginity are highly valued, and type III surger¬ies involving infibulation may be expressive of these values, but those chastity and virginity concerns are neither distinctive nor characteristic of all societies for whom genital sur¬geries are customary. Indeed, female genital surgeries are not customary in the vast majority of the world’s most sexually restrictive societies.

    6. Female genital surgery in Africa is typically controlled and managed by women. Similarly, male genital surgery is usually controlled and man¬aged by men. Although both men and women play roles in perpetuating and supporting the genital modification customs of their cultures, female gen¬ital surgery should not be blamed on men or on patriarchy. Demographic and Health Survey data reveal that when compared with men, an equal or higher proportion of women favor the continuation of female genital surgeries. A more thoughtful analysis is needed: those who want to ensure that women have a say in the conduct of their lives should support women in their quest for choices about their own bodies and traditions. Ironically, the effect of some anti-mutilation campaigns in Africa is to weaken female power centers within society and bring women’s bodies and lives under the hegemonic control and management of local male religious or political leaders. We see it as preferable that any changes that may be made are led by the women of these societies themselves.

  39. says

    Dear 123454321

    I do think fact checking and trying to cover all sides of any story is a good idea for journalists (and research scholars as well). It is probably also a good idea for journalists to maintain their independence of thought and tough minded skepticism when presented with horror stories that play to their prejudices and not be too reliant on sources from within an opposition movement. Below is a section from my essay “The Goose and the Gander: The Genital Wars”, which examines what happens when these conditions are not met, with special reference to claims about sexuality and female genital modifications of the sort that frequently get recapitulated in the mainstream media, including the Guardian. It discusses as well some of our own common misunderstandings about genital anatomy. Citations to any source materials mentioned below can be found in the original Open Access essay, which as I noted in an earlier comment can be found with this link:

    http://www.tandfonline.com/doi/abs/10.1080/23269995.2013.811923#.VNe_BvnF9qU

    “Given that Western media coverage of female genital circumcision in Africa has been almost totally reliant on sources from within an opposition movement, it is likely that most readers of this essay will be under the impression (and perhaps even think it self-evident) that girls who have undergone genital surgeries in Africa are sexually impaired: that they are unable to experience orgasm; that they react to sexual intercourse with feelings of pain; that they have a reduced interest in sex in general and suffer in their marriages and other sexual encounters because sex is not pleasurable. When a discourse is shaped entirely by partisans it is unlikely that truth will prevail.

    When British colonists and evangelical missionaries first sought to eradicate female circumcision in Africa in the 1920s they did not make strong claims about the effects of genital surgeries on orgasms and sexual pleasure. Cultural attitudes towards erotic activities and sexual encounters inside and outside of marriage are not uniform across the ethnic groups of the world, and it is not just anthropologists who know this. In Kenya in the 1920s at least the sexually modest British missionaries seemed to be aware that female initiation ceremonies could be sexually charged festivities. While the British colonists and missionaries disapproved of the public ceremonies as licentious events they were more concerned about the consequence of female circumcision for reproductive success. The British wanted the population in their African colonies to grow for the sake of a large labor force. They advertised what turned out to be erroneous claims about the effects of female circumcision on fertility. These claims still circulate today and get used in the literature of NGO eradication campaigns, despite the evidence mentioned earlier demonstrating no difference in levels of fertility for “cut” and “uncut” women in Africa.

    These days however claims about the effects of genital surgeries on female sexuality are center stage. Cultural attitudes towards family size, sexual pleasure, and the sexuality of women began to shift in the 1960s in North America and Europe. Thus with the return in the late 20th century of foreign campaigns to uplift Africans and liberate them from their ethnic traditions the advocacy literature calling for the eradication of female genital surgeries has shifted its attention in recent decades to the topic of sex. Featured in the advocacy literature (and advertised in the mainstream press in North America and Europe) are the horrifying and wince inducing images of female genital cutting as “female castration” and “the sexual blinding of women.” According to those who oppose the practice African women in circumcising ethnic groups are sexually disabled.

    Similar claims about the negative effects on male sexual pleasure of removing the foreskin have been popularized by anti-male circumcision groups. It is true that the famous 12th century Jewish rabbi Maimonides and some American physicians in the late 19th and early 20th century (along with some highly educated members of the general public in the United States) endorsed and promoted the practice of male circumcision because they thought it might work as an antidote to uncontrolled erotic impulses and make it easier to be moral and resist the temptation to masturbate (which was viewed as a carnal, worrisome and even health depleting indulgence). One can find African women and men in some African ethnic groups today who out of a variety of concerns (including fears about uncontrolled erotic impulses and sexually transmitted diseases) commend female genital surgeries in similar terms. But Maimonides was wrong! Removing the foreskin does not make men less carnal or reduce the frequency of masturbation. And Maimonides is not the only one who has been wrong about genital cutting and sexuality over the centuries. The best contemporary evidence strongly suggests that circumcised African women have rich sexual lives or at the very least are no more sexually impaired than women in Europe or North America.

    Fortunately there are a few high quality scientific studies on the topic of genital cutting and sexuality. If the truth is to prevail and critical reason brought to bear on a visceral, culturally tabooed and ideologically charged topic such as genital cutting one must rely on high quality studies. Methodological rigor and data quality control are essential if one is to fairly and dispassionately assess the validity of empirical claims. A recent commentary by two Swedish researchers, Sara Johnsdotter (an anthropologist) and Birgitta Essen (a MD in gynecology and obstetrics) summarizes the results of the most rigorous and unbiased studies available in the literature. They begin with a bit of history.

    “The first actual study to challenge widespread assumptions about lost ability to enjoy sex as an inevitable effect of genital cutting was presented by Lightfoot-Klein [an opponent of the practice] in 1989. Her book was built on interviews with some 300 infibulated Sudanese women. Her interviewees gave testimony of their enjoyment of sex. A high percentage of the women (about 90%) produced convincing accounts of the experience of orgasm.”

    With regard to the experience of painful sex Johnsdotter and Essen discuss the large Medical Research Council community-based study in West Africa comparing well over a thousand “cut” and “uncut” Gambian women. No significant differences were found between the two groups in reports of painful sex – 15% of “cut” women versus 14% of “uncut” women experience pain during sex. With regard to the frequency of coitus in marriage they point to a large population survey of thousands of “cut” and “uncut” women in the Central African Republic, where 47% of “cut” women versus 39% of “uncut” women report having sexual intercourse more than five times in the last month.

    They draw our attention as well to a study comparing the sexual lives of “cut” African women (mostly from Ethiopia and Somalia) and “uncut” Italian women who use the services of a health clinic in Florence, Italy (Catania et al 2007). Eighty-six percent (86%) of the “cut” African women were found to experience orgasms. With respect to the dimensions of sexuality investigated in the study (desire, arousal, satisfaction, and orgasm) those African women living in Florence led sexual lives that were as rich if not richer than “uncut” Italian women.

    Here I caution the reader. There are well-recognized difficulties and inhibitions associated with reading and writing about private, intimate and tabooed parts of the human body and their functions. What follows is a somewhat graphic description of the genital regions of the human body.

    If your picture and understanding of the anatomy of the clitoris is the one shared by many educated and sexually experienced adults in North America and Europe (it was once my picture) you are likely to resist the implications of even high quality scientific studies documenting the rich sexual life of circumcised African women. You might even be inclined to dismiss the findings as implausible. You probably equate the clitoris with that smaller part of its total structure that protrudes beyond the vulva and is visible to the eye or most easily touched. Sigmund Freud and other classical psychoanalysts also made the understandable mistake of accepting that equation. That led them to view the clitoris as a diminutive penis and to the invidious speculation that women experience penis envy. If you hold to that picture of the clitoris it will seem self-evident that female genital surgery must dampen the capacity for orgasm and the experience of sexual pleasure. The picture however is flawed and misleading.
    Based on contemporary methods of anatomical analysis it would be far more accurate to imagine a male’s penis as an externalized clitoris that has been lifted out of the body; or perhaps alternatively to imagine a female’s clitoris as a mostly (but not quite fully) internalized and largely (but not quite completely) concealed penis. The clitoris in its entirety is nearly four inches long and should be visualized as a deeply embedded wishbone shaped structure that surrounds the vaginal wall and is mostly hidden from naked view. Consequently a massive amount of female erectile tissue and abundant nerve endings enabling the experience of sexual pleasure and the capacity for orgasm reside beneath the surface of the vulva and beyond the scope of any customary African circumcision procedure.

    That more accurate picture of female genital anatomy (recognizing the embedded depth of the clitoris and dismissing the naïve equation of the clitoris with its visible external parts) is eye-opening for several reasons. The picture suggests that given the deeply embedded anatomical structure of the clitoris and its intimate connections with the vaginal wall there may be little value in trying to draw a sharp distinction between a clitoral and a vaginal orgasm. The picture also exposes Freud’s error: there is no invidious comparison to be drawn once it is understood that a penis is homologous to a clitoris pulled out of the body. It unmasks as well the grotesque fallacy in the polemical, horror-inducing representations which analogize the African trimming or excision of the visible part of the clitoris to the removal of the entire penis from a man (and in some versions of this nightmarish analogy the imagined removal involves not just the entire penis but the scrotum too). (I did caution that this was going to be graphic. The anti-mutilation activists specialize in rousing polemical imagery).

    Most importantly, that corrected picture makes it apparent that female genital surgeries (whether in Africa or Beverly Hills) are NEVER designed to remove the clitoris in its entirety but rather to trim back, smooth out or reshape only its most visible external parts. The picture lends some plausibility to the research evidence mentioned earlier which suggests that the sexual life of a circumcised African woman is not typically impaired by the surgery.”

  40. Mike W says

    Comment 28 by Allo V Psycho.
    A few more thoughts, following an “intervention by life”. As a rank amateur in this area I defer to Richard and Fuambai, not only for their eloquence, but clearly for their vastly superior factual knowledge gained from rigorous research and academic analysis. I hope, however, to be able to add some perspectives based on an intuitive, common-sense view of absolute natural justice combined with a degree of intellectual rigour.
    The final paragraph of Comment 28 raises a very important issue with which I am in full agreement. One of the great disservices (and there are many) which the anti-FGM activists do to girls and women in circumcising cultures is the adoption of a fanatical zero-tolerance approach, including prohibition of any medicalisation of the traditional operations. This condemns further generations of girls to be operated on in primitive and dangerous conditions, with associated risks of both acute and chronic complications including death. A far more enlightened, humane, and constructive approach, with both short-term and long-term benefits, would be to encourage and support medicalisation, thus practically eliminating complications and, importantly, enabling progressive moderation of the more damaging traditional practices, for example by performing less radical infibulation or persuading parents to accept Type II instead of Type III. I have heard anecdotal evidence that there are, in fact, privately funded medical aid organisations which discreetly adopt this approach, as well as training traditional operators in sterile techniques to make their activities safer, and that the availability of such a safe (and free !) service is readily accepted by the communities in question.

  41. Mike W says

    Comment 32 by StillGjenganger.
    Several more interesting points here. (Written before reading Richard’s Comment 40)
    All traditional operations carried out under primitive conditions involve the risk of medical complications, and male circumcision is a highly relevant example. There is more than anecdotal evidence (isolated press reports but, to the best of my knowledge, no systematic study) that in South Africa in the male circumcision “season” certainly dozens and possibly hundreds of young men die or suffer severe mutilation (in its true sense) as a result of botched traditional operations. But is there a national or global campaign to eliminate the practice ? No !
    Concerning sexual pleasure I am on uncertain ground, but Fuambai’s explicit personal testimony (Comment 26), together with her research findings, directly contradicts the assertions of the anti-FGM activists, and I have heard supporting anecdotal evidence elsewhere. I believe the answer lies in the wide variation in operative techniques, not fully represented in the WHO classification, and in particular whether only the small external part of the clitoris is removed, or a deeper excision is performed or other techniques used to destroy internal nerves. I believe that, in cultures which favour the more radical operations (typically in and around the Horn of Africa) the intention is to prevent orgasm, and this is achieved. This, of course, is anathema to the Western feminist clitoricentric mind, which unconditionally equates orgasm with sexual pleasure. It is often said, though, that the most important sexual organ is the brain, and sexual pleasure can also have strong cultural dimensions. One only has to go back a few generations in our society to find very different attitudes to sex and its associated pleasures (mother to daughter: “Don’t worry about the wedding night, my dear – just lie back and think of England!”). It is not unreasonable to suppose that today, in “less developed” societies, women themselves still place higher value on traditional feminine dignity and self-control than on the superficial instant gratification which pervades Western thinking.
    For present purposes I can simplistically accept your hypothesis that some forms of female circumcision could be socially acceptable, while others are not, however I strongly disagree with your suggestion that this could justify a total ban on all forms. The logically correct approach would be to ban the unacceptable forms only, thus giving adherents of the more extreme practices an easy option to moderate their practice rather than continuing it surreptitiously.
    I agree with the general thesis of your final paragraph, however it could be the subject of endless discussion of detail and opinion. I think the core issue is the threshold of detail at which rights and morals should cease to be of public interest, and should become personal, private, or family matters. I think male circumcision falls below the threshold, and this is the case in our society despite the presence of detractors making exaggerated and erroneous claims of its unacceptability. Dispassionate comparative logic says that at least the less radical forms of female circumcision should be treated similarly although, as a concession to the principle that immigrants should integrate into the society in which they have chosen to live, it should probably be consensual, and it should certainly not be performed in a traumatic manner. Whatever the conclusions at this level, it beggars belief that UK law prohibits an adult woman, who can have radical cosmetic surgery on any other part of her body, from choosing to be circumcised for purely personal reasons.
    Using your examples to further confuse the issue, it seems that others definitely consider it their business when the Saudi approach to blasphemy involves 1,000 lashes, and there is no sign of anyone going to war with Sudan or other countries where slavery is still said to exist ! More seriously, your final comment about proportionality of suffering is highly relevant to the consequences of criminalisation of female circumcision – but that discussion must be for another time.

  42. says

    Hi AVP,

    Please excuse typos below (and previously); I’m trying to cover as many questions as quickly as possible:

    On medicalization of traditional female genital modifications – In Guinea, which borders Sierra Leone, many girls are taken to local health centers for the circumcision procedures and then back to the traditional settings for other aspects of initiation rituals. However, WHO prohibits this kind of medicalization of these practices. I must say that what excited me over twenty years ago to undergo traditional initiation was the fact that it was “traditional”. I wanted to experience what my mother, aunts, female cousins, grandmother, great grandmother experienced. I wanted to be a part of the huge ritual celebrations with masquerades and so on that I witnessed as a little girl living in Sierra Leone. I wanted access to the exclusive knowledge and conversation that was the preserve of initiated women so I wanted to go through whatever they went through that made them seem so empowered.

    Although I didn’t know much about the “surgery” at the time I was initiated, I can say with complete confidence that the women who are circumcisers are for the most part well trained and have been practicing their vocations since they were young girls themselves. I was surprised at the precision, lack of bleeding and speedy healing of my own procedure and the subtle but impressive aesthetic change. It was this experience and this moment, holding a mirror between my legs, that sold me. Prior to that, I was just as skeptical as many of you that what happened to me was not in fact a barbaric practice that has no place in modern society.

    What I can say is that for most women who were present and participated in my ceremony (and there were hundreds), what was compelling was that it was a gathering and celebration of, for and by women and that the procedures are carried out by women under the direction and management of experienced women. The idea of having a genital operation just for the sake of say cosmetic reasons in a clinic setting with some strange medical doctor wearing a white coat and wielding surgical tools in some cold room with only other nurses and assistants and their surgical masks would be horrifying to most of these women, certainly to me.

    I would never have elected for any “female genital cosmetic surgery” but I chose female initiation, which included a traditional excision procedure. My mom carefully selected my circumciser, who was also a well-known traditional mid-wife with an outstanding reputation. During my years of fieldwork in The Gambia, time and time again I heard women mention that they were delivered from their mothers’ wombs by the very women who circumcised them and that these same circumcisers helped these women to deliver their own children and so on. The traditional circumcisers are important women of high standing who develop very close familial relationships with village and townswomen over a period of generations.

    I would certainly agree that improving the traditional methods and environment to make them as sterile as possible (a very difficult prospect since many of these procedures are carried out outdoors in the open air) as well as training circumcisers is a worthwhile intervention. But I do want to point out that even under these so-called primitive conditions there are few cases of infection or excessive bleeding that lead to serious morbidity let alone death. Mistakes do happen (even under the most aspetic clinical settings) and there are very rare cases of death just as there are with boys’ circumcisions both in traditional settings and in modern hospitals. My point is we need to retain the traditional aspects of these rituals as an option for women (and arguably consenting adolescents) and provide already skilled circumcisers with even more training in the use of antiseptic techniques, tools and protocols – as is being done by WHO in the training of traditional male circumcisers in Africa. But, in places like Sierra Leone, transferring these female controlled practices to the predominantly male medical sector in my view takes away from a very important traditional power base for women in these societies.

    On the issue of sexuality – I think Rick has pointed out the important research and data from the Hastings Center Report. Even women who have undergone Type III infibulation experience very rich sexual lives, have orgasms and enjoy having sex with their partners. Ardent anti-FGM activists such as Hanny Lightfoot-Klein also found that over 90% of infibulated women in the Sudan reported having orgasms and enjoyed regular sex with their husbands. Certainly, this contradicts popular notions of female sexuality and the role of the external clitoris but this data does make sense in light of recent scientific studies on female sexuality. The enjoyment of sex and experience of orgasm in women is very context specific and changes from woman to woman. I have western friends with so called intact clitorises who have never experienced an orgasm. I have provided a very detailed account of my own experience in an earlier commentary.

    A few quick points (not sure who raised which ones):
    On whether or not I think that female (and male) genital surgery of any type is an assault on a non-consenting child based on the example that was given, my answer is no, not necessarily – it depends on the context. But I will have to elaborate further tomorrow. I’d like to qualify now that my “no” is not a rigid “no” but one that can change or is open to compromise depending on the type of operation and how similar operations are handled vis a vis children in dominant cultural groups in western societies (i.e. I am totally against the differential treatment of African or non-white girls while comparable operations are permitted on boys and white girls whose mothers take them for labiaplasties or other forms of so-called cosmetic surgeries in western countries).

    On the term clitoridectomy – for me personally it has the connotation of the complete removal of the clitoris which is physiologically impossible (what I had removed was the small visible, protruding glans and foreskin). Also, my true preference is the term female circumcision because of the procedure’s basis in religious or cosmological beliefs of my ethnic group and parallel with male circumcision.

    On the full autonomy of woman – I agree. This is why I find it particularly concerning that adult African women do not have full autonomy over their own bodies in many western countries unlike their western female counterparts who can opt for any type of “female genital cosmetic surgery).
    FSA

  43. Ally Fogg says

    MikeW

    All traditional operations carried out under primitive conditions involve the risk of medical complications, and male circumcision is a highly relevant example. There is more than anecdotal evidence (isolated press reports but, to the best of my knowledge, no systematic study) that in South Africa in the male circumcision “season” certainly dozens and possibly hundreds of young men die or suffer severe mutilation (in its true sense) as a result of botched traditional operations. But is there a national or global campaign to eliminate the practice ? No !

    You’re quite correct about this (although the evidence is vastly more than ‘anecdotal evidence (isolated press reports)’ – there is extensive evidence collected by the South African department of health, not to mention many peer reviewed papers.)

    And while it is probably true to say there isn’t a global campaign to eliminate the practice, the conclusion we should reach is that there should be equivalent efforts to eliminate those circumcision ceremonies as there are for FGM – not that we should abandon the latter.

    I’ve made that very point in the Guardian, as have other writers including many from South Africa and other relevant countries.

    http://www.theguardian.com/commentisfree/2014/aug/25/male-circumcision-ceremonies-death-deformity-africa

    The point I make in that piece, which is also very relevant to this discussion of FGM, is that by abrogating our commitment to human rights on this front, we do not adopt a neutral position, what we do is abandon the many, many brave campaigners for progress, human rights and cultural evolution in the affected communities, where their voices are often suppressed, when they desperately need the support and assistance.

  44. StillGjenganger says

    @MikeW 42
    I rather like your proposals. The obvious stance would be to allow traditional procedures that do not cause significant damage (like male circumcision and some types of FGM), and to ban only things that cause actual damage. And if bad hygiene and bad health systems cause unnecessary suffering, the obvious response is to improve them, not to use the bad health systems of Africa as a handy excuse to ban something you are against on purely ideological grounds.
    The thing is, I do not know that much about FGM, and I do not want to wade in and propose all kinds of changes – against a well-established consensus – when I do not know that much about what the consequences would be. Considering how much work and weight went into creating the current consensus, it takes more than a few quick arguments to reverse it.

  45. StillGjenganger says

    @Ally 44

    The point I make in that piece, which is also very relevant to this discussion of FGM, is that by abrogating our commitment to human rights on this front, we do not adopt a neutral position, what we do is abandon the many, many brave campaigners for progress, human rights and cultural evolution in the affected communities, where their voices are often suppressed, when they desperately need the support and assistance.

    Similar things could be said about any strongly felt cultural difference, anywhere. How about this one:
    By abrogating our commitment to [the True Faith] on the front of [Western societies] we do not adopt a neutral position, what we do is abandon the many, many brave campaigners for [sharia law and the protection of the name of the Holy Prophet] in the affected communities, where their voices are often suppressed, when they desperately need the support and assistance” Conflicts at this level are sometimes unavoidable. But peaceful coexistence in a multipolar world demands that we reduce this kind of all-or-nothing conflict to the minimum possible number of cases. Leaving people in peace to continue with practices that are important to them and that in themselves cause no significant damage might be a good place to start.

  46. Ally Fogg says

    Leaving people in peace to continue with practices that are important to them and that in themselves cause no significant damage

    Please Gjenganger, spend two minutes here, then come back and talk to me about “no significant damage”

    http://ulwaluko.co.za/Photos.html

  47. StillGjenganger says

    @Ally 47
    Can’t do that – I am at work and I can guess what it will show. Anyway, I am sure that when carried out incompetently, or with bad hygiene, circumcision can have pretty horrific results – just like I am sure that it must be possible to do it quite safely if you are sufficiently careful. If many youngsters in South Africa suffer crippling injuries after circumcision something surely should be changed. The question is which something, and how to change it.

  48. Mike W says

    Comments 45 & 46 by StillGjenganger.
    Very well expressed, and I thoroughly agree, however I would make one comment about consensus. This is the first example which comes to mind, and it might appear facetious, but think about it.
    In the Middle Ages there was a very broad consensus that the sun moves around the earth, and this was so strong that anyone questioning it was liable to be convicted of heresy and burned at the stake.
    Today, in business and other contexts, there is awareness of the danger of “Group Think” leading to disastrous decisions when an apparent consensus is based on assumption, emotion, or an irrational foregone conclusion rather than rational analysis of all available factual information.

  49. says

    Rarely heard are the voices of the many educated African women who are attached to their cultural traditions, find meaning in them and don’t view themselves as mutilated victims, but quite the contrary feel empowered, enhanced and even aesthetically appealing as a result of the procedure.

    Yeah, there’s plenty of guys — including well-educated guys — who say the same thing about circumcision: “I went through it, it wasn’t all that horrible for me, so that makes it okay.” If a particular culture had a longstanding tradition of lopping off fingers, you can bet there’d be plenty of people who grew up in that culture who had their fingers lopped off, grew up and learned to live without them, and would happily tell you it’s no big deal and who are you to criticize someone else’s culture?

    Also, there are plenty of men and women from places where FGM is practiced, who abhor the practice and say it was not at all good for them. Why are their opinions less valuable than those of FGM’s supporters?

  50. says

    But peaceful coexistence in a multipolar world demands that we reduce this kind of all-or-nothing conflict to the minimum possible number of cases. Leaving people in peace to continue with practices that are important to them and that in themselves cause no significant damage might be a good place to start.

    So basically you’re advocating not standing up for our basic ethical principles, just to avoid conflict. Hey, if we’re okay with bodily mutilation, just to avoid cultural conflict, why stop there? After all, every time we assert a principle, there’s bound to be people who don’t agree with it…so let’s avoid conflict and have peace by never standing up for any principle, except for the principle of peace at any price, of course.

    And who the fuck are you to say the damage done to another person’s body is not significant? You’re no better than that hateful little rabbi who said, why should we Jews give up our God-given practice of circumcision just so boys could have a little more fun masturbating?

    Tell me, if someone chopped your arm off, how “significant” would the damage be to me?

  51. says

    That more accurate picture of female genital anatomy (recognizing the embedded depth of the clitoris and dismissing the naïve equation of the clitoris with its visible external parts) is eye-opening for several reasons. The picture suggests that given the deeply embedded anatomical structure of the clitoris and its intimate connections with the vaginal wall there may be little value in trying to draw a sharp distinction between a clitoral and a vaginal orgasm.

    Oh great — another guy making “scientific” decisions about which perfectly healthy and harmless parts of a woman’s body a woman can do without. Whatever happened to that “do no harm” rule?

    The possibility of appendicitis is not considered good enough reason to routinely remove all babies appendices at birth. And there’s even less good reason to routinely chop out female body parts.

  52. Mike W says

    Comments 44 & 47 by Ally Fogg.
    I have not actively searched for information on the South African situation, therefore I appreciate the corroboration based on greater knowledge.
    I find it disappointing, however, that, while the original article was generally open-minded and thoughtful, albeit with a partisan slant, the approach is now dogmatic, dictating “… the conclusion we SHOULD reach ….” and resorting to the usual activist shock tactic of showing the exceptional worst-case outcomes while ignoring the vast majority of problem-free cases. The argument being made is similar to demanding that all hospitals should be closed down because occasionally serious mistakes are made and people die unnecessarily. It is only if one disrespects the majority view in circumcising cultures, i.e. that circumcision is individually and socially beneficial, that is is possible to draw any logical distinction between the two arguments.

  53. says

    On the full autonomy of woman – I agree. This is why I find it particularly concerning that adult African women do not have full autonomy over their own bodies in many western countries unlike their western female counterparts who can opt for any type of “female genital cosmetic surgery).

    Your comparison is not at all valid: first, most of the cosmetic surgery you speak of in the West is done by and for consenting adults, and there is no uniform religious or cultural imperative requiring it, and no widespread ostracism of people who choose not to have it done. And second, there is significant popular opposition to the practice of having such surgeries done on minors for any reason other than correcting an obvious defect. That’s a very new practice, and it’s nowhere near widely accepted as “part of our culture.”

    Using Western cosmetic surgery to justify or excuse FGM is bullshit. According to basic and longstanding principles of medical ethics and bodily autonomy, the proper and consistent stance to take, is to oppose ALL forms of genital surgery on minors that are not medically necessary.

  54. says

    The argument being made is similar to demanding that all hospitals should be closed down because occasionally serious mistakes are made and people die unnecessarily.

    Um, no, there’s no similarity at all. Hospitals in general perform medical procedures that are NECESSARY, and where the risk of inaction is greater than the risk of action. That’s why we have to have hospitals, even though serious fatal mistakes are made in them. FGM and MGM are nowhere near as necessary, so the risks of such procedures are great enough that they should never be done without good medical cause.

  55. StillGjenganger says

    @Raging 51
    We all think our principles are better than anybody else’s, but the other bastards just will not accept that you are right and they are wrong every single time. So unless you want unending strife, you had better accept that you cannot win them all, and concentrate your efforts on the parts of the world where you have a stake, and/or the most serious problems. Which is why I am fine with the ban on FGM (until someone convinces me it is much less harmful than previously thought), but cannot see any justification for trying to ban (properly executed) circumcision.

  56. says

    StillGjenganger: your prescription only makes sense if the only response we have to injustice is military force. But we do have a wide range of other responses, from public debate to targeted economic aid to international public-education campaigns to non-coercive NGO actions…lots of stuff that doesn’t involve even drone-strikes, let alone getting mired in endless regime-change campaigns. So that leaves us a lot more room for multitasking than you seem to think.

    And besides, it generally doesn’t hurt to let people know you have a worldview that encompasses the whole world, even if you can’t be involved in all places at once.

  57. StillGjenganger says

    @Raging 57
    Power is power, even if it is not military. If I cannot live openly as the person I would be, or pass my culture on to my children, it matters little if it is the US airforce, the secret police, or a democratically passed law, the threat of prison or ostracism, that prevents it.

    Besides, this is not only a matter of what you can get away with. Tolerance of people who disagree with you is a good in itself. It might protect you some day, but meanwhile, the world is a better and happier place if people can live and feel a home in the world even if their way of life is different from that of others. The same principle protects, transsexuals and radfems, Christians and Muslims, Jews and Atheists, gays and fundamentalists, you and me. Often enough there is only room for one norm for all: Abortion, hate speech, drawings of the Prophet, gay marriage, etc. are either legal or not, supported by the mainstream or not. If we want the world to have room for different kinds of people we need to leave space for differences where we can. And the price of that is that we cannot be too all-fired eager to impose our own norms on everybody else whenever we get the chance.

  58. H.E. Pennypacker says

    @Richard Shweder

    On a completely unrelated sidenote I’m guessing that you’re the same Richard A. Shweder that I just saw a reference to (specifically the idea that humans, uniquely, inhabit ‘intentional worlds’) whilst rereading an essay by Tim Ingold, in his book The Perception of the Environment.

  59. says

    Dear H.E. Pennybacker

    You guessed right. It is good of you to notice the connection.

    Returning to the ongoing conversation – with regard to assessing risk and degrees of harm, rousing imagery and personal testimonials are no substitute for carefully conducted research. There is little doubt, however, that good theater often does have a greater impact on popular opinion than good science. In this instance the good science has been almost totally ignored by the mainstream media. Try finding any coverage in the Guardian or the New York Times of the Medical Research Council publication where the researchers suggest that anti-fgm activists stop exaggerating the reproductive health consequences of female genital modifications (a link to this publication is provided in comment #33) or to the Carla Obermeyer review of the medical literature where she questions the empirical foundations of the nightmarish images of African adults maiming and murdering their daughters and depriving them of a sexual life (a link to this publication is provided in comment #13).

    There was once a “consensus” among journalists about weapons of mass destruction in Iraq, even though many experts in the intelligence community had their doubts. The closest one gets to a consensus statement among academic experts about the facts concerning female genital surgeries in Africa is the Hastings Center Report Advisory mentioned several times in earlier comments (comment # 8 for example). Hope springs eternal however – and what one hopes in this case is that mainstream media outlets and courageous journalists will start recognizing the extent to which they have allowed themselves to become public relations agents for advocacy organizations.

    Below is a link to an essay I wrote some years ago titled “What About ‘Female Genital Mutilation’: And Why Understanding Culture Matters in the First Place.” It addresses several topics of relevance to this conversation including a recommendation for a public policy response to both male and female “circumcision.”

    https://humdev.uchicago.edu/sites/humdev.uchicago.edu/files/uploads/shweder/whataboutfgm.pdf

  60. Allo V Psycho says

    OK, I am exhausted after a 14 hour day trying to improve health care in my own particular way, so what I’m going to say as my view may come across as being (may indeed be) simplistic.

    First, there are no gods or goddesses. It follows that there are no ‘sacred’ texts. Traditional practices may be good, neutral or profoundly harmful. Tradition itself is no guide.

    Second, there are self-evident human rights, to life, liberty the pursuit of happiness, and autonomy over one’s body. These obviously apply to both women and men, though for women, they have been, and are even yet, often denied. These rights are more important than cultural traditions.

    The requirement for consent for non-emergency medical procedures is essential. (Richard, I’m missing where you address consent). Infants and children cannot give true consent: true consent is an act of the competent and fully informed adult.
    The need for consent may be over-ridden where (a) it cannot be obtained and (b) mortality of substantial morbidity may result.
    Immunisation is not a counter example. Without immunisation, children, children round them, and adults round them, may die or be disabled.

    An irreversible, non-consensual, body modification, either on adults or children, is an assault.

    The severity of the assault is positively related to (a) the harm caused and (b) the risk of things going wrong. I’ve seen babies with pierced ears: meh. The ears will heal, if the adult wishes it. Male circumcision? More significant than pierced ears, but in my reading, relatively neutral. Modify the genitalia of a female infant or child? No. It is major, has the potential to lead to significant loss of function, and is deeply hazardous if it goes wrong. Modify the genitalia of female infants and children in non-sterile conditions? No. Modify the genitalia of infants and children irreversibly, when they cannot give consent? No.
    If competent adults wish to undergo body modification, whether for medical, aesthetic, sexual preference, or cultural reasons, and have received full information on the implications: that lies within their choice.

    So, that’s my view. I’m happy to campaign for my views (although they are close to the current social and legal consensus in my jurisdiction). I fully believe others are entitled to campaign for different views on adult choices; but to pre-empt the discussion by non-consensual procedures on female infants and children: I believe that is hard to justify. I believe it is an assault. I believe it is a serious assault. I believe it is a crime.

  61. StillGjenganger says

    @Allo 61
    Very reasonable account. But the idea that tradition is inherently worthless, and that right and wrong should be determined form the holy text of the declaration of human rights, as interpreted by the priesthood of the ECHR, is just your personal ideology. Someone else might say that tradition is valuable, and that it was up to the parents to decide on behalf of their children whether the advantages outweigh the risks of circumcision. Childhood forms both the body and the mind in a way that is irreversible. Obesity, fitness, intellectual ability, the capacity for elite sports, are set before adulthood and cannot really be made up once you are grown. Everybody would agree that mutilation (destroying the capacities of your body) is bad. Whether keeping a small flap of skin is more important than growing up initiated in your culture, or following the world of God, depends on your ideology.

  62. H.E. Pennypacker says

    @Allo vs Psycho

    Your argument that human rights are ‘self-evident’ but that something like FGC are merely ‘cultural’ is a common but very interesting and problematic one.

    Before the second half of the twentieth century, Western chauvinists were in the habit of claiming superority over other cultures on the basis that Europeans were more cultured, that they had attained a higher degree of civilisation. That the people that the colonialists encountered were less able to understand how the world worked, and less able to act morally because they had not yet reached the same level of culture as the Western imperialists. This sort of thinking was even discernible amongst those who were wary of claiming the West’s superiority.

    In the second half of the 20th century this picture largely changed. It becam rather a faux pas to refer to ones own society as more cultured an those of people living in distant lands as ‘primitive’ or ‘savage’. Strangely the picture was reversed: rather than Western superiority resting on a higher degree of culture it was now thought to depend on the ability to stand outside of culture. The people who it was no longer OK to refer to as primitive, the non-Western ‘Others’ were now said to live in culturally constructed worlds, blinded to the true nature of reality by tradition.

    The Westerner however had lifted back the veil of culture, he could perceive what was natural, self-evident, and universal. Human rights were not the ultimate moral code due to being the product of the most advanced culture; there superiority to every other way of conceiving morality and goodness came from the fact that they had been perceived by he who had removed the blinkers of culture.

    In exerting his considerable power to make ‘traditional cultures’ change their ways he is not trying to force his own values upon them, rather, he is opening their eyes to the divine light of universal truth. He is merely telling them the Good News.

  63. StillGjenganger says

    @ H.E.P 63
    Very true.
    To be fair the declaration of human rights is probably not a bad stab at selecting a universal set of principles, provided that you see them as general principles. They are positive enough and vague enough that just about everybody could actually agree. Once you start interpreting them in the light of individual questions, using a body of case law (or ‘priestly’ interpretation) to freeze the result, they can no longer be universal. Instead the case law becomes a prescription of the one true way for organising a society, and can claim no loyalty from people who happen to disagree. Whether circumcision is permissible – or whether at least some prisoners must have the right to vote while still in British prison – is not a matter of universal agreement.

  64. Mike W says

    Comment 43 by FSA.
    Clearly this was a particularly rich and empowering socio-cultural experience, combined with a result which was highly pleasing at a personal level, and it is inconceivable that similar views are not held by other participants. There is no logical reason that such positive testimony should be assigned less credibility than that of others who have had the misfortune to suffer a negative experience. Furthermore, such a considered testimony based on direct experience is far more convincing than the views of “outsiders” who have experienced neither the culture nor the physical effects.
    Let me clarify that, in advocating medicalisation, I did not intend to imply the necessity of a clinical environment, but simply that medical or similar techniques should be used to ensure reasonable safety. There should be no excuse for activist writings to include the standardised recital about blind old women with rusty razor blades or pieces of broken glass.

  65. Mike W says

    Comment 55 by Raging Bee.
    There is no absolute meaning of “NECESSARY”. It is a matter of opinion, heavily influenced by social and cultural values. In the societies in question, circumcision is seen as socially necessary. You may not understand, and clearly you do not agree, but it is their business, not yours.

  66. Mike W says

    Comments 58, 62, 64 by StillGjenganger.
    Very eloquently stated, and I agree completely. Mutual tolerance and respect are sadly lacking in human nature. Cultural terrorism is, in principle, as despicable as religious terrorism.
    BTW, Hva slags gjenganger er du ?

  67. StillGjenganger says

    @Mike W 67
    Thanks.
    En der er gaaet bort men er kommet igen. Jeg siger ikke hvor, men taenk paa Guardian CiF.

  68. says

    Tolerance of people who disagree with you is a good in itself.

    Tolerance of PEOPLE is not the same thing as tolerance of SPECIFIC VIOLATIONS OF BASIC HUMAN RIGHTS. Are you trying to equate the two? If so, you’ve just put yourself in the same league as the child-rape apologists of the Catholic Church.

    …the world is a better and happier place if people can live and feel a home in the world even if their way of life is different from that of others.

    Not for the victims of gross physical abuse it isn’t.

    … with regard to assessing risk and degrees of harm, rousing imagery and personal testimonials are no substitute for carefully conducted research.

    If your “carefully conducted research” is “careful” to exclude or minimize the “personal testimonials” of persons who were victimized by a particular action, then it’s nothing but carefully crafted bullshit and obfuscation. It’s perfectly obvious that you’re using a façade of sciencey discourse and detachment as cover for an action that is in direct and blatant violation of basic Western ethics. I’ve heard fake scientists like you use similar scholarly discourse to “dispassionately” justify male circumcision, lobotomies, forced commitment in warehouse mental institutions, economic exploitation of less-powerful peoples, and even negro slavery in America (the latter in the Economist no less).

    There was once a “consensus” among journalists about weapons of mass destruction in Iraq, even though many experts in the intelligence community had their doubts.

    So fucking what? People were wrong about something else, therefore…what? We should all just shut up and listen to a guy in a white coat telling us we’re wrong to apply basic rules of ethics in the real world? As Ed Brayton often says, I’ll take diversionary non-sequiturs for $1000, Alex.

    But the idea that tradition is inherently worthless, and that right and wrong should be determined form the holy text of the declaration of human rights, as interpreted by the priesthood of the ECHR, is just your personal ideology.

    StillGjenganger, you are flat-out lying about what Allo very plainly said. NO ONE here is arguing from a “holy text,” “as interpreted” by any “priesthood,” we’re arguing from basic principles of human rights that have been derived from centuries of observation of the benefits and harms done to people. Your blatant misrepresentation of such common and easily-understood principles just proves your dishonesty and bad faith.

    To be fair the declaration of human rights is probably not a bad stab at selecting a universal set of principles, provided that you see them as general principles. They are positive enough and vague enough that just about everybody could actually agree. Once you start interpreting them in the light of individual questions, using a body of case law (or ‘priestly’ interpretation) to freeze the result, they can no longer be universal.

    So universal human rights are okay as long as we keep them meaningless and don’t actually try to apply them in the real world. Gosh, that sounds familiar…like someone else has said the same thing…oh yeah, that would be every tyrant, bigot, bully and phony priest who’s ever been accused of violating anyone’s human rights. Swell company you’re keeping there, StillG.

  69. Mike W says

    Comment 63 by H E Pennypacker.
    Another eloquently presented and interesting observation. On reading the final two paragraphs, I took them to be loaded with irony but, on review, I am not so sure. Whatever the intended meaning, it should be recognised that a perfectly valid response to evangelism is rejection. There is no certainty that the evangelist’s proposition has any greater validity (in whatever frame of reference one may choose) than the cultural model which he seeks to displace.

  70. says

    Assessing human rights arguments

    The arguments calling for eradication come in two kinds: harm arguments (for example, effects on health and sexuality) and human rights arguments (for example, claims about non-consensual violations of bodily integrity). Dispassionate review of the highest quality scientific research on female genital operations suggests that the harm claims have been highly exaggerated and can be mitigated without eradication. But the human rights claims seem pretty problematic too, for some of the reasons I recount below.

    “The idea that there is some kind of inherent opposition between rights and culture has gained some currency in the academic and advocacy literatures in recent years (see e.g., Okin 1999 and the critique by Volpp 2001), although I confess I don’t find the idea appealing or even coherent.

    If there actually are real, objective, natural or inalienable human rights (for example, a right to freedom of association, freedom of religion, freedom of expression, or the right of parents to educate their children into the beliefs and values of a particular way of life – the way of life of their ancestors) then the very process of group and family formation and the entire symbolic and expressive side of culture might rest on them, and might be well-justified by reference to some set of human rights.
    On the other hand, if real, objective, natural or inalienable human rights don’t exist, as some have argued, then they can hardly be said to be in tension or conflict with culture. And if they exist only as “positive rights” (rights granted by consensus or declaration or promulgation by some groups at some points in history but not by other groups at other points in history; in other words if they are understood to be convention based, vote based or “alienable” rights) then it is one’s particular location in culture and history that is the only source of authority for any claim to have a right. So I don’t find the opposition of rights versus culture very helpful.

    Ontologically speaking, what is a real, natural, objective or “inalienable” human right? Presumably it is something to which everyone is entitled simply by virtue of being a human being. If that is the case then it is an entitlement that derives not from who you are in particular or from what you have accomplished in life. And it is not an entitlement whose authority derives from the will of some person or group who decides or elects to honor the things called rights. A “natural” or “inalienable” right, in the strong sense, must be something transcendental or overarching, something that we may discover but not something we simply make up or invent, either individually or collectively; for then the right would be subjective, not objective, and it would not be universally binding….

    …It seems to me that the global discourse concerned to eradicate the customary African practice of female genital modification has not come to terms with, or even systematically addressed, these kinds of issues: whether “rights” are objective or subjective, discovered or made up, products of reason or expression of personal or collective preference and taste; whether there is a rational basis for extending the authority of rights claims beyond the scope of those who have agreed to honor them; whether the rights that have been invoked in the global discourse are both concrete and context relevant enough to be decisive or criterial yet transcendental and objective enough to make universal claims.

    For example, Shell-Duncan and Hernlund (2000:27-31) have exposed some of the difficulties with applying human rights arguments to support the current “anti-FGM” eradication campaign. In the course of their discussion they mention several “rights”, which have been invoked in various U.N. Declarations (The 1959 Declaration of the Rights of the Child; the 1984 Convention Against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment). One such right is the right of the child “to develop physically, mentally, morally, spiritually, and socially in a healthy and normal manner and in conditions of freedom and dignity.”

    There are numerous and obvious problems with such a formulation when applied to the normative and socially valued practice of genital modification in East and West African communities. For one thing, as Shell-Duncan and Hernlund note, “normal” development in many African ethnic groups involves the cultural remaking of the human body (of both boys and girls) for the sake of their physical, mental, moral, spiritual and social development. Thus the statement of the right is too abstract to be criterial; and any informed application of the right to the case at hand might well lead to the conclusion that the practice is entirely consistent with the rights of the child.

    Secondly, some components of the statement of the right (a right to “develop…in conditions of freedom…”) seem to deny the reality of normal and healthy developmental processes and development promoting social relationships, which are often commanding and hierarchical and always constraining and limiting of options, often to a rather high degree. For example, children are not free to decide not to go to school or not to have an inoculation; they are not free to decide to move to some new residence or location, or to select the religion that will be practiced at home, etc. etc. A very particular and culture-specific (and perhaps social class specific) kind of liberationist or radical autonomy perspective seems to have been written into this rather ideologically loaded (and hence subjective) formulation of a supposed “natural right.”

    Even the idea of a right to bodily integrity seems problematic as a possible foundation for criticizing this particular practice of African body modification. For one thing, if there is a natural human right to bodily integrity of the type supposed it would extend to the practice of male genital surgeries as well, and might well run counter to the rights to religious freedom and family privacy of Jews and Muslims around the world. Secondly, it is not at all clear what “the integrity of the human body” actually amounts to, once the overheated and sensationalized morbidity, mortality and sexual dysfunction claims are viewed with a cautious or skeptical eye. From the cultural perspective of Jews, Muslims and those Africans (Muslim and non-Muslim) who “circumcise” their children (both boys and girls) the human body lacks integrity (contains unbidden, immature, problematic or even ugly and disgusting components) until it is improved, purified and made “normal” by means of cultural intervention and the status conferring procedure of a genital modification (see Ahmadu 2000, Lane and Rubinstein 1996, Meinardus 1967, Shweder 2003).

    But perhaps the most problematic aspect of a human rights argument for those engaged in the global eradication campaign is that the global eradication campaign itself appears to violate several readily recognizable supposed human rights. A short list of such rights includes the right of peoples and nations to autonomy and self-determination, the right of parents to raise their children as they see fit, the right of members of a family to be free of government intrusion into decisions that are private, the right of members of a group to favor their own cultural traditions in the education and socialization of their children, the right to freedom of religion (for example, among the Mandinka people of Guinea-Bissau , bodily integrity, interpreted as bodily purity via genital modification, is a prerequisite for prayer)(Johnson: 2000), the rights of both girls and boys to equal regard, etc. [In most ethnic groups where female genital modification is a socially valued practice, male genital modification is socially valued as well, and both are associated with access to many social goods. So this is not a case of society picking on women. Quite the contrary, where there are customary female bodily modifications there are customary male bodily modifications, and in many of these ethnic groups both sexes are treated with equal regard for their courage and for their social, moral and physical development].

    Recently, Elizabeth Boyle (2002) has written an informative book about how global institutions (the WHO, the UN, “First World” governments, the World Bank, and feminist and human rights activist organizations and NGO’s) are pressing for global cultural homogenization in ideas about the body, the family and child development, and how, with regard to the campaign against “FGM”, they have made use of their unequal bargaining position, power, influence and wealth to essentially intrude into the internal affairs of the poor and financially dependent nations of East and West Africa. It is a noteworthy fact that in at least seven African nations 80-90% of the popular vote would probably vote against any policy or law that criminalizes the practice of genital modification for either boys or girls. Yet in many of those African countries, third world elites (acting as “Enlightened” or “liberated” patrons of progressive cultural development, or acting as recipients of foreign aid and largesse, or simply acting under international pressure) have promulgated administrative policy statements and laws that criminalize a practice that vast majorities of their own citizenry endorse, value or embrace. The last thing in the world that those who support the global campaign want is to give voice to popular sentiment or to support the principles of democratic self-governance. If you put it to a popular vote in Mali or Egypt or Sierra Leone you lose, so you don’t put it to a vote.
    When it comes to drawing up lists of human rights violations the results can thus be surprising. Given that those with the money and power have been engaging in what amounts to a propagandistic and excessively rhetorical disinformation campaign about the health consequences and mortality risks of genital modifications, one might suggest that it is not Africa that should be viewed as a “dark continent.’’ The “First World” begins to look darkly ironical (some might say, hypocritical) when North Americans and Europeans who say they value family privacy and self-determination for themselves seem eager to deny both those rights to African parents.

    These are, of course, disturbing conclusions; and they are not ones that will be welcome by “anti-FGM” activist organizations and their supporters. But perhaps they will serve as a wake-up call for those who value fair play, democratically evolved pluralism, and the toleration of differences. Perhaps it is time for liberal free thinking citizens in Europe and North America to recognize that the global campaign is a flawed game. And perhaps it is time for those who care about the accuracy of cultural representations in public policy debates to insist that the voices of the many African women and girls who value the practice be heard and acknowledged; and time to insist, as well, that when it comes to preemptive strikes against other peoples cultural customs, there should be no free ride through the international court of critical reason.”

    (The full reference information for citations in this excerpt can be found in the original essay, which is available here):
    https://humdev.uchicago.edu/sites/humdev.uchicago.edu/files/uploads/shweder/When%20Cultures%20Collide.pdf

  71. says

    No, it’s not a matter of rage overriding reason; it’s a matter of basic morality being the underpinning of reason.

    The fact that you consider the upholding of a basic human right to be an act of “rage” says a lot about your mindset.

  72. says

    In this particular case I am happy to choose my company over yours.

    So you’re perfectly happy to be in the company of people like Vladimir Putin and his Russian Orthodox gay-bashing chums? Perhaps you should consider moving to Russia. Unless of course you’d prefer ISIL’s customs.

  73. StillGjenganger says

    @Raging 74
    Well, since you ask, Putin is likely to be both more polite and more interesting company than you. As for who did the more damage, we’d have to let you run a nuclear power for a few years and look at your track record then. I would not place any bets.

  74. says

    There is no absolute meaning of “NECESSARY”. It is a matter of opinion, heavily influenced by social and cultural values.

    Bullshit. Medical necessity is easily verified observing a person’s physiological condition. “Cultural necessity” is a cultural construct, and should never override considerations of medical necessity. That’s why torture and corporal punishment are wrong, and that’s why ritual bodily mutilation is wrong.

    “It’s all a matter of opinion” is how grade-school kids effectively admit they’ve lost an argument.

    Let me clarify that, in advocating medicalisation, I did not intend to imply the necessity of a clinical environment, but simply that medical or similar techniques should be used to ensure reasonable safety. There should be no excuse for activist writings to include the standardised recital about blind old women with rusty razor blades or pieces of broken glass.

    The problem with this dodge is that you cannot separate the two issues. If a certain medical procedure is deemed a “cultural necessity” and required for all girls or all boys, then that makes the gross abuses by amateurs inevitable, since a) not all of the girls or boys who have to undergo the procedure will have access to proper medical facilities; and b) putting a “cultural necessity” above personal health will inevitably create a climate where personal medical health is simply not important, and not upheld.

  75. says

    Dispassionate review of the highest quality scientific research on female genital operations suggests that the harm claims have been highly exaggerated and can be mitigated without eradication.

    I’ve heard Dick Cheney and his chums say the same thing about waterboarding. I’ve also heard a “professor” or two say the same thing about rape.

    But the human rights claims seem pretty problematic too, for some of the reasons I recount below…

    And here we go with yet another droning attempt to “reason” away basic rights according to some authoritarian’s convenience.

    There are numerous and obvious problems with such a formulation when applied to the normative and socially valued practice of genital modification in East and West African communities. For one thing, as Shell-Duncan and Hernlund note, “normal” development in many African ethnic groups involves the cultural remaking of the human body (of both boys and girls) for the sake of their physical, mental, moral, spiritual and social development.

    And why is the “cultural remaking of the human body” necessary for a child’s development? Because their culture says so, and because they simply do not consider a child “developed” unless and until they’ve been “remade.” That’s a purely cultural construct, and it should NEVER be allowed to take precedence over a child’s physical health, bodily autonomy oar basic individual rights.

    But perhaps the most problematic aspect of a human rights argument for those engaged in the global eradication campaign is that the global eradication campaign itself appears to violate several readily recognizable supposed human rights. A short list of such rights includes the right of peoples and nations to autonomy and self-determination, the right of parents to raise their children as they see fit, the right of members of a family to be free of government intrusion into decisions that are private, the right of members of a group to favor their own cultural traditions in the education and socialization of their children, the right to freedom of religion…

    That’s the standard checklist of “rights” invoked by authoritarians of all stripes as excuses to disregard individual rights: abusive parents, “states’ rights” segregationists, Islamofascist hatemongers, slave-owners who don’t want to comply with the Bill of Rights, religious bigots who want to keep on discriminating against gays and atheists, and other people engaged in practices that are clearly harmful to others, contrary to basic rights, and wrong by just about any other commonly-used measure.

    Questioning and changing one’s tribal customs is not just something “cultural imperialists” do; it’s something EVERYONE does, at one time or another, when they want to advance past tribalism and improve their condition as civilized beings. That’s what progress IS.

  76. says

    …the right of members of a family to be free of government intrusion into decisions that are private…

    This is standard libertarian doublethink: when people are oppressed and routinely abused by tribal or family authorities, it’s “freedom,” but when a government authority tries to stop the oppression and abuse, according to a clear and documented law or right, that’s “tyranny” and “interference” and COMMERNISM!!! (And BTW, the decisions cannot be considered “private” if they affect other non-consenting parties.)

    Any person who routinely spouts such obvious dishonesty can be safely disregarded, and should be kicked to the curb without further ado.

  77. Allo V Psycho says

    I see. So human rights are dispensible, because tradition. So consent to medical procedures, so autonomy over your own body can be discarded, because tradition. So maiming infants is fine, because tradition. Because, of course, you OWN those children: they belong to you as chattels. Because tradition. So safe, sterile medical practice is secondary to….tradition. And after all, sepsis is quite traditional. And we don’t need your Western reductionist vaccines and medicines, they’re not traditional at all, unlike rubella and smallpox and malaria.

    So, if it’s not an assault and a crime to carry out labiectomy and clitoridectomy on unconsenting children, then it’s not a crime to carry them out on unconsenting adult women. It’s not even an assault. That’s tradition for you.

    So slavery is fine: because it’s traditional, and anyway, human rights are just a Western invention. So stoning adulterers is fine, because it’s traditional. So killing your new born, by putting ghee on the cut umbilical cord is recommended, because it’s traditional. So infibulation of young girls is to be campaigned for, because it’s traditional.

    Gay? Choose your country of birth carefully. You might run into tradition. Female? Likewise. Public flogging for dissent? Don’t even think about objecting: it’s the way things have always been done around here.

    And having read and considered the arguments put forward in support of indefensible cultural practices, because they are…traditional….then I note these arguments are so flimsy, so specious, despite their tawdry dress of flimsy scholarship, that they are not really arguments at all: they are rationalisations. Justifications of unjustifiable practices, done to children. Because….”that’s what we have always done round here”. It has indeed an educative process.

  78. StillGjenganger says

    @Allo 81
    Do calm down. Human rights are not dispensable because of tradition. Neither is tradition dispensable because of human rights, unless your personal ideology says that they are. You need to sort out when something is so important that you must force other people to comply with it, and when the value of letting people live according to their own principles should count as more important. I, e.g. am still against FGM until someone can convince me that the medical consequences are light enough to be borne – though the fact that people like you and Ally do not even try to argue that point is a bit suspicious.In a world where people have different morals and different priorities it does get rather messy to decide what everybody should do – but the only simple solution possible is “I know I am right so we always do it my way.

  79. says

    @StillGjenganger 82

    Do calm down. No one is talking about “forcing” anyone to “comply” with anything. We’re engaging in something called “criticism.” Look it up someday.

  80. says

    Neither is tradition dispensable because of human rights…

    Actually, yes, tradition IS dispensable because of human rights. If there’s a tradition that predictably results in an obvious violation of a non-consenting person’s basic rights, then the people affected by it are perfectly within their rights to change it; and the rest of the world are under absolutely no obligation to respect, support or enable such a tradition. We have inalienable rights, but not inalienable traditions.

  81. StillGjenganger says

    @Raging
    This is exactly where we disagree. I cannot put it better than H.E.Pennypacker did:
    In exerting his considerable power to make ‘traditional cultures’ change their ways [the westerner] is not trying to force his own values upon them, rather, he is opening their eyes to the divine light of universal truth. He is merely telling them the Good News.

    Sometimes, I agree, forcing your norms onto someone who disagrees is justified, but sometimes it might not be. Either way you should have the honesty to admit openly that this is what you are doing, and to consider why, in this case, your values should trump other people’s.

  82. says

    Um, no we Westerners don’t need to open anyone’s eyes — the people who have been victimized by backward and barbaric customs have been opening OUR eyes. After fleeing said barbaric customs and seeking better lives in the West.

  83. H.E. Pennypacker says

    @Allo 81

    I see. So human rights are dispensible, because tradition.

    To be honest I would contest your use of “tradition”. This is the vision of the moderns: everyone outside of Western modernism is consigned to a static past where they endlessly reproduce their own ignorance because it is the way they have always done things. The West has progress, a teleological and steady increase in knowledge and morality, whereas all others have tradition – blindly copying their forefathers.

    “Because people did it in the past” is, on it’s own, not a particularly good reason for doing something. People who practice female and male circumcision may well point to the fact that their ancestors have long carried out the ritual but what is important is the fact that it creates meaningful and enriching experiences for people in the here and now.

    So consent to medical procedures, so autonomy over your own body can be discarded, because tradition.

    Again you are completely utterly blind to the specific cultural assumptions underlying what you’re saying. The idea of the self contained individual, set-off from the world and existing outside of it’s relationships with the world around it (on which an idea like bodily is based) is a particular way of conceiving the person which is by no means universal.
    So safe, sterile medical practice is secondary to….tradition. And after all, sepsis is quite traditional. And we don’t need your Western reductionist vaccines and medicines, they’re not traditional at all, unlike rubella and smallpox and malaria.
    So, if it’s not an assault and a crime to carry out labiectomy and clitoridectomy on unconsenting children, then it’s not a crime to carry them out on unconsenting adult women. It’s not even an assault. That’s tradition for you.
    So slavery is fine: because it’s traditional, and anyway, human rights are just a Western invention. So stoning adulterers is fine, because it’s traditional. So killing your new born, by putting ghee on the cut umbilical cord is recommended, because it’s traditional. So infibulation of young girls is to be campaigned for, because it’s traditional.
    Gay? Choose your country of birth carefully. You might run into tradition. Female? Likewise. Public flogging for dissent? Don’t even think about objecting: it’s the way things have always been done around here.
    And having read and considered the arguments put forward in support of indefensible cultural practices, because they are…traditional….then I note these arguments are so flimsy, so specious, despite their tawdry dress of flimsy scholarship, that they are not really arguments at all: they are rationalisations. Justifications of unjustifiable practices, done to children. Because….”that’s what we have always done round here”. It has indeed an educative process.

  84. H.E. Pennypacker says

    “So safe sterile…” onwards shouldn’t have been part of that post. It was copy and pasted from Allo vs Psycho’s post at 81

  85. says

    To be honest I would contest your use of “tradition”. This is the vision of the moderns: everyone outside of Western modernism is consigned to a static past where they endlessly reproduce their own ignorance because it is the way they have always done things. The West has progress, a teleological and steady increase in knowledge and morality, whereas all others have tradition – blindly copying their forefathers.

    What the fuck does any of that have to with our specific criticisms of FGM? It sounds like nothing more than vague incoherent anti-Western blathering, which we’ve all heard before as a dodge.

    Oh, and do you not even know how to use italics (or just quotation-marks) and extra linefeeds to separate your words from whoever you’re responding to? Your failure to use even those rudimentary formatting tools makes your comment even less coherent than it already is.

  86. H.E. Pennypacker says

    Raging bee wrote:

    Oh, and do you not even know how to use italics (or just quotation-marks) and extra linefeeds to separate your words from whoever you’re responding to? Your failure to use even those rudimentary formatting tools makes your comment even less coherent than it already is.

    H.E. Pennypacker had previously written:

    “So safe sterile…” onwards shouldn’t have been part of that post. It was copy and pasted from Allo vs Psycho’s post at 81

    Raging Bee

    What the fuck does any of that have to with our specific criticisms of FGM? It sounds like nothing more than vague incoherent anti-Western blathering, which we’ve all heard before as a dodge.

    H.E. Pennypacker said:

    “Because people did it in the past” is, on it’s own, not a particularly good reason for doing something. People who practice female and male circumcision may well point to the fact that their ancestors have long carried out the ritual but what is important is the fact that it creates meaningful and enriching experiences for people in the here and now.

    and

    Again you are completely utterly blind to the specific cultural assumptions underlying what you’re saying. The idea of the self contained individual, set-off from the world and existing outside of it’s relationships with the world around it (on which an idea like bodily is based) is a particular way of conceiving the person which is by no means universal.

    I have plenty more arguments linking this to your criticisms but I’m unwilling to spend my time typing them up until you’ve displayed that you possess basic reading comprehension skills.

  87. says

    Because people did it in the past” is, on it’s own, not a particularly good reason for doing something. People who practice female and male circumcision may well point to the fact that their ancestors have long carried out the ritual but what is important is the fact that it creates meaningful and enriching experiences for people in the here and now.

    The thing is, there’s people who underwent such rituals who did NOT get any “meaningful and enriching experiences;” they just got permanently and painfully mutilated, and now they’re speaking out to have the practice eliminated. Are their opinions worth less than those of the practice’s supporters? Who are you to insist a tradition be respected by foreigners, when it’s being actively opposed from within the community that clings to it? Would you want, say, a Chinese NGO saying no one should be so presumptuous as to question a hallowed American tradition such as racial segregation in public facilities?

    The idea of the self contained individual, set-off from the world and existing outside of it’s relationships with the world around it (on which an idea like bodily is based) is a particular way of conceiving the person which is by no means universal.

    First, no one here is advocating such a totally insular concept of individuality; it’s really not needed to support a right of bodily autonomy. And second, even if the concept of bodily autonomy is Western in its origin, that doesn’t make it invalid, or meaningless outside the West; nor does it mean no one outside the West has any use for it. In fact, one of the reasons there’s such controversy around FGM today is that non-Westerners also want to have bodily autonomy. And if we have reasons to believe an idea is good, why shouldn’t we advocate it for others? Or do you support the old South African idea of “separate development?”

  88. StillGjenganger says

    @Raging 91
    I do not doubt that there are people in Africa who are against various forms of circumcision, but if there is more than a small minority they have yet to appear outside your posts. Do link to some data, if you have them. Meanwhile a few individual African allies does not make your cause African, any more than a single communist millionaire means that the rich are in favour of the dictatorship of the proletariat. If huge numbers of Africans were against circumcision they could surely fight their battles on their own. The situation is rather the opposite: a small minority of local anti-circumcision activists, who want to impose their ways on an unwilling majority – with heavy western backing to make up for their lack of clout in their own country. Which makes your fight for the poor circumcision-ridden Africans look more than anything like a pretext, like Putin’s fight for the poor Ukranian Russians oppressed by the fascist government in Kiev..

  89. says

    Meanwhile a few individual African allies does not make your cause African…

    So how many individuals in Africa have to join the cause before you (in what country again?) recognize they’re enough Africans to be labeled an African cause?

    …a small minority of local anti-circumcision activists, who want to impose their ways on an unwilling majority…

    Yeah, standing up for one’s own rights = tyranny over others. Do you have any idea how many ignorant bigots say exactly the same thing when they’re faced with losing their power over other people?

    Which makes your fight for the poor circumcision-ridden Africans look more than anything like a pretext, like Putin’s fight for the poor Ukranian Russians oppressed by the fascist government in Kiev.

    Yeah, right — criticizing injustices in another country is exactly the same as supporting armed aggression in that country. Just two more items on the authoritarian’s fake-rights checklist.

  90. Anton Mates says

    I do not doubt that there are people in Africa who are against various forms of circumcision

    That’s rather an understatement. According to UNICEF, there are 29 African countries where FGM is practiced, and in all but ten of those countries, the majority of girls and women think it should end. There are only two countries–Mali and Guinea–where less than a quarter of girls and women think FGM should end.

    So yeah, there are a lot of people in Africa who are against at least one form of circumcision. Of course, even if the number of people against it was relatively small, it would still be a human rights violation to force them to undergo circumcision. (And Ally has documented this happening to men as well as women.) Even small minorities have rights.

  91. Bob_of_Bonsall says

    My take on this case is that it was prosecuted with the full expectation of failure and done simply to give an excuse for taking no action.

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