On May 1, the American Academy of Pediatrics issued a statement supporting pediatrician involvement in female genital mutilation. I have frankly been in shock. I get the idea that it will support immigrant communities. But the idea I finally came around to, that Marilyn Fayre Milos, director of nocirc.org, elucidates so beautifully below, is… who is supporting the children?

Greetings,

As the founder and Executive Director of the National Organization of Circumcision Information Resource Centers (NOCIRC) and a founding board member of Intact America, you can understand that I have received an impressive number of complaints about the AAP’s new Policy Statement Ritual Genital Cutting of Female Minors. Educated,informed people are scrutinizing the AAP’s statements on bioethics,female genital cutting, and male genital cutting (aka “circumcision” or”genital mutilation”). The AAP will no longer get away with shenanigans, as evidenced by the 1989 Task Force Committee on Circumcision under the leadership of circumcision advocate Edgar Schoen, MD, which was such an embarrassment to the AAP.

Even granted the best of intentions, the AAP is now in a precarious situation that needs to be rectified. And, I don’t mean rectified with an attempted explanatory cover-up letter by its President, echoed in the numerous letters sent out by its Executive Director.

Equality Now, FORWARD, Doctors Opposing Circumcision, NOCIRC, IntactAmerica, Attorneys for the Rights of the Child, the International Coalition for Genital Integrity, MGMbill.org, and untold numbers of concerned individuals have asked for a retraction of the AAP’s current policy statement and reinstatement of its previous one, condemning female genital cutting.

While cultural sensitivity is important, human rights trump personal preference, cultural conditioning, and religious affiliation, especially when it concerns the minor child.

The AAP statement says, “…the ritual nick suggested by some pediatricians is not physically harmful and is much less extensive than routine newborn male genital cutting.” Believe me, spreading the legs of a young girl to “nick” her genitals is not “minor” to that child; it is both physically and psychologically traumatic. To pretend otherwise is devoid of empathy for the minor child, the patient. It’s nice, however, to know that the AAP now recognizes the extensiveness of newborn male genital cutting. When, however, will it acknowledge the pain, trauma, and lifelong harm inflicted upon the male child or his right to genital integrity?

The AAP goes on to say, “There is reason to believe that offering such a compromise may build trust between hospitals and immigrant communities, save some girls from undergoing disfiguring and life-threatening procedures in their native countries, and play a role in the eventual eradication of FGC.” Build trust on a human rights violation? Rather than being sent home to be cut, girls will be shamed,pained, and humiliated by pediatricians in the USA. Who really believes legitimizing female genital cutting by medicalizing it will lead to the eradication of harmful practices? What were those on the committee really trying to accomplish here?

After the Policy Statement was severely criticized, AAP President, Judith Palfrey, wrote, “The AAP does not endorse the practice of offering a ‘clitoral nick.’ This minimal pinprick is forbidden under federal law and the AAP does not recommend it to its members.” However,the policy statement said, “It might be more effective if federal and state laws enabled pediatricians to reach out to families by offering a ritual nick as a possible compromise to avoid greater harm.” So, was the AAP advocating for a change in federal and state law? Palfrey’s words, used after the damning comments in the statement, were meant to appease, however, they failed, and the AAP is being accused now of double-speak and attempting to cover its own derriere.

Parental preference or cultural conformity in the face of human rights violations of infants and children are to be condemned. Drawing a drop of blood not only will deleteriously affect the body and psyche of the child, it allows entry of pathogens, including MRSA and other antibiotic-resistant strains of bacteria, putting the child at risk.This is contrary to a physician’s oath to “First, do no harm.”

There is no place for anachronistic blood rituals in civilized society.The first “nick” or cut into the normal genitals of a non-consenting minor are what violates human rights. The amount of damage done to the child after that penetration is not the issue; it’s the inherent genital integrity rights of the child that is.

Worldwide, efforts to eradicate female genital cutting are succeeding.The AAP has just attempted to reverse that trend by legitimizing the unconscionable. Cultures do survive eradication of harmful traditional practices as these practices are replaced with healthy, life-affirmingcelebratory traditions. Education is key. The AAP is in a uniqueposition and, rather than compromise the health and well-being of theminor child, it should offer an example by promoting and protectinggenital autonomy for all children, females and males alike.

I invite those on the Bioethics Committee and the Task Force Committees on Genital “Cutting” to attend the XIth International Symposium on Circumcision, Genital Integrity, and Human Rights, which will be held at the University of California, Berkeley, 29-31 July 2010 (see www.nocirc.org), in order to gain a better understanding of the pain, trauma, and lifelong harm of circumcision, genital cutting, and/or genital mutilation of infants and children and the bioethical issues that must be considered in defending the genital autonomy rights of the child.

And, again, “First, do no harm!”

Sincerely,

Marilyn Fayre Milos, RN
Executive Director, National Organization of Circumcision Information Resource Centers
Coordinator, International Symposia on Circumcision, Genital Integrity, and Human Rights
www.nocirc.org
www.IntactAmerica.org

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