Should We “Nick” Our Baby Girls?

I had a boyfriend in college who was from Eritrea and had fought in the war of independence from Ethiopia.

He fought side by side with women soldiers, some of whom had had their clitorises cut off when they were small children.

“What does it feel like?” He asked his fellow soldiers.

The women laughed at him. “How should we know?” They said. “We’ve never known anything different!”

Clitoridectomy, known in the Western world as female genital mutilation (FGM) is no laughing matter. According to the World Health Organization, between 100 and 140 million women and girls have already had their clitorises (often along with other parts of their female anatomy) cut off and about three million girls each year are at risk of having this procedure done (see the WHO’s “Eliminating Female Genital Mutilation“).

When this procedure is done on a newborn baby girl without her consent, it is the worst and cruelest kind of mutilation.

Which is why so many activists are very upset by the recent policy statement, issued by the American Academy of Pediatrics (AAP), that seems to condone FGM in America.

In a statement issued at the end of April 2010, the AAP (calling the procedure “Female Genital Cutting” instead of “Female Genital Mutilation”) emphasizes that the procedure is harmful and dangerous but also suggests that it be decriminalized in the United States so that doctors can perform a “ritual nick” on baby girls, in order to “offer compromise and build trust between hospitals and immigrant communities.” The policy statement continues:

It might be more effective if federal and state laws enabled pediatricians to reach out to families by offering a ritual nick as a possible compromise to avoid greater harm.

Efforts should be made to use all available educational and counseling resources to dissuade parents from seeking a ritual genital procedure for their daughter. For circumstances in which an infant, child, or adolescent seems to be at risk of FGC, the American Academy of Pediatrics recommends that its members educate and counsel the family about the detrimental health effects of FGC. Parents should be reminded that performing FGC is illegal and constitutes child abuse in the United States” (my emphasis).

Is a “ritual nick” really something we should be promoting in this country?

I read about this when the AAP statement was first issued but wasn’t sure how I felt. It was a friend who urged me to write about it, Kristen Gough, a parenting, pregnancy, and food writer who also has a blog called My Kids Eat Squid.

Many thoughtful parents believe that the new AAP policy may actually help immigrant baby girls, which is the reason it was developed in the first place. They argue that on the surface it seems horrifying to consider that American doctors would even think about any form of FGM but if the alternative is that these girls are taken to other countries to undergo much more traumatic, life-threatening procedures instead, maybe a “nick” approach could actually help save them from harm. In an NPR story about the subject, one of the interviewees made the comparison to giving clean needles to heroin users without supporting heroin use. As a friend who wants to remain anonymous said to me, “In a perfect world, the AAP’s policy statement would be unconscionable but in the real world, it’s compassionate.”

On the other side are the outraged activists, both people from developing nations where this kind of mutilation continues and Americans who believe that a baby’s genitalia should never be harmed or cut in any way unless it is absolutely medically necessary. Taina Bien-Aime, executive director of Equality Now, argues that being respectful of the cultural norm is misguided and calls the AAP policy statement ill-advised. In a Huffington Post commentary she writes: “Hundreds of African women – and men – have dedicated their lives to end FGM in their own communities through awareness-raising, education, and advocacy for legal and policy changes. While resistance to progress may be at times fierce, as in most social change movements, stories of girls and their families who are successfully rejecting the practice and mobilizing their communities and governments to eradicate FGM are proliferating. The AAP should honor those commitments and not seek to undermine such advances” (my emphasis).

Georganne Chapin, executive director of Intact America, is completely against the statement. In a call to action Intact America insists: “At Intact America, we know that any form of genital cutting of babies is wrong – ethically, morally, and medically” (their emphasis).

This is one of those thorny issues where I can see both sides. I appreciate that the AAP is being culturally sensitive but I’m not sure that “nicking” a baby girl’s genitals should be legal in this country.

What do you think? Is the AAP being culturally sensitive and keeping baby girls from further harm or are they tacitly condoning female genital mutilation and undermining the activists trying to change cultural practices?

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15 thoughts on “Should We “Nick” Our Baby Girls?”

  1. I agree with you. I think it is horrifying and inhuman, but I do understand the attempt to bridge a cultural divide and keep children safe if parents insist on this (which I do not understand and find sickening). I think though the AAP ought to also talk about a ritual nick for boys too. I understand the debate about circumcision, but in my opinion most parents do it for cultural, not health reasons. Why not offer this alternative for boys as well? I would like to see both practices disappear for good.

  2. Jennifer–

    Thanks so much for offering this balanced story about such a sensitive, difficult topic. Until I heard about the AAP’s policy statement, I’d only heard about ritual cutting in passing. While I don’t support FGC, I do understand that the doctors who urged the AAP to come up with the policy statement were doing so in the best interest of the children that they serve–they wanted to appease parents who asked for the procedure with something far less invasive.
    .-= Kristen´s last blog ..Spinach-Blueberry Brownies =-.

  3. This is such a tough one. I am opposed to FGM, as well as to circumcision. But cultural habits die hard. I can see how there would be a risk of parents taking their female babies back home to countries to have this practice done. It will take education within the immigrant community and no doubt several generations to put an end to this completely in the United States. Thanks for writing about it and raising awareness one person at a time …
    .-= Alexandra´s last blog ..Sven & Robert Finch Enjoy Walking in the Fog =-.

  4. The AAP is way out of line in my opinion.

    If if was considered a good thing in some cultures to cut off an infants foot, does that mean we should encourage doctors to do it (in any country)??

  5. You’re right. This is a tough issue. But there are some unanswered questions. What exactly is a “little nick” and how will it affect these women? Will they be able to orgasm later in life? I guess it the “nick” some how preserves the ceremonial aspects of it without permanently maiming these babies, I can understand the recommendation. But if it’s still hurting them for life–just less severely–then it probably does more harm than good.

    I thought it was interesting though that it’s still commonplace to surgically remove a little boy baby’s foreskin.
    .-= Alisa Bowman´s last blog ..Odd Todbits That Fail to Bore =-.

  6. I agree with Melissa. We cannot condone genital cutting. And “nicking” is such a euphemism. I understand that culture is hard to change,but isn’t it more beneficial in the long run to take the stance as a country that cutting is wrong?

  7. Wow. This is tough. And so upsetting. I can see how doctors here might need to appease the immigrant community but that brings up so many questions, among them: what is a “ritual” nick and how is this preserving a woman’s body? Where do you draw the line between appeasement and mutilation? It’s an issue that is so complicated and confusing, really. Personally, I think the practice is unbearably horrifying and backward.
    .-= sheryl´s last blog ..What You Should Never Leave Home Without =-.

  8. Hmm, I’ve read graphic depictions of the way female circumcision is often performed and i think a little nick which leaves no permanent mark is highly preferable to removing the clitoris and suturing the vagina, which leaves a lifetime of agony.
    .-= Almost Slowfood´s last blog ..Breakfast: Poached Eggs over Polenta =-.

  9. First, do no harm. Surely even a “nick” would be contrary to this oath.

    Culture changes. We are not helping girls in the long run by conceding to perform a “nick”.
    .-= Globetrotter Parent´s last blog ..Anjajavy =-.

  10. I’m working on a post about this right now, Melissa. Just waiting for the AAP President to return my phone call so I can get a good quote!

  11. Posts like this are suck a smack upside the head for me – yes, there are places in the world where this still happens. It’s good to get popped out of your bubble every once in a while, but cripes, this is a brutal procedure.
    .-= Stephanie – The Culinary Life´s last blog ..Google Analytics Primer =-.

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