AAP changes stance on FGM

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Have you heard about the AAP's change on its stance on FGM (female genital mutilation)? In it's new policy statement, issued April 26th, it suggests that US federal law should be changed to allow pediatricians to perform a 'ritual nick or incision' of the female privy parts. This is known as stage IV FGM.

http://aappolicy.aappublications.org/cgi/content/abstract/pediatrics;125/5/1088?rss=1

So - would you assist with such a procedure?

I am just a nursing student. But I can say with great conviction my answer is a loud and outraged, "NO WAY."

I'd love to hear the opinions of my fellow students and practicing nurses!

Specializes in Hem/Onc, LTC, AL, Homecare, Mgmt, Psych.

I didn't see that it changed its stance at all....... FGM still constitutes child abuse in the US.

"The American Academy of Pediatrics opposes all types of female genital cutting that pose risks of physical or psychological harm, counsels its members not to perform such procedures, recommends that its members actively seek to dissuade families from carrying out harmful forms of FGC, and urges its members to provide patients and their parents with compassionate education about the harms of FGC while remaining sensitive to the cultural and religious reasons that motivate parents to seek this procedure for their daughters."

No, but I don't assist with male genital mutilation either!

I didn't see that it changed its stance at all....... FGM still constitutes child abuse in the US.

"The American Academy of Pediatrics opposes all types of female genital cutting that pose risks of physical or psychological harm, counsels its members not to perform such procedures, recommends that its members actively seek to dissuade families from carrying out harmful forms of FGC, and urges its members to provide patients and their parents with compassionate education about the harms of FGC while remaining sensitive to the cultural and religious reasons that motivate parents to seek this procedure for their daughters."

It's in the last paragraph

" Most forms of FGC are decidedly harmful, and pediatricians should decline to perform them, even in the absence of any legal constraints. However, the ritual nick suggested by some pediatricians is not physically harmful and is much less extensive than routine newborn male genital cutting. There is reason to believe that offering such a compromise may build trust between hospitals and immigrant communities, save some girls from undergoing disfiguring and life-threatening procedures in their native countries, and play a role in the eventual eradication of FGC. It might be more effective if federal and state laws enabled pediatricians to reach out to families by offering a ritual nick as a possible compromise to avoid greater harm." [bolding mine]

Specializes in mental health, military nursing.

I actually think that this is a sensible approach to a very complex problem. The things that I oppose about FGM are the desire to control a woman's sexuality to the point of causing her life-long pain and suffering - more akin to making boys eunuchs in order to eliminate sexual threat.

I think that the comparison to male circumcision is apt. While nowadays male circumcision has been shown to reduce certain disease transmission, it doesn't change the fact that it has strong religious and cultural ties, and advocates often touted circumcision as a way to control sexual behaviors (like the myth of preventing the ability to masturbate).

While I find the idea of genital "nicking" to be unappealing, I don't have the same gut reaction to infant male circumcision, mostly because it's an accepted part of my culture.

The majority of forms of FGM are horrible abuses, and should be treated as such. The AAP position clearly differentiates between forms of FGM and what they condone. The fact that they have research to back up the stance that offering families a sterile, superficial form of this ritual will prevent people from seeking it in the community, and help education, is key.

So, just a little violation of their body is acceptable? Not the full violation, just a little one?

FGM, in all of its forms, is sexual violence - as the WHO and many other advocacy groups have long stated. I am outraged at this attempt at cultural sensitivity. It misses the mark entirely, and belittles the plight of women who have had to live through it.

I feel the same way about this as I do about male genital mutilation. No way would I assist in mutilating a baby! It's a shame that America is full of hypocrites and don't realize the same for males. :(

Specializes in mental health, military nursing.
So, just a little violation of their body is acceptable? Not the full violation, just a little one?

FGM, in all of its forms, is sexual violence - as the WHO and many other advocacy groups have long stated. I am outraged at this attempt at cultural sensitivity. It misses the mark entirely, and belittles the plight of women who have had to live through it.

Out of curiosity, are you opposed to male circumcision as well?

The fact is, genital mutilation is a deep-rooted tradition for many cultures (including our own), and it's not going to go away because we, as outsiders, tell them it's wrong. I think that the AAP is demonstrating cultural sensitivity, is backing up their claims with research, and offering healthcare providers a means of helping different ethnic groups transition a part of their culture into a more modern, safe practice. A ritual piercing or nicking will not functionally harm a woman, and doesn't prevent her from enjoying sexual experiences later in life.

On a different note (but one that seems to be emerging on this thread as well), male circumcision is now recommended by the WHO, which states "While male circumcision is not a replacement for other known methods of HIV prevention, it should be considered as part of a comprehensive prevention strategy." The New York Times ran a fascinating article last week on the use of adult male circumcision (ouch!) in Africa. Check it out! http://www.nytimes.com/2010/04/26/health/policy/26safrica.html?pagewanted=2&sq=circumcision&st=cse&scp=2

Specializes in Hem/Onc, LTC, AL, Homecare, Mgmt, Psych.

Ok, I read the full text article now. I guess FGM has such a barbaric history that the whole idea and anything related to it is disgusting to me. But when you break it all down .... done in a medically safe environment, done for cultural, appearance or religious reasons... would this "nick" really be any different than assisting with a circumcision... at this point? What would be nice would be to to move away from either forms of genital mutilation male or female. But then we would be faced with people performing these procedures on babies & children in their homes with unsterilized equipment and no medical knowledge.

Out of curiosity, are you opposed to male circumcision as well?

The fact is, genital mutilation is a deep-rooted tradition for many cultures (including our own), and it's not going to go away because we, as outsiders, tell them it's wrong. I think that the AAP is demonstrating cultural sensitivity, is backing up their claims with research, and offering healthcare providers a means of helping different ethnic groups transition a part of their culture into a more modern, safe practice. A ritual piercing or nicking will not functionally harm a woman, and doesn't prevent her from enjoying sexual experiences later in life.

On a different note (but one that seems to be emerging on this thread as well), male circumcision is now recommended by the WHO, which states "While male circumcision is not a replacement for other known methods of HIV prevention, it should be considered as part of a comprehensive prevention strategy." The New York Times ran a fascinating article last week on the use of adult male circumcision (ouch!) in Africa. Check it out! http://www.nytimes.com/2010/04/26/health/policy/26safrica.html?pagewanted=2&sq=circumcision&st=cse&scp=2

Last time I knew, the WHO was reconsidering their stance. As I'm sure you know, the findings they're going by are studies done in Africa. I wish people would look at the BIG picture and not just a small study or 2 done in such a poor country. What the WHO fails to point out is that rape and infidelity rates are extremely high there, not to mention lack of education regarding safe sex. If this study is valid, which it has been proven not.....why does America have such a high STD rate AND the only country still routinely circumcising? It seems that circumcision doesn't work for Americans. So bottom line....parents SHOULD be teaching their kids abstinence and safe sex rather then mutilating them at birth and thinking they're safe. I'm not directing any of this at you, I'm talking about any American that believes everything that comes from any big money hungry organization. If nicking/piercing doesn't harm a woman, would you have it done? Would you do it to your daughters?

Out of curiosity, are you opposed to male circumcision as well?

No, I'm not opposed to male circumcision if an adult male decides he wants to be circumcised.

I am opposed to genital alterations of infants or minors, male or female. I believe the owner of the genitals should decide what should get cut, if anything.

I can not imagine that the FGM law would actually change, but I've been shocked before.

ok, i read the full text article now. i guess fgm has such a barbaric history that the whole idea and anything related to it is disgusting to me. but when you break it all down .... done in a medically safe environment, done for cultural, appearance or religious reasons... would this "nick" really be any different than assisting with a circumcision... at this point? what would be nice would be to to move away from either forms of genital mutilation male or female. but then we would be faced with people performing these procedures on babies & children in their homes with unsterilized equipment and no medical knowledge.

nah, i personally don't think that would happen. but i could be wrong. when the canadian healthcare system stopped paying for circumcisions a few years back, the rates declined tremendously. they stopped not because parents/doctors woke up but because parents didn't want to pay out of pocket. it's a shame that it took that for this barbaric practice to slow down but whatever works. even here, insurances/medicaid are slowly stopping paying for it. not sure if that's the reason why rates are decreasing or if it's because more and more parents are educating themselves....doesn't matter to me though.

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