American Academy Of Pediatrics Calls Ritual 'Nick' Option 'Last Resort' To Prevent Female Genital Mutilation

The American Academy of Pediatrics' committee on bioethics released a policy statement last week noting that some U.S. physicians who work closely with immigrant populations in which female genital mutilation is endemic have cited concerns with the adverse effects of criminalization of FGM and advocate for performing a ceremonial "nick" or pinprick procedure on girls from African or Asian cultures to prevent their families from sending the girls overseas for female genital cutting, the New York Times reports. The statement terms a ritual nick a "last resort" in such cases and mentions that current U.S. law criminalizes "any nonmedical procedure performed on the genitals" of a girl.

Lainie Friedman Ross, associate director of the MacLean Center for Clinical Medical Ethics at the University of Chicago and a member of the AAP bioethics committee, said the panel's members "oppose all types of female genital cutting that impose risks or physical or psychological harm" on girls and that their intent was to issue a "statement on safety in a culturally sensitive context." The panel felt that a "just-say-no policy may end up alienating these families, who are going to then find an alternative that will do more harm than good," she added, noting that procedures performed in foreign countries might be performed "without anesthesia, with unsterilized knives or even glass." She said the nick is "supposed to be as benign as getting a girl's ears pierced. It's taking a pin and creating a drop of blood."

Some advocates against female genital mutilation criticized the policy statement. Rep. Joseph Crowley (D-N.Y.) said, "I am sure the academy had only good intentions, but what their recommendation has done is only create confusion about whether [female genital mutilation] is acceptable in any form, and it is the wrong step forward on how best to protect young women and girls." Crowley recently introduced legislation (HR 5137) to strengthen federal law by making it a crime to bring a girl overseas for circumcision. The AAP statement acknowledges that opponents, "including women from African countries, strongly oppose any compromise that would legitimize even the most minimal procedure."

More than 130 million women and girls around the world have undergone female genital cutting, according to the American Congress of Obstetricians and Gynecologists. The procedure is most common on girls younger than age 15 in Ethiopia, Somalia and Sudan (Belluck, New York Times, 5/6).


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