When most of us think of female genital mutilation, we probably think of faraway places. Well, peel off those blinders. In 1997, our very own Department of Health and Human Services estimated that 168,000 girls and women living in the United States had been or were at risk of being subjected to some form of the abhorrent practice known as female genital mutilation (FGM).
Not only is FGM being practiced relatively widely in the United States, it's happening in the most hallowed halls of American medical science. In fact, the head of the pediatric urology department at Cornell University's New York Presbyterian Hospital -- which is often ranked among the top 10 hospitals in the country -- has been operating on young girls who suffer from what he (and likely the girls' guardians) have decided is "clitorimegaly," or oversized clitorises.
In order to relieve these girls from what seems like little more than a cosmestic issue, Dr. Dix P. Poppas cuts out parts of the clitoris' shaft, saving the glans, or tip, for reattachment. Poppas triumphantly calls the procedure -- rebranded a clitoroplasty -- a "nerve sparing" one unlike the FGMs practiced in other countries.
How does the good doctor know that nerves have been spared? Well, Poppas and his nurse practitioner developed a series of sensory followup tests involving Q-tips, their fingernails and vibrators. But don't worry, a family member was always present in the room. As the resulting journal article notes, management of such situations requires a "compassionate and multidisciplinary approach."
Activists Alice Dreger and Ellen K. Feder, a professor of medical humanities and bioethics and a professor of philosophy, respectively, have been railing against the practice of FGM -- of any kind -- for a decade. They are part of the majority medical view that questions the very basis of clitoroplasties. (The American Academy of Pediatrics disturbingly stated in May that it only had an issue with "all types of female genital cutting that pose risks of physical or psychological harm" -- as if any kind of clitoral mutilation did not necessarily entail such harm. The AAP recanted the shocking affront to women's physical and mental health only a few weeks later.)
"We still know of no evidence that a large clitoris increases psychological risk (so is the surgery even necessary?), and we do know of substantial anecdotal evidence that it does not increase risk. Importantly, there also seems to be evidence that clitoroplasties performed in infancy do increase risk — of harm to physical and sexual functioning, as well as psychosocial harm," Dreger and Feder wrote in an article lambasting Poppas' study.
These procedures seem motivated mostly by an obsession with having "normal" genitalia -- and normal kids. The fact that cosmetic genital surgery is on the rise is one sign of this. And given that only one of every 2,000 infants is born with genital ambiguity, parents faced with an "abnormal" clitoris are not likely to have ever seen one before and may react with trepidation. Will my kid be a lesbian? Will my little girl want to become a boy? We know children are all unique, like snowflakes, but when it comes to vaginas, sexual orientation and gender identity, it seems we'd prefer cookie-cutter, please.
So parents go to Dr. Poppas who mirrors their fears and offers a medical procedure that Cornell's Web site recommends "because female patients are able to undergo a more natural psychological and sexual development." What parent would withhold such treatment, recommended by a top-notch pediatrician and hospital?
Poppas cuts off parts of the perfectly healthy, albeit-larger-than-we'd-like clitoris, the only organ in either sex whose only known function is sexual pleasure.