Female Genital Cutting: Affecting Young Girls in America

Dilemma Doctors Face

According to Dr. Doug Diekema, a pediatrician at Seattle's Children's Hospital and former chairman of the American Academy of Pediatrics' bioethics committee, by refusing to cut girls in the U.S., many doctors may be putting these girls' lives in jeopardy.

"It's very easy to take the high road in cases like this," said Diekema. "But when you're dealing with religious or cultural beliefs, saying no sometimes is not sufficient for people and it will not necessarily eliminate the practice."

In fact, Diekema and a few of his colleagues put forth the idea that American doctors use a so-called ritual nick as an alternative , to keep parents from seeking more dangerous methods of cutting. And, based on Diekema's recommendation, the American Academy of Pediatrics (AAP) released an official policy statement saying, "the ritual nick would not cause physical harm."

"The cut itself would be tiny, really just like a poke with a needle so that there might be a drop of blood," said Diekema.

But to many opponents of any form of procedure resembling the traditional female cutting, a ritual nick should not be acceptable as a substitute.

"What the AAP is in fact doing is 'wink, wink, nod, nod' in order to protect your patient from a possible worse form of [FGC], let's just spread her legs and nick her," said Taine Bien-Aime, president of the international human rights organization, Equality Now. "The reality is that what [that] statement does is perpetuate female genital mutilation. There is no other way around it."

But Diekema said that the proposed ritual nicking should not be considered a form of mutilation. "If you look up any definition of mutilation in the dictionary, it doesn't apply to this particular procedure," said Diekema.

Running Out of Options

For Mary, who has seen too many friends suffer through this, ritual nicking is not an acceptable compromise by doctors to keep parents from vacation cutting.

When asked by senior health and medical editor, Dr. Richard Besser, what pediatricians should do when faced with a family who wants to take their daughter back to their home country to undergo genital cutting, Mary said, "Call child services on them."

But, Dr. Nawal Nour, director of the African Women's Health Center at Brigham and Women's Hospital in Boston, Mass., said it is important not to vilify the immigrant community.

"Blame is never the solution," said Nour. "Empower them, rather than let's cut them and hurt them."

The center, which exclusively helps immigrant women deal with the complications caused by FGC, educates women about the dangers of FGC to prevent cutting for future generations. Layla Guled, a Somali language interpreter, says parents often feel as though they don't have a choice. Moreover, she says, they have the best intentions.

"Our mothers are trying to do the right thing for us," said Guled. "But our generation is trying to fight it."

The AAP offered clarification to their initial policy statement, saying that while the ritual nick may be considered an option, the practice of cutting is still harmful to girls. But after questions by ABC News regarding ritual nicking recommendations, the AAP withdrew their policy statement completely, saying that it had caused too much confusion and controversy.

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