Medically Unnecessary Genital Cutting and the Rights of the Child: Moving Toward Consensus

,

doi:10.1080/15265161.2019.1643945

Cited by 66 publications

(7 citation statements)

References 56 publications

(55 reference statements)

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“…These include children who may be categorized as either female or male at birth who have certain intersex traits, sometimes called differences of sex development or variations of sex characteristics (Monro et al, 2017;Carpenter, 2018a), and children who, at birth, do not appear to have such traits and are categorized as male. 8 A growing number of scholars argue that an age limit or consent criterion should be applied to these children too (Tangwa, 1999;Toubia, 1999;Lightfoot-Klein et al, 2000;Mason, 2001;Ehrenreich and Barr, 2005;Darby, 2013;Svoboda, 2013;Ungar-Sargon, 2015;Earp, 2016b;Svoboda et al, 2016;Steinfeld and Earp, 2017;Chambers, 2018Chambers, , 2022BCBI, 2019;Reis, 2019;Townsend, 2020Townsend, , 2022Bootwala, 2022).…”

Section: Discussionmentioning

confidence: 99%

Genital Cutting as Gender Oppression: Time to Revisit the WHO Paradigm

Earp

2022

Front. Hum. Dyn.

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The World Health Organization (WHO) condemns all medically unnecessary female genital cutting (FGC) that is primarily associated with people of color and the Global South, claiming that such FGC violates the human right to bodily integrity regardless of harm-level, degree of medicalization, or consent. However, the WHO does not condemn medically unnecessary FGC that is primarily associated with Western culture, such as elective labiaplasty or genital piercing, even when performed by non-medical practitioners (e.g., body artists) or on adolescent girls. Nor does it campaign against any form of medically unnecessary intersex genital cutting (IGC) or male genital cutting (MGC), including forms that are non-consensual or comparably harmful to some types of FGC. These and other apparent inconsistencies risk undermining the perceived authority of the WHO to pronounce on human rights. This paper considers whether the WHO could justify its selective condemnation of non-Western-associated FGC by appealing to the distinctive role of such practices in upholding patriarchal gender systems and furthering sex-based discrimination against women and girls. The paper argues that such a justification would not succeed. To the contrary, dismantling patriarchal power structures and reducing sex-based discrimination in FGC-practicing societies requires principled opposition to medically unnecessary, non-consensual genital cutting of all vulnerable persons, including insufficiently autonomous children, irrespective of their sex traits or socially assigned gender. This conclusion is based, in part, on an assessment of the overlapping and often mutually reinforcing roles of different types of child genital cutting—FGC, MGC, and IGC—in reproducing oppressive gender systems. These systems, in turn, tend to subordinate women and girls as well as non-dominant males and sexual and gender minorities. The selective efforts of the WHO to eliminate only non-Western-associated FGC exposes the organization to credible accusations of racism and cultural imperialism and paradoxically undermines its own stated goals: namely, securing the long-term interests and equal rights of women and girls in FGC-practicing societies.

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Section: Discussionmentioning

confidence: 99%

Genital Cutting as Gender Oppression: Time to Revisit the WHO Paradigm

Earp

2022

Front. Hum. Dyn.

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“…Some health care providers maintain that the less extensive forms of FGM/C, such as symbolic nicking, should be permitted in place of more extensive cutting to minimize harm [66][67][68]. By including items that assess strongly empathetic attitudes toward FGM/C, researchers and educators may be able to provide additional education to health care providers in the diaspora regarding the possible physical harms that may result from the different forms of FGM/C, and the ethical arguments that support the opposition to FGM/C on a girl child because it causes irreversible change, physical harm, and that a child cannot consent to the practice [69]. Some argue that minors (child with male, female, or intersex genitalia) must be protected from bodily harm, which includes nontherapeutic genital surgery or cutting (including male circumcision) [70].…”

Section: Discussionmentioning

confidence: 99%

Assessing the reliability and validity of attitudes and confidence scales for the care of women and girls affected by female genital mutilation/cutting

et al. 2021

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Background Approximately 545,000 women and girls in the USA have undergone Female Genital Mutilation/ Cutting (FGM/C) or have mothers from a country where FGM/C is practiced. Women and girls living with FGM/C in the USA may experience stigma and bias due to their FGM/C, immigration, racial, and language status. Health care provider attitudes toward FGM/C and confidence for related clinical care may affect the quality of care, yet there are no validated instruments to measure these constructs. Methods We developed the instruments via review of the FGM/C literature, the development of scale items, expert review, and pre-testing. We validated the instruments using a convenience sample of providers in Arizona and Maryland. We used exploratory factor analysis (EFA) to confirm factor structures, and compared scores between known groups to assess validity. Results The EFA revealed a two-factor solution for attitudes, including subscales for Negative Attitudes and Empathetic Attitudes toward FGM/C and those who practice with Cronbach’s alphas of 0.814 and 0.628 respectively. The EFA for confidence revealed a two-factor solution including Confidence in Clinical FGM/C Care and Confidence in Critical Communication Skills for FGM/C Care with Cronbach’s alphas of 0.857 and 0.694 respectively. Conclusions Health care provider attitudes and confidence toward FGM/C care may affect quality of care and health outcomes for women and girls. Our study describes the rigorous psychometric analysis to create reliable and valid instruments to assess health care provider attitudes and confidence for the care of women and girls who have experienced FGM/C. Trial registration ClinicalTrials.gov, NCT03249649. Registered on 15 August 2017. Retrospectively registered.

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“…The condemnation of some genital modification practices and the acceptance, or even legitimation, of others lead to the question: what could be an acceptable baseline for determining the (in)tolerance towards bodily practices: consent, age, health consequences, or gender? To this question, a consortium of 91 scholars from various disciplines and countries 14 known as the Brussels Collaboration on Bodily Integrity [57] since the idea emerged during the symposium-responded that the respect for the bodily integrity of all children can be a non-discriminatory basis to avoid medically unnecessary genital modification practices on minors. What this collaboration further demonstrates is that a large group of experts with different scientific interests-whether specialists in FGC, genital cosmetic surgery, male circumcision or intersex surgeries-are able to collaborate in order to try to reach consensus.…”

Section: Discussionmentioning

confidence: 99%

Rethinking the Anti-FGM Zero-Tolerance Policy: from Intellectual Concerns to Empirical Challenges

O‘Neill

Bader

Kraus

et al. 2020

Curr Sex Health Rep

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Purpose of Review Based on the discussions of a symposium co-organized by the Université Libre de Bruxelles (ULB) and the University of Lausanne (UNIL) in Brussels in 2019, this paper critically reflects upon the zero-tolerance strategy on “Female Genital Mutilation” (FGM) and its socio-political, legal and moral repercussions. We ask whether the strategy is effective given the empirical challenges highlighted during the symposium, and also whether it is credible. Recent Findings The anti-FGM zero-tolerance policy, first launched in 2003, aims to eliminate all types of “female genital mutilation” worldwide. The FGM definition of the World Health Organization condemns all forms of genital cutting (FGC) on the basis that they are harmful and degrading to women and infringe upon their rights to physical integrity. Yet, the zero-tolerance policy only applies to traditional and customary forms of genital cutting and not to cosmetic alterations of the female genitalia. Recent publications have shown that various popular forms of cosmetic genital surgery remove the same tissue as some forms of “FGM”. In response to the zero-tolerance policy, national laws banning traditional forms of FGC are enforced and increasingly scrutinize the performance of FGC as well as non-invasive rituals that are culturally meaningful to migrants. At the same time, cosmetic procedures such as labiaplasty have become more popular than ever before and are increasingly performed on adolescents. Summary This review shows that the socio-legal and ethical inconsistencies between “FGM” and cosmetic genital modification pose concrete dilemmas for professionals in the field that need to be addressed and researched.

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Medically Unnecessary Genital Cutting and the Rights of the Child: Moving Toward Consensus

Cited by 66 publications

References 56 publications

Genital Cutting as Gender Oppression: Time to Revisit the WHO Paradigm

Genital Cutting as Gender Oppression: Time to Revisit the WHO Paradigm

Assessing the reliability and validity of attitudes and confidence scales for the care of women and girls affected by female genital mutilation/cutting

Rethinking the Anti-FGM Zero-Tolerance Policy: from Intellectual Concerns to Empirical Challenges

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