Female Genital Mutilation vs. Female Breast Mutilation

Ritual ‘nicking’ of female genitals should be legal, according to a new policy from the American Academy of Pediatrics.  In a recent statement issued by its Committee on Bioethics, the AAP suggested that federal and state laws in the U.S. that currently prevent pediatricians from performing Female Genital Mutilation (FGM) should be revised to allow “a ritual nick”.  Such a procedure, which draws only a drop of blood, would “appease” the cultural dictates of parents from minority cultural groups while preventing the actual “cutting” of female genitalia, the Committee argues.

The announcement by the AAP has produced debate among both conservative critics who are opposed to cultural accommodation for minority groups in any form and feminist critics who see “appeasement” as a means of ratifying the underlying premise that female genitalia must be altered to please men.

The policy statement itself is stringent in outlining the fact that the AAP is unequivocally opposed to all forms of genital mutilation. The option of a “ritual nick” has been suggested by physicians working in minority communities to retain the ceremonial aspects of the practice while eliminating the devastating psychological and health consequences of actual mutilation.

The AAP’s statement produces a vexing conundrum for feminists: outright opposition to such cultural appeasement rightly underscores the point that the retention of practices that alter female bodies, even when merely ritualistic, is patently unacceptable. At the same time, such a position also places feminists in the same camp as conservative critics whose outcry against the AAP’s statement may be equally, if not entirely, motivated by an aversion to cultural accommodation as by opposition to FGM itself. To escape such a co-option of the feminist position, it is crucial to critique not just those aspects of foreign cultures that prescribe the surgical alteration of female bodies but also those aspects of  American culture that impose similar dictates on women.

One immediate way to do this would be for feminists to draw an analogy between FGM, a practice that involves the partial or complete cutting of the clitoris, and breast augmentation surgery, which involves cutting through female breast tissue to place saline bags under the skin. If Egyptian and Somali cultures impose a burden on women to undergo FGM to be considered desirable by the opposite sex upon marriage, American culture seemingly imposes a similar burden that requires women to have large breasts in order to be considered sexually attractive. If FGM reduces sexual sensation, imposes heavy psychological costs and increases risk of infection, breast implant surgery similarly reduces or eliminates sensation in the breast and nipple area, causes interference with nursing, involves a risk of rupture and leaching and impedes breast cancer detection during mammography.

Indeed, being against “ritual nicking” proposed by the AAP on grounds that it is the parents of minor girls that would impose the practice is a different basis of opposition. It could be addressed simply by altering the age of consent for all circumcision procedures. However, if the core issue is opposing all patriarchal cultural mores that sell women the idea that they must alter their physical bodies to achieve cultural standards of beauty, then questioning Western cultural paradigms that impose similar burdens is essential. FGM is thus wrong, even in its ritualistic formulations, but then so is FBM, Female Breast Mutilation, which imposes similar burdens and yet is considered acceptable, perhaps purely because the demand for it is fueled by American mainstream culture.

Photo from http://www.flickr.com/photos/andreweason/ / CC BY-SA 2.0


  1. I totally agree. If we don’t condemn our Western ways of female submisiveness to patriarchy, feminist can be co-opted by conservative narratives which we do not accept, either.
    Another example is the veil and the high heels. They are patriarchy in different ways, no matter where they came from.

  2. That Ms. Magazine would pose the question as to whether or not female genital mutilation (FGM) produces a “vexing conundrum for feminists” is outrageous and disheartening. Ms. was arguably the first US magazine to bravely discuss FGM as a human rights violation against women and girls. This should still be the case thirty years later. The author narrows the significance of FGM as vaginal alteration to please men. FGM is gender-based violence and discrimination against women and girls. It is performed to control their sexuality; guarantee their virginity until marriage; and is a prerequisite to marriage. That the American Academy of Pediatrics (AAP) now condones the “nicking” of girls’ clitorises to satisfy their parents’ cultural and religious beliefs flies in the face of decades of work at the grassroots and international levels to end this harmful cultural practice. The author should also know that the federal law and states already prohibit FGM of minors, which the AAP is also calling to amend to allow “nicking”. Should we analyze breast implants as a feminist issue and a consequence of patriarchy? Absolutely. But please don’t compare adult choices to increase breast sizes to violating the fundamental rights of girls who have no voice. Instead, Ms. should urge its readers to contact the AAP and retract its revised 2010 policy statement on FGM. Their 1998 statement is clear, strong and doesn’t promote harming girls based on their parent’s cultural mores.

  3. Well said, Taina. Breast augmentation, while still an issue for feminist discussion, is NOT comparable to genital mutilation.

  4. I am 100 % with Taina. I get where Ms. is taking it but it is too far. FGM is something that is forced where the breast implants are by choice as adult women … You can debate that in a different forum.

    The PRIMARY issue at heart should be strictly focused on the FGM.

  5. I agree with what Tania says. I think the comparison of FGM to breast augmentation is poor. Perhaps it is necessary to be able to compare FGM to a culture issue here in “the West”, but a choice by an adult woman to enhance her breasts is no where near the issue that FGM is. FGM is a far more pressing issue than someone increasing their breast size.

    Sadly, knowing the backlash the human rights organizations have suffered in trying to protect young girls from FGM, I fear that the AAP came out with these guidelines in order to protect girls here within cultural communities. I hear the practice is reaching girls as young as six. Something needs to be done about it, but while I find it is a human rights issue, the women in these cultures fully embrace it. Who are we, as westerners, to tell them, as women, that they are wrong?

  6. It definitely is a human rights issue … and as westerners, we have this freedom … which applies to an individual person … taking a knife to someone “unnecessarily” with out them being able to have voice … well.

    And as a mom of two boys – yes I did circumcise – but I waited on the first son – two weeks … almost did not go through with it. And I probably would not again … but I gave in to the culture here. They have to do it immediately to the newborn boys, the longer you wait, the more problems can occur … two weeks was pushing it. Had I more support on not doing it, and it is stated an unnecessary procedure by the AAP … there are no more reasons to do it than not to do it. On boys any more here we do it because it is the norm and really to most – cosmetic. (now telling my self I REALLY wish I would not have done it for those reasons)

    On a girl it deadens sensations, even if it is a nick. It is submissive and intended to be “a guarantee their virginity until marriage; and is a prerequisite to marriage.” If nicking a child
    with a knife is to “satisfy” a parent? Really? Those that truly believe in that will not be satisfied unless it is fully done – at least that is how I feel.

  7. I am wholly against FGM, as well as “MGM”, or circumcision…it’s the same thing. When are we going to stop brutally modifying the equipment men are born with, while they are infants and have no say. Let them grow up and make their own decision too. Yes, I am a feminist…feminism is about equality between the sexes. Save the genitalia of children of both genders!

  8. Jen Morgart says:

    I want to know if I’m understanding this correctly… It’s sounding like this “nicking” will make it so that the eastern cultures can keep their ceremonial rituals without full on “mutilating” the female genitals.

    While I obviously am opposed to genital mutilation on these young girls I am curious if this “nicking” will save these girls from the more horrific “mutilation” of their genitals. Being such a big part of these cultures I’d imagine that members of these cultures are finding ways to carry out the practice regardless of it’s “legality.”

    But yes, the posts above are right in the fact that the practice of mutilation is about so much more than making a girl sexually appealing to men and is meant to ensure virginity at marriage. Ultimately it is taking away a females ability to feel pleasure during sex, which is meant only for pro-creation.

    I’d like to know more about this “nicking.” How invasive is it? Are their any sexual and health symptoms because of it? More information is needed before I can say whether or not the AAP is right or wrong in allowing this.

  9. Rafia Zakaria says:

    Dear Taina and respondents:
    Thank you for your comments, I would like to clarify one thing…as the article clearly says FGM is wrong and a human rights violation in all its form including ritual nicking proposed by the AAP…the question I am posing is not whether its wrong or not but the reasons WHY we consider it wrong…if its only a consent isssue as Taina seems to suggest where the minor age,lack of capacity etc is at issue…would we consider it permissable if it were an “adult” choice that was insistently “voluntary”? If its not a consent issue and extends also to the other surgical alteration of female bodies that are considered “chosen” should we oppose them also?
    I just wanted to clarify the question I am posing…and to emphasize that its not a question of whether FGM is ever permissable…(never in my opinion) but WHY we oppose it?

  10. I dont find the concept of allowing a nick wrong. Is it sad that there is even a need to propose such an action? Yes, but if it creates an opportunity for a woman to keep her clitoris…. yes- do that. If the practice can be reduced to a symbolic action eventually the action will be divorced from context and will be dropped from practice.

  11. Are breast implants really a matter of choice, or fraud? If women were fully informed about the risks, especially of silicone implants, and felt no pressure from society, I doubt any woman would freely choose to “augment” her breasts, except possibly to reconstruct them after mastectomy. Autoimmune diseases are no picnic, and whatever benefit a woman is convinced she will obtain is fraudulent. There can be no meaningful consent to such a procedure in the context of medical misinformation and the social pressures to look good in the eyes of men.

    That said, however, I agree the analogy between FGM and breast implants is stretched. There is a difference between a choice made by adult women for the wrong reasons and imposing FGM on a girl with no choice at all. What I see as a larger issue is why it is considered acceptable for women and girls to be mutilated in any way to satisfy the expectations of male-dominant cultures.

  12. All women should be appalled by the very thought of this. If you are in agreement simply because you don’t want to be co-opted by conservatives you need to take a deep breath and really listen to what you are agreeing to. Breast implants ladies, are your choice, you decide as an adult to go under the knife usually based on your own insecurities or because of a medical-reconstructive need. This does NOT compare in any way to the mutilation of children. When are the feminist going to start standing up for women. Have you not noticed that the cultures that advocate for this also treat women as garage sale fodder, find it acceptable to set women on fire to end a marriage or force a child to stone their own mother to death for any number of ridiculous reasons. Wake-up, get a clue and do not allow anyone to push this door open even a crack. It is time to STOP this crap not give it credance.

  13. I’m with Tania. And While I too, disagree with circumsision, I don’t think it carries the same weight as FGM which is designed to control a woman’s sexuality. The connotations and history behind FGM are far darker and disturbing.

  14. Rafia,

    Thanks for this thoughtful post. Tempting as it is to unilaterally condemn FGM (or FGC, the term the AAP recommends so as to avoid alienating women who don’t like being referred to as “mutilated”), revile its practitioners and stop there, what you say is right: it’s a risky because ethnocentric stance. That’s what it shares with the conservative critics. More to the point: as stances go, it isn’t an effective one. If the goal is to reduce the *practice* of FGC, the one strategy that really won’t work is telling the cultures where it’s practiced that they’re barbaric and woman-hating, and the women concerned that they’re victims. A better approach–and one the AAP is attempting, however clumsily–is to start a conversation with the other side.

    That’s particularly hard to do in this case, and the AAP “nick” suggestion is dangerous for several reasons, but what we risk by focusing the entire discussion of FGC on masculine power structures is exactly what you’re suggesting by the breast augmentation analogy: we don’t want to admit that women who undergo voluntary breast augmentations are victims because to do so would strip them of agency. And to depict all the women in a culture as victims is tantamount to making their personhood disappear.

    Jane’s point is well-taken: most clitorectomies are performed on girls, not women, and that does show that the breast augmentation analogy isn’t perfect. But the uncomfortable fact remains that many girls want and look forward to the procedure, and that some don’t, and forgo it.

    (Anybody interested in how women in the cultures where FGC is practiced feel about it might take a look at what Fuambai Ahmadu has to say here: http://www.arts.uregina.ca/dbfm_send/637. Also, a great conversation on the “non-debate” on FGC in the US and on the sources of the discomfort you raise is here: http://zunguzungu.wordpress.com/2010/05/10/the-non-debate-on-fgc/).

    That said, there are serious problems with the “ritual nick” idea. First, there’s no reason to believe it’ll work. To the extent that FGC serves a cultural function (uniting a group of young girls for whom the event marks an important transition), that function won’t be fulfilled by an American doctor who, moreover, would be “nicking” not a girl, but an infant. This suggests that the AAP, despite their careful efforts, basically misunderstand the purpose of FGC and are thinking of it in mainly anatomical as opposed to cultural terms: if we just do *SOMETHING* to them down there, the thinking goes, maybe they’ll stop! It’s well-intentioned, but sort of like suggesting that the solution to the veil debate is that Muslim women wear a bandana instead of a hijab.

    Secondly, and more seriously (I think), is how the AAP suggests we treat the problem of FGC in the US. It’s a dangerous thing to try to dictate right practice re: FGC to other countries, but when we open the door to FGC in the US, the waters get extremely murky.

    Here’s why: the AAP is proposing a policy that would have American doctors *actively* performing a practice that has no medical benefit whatsoever as a hypothetical and inadequate solution to an unsubstantiated problem. According to the AAP recommendation, the condition that prompted the recommendation can’t even be said to actually exist (I’m only talking about the US, of course).

    Dr. Friedman Ross, a member of the AAP Bioethics Committee, phrased the situation in this way (from the NY Times, emphasis mine):

    “If we just told parents, ‘No, this is wrong,’ our concern is they MAY take their daughters back to their home countries, where the procedure MAY be more extensive cutting and MAY even be done without anesthesia, with unsterilized knives or even glass,” she said. “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.”

    What amazes me about this quote is that it’s entirely speculative. There’s no data in the AAP report suggesting that any of this is happening. And the sequence of events Dr. Friedman Ross outlines is unlikely, to say the least. How many girls are being sent back to their “native countries” (at considerable expense to their families) and THEN cut “with unsterilized knives or even glass”? Without actual numbers showing that this is a significant problem (and one the medical community has a hope of addressing), it makes no sense to advocate a policy that would make what’s currently costly, illegal and difficult—-safeguards in their own right-—easy, legal and cheap. Without demonstrating a clear need, the AAP is in effect proposing that it be possible for every female infant whose parents so choose to have her genitals cut when there is no medical benefit to doing so.

    To suggest, as the AAP does, that doctors in the United States adopt this scattershot approach, where many women would be harmed and none (according the data) saved, is as nonsensical as it is pernicious.

    Thanks again for writing this. (And apologies for the novel this comment became.)

  15. Bernadette says:

    I agree with Taina and Jana. We must not/not give in to so-called cultural-religious influence. What is referred to in the article as cultural accomodation is a hugh problem here in Europe where all kinds of human rights abuses are tolerated in its name. I will name just a few: the killing of girls and women in the name of so-called honour if they are considered to have behaved unacceptably e.g. if they refuse a forced marriage, have an abortion or want a separation. Perpetrators often get lower sentences based on their cultural background. We even had a female judge refuse a battered wife an early divorce on the grounds that she should have known what she was letting herself in for when she married a Muslim man. The judge was later suspended but it shows what happens when ethnic groups press their interests in an aggressive way, which some do here in Europe all the time. Violence in migrant circles in a tabu topic as is the call for a ban on veiling. We women’s rights activists in Europe are sometimes referred to as racists because we call for a ban of veiling in schools and other public buildings to give children the right to grow up in a neutral environment as they can do in France. We have even heard it said the Muslim women are very happy that this ban exists in France because it gives their daughters a chance to experience normal life at school whereas in Germany non-veiled girls (both Muslim and non-Muslim) are harassed and molested by orthodox Muslim pupils (both boys and gilrs) for not being veiled.
    In Africa, anti-FGM projects go in and talk to villagers and try to educate people as to the terrible anguish suffered during and life-long after FGM. Do we want to eradicate these practises or not? We need to talk to these ethnic communities and tell them about the horrific effects of FGM and explain that these practises are hundreds of years old, and are nothing but torture for the girls and women concerned. Haven’t they seen the film “Desert Flower”, Maimooma and the many other films available on this topic.
    Just one last comment on MGM – I personally consider this a totally unnecessary practise, unless there is some medical need. Almost no men in Europe have been circumcised, except for orthodox Jews as far as I know and this is considered normal.

  16. Can I suggest an alternative comparison – instead of Breast Augmentation, we look at the growing rise of Labioplasty in the Western World; women who want (or whose S.O wants) a porn-star labia, a “designer vagina”.

    Is it hypocritical of us to condemn FGM, and not this too? And how far is labioplasty (which deadens nerve endings, and often results in an “attractive” appearance, but also painful or sensationless sex) really an “elective” procedure? Because that is the only difference I can see between the two; the issue of consent.

  17. Michele says:

    “We even had a female judge refuse a battered wife an early divorce on the grounds that she should have known what she was letting herself in for when she married a Muslim man. The judge was later suspended but it shows what happens when ethnic groups press their interests in an aggressive way, which some do here in Europe all the time.”

    For the life of me, I cannot see how or why it would be in the “interests” of Muslims to convince a community that battering is an important component of their “ethnic group.” The first sentence here suggests that the judge was expressing a bias against Muslims, not for them.

  18. I believe that the case we are referring to is this
    Where a German judge refused to grant a Muslim woman divorce based on domestic battery saying that the Koran said it was okay for a man to do that.
    As the article says, Muslim groups condemned the decision. The quandary here is this…there ARE distorted interpretations of the Quran that promote such ideas…and Muslim feminists are fighting them everyday, including feminist interpretations by scholars such as Laleh Bakhtiar.
    It is an ongoing fight…but just renunciation of religion doesnt challenge patriarchal interpretations it just allows them to exist.

  19. FGM, “cosmetic” breast procedures, labiaplasty… the prevalence of these procedures, whether performed on consenting adults or children, demonstrates persistent and pervasive inequality of female people. I condemn all these unnecessary “procedures” and regard them each as a form of mutilation. It is appropriate on some occasions to tie all these widespread “procedures” together in a whole-picture scenario, where the phenomenon of the modification of the female body can be examined in its entirety. If there are “feminists” out there who are not willing to critique some of these procedures because women choose to have some of these mutilations performed on their own bodies, I would hope that at some point these “feminists” examine the reasons many of these women have these things done to themselves.
    I condemn “breast enhancement”, labioplasty, and FGM. I do so and do not care that to some I will be perceived as “picking on women” for the “choices” women make. I am frustrated with medical professionals who make enormous profits performing medically unnecessary, risky “cosmetic” procedures on women, and profit enormously from the persistent, pervasive inequality of women, from the crushed self esteem of women, from cultural forces that do not accept unmodifed female people. I am frustrated that this earning of profits from unnecessary, risky, damaging procedures performed on the female body had attempted to extend its reach into yet another medical field.

  20. Hi, I just want to recommend Sunsara Taylor’s talk “From The Burkha to the Thong, Everything Must, And Can Change – WE NEED TOTAL REVOLUTION”; it is available online in its entirety at [http://www.revolutionbooksnyc.org/Webcast%20flyer.htm]. I think it completely relates to this blog-entry but it also offers a very radical solution. Please let me know what you think…amina@atheist.com

  21. Unnamed says:

    The direct comparison between forced genital amputation to any form of cosmetic surgery sought out by an adult (for any reason) is grossly misguided at best. In the first case you have a part of the genitals removed from a child before she/he ever learns the true value of that part of their anatomy. The degree of intrusion and complete lack of autonomy cannot be overcome by the comparison.

  22. Why can't people just do to their bodies as they want? Why do we always have to please someone else? Whether it is breast mutilation, genital mutilation (boys and girls), tattoos, piercings, ear and tail docking in dogs, etc. It's all injurious to society. It doesn't prevent, promote or enhance anything but a sense of helplessness in the victim.

    Protect each others rights – including those of our defenseless: CHILDREN.

  23. Angela Vistry says:

    Wouldn’t a closer comparison be between FGC done for ritual reasons and surgery done on intersex infants? Standard practice in North America has long been for infants born with ambiguous genders to be surgically altered (http://www.isna.org/faq/standard_of_care; http://www.intersexinitiative.org/articles/intersex-faq.html). Although in 2006 the AAP issued a consensus statement advocating more cautious approaches to surgery, they didn’t argue against it in all cases, and there are no enforcement or monitoring methods. So, both are forms of cutting infant genitals, for cultural reasons (to make genitals look ‘right’) and done without the child’s consent.

  24. Thank you very much for posting this line of thought. There are other Western cultural practices that also mutilates women’s body or are performed by medical practitioners that are not medically necessary and yet they are still legal eg is Labiaplasty which is sometimes performed with clitoral hood removed, clitoridectomy, breast enlargement, face lift etc. the question still remains: why are these procedures not illegal since they involve almost same risk as FGM. If FGM is ilegal because it inloves mainly infants and hence consent can not be obtained, then adults medical profession should be allowed to perform FGM on adult women who give their consent and want it, secondly, if it is the poor hyginic condition and non-medical personnel performing FGM that is the issue, then the medicalisation of FGM is the solution. not arresting parents. To be fair and not discriminate, the law must then criminalise all forms of woman body alterations that are not medically necessary or beneficiary and that confroms to the oppression of women to please men not criminalising FGM only because it is the cultural pratice of a minority race. what is the differnce between the designers v aginer and FGM? they are almost the same. yet one (FGM)AS is a crime because it is a cultural issue and the other is (DESIGNERS VAGINER) not because it is done for cosmetic reasons. thanks


  1. […] This post was mentioned on Twitter by Justin Kownacki, Jessica Wakeman, realitygal, Mikhail Lyubansky, Patricia Bynes and others. Patricia Bynes said: RT @msmagazine New policy from the American Academy of Pediatrics recommends allowing female genital mutilation- http://ht.ly/1NiiS […]

  2. […] suggesting that American doctors should be allowed to “nick” girls’ genitals if it would save them from being sent overseas to have a full female genital cutting procedure done, […]

  3. […] of the cruelest things humans do to other humans. Ms. Magazine also detests genital mutilation, and this article discussed the recent statement issued by the American Academy of Pediatric’s Committee on […]

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