In the UK, female genital mutilation is unlawful, not only when performed on minors, but also when performed on adult women. The aim of our paper is to examine several arguments which have been advanced in support of this ban and to assess whether they are sufficient to justify banning female genital mutilation for competent, consenting women. We proceed by comparing female genital mutilation, which is banned, with cosmetic surgery, towards which (...) the law has taken a very permissive stance. We then examine the main arguments for the prohibition of the former, assessing in each case both (a) whether the argument succeeds in justifying the ban and, if so, (b) whether a parallel argument would not also support a ban on the latter. We focus on the following arguments. Female genital mutilation should be unlawful because: (1) no woman could validly consent to it; (2) it is an oppressive and sexist practice; (3) it involves the intentional infliction of injury; (4) it causes offence. Our view is that arguments (3) and (4) are unsound and that, although arguments (1) and (2) may be sound, they support not only a ban on female genital mutilation, but also one on (some types of) costmetic surgery. Hence, we conclude that the present legal situation in the UK is ethically unsustainable in one of the following ways. Either the ban on female genital mutilation is unjustified because arguments (1) and (2) are not in fact successful; or the law's permissive attitude towards cosmetic surgery is unjustified because arguments (1) and (2) are in fact successful and apply equally to female genital mutilation and (certain forms of) cosmetic surgery. The people of the countries where female genital mutilation is practised resent references to ‘barbaric practices imposed on women by male‐dominated primitive societies’, especially when they look at the Western world and see women undergoing their own feminization rites intended to increase sexual desirability: medically dangerous forms of cosmetic plastic surgery, for instance …. (shrink)

Debates about female genital mutilation/cutting have polarized opinion between those who see it as an abuse of women’s health and human rights, to be ‘eradicated’, and those who may or may not oppose the practice, but see a double standard on the part of western campaigners who fail to challenge other unnecessary surgical interventions — such as male circumcision or cosmetic surgery — in their own communities and cultures. This article interrogates these debates about FGM/c in the (...) context of measures to reduce it in the UK over recent decades. It does not suggest that FGM/c is a legitimate practice, seeing it, rather, as an abuse of women’s and children’s rights that should be combated using a combination of measures. However, it argues that reduction strategies are undermined by inconsistencies in the law and the failure to back up the law with research and education. (shrink)

It is sometimes argued that the non-therapeutic, non-consensual alteration of children‘s genitals should be discussed in two separate ethical discourses: one for girls (in which such alterations should be termed 'female genital mutilation' or FGM), and one for boys (in which such alterations should be termed 'male circumcision‘). In this article, I call into question the moral and empirical basis for such a distinction, and argue that all children - whether female, male, or indeed intersex - (...) should be free from having parts of their genitals removed unless there is a pressing medical indication. (shrink)

Khalafzai, Rida Usman Female genital mutilation (FGM) is thought to be a custom practiced for the subjugation of women. The significance of FGM for practicing communities, however, is much more profound. The best hope of eradicating this practice lies in the recognition and comprehension of its cultural and social meanings.

Female genital mutilation is the removal or restructuring of healthy genital tissue. Under natural law, mutilation is an intrinsic evil and a grave violation of human dignity. If mutilation alleviates a threat to a person’s well-being, it may sometimes be permissible, but healthy genitals pose no such threat. The purported social benefits of FGM, such as decreased promiscuity, do not justify the practice, because there is no causal relationship between mutilation and virtue. In (...) terms of autonomy, victims are usually children and unable to consent. Parental rights and the rights of religion do not override children’s inherent rights to physical integrity and safety. Current support for minimal forms of FGM in an attempt to reduce the incidence of severe forms will instead prolong the practice and increase the number of victims. Finally, FGM differs from male circumcision in that it destroys the function and integrity of the organs themselves and promotes profound gender inequality. (shrink)

Despite global and local attempts to end female genital mutilation , the practice persists in some parts of the world and has spread to non-traditional countries through immigration. FGM is of varying degrees of invasiveness, but all forms raise health-related concerns that can be of considerable physical or psychological severity. FGM is becoming increasingly prohibited by law, both in countries where it is traditionally practised and in countries of immigration. Medical practice prohibits FGM. The Italian parliament passed (...) a law prohibiting FGM, which has put in place a set of measures to prevent, to oppose and to suppress the practice of FGM as a violation of a person’s fundamental rights to physical and mental integrity and to the health of women and girls. The Italian law not only treats new offences but also wants to deal with the problem in its entirety, providing important intervention in all the sectors. Different kinds of interventions are considered, starting with the development of informative campaigns, training of health workers, institution of a tollfree number, international cooperation programmes and the responsibility of the institution where the crime is committed. Particularly, the law recognises that doctors have a role in eliminating FGM by educating patients and communities. (shrink)

Herbert, Dilinie This article reports on the experiences of Female Genital Mutilation/Cutting for women living in countries where it is widespread and for those who migrate to Western countries. It explores the attitudes that shape the ongoing practice of FGM/C and the role of female hierarchy in sustaining these customs in practising communities. In particular, it investigates the dialogue between health professionals in Western countries like Australia and women presenting for antenatal care. This includes conversations around (...) de-infibulation. (shrink)

In the UK, female genital mutilation is unlawful, not only when performed on minors, but also when performed on adult women. The aim of our paper is to examine several arguments which have been advanced in support of this ban and to assess whether they are sufficient to justify banning female genital mutilation for competent, consenting women. We proceed by comparing female genital mutilation, which is banned, with cosmetic surgery, towards which (...) the law has taken a very permissive stance. We then examine the main arguments for the prohibition of the former, assessing in each case both (a) whether the argument succeeds in justifying the ban and, if so, (b) whether a parallel argument would not also support a ban on the latter. We focus on the following arguments. Female genital mutilation should be unlawful because: (1) no woman could validly consent to it; (2) it is an oppressive and sexist practice; (3) it involves the intentional infliction of injury; (4) it causes offence. Our view is that arguments (3) and (4) are unsound and that, although arguments (1) and (2) may be sound, they support not only a ban on female genital mutilation, but also one on (some types of) costmetic surgery. Hence, we conclude that the present legal situation in the UK is ethically unsustainable in one of the following ways. Either the ban on female genital mutilation is unjustified because arguments (1) and (2) are not in fact successful; or the law's permissive attitude towards cosmetic surgery is unjustified because arguments (1) and (2) are in fact successful and apply equally to female genital mutilation and (certain forms of) cosmetic surgery. The people of the countries where female genital mutilation is practised resent references to ‘barbaric practices imposed on women by male‐dominated primitive societies’, especially when they look at the Western world and see women undergoing their own feminization rites intended to increase sexual desirability: medically dangerous forms of cosmetic plastic surgery, for instance …. (shrink)

Sitting down to write this editorial on 6 February, the Global ‘Day of Zero Tolerance’ for female genital mutilation (FGM), it feels somewhat disconcerting to be introducing a feature article arguing for a ‘compromise position’ towards a practice that is widely accepted as abhorrent. Indeed, I'm sure many of the journal's readers will share my intuitive response that there is little scope for ethical disagreement on this issue, particularly in light of recent evidence that suggests that at (...) least 200 million girls and women alive today have been subjected to this practice.1 Here, I introduce the collection of papers on FGM in this issue, expanding briefly upon the main arguments and counter-arguments put forward. The main argument is controversial, but its airing on the pages of the journal has a clear purpose: by subjecting FGM in its many forms to ethical analysis, we will be in a stronger position to develop and tailor interventions that function to prevent indefensible practices of this kind. Arora and Jacobs's paper has a number of complementary aims. They begin by seeking to re-characterise FGMi practices by introducing a typology based on the functional impact of the procedure. They go on to argue against prohibiting procedures that have no lasting effect on morphology or function if performed …. (shrink)

Introducción: La ablación o mutilación genital femenina incluye una amplia variedad de prácticas que suponen la extirpación total o parcial de los genitales externos o su alteración por razones que no son de índole médica. Causa daños irreversibles y pone en peligro la salud, e incluso la vida de la mujer o niña afectada. Objetivo: Caracterizar la mutilación genital femenina y sus complicaciones a largo plazo en la comunidad de Fajikunda, Gambia, entre marzo y septiembre de 2012. Método: (...) Se realizó un estudio descriptivo prospectivo a 117 mujeres que asistieron al centro de salud por cualquier motivo que requiriera examen ginecológico y se estudiaron las variables grupo de edades, tipo de mutilación, grupo étnico y complicaciones. Resultados: Del total, 98 mujeres eran de 45 años de edad o menos; la clitoridectomía fue la práctica más frecuente; la inflamación pélvica crónica y el dolor en los genitales fueron las complicaciones a largo plazo que mayor asociación estadística demostraron con relación a la mutilación. La anorgasmia presentó una alta incidencia en la población estudiada. Conclusiones: La prevalencia de la mutilación genital femenina en Fajikunda es aproximadamente la misma que en Gambia, la tipo I es la más practicada y generalmente en jóvenes de la etnia Mandinga. Introduction: The ablation or female genital mutilation includes a wide variety of practices dealing with total or partial extirpation of the external genitalia or its alterations for reasons other than of medical nature. It causes irreversible damages and puts in danger the health or even the life of the woman or child involved. Objective: The aim of the present study is to characterize female genital mutilation and its long-term complications in Fajikunda community, Gambia, between March and September 2012. Method: A descriptive prospective study was performed to 117 women that attended the health unit for reasons requiring gynecological examination and the variables age group, mutilation type, ethnic group and complications were studied. Results: Of the total, 98 women were 45 years old or less; the clitoridectomy was the most frequent practice; cronical pelvic and genital pains were the long-term complications that showed a major statistical association with relation to mutilation. Conclusions: The prevalence of female genital mutilation in Fajikunda is approximately the same as in Gambia, the type I is the most performed and generally within young women belonging to Mandinga ethnic group. (shrink)

This article uses the voices of women to investigate the horror of the cultural practice of female genital mutilation. Case studies graphically illustrate the way in which the bodies of young girls are literally moulded for male satisfaction, physical, religious and cultural. Female genital mutilation is a socio-cultural offensive against women and young girls which we would join with female theologians in condemning.

Background Female genital mutilation and circumcision (FGM/C) practices present physicians in Germany with numerous challenges. One possible intervention is elective clitoral reconstruction for esthetic and physiological recovery after FGM/C. Even if the study situation regarding the results achieved by clitoral reconstruction is controversial, the range of reconstruction options is increasing. Arguments The aim of this study is to critically examine the epistemic and ethical dimensions of the interdisciplinary debate on clitoral reconstruction that has arisen over the last (...) 20 years. It is intended to provide orientation in the complex field in which cultural, gender-specific, sexual, and psychosocial factors interact with anatomical–physiological knowledge and the lack thereof. The analysis shows the ambivalent role of evidence claims and promises in relation to clitoral reconstruction. Conclusions Difficulties in testing and comparing existing surgical procedures and in the use of standardized questioning tools demonstrate how essential cultural competence and diversity awareness are in dealing with those affected. The prima facie correct argument of insufficient evidence on the efficacy, comparability, and long-term consequences of reconstruction procedures proves to be problematic for ethical and epistemic reasons. In order to generate valid and useful data on sexuality, body perception, pain, and pleasure before and after clitoral reconstruction, survey modalities that address the culturally heterogeneous target group of women with FGM/C are needed. Cultural competence and sensitivity in medicine are also urgently needed for target group-oriented education and counseling as a prerequisite for self-determined decisions for/against clitoral reconstruction. (shrink)

Female Genital Mutilation (FGM) is a universal issue which affects girls in Africa, the Middle East, Asia and South America, and immigrant communities in Western Europe, North America, Australia and New Zealand. FGM is a cultural practice in approximately 29 countries in Africa, affecting over 140 million girls. FGM is practiced as a rite of passage, where girls are initiated into womanhood. This practice is promoted as a means for incorporation, thus ascribing personhood, and belonging for girls (...) to their communities. African scholars hold conflicting positions about FGM, with some arguing that it is essential for relational fullness and harmony. While others believe FGM is unjustified because of the health and social risks associated with the practice. We argue, applying sustainable social harmony and Gyekye's views on cultural revitalization, that FGM is morally unjustified and should be prohibited. We believe the claims that FGM fosters harmony, a value of Ubuntu, are fallacious, and this perceived harmony is pretentious and unsustainable. We claim that FGM is inauthentic, unjust and steeped in patriarchal underpinnings that are unsustainable, thus it is a disharmonious practice. Cultural practices that are disharmonious should be refined and pruned and must be dynamic and responsive to current realities. (shrink)

In this article we focus on female genital mutilation. We analyse this problem as one of the most important issues of multiculturalism, which is also coming to the attention of the public in Italy as a consequence of the growing number of immigrants from African countries. The fundamental problem is about the acceptability of this practice: can female genital mutilation be permitted and, if so, on what basis? We will try to cope with this (...) as a genuine conflict between culture-relative values and universal values, such as human rights. Some attention will be drawn to Italian law. Finally, the impact on nurses of requests for genital mutilation will be described. (shrink)

Within Western European countries the number of women and girls already genitally mutilated or at risk, is rising due to increasing rates of migration of Africans. The article compares legislative and ethical practices within the medical profession concerning female genital mutilation (FGM) in these countries. There are considerable differences in the number of affected women and in legislation and guidelines. For example, in France, Great Britain and Austria FGM is included in the criminal code as elements of (...) crime, whereas in Germany and Switzerland FGM is brought to trial as bodily injury. So far trials only in France and Switzerland in connection with FGM resulted in convictions. France and Great Britain as former Colonial countries serve as an example of countries with a comparably great number of African immigrants. These countries have the best possibilities to intervene preventatively, due to legislation and detailed medical guidelines. For instance, an obligation exists in France to inform administrative and medical authorities if FGM is suspected. FGM so far is not explicitly part of the curriculum for medical training in any of the examined countries. (shrink)

A UK doctor was recently acquitted of charges of reinstating a variety of female genital mutilation after delivering a child. In this paper, I contend that this incident reflects a broader confusion concerning the ethico-legal status of non-therapeutic genital surgeries for children and adults, which are not derivable from tenets of medical ethics, but rather violate them. I argue that medical professionals have an obligation to announce and address this confusion in order to motivate legislative reform, (...) since the inconsistency of the current law entrenches the underlying sexism and ethnocentrism upon which its sense depends. Without convincing arguments for condoning male circumcision and female cosmetic genital surgery and for treating adult women of colour as lacking the capacity to consent, the current legislation stands in need of urgent revision. (shrink)

This essay considers the tension between political liberalism and gender equality in the light of social construction and multiculturalism. The tension is exemplified by the work of Martha Nussbaum, who tries to reconcile a belief in the universality of certain liberal values such as gender equality with a political liberal tolerance for cultural practices that violate gender equality. The essay distinguishes between first? and second?order conceptions of autonomy, and shows that political liberals mistakenly prioritise second?order autonomy. This prioritisation leads political (...) liberals to seek to limit state interference in individuals' choices. However, the essay argues that if options, choices and the preferences which lead to them are socially influenced or constructed, it is no longer clear that state non?interference secures autonomy. Instead, it becomes a matter of justice what the content of the social or state influence is, which options are open to people, and political liberalism cannot deal with many forms of injustice. Rather than emphasising state neutrality, liberals should endorse state prohibition of practices which cause significant harm to those who choose them, if they are chosen only in response to unjust norms. (shrink)

Immigration changed the ethnic composition of Western European societies. The new populations brought a series of culturally determined practices that challenged the liberal framework of values of the receiving states. Despite the existence of important variations between the official discourses and the actual policies finally implemented, the responses to those challenges varied with the models of integration defined by each country to deal with ethnic diversity. In this article, we study the policies designed and implemented by the United Kingdom and (...) France against “female genital mutilation” practices, analyzing how both British and French policies affected these types of practices. (shrink)

According to the World Health Organization, female genital cutting affects millions of girls and women worldwide, particularly on the African continent and in the Middle East. This paper presents a plausible, albeit hypothetical, clinical vignette and then explores the legal landscape as well as the ethical landscape physicians should use to evaluate the adult patient who requests re-infibulation. The principles of non-maleficence, beneficence, justice, and autonomy are considered for guidance, and physician conscientious objection to this procedure is discussed (...) as well. Analyses of law and predominant principles of bioethics fail to yield a clear answer regarding performing female genital cutting or re-infibulation on an adult in the United States. Physicians should consider the patient’s physical, mental, and social health when thinking about female genital cutting and should understand the deep-rooted cultural significance of the practice. (shrink)

This chapter analyzes a case involving a mother who brings her nine-year-old daughter to Dr D requesting that she be ‘circumcised’. The mother explains that she wants the procedure done for fear that the daughter will not be eligible for marriage in her community if it is not done. It discusses what Dr D should do, taking into consideration medical, ethical, legal, and human rights aspects of the case.

Recent events in the United States and beyond have brought debates over the practice of female genital cutting back into public, academic, and policy discourses.1 In April 2017, Jumana Nagarwala, a Michigan-based emergency medicine physician from a small Shia sect known as the Dawoodi Bohra, was charged with performing female genital mutilation. The procedure is prohibited by federal law and defined as the circumcision, excision, or infibulation of the whole or any part of the (...) class='Hi'>female genitalia under the age of 18. Nagarwala argues that she did not mutilate, but rather performed a variation of a religious ritual, termed Khatna, which involves the nicking... (shrink)

Despite global and local attempts to end genital mutilation, in their various forms, whether of males or females, the practice has persisted throughout human history in most parts of the world. Various medical, scientific, hygienic, aesthetic, religious, and cultural reasons have been used to justify it. In this symposium on circumcision, against the background of the other articles by Hutson, Short, and Viens, the practice is set by the author within a wider, global context by discussing a range (...) of rationalisations used to support different types of genital mutilation throughout time and across the globe. It is argued that in most cases the rationalisations invented to provide support for continuing the practice of genital mutilation—whether male or female—within various cultural and religious settings have very little to do with finding a critical and reflective moral justification for these practices. In order to question the ethical acceptability of the practice in its non-therapeutic forms, we need to focus on child rights protection. (shrink)

Western media coverage of female genital modifications in Africa has been hyperbolic and one-sided, presenting them uniformly as mutilation and ignoring the cultural complexities that underlie these practices. Even if we ultimately decide that female genital modifications should be abandoned, the debate around them should be grounded in a better account of the facts.

This paper examines the attitudes of circumcised women towards female circumcision in a community where the practice is in vogue. Also described are the type of circumcision performed, who usually performs the circumcision and complications. One hundred volunteers across the social strata were interviewed by means of a structured questionnaire. Data were analysed using frequency tables. The study revealed that 62% of respondents favoured the practice as an instrument for the control of female sexuality and maintenance of cultural (...) pride. Circumcision is mainly by excision of the clitoris and the labia minora performed mainly by traditional birth attendants. Complications include severe pain, difficulty with urination and excessive bleeding. Based on the findings, it is suggested that communities where femal genital mutilation is practised as a social norm should be involved in any eradication campaign, with the support of national and international organisations. Research is also essential to understand FGM in order to design effective reforms. (shrink)

This study reviews various discourses around female sexual mutilation from the perspective of the human and social sciences, and also current debates between supporters of the cultural argument and those defending the universality of human rights. An aside about the Dogon myth of world order recorded by Marcel Griaule in Dieu d’eau or Aristotle’s philosophical discourse in the Reproduction of Animals is required in order to widen the debate and see its importance as regards the dignity of the (...) human person. In Aristotle woman is a freak accident, she interrupts the circle that goes from man to man so that he can start off again. Woman is a "catastrophe" necessary to the exercise of the male genitalia; her body is naturally mutilated and incomplete. In the Dogon myth the clitoris rises up like a termite-hill, it is oversized and must be knocked down, that is, excised. Between excessive size, monstrousness and ugliness come discourses which have since time immemorial accompanied and justified wounding the female genitals. But today a medical type of discourse, which is widely accepted, is aiming to repair excised genitalia and give back to women the happiness of a recovered body. Thus we may ask what "woman’s dignity" consists of and whether it is the same as the "dignity of the human person". (shrink)

This chapter considers the role of choice as a normative transformer in relation to the practice of female genital cosmetic surgery. It is common, in law and practice, to distinguish between two sorts of female genital cutting. One is described as ‘female genital mutilation’ (FGM) and prohibited; the other is described as ‘female genital cosmetic surgery’ (FGCS) and permitted, even provided by the state in certain circumstances. The chapter argues that distinguishing (...) between the two requires going beyond a simplistic contrast between choice and coercion. Both practices can be understood only within a cultural context that makes them available and marks them as appropriate. As with many other forms of cosmetic surgery, FGCS cannot be exonerated merely by an appeal to individual choice. (shrink)

The results of a recent survey of Nigerian women might give pause to opponents of female genital mutilation (FGM). One could well argue that if these Nigerian women themselves favour FGM, then it is ironically paternalistic to oppose it. Should Western feminists actually support FGM if it is what women in the South want? I argue in this commentary that such an argument rests on shaky statistical, psychological, medical, political and philosophical grounds. We should go on opposing (...) female genital mutilation with all our power. (shrink)

Purpose: The sensitization which this discussion engenders, has the objective of instituting an ever more formidable resilience in the advocacy against female genital mutilation (FGM) around the globe. Methodology: Besides the expository, analytic and evaluative character of this work, a particular effort is made to unveil the political and epistemological trappings that undergird the condemnable, but on-going practice of female genital mutilation in different parts of the world, especially in the continent of Africa. Findings: (...) Some people point out that the word "cutting" is less judgmental and relates better to terms used in many local languages. However, many women's health and human rights organizations use the word "mutilation," not only to describe the practice, but also to point out the violation of women's human rights. Unique Contribution to theory, practice and policy (recommendation): Ritual circumcision of young males and females is a practice seen in many cultures across the world, including sub-Saharan and North Africa, the Muslim Middle East, the Jewish diaspora, Aboriginal Australia, the Pacific Islands, Southeast Asia, etc. This work discuses female circumcision as “female genital mutilation” and rejects the view proposed by some that its practice is culturally and ethically relative. All three terms, female genital cutting (FGC), female circumcision, or female genital mutilation (FGM) describe the procedure that cuts away part or all of the external female genitalia and are used to describe the same thing, that is, mutilation. Some people fear that parents may resent the implication that they are "mutilating" their daughters by participating in this largely cultural event, and so reject the term FGM in favour of FGC. (shrink)

The bodies of non-White girls are hyper-visible in humanitarian discourses. This article engages in theoretical reflections around the articulation of Whiteness through the body of the third world girl. I curate and examine an archive of texts and visuals from menstrual hygiene and female genital mutilation (FGM) awareness campaigns to show how the figure of the third world girl is materialised simultaneously as deserving of care/protection and as a contaminant/imperfection. These apparently contradictory registers of legibility are possible (...) due to the reiteration of the non-White female body as ontologically dirty, incomplete and an imperfect representation of full humanity. The third world girl then is the constitutive outside of Whiteness, and her production as such conjoins humanitarian protection codes with penalising political regimes. The latter is reflected by new border patrolling initiatives in the US and UK, launched specifically to identify victims of FGM. Such exercises of state power craft racialised bodies for constant interrogation, prodding and, ultimately, ejection. These bodies then become the loci of benevolent necropower and experience slow social death. (shrink)

Arora and Jacobs (2016) assume that liberal societies should tolerate non-therapeutic infant male circumcision, and argue that it follows from this that they should similarly tolerate—or even encourage—what the authors regard as ‘de minimis’ forms of female genital mutilation (as defined by the World Health Organization). In this commentary, I argue that many serious problems would be likely to follow from a policy of increased tolerance for female genital mutilation, and that it may therefore (...) be time to consider a less tolerant attitude toward non-therapeutic infant male circumcision. Ultimately, I suggest that children of whatever sex or gender should be free from having healthy parts of their most intimate sexual organs either damaged or removed, before they can understand what is at stake in such an intervention and agree to it themselves. (shrink)

Polygamy, forced marriage, female genital mutilation, punishing women for being raped, differential access for men and women to health care and education, unequal rights of ownership, assembly, and political participation, unequal vulnerability to violence. These practices and conditions are standard in some parts of the world. Do demands for multiculturalism — and certain minority group rights in particular — make them more likely to continue and to spread to liberal democracies? Are there fundamental conflicts between our commitment (...) to gender equity and our increasing desire to respect the customs of minority cultures or religions? In this book, the eminent feminist Susan Moller Okin and fifteen of the world’s leading thinkers about feminism and multiculturalism explore these unsettling questions in a provocative, passionate, and illuminating debate. Okin opens by arguing that some group rights can, in fact, endanger women. She points, for example, to the French government’s giving thousands of male immigrants special permission to bring multiple wives into the country, despite French laws against polygamy and the wives’ own bitter opposition to the practice. Okin argues that if we agree that women should not be disadvantaged because of their sex, we should not accept group rights that permit oppressive practices on the grounds that they are fundamental to minority cultures whose existence may otherwise be threatened. In reply, some respondents reject Okin’s position outright, contending that her views are rooted in a moral universalism that is blind to cultural difference. Others quarrel with Okin’s focus on gender, or argue that we should be careful about which group rights we permit, but not reject the category of group rights altogether. Okin concludes with a rebuttal, clarifying, adjusting, and extending her original position. These incisive and accessible essays — expanded from their original publication in Boston Review and including four new contributions — are indispensable reading for anyone interested in one of the most contentious social and political issues today. The diverse contributors, in addition to Okin, are Azizah al-Hibri, Abdullahi An-Na’im, Homi Bhabha, Sander Gilman, Janet Halley, Bonnie Honig, Will Kymlicka, Martha Nussbaum, Bhikhu Parekh, Katha Pollitt, Robert Post, Joseph Raz, Saskia Sassen, Cass Sunstein, and Yael Tamir. (shrink)

Background Female genital mutilation and circumcision (FGM/C) practices present physicians in Germany with numerous challenges. One possible intervention is elective clitoral reconstruction for esthetic and physiological recovery after FGM/C. Even if the study situation regarding the results achieved by clitoral reconstruction is controversial, the range of reconstruction options is increasing. Arguments The aim of this study is to critically examine the epistemic and ethical dimensions of the interdisciplinary debate on clitoral reconstruction that has arisen over the last (...) 20 years. It is intended to provide orientation in the complex field in which cultural, gender-specific, sexual, and psychosocial factors interact with anatomical–physiological knowledge and the lack thereof. The analysis shows the ambivalent role of evidence claims and promises in relation to clitoral reconstruction. Conclusions Difficulties in testing and comparing existing surgical procedures and in the use of standardized questioning tools demonstrate how essential cultural competence and diversity awareness are in dealing with those affected. The prima facie correct argument of insufficient evidence on the efficacy, comparability, and long-term consequences of reconstruction procedures proves to be problematic for ethical and epistemic reasons. In order to generate valid and useful data on sexuality, body perception, pain, and pleasure before and after clitoral reconstruction, survey modalities that address the culturally heterogeneous target group of women with FGM/C are needed. Cultural competence and sensitivity in medicine are also urgently needed for target group-oriented education and counseling as a prerequisite for self-determined decisions for/against clitoral reconstruction. (shrink)

Female genital mutilation/cutting is a multifaceted, culturally entrenched issue. In response to the United States Conference of Catholic Bishops’ resources dealing with the issue of FGM/C, this paper explores what resources sexual ethics can provide Catholic hospitals facing this issue, specifically with regards to the request for reinfibulation. FGM/C ought not to be treated as a univocal medical practice; rather, in natural law evaluations of the act, the practice of reinfibulation ought to be separately acknowledged. Reinfibulation cannot (...) be properly considered a mutilation in the same way that other types of FGM/C are. Thus reinfibulation should be performed in Catholic hospitals for those women who request it, as part of delivering culturally competent care, justifiable through the principle of material cooperation. (shrink)

Female genital mutilation generates passionate argument about child abuse and the limits of cultural independence. The Sudanese Women's Rights Group (SWRG), which is based in the United Kingdom (UK) issued a press release expressing grave concern about the Sudanese government's intention to legalise female genital mutilation (circumcision) (Sudanese Women's Rights Group press release Legalisation of female circumcision in Sudan, 18 June 2002). The Sudanese Ministry of Religious Affairs and Endowment, together with an Islamic (...) university, held a workshop entitled Towards the Legalisation of Female Circumcision & Establishment of Training Centers for Operators (excisors). It recommended that female circumcision should be legalised, awareness about its importance in society should be raised, and the Islamic University should establish centres all over the country for training practitioners of female circumcision. The SWRG is concerned about the strong support for the recommendations among government officials, in a country where 89% of women have been mutilated.1 The Sudanese government's actions came just a few months before female genital mutilation was rejected at a 190 country strong world summit.2 The summit agreed that health care services must “conform to basic human rights and fundamental freedoms”, a provision designed to prevent female genital mutilation. Around the same time the American embassy in Nairobi said that Somali refugees who had rushed to circumcise their daughters before being moved to the US would probably be barred from emigrating.3 The statement prompted fierce debate, and the US later backtracked.4 Recent debate in the UK focused on taking young girls abroad for mutilation. Nothing in UK law specifically prohibits families from taking daughters abroad for female genital mutilation, but doctors must consider what action they should take to protect a child at risk of being mutilated. The government is exploring ways to strengthen the Prohibition of Female …. (shrink)

The book is an exploration of the medical, legal, moral and cultural aspects of the practice of circumcision. The title suggests that the book will cover both topics, male and female circumcision. This, however, is misleading. The main focus of this collection is on male circumcision. This is problematic because the fact that female circumcision is left with much less attention means the reader may get the false impression that the practice of female genital mutilation (...) (FGM) is not very widely spread or has less serious consequences than male circumcision. In reality, however, FGM is still extensively practised in different parts of the world and due to its radical nature its physical, mental and social effects are usually even more devastating than those of male circumcision. This important fact is undermined in the very first chapter of the book, in which the trauma of male circumcision is emphasised by the claim that the differences between …. (shrink)

This book provides an analysis of the debate surrounding cultural diversity, and attempts to reconcile the seemingly opposing views of "ethical imperialism," the belief that each individual is entitled to fundamental human rights, and cultural relativism, the belief that ethics must be relative to particular cultures and societies. The author examines the role of cultural tradition, often used as a defense against critical ethical judgments. Key issues in health and medicine are explored in the context of cultural diversity: the physician-patient (...) relationship, disclosing a diagnosis of a fatal illness, informed consent, brain death and organ transplantation, rituals surrounding birth and death, female genital mutilation, sex selection of offspring, fertility regulation, and biomedical research involving human subjects. Among the conclusions the author reaches are that ethical universals exist, but must not be confused with ethical absolutes. The existence of ethical universals is compatible with a variety of culturally relative interpretations, and some rights related to medicine and health care should be considered human rights. Illustrative examples are drawn from the author's experiences serving on international ethical review committees and her travels to countries in Africa, Asia, and Latin America, where she conducted educational workshops and carried out out her own research. (shrink)