Hello, all, I'd just finsihed writing a whole post on this and I
clicked send and it's gone!  Is there a link to the blog/article?  All
I'll say, in short, because I don't feel like typing up the long post
again, is that I think my opinions are changing on this issue,
especially since the medical data is not seeming to support what
different organizations have been saying about this practice!

Ginny



On 12/7/07, ABDOUKARIM SANNEH <[log in to unmask]> wrote:
> Ylva
>   Thanks for the forward. Recently I learned that you a research fellow at
> University of Washington Seatle. I learned you Doctoral research was on the
> issue of Female circumcision. Can you please forward the abstract to enhance
> the debate about the issue especially in relation to the right of the girl
> child. With my ethnic background having known about the health implication
> even having a wife from my ethnic background, If I have a girl child is a
> life principle to know that female circumcision is a violation the right of
> girl children. It will be great to know abot the themetic issue of your
> resaerach about such a social anthropological issue which our politicans did
> not want to debate about because of fear for majority vote. Ylva as from now
> I don,t know any policy intervention about the issue.
>
> Ylva Hernlund <[log in to unmask]> wrote:
>   Dr. Ahmadu asked me to forward this (she is a member of Gambia-l but for
> some reason her posts are
> rejected). Ylva
>
>
> ---------- Forwarded message ----------
>
> For those of you who are following or have had a chance to glance at the
> NY Times debate on female circumcision (see John Tierney or Tierneylab),
> which preceded the American Anthropological Association Public Policy
> Forum on Female Genital Cutting last Saturday in DC, I am forwarding the
> most recent contribution by Rick Shweder, from the University of
> Chicago. Many of you expressed concerns about the health implications of
> various forms of FGC; Shweder's article is a very important critical
> analysis of current research on the medical evidence that few of us
> Africans can afford to ignore -- given the exaggerated and
> sensationalized claims that are often made in the media. In exposing and
> challenging much of the hyperbole, I do not wish to minimize
> the experiences and rights of women (and yes, men), however rare these
> cases may be, who have been traumatized physically or psychologically by
> their experiences of genital cutting - whether in the "bush" or in
> clinical settings (as in some cases of male circumcision
> gone awry). One of my intentions as an anthropologist as well as an
> African from an ethnic group that practices both male and female
> initiation is to promote policies that respect both cultural and
> individual rights, dignity and autonomy. So, I hope of some of you,
> especially women, will weigh in on these very significant discussions on
> John Tierney's blog and contribute your own thoughts, ideas, suggestions
> or experiences whether for or against, good or bad or none of the above.
> I'd also welcome talking to anyone of you either through leonenet
> discussions or by direct email ([log in to unmask]) on this topic.
>
>
> From The TierneyLab (New York Times):
>
> My post about a debate over a female initiation rite in Africa prompted
> lots of angry reactions, some quite thoughtful ones, much misinformation
> and one entirely reasonable request from Charles:
>
> Having read dozens of passionate comments, are there any
> dispassionate factual examinations of the subject addressing
> (a) the health risks, (b) the health benefits, and (c) the
> actual effect of the procedure on the lives of those subject
> to it, all categorizing by the varieties of practice? It
> would be nice to have some granular facts rather than summary
> conclusions.
>
> I'm not sure it's possible to find anyone dispassionate on this subject.
> The experts, like Lab readers, can't even even agree on what to call this
> procedure. (In my post I used several of the terms: circumcision, female
> genital mutilation, female genital cutting, genital modification.) But I
> would like to give Lab readers a sense of the research results and range
> of expert opinion. I've asked several researchers to respond to Charles'
> question and to other concerns raised by Lab readers. The first response
> (others will follow) is from Richard Shweder, a cultural anthropologist
> at the University of Chicago and one of the organizers of Saturday's
> debate on this topic at the American Anthropological Association's annual
> meeting. Here's Dr. Shweder's response:
>
> "Female genital mutilation" is an invidious and essentially
> debate-subverting label. The preemptive use of that
> expression is just as invidious as starting a conversation
> about a women's right to choose by describing abortion as the
> "murder of innocent life." Pro-choice advocates rightly
> object to the presumptive disparagement implied by that
> label; many African women similarly object to naming a
> practice which they describe in local terms as "the
> celebration" or the "purification" or the "cleansing" or the
> "beautification" as "the mutilation". Notably in most ethnic
> groups where female genital surgeries are customary, male
> genital surgeries are customary as well and are named with
> the same terms.
>
> Charles calls for a dispassionate factual examination of the
> risks and consequences of female genital surgeries. Fact
> checking has not been the strong suit of anti-"FGM" advocacy
> groups or of the American press. Indeed, the press in general
> has served as an effective outlet for the advocacy groups and
> has kept itself innocent of available sources of information
> that run counter to the received horror arousing story-line
> about barbaric or ignorant or victimized Africans who maim,
> murder, and disfigure their daughters and deprive them of a
> capacity to experience sexual pleasure. With rare exceptions,
> the only African women who have been given a direct voice and
> allowed to speak for themselves in our media are those who
> oppose the practice.
>
> For example, in recent years there have been two major
> scientific reviews of the medical literature and an exemplary
> Gambia-based research study, which have raised serious doubts
> about the supposed effects on mortality, morbidity and
> sexuality that are so often attributed to these customary
> surgeries; yet, as far as I know, there has been absolutely
> no mention of these reviews and studies in any American
> newspaper or on NPR, although one might have thought they
> were sufficiently eye-opening and significant to warrant
> media coverage.
>
> Any reasonably objective assessment of the risks and
> consequences of female genital surgeries should begin with
> the epidemiologist and medical anthropologist Carla
> Obermeyer's comprehensive and critical reviews of the medical
> and demographic evidence on the topic (published in the
> journal Medical Anthropology Quarterly). Her first
> publication reviews and critiques the available literature on
> female genital surgeries through 1996; her second publication
> reviews the subsequent literature from 1997-2002. The third
> key source is a research report by Linda Morison and her
> Medical Research Council team published in 2001 in the
> journal Tropical Medicine and International Health. That
> research, conducted in the Gambia, is the most systematic,
> comprehensive and controlled investigation of the health
> consequences of female genital modifications yet to be
> conducted.
>
> This is what Carla Obermeyer says in her first comprehensive
> review. "On the basis of the vast literature on the harmful
> effects of genital surgeries, one might have anticipated
> finding a wealth of studies that document considerable
> increases in mortality and morbidity. This review could find
> no incontrovertible evidence on mortality, and the rate of
> medical complications suggest that they are the exception
> rather than the rule." …"In fact, studies that systematically
> investigate the sexual feelings of women and men in societies
> where genital surgeries are found are rare, and the scant
> information that is available calls into question the
> assertion that female genital surgeries are fundamentally
> antithetical to women's sexuality and incompatible with
> sexual enjoyment."
>
> Perhaps the most scientifically rigorous and large-scale
> study of the medical consequences of female genital surgeries
> in Africa is the Morison et al Gambia study. In the Gambia a
> customary genital surgery typically involves an excision of
> the visible or protruding part of the clitoris and either a
> partial or complete excision of the labia minora. (It is
> important to note that the visible part of the clitoris,
> which many African women view as an unbidden, unwanted, ugly
> and vestigial male-like element that should be removed for
> the sake of gender appropriate bodily integrity and a sense
> of mental well-being, is not the entire tissue structure of
> the clitoris and much of that tissue structure, a good deal
> of which is not visible and protruding but is rather
> subcutaneous, remains even after the surgery, which may
> explain why "circumcised" women remain sexual and have
> orgasms.)
>
> The Morison et al study systematically compared "circumcised"
> with "uncircumcised" women. More than 1,100 women (ages
> fifteen to fifty-four) from three ethnic groups (Mandinka,
> Wolof, and Fula) were interviewed and also given
> gynecological examinations and laboratory tests. This is rare
> data in the annals of the literature on the consequences of
> female genital surgeries.
>
> Overall, very few differences were discovered in the
> reproductive health status of "circumcised" versus
> "uncircumcised" women. Forty-three percent of women who were
> "uncircumcised" reported menstrual problems compared to 33%
> for "circumcised" women but the difference was not
> statistically significant. Fifty-six percent of women who
> were "uncircumcised" had a damaged perineum compared to 62%
> for "circumcised" women, but again the difference was not
> statistically significant. There were a small number of
> statistically significant differences – for example, more
> syphilis (although not a lot of syphilis) among
> "uncircumcised" women, and a higher level of herpes and one
> particular kind of bacterial infection among women who were
> "circumcised."
>
> But in general, from the point of view of reproductive health
> consequences there was not much to write home about. As noted
> in the research report, the supposed morbidities (such as
> infertility, painful sex, vulval tumors, menstrual problems,
> incontinence and most endogenous infections) often cited by
> anti-"fgm" advocacy groups as common long-term problems of
> "fgm" did not distinguish women who had the surgery from
> those who had not. Yes, 10% of circumcised Gambian women in
> the study were infertile, but the level of infertility was
> exactly the same for the "uncircumcised" Gambian women in the
> study. The authors caution anti-"FGM" activists against
> exaggerating the morbidity and mortality risks of the
> practice. In addition, circumcised Gambian women expressed
> high levels of support for the practice; and the authors of
> the study write: "When women in our study were asked about
> the most recent circumcision operation undergone by a
> daughter, none reported any problems."
>
> My conclusion from reading those three publications is that
> the harmful practice claim has been highly exaggerated and
> that many of the representations in the advocacy literature
> and the popular press are nearly as fanciful as they are
> nightmarish. A close and critical reading of the much
> publicized 2006 Lancet publication of the "WHO Study Group on
> Female Genital Mutilation," which received widespread,
> immediate and sensationalize coverage in the press because of
> its purported claims about infant and maternal mortality
> during the hospital birth process, suggests to me that again
> there is not very much to write home about.
>
> In that WHO study, not a single statistically significant
> difference was found between those who had a "type 1" genital
> surgery versus no surgery; no statistically significant
> differences were found between those who had no genital
> surgeries and those who had type 1, 2 or 3 genital surgeries
> for the best predictor of infant health, namely birth weight;
> the perinatal death rate for the actual women in the sample
> who had a "type 3" surgery was in fact lower (193 infant
> deaths out of 6595 births) than those who had no surgery at
> all (296 deaths out of 7171 births) and only became
> statistically significant in a negative direction through
> non-transparent statistical manipulation of the data; the
> study collected data on women across six nations but never
> displayed the within nation results; there was no direct
> control for the quality of health care available for
> "circumcised" versus "uncircumcised" women; the sample was
> unrepresentative of the whole population; and in general any
> reported increased risk for genital surgery was astonishingly
> small and hardly a mandate for an eradication rather than a
> public health program.
>
> The best evidence available at the moment suggests to me that
> the anthropologist Robert Edgerton basically had it right
> when he wrote about the Kenyan practice in the 1920s and
> 1930s as a crucible in which it is not just the courage of
> males but also the courage of females that gets tested:
> "…most girls bore it bravely and few suffered serious
> infection or injury as a result. Circumcised women did not
> lose their ability to enjoy sexual relations, nor was their
> child-bearing capacity diminished. Nevertheless the practice
> offended Christian sensibilities". As Charles put it in his
> comment: "Personal revulsion is not a good basis for making
> general policy."
>
> It is noteworthy, perhaps even astonishing, that in the
> community of typically liberal, skeptical and critical
> readers of the Times there has been such a ready acceptance
> of the anti-FGM advocacy groups' representations of family
> and social life in Africa as dark, brutal, primitive,
> barbaric, and unquestionably beyond the pale. Many
> commentators are confident that when it comes to this topic
> no debate is necessary.
>
> One witnesses the ready assumption that any deliberate
> modification of the female (and even the male) anatomy is an
> example of oppression or torture (as though we should begin
> describing the Jewish practice as "male genital mutilation")
> and that these coming-of-age and gender identity or group
> identity ceremonies of African mothers should be placed on
> the list of absolute evils along with cannibalism and
> slavery. At the panel on "Zero Tolerance" policies held on
> Saturday at the American Anthropological Association meeting,
> one of the participants Zeinab Eyega, who runs an NGO
> concerned with the welfare of African immigrants in the USA,
> noted that these days in New York "the pain of hearing
> yourself described is more painful than being cut."
>
> The anthropologist Clifford Geertz once wrote: "Rushing to
> judgment is more than a mistake, it is a crime." For those
> who are prepared to be slower to judge and learn more about
> the topic, have a look at my own first detailed attempt to
> come to terms with this type of cultural difference and to
> address many of the issues raised by the commentaries– an
> essay titled "What About 'Female Genital Mutilation': And Why
> Understanding Culture Matters in the First Place", available
> here.
>
> Readers can find other scholarly treatments of this topic in "Female
> 'Circumcision'
>
>
> Fuambai Sia Ahmadu
>
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