AAP on FGM and MGM

http://pediatrics.aappublications.org/content/125/5/1088.full

The AAP opposes all forms of FGM, counsels its members not to perform such ritual procedures, and encourages the development of community educational programs for immigrant populations.

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Fgm and Mgm compared

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-for more info- http://www.circumstitions.com/FGMvsMGM.html

…..

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http://www.prb.org/pdf08/fgm-wallchart.pdf

Procedures vary throughout the world but the WHO classifies FGM2 into four types as follows:
Type 1: Excision of the prepuce with or without excision of the clitoris.
Type 2: Excision of the clitoris with partial or total excision of the labia minora.
Type 3: Excision of part or all of the external genitalia and stitching together of the exposed walls of the labia majora, leaving only a small hole (typically less than 5cm) to permit the passage of urine and vaginal secretions. This hole may need extending at the time of the menarche and often before first intercourse.
Type 4: Unclassified, covers any other damage to the female genitalia including pricking, piercing, burning, cutting or introduction of corrosive substances.

for more info- http://www.ednahospital.org/hospital-mission/female-genital-mutilation/
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http://www.slideshare.net/AaronJose1/multilation-bioethics

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A link to a blog post putting the aap stances on fgm and male circumcision side by side

http://www.circumstitions.com/AAP.html

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I’m looking for a chart of the different types if male circumcision or make genital mutilation but its hard.
Some types are:
*Circumcision as we know it- removing various amounts of foreskin
*in some cultures it’s a simple dorsal slit

* in some cultures it’s sub-incision- where they actually cut the penis length-wise
http://books.google.com/books?id=xmdKklZM9-kC&pg=PA164&lpg=PA164&dq=cultures+who+subincision&source=bl&ots=0QOxHnsSky&sig=IF0hISOISRhB_14NqL4VGtzRqR0&hl=en&sa=X&ei=q2NlUdOCF4vI9QSptIHYBw&ved=0CFAQ6AEwBg

–***
An excellent slide show analyzing fgm and MGM as well as organ donation
http://www.slideshare.net/AaronJose1/multilation-bioethics

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Aap on male circumcision

http://pediatrics.aappublications.org/content/130/3/e756.full.pdf

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So according to the AAP all forms of female circumcision are wrong and drs are not to perform them no matter parental beliefs or preference
However, there is no actual prohibition of any type of circumcision surgery for boys… And drs are to make circumcision readily available and to take into account parental beliefs and preferences.

According to AAP
Female circumcision- illegal since the 1990’s- any type- even a similar procedure to male circumcision of just “snipping” the female prepuce/foreskin.
Parental preference- not taken onto consideration.

Male circumcision- possible benefits outweigh the risks and although the AAP does NOT recommend all boys be circumcised. The AAP recommends that drs perform it on parental request alone even with no medical need.
In fact, recommends that insurances, should cover it for any reason.

***please remember that some of the risks of infant male circumcision can be penile loss of function or penile amputation or death. Although rare, the AAP says the possible benefits outweigh the possible risks.

So lets see- possible STI when having unsafe sex if the man is uncircumcised/intact/natural (which even a circumcised man can get having unsafe sex)
Or
Possible death, or loss of penis when this medically unnecessary surgery is performed on a healthy infant with natural intact genitals purely for parental preference…..

Make sense?????

Moreover, it is illegal to cut juvenile female genital tissue due to medical issues like UTIs, yeast and bacterial infections
But
It’s perfectly ok to cut genital tissue from boys for the same reasons?

Huh? Come again? How do you treat female issues? Treat men the same!

any forced genital cutting of infant/child females, intersexed and infant/child males is wrong

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http://mondofown.blogspot.com/2012/06/female-circumcision-health-benefits.html?m=1

One of the arguments you will hear trying to justify male circumcision and denounce female circumcision is that “Male circumcision has health benefits but Female Circumcision has no health benefits”. In actual fact there are at least 2 studies listed below that show a correlation between female circumcision and lower HIV infections, and medical practitioners in femcirc cultures report that clinical experience shows that female circumcision does indeed have health benefits (below).

My opinion is that health benefits or no health benefits, that human rights supercede any such health benefits.

There are 2 issues here.

1 Cultural values. Some western cultures value male circumcision, but most do not. All western cultures view female circumcision as a human rights violation.

2 Availability of data. The truth is there is very little reliable or valid data about the health benefits of female circumcision because no-one is interested if there are any benefits.

Given that cultural values determine where research money is put and what research is done, you’ll find lots of western research into male circumcision and virtually none except for 2 isolated studies on female circumcision, which follow. Since the rich west, in particular the USA has a culture of male circumcision, lots of money goes into trying to find or prove health benefits for male circumcision. Whereas female circumcision is unfamiliar, and seen as a human rights violation, therefore no money is placed to determine whether any such health benefits exist. Infact the opposite is true, Stallings (2005) were given research money to find that circumcised women had a greater susceptibility to HIV (Probably to confirm our moral superiority in the west vs the barbaric female circumcisers) But alas the researchers were devaststed when they found that circumcised women had half the rate of HIV infections compared to uncircumcised women.

“Stallings et al. (2005) reported that, in Tanzanian women,
the risk of HIV among women who had undergone FGC
was roughly half that of women who had not; the association
remained significant after adjusting for region, household
wealth, age, lifetime partners, union status, and recent ulcer.”

The disappointment of the researchers was palpable, no celebrations, no calls for funding to do RCT’s to further validate their findings, just disappointment “for better or worse” they stated. “Female circumcision and HIV infection in Tanzania:for better or for worse? (3rd IAS conference on HIV pathogenesis and treatment)”.
International AIDS Society.

Now instead of using this research to argue that female circumcision had health benefits afterall, the values of the researchers intervened, and they were at a loss to explain this unwanted finding. Note the difference to how the American researchers celebrated when they found male circumcision had a slight reduction in HIV infections. VALUES!!!!!!

However, Rightly so that no funding was then generated to conduct RCT’s on female circumcision and its protective effect for HIV. It was morals about human rights which prevailed, but only because it was female circumcision and foreign to American Culture. Imagine if well funded Egyptian researchers had found this, in a culture where female circumcision is common?

The 2005 Stallings research is not the only research to find this link between female circumcision and lower HIV infections. Kanki et al found the same:

Kanki et al. reported that, in Senegalese prostitutes,
women who had undergone FGC had a significantly
decreased risk of HIV-2 infection when compared to
those who had not.

Kanki P, M’Boup S, Marlink R, et al. “Prevalence and risk
determinants of human immunodeficiency virus type 2
(HIV-2) and human immunodeficiency virus type 1
(HIV-1) in west African female prostitutes”.
Am. J. Epidemiol. 136 (7): 895-907. PMID

Again no celebrations, and “NO” demand for RCT’s, WHY = Cultural Values!!!!!!!

So the issue here is that Cultural Values determine whether research money is devoted to finding health benefits for any procedure. Given female circumcision is rightly seen as a human rights violation, no research or money is devoted to investigating the health benefits of circumcision on women. Human Rights correctly trump health benefits when it comes to female circumcision, but certainly not when it comes to male circumcision.

So does female circumcision have health benefits? The truth is we dont really know, but there is some evidence to suggest that removing female genital skin has a correlation with reduced HIV infections. This would need to be confirmed by further study, but you and I know this isnt going to happen because of our western values against female genital cutting. Even if it was confirmed female circumcision had health benefits, it is still morally and ethically wrong. In some way yes if you remove genital skin you wont have problems with something that doesnt exist anymore, its just that ethics prevent western society from wanting to reduce female genital skin to achieve any health benefits because ethics and human rights are considered important in the case of women’s genitals……..read more ….

— Stalling’s research on FC
4.Stallings RY, Karugendo E (2005) Female circumcision and HIV infection in Tanzania: For better or for worse? [poster] 3rd International AIDS Society Conference; 2005 24 July–27 July; Rio de Janeiro, Brazil. International AIDS Society. Available: http://www.hiv-knowledge.org/iasmaps/i10​.htm. Accessed 13 December 2005 .

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“Fantastic paraphrasing of the AAP’s circumcision policy
by Norm Cohen {as found in NOCIRC of Michigan’s Spring Newsletter}:

“Someday, a boy may or may not get a disease if he is not circumcised, and he may or may not get a disease if he is circumcised, and the difference due to circumcising him is so small that we can’t even recommend that all parents should have it done, even after spending five years looking for the research findings that agreed with our preference, unless parents for whatever reason, also have the same preference, in which case the government or insurance companies should pay us doctors to do it.

Oh, and by the way, we don’t know the purpose of the foreskin that we’re cutting off, and we’re not sure how often the surgery goes bad.””

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Another baby hemorrhaging… Lucky to be alive and yet supposedly the risks are worth it? How is almost dying worth it? How is almost dying because of a medically unnecessary surgery being performed on a healthy infant worth it?

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