the clitoral discourse

The Clitoral Discourse

I SUPPORT HB22 WHOLEHEARTEDLY!

I support HB22 Bill sponsored by Hon. Janet Adeyemi in the Federal Republic of Nigeria wholeheartedly.

I am glad that someone has moved to enable females in the country have the right over their own bodies. Both males and females have a right to Reproductive health and any form of mutilation whether guised as circumcision or not is child abuse and this must be stopped! If circumcision is so "helpful", let the child grow up and perform it individually, don't make an irreparable damage to someone else's body.

I have read the letter of a Nowamagbe Omoigui and I pass it off as one of the reasons of how female circumcision is trivialized. Readers should check http://www.noharmm.org/trivial.htm for further details. Since the letter writer is a medical doctor, I will reference the link to a write-up by a doctor as well; http://www.noharmm.org/toubia.htm Although Dr Omoigui raised many issues, I will only respond to the topic which is HB22 bill.

I wish to state that there is no medical proof that the prepuce of females has no sexual function as the writer claimed. Let the writer provide references for such a claim. I also have friends from Edo State in Nigeria who have their clitoris and labia minora mutilated. (Of course, the writer may pass this off as 'not properly' circumcised!).

Our constitution recognizes that no one should be maimed! That is the law. If any adult wants to be mutilated or circumcised, so be it, but not innocent children. The customs we adhere to must be customs that support our health.

Killing of twins was once a custom in Calabar, thanks to Mary Slessor that was outlawed. This is the same issue here. Health is the issue, don't deny a woman to right to wholeness under the guise of customs.

Education is what is needed in our country. I am sure that if proper education is carried out female genital mutilation will become obsolete like killing of twins.

I will end by remarking that it is very convenient for a western trained doctor to remain in the United States of America and cry for the preservation of female genital mutilation in Nigeria while his daughters will not undergo the same process here in the United States. It is very convenient to put the health of others at risk while his is relatively secure. I begin to wonder what kind of oath this doctor took at the beginning of his medical career.

I encourage the National Assembly to legislate this bill and support the health of Nigeria women. Let our daughters live to develop our nation and be a blessing to us and the whole world. Let us uphold healthy customs and traditions and shun the ones that harm us.

Thank you.

Oluwatoyin Akinpelu MS MPH Loma Linda California

Re: I SUPPORT HB22 WHOLEHEARTEDLY!

Sir/Madam:

The "let children grow up and decide" argument can equally apply to all other aspects of life. Let them grow up and decide whether and what schools to attend; what religion to practice; whether to cut their hair, pierce their ears, shave their armpits, shave their legs; what foods to eat; what language to speak, etc etc... They might even have the right to divorce their parents - as occurred in Florida recently.

That "13 states out of 21 practised type I and II FGM" is not relevant to the point I was making about representativeness. I have never claimed that female or male circumcision is not practiced in Nigeria. And I have always stated that the practice is not consistent in the way it is applied. My comment about representativeness refers to broad assumptions that simply because maternal and child mortality is high in Nigeria it is female circumcision that is the problem - when there has NEVER been a randomized trial with representative samples to prospectively evaluate that outcome, controlling for confounders. Public policy should not be made using weak data - even if one were to accept the shaky argument that medical research should determine cultural and religious beliefs. Those who do not want to be circumcised can stay uncircumcised. Those who do not want their children circumcised can opt for that too. But those who want to observe their customs need not be harangued by those who think they know best what is good for others using the instrument of state power as a weapon of cultural terrorism.

It is not I who is telling anyone-else to get circumcised. It is advocates of HB22 who are saying no one can get circumcised until they have been conditioned by western influence and values 18 years later whether or not it is the custom, culture or religion of their families. That is an arbitrary value judgment that amounts to a pervasive interference in the right of families to rear their children in their own cultural and religious likeness.

The Jehovah's witness example was very apt because the implications of exercising that preference to refuse what the medical world thinks is beneficial is a life and death issue - more profound than the physical appearance of an organ in someone who is alive. That right is protected by law. Whether or not I can circumcise my daughter inside the US is not relevant. Every country and culture has it own laws and regulations.

There are many things an American living in Nigeria (or China or Saudi Arabia or anywhere else) cannot do which he or she may be able to do in the US. American diplomats are trained to respect the customs of their host countries. In the US belching loudly after a meal is rude. In Saudi Arabia, NOT belching after a meal is rude.

In any case the fact is that the so called 'law against circumcision' in the US will someday be challenged in the Supreme Court. Many so called laws are only stable over time to the extent that they do not violate the Supreme Court's interpretation of the US constitution. That a well funded group of advocates for a certain position managed to push the issue through Congress at a certain point in time is not a guarantee for the future. America's immigrant population ratio is dynamic. Even the right to abortion can be overturned any time the ratio of judges changes on the bench.

If those who claim absolute knowledge of what is right for others want to be consistent let them get male circumcision banned the world over. Are males exempt from the requirement to be "in charge of their own bodies"? What gives a little girl more right to 'control her body' than a little boy? What 'control' does a little girl have over her body when her bath water, soap, lotion, clothes, shoes, perfume (if relevant), skin marks, length of her navel, ear (or nasal) holes, armpit hair length, leg hair length, pubic hair length, head hair design, eye lash length, body odor, sex education, menstrual sanitation practice, tooth care, nail length and color, jewelry (if relevant) and other paraphernalia are predominantly determined by her parental and family upbringing? When an American child is told by her mother to shave the hair on her legs or armpit "because that is the decent thing to do in our custom" what control is she exercising over her body?

The excuse that African women now want to 'control their bodies' is tenuous. What we all do with our bodies is a function of culture and environment. And what is happening is that one culture - which has captured the minds of some of our people - is trying to force its way down the throats of others. My position is that those individuals and families who do not want to circumcise themselves or their kids are free to exercise that discretion as well as the implied discretion not to partake in those traditional ceremonies that require prior circumcision. But those who do should be protected under the law.

I do not support HB22. But I respect your right to disagree. Enough said.

Nowa Omoigui, MD, MPH, FACC Columbia, SC USA

Re: I SUPPORT HB22 WHOLEHEARTEDLY!

Dear Sir/Madam,

Reading Nowa's response clearly shows that he is insensitive and partial to his claim of 'supporting the right of others to hold opinions and do what they feel is right and customary' If that were the case, what is wrong in allowing children grow up and decide if they want to be mutilated (or I forgot, the term to use is circumcised).

I question this familiarity with literature on female circumcision which does not apparently include a study carried out by Nigerian Association of Nurses and Nurse-Midwives in 1985-86 revealing that 13 states out of 21 practised type I and type II FGM. How such a study is classified as unrepresentative is questionable. Please see link: http://www.who.int/frh-whd/FGM/infopack/English/fgm_infopack.htm

Let Nowa design a randomized controlled trial about EVERY aspect of the custom. Then he will have more than emotional attachment to his custom as a defense.

Comparing FGM to Jehovah's witnesses refusing blood transfusing is tantamount to comparing yams and apples. In case of adults it is their choice which they are entitled to (HB22 will not prevent any adult who desires to be mutilated, or excuse me, circumcised). In case of children, US law makes a provision for parental decision in the case of a child who is ALREADY ILL! (Referring to children of parents who are Jehovah's witnesses). HB22 will prevent parents from making healthy, whole children SICK and MAIMED!

I must comment here that common sense many times is uncommon. Nowa and his mother are circumcised and proud of it, however many others are, but not proud. As he has claimed to die before giving his custom up, let him reveal whether he can circumcise his daughter here in the US! He would have to smuggle her out to Nigeria before such can occur.

Assuming his daughter is circumcised and assuming that she is now an adult, if she comments that she perceives herself as 'incomplete' because some parts of her body is missing, "how proud would he be then?" It is interesting to make light of another human being's body "as confused by western propaganda". The western education Nowa and his mother received surely was not confusion! I wonder why their 'custom adherents' did not provide them with education as well. Nowamagbe asked "Why now? What is all this preoccupation with the genitals of african women?" Answer; African women want to be in charge of their own bodies. That's why. They want to make informed decisions. Enough of being told by others what is the best for their lives and their bodies, they want to be in charge of their reproductive health. We want our rights over our bodies to be respected! I must also bring to Nowa's notice that FGM is not done only by women, I have first hand information of Type I performed by men in Ife, Osun State, Nigeria. Both sexes carry out the act and also, women in Nigeria have a history of being conditioned by men. Nigeria is still largely (the whole world actually, but Nigeria surely) is a patriarchal system. With a maternal mortality rate of 1000 women per 100,000 and an infant mortality rate of 112 per 1,000, female genital mutilation (or female circumcision as some prefer to call it) is one of Nigeria's problems and it should be rectified.

Oluwatoyin Akinpelu MS MPH Loma Linda, California

Re: I SUPPORT HB22 WHOLEHEARTEDLY!

Sir: Although I disagree with Oluwatoyin's position, I support the right of others to hold their opinions and do what they feel is right and customary. I am familiar with the literature on female circumcision in Nigeria. There has NEVER been a randomized controlled trial about ANY aspect of the custom. As Toyin knows, reliance on observational studies of unrepresentative samples is very misleading - particularly when interpreted though the prism of predetermined bias. That said, I deal with all kinds of people everyday and have learnt to respect vast differences between cultures. I have had highly educated patients who are Jehovah's witnesses who refused to take blood transfusion at the point of death knowing full well the probable consequences of their actions - because that is their belief.

In most states, US law protects them - even when they are carrying out the decision on behalf of a minor. If a physician gives blood to save a bleeding Jehovah's witness in the belief that he or she is saving his life, that physician can be sued - even if he or she was 'right'. The law recognizes the religious rights of individuals to make health care decisions. Our job is to provide reliable information on risks, benefits and alternatives, not to pass judgements on people's religious convictions or call the Police. The final decision is theirs to make for themselves and their families - irrespective of what we may think. Unfortunately, the politics of female circumcision seems to have overridden common sense.

I am circumcised and proud of it - even though the most common indication for male circumcision is simply cultural preference. A medical indication for male circumcision is rare. I will not support banning male circumcision any more or less than I will support banning female circumcision.

That is my custom and I will die first before I give it up. No apologies to anyone. My mother is circumcised and VERY VERY proud of it - a successful highly educated professional Nigerian (Edo) woman in her own right (with several University degrees) who is the mother of five very successful professional kids and has been continuously married in a monogamous relationship for well over 40 years. She will defend the right to circumcision at any time - as do many women in her generation who have not been confused by western propaganda. She considers the campaign against female circumcision totally ridiculous. In all the years of British rule in Nigeria no colonial official tried to ban female circumcision - including those Oluwatoyin makes reference to who banned twin killing. So why the sudden discovery of female 'mutilation'? Why now? What is all this preoccupation with the genitals of african women? When an african child gets her ears pierced and develops a huge keloid is that not mutilation of the ears? Why are we not campaigning to ban ear piercing? What about the 'custom' of killing female children in China - which still goes on today? What does the WHO or EU or the US have to say about that? One man's meat is another man's poison. In India, drinking urine is a custom - and those who do it claim it makes them live longer.

Even Mahatma Ghandi - the great Indian leader after whom Martin Luther King patterned his protesting style - used to drink his own urine in the mornings. At least one former Indian Prime Minister - Moraji Desai also drank his own urine. We do not (to my knowledge) do that in Nigeria - although at least one tradomedical expert has advocated it. Is that barbaric? Should it be made a criminal offence by the World Health Organization or the Indian government?

This is a multicultural world. Some people worship cows (like Hindus). Others are into plastic surgery to alter their looks. Others believe it is okay to transplant body parts from animals into humans. Let us respect each other's peculiarities. Those who want to practice their customs need not be branded criminals nor judged by others. We need to appreciate the rights of various nationalities in Nigeria. There are clans that do not circumcise their women at all. That is their tradition - and I respect them for it. Others do and should be treated with sensitivity. Female circumcision did not arise from hatred of womenfolk. In many clans it is linked to other prestigious ceremonies - all of which will presumably no longer take place as a consequence of this proposed legislation. There are more important things in life and certainly more important legislation for the National Assembly to be focused on. Female circumcision is not Nigeria's problem.

Nowa Omoigui, MD Columbia, SC USA

Girl 15, defends breast implant

Subject: Re: I SUPPORT HB22 WHOLEHEARTEDLY!

This will be my last contribution on this issue. I support HB22 because it gives women the right to choose whether to put their reproductive health at risk or not. Parents should not protected by law to maim their children, that is child abuse.

Nigeria is a signatory to the Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW). FGM is violence against women and a form of discrimination. The female genital is important for women's health and this should not be mutilated. Article 2.2 of the Nigerian Declaration of Human Responsibilities forbids anyone in our society to maim. FGM is maiming of the female genitals.

Immediate effects of FGM are haemorrhage, shock, infection and injury to adjacent tissue. One of the many long term effects is complications during labour and delivery. This is more than enough proof that FGM is a contributor to our maternal and infant mortality rate. 'A randomized trial with representative samples to prospectively evaluate that outcome, controlling for confounders' according to Nowamagbe is not needed for that conclusion.

I have not stated that FGM CAUSES a high infant and maternal mortality rate. I am declaring that FGM IS A contributor! However, devoted to research, I would encourage Nowa to design such a study and carry it out in his community back home. The results would benefit us all.

But those who want to observe their customs need not be harangued by those who think they know best what is good for others using the instrument of state power as a weapon of cultural terrorism.

The instrument of state is the the only tool for justice and the child has rights. The child must also be protected by law. If the child will love FGM, why should the parents be bothered about not performing it in childhood, afterall the child can make a quality decision at 18 years on her own!

On the contrary, it is you, Nowamagbe Omoigui, who is attempting to withhold the reproductive health rights of the next generation from their hands. You forget that they, these innocent girls, have to live with the consequences of FGM. When they develop a problem during labor and delivery due to scarification of their genitals, will the custom ease their pain?

That is an arbitrary value judgment that amounts to a pervasive interference in the right of families to rear their children in their own cultural and religious likeness.

Rather this is an opportunity for families to embrace health and enjoy the consequences of health and preservation of physical wholeness. Healthy families, a desire we possess strongly in Nigeria would be facilitated through this process.

May I bring to light the fact that FGM is not associated with any religion. It is a cultural procedure. No religion can lay claim to FGM. Banning FGM therefore is not restricting any Nigerian citizen from his/her religious rights.

Clearly the above statement is uncalled for, however it shows what is really in the heart of the writer. For the sake of clarity, I declare that I DO NOT CLAIM ABSOLUTE KNOWLEDGE OF WHAT IS RIGHT FOR OTHERS. I never have and I never will. I DO CLAIM THAT EVERY HUMAN BEING HAS THE RIGHT TO DECIDE WHAT HAPPENS TO THEIR PERSONAL BODIES!

Dr Omoigui certainly has an issue with male circumcision, but I shall not comment on that because my focus is HB22. As a free Citizen, he can use appropriate channels to voice his concerns.

Lastly, responding to the following sentence,

But those who do should be protected under the law.

Those who want FGM should INDEED be protected by law. Let them (adults 18 years and over) practice FGM on themselves. Our law should not endorse a parent, relative or guardian to mutilate a child. When the child becomes an adult, having enjoyed the consequences of health and wholeness for the first 18 years, let the new adult then choose the destiny of her genitals.

Thank you.

Oluwatoyin Akinpelu MS MPH Loma Linda, California