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NYTimes debate on female genital surgery

9 March, 2008

Generally, I avoid commenting too much on the debate on female genital ‘mutilation’/’surgery.’ It’s sort of like the ‘pro-choice’/’pro-life’ debate in the United States; even the terms that one might use are so loaded that it’s almost impossible to make any point other than with one’s own choir.  But John Tierney has a fascinating discussion of the debate at The New York Times.  You can link to the discussion, which sprawls over several different pages, through his recent commentary, ‘Cultural Imperialism at the W.H.O.?‘ I’ve been sitting on some thoughts about this one, not sure entirely that I’m of one mind on this, but I feel like I need to just do the deal already, and hit the ‘publish’ button. As someone who teaches about ‘Culture and Human Rights’ (it’ll be offered in the first half of 2009, if you’re interested), and as a human rights activist (though not so much on women’s rights), it’s an issue that I feel I need to discuss even if I’m not terribly confident doing so.

The original provocation of the exchanges (multiple different directions) on Tierneylab seems to be a study published in Lancet in 2006 (download a pre-print .pdf version of the study) and a debate at the 2007 meeting of the American Anthropological Association (see Tierney’s account here). The panel abstract included an explanation of how the presentations differed from what one might expect:

The panel includes for the first time, the critical “third wave” or multicultural feminist perspectives of circumcised African women scholars Wairimu Njambi, a Kenyan, and Fuambai Ahmadu, a Sierra Leonean. Both women hail from cultures where female and male initiation rituals are the norm and have written about their largely positive and contextualized experiences, creating an emergent discursive space for a hitherto “muted group” in global debates about FGC [female genital cutting]. (Note: excerpt of abstract from Tierney’s website)

I didn’t attend the panel; I’m sure I was somewhere else at the Anthropalooza, ordering skulls for MU, trying to viral market my book, or standing in line for someone’s autograph. As anyone knows who has been to the AAAs, it’s usually such a mass of hive-like activity that one quickly becomes overwhelmed by the sheer anthro-excitement of it all (or gets a splitting headache from being at the wrong panel; e.g., ‘…my original paper is 83 pages long, so I’ll try to condense as I go. How much time do I have?…’).


Tierney provides links to more essays written by Dr. Ahmadu, a post-doctoral fellow in Human Development at the University of Chicago, who was raised in America and returned to Sierra Leone as an adult to undergo FGC along with fellow Kono women. Ahmadu has argued that critics of these initiation rites often exaggerate the dangers and assume that the practice is oppressive to women, when they don’t really understand either its significance or its effects. Needless to say, Dr. Ahmadu does not see eye-to-eye with some feminist and pro-feminist activists who see FGC as one of the most dramatic examples of women’s oppression. In contrast, Dr. Ahmadu, like a number of African activists before her, sees the procedure as a powerful, distinctive expression — and generator — of her identity.

I’m a bit less interested in the piece by the scientists from the World Health Organization (‘W.H.O. responds on FGM‘), nor really in the measured response of another anthropologist, Bettina Shell-Duncan of the University of Washington. I’m interested in the pieces written by Richard Shweder, an anthropologist at the University of Chicago whose work on culture and psychology I have long admired. Tierney provides a link to a paper that Shweder presented at a conference in 2003, ‘When Cultures Collide: Which Rights? Whose Tradition of Values?: A Critique of the Global Anti-FGM Campaign’ (it’s a .doc file, so go to Tierney’s site if you want to link to a copy), and his subsequent comments when his original paper was attacked and, well, sort of attacked by the W.H.O. authors. That is, Shweder and the W.H.O. (and others, for that matter) seem to be arguing past each other on this one, and I think it’s helpful to think about why.

Shweder and Ahmadu and Shell-Duncan (and others) point out that the rhetoric of the anti-FGC movement is inaccurate and inflammatory. In particular, they highlight the fact that the over-heated language of the activists — discussing ‘mutilation,’ ‘suffering,’ ‘death,’ and other complications — ignores the fact that medical data does not support the argument that FGC is a kind of auto-genocide. Shweder quotes Carla Obermeyer from the Medical Anthropology Quarterly:

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.

Shweder’s comments are voluminous and well-argued, if a bit combative (of course, seeing as this has been going on for at least four years for him, and reading the comments online, I can certainly understand why). Shweder argues, then, that those who wish to ban FGC, with or without the consent of the groups involved, are engaged in a form of cultural imperialism, and he points out the lack of similar outrage about male circumcision.

Well, all I can say is that Shweder poked the stick in the hornet’s nest (and seems to be pretty capable of doing it again and again — I’ll say this for him, he’s a model of tenacity). The comments that follow, with assertions about FGC, male circumcision, and patriarchy, various types of ‘barbarity,’ attacks on people’s character, and the lobbing of all sorts of rhetorical grenades, show that this debate is going to continue to be conducted at high volume. Some of the comments are extraordinarily intense, so much so that they sound like willful distortion of the other’s position. Of course, I understand the intensity; there’s a visceral reaction to descriptions of all these procedures. But then again, I have a visceral reaction to most descriptions of invasive surgery.

But my point with all this is not to take one side or the other, it’s simply to point out, pragmatically, that condemning or condoning from outside, calling for a ban or for an iron-clad respect for cultural diversity, is simply irrelevant to whether or not the procedure will continue. Even when bans have been instituted on the procedure, they have been evaded and defied, as long as the groups involved still support the procedure. Ultimately, a human rights-based approach to FGC has to have three qualities that seem in short supply in this whole debate:

1) Human rights are ultimately the rights of those involved, not a list of qualities imposed upon them. So if a person given her or his own freedom opts to do something, as long as it doesn’t harm others, it’s hard to argue that they can be prevented from doing so based upon their own ‘human rights.’ That means that, at the end of the day, given all the information, an adult freely consents to undergo a procedure, no matter how much you dislike it, that’s they’re right, as long as they’re not harming someone else.

There seems to be a fair bit of ‘ends-justifies-the-means’ willingness to… well, for want of a better word, lie. In fact, the medical data on FGC is not nearly as clear as some would have us believe. That’s okay, the activists can still argue against it. I would still try to persuade a female friend not to get breast implants, and I think I could come up with some persuasive points, but I can’t do so by lying to her. The problem is not just that’s it’s dishonest, it’s that it will usually become quite clear that I’m a liar, and everything I say will get discredited.

If FGC has been going on for a long time, then odds are that it’s not killing severely impairing everyone involved, or the news would have gotten out within these communities. If Shweder is right, and I suspect he is (mostly) from looking at the W.H.O. piece and others, then arguing that FGC is more dangerous than it is will not be a sustainable way to change anyone’s mind.

2) Human rights is an emergent, unfolding process or set of changing goals, not a list of minimal humane standards. That list of minimal standards is just the starting point — don’t torture, don’t discriminate, don’t treat unjustly. Human rights are a way of grounding the legitimacy of government, and the standards that communities set for themselves. In fact, human rights take time. The require education, development of institutions, creation of widespread community support. They can’t simply be helicoptered and dropped in. Screaming at people that they are violating human rights — when they think differently — will do little to change their attitudes. In fact, the targets of all the screaming are likely to harden their position. Being an American, I’ve been sickened by the torture practices of my own country, but I realize that what needs to happen to make torture less likely in the future is a widespread campaign to change community standards. Ironically, it’s much like the campaign waged, through all sorts of channels, to decrease the American community’s sensitivity to torture done in its name.

I guess what I’m saying is that, even if FGC is manifestly and fundamentally wrong (which I’m not entirely persuaded of, in all cases), just saying this over and over again will do little to change the situation. It’s ironic to me that activists think that women’s rights will be realized instantly, with a simple act of law, in Africa and elsewhere FGC is practiced when they should know damn well that women’s rights have taken a very long time to emerge in the West — and continue to need to be pursued through efforts in the community. We’re more than willing to put efforts into consciousness-raising efforts about sexuality, domestic violence, everyday sexism, and the like in our own communities, why wouldn’t we use the same approach elsewhere?

3) Human rights processes must be dialogues. No one will come to the table just to be told he or she is wrong. This means that, even if you are certain that your position is correct, you must be willing to learn and change to persuade someone else that they should learn and change. There’s an AMAZING shortage of humility in the postings on Tierneylab (there’s a few humble comments, but not a lot).

The truth is that the discussion about FGC will probably educate us all, and it may change everyone’s position. For example, Dr. Ahmadu’s accounts may leave an open-minded activist more sensitive to what might be lost if the practice is given up. Even if the activist remains committed to the cause of women’s human rights, to approach the Kono or any other community in good faith, to discuss with them the possibility of changing, the activist too has to be willing to change, to learn, and to maybe emerge with a new understanding of human rights.

At the end of the day, some of the arguments about the ‘barbarity’ of FGC seem to me to assume that other groups are idiots, don’t care for their children, willingly torture their own daughters, and are so oppressed that they can’t even know their own interest. Even if that’s TRUE (and this is what I want to emphasize), treating someone this way is not the ideal tactic for changing them. I don’t think it’s the case that all the groups doing FGC, in fact, are monsters, misogynists, and child torturers, but EVEN IF THEY ARE, we’re going to have to work with them.

But here’s where I part ways with Shweder: he seems to assume that ACTIVISTS are the ones who should be exposed for the barbarians that they are (I’m exaggerating for rhetorical effect). That is, I think, as human rights activists, we have to work gently and sensitively, not merely with people from other cultures, but with people from our own. There are many things about the anti-FGM comments that make me uncomfortable — the inability to see misogyny in their own communities, the willingness to criticize others, the insensitivity to cultural difference, the enthusiasm for coercive solutions, the assumptions about communities involved, and many other things — but I have to remind myself that these activists, however over-enthused and over-certain of their own perspectives that they are, are persuaded that they are working for the good of the women involved. They may have limited ideas about what it means to be a woman, may not read the medical data too carefully, may even harbor ‘cultural imperialist’ attitudes, but thank God that they care about women in other parts of the world. Part of me wants to ask Shweder if this is really the worst example of cultural imperialism or human rights myopia he can think of because I feel like, when I teach introduction to anthropology courses, I’m still grappling with some students’ much more pernicious beliefs and attitudes.

I guess what I’m saying is that, for me, and probably for Shweder to, the debate about FGC is really a way of smoking all sorts of attitudes out of people. A lot of the ‘activism’ involved is hardly that; it’s often just an easy bias against the practices of other people rather than a concern for the status and treatment of women everywhere. It’s easy to get worked up and write an email or blog posting about someone else’s ‘barbarity.’ The danger, however, is that I think we need to work with patience and good faith with all parties or else we don’t get very far. The firestorm provoked by Shweder’s comments suggests this to me. Shweder’s points need to be made, but I wonder if we can do so in a way that doesn’t harden activists’ worst instincts, that instead moves them toward greater sensitivity and awareness, just as the activists need to be careful not to harden attitudes in the communities they hope to change.

10 Comments leave one →
  1. 10 March, 2008 5:14 am

    Don’t you think, perhaps, that one of your central points is precisely the rub for many activists involved in this debate? You say (emphasis mine):

    Human rights is an emergent, unfolding process or set of changing goals, not a list of minimal humane standards.

    The presumptive starting point for many is that human rights are universal, immutable, and derived from natural law.

  2. Jacob Hickman permalink
    11 March, 2008 1:16 am

    Binky,

    This is certainly the presumption of human rights activists. The “rub” from an anthropological perspective, however, is that the values that are presumed to be universal and immutable by Western human rights advocates are based on culturally specific notions that are deeply rooted in the Western “enlightenment” tradition. The presumption that these are based in natural law is an interesting one, but the assertion is easily complicated in the light of cross-cultural research.

    In fact, if one were to ask the African women engaged in this practice (as but one example of where human rights collide with non-Western cultural values) about their values, they would likely respond that their beliefs are equally perceived to be based in universal values (the “right” to a well-defined gender identity, for example). So, when these values collide with one another, are we really willing to say that the Western “enlightenment” tradition trumps all others, when both are perceived to represent moral universals within their own traditions?

    If nothing else, it is essential in human rights activism to at least recognize the historicity of our own “universal” values, as well as the “universal” nature of other society’s values. In doing so, it leads one to at least thoughtfully consider the extent to which we really need to change the “other.”

  3. 11 March, 2008 1:47 am

    3) Human rights processes must be dialogues. No one will come to the table just to be told he or she is wrong.

    Part of me wants to ask Shweder if this is really the worst example of cultural imperialism or human rights myopia he can think of because I feel like, when I teach introduction to anthropology courses, I’m still grappling with some students’ much more pernicious beliefs and attitudes.

    Thanks for the post. Until I grapple with my own beliefs and have no “shortage of humility” there in myself, until I learn to soften and to change my own big ideas, then how ever can I listen? And then what’s the point of “dialogues” until. . . ?

  4. 11 March, 2008 3:35 pm

    Greg, thanks for your thoughtful discussion of these issues. I finally found that short article I was telling you about, which was reported in New Scientist, where the author reports on an article in Culture, Health and Sexuality that discusses debate over whether “labial elongation” (only 5 cm, not 5 inches, as I told you before — that would really be something, wouldn’t it?) in Rwanda constitutes “genital mutilation” or “genital modification.” See http://www.newscientist.com/article/mg19726444.100-ultrasound-nails-location-of-the-elusive-g-spot.html (pasted below):

    Can women ejaculate or not?

    Female ejaculation is considered rare in the west, and even, by some, abnormal. In Rwanda, however, it is the norm.

    Social scientists Marian Koster and Lisa Price of Wageningen University in the Netherlands interviewed 11 women and two men in Rwanda about “gukuna imishino”, which is the practice of elongating the labia minora, the inner vaginal lips. “The Rwandan women and men we interviewed were clear in their opinion that all Rwandan women are able to ejaculate, the ejaculation being different from the mere squirting of urine,” Koster says. “Elongated labia are seen as crucial in this respect.”

    From around puberty onwards, Rwandan girls start stretching the labia minora using plant extracts with antiseptic and anti-inflammatory properties, with the aim of achieving a length of about 5 centimetres. The WHO considers this practice as a form of genital mutilation, but Koster and Price argue that it should be reclassified as genital modification. “We believe that there are cultural practices that are not harmful to women’s integrity and rights,” says Koster.

    Their interviewees reported, and Koster and Price speculate, that labial elongation increases the sexual pleasure of both sexes. “Since the labia minora swell during sexual excitement, there is a larger surface area for penile friction during coitus,” they write (Culture, Health & Sexuality, DOI: 10.1080/13691050701775076).

    Rowan Hooper

  5. 16 March, 2008 3:32 am

    While I agree with you, Jacob, about the problems with claims to universality, I question the utility of asserting “human rights are an unfolding process…” as a basis for further discussion with people who believe no such thing. Experiencing an attack on one’s philosophical, religious and cultural identity (e.g. “your universalism doesn’t exist”) might not encourage constructive dialogue. Especially when those who hold those values operate from within a culture of dominance and privilege.

    Perhaps this is an artifact of disciplinary focus, but I’m thinking more about the diplomacy of “how to engage the process” rather than the rightness of “which values are better.”

  6. gregdowney permalink
    20 March, 2008 3:46 pm

    Binky, I think you’re right; someone who firmly believes that their values are universal and should be universally imposed is going to have problems no matter what with engaging other people over the issue of human rights, though. For example, human rights generally have tolerance of other people’s distinctiveness — their ‘human right’ to follow their own religion, for example — is always going to be a problem for the aggressive universalist. The hostility of some elements of conservativism toward human rights, for example, is only matched by the hostility toward human rights of some on the authoritarian left; if arch-conservatives and Stalinists could agree on one thing, it was that human rights were only a good thing when they were a stick that could be used to beat on the other side.

    There might have to be a previous step, before you can even get someone to the table to talk about how to go about securing people’s rights, and that’s selling some of them on the concept at all. Not everyone firmly supports the idea that human rights are or should be foundational to the legitimacy of governments. I guess I wasn’t really thinking about those folks too much when I made my comments on women’s human rights. I mean, I’m not going to wait around for the most hardened misogynist elements in society to become convinced that women deserve respect to start pushing for women’s rights; I’m going to look around me for people who seem to be committed in principle to women’s rights, and then work with them to try to establish a toe-hold for securing them and expanding them.

    But I guess one point to the ‘processual’ conception of rights, that is, to seeing human rights as unfolding over time, not handed down on stone tablets, aside from its — for want of a more diplomatic way of putting it — basis in historical reality, is that it does tend to make people open to work together, agree on what they can agree upon, and work toward greater consensus. The alternative is to assume from the beginning that your side has the answers, and anyone who disagrees with you needs to get with your program right quick.

    The example of female genital modification is a great one to consider this because it does mess with our heads; not only does it require us to see the humanity in ‘the other side’ when that might initially be hard, but it also makes us think very seriously about the issue of consent and how we respond to someone who would use their rights to do something very different than us. I think that rights around sexuality, including the right to ‘repress’ one’s own sexuality, are very much like this for some Westerners; they challenge some people who might be complacent about their own need to continue learning and respecting others’ perspectives.

    But on a shorter note, there’s a great piece on this just posted on Tierney’s site. Tierney has posted a rather long discussion by Dr. Fuambai Ahmadu, a post-doctoral fellow at the University of Chicago’s Human Development program and a native of Sierra Leone who underwent initiation as an adult. I don’t know how to make a link in a comment, so I’ll just give you the address: http://tierneylab.blogs.nytimes.com/2008/03/19/a-compromise-on-female-circumcision/#more-245 you may have to paste it into your browser.

  7. 22 March, 2008 5:42 am

    Right. The goal would be to get universalists who extract their view of human rights from natural or religious law (a big part of some of the founding ideas of international law, especially abolitionism) to find common ground with positivists who believe in social constructivism. It’s an oversimplification to say that all (human rights movement) roads lead back in time to abolitionist universalism, however I think it’s important to recognize that international law (flawed and eurocentric as it is) still has this significant and ongoing tradition.

    Also, as you note, the issue of consent is key to the discussion, and a delicate path to tread regarding systems of dominance and hierarchy that continue to operate well past the age of majority. But I suppose that is probably a discussion for another time, or another blog.

  8. Sheree F. permalink
    7 August, 2008 5:19 pm

    Fascinating article llwynn – I find it amusing that “modern” labial stretching is rather popular in the tattoo/body mod community and is often showcased on BME and other mod sites (I’m pretty sure there is an entire web-page dedicated to the modern practice).

    To this extent I completely agree that it should be considered a form of modification and as someone who is interested in adornment and body modification, I would argue that by some standards, modern mods are just as painful, inhibiting and more importantly, identity forming (mods vs. non-mods “preps” etc) than so called “mutilation”.

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