Female Genital Alteration: a Compromise Solution Kavita Shah Arora,1,2 Allan J Jacobs3,4
Clinical ethics PAPER Female genital alteration: a compromise solution Kavita Shah Arora,1,2 Allan J Jacobs3,4 1Department of Obstetrics and ABSTRACT FGA. Eighty-five per cent had an intention to Gynecology, MetroHealth Despite 30 years of advocacy, the prevalence of non- subject their daughters to an extensive FGA proced- Medical Center, Cleveland, therapeutic female genital alteration (FGA) in minors is ure, and 90% supported the continuation of the Ohio, USA 7 2Department of Bioethics, Case stable in many countries. Educational efforts have practice. There have been some more encouraging Western Reserve University, minimally changed the prevalence of this procedure in studies, however. In Kenya, for example, prevalence Cleveland, Ohio, USA – 3 regions where it has been widely practiced. In order to has dropped from 49% in women ages 45 49 years Department of Obstetrics and better protect female children from the serious and long- to 15% in girls ages 15–19 years and in Liberia, the Gynecology, Stony Brook University, Stony Brook, term harms of some types of non-therapeutic FGA, we prevalence has dropped from 85% to 44%, 89 New York, USA must adopt a more nuanced position that acknowledges respectively. a wide spectrum of procedures that alter female Immigrants to Western nations may continue to – Correspondence to genitalia. We offer a revised categorisation for non- subject their daughters to genital alteration,10 12 Dr Kavita Shah Arora, fi Department of Obstetrics and therapeutic FGA that groups procedures by effect and though the frequency is dif cult to assess. While Gynecology, MetroHealth not by process. Acceptance of de minimis procedures laws enacted in these countries make procedures Medical Center, 2500 that generally do not carry long-term medical risks is that alter a female’s external genitalia illegal, they MetroHealth Drive, G230E, culturally sensitive, does not discriminate on the basis of may in some instances worsen health outcomes by Cleveland, OH 44109, USA; gender, and does not violate human rights.
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