After Cutting Little Girls’ Clitorises, Ivy League Doctor Tests

19/06/10 0 COMMENTS

After Cutting Little Girls’ Clitorises, Ivy League Doctor Tests
Handiwork With a Vibrator
By Daniela Perdomo, AlterNet
Posted on June 18, 2010, Printed on June 18, 2010

When most of us think of female genital mutilation, we probably think
of faraway places. Well, peel off those blinders. In 1997, our very
own Department of Health and Human Services estimated that 168,000
girls and women living in the United States had been or were at risk
of being subjected to some form of the abhorrent practice known as
female genital mutilation (FGM).

Not only is FGM being practiced relatively widely in the United
States, it’s happening in the most hallowed halls of American medical
science. In fact, the head of the pediatric urology department at
Cornell University’s New York Presbyterian Hospital — which is often
ranked among the top 10 hospitals in the country — has been operating
on young girls who suffer from what he (and likely the girls’
guardians) have decided is “clitorimegaly,” or oversized clitorises.

In order to relieve these girls from what seems like little more than
a cosmestic issue, Dr. Dix P. Poppas cuts out parts of the clitoris’
shaft, saving the glans, or tip, for reattachment. Poppas triumphantly
calls the procedure — rebranded a clitoroplasty — a “nerve sparing”
one unlike the FGMs practiced in other countries.

How does the good doctor know that nerves have been spared? Well,
Poppas and his nurse practitioner developed a series of sensory
followup tests involving Q-tips, their fingernails and vibrators. But
don’t worry, a family member was always present in the room. As the
resulting journal article notes, management of such situations
requires a “compassionate and multidisciplinary approach.”

Activists Alice Dreger and Ellen K. Feder, a professor of medical
humanities and bioethics and a professor of philosophy, respectively,
have been railing against the practice of FGM — of any kind — for a
decade. They are part of the majority medical view that questions the
very basis of clitoroplasties. (The American Academy of Pediatrics
disturbingly stated in May that it only had an issue with “all types
of female genital cutting that pose risks of physical or psychological
harm” — as if any kind of clitoral mutilation did not necessarily
entail such harm. The AAP recanted the shocking affront to women’s
physical and mental health only a few weeks later.)

“We still know of no evidence that a large clitoris increases
psychological risk (so is the surgery even necessary?), and we do know
of substantial anecdotal evidence that it does not increase risk.
Importantly, there also seems to be evidence that clitoroplasties
performed in infancy do increase risk – of harm to physical and sexual
functioning, as well as psychosocial harm,” Dreger and Feder wrote in
an article lambasting Poppas’ study.

These procedures seem motivated mostly by an obsession with having
“normal” genitalia — and normal kids. The fact that cosmetic genital
surgery is on the rise is one sign of this. And given that only one of
every 2,000 infants is born with genital ambiguity, parents faced with
an “abnormal” clitoris are not likely to have ever seen one before and
may react with trepidation. Will my kid be a lesbian? Will my little
girl want to become a boy? We know children are all unique, like
snowflakes, but when it comes to vaginas, sexual orientation and
gender identity, it seems we’d prefer cookie-cutter, please.

So parents go to Dr. Poppas who mirrors their fears and offers a
medical procedure that Cornell’s Web site recommends “because female
patients are able to undergo a more natural psychological and sexual
development.” What parent would withhold such treatment, recommended
by a top-notch pediatrician and hospital?

Poppas cuts off parts of the perfectly healthy, albeit-larger-than-
we’d-like clitoris, the only organ in either sex whose only known
function is sexual pleasure.

Although Poppas boasts of the “nerve sparing” nature of his procedure,
a study in the Lancet showed some women who underwent other nerve-
sparing surgeries “had the worst possible score for orgasm
difficulties.” Not to mention the fact that simply preserving the
glans may not be enough, given that many women find more pleasure is
derived from the shaft than the tip, which can be overly sensitive.

The horrors of clitoroplasties aside, Poppas’ particular brand of FGM
adds an extra layer of psychological damage. When Dreger told Ken
Zucker, a child psychologist about how Poppas used a vibrator to test
a little girl’s clitoral sensation, he said: “Applying a vibrator to a
six-year-old girl’s surgically feminized clitoris is developmentally

Dreger and Feder write:

[The study’s authors] describe the girls “sensory tested” as being
older than five. They are, therefore, old enough to remember being
asked to lie back, be touched with the vibrator, and report on whether
they can still feel sensation. They may also be able to remember their
emotions and the physical sensations they experienced. Their parents’
participation may also figure in these memories. We think therefore
that most reasonable people will agree with Zucker that Poppas’s
techniques are “developmentally inappropriate.”
Of course it’s inappropriate. And lest that is not obvious on its own,
transgendered adults have long been vocal about how genital displays
in medical exams were among the most traumatic experiences of their
entire lives.

In this case, as sex columnist Dan Savage writes, “These post-op
visits with the doctor and his vibrator do the girls no good — what
can the doctor do if a girl reports no sensation? reassemble her clit?
— and retaining sensation isn’t proof that these girls will grow up
to be healthy, sexually functional adults.”

The sad irony is that maintaining these girls as healthy, sexually
functional, happy adults is the cause of all these problems in the
first place. Parents and the doctors who legitimize their fears need
to know that reconstructing a clitoris — or any other ambiguous
genitalia — to meet “normal” standards does nothing to change what
may be behind the differences to begin with. You can’t “fix” your
kid’s genetic and hormonal makeup — you can only cover it up, and
such efforts can have tragic psychological and physiological results.

The least we can do is give every kid a chance to figure out who he or
she is and what he or she wants when he or she is old enough to do
make that call — and to accept them as they are throughout the entire

Daniela Perdomo is a staff writer and editor at AlterNet. Follow
Daniela on Twitter. Write her at danielaalternet [at] gmail [dot] com.

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Mistress Eva: I find any mutiliation of the female genitals barbaric and uncalled for. Its one thing if a adult woman decides to have her Clitoris operated on, its another when parents or doctors try to change her so see can fit in. Sparing the nerves does not make it OK! Then Doctors stimulating the poor young girls to make sure their clits work? Its just ethically wrong!