BMJ  2006;333:259-260 (29 July), doi:10.1136/bmj.333.7561.259-b

Letter

Female genital mutilation: whose problem, whose solution?

Mutilation or modification?

EDITOR—Conroy's editorial and the study by Elmusharaf et al contribute to a literature that has often tended to be long on polemic and short on data.^{1 2} Conroy's recognition that our conceptions of what constitutes female genital mutilation need further thought is long overdue. As I have argued, a coherent response requires both that female genital alterations are considered in terms of their sociocultural significances and that the full range of practices from around the globe are examined together.³ This entails that responses to and definitions of mutilation recognise the increasing range of genital plastic surgeries and the use of body alterations, such as genital piercing. In addition, any attempt at reconceptualisation and reclassification should examine arguments from those claiming that in some instances male circumcision and intersex surgeries constitute genital mutilation.

Such an endeavour would raise difficult ethical, legal, and medical issues on, for example, drawing distinctions between modifications and mutilations and the relevance (or irrelevance) of fully informed consent on the part of the (adult or child) patient on the receiving end. Also, the various cultural and religious defences of the practices would need to be re-examined and reassessed along with human rights and established health concerns. Some of these issues have already been explored.⁴

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Beyond this, although it is important to raise concerns about the "burgeoning industry'" which sells the "cyborg porn babe" body, it is crucial also to be aware that this perspective risks both undermining the autonomy of women who buy the "products" and disregarding their perspectives.⁵ It would be wrong simply to cast such women or (for want of a better term) "non-Western" women who have had genital alterations as victims.

School of Law, University of Bristol, Bristol BS8 1RJ Lois.S.Bibbings{at}Bristol.ac.uk

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Competing interests: None declared.

References

1. Conroy RM. Female genital mutilation: whose problem, whose solution? BMJ 2006;333: 106-7. (15 July.)[Free Full Text]
2. Elmusharaf S, Elhadi N, Almroth L. Reliability of self reported form of female genital mutilation and WHO classification: cross sectional study. BMJ 2006;333: 124-7. (15 July.)[Abstract/Free Full Text]
3. Bibbings LS. Female circumcision: mutilation or modification. In: Bridgeman J, Millns S, eds. Law and body politics: regulating the female body. Aldershot: Dartmouth, 1995: 151-70.
4. Sheldon S, Wilkinson S. Female genital mutilation and cosmetic surgery: regulating non-therapeutic body modification. Bioethics 1998;12: 263-85.[CrossRef][ISI][Medline]
5. Davis K. Reshaping the female body: the dilemma of cosmetic surgery. London: Routledge, 1995.

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