An international team of experts, led by Dr Arianne Shahvisi from Brighton and Sussex Medical School (BSMS), is calling for a new moral standard for genital cutting procedures, following a recent editorial in The Lancet that condemned the rise in "medicalised" female genital mutilation (FGM) performed by healthcare practitioners.
In their response, the experts argue that the line between medicalised FGM and female genital cosmetic surgery is blurred, as both involve similar procedures conducted in clinical settings. Although medicalised FGM is predominantly performed on underage girls and female genital cosmetic surgeries are generally chosen by consenting adults, the team points out that the World Health Organization’s definition of FGM makes no distinction based on age or consent. They further highlight that Western countries increasingly perform cosmetic genital procedures on teenagers, as well as other non-medically necessary surgeries on young children, such as infant intersex surgeries and male circumcision.
Lead author Dr Shahvisi, a Senior Lecturer in Ethics at BSMS, suggests that a double standard exists. “There appears to be discrimination at work, since procedures performed by people of colour in the Global South are criticised, regardless of age or consent, while clinically equivalent procedures in the Global North are permitted,” Shahvisi said.
“We propose a new moral standard which promises to move us all beyond these inconsistencies. We define ‘unethical genital modification’, to mean any procedure that modifies or injures a person’s genitals without medical necessity or informed consent. In adopting this standard as the basis for condemnation or elimination efforts, medical bodies and journals can avoid discriminating on the basis of cultural origin, sex, or gender.”
In addition to Dr Shahvisi, the expert team includes Jasmine Abdulcadir (Geneva University Hospitals), Mireia Garcés de Marcilla (University of Exeter), Tammary Chepkoech Rotich (Amref International University), and Brian D. Earp (University of Oxford and National University of Singapore).