While the whole world was debating the American Academy of Pediatrics’ position on “female genital cutting”—the AAP was against it before they were for it, and now, after an outcry, they’re against it again—Alice Dreger and Ellen Feder have been raising the alarm about “medical research” currently being conducted at Cornell University. A pediatric urologist at Cornell—Dix Poppas—has been operating on little girls with what he judges to be oversized clitorises, cutting away important clitoral tissues, and then stitching the glans to what remains of the shaft. Poppas claims that, unlike past clitoral-reduction procedures, his procedure is “nerve sparing.”
First big problem: “nerve-sparing” surgeries don’t always work. And the chunks of these girls’ clitorises that the doctor is cutting away—large pieces of their clitoral shafts—may be just as important as the clitoral glans. Dreger:
To shorten these clitorises, Poppas is saving the glans (tip) but cutting out parts of the shaft. Bo Laurent has pointed out that Masters and Johnsons showed that many women masturbate by rubbing the shafts of their clitorises. (Think about it: the clit is the homologue of the penis. How do men masturbate?) Many women seem to find their clitoral glans almost too sensitive. Poppas’s patients are loosing the option of touching parts of their shafts, because he’s throwing them out (after the cut-away parts have been sent to pathology to see if he accidentally took out a nerve).
There’s lots to be outraged about here: there’s nothing wrong with these girls and their healthy, functional-if-larger-than-average clitorises; there’s no need to operate on these girls; and surgically altering a girl’s clitoris because it’s “too big” has been found to do lasting physical and psychological harm. But what’s most outrageous is how Poppas is “proving” that his surgery “spares nerves.” Dreger and Feder:
But we are not writing today to again bring attention to the surgeries themselves. Rather, we are writing to express our shock and concern over the follow-up examination techniques described in the 2007 article by Yang, Felsen, and Poppas. Indeed, when a colleague first alerted us to these follow-up exams—which involve Poppas stimulating the girls’ clitorises with vibrators while the girls, aged six and older, are conscious—we were so stunned that we did not believe it until we looked up his publications ourselves.
Here more specifically is, apparently, what is happening: At annual visits after the surgery, while a parent watches, Poppas touches the daughter’s surgically shortened clitoris with a cotton-tip applicator and/or with a “vibratory device,” and the girl is asked to report to Poppas how strongly she feels him touching her clitoris. Using the vibrator, he also touches her on her inner thigh, her labia minora, and the introitus of her vagina, asking her to report, on a scale of 0 (no sensation) to 5 (maximum), how strongly she feels the touch…. Poppas has indicated in this article and elsewhere that ideally he seeks to conduct annual exams with these girls….
Although we have tried, we have been unable to locate any other pediatric urologist who uses these techniques. Indeed, we doubt many would, because we think most would—as we do—find this technique to be impossible to justify as being in these girls’ best interests. We understand that these tests might produce generalized knowledge that shows whether Poppas’s techniques are better than some other surgeons’, but it isn’t clear to us how this kind of genital touching post-operatively is in individual patients’ best interests. If the testing shows a girl has lost sensation through the surgery, her lost clitoral tissue cannot be put back. However, the tests would seem to expose the girls to significant risk of psychological harm.
In the course of our inquiries, made in preparation for this publication, nearly all clinicians to whom we described Poppas’s “clitoral sensory testing and vibratory sensory testing” practices thought them so outrageous that they told us we must have the facts wrong. When we showed them the 2007 article, their disbelief ceased, but they then seemed to become as agitated as we were. At an international conference two weeks ago, when Dreger told Ken Zucker, a psychologist at the Hospital for Sick Children in Toronto and member of the clinical establishment, about this, Zucker said that we could quote him as saying this: “Applying a vibrator to a six-year-old girl’s surgically feminized clitoris is developmentally inappropriate.” We couldn’t find a clinician who disagreed with Zucker.
Yang, Felsen, and Poppas 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.”
The 2007 article documenting Poppas’s research is here.
Now more from Dreger’s post at Psychology Today:
So why the heck do Poppas and other surgeons do these surgeries? They believe it is necessary to ensure “normal” sexual development…. Many of us happen to think “normal” sexual development is actually likely to be thwarted by having parts of your genitals taken away without your consent, and thwarted by follow-up exams like the ones we are describing. Ellen and I have gotten to know hundreds of adults born with sex anomalies who went through these medical scenes growing up. Many have told us that the genital displays involved in the follow-up exams were more traumatic than any other part of the experience. Indeed, when I once asked a group of women with androgen insensitivity syndrome what they wanted me to work on primarily in my advocacy work, they said stopping the exams, particularly those in which med students, residents, and fellows parade through to check out the surgeon’s handiwork.
There’s so much to be angry about I hardly know where to start. Applying a vibrator a girl’s clitoris after it’s been surgically shortened may demonstrate that she still has “sensation” in what’s been left behind—that she still has a few nerve endings that function—but that’s not proof that she hasn’t been physically or emotionally harmed by the surgery and those traumatic follow-up “procedures.” 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. All of the tissues that make up the clitoris—the glans, the stem, the erectile tissues—are important to sexual response, orgasm, and fulfillment, not just the part of the clitoris that’s “normally” exposed.
There’s another disturbing reason this surgery is being performed: girls with large clitorises are more likely to identify as lesbians when they grow up. Needless to say (or maybe not-so-needless): carving up a girl’s clitoris does nothing to change the underlying hormonal and genetic factors that contribute to lesbian orientation and identity. Big clits don’t make lesbians—lesbians sometimes make big clits. These surgeries are partly motivated by out-and-out homophobia, by the belief that “fixing” a large clit somehow prevents lesbianism. (Larger penises correlate positively with gayness in males but no one is out there shortening boys’ penises.)
Please go and read Dreger and Feder’s piece—”Bad Vibrations“—at the Bioethics Forum. And read Dreger’s post at her own blog.
And if you’re reading this and you’re a student at Cornell: female genital mutilation is being practiced on your campus. What are you going to do about it?
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I am a 60 year old woman, and this make me cry. I do not have much if any sexual response, and never have, really – I liken the experience to a nice back rub – it’s the closeness, and satisfaction to my partner that gives me the most pleasure, but the thought of otherwise intact little girls, whose only alleged ‘medical’ problem is ‘enlarged’ clitorises, being surgically altered is nothing less than barbaric. At 6 years of age, who knows what will happen? Maybe they will ‘grow into’ their clits. Surgery to shorten,or ‘feminize’ them is sick and wrong. This so-called doctor should have his medical license revoked for such blatant abuse. What does he have against larger clitorises anyway? Who is to say what is within the ‘normal’ range? Certainly not one sick man. This is nothing short of pedophilia by proxy. The girls are more traumatized by the genital exposure than the actual so-called exams, as well they should be. They are at an age when they are becoming more aware of their body, and are unwilling to expose their ‘private parts’ because they are just that! PRIVATE parts! And they should remain so.
@196: One, circumcision removes a section of skin, not a chunk of erectile tissue. Two, guys tend to have it easier than girls in terms of having an orgasm from sex. If a guy lasts twice as long because he’s circumcised, most people would consider that a good thing. Three, having no foreskin makes it a lot harder to get anything caught in a pants zipper, I’d say.
Looks like I am the only one who doesn’t find it so outrageous.
There are two things here 1. the mutilation itself and 2. the way the checkup is performed. I generally oppose mutilation but I don’t see what is so wrong with the whole examination. I don’t see how it can be construed as inappropriate from sexual POV, first the parent initiates the whole thing and second he is always present so can intervene or skip the followup if he feels it’s in any way wrong. The examinations do not differ from a routine gynecological examination, it’s not like he is penetrating them with a real vibrator or inducing orgasm, he is just using a vibrating instrument to test touch sensitivity, how on Earth would you do it if not by touching? And the parents naturally want to know if the operation was successful and the child retained the sense of touch.
The hole experience seems much better then the mutilation done in Africa and while I do not support it I think the righteous anger of some of the comments here is blown way out of proportion. I had my genitals inspected as a child and it was completely harmless and irrelevant experience with zero effect on my development.
wrote a letter to cornell and will call tomorrow. It was difficult reading th article, being a survivor of abuse. We have to do whatever we can to stop this monster and anyone who enables him. This will haunt these girls for the rest of their lives!!!
what else can we do?
This violates every conceivable ethical instinct, (and probably actual guidelines.) So, your job is to chop up little girls’ clitorises, for NO rational reason, then molest them? WTG, Doc. Proportional growth, (i.e., babies heads are oversized for their bodies, boys’ penises are small relative to height before puberty, etc.,) isn’t always the case in infants and children. If someone wants to have genital surgery as an adult, (regardless of whether it’s psychologically motivated vs. rational,) that’s up to them. These children are being surgically abused, psychologically traumatized, and, to be frank – molested, by a doctor with their parents’ consent. How on earth is this even permitted at Cornell, let alone, not a criminal offense?
I sincerely hope that children’s services steps in, at a minimum.
What the hell happened to, “Primum non nocere?”
This is nothing short of disgusting. Even my mate was sickened and angered over this, just as he is sickened and angered about male circumcision. BS to the people who try to say the two are somehow different; you’re still taking something extremely sensitive and important and cutting chunks of it off, removing so many nerves in the process and potentially causing problems later in life, and yes, the clit is analogous to the penis. (personal anecdote: my mate was circumcised without his consent as a child, and had issues both centering around his ability to be physically stimulated, as well as issues with his gender through his adolescent years because of this issue. Both were remedied with loving support and a manual restretching of the skin, and he’s a lot more comfortable for it, both mentally and physically, though those chopped-off nerves are still gone and always will be; we also found out after this that he couldn’t reach his full length because of the circumcision, the remaining skin was too tight to allow it).
It’s absolutely ridiculous that someone thinks they can set a standard for “normal” size when biology regularly allows for a wide varietal range when it comes to size. The theory that girls who have big clits become lesbians is like saying guys with small dicks invariably become effeminate gays, which is just silly. They might have self-esteem issues due to the stupid idea that “bigger is better” in today’s society, but seriously? The problem is not the genitalia, it’s the obsolete way of thinking most people hold out of ignorance; in the case that an enlarged clitoris legitimately causes problems once an individual is sexually mature, THEN you can go in with the invasive surgery with their consent, cause not every big clit is gonna be troublesome.
Trying to find a way to ‘fix’ or ‘prevent’ homosexuality is pointless, bigoted, and is absolutely no excuse to harm and completely traumatize people’s young children, especially in what is *supposed* to be an advanced society. If you can’t stand things that are different to you, GTFO and go back to the dark ages. Or Africa.
This savagery taking place in 21st century United States. “Primum non nocere” is now considered no more than a quaint throw back to a time when Medicine played a part in Health Care, before it was co-opted by Health as Industry. If these butchers are capable of self-reflection they should be ashamed of themselves.
I just want to remind everybody that there is now a facebook group dedicated to this.
http://www.facebook.com/group.php?gid=13…
Google clitorimegaly, it is a disorder and it can be pretty damn extreme in some cases, so it’s not hard to see why parents decide to have such an operation.
I bet many of the outraged here would opt for the operation themselves if their daughter had a small penis in place of clitoris and I bet they would be grateful the doctor did it in the way that preserves nerves. I also bet most of you would be freaked out if you attempted sleeping with such a girl.
Try to get the other side of the story before you start throwing accusations around.
This is totally absurd and unethical.
There’s nothing wrong with variation in genitalia. In fact, I’m fairly certain most women aren’t even aware if they have a larger-than-average clitoris. Case in point: it was only after reading this article and looking up average clitoris size that I realized I have a somewhat larger clitoris. It’s not like I’ve ever cared or bothered to compare my clitoris to other women’s. And I doubt any guy is going to pull out a ruler before intercourse and start measuring it for me.
While in the long run, it probably won’t matter much, I just sent a somewhat scathing, but mostly disappointed email to the dean and the president. Don’t just comment here, do something about it – write an email, make a phone call, spread the word.
@209
I bet they wouldn’t; that’s the point.
@202 and @203: Enter the trolls. Please don’t feed them.
@209, on the chance that you are not a troll: read the primary documents. Both “sides of the story” are represented here, linked in the original article, which includes Dr. Poppas’ own reporting of his study and the article in BioEthics Forum.
The outrage is warranted.
@zxcrecord re: #209, if you’d read the wiki article on Clitoromegaly http://en.wikipedia.org/wiki/Clitoromega… you’d see that in itself, it is not a disorder, but may indicate an intersex person, with other factors present. However, I’d say that a 6 year old having sex, isn’t something we want to see, would you agree? The age of 14 is the minimum legal age of medical consent in some states, in others, it may be slightly lower or higher. If someone does NOT have a medically necessary, but merely cosmetic desire for clitoroplasty, I’d say it’s reasonable to at least wait until they can make that decision. Wouldn’t you? Again, the size of any body part, relative to the overall size of the whole body, can vary greatly and still be NORMAL, prior to puberty. To put it as bluntly as possible: The head of an infant is grossly oversized compared to the rest of the body. We don’t go around decapitating infants because of it, do we?
It would be helpful if someone would actually read the research papers, instead of relying on a blog of a blog about it for “facts”. I’m a strong advocate against female genital mutilation and Dr. Poppas’s research is not that.
I pulled up the abstracts on Pubmed to see the research, which can be found here:
http://www.ncbi.nlm.nih.gov/pubmed/17707…
http://www.ncbi.nlm.nih.gov/pubmed/17707…
The patients that Dr. Poppas operated on had a diagnosis of Congential Adrenal Hyperplasia, which basically means that the adrenal glands, which produce the sex steroids (and other steriods) don’t work or aren’t sensitive to the chemical signals during fetal development. There are several genetic causes for this, but it can lead to maldevelopment of both female and male sex organs (and in some cases, being unable to tell gender based on external sex organs). In women with the classic syndrome, this can means an enlarged clitoris, fusion of the labia and improper development of the vagina. It can be severe enough that the clitoris can resemble a penis and become engorged and develop erections, just like a male penis.
There is debate as to how to treat this syndrome. I don’t know much, because I’n not in urology or in pediatrics and therefore, never see it. This seems to be a good review article discussing some of the controversy with treatment, especially considering surgery and reconstruction, one of the reasons because they don’t know how it’s going to effect their sexual function as they get older. Warning, there are detailed drawings of the surgical procedures and of genitalia and it is rather dry and technical in places. The research that Dr. Poppas was doing was to try to perserve as much sexual function as possible, while making the clitoris appear more cosmetically more female, so that the surgeries are safer and better for the girls.
And on an end note, this study looked at sexual satisfaction in a few patients with CAH and ambiguous genitalia who underwent the surgery and found that overall, their sexual experiences and satisfaction were equal to those who did not.
He is a child molester; plain & simple!
He is a child molester; plain & simple!
http://www.weillcornell.org/dppoppas/
He’s got a list of his “Professional Memberships” on the bottom of that page… Maybe those organizations could use a few emails encouraging them to investigate?
i think this is some sick way of getting away with sexual abuse.. I cant believe this kind of practice is allowed….This is the Dr.Kavorkian of sexuality…
Dr Redhead, are you proposing that surgery to the clitoris somehow helps with this so called condition? Isn’t surgery only to be used to correct problems, such as fused labia would be a real medical problem? It is cosmetic only unless reducing the size of the clitoris has some to me unbeknown benefits. In addition, the follow up procedures are still psychologically traumatizing and have no value to the patient, only to his research, therefore only due harm which I thought was to be avoided in medicine. They are therefore unethical.
Male infant circumcision has been shown to reduce erect penile length by varying amounts depending on the study you believe, from self-reporting I’ve seen its about 1″ which is hardly “unnoticeable”
Since infant circumcision is unnecessary and causes more deaths than choking which is endlessly crusaded against it would absolutely not surprise me if homophobia has replaced fear of masturbation as the primary reason for circumcision of males.
Cosmetic surgery just shouldn’t be done on people too young to consent. (I would accept surgery to repair obvious problems on face and other highly visible body parts in children old enough to express a clear wish to have it done. But I’d much rather find a solution to bullying of all children instead)
redhead: regardless of the medical diagnosis, it’s sick and wrong to use vibrators on little girls. period. you don’t think these girls aren’t going to have long-term trauma from this? even if these girls do end up with “abnormal” genitals they would be better off dealing with what nature gave them than having to sort out being part of some crazy experiment. let them decide as adults if they want plastic surgery.
One more example of the sort of harm visited on children, due to the ODIOUS name change from “Intersex”, to “Disorders of Sex Development”. People with atypical presentation of gender are now “Disordered”. Concerned parents have more pressure on them to “fix” their children, rather than embrace them as the unique persons they are & provide them with age appropriate information on Intersex folk, so those children, can, in time make their won choices, based on what is right for that individual person.
More information regarding how Intersex folk feel about “Disorders of Sex Development”, at OII.org.
Yeah, I am Intersex.
@203: I still remember when I had to have my genitals examined by my doctor when I was a child – I don’t remember the reason why, but I remember the examination and how I felt, and I hadn’t had surgery to alter my genitalia, nor was I being touched to explore sensitivity.
Trust me, there is a very great chance that these girls will remember this for the rest of their lives and be traumatised by it.
someoneinWA: I’m not a surgeon, I just know how to do a literature search. 🙂 Congential adrenal hyperplasia is a real medical condition (it’s easily googled). It’s inherited problem with the adrenal system; the adrenal system produces the sex hormones that direct the developement of genitalia while as a fetus (as well as affects electrolytes and blood pressure and all sort of things like that). If these hormones aren’t produced OR if the sex hormones aren’t sensitive to them, then abnormalities of the genitalia can occur, to the point where it’s really difficult to tell what sex the baby is when it’s born. Google images has several examples of the external genitalia of these babies and children; it can be quite devastating.
CAH is treated medically with a variety of steriods to help reduce the electrolyte abnormalities (and sometimes to balance the amount of testosterone). But since the changes to the genitalia occured in vivo (during development), the treatment in the past has been surgical: to give the girls a vagina, to reduce the size of the clitoris so it no longer looks like a penis, etc. There can be medical complications from the abnormal genitalia: the girls have normal internal organs, ie ovaries and uterus, and therefore have menses which can cause problems if there’s no vagina or a fused labia.
The surgical review article suggested that in the past, they removed the clitoris entirely, which obviously, lead to many complications. These studies that Dr. Poopas and others are doing are evaluating new surgical techniques to reduce the amount of nerve disturbance, so as to preserve sensation and sexual function. Looking at other review articles showed similar sorts of methods to document preservation of sensation, as well as looking at the number of nerves in the removed tissue, doing nerve conduction studies (with needles and/or electrical stimulation) to the remaining clitoris), etc. In medicine, it’s hard to know whether or not your intervention works unless you have some way to measure success or failure.
Sorry if this is rambling. It’s getting late.
And as an aside, there has been some suggestion that girls with CAH are more likely to form lesbian relations as teenagers and adults, but this is not thought to be due to the size of the clitoris, rather from the effects of testosterone on the developing fetus or from other psychosocial interactions.
@ 213 – Venomlash @ 202 is a long standing and welcome member of the SLOG community. You just registered earlier today. You do not get to call Venomlash a troll.
@ 203, OTOH, total troll. But you owe Venomlash an apology.
@177 – I’m pretty certain my mother and doctors wanted me to have cleft lip surgery so I could breathe, eat and talk right. I’m fairly certain a lot of cleft lip and palate ‘sufferers’ would agree with me.
My genitalia has no reason to be operated on unless it’s preventing me from urinating or having menstrual discharge or some other medical reason. A large clitoris or being intersex is not a good medical reason. Children will eventually identify and then they can decide what they want to do, post-puberty. That goes for boys, too.
Seems like a misguided(and very sick, abusive) method of gender or sexual reassignment early on, but we all know that doesn’t change the genetics or the brain. And the implications of sexual abuse, which I’m sure it feels like psychologically for these little girls. I keep hoping this is some huge internet joke someone started. I am very discouraged at how backwards women in our society have become, young women are being exploited to such a degree it’s soul defeating observing it daily. The way they’re mutilating their bodies too, the disappearing vagina I call it… Really, no words can express the disgust I am feeling after report. Throughout history doctors have perpetrated horrors and abuse using science and research as a rationalization and license to torture and abuse.
What a bunch of analytical bullcrap!
The doctor is a child molester.
He is doing unnecessary surgeries and is risking the future sexuality of all his patients because of the unnecessary surgeries. He is also traumatizing the girls by performing painful surgeries on their sex organs.
Why is there such a problem that there are multiple pages of detailed analysis of the experiments, surgeries, assaults, and molestations, yet not a soul has turned in the good doctor for molesting children? There’s no need to go over all the risks, the wrongs being committed, the trauma to the patients. All that’s necessary is to go to the local police department and file a complaint. Give the name of the doctor, the location where the molestations are occurring, the nature of the molestations, etc.
I’d enjoy watching this doctor explain to a jury how he uses a Q-Tip to test his patients for residual sexual function. Yes, those details should be very satisfying when heard before a jury in a court of law. Repeating details of the doctor’s experimentation doesn’t do much for solving anything until charges are filed against the doctor and he is finally shown to be the abuser that he is.
So who among this group resides in or around the area where the crime is being committed? There are various complaints that can be filed. If you are hesitant as apparently all of you are, get a note from one or more of the other doctors who are also outraged by the behavior of this perverted predator. .
Bottom line – MAKE A COMPLAINT to the local police department ABOUT THE CHILD ABUSE AND ASSAULT BEING, COMMITTED UPON LITTLE GIRLS AS YOUNG AS 5 YEARS OLD AND LESS. You may want to alert the local newspapers as well as the police to be sure your complaints are filed. I’d go for numbers of complainants. Get whoever you can who lives in the area where the doctor practices to make a complaint with you. The more the merrier.
It’s amazing how long these practices can continue without interruption when nobody makes an official complaint. This is not legitimate research. It’s the work of a pervert getting his rocks off by manipulating Q-Tips on post-surgical 5 year old little girls’ vaginas. See how your local cops like this Q-tip method of testing the surgical results.
Why dont parents stop focusing so much on making their child normal , and just focus on making them happy? That is all that really matters. This case is disgusting.As someone who just finished a degree in the medical field, I absolutely hate the way that medicine attempts to pathologize our bodies and “fix”them. If you are healthy , who gives a fuck what form that comes in.
“The Rape of Innocence: Female Genital Mutilation and Circumcision in the USA” is my bio and gentle rant on this subject – It took me ten years to edit the fury out of my heart and the book so it could be published. FGM used to be quite common in the US. No, i’m not of African descent, but WASP – English & French – born & raised in Kansas. I’ve met other women who were c’d. It was not rare. Blue Cross Blue Shield covered clitoridectomies until 1977.
There is WAY too much preoccupation in the medical community on the genitals of tiny children. Medicine is a convenient career for people who care overly much about children’s genitals. And there is WAY too much “fanning the flames of neuroses” over the appearance of children’s genitals. Genital are not designed for eyes to look at; they are meant to feel good. Cutting makes scar tissue and then genitals feel icky, rather than good. Cutting is abusive and counterproductive.
Leave the fate of children’s genitals to their owners… not parents or MDs.
My concerns: I am relatively certain if male circumcision was not practiced in the US, then I wouldn’t have been circumcised, these little girls we are freaking out over at Cornell wouldn’t have been “genitally reduced” and most of the little boys in the US wouldn’t have had their foreskins cut off (and sold to pharmaceutical and cosmetics companies), because genital interference and alteration would be the LAST thing on any normal, natural, healthy adult mind.
Little children who are cut (or sexually abused in other ways), have no words for their distress and so they “act out” – dramatize – what happened to them by cutting others. Monkey see, monkey do. Circumcision makes circumcisers; mutilation makes mutilators. To end the cycle of abuse, we have to end the abuse of everyone, of both genders and learn to accept diversity with peaceful minds. It’s not rocket science. As long as someone sick can justify cutting anyone’s genitals, they will cut and cut and cut. It would be better to get them help when they indicate they might want to take a knife to human flesh. The compulsion to cut human flesh is a disease… the unfortunate remnant of Nazi experimentation when thousands of German MDs immigrated to the US in Operation Paperclip after WWII & taught cruelty to US medical students.
All that said, my main concern is not the physical but the psychological impact. A knife to the genitals significantly diminishes the quality of life for any person who has been cut. Sensual comfort is gone. PTSD is common. Suicidal ideation is common. Night terrors & nightmares. Self-hatred. Feelings of powerlessness, learned helplessness. All sorts of ills are possible due to negative decisions made by the very young child.
Mutilation is mega-rape, rape by knife. Rape may or may not be any individual MD’s intention, but rape is how those who were genitally cut depict it.
It’s terrible cruelty, all genital cutting.
@Dr Redhead:
You mention published work where Poppas speaks of surgery to correct CAH, but the article under discussion in this thread is the one cited by Savage:
http://www.thestranger.com/images/blogim…
which talks about using his same methodology to correct, and I quote:
clitorimegaly
which is merely a larger than average clitoris. IOW, AFAICT, this paper refers to using clitoroplasty for merely cosmetic reasons.
so, there IS a reason to debate the ethical nature of this work, and how it is applied, aside from whether the methods utilized themselves are ethical or not.
What sort of parent exposes their child to this type of abuse?
It has either to do with an obsession with appearance, looking like everybody else. Or as mentioned in the article: homophobia. Either one is not a valid reason to perform the surgery and subject the child to the horrific and abusive follow-up exams.
There is no reason not to wait for these girls to grow up and let them decide for themselves whether they want surgery or not.
This screams child molestation on the part of the doctor as well as the parents.
Thank you Dr. Redhead for an objective POV. Albeit, when I read the excerpt I too was offended and very much put off by the overall procedure. I found myself questioning the reasoning behind such research. As with any article I read, I also question the authors intent/motivation. There is likely more to this than meets the article. What we don’t know about the patients in this research is the severity or acuteness of their malformations. Did Dreger interview the parents to fully understand their motivation? Shouldn’t we trust that the larger number of parents in New York City (or in any American suburb), operate in the interest of their offspring. Sure there are some whack jobs out there. How many of them can afford the type of medical costs associated with this program/research. If this research were conducted in East LA, Harlem or some back woodsy township in West Virginia (no offense meant to anyone calling these locations home) preying on uneducated, low income families, I would be up in arms with the rest.
It’s easy to find passion for protecting the children of this world that have little or no choice in defining their existence. I’ve read articles on the cutting away of the labia with a sharp edged stone in Africa for no other reason than to cut away the evil flesh. Cornell University is and has been a beacon of academia for many years. I am sure that much consideration from many astute scholars goes into the granting of resources for such research.
There are always two sides to a story. Dreger’s is one side. In the interest of diversity lets keep our minds open for the other side. Best wishes to all.
@226 Read @202 again. That post is purposefully provocative, using childishly inaccurate statements to start a fight. Read it again, and tell me that it was intended as a positive contribution to the discussion. Perhaps this will help: http://tinyurl.com/yyx3ns
If all 226 outraged posters were to go to child protection and the sheriff you could stop them – something other than expressing views has to be done about this. What is the matter with the hospital ethics committee. Are they on permanent sabbatical?
Cute trick, stimulating the clitoris to enlarge it, then judging it too large, then judging it has to be cut off. What are these mutilators using as a standard? The standard clitoris in the archives in Paris?
And from what arrogant, invasive, mercenary, cowardly, malicious standpoint and perverted mentality does anyone trained to practice fiduciary responsible therapy judge they have the authority to cut infants and children’s genitalia to begin with?
They should all be jailed.
@Dr Redhead
Actually, the abstract states that the purpose of the study was to practice clitoroplasty to be used on patients with Adrenal Hypoplasia, BUT the patients in the study itself do not have Adrenal Hypoplasia.
“Enlargement of the clitoris is often a prominent manifestation of virilizing congenital adrenal hyperplasia and other disorders of sexual development. Controversy persists regarding the viability and sensitivity of the clitoris following clitoroplasty. We present 51 consecutive cases of nerve sparing ventral clitoroplasty performed by a single surgeon.”
“A total of 51 patients 4 months to 24 years old (mean age ± SD 4.6 ± 6.8 years) with clitorimegaly underwent nerve sparing ventral clitoroplasty.”
He is just describing the techniques used on these independent elective clitoroplasties and talking about how it could apply to patients with Adrenal Hypoplasia.
Also, while reading the abstract and text of a study is always a good thing, perhaps read it with a more critical eye the next time before admonishing everyone in the thread.
Here’s the thing- no ethics committee actually gave Pappas permission to do these clitoroplasties. They were done, and he asked permission to review his notes and write up a study about it. So there was no independent ethical board sitting to the side and giving him permission to cut these girls clitorises- that is why it is so absurd to defend him saying “Well surely if the other members of the university approved it happening…” They didn’t- they just approved him amalgamating notes from these previous surgeries.
The place where he really crosses the line is taking his IRB approval for a retrospective chart review of the surgeries and instead interpreting it as permission to do post-op tests on these little girls. He did not have permission to do that in the name of a study, and without a study justifying it there was NO REASON for him to be conducting these post operative tests. They held no benefit for the patient (as many have said- even if they were insensate he can’t go back and reattach the bits), just for his curiosity to see if his amazing ‘technique’ actually worked. So he went home satisfied with his results and those girls went home with a traumatic experience.
@ 235, longtime sloggers with a history of insightful comment get a pass around here if they are occasionally provocative. But I believe it is you who needs to cool off, then re-read @202. Nothing he wrote is childish or provocative, especially in context of the comment he was answering. It appears that you’re someone who believes so fervently in your cause that you can’t assess a differing opinion accurately.
WHAT THE HELL!!!!! I HAVE A BIG CLIT AND LOVE IT SO DOES EVERY MAN I’VE EVER MET, THAT SOUNDS LIKE TORTURE THIS PIG SHOULD GO TO JAIL!!!!!!!!!
Child rape, child mutilation.
We operate on animals without consent because the possibility that they will regret something is not considerable.
we vaccinate children without consent because otherwise they are going to die.
I have twins (2 girls) one was born average and the other had a rather large ‘bit’ .You know what I did about it? Nothing. You know why? Because if my son (who is un-circumsized) Were to have a extra large ‘bit’ I wouldn’t cut his off either.In truth she ‘grew into’ it like a puppy with too big feet. About the time she was 11/2 to 2 she was more ‘normal’ looking . I have a very hard time understanding why this is SO important to these parents anyway . What does your childs sexual organs have to do with you? Even intetrsex children? These things have happened since there have been people so why go through all these life destroying things when simply sitting your child down and telling them of the difference and letting them decide at an adult age what to do about it? I know that came off as sounding dumb to a lot of people who will read this but, really think about it .I would bet there are a lot of people in this world who would love to have had the chance to develop mentally as a child without all of ‘this’ in their lives ,then at 23 (or whenever) had the surgery IF they chose to. I find it hard to understand how these parents aren’t just floored by the guilt of first of all mutilating their infant daughters and secondly watching them literally be assaulted. I can only imagine the confusion in these little girls minds …..mommy tells me about bad touch but, it is ok if she is watching? WTF!!!! I bet they would not line themselves up for this so why do it to a baby who is a whole lifetime away from being a sexual being ,and (not that it is ok for boys either) but, we don’t exactly pee standing beside eachother, nor do we get out the combs for a measuring contest. In effect it WOULD be her secret till she was older and was confident enough in her self to live the was SHE chooses. I think it should be the same for boys too with circumcision. There is no medical need for it for either sex .
Aw, thanks, Matt from Denver. I did mean that comment in all sincerity; this thread has enough argumentative rambling without anyone trying to add to the mix. (And as a guy who IS cut, I think I have a perspective from which to make that earlier statement.)
@240: Of course every man you’ve ever met has a big clit; it’s called a penis. Or did you mean the part about loving it? Don’t dangle your modifiers in public.
This is just disgusting! As a mother of a little girl I cannot imagine what would possess another mother to allow this person to do this to their child. Plain and simple this is child abuse.
These guys must be buddies with John Money.
I never dreamed that this was happening to girls without parental permission. I knew of parents that allowed it to be performed (the surgery)which is possibly more to blame on the medical staff for cohercion of the parents to allow permission to, but never the sensation testing post-op. What do parents have in their conscience about allowing their child to be stimulated for testing sensation. If the nerve function is to be analyzed professionally, I would think that questioning the child could be adaquate. Obviously the child themselves knows if their body feels touch or not. It does seem like the doctor is wrong to think he has priviledge to stimulate the childs genital areas.
I would be furious if any so-callled professional even implied that I had no right to refuse surgical alteration, reduction, or reconstruction to be inflicted on my child. If this’s what our laws state, “we cannot refuse it!”, the authorities will have to come and better expect a fight; physically and legally! The right of people to have parental authority over their children’s wellbeing is worth fighting for IMO!
To 146:
Most of these girls aren’t even aware there is anything ‘wrong’ with their clitorises. They are infants. There is no pain or discomfort until a surgeon cuts them. Although they probably are VERY aware of the yearly genital vibrating/touching when they are older.
To 157:
CAH’s life threatening conditions are not treated with genital surgery. The condition remains no matter what they do to body parts they think aren’t normal enough. And our clits only become NON-functioning AFTER a surgeon cuts nerves. The function of a clitoris (as far as my research goes) is about pleasure. Surgeons still don’t know whether they cause nerve damage… that’s why one of them wants to know. But it doesn’t help that child at all. Damage done cannot be undone.
To 163:
Not all women want to have intercourse with a man. To shape our infant bodies believing that “if we build it, they will come” is heterosexism in its most perverse form.
To 165 & 178:
Amen. And 178… I love your screen name too.
To 166:
It is ABSOLUTELY a difficult decision for parents. That’s why every parent should have FULL INFORMED CONSENT and they shouldn’t be rushed into any decision. Remember, these are NON MEDICALLY NECESSARY surgeries done on INFANTS.
COSMETIC SURGERIES done on INFANTS.
To 209:
Sleeping with a woman with a larger than average clitoris is no better/worse than sleeping with a man with a shorter than average penis.
And girls don’t have a small penis in place of a clitoris. IT’s THE SAME ORGAN! When you have an XY child it’s called a penis. When the child is XX it’s called a clitoris. Please pay attention the next time Biology 101 is offered.
To 230:
Welcome to the field of medicine. We need MORE physicians with your outlook. For Clinical guidelines for patient centered care, please go to: http://www.accordalliance.org
There are Parent Guidelines too – all free & downloadable.
To 240:
Amen to you too. And if a surgeon wanted to ‘normalize’ you, I doubt you’d choose that option!
This is the most ridiculous thing I have ever read. What this man is doing to *children* is awful, if it was any other human being they would be arrested, but because this is a “doctor” it’s acceptable. No. Also as a and alli to the gay community anyone having the idea to “fix” lesbianism, is down right awful, and gross. Using a vibrator on a child, this man’s medicaal license should be revoked and burnt, and then just for spite he should be punched in the stomach and have his sexual organs clipped and just thrown away.
What the FUCK!?!?! As a 1) mother of girls, 2) woman and 3) human being, I think the parents who consent to this procedure and follow-up should be arrested, along with this doctor. Who the hell ALLOWS this to happen?!?
I never dreamed that this was happening to girls without parental permission. I knew of parents that allowed it to be performed (the surgery)which is possibly more to blame on the medical staff for cohercion of the parents to allow permission to, but never the sensation testing post-op. What do parents have in their conscience about allowing their child to be stimulated for testing sensation. If the nerve function is to be analyzed professionally, I would think that questioning the child could be adaquate. Obviously the child themselves knows if their body feels touch or not. It does seem like the doctor is wrong to think he has priviledge to stimulate the childs genital areas.
I would be furious if any so-callled professional even implied that I had no right to refuse surgical alteration, reduction, or reconstruction to be inflicted on my child. If this’s what our laws state, “we cannot refuse it!”, the authorities will have to come and better expect a fight; physically and legally! The right of people to have parental authority over their children’s wellbeing is worth fighting for IMO!