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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359 replies on “Female Genital Mutilation at Cornell University”

  1. #243 Unless you consented to your cut as an adult, you are in no position to make statements about foreskins, with which you have no experience, nor about the decision to cut (self or non-consenting child), about which you have no experience.

    #239 Thanks for the clarification about what is tolerated here. Good to know. You are right about the context of the comment he was answering: #196 obviously didn’t read the comment thread before writing, and the comment’s tone is off-putting and ignorant. Which is why it didn’t deserve a response. Especially a response which is deliberately dismissive and ignorant. That would be called flaming, and, you know, why?

  2. @163 and @167: finally voices of reason after over a hundred examples of jump-onto-the-pedophilia-bandwagon exaggeration.

    Silvio Levy

  3. @251, I think as a man Venomlash has every right to comment on male circumcision (I’m female). He’s a male who was circumcised and he’s not traumatized. He’s perfectly OK with that. I’m guessing he was circumcised for a brit milah, unless his Judaism stems from conversion.

    @Venomlash, As a Jewish man, would you have felt left out or odd if you hadn’t been circumcised with a bris? It’s a hugely important ceremony, after all. Maybe a Jewish boy would feel traumatized that someone didn’t make the decision for him and now he doesn’t feel Jewish anymore. Perhaps the same goes for a Muslim boy who believes circumcision is important.

    Men who are happy being circumcised are told by the anti-circumcision crowd that they don’t know any better, that they don’t know they were mutilated. Well, maybe they do know better. Maybe they’re just happy with their bodies the way they are. Maybe the anti crowd is the one who wants to wave their banner so fervently that they don’t realize their views aren’t golden truth. Personally, I do feel that circumcision should be a decision made by a consenting adult, but most parents aren’t out to traumatize their kids.

    Male circumcision aside, this is terrible. Even skimming over the surgery—um, stimulating a child with a vibrator? Really? That sounds like it needs some scientific tweaking. Besides that, how accurate could his results really be? These are probably nervous, scared little girls being touched in their “private” zone by someone they should trust. Didn’t their parents warn them about that kind of thing already? Why are Mommy and Daddy changing their minds? Even if I could accept the bizarre protocol, I’m doubtful of any true scientific validity.

  4. I want to do something. What can I do? I’m already getting the word out around my friends and facebook community, and writing a blog about it (also including some info about how intersex adults feel about having surgery performed on them when they were kids without their permission).

    Is there any online petition anywhere? I would prefer if it was started by the students at Cornell University, but I’ll sign anything.

  5. it wouldn’t be tompkins county – weill is in new york. Someone who knows someone who works at the times pass this on. Once this gets in the news – he’s done. And, typically, (as an academic myself) I’ve seen sick bastards like this work with women/black/hispanics whichever on purpose to defray criticism of their perverted/racist/xenophobic fucked up shit.

  6. I’m with the dissenters here— I’m not saying female genital mutilation is okay, nor am I saying that little girls should be molested, I’m saying KNEE JERK REACTION is bad. I’m in the middle of reading the primary sources, and you should too before commenting. Dan’s article is talking about the reaction of two writers, so you need to look at the original source. FWIW, I just read that the average clitoris is about 3-4 mm, whereas these patients were between 1 – 4.5 cm. Centimeters. Think about that for a second, and maybe you’ll consider that a) the parents were concerned and b) this possibly may have caused extreme irritation/pain.

    I’m not done with my research, so I don’t know enough to form a complete, informed opinion, it seems that clitoromegaly does seem to happen in intersex people (as an effect, not a cause) so I do question to the wisdom in the procedure. However, I am not about to join a facebook page ranting for this guy’s head, without more information. If the guy became a celebrated physician, he must have had patients who were satisfied. And I don’t think that anything resembling “female mutilation” and “infant masturbation” would have gotten past multiple administrations in today’s litigious age without intense scrutiny, way more than usually happens than a single SL article (sorry Dan).
    There must be more to this story.

    So please, before your knee jerk outrage, do your research.

  7. One of the reasons for circumcising a boy tribally is because the intact penis is “too feminine” and this is sometimes heard in the modern denigration of the foreskin used to justify the surgical procedure. So there is a parallel between these two surgical reductions for “too much of the wrong sex”. The foreskin contains ~20,000 specialised nerves (in a uniquely mobile structure, strategically placed) so “[a]ll 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” is equally true (mutatis mutandis) of males.

    The male operation is done every 26 seconds in the US while the Cornell experiments are mercifully rare. Neither fact redeems the unique vileness of cutting a baby girl’s genitals and then stimulating them years later to see how much damage one has done.

    AAP Bioethics Committee chair Douglas Diekema (who defended the “ritual nick” of girls) earlier said “the request of a parent or surrogate decision-maker is never sufficient to justify a particular clinical intervention” and the Committee’s policy on consent says “[P]roviders have legal and ethical duties to their child patients to render competent medical care based on what the patient needs, not what someone else expresses. … The pediatrician’s responsibilities to his or her patient exist independent of parental desires or proxy consent”. All this seems to fly out of the window when parents bring whims about their child’s genitals in the door.

  8. @253 Leslie N: Maybe if circumcision were somehow augmentative, your argument might have some validity, but it isn’t and it doesn’t. Circumcision removes, and circumcised men don’t know what they are missing. If intact Jewish or Muslim men (and there are many of the first, and maybe the second, somewhere) want to be circumcised they can, and that is fully accepted by their tribes, but many choose not to, and the case for it (like clitoral reduction) to be “a decision made by a consenting adult” applies equally to them.

  9. This is terrible. I would love to read how this pervert got this past the ethics board. It is mutilation, pure and simple. And how can you justify STIMULATING a childs gentials as good for science. and for that matter WHO CARES if a girls clit is “too big”? This has the potential to sexually scar the child for the rest of her natural life. Utterly horrible, this man should go to jail.

  12. Just when you think we are living in a more advanced society, you find you have things like this going on, and in our own backyard. Is there a way to cure social disease?

    Is this eventually going to lead to little boys or young men with larger dicks having ‘Dick Reduction’ operations? This way all the little ‘dick’ people will not have to feel self concious anymore.

  13. Jesus fucking Christ! What the hell is wrong with this doctor? Slicing away genital tissue? Using a fucking vibrator on a child and asking how it feels? How the hell did this get past the IRB- can we say “vulnerable population”?

  18. Sorry, link fail above. Here’s the contact info:

    Office for Human Research Protections
    1101 Wootton Parkway, Suite 200
    Rockville, MD 20852

    Toll-Free Telephone within the U.S. (866) 447-4777
    Telephone: (240) 453-6900
    Fax: (240) 453-6909
    e-mail: OHRP@hhs.gov

  19. @261, 266

    Framing the discussion of infant male circumcision as a “men’s issue” and juxtaposing it to a “women’s issue” is exactly why it needs to be discussed. FGM is rare in the United States outside of certain African immigrant communities. The senseless genital cutting of boys genitals is the abuse happening right next door to you, the one you might contemplate yourself, all with broad societal approval. That is why is deserves mention here.

    I am lesbian so penises are more an abstract concept than part of my life, but protecting the rights of all children, boys or girls, is dear to my heart.

  20. I sent this story to the Joint Commission, in an effort to get them to analyze whether Cornell’s medical facilities (which, by the way, are not on the Cornell Campus in Ithaca NY, rather they are in NYC, despite what the author states at the end of the article) should even have funding or accreditation.

    How horrifying. And what parent in their right mind would EVER allow ANYONE near their daughter like this? WTF? We don’t just have these “doctors” to blame, we also have the parents as well.

  21. Advocates for Informed Choice is a non-profit organization advocating for the legal and human rights of children with intersex conditions or differences of sex develoment, like the ones in this story. We work in collaboration with bioethicists, doctors, parents, affected adults, and many others. If you are interested in taking action to help protect these children, and to be sure that possible human rights violations are investigated, please join our Facebook page at http://www.facebook.com/pages/Advocates-… or sign up for our Twitter feed at http://twitter.com/aiclegal.

  22. Advocates for Informed Choice is a non-profit organization advocating for the legal and human rights of children with intersex conditions or differences of sex develoment, like the ones in this story. We work in collaboration with bioethicists, doctors, parents, affected adults, and many others. If you are interested in taking action to help protect these children, and to be sure that possible human rights violations are investigated, please join our Facebook page at http://ow.ly/20wTY or sign up for our Twitter feed at http://twitter.com/aiclegal.

  23. This is Dr. Poppas. I think none of you appreciate the enormity of having to suffer oversized, freakish genitals. (Except males of the African American community.) Left untreated, these girls would have been condemned to an abnormal sex life in which they would have been unable to achieve intercourse without resorting to unladylike pelvic thrusts and even bodily spasms. In any case, I want you all to know that the girls felt no pain. I was very gentle, kissing their nipples etc.

  24. @269 While I don’t agree with male circumcision, it does not mutilate a penis. Men are still able to have proper sexual function- they can orgasm and do so without pain- as well as the ability to urinate without pain, all without the horrible psychological damage associated.

    Also, forgive me, but I give a crap about Africa and what happens to women there just as much as I care about what happens “next door” to me. Especially since there it is not being done under the guise of a study, where they at very least have anaesthetic and a clean environment, but instead in the home, generally with whatever sharp object is nearby. So excuse me for being angry when these two are compared because I do think this is a tad bit more serious, and I am sick and tired of something so traumatic being equated to a practice that millions of men go through with no major regrets. So while I too disagree with male circumcision, maybe we can deal with the more physically and mentally scarring and just generally more heinous matter at hand first.

  25. @269 A side note: maybe it deserves mention here, but it has completely dominated the conversation. And you know what I would love to talk about on this blog entry? FGM. It seems like the place to do it, unless I could find a good male circumcision post to derail into FGM, that might be appropriate.

  26. I’m still upset about not having a foreskin and not sure who to sue or blame for that. The human species is in general screwed up about sex and the naughty parts that are so engorged and tingling at certain times and with certain people. I don’t see any culture that has any non-twisted sexual ideas, maybe say the Hawaiian Islands before the arrival of the white man. Or maybe animals who aren’t cursed with as devious an intelliegence as the human being. Go ask someone at the UW School of Experimental Psychology what their current project is, one mother I heard on the UWTV channel was happy with their “experimental infant stimulation” and said her child was “flourishing” as a result. But the reason that all that academic and medical jargon and terminology exists is so you can’t say “baby rape.” I still have people I know that I have to convince that intimate relations among close genetic matches are less savory than their religious tradition (of silence and secrecy) would suggest. Ultimately I’m not too disappointed in that everything still works but my life and surroundings have so damaged my sense of trust in people that getting an actual relationship going would be laden with enough baggage to weigh down her as well as me as well as anyone who would be so burdened as to have to hear about it. So here’s a big “thumbs up” to YouPorn for filling in that missing piece of my artificial life.

  27. Not having read every comment, I may have missed this in another’s post, but to me it smacks of control over and hatred of females. This prick is in the perfect position to convince parents that he is doing this for their childs welfare, all the while gleefully and patiently waiting for his next victim. I would love to know what his history and family life are like. My guess is that there are closets bursting with skeletons. What if he actually did very little to the kids during surgery and this was his method of having a life long supply of victims that will come to him, every year?

  28. Another spectacular example of the depravity humanity is capable of. I weep for the girls that have been permanently damaged.

  29. For all this talk of “derailing”, nobody is defending these experiments, just pointing out an operation that is much more common (1.2 million annually, compared with 51 in 2007) but not dissimilar – and not nearly as “nerve-sparing”. The paper itself says “In 2002, a consensus statement recommended that it is crucial to preserve the neurovascular bundle, the glans and the preputial skin of the glans if clitoral reduction is to be performed.”

    Since the children have all been diagnosed with “clitoromegaly” a “disorder” on the “intersex” spectrum associated with “ambiguous genitalia”, it’s debatable whether these operations are not, in fact, penis reductions. These “girls” may grow up to identify as men and complain bitterly that that is just what they were subjected to.

  30. “They appear to try to be addressing this condition: http://en.wikipedia.org/wiki/Congenital_…

    If you read the abstract to the work done in 2007: http://www.jurology.com/article/S0022-53…

    The sensitivity is to check if the sexual development of the patients is normal.

    For those who are upset by this, what do you think the motive of the doctor’s is in doing this research?

    I think in biology you can almost always find someone who thinks it is immoral.”

  31. Hate to add my $0.02 worth but you know they’ve been mutilating little boys for many many years and in some cultures centuries, just because the parents don’t want to take the time to teach the kid how to skin it back and keep it clean. No one seems to mind that though. Matter of fact it’s thought gross if they don’t have their male child circumsized. Have you ever watched while they strap a male infant that’s only a few days old to a restraining board and cut off his foreskin? I can tell you they don’t much care for it. I know,,, it’s just excess skin,,, and he’s just a boy. So it’s no big deal,,, RIGHT?

  33. “@269 A side note: maybe it deserves mention here, but it has completely dominated the conversation. And you know what I would love to talk about on this blog entry? FGM. It seems like the place to do it, unless I could find a good male circumcision post to derail into FGM, that might be appropriate.”

    And you know what -I- would love to talk about on this blog entry? GM. It seems it’s pissing people off that we are exposing the double-standard that exists in this country.

    FGM is happening in this country, and people are outraged. But here’s the thing; this is what SHOULD be happening. If the blatant human rights violation weren’t that obvious and people didn’t care, THEN it would be a problem.

    It is kind of hypocritical that people are outraged about what’s happening to perfectly healthy girls, but no one seems to think it’s a problem that boys are mutilated daily in this country, people can’t seem to produce enough “studies” that legitimizes mutilation, and this is not a problem.

    The principle violated in the girls in these experiments is the exact same principle violated in boys 3,000 times a day in this country. The only thing that differs is the sex. That cutting up the genitals of one sex is “normal,” but “mutilation” in the other is a double-standard.

    Unless you’re willing to talk about the boys, then shut the heck up about the girls.

    It’s none of your business what parents want to have done to their children.

    Does that sound familiar to you?

  34. @ohflattery

    “forgive me, but I give a crap about Africa and what happens to women there just as much as I care about what happens “next door” to me. Especially since there it is not being done under the guise of a study, where they at very least have anaesthetic and a clean environment, but instead in the home, generally with whatever sharp object is nearby. So excuse me for being angry when these two are compared because I do think this is a tad bit more serious, and I am sick and tired of something so traumatic being equated to a practice that millions of men go through with no major regrets. So while I too disagree with male circumcision, maybe we can deal with the more physically and mentally scarring and just generally more heinous matter at hand first.”

    This post is kind of hard to understand. I’ll try to address it as best I can…

    If what happens to women in Africa pisses people off, shouldn’t it be pissing people off MORE that this is actually being allowed in one’s own country?

    When something is a violation of basic human rights, does it really matter that it is done at a hospital, in a sterile environment, by a trained professional, with clean tools, with anaesthesia?

    “I am sick and tired of something so traumatic being equated to a practice that millions of men go through with no major regrets. So while I too disagree with male circumcision, maybe we can deal with the more physically and mentally scarring and just generally more heinous matter at hand first.”

    I am sick and tired of people trying to convince me that an action is “different” when it is performed at a hospital than it is in the bush. Or when it is performed on a girl, than it is performed on a boy. Or when it is performed with anaesthetic, than it is performed without. Or when the subject is a baby instead of a teenager being held down.

    When an action is a violation of basic human rights, does it really matter where it is done? Who it’s done by? That it is done with pain killers? That it is done with clean utensils? That it is done to a child when s/he will be too young to remember? That it is done under the guise of a “study?”

    Maybe a rapist can get away with having his way with a girl in a coma because “she won’t remember.” Maybe he can get away with it if he were a doctor in a white lab coat, and calling it a “study.” “We’re trying to see if having sex with a person in a coma will affect her.” Uh… yeah.

    There is always some “excuse” as to why they’re not comparable, is there.

    The action is the same.

    You cannot condemn an action in one instance, but then condone it when it happens in your home country.

    Boys have been circumcised in this country for a century under the guise of “medicine.” There is a long list of “studies” that attempt to legitimize taking a healthy, non-consenting individual and cut off a piece of his penis which people try to argue tooth and nail that is “useless” and “extra.” (Just like the length of the clitorises in this “study.”)

    “Studies” attempting to legitimize infant genital mutilation have been written for YEARS.

    Now we have ONE “study,” trying to legitimize taking a healthy girl to cut off the “extra” part of her body, and we have this “outrage.” Absolute double-think. This commentary is the perfect place to bring it up. Unless you can talk about the mutilation that happens 3,000 times to BOYS in this country, then there is nothing to talk about. A doctor mutilates girls and calls it “medical science.” People get outraged. But guess what; they’re SUPPOSED to. That’s not nothing new. There’s no new dialogue or discourse going on.

    That taking a girl and cutting out part of her genitals is mutilation is acknowledged and agreed upon. You don’t need to convince anyone on here of that.

    The question that needs to be asked is, why don’t we feel the same disdain when the same thing happens to boys?

    It’s done by a doctor; it’s done at a hospital; it’s done with clean tools; it’s done with anaesthesia; it’s done by parents that want it; it’s done to “fix” what parents and doctors have agreed “isn’t normal.”

    So how is this “different” and “not comparable” with male circumcision, where it is done at a hospital, with clean tools, when “he can’t remember,” with parental consent, to “fix” the foreskin?

    By the way, what’s WRONG with a body part that every male human child is born with that it needs to be “fixed?”

  35. I think most of what I wanted to say has been said. But in closing, this “study” is a complete outrage. It is absolutely DISGUSTING what this quack is trying to pass off as “medical science.” It is absolutely outrageous that what is supposed to be an institution of higher education has actually funded and accomodated it.

    Usually, science tries to find a solution to a problem. To present a “solution” first and then to try to support it by searching for uses for it is backwards. Trying to find a surgical “solution” for girls who aside from “unusually large” clitorises are perfectly healthy is sickening and disgusting.

    The person who should be consenting to these “procedures” should be the girls themselves IF AND WHEN they believe their condition to be a “problem.”

    The notion that just because an individual is born with ambiguous genitalia a doctor is entitled to a science experiment is ethically repugnant. In the past, boys with micropenis were re-assigned as girls. Some grew to like it, but I’ve read of quite a few accounts where boys, no matter how hard doctors tried, could not be reasigned as girls.

    These “experiments” and “studies” violate the basic human rights of healthy, non-consenting individuals, and they should stop.

    But, as a side note, just as “studies” that try to legitimize female genital mutilation cause outrage, the same should go for “studies” that try to legitimize male genital mutilation. This is but a one FGM “study,” there is a long list for male circumcision. WHY is it acceptable to try and scientifically legitimize the needless genital mutilation of healthy male babies, but even a single FGM “study” incites outrage?

    The AAP looks the other way for baby boys. Just last month, it tried to ratify a “ritual nick” in girls, for the same reason we allow male circumcision in boys; “because it’s culture; we need to be more culturally sensitive.” Well, the world told the AAP that we will not allow as much as “a nick” to happen at hospitals in the name of “culture,” etc. It is a double-standard that “not a nick” should be allowed in girls for ANY reason whatsoever, but with male circumcision, suddenly “culture and tradition” is important.

    Just like this “study” enrages us, so too should we be enraged when some “doctor” says he’s found some “new and innovative” use for circumcising healthy baby boys.

    The bottom line is the same; when it comes to a person’s genitals, it should be HIS/HER body, HIS/HER choice.

    The this issue is much more related to male infant circumcision than people care to realize.

    If we can’t talk about needless genital alteration of healthy individuals of either sex, then this commentary is pretty much worthless.

    FGM is horrible. DUH! Now let’s talk about the MGM that happens daily in our country.

    “No but…”

    No but you’re no better than people in Africa then. Quit trying to pretend you’re just so much “civilized.”

  36. This is hideous, yes, but I still can’t get over the phrase “surgically feminized clitoris”…

    Opposed as they are to the techniques of this doctor, even Alice Dreger and Ellen Feder seem to implicitly buy in to the idea that men and women do and should conform to socially approved appearance standards, and that those standards are appropriately applied to genital size.

    “surgically feminized clitoris”
    It’s a clitoris – you can’t get much more feminine than that.

  37. A few points. I’m Intersexed, and so is my son. Both of us have had genital reconstruction. In his case, as an infant, to ensure urinary continence and relieve increasing pain. My case was more radical, but performed with informed consent as an adult.

    1. Genital mutilation of Intersexed infants happens routinely. When sex reassignment is performed so the operation is easiest, one in three end up effectively transsexual, where their assigned sex differs from their sex identity. Where extreme care is taken to guess as accurately as possible what the gender identity is likely to be, this shrinks to 10% – still a completely unacceptable figure.

    The most common operation though is clitoral reduction for cosmetic purposes.

    2. The “vibrator” in the exam here is not a sex toy. Here, I’ll quote from the paper:
    “Patients older than 5 years were considered candidates for CST. CST was performed using a cotton tip applicator.
    Using a scale of 0—no sensation to 5—maximum sensation, the patient was asked to report the degree of sensation at various points of the inner thigh and genitalia (labia majora,
    labia minora, vaginal introitus and clitoris). Inner thigh stimulation was set at level 3 for each patient and used as a baseline to compare other areas tested. In addition, these
    patients also had vibratory sensory testing performed using a biothesiometer designed to quantify the ability of patients to detect vibratory stimuli. A biothesiometer is most commonly
    used in testing for neurological diseases, such as peripheral neuropathy.6 The device generates a vibratory stimulus of varying amplitudes that can be gradually increased
    until the sensation is perceived by patients. A quantitative measure was established by recording the amplitude of vibration (on a scale from 1 to 10), which correlated with
    the threshold. The amplitude of vibration was inversely proportional to vibratory sensing ability.”

    Now I have EXTREME misgivings about subjecting 5 year olds to such tests. A 14 year old able to understand the usefulness of the test to improve treatment, and able to consent – or NOT consent – that is a different matter.

    3. Genital Mutilation is not a necessary part of treatment for CAH. 46,XX people with CAH usually have a female gender identity, but 10% identify as males. For them, such surgery would be catastrophic in every sense of the word.

    From the paper:
    ” Of these patients 46 (90%) were genetic females with congenital adrenal hyperplasia, 3 (6%) were 46 XY who had undergone sex reassignment surgeries and 2 (4%) were 46 XX disorder of sexual development.”

    Note that 3 of the babies were born with penises judged too small to be acceptable, so these were reduced using the same techniques, and female external genitalia fashioned. With castration as needed.

    I find that… difficult to write. It makes my blood boil. knowing that such surgeries happen routinely is very difficult to deal with. We – IS advocates such as OII – have been trying to get this stopped. This publicity will help there.

    We advise only such surgery as is medically necessary when young. For example, for fecal or urinary continence, or to reduce discomfort. Long-term cancer risks are not to be used as an excuse for butchery. In all cases, surgery should not compromise fertility nor sensation.

    When the patient is old enough to give informed consent – that will depend on individual cases, but is usually between 12-15, then more radical or cosmetic surgical options should be made available to them.

    I cannot agree that this doctor is a “child molester” in the usual sense of the term. I think his experimentation, for the highest motives, violates ethical boundaries. It’s an attitude suitable for work on an experimental animal, but not on a human being. A mistake, a gross mistake, but one of judgement rather than morals.

    A far bigger issue is the medically accepted practice of mutilating intersexed kids in the first place. He’s just trying to minimise the damage from that, and should be commended for it. But censured for having any part of this barbarity in the first place, even though it is “accepted practice”. So much so that such surgeries have been performed against the parents directly expressed wishes, without it being deemed malpractice by the courts.

  38. First of all, medical research at Cornell is more likely to be at Cornell-Weill Medical Center in New York City – not in Ithaca. Second, most, if not all, medical research is funded by a US Fedral Government grant, either NSF or NIH, and I am sure this was as well. Third, Cornell Medical is technically merged with Columbia, so they get some of the blame as well. Fourth, all of this should be documented somewhere on the articles purblished that report the “findings”. Fifth, last time I looked, what is reported here as this man’s doing is AGAINST THE LAW, and shoudl be reported ASAP. Just find out where this is taking place, and call the police. I am going to look up the article, print it out, and send it anywhere I think it will do some good, the NYC DA, the State Attorney General, the New York Times and Wall Street Journal. Oh, and the Medical Board of Ethics, although a more impotent bunch of people you will never see elsewhere (and yes, I chose the word deliberately).

    I’m a doctoral candidate in social work, and I have gone through hell getting MY research approved, and all I want to do is ask people questions on a written survey! How this gets through IRB is beyond me. And honestly? I don’t care what any doctor or pediatric society or anyone who thinks they know anything says, cutting into the glans of a clitoris is NOT like cutting the forskin off from around a penis, it’s like cutting off a piece of the HEAD of a penis.

    And what lunatic decided the size of a clitoris has anything to do with anything? And so much so that it requires surgery to rectify? This guy is Mengele. There is NO justification for anything that he is doing. He needs to be stopped.

  39. I’m absolutely opposed to these unnecessary surgeries (with a *possible* exception if a child requests it, which is very unlikely), but I don’t understand the furor over testing to see whether the surgery was successful. How else is a surgeon ever to know whether a surgery was successful other than by testing? I don’t buy the unfounded assertion that the application of a vibrator will harm anyone, but I *can* see how some children would find the experience in front of witnesses unduly embarrassing.

  40. Forget the vibrators for minute. Forget the fact that this clearly didn’t pass any ethics board worthy of the title.

    We’re looking at criminal non-therapeutic amputations of the exact sort congress meant to prohibit in 1996. It has been illegal since the law took effect in 1997.

    Why are these monsters walking the streets?

  41. I’m still against this type of surgery in almost all cases, but since some posters have claimed that these large clitorises may only be *proportionally* large and a girl may grow into them, I’ll just point out that at the lower range (1 cm, about 3/8 inch) this is correct, but at the larger end of the range (4.5 cm, over 1-3/4 inches) this would be large even for an adult.

  42. I don’t have a problem if someone wanted to be mutilated like this… but I think that’s very unlikely. If someone asked to mutilate your genitals, would you be willing to? Most likely not, so why is genital mutilation – of either gender – ever legal to do to young children against their will? It is a sick tradition that needs to be outlawed, except in the rare cases where it’s necessary to save someone’s life. No one should get to hide behind their religion to mutilate their children against their will.

  43. The article you quote, and most of the comments, somewhat dance around the glaring fact that this man is a pedophile who is sexually abusing these children. People with adult orientated sexuality don’t place vibrators on the sexual organs of six year olds.

  45. @289 I understand the argument that he was doing a study and he needed to perform a follow-up to determine the results of his study, but divorce yourself from medical objectivity for a minute and consider that this is an adult stimulating the genitalia of children – children who aren’t old enough to even consent to the surgery that they’ve undergone, let alone old enough to understand why it’s okay for the doctor to play with their clits, but not other trusted adults. Also consider the fact that the follow-up is only useful as pertains to his study. If he fucked up and they have no sensation left in their clits, it’s not like he can go back and fix it. The follow-up procedure only satisfies his own curiosity. Also, consider that there was no control group – meaning, no children with clitoromegaly or CAH who had not undergone the surgery – that he performed the genital stimulation on to compare sensitivity to the children who had. That’s because for the post-operative children it’s “follow-up,” but for kids who haven’t been operated on, it’s much closer to “molestation.” So everyone who argues that this is science and it was just follow-up, which is what you need to logically do if you’re performing an experiment, needs to keep in mind that he didn’t even complete the research that would be needed to “legitimize” his experimental procedure.

    We live in a society where the stigma of child rape is so great that pedophiles in prison get shanked before murderers do. Everyone on this thread who jumps on the molestation bandwagon believes that there is never an acceptable reason for an adult to be fucking with a kid’s genitals, and that includes doctors. The welfare of children is more important than experimental medical science. Medical objectivity isn’t really objective, it’s just a way of saying that the field of medicine is more important than the patients.

    And by the way, being made to show your genitals to your doctor when you’re six years old and then being told that you have to let him touch your private bits is probably embarrassing whether there are witnesses in the room or not. I would think that parents would probably want to stay in the room for that part of the procedure.

  46. “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.”

    There is no evidence to back this up, researchers at one thought so. But this was based on biased assumptions of sexist doctors of the time. Why are you repeating this pseudo-scientific information? This is an intersex issue, not a gay issue.

    Please offer credible evidence this true or pontificate about something you know about.

  48. Dear God what can you say about these people. Dr. Mengeles (of Nazi Concentration fame) is alive and well and living among us.

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