Female genital mutilation a practice America must do more to condemn

Female genital mutilation a practice America must do more to condemn
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As an obstetrician treating a patient, there is a moment I experience in the exam room a few times a week that hangs thick in the air. I see a woman's body stiffen, her spirit crumpled; she has been violated in the most horrific of ways, the intimate parts that make her a woman knifed off in a barbaric ritual that is common across West Africa.  
 
As an OB/GYN doctor practicing in a suburb of Washington, D.C., I see women every day in my office that have some form of this practice known as female genital mutilation (FGM). Alarmingly, the number of U.S. women and girls who have undergone or are at risk of undergoing this horrific practice has more than tripled over the last two decades due to the rapid growth of immigrants from countries where the risk of FGM is greatest. My personal experience as a physician administering to patients in Prince George's County, Maryland, confirms a 2013 Population Reference Bureau census finding that there are approximately 500,000 women and girls in the United States that have undergone or are at risk of the procedure.
 
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This brutal procedure is seen as a rite of passage in many West African communities, where it's often performed on young girls between the ages of 4 and 10. These cultures believe the practice promotes purity and increases the chance of marriage. I have many West African patients, including from Sierra Leone, a country where the rate of FGM is 94 percent, and 88 percent of the population believes the practice should continue.
 
 
It goes without saying that a procedure which cuts off a woman's external genitalia and sometimes also her clitoris subjects her to extreme pain. Variations of the procedure run the gamut from pricking the clitoris to removing it completely and sewing up the skin around the vagina. 
 
FGM can lead to complications like infections, sepsis, urinary retention, chronic urinary infections, localized infection and abscess formation, pelvic infection, tetanus and human immunodeficiency virus (HIV) infection. That's not to mention the psychological damage.
 
More than 200 million women and girls alive today in at least 30 countries have been subjected to FGM, according to UNICEF. As CNN reported, that's equal to "the entire populations of France, Germany and Italy, combined." About 44 million of the survivors are younger than 15. Over three million girls are estimated to be at risk each year, according to the World Health Organization. 
 
It is impossible to describe the barbarity of what these women have experienced. I see them in my office because they are pregnant, yet a cultural decision to ravage their bodies before they were old enough to even comprehend what was happening to them has robbed them of the ability to experience the pleasure of sexual activity.  These women cannot experience the most basic of human pleasures, a simple part of the human experience God granted equally to the rich and poor alike.  
 
Imagine what it does to a society when half its population — the women — have been brutalized in this fashion. And while it is nothing like the horror inflicted on the women, imagine too what happens in a society when men's experience with sex is a woman cringing in pain.
 
What is a doctor to do when caring for a patient like this? How do we treat them; how do we counsel them; how do we talk to them?
 
This isn't a problem that's only going on in some remote part of the world; there are women and girls experiencing this right here in America. On at least three occasions, parents have hinted to me that they wanted me to perform FGM or recommend someone else who would. 
 
The U.S. Department of Justice brought the first known criminal case against two Michigan doctors accused of cutting at least six girls in the suburbs of Detroit. The most serious charge against Drs. Nagarwala and Attar, carrying a life sentence, was dropped in January 2018. There are eight charged in the case: the other defendants are the girls' mothers, accused of subjecting their daughters to FGM, and Attar’s wife, charged with holding the girls’ hands during the procedures and lying to investigators," reports the Detroit Free Press. 
 
My experience working with these traumatized women has seared into my soul the certain knowledge that this horrific practice must be condemned and consigned to the ash heap of history, and that we must do everything we can to treat the women mutilated by FGM with the utmost respect and care.

Dr. Saul Weinreb, M.D. is an obstetrician-gynecologist affiliated with the Pregnancy Aid Center in College Park, Md. and Holy Cross Hospital in Silver Spring, Md. He served in Iraq as a physician in the Army Reserves and received his medical degree from University of Illinois College of Medicine.