Online Program

Female genital alteration: A novel clinical categorization system

Tuesday, November 3, 2015

Kavita Arora, MD, MBE, Department of Ob/Gyn, MetroHealth Medical Center and Case Western Reserve University School of Medicine, Cleveland, OH
Allan Jacobs, MD, JD, Stony Brook University School of Medicine, Stony Brook, NY
Despite 30 years of advocacy, the prevalence of non-therapeutic female genital alteration in minors is stable in many countries. Educational efforts have minimally changed the prevalence of this procedure in regions where it has been widely practiced.  In order to better protect female children from the serious and long-term harms of some types of non-therapeutic female genital alteration, we must adopt a more nuanced position that acknowledges a wide spectrum of procedures that alter female genitalia.  While “female genital mutilation” is the term currently used most widely by international health and policy organizations, the current categorization inappropriately conflates all procedures that alter female external genitalia, while not accounting for their disparate risk profiles and entirely misses other commonly performed procedures.  We offer a revised categorization system for non-therapeutic female genital alteration that groups procedures by effect and not by process in order to allow for a more informed and clear discussion of these procedures. Since it is the health consequences of these procedures that are the most worrisome to international health groups, it is logical to group the procedures based on these effects, rather than groups of procedures with a wide range of resultant consequences within each group.  This new categorization system will aid in clarifying academic discussion and policy efforts aimed at minimizing the harmful effects of some types of female genital alteration.

Learning Areas:

Diversity and culture
Ethics, professional and legal requirements
Public health or related public policy

Learning Objectives:
Describe the current WHO classification system for female genital alteration/mutiliation Discuss a novel categorization system that reclassifies female genital alteration procedures based on effect rather than procedure Demonstrate superiority of the novel categorization system in terms of clarity for research and advocacy thus aiding in efforts of minimizing the harmful effects of some types of female genital alteration

Keyword(s): Women's Health, Cultural Competency

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a practicing obstetrician-gynecologist and a bioethicist with a strong background in policy who focuses on the intersection of culture, religion, women's rights, and public policy.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.