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FORUM
Cultures Cross over Circumcising Girl By Ellen Rothman "Will you circumcise my baby for me?" Marie asked. I have heard this question over and over again in my two years of working in pediatrics. It is a standard one for parents of baby boys, and I am fluent with the possible risks and potential benefits. It's a question I know well. But this mother was the parent of a baby girl. It was only the beginning of a busy afternoon at my primary care clinic that serves a large immigrant population, and Marie was one of my favorite though most challenging parents. I had met her and her older son Kofi nearly a year earlier. She had emigrated from Nigeria, and after a year in New York, moved to Boston. She showed up at my clinic with a chubby, circumcised three-month-old son. Except for when he was born, he had never been seen by a doctor. Marie didn't even know what a vaccine was. Marie was one of the most desperate parents I have met since working in this clinic. I sent visiting nurses out to her home to assess its safety and found that she was living in a corner of her brother's living room without even a blanket, let alone a bed. But over the course of the year, our social worker helped her apply for welfare, and with her brother's support, she moved into her own apartment. She and Kofi came in for regular appointments. We got to know each other quite well. Culture ClashI knew that Kofi's father didn't live in Boston, but his mother had hoped that they would again become a couple. I was surprised one visit to find Marie visibly pregnant.Just as I was getting ready to send them home, Marie looked at me, absently rubbing her belly. "Ellen, if my new baby is a girl, will you circumcise her for me?" I was taken aback by the question. Of course, I wouldn't circumcise her baby girl. But how could I explain why I wouldn't in a way that she could accept? Not only did I have to address the medical risks and emotional injury that can result from female circumcision, I also had to help her understand why in America her baby boy can be circumcised but her baby girl cannot. I fumbled to explain my concerns. "But it's very important to me," Marie said. "I'm circumcised. My mother is circumcised, and all my sisters are circumcised. I want my baby to look like me. And the circumcision makes women not like sex too much." "Marie, that's exactly the reason that people in America don't like to circumcise girls. We think they should have the right to enjoy sex," I said. I asked Marie if we could continue the conversation at our next visit. The following week, Marie said she didn't want me to circumcise her baby anymore. "I've been talking to my friends. They say you can't have a girl circumcised in America. They say I will go to jail." But, Marie said, if she went back to Nigeria, she would take her baby girl and have it done there. Tangled EthicsI wondered whether I would be obligated to take legal action if she chose to take the baby to Nigeria for circumcision. Would this constitute child abuse? What was the most culturally sensitive way to protect this infant from a mother who held her baby's best interests at heart?Marie and Kofi missed their next appointment. But his new baby sister appeared on my clinic schedule a few weeks later. "Marie," I asked her, "have you thought anymore about the circumcision issue?" "I don't want to do it anymore," she said. "Not even in Nigeria?" I asked. "No," she assured me. "Why not?" I asked. "Because I will go to jail. My friends told me that even if they find out the baby was circumcised in Nigeria, I will go to jail." As her children's pediatrician, I was in a position to teach Marie to see her culture's ideas about female circumcision from an American feminist perspective. I wanted to treat her values compassionately but also in an ethically responsible way. The pediatricians before me had certainly gotten the point across to her community—we would put them in jail for circumcising a girl. Yet Marie and I had missed the opportunity to understand each other's views on a procedure that I found troubling and she found central to her beliefs about womanhood. Ellen Rothman, HMS '98, is completing her second year of residency in pediatrics at Children's Hospital in Boston. Patient names in this column are pseudonyms. |
