In the 1980s a growing number of activists in countries where these rites are popular tried to stop these practices or at least substitute less mutilating rites (nicking the labia or the foreskin around the clitoris) for the more mutilating forms, which were and in some cases still are practiced widely, especially in Africa, and some Middle Eastern countries. Those rites include Type 1 (removal of the prepuce with or without removal of all or some of the clitoris), Type 2 (removal of the entire clitoris and all or most of the labia minora), and Type 3, or pharaonic circumcision (removal of all of the clitoris and labia minora and parts of the labia majora) as well as the practice of infibulation (the wound to the vulva from the cutting is stitched closely, leaving a tiny opening so that the woman can pass urine and menstrual flow). Also included among those rites are scraping or cutting tissue at the vaginal opening or the vagina and placing corrosive substances into the vagina to induce bleeding or narrow or tighten it (WHO, 2000).
Prominent African activists, including Olayinka Koso-Thomas (author of the main entry above), Nahid Toubia, and Raquiya Abdalla, have long advocated stopping all forms of genital mutilation and cutting while retaining the cultural and religious rituals that educate and welcome girls into adulthood and the community. They favor "circumcision through words" and family-planning education that includes telling young males about the health hazards to women and asking them to make a vow not to require circumcision as a condition of marriage. Those changes might accommodate important religious, cultural, economic, community, and family considerations without harming girls.
Others argue that a more effective approach to zero tolerance would be to replace the mutilating rituals with removal of the foreskin around the clitoris or tiny nicks in the labia (Davis; El Dareer). This, they argue, might "wean" people away from the more extreme forms of genital mutilation. If there are no complications, the tiny nicks do not preclude sexual orgasm later in life. The chance of success with this tactic is more promising and realistic, they hold, than would be the case with an outright ban; people could maintain many of their traditions and rituals of welcome without causing as much harm, especially if the operations were done by doctors and nurses under sterile conditions. However, Nahid Toubia objects, stating that removal of the clitoral hood invariably causes considerable, even if unintended, harm to the clitoris because tissue from the clitoris is very likely to be taken.
Dena Davis expresses the concern that something other than zero tolerance could send the wrong message to immigrants:
Because FGA [female genital alteration] in its most common forms around the world is mutilating and life threatening, it is reasonable to adopt a "zero tolerance" policy to make it absolutely clear to immigrants that this practice is never acceptable ...
further, an argument could be made that, once a "nick" is allowed, it would be difficult if not impossible for the state to make sure this did not become a loophole through which the worst elements of FGA would slide. As MGA [male genital alteration] is not anywhere close to as mutilating and threatening to life and health as are many forms of FGA, this argument would serve as a constitutionally valid distinction between the two practices. (p. 561)
In the end, however, Davis tries to justify a compromise for the sake of cultural sensitivity, legal consistency, and medical safety, arguing that procedures might be permitted that allow roughly the same harm done to girls as is done to boys in male circumcision: a minor nick in a girl's labia or clitoral hood.
Raquiya Abdalla, however, objects to equating female circumcision with male circumcision because their purposes differ and the degree of harm frequently is drastically different. For some people the best reason for drawing parallels between male and female genital cutting is to help abolish both practices. Even if the timetables do not coincide exactly, they hold, comparisons should not be used to allow some female circumcision in countries that permit male circumcision. Still others maintain that there are health benefits to male circumcision that justify distinguishing the two. Most agree, however, that it is unfortunate that the same word, circumcision, is used for the full range of practices, from trivial to mutilating. Removal of the clitoris is comparable to amputation of the penis rather than removal of the foreskin in men.
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