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The medicalization of female "circumcision": harm reduction or promotion of a dangerous practice?

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  • Shell-Duncan, Bettina

Abstract

In recent decades the practice of female "circumcision" has come under intense international scrutiny, often conceptualized as a violation of women's basic right to health. Although the adverse health consequences of female "circumcision" form the basis of opposition to the practice, anti-circumcision activists, as well as many international medical associations, largely oppose measures to improve its safety. The debate over medicalization of female "circumcision" has, up until now, been cast as a moral dilemma: to protect women's health at the expense of legitimating a destructive practice? Or to hasten the elimination of a dangerous practice while allowing women to die from preventable conditions? This paper seeks to re-examine this debate by conceptualizing medicalization of female "circumcision" as a harm-reduction strategy. Harm reduction is a new paradigm in the field of public health that aims to minimize the health hazards associated with risky behaviors, such as intravenous drug use and high-risk sexual behavior, by encouraging safer alternatives, including, but not limited to abstinence. Harm reduction considers a wide range of alternatives, and promotes the alternative that is culturally acceptable and bears the least amount of harm. This paper evaluates the applicability of harm reduction principles to medical interventions for female "circumcision," and draws parallels to other harm reduction programs. In this light, arguments for opposing medicalization of female "circumcision", including the assertion that it counteracts efforts to eliminate the practice, are critically evaluated, revealing that there is not sufficient evidence to support staunch opposition to medicalization. Rather, it appears that medicalization, if implemented as a harm-reduction strategy, may be a sound and compassionate approach to improving women's health in settings where abandonment of the practice of "circumcision" is not immediately attainable.

Suggested Citation

  • Shell-Duncan, Bettina, 2001. "The medicalization of female "circumcision": harm reduction or promotion of a dangerous practice?," Social Science & Medicine, Elsevier, vol. 52(7), pages 1013-1028, April.
  • Handle: RePEc:eee:socmed:v:52:y:2001:i:7:p:1013-1028
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    Citations

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    Cited by:

    1. Nina, Van Eekert & Naomi, Biegel & Sylvie, Gadeyne & De Velde Sarah, Van, 2020. "An examination of the medicalization trend in female genital cutting in Egypt: How does it relate to a girl's risk of being cut?," Social Science & Medicine, Elsevier, vol. 258(C).
    2. Michela Villani & Judith Louise Griffin & Patrick Bodenmann, 2016. "In Their Own Words: The Health and Sexuality of Immigrant Women with Infibulation Living in Switzerland," Social Sciences, MDPI, vol. 5(4), pages 1-12, November.
    3. Engelsma, Brian & Mackie, Gerry & Merrell, Brandon, 2020. "Unprogrammed abandonment of female genital mutilation/cutting," World Development, Elsevier, vol. 129(C).
    4. Presler-Marshall, Elizabeth & Jones, Nicola & Endale, Kefyalew & Woldehanna, Tassew & Yadete, Workneh & Abdiselam, Abdilahi, 2024. "“People will talk about her if she is not circumcised”: Exploring the patterning, drivers and gender norms around female genital mutilation in Ethiopia's Somali region," Social Science & Medicine, Elsevier, vol. 345(C).
    5. Colfer, Carol J. Pierce & Achdiawan, Ramadhani & Roshetko, James M. & Mulyoutami, Elok & Yuliani, E. Linda & Mulyana, Agus & Moeliono, Moira & Adnan, Hasantoha & Erni,, 2015. "The Balance of Power in Household Decision-Making: Encouraging News on Gender in Southern Sulawesi," World Development, Elsevier, vol. 76(C), pages 147-164.
    6. Chesnokova Tatyana & Vaithianathan Rhema, 2010. "The Economics of Female Genital Cutting," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 10(1), pages 1-28, July.

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