The proposal of a "harmless and symbolic" alternative to female genital mutilation, to be practised on African women at a public hospital in Florence, has sparked strong reactions in Italy.
The alternative "ritual," consisting of a puncture of the clitoris under local anaesthesia that would let a few drops of blood out, has been proposed by Omar Abdulcadir, a Somali gynaecologist who graduated in Florence about 25 years ago and now heads the centre for the prevention and therapy of female genital mutilations at the Careggi Hospital, Florence.
"We strongly oppose female genital mutilation, and we hope the practice will disappear all over the world," said Dr Abdulcadir. "Unfortunately, we deal every day with women, especially from the Horn of Africa, who are so attached to their customs that they plan to bring their young daughters to Africa to perform the infibulation, which is one of the worst forms of mutilation."
"Based on the questionnaires administered in a study we are conducting on the sexuality of 137 mutilated women living in Italy and in the United States, we came to the conclusion that any substitute method should still involve blood and the female genitals in order to be acceptable" continued Dr Abdulcadir.
"We consulted with the women attending our meetings and with the leaders of 10 local communities of immigrants from Africa, who have a strong influence, and they agreed this could be a last resort option for the women who didn't accept to abandon the practice. Of course, we cannot be sure this symbolic alternative will satisfy everyone, in Italy and in Africa."
Dr Abdulcadir has obtained the support of the leaders of 10 local communities of immigrants from Africa, and was surprised of the political and media storm ignited by his proposal. Opposition was first raised by Aidos, a non-governmental organisation based in Rome, working with women in the developing world.
"Safeguarding the symbolic value of a ritual whose scope is the control of female sexuality by males would mean legitimising the cultural belief system behind it, making it more difficult to eradicate female genital mutilation," objected Cristiana Scoppa, director of communication for Aidos.
"In particular, we oppose this ritual requiring the manipulation of the genital area, both because it compromises the integrity of the body and because it would be completely useless, since the puncture would of course leave no visible sign. Once brought to Africa, the girl would risk being mutilated as if no ritual had ever taken place."
Many gynaecologists have spoken out against the proposal too: "I think we must refuse all forms of mutilation, even the tiniest ones, while continuing to inform women and doctors about this delicate issue," affirmed Gianfranco Gori, a gynaecologist working in the Pierantoni Hospital in Forlì, in the Emilia Romagna region. He surveyed about 2000 doctors and midwives in the region in 2002. (See www.saperidoc.it/doc_120.html)
According to the 438 questionnaires received, around 60% of the health professionals had seen at least one mutilated woman during their career (40% had been infibulated and 60% had a less serious mutilation). Carrying out female genital mutilation carries a penalty of up to 12 years in jail under Italian penal code.
Dr Abdulcadir's proposal is being evaluated by the regional bioethics committee of Tuscany, which should give a decision in March. The president of the National Bioethics committee, Francesco D'Agostino, has already said he is against its approval.