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Female Genital Mutilation at Cornell University


Wednesday, June 16, 2010

Female Genital Mutilation at Cornell University

Posted by Dan Savage on Wed, Jun 16, 2010 at 7:15 PM

While the whole world was debating the American Academy of Pediatrics' position on "female genital cutting"—the AAP was against it before they were for it, and now, after an outcry, they're against it again—Alice Dreger and Ellen Feder have been raising the alarm about "medical research" currently being conducted at Cornell University. A pediatric urologist at Cornell—Dix Poppas—has been operating on little girls with what he judges to be oversized clitorises, cutting away important clitoral tissues, and then stitching the glans to what remains of the shaft. Poppas claims that, unlike past clitoral-reduction procedures, his procedure is "nerve sparing."

First big problem: "nerve-sparing" surgeries don't always work. And the chunks of these girls' clitorises that the doctor is cutting away—large pieces of their clitoral shafts—may be just as important as the clitoral glans. Dreger:

To shorten these clitorises, Poppas is saving the glans (tip) but cutting out parts of the shaft. Bo Laurent has pointed out that Masters and Johnsons showed that many women masturbate by rubbing the shafts of their clitorises. (Think about it: the clit is the homologue of the penis. How do men masturbate?) Many women seem to find their clitoral glans almost too sensitive. Poppas's patients are loosing the option of touching parts of their shafts, because he's throwing them out (after the cut-away parts have been sent to pathology to see if he accidentally took out a nerve).

There's lots to be outraged about here: there's nothing wrong with these girls and their healthy, functional-if-larger-than-average clitorises; there's no need to operate on these girls; and surgically altering a girl's clitoris because it's "too big" has been found to do lasting physical and psychological harm. But what's most outrageous is how Poppas is "proving" that his surgery "spares nerves." Dreger and Feder:

But we are not writing today to again bring attention to the surgeries themselves. Rather, we are writing to express our shock and concern over the follow-up examination techniques described in the 2007 article by Yang, Felsen, and Poppas. Indeed, when a colleague first alerted us to these follow-up exams—which involve Poppas stimulating the girls' clitorises with vibrators while the girls, aged six and older, are conscious—we were so stunned that we did not believe it until we looked up his publications ourselves.

Here more specifically is, apparently, what is happening: At annual visits after the surgery, while a parent watches, Poppas touches the daughter's surgically shortened clitoris with a cotton-tip applicator and/or with a "vibratory device," and the girl is asked to report to Poppas how strongly she feels him touching her clitoris. Using the vibrator, he also touches her on her inner thigh, her labia minora, and the introitus of her vagina, asking her to report, on a scale of 0 (no sensation) to 5 (maximum), how strongly she feels the touch.... Poppas has indicated in this article and elsewhere that ideally he seeks to conduct annual exams with these girls....

Although we have tried, we have been unable to locate any other pediatric urologist who uses these techniques. Indeed, we doubt many would, because we think most would—as we do—find this technique to be impossible to justify as being in these girls' best interests. We understand that these tests might produce generalized knowledge that shows whether Poppas's techniques are better than some other surgeons', but it isn't clear to us how this kind of genital touching post-operatively is in individual patients' best interests. If the testing shows a girl has lost sensation through the surgery, her lost clitoral tissue cannot be put back. However, the tests would seem to expose the girls to significant risk of psychological harm.

In the course of our inquiries, made in preparation for this publication, nearly all clinicians to whom we described Poppas's "clitoral sensory testing and vibratory sensory testing" practices thought them so outrageous that they told us we must have the facts wrong. When we showed them the 2007 article, their disbelief ceased, but they then seemed to become as agitated as we were. At an international conference two weeks ago, when Dreger told Ken Zucker, a psychologist at the Hospital for Sick Children in Toronto and member of the clinical establishment, about this, Zucker said that we could quote him as saying this: "Applying a vibrator to a six-year-old girl's surgically feminized clitoris is developmentally inappropriate." We couldn't find a clinician who disagreed with Zucker.

Yang, Felsen, and Poppas describe the girls "sensory tested" as being older than five. They are, therefore, old enough to remember being asked to lie back, be touched with the vibrator, and report on whether they can still feel sensation. They may also be able to remember their emotions and the physical sensations they experienced. Their parents' participation may also figure in these memories. We think therefore that most reasonable people will agree with Zucker that Poppas's techniques are "developmentally inappropriate."

The 2007 article documenting Poppas's research is here.

Now more from Dreger's post at Psychology Today:

So why the heck do Poppas and other surgeons do these surgeries? They believe it is necessary to ensure "normal" sexual development.... Many of us happen to think "normal" sexual development is actually likely to be thwarted by having parts of your genitals taken away without your consent, and thwarted by follow-up exams like the ones we are describing. Ellen and I have gotten to know hundreds of adults born with sex anomalies who went through these medical scenes growing up. Many have told us that the genital displays involved in the follow-up exams were more traumatic than any other part of the experience. Indeed, when I once asked a group of women with androgen insensitivity syndrome what they wanted me to work on primarily in my advocacy work, they said stopping the exams, particularly those in which med students, residents, and fellows parade through to check out the surgeon's handiwork.

There's so much to be angry about I hardly know where to start. Applying a vibrator a girl's clitoris after it's been surgically shortened may demonstrate that she still has "sensation" in what's been left behind—that she still has a few nerve endings that function—but that's not proof that she hasn't been physically or emotionally harmed by the surgery and those traumatic follow-up "procedures." These post-op visits with the doctor and his vibrator do the girls no good—what can the doctor do if a girl reports no sensation? reassemble her clit?—and retaining sensation isn't proof that these girls will grow up to be healthy, sexually functional adults. All of the tissues that make up the clitoris—the glans, the stem, the erectile tissues—are important to sexual response, orgasm, and fulfillment, not just the part of the clitoris that's "normally" exposed.

There's another disturbing reason this surgery is being performed: girls with large clitorises are more likely to identify as lesbians when they grow up. Needless to say (or maybe not-so-needless): carving up a girl's clitoris does nothing to change the underlying hormonal and genetic factors that contribute to lesbian orientation and identity. Big clits don't make lesbians—lesbians sometimes make big clits. These surgeries are partly motivated by out-and-out homophobia, by the belief that "fixing" a large clit somehow prevents lesbianism. (Larger penises correlate positively with gayness in males but no one is out there shortening boys' penises.)

Please go and read Dreger and Feder's piece—"Bad Vibrations"—at the Bioethics Forum. And read Dreger's post at her own blog.

And if you're reading this and you're a student at Cornell: female genital mutilation is being practiced on your campus. What are you going to do about it?

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Comments (211) RSS

Banna 1
Does he punch them in the face after the operations?
Posted by Banna on June 16, 2010 at 7:22 PM
Dix Poppas?
Posted by 311_TruthMovement on June 16, 2010 at 7:23 PM
How did that get past ethics?
Posted by KayElle on June 16, 2010 at 7:29 PM
Lurleen 4
One word: CONSENT. A child can't consent and therefore any adult, whether a parent or doctor, who mutilates a child's body is committing a crime. I include circumcision in the mutilation category. Whether the child is female or male, the term "mutilation" applies because the child can't possibly consent.

My uncle was circumcised on the kitchen table. I shudder to think of what parents do when of the mindset "we know better than nature".
Posted by Lurleen on June 16, 2010 at 7:30 PM
Pol Pot 5
This evil, good for nothing piece of child mutilating AND molesting piece of shit is allowed to live... why?
Posted by Pol Pot on June 16, 2010 at 7:35 PM
opera cat 6
And presumably we can operate on animals without their consent because . . . ?
Posted by opera cat on June 16, 2010 at 7:36 PM
...I don't think I've ever cried such much over an article before. Please tell me we can do SOMETHING to stop this from happening to these girls?
Posted by dakoneko on June 16, 2010 at 7:37 PM
What the MOTHER FUCK. And speaking of mothers, what kind of a sick bitch voluntarily does this to their child?

My clit is pretty big. But I didn't *know* it was bigger than average until I explored my bisexuality and saw someone else's clit, and having a bigger than average clit has not in any way negatively impacted my life or my sexuality. Contrary to what these doctors and parents seem to think, six year olds are NOT comparing clit size during kindergarten nap time. And who the hell is judging what's "normal" and what isn't? Christ on toast, this pisses me off.

I wish I went to Cornell so I could raise holy stinking hell about this. In the office of the president, in front of television cameras.
Posted by Hannah in Portland on June 16, 2010 at 7:39 PM
Puck Falin 9
Dude... excuse me while I pick up my jaw. This is crazy! The supposed benefit of this study couldn't possibly outweigh its sheer outrageousness.
Posted by Puck Falin on June 16, 2010 at 7:39 PM
Just what is he telling the parents of these girls to get them to consent to this bullshit surgery? Are they immigrants who might have a cultural background of sexual surgery on young girls? And a what age is he doing this?
Because if ever there was a reason to pull a doctors credentials, this is it.
Posted by BakerB on June 16, 2010 at 7:40 PM
balderdash 11
I think there needs to be some real scrutiny into whoever approved this unbelievable fuckhead's funding. He's clearly at least a little demented, but someone, as @3 observed, had to approve his proposal and give him the money for it.

The procedure - and the entire conceptual framework behind it - is appalling. The fact that it's bad science, that the follow-up "testing" is so utterly facile, just adds to the indignity.
Posted by balderdash on June 16, 2010 at 7:42 PM
What's the difference between a bar and a clitoris?

Most men have no trouble finding a bar.

Q: What do a clitoris, an anniversary and a toilet have in common? A : Men usually miss them.
Posted by Kevin Keegan on June 16, 2010 at 7:42 PM
Chaparringes 13
I feel disgusted. How is this legal? Don't these little girls have rights? What are the parents thinking? Mutilating your child is not going to make them normal, it's going to fuck them up even more. And the post operative touching of genitals...ugh. I feel it's even worse that the parents are in the room. These people are supposed to protect their children, not stand by as someone causes them psychological damage.
Posted by Chaparringes on June 16, 2010 at 7:47 PM
Head aspload
Posted by cardigan weather on June 16, 2010 at 7:51 PM
Canuck 15
If anyone finds it hard to believe that a parent would allow this to happen to their child, they might want to read Middlesex by Jeffrey Eugenides, aside from being a really amazing book, a large part is devoted to the main character undergoing similar "testing and exams" shortly after puberty. Although it's fictional, I gather it's based on real events.…
Posted by Canuck on June 16, 2010 at 7:51 PM
npage148 16
good job Cornell IRB
Posted by npage148 on June 16, 2010 at 7:52 PM
@4, a child can't consent, but their parents certainly can for them - otherwise every single medical treatment ever performed on a child would be assault.
Posted by KayElle on June 16, 2010 at 8:00 PM
Dan- where should concerned readers direct our comments and disapproval to? You were so great about providing the emails and phone numbers of the authorities in Constance McMillan's case - please, deploy your troops once again!
Posted by Jesi on June 16, 2010 at 8:03 PM
elenchos 19
It's as reckless and irreparable as wanting to nuke an offshore oil leak.

How did this get past ethics review? How?
Posted by elenchos on June 16, 2010 at 8:03 PM
Confluence 20
Wait, larger penises correlate with gayness in males?? Cite yer source! If that's true, it's so fucking unfair. Why do we straight chicks have to get stuck with all the micropenises?
Posted by Confluence on June 16, 2010 at 8:07 PM
Anne in MA 21
Jesus motherfucking christ

Also - using a vibrator on a 6 year old girl? Last I checked, vibrating someone to orgasm counts as having sex. This piece of shit is having sex with six year old girls.

This whole story is mind-bloggling.
Posted by Anne in MA on June 16, 2010 at 8:09 PM
Canuck 22
Way to be an asshole, Confluence. Don't joke about stuff like that.
Posted by Canuck on June 16, 2010 at 8:09 PM
This makes me sick. How is this guy not in prison? Isn't this child molestation? What, because the parents tell him to do it, that makes it ok for him to essentially fuck their daughters w/ a vibrator? I've never seen another clit (except in porn) and I don't sit around thinking "wow, mine is so much bigger!" And you would think a big clit would be a good thing...easier for a partner to find it!
Posted by CTlady on June 16, 2010 at 8:11 PM
"At annual visits after the surgery, while a parent watches, Poppas touches the daughter's surgically shortened clitoris with a cotton-tip applicator and/or with a "vibratory device," and the girl is asked to report to Poppas how strongly she feels him touching her clitoris. Using the vibrator, he also touches her on her inner thigh, her labia minora, and the introitus of her vagina, asking her to report, on a scale of 0 (no sensation) to 5 (maximum), how strongly she feels the touch.... Poppas has indicated in this article and elsewhere that ideally he seeks to conduct annual exams with these girls...."

Sounds like a child molester to me. With the added thrill of having the parents present while he molests them. What a sick fuck.
And where is the IRB here? Where is the Medical Board?
And where are those evangelicals who claim they want to protect innocent life (think of the children!)?
Posted by StuckInUtah on June 16, 2010 at 8:14 PM
As a bioethicist, I am thoroughly disgusted to hear about this and have alerted my colleagues to this egregious violation of ethics. I am deeply opposed to the position taken by some that "some circumcision" of female genitals are acceptable in America to avoid more severe mutilation overseas (yes, I am against non-medical circumcision of all children, male and female, since they cannot consent). This shows the disturbing approaches and assumptions made by many in the medical community, and Dan's caution about lesbians and enlarged clitorises is right on the mark.

Thank you, Dan, for posting on this.
Posted by MemeGene on June 16, 2010 at 8:17 PM
Delishuss 26
Dan! I second 18! Who do we call?
Posted by Delishuss on June 16, 2010 at 8:21 PM
Fnarf 27
Child rape, child mutilation. I am absolutely stunned. Who does this freak work for? He's got a department and a department head. He's got staff, nurses, everything. All of these people should be held accountable.

It is absolutely no exaggeration to call this Nazi medicine.

Weill Medical Collge needs to be thoroughly examined from head to toe to find out what the hell is going on and who knew about it. All of these people need to be censured if not actually imprisoned. Dix Poppas needs to never see the sky again.

The other two doctors are women: Jennifer Yang, Diane Felson. WHAT THE FUCK WERE YOU THINKING?
Posted by Fnarf on June 16, 2010 at 8:23 PM
venomlash 28
Fucking hell.
Posted by venomlash on June 16, 2010 at 8:28 PM
Goddammit this is depressing. Even *if* the science here *was* "good science'' this would still be just fucking horrifying and sad.
Posted by college dude from madison on June 16, 2010 at 8:29 PM
Matt from Denver 30
I'm going to be sick. I have two little girls myself.

Confluence is one of the worst hack commenters polluting SLOG these days, Canuck. Don't encourage her.
Posted by Matt from Denver on June 16, 2010 at 8:32 PM
Posted by Fnarf on June 16, 2010 at 8:35 PM
Delishuss 32
Thanks, Fnarf. I and every doctor friend I have are on it.
Posted by Delishuss on June 16, 2010 at 8:36 PM
Thanks @31. I just sent that link as well as the article link to all my teacher and social worker friends.
I haven't felt this disgusted and infuriated since I watched Mississippi Burning. Time for a good, long run. Uphill.
Posted by StuckInUtah on June 16, 2010 at 8:45 PM
I'm for castrating this doctor, displaying him, using a vibrator on him, and asking him if he has sensations, then putting his scrotum in a vice and telling him to let them know, between 1-10, the level of pain. Cornell should be blackballed by the AMA (no pun intended) and DCFS should step in before corrective action is taken. Does he also shorten the shafts of little boys who may be too large for comfort? Who gave him this right. How many men are angry because the procedure to remove their foreskin was made by someone else! I've met quite a few! I am so enraged about this !!!!
Posted by Sage on June 16, 2010 at 8:46 PM
Geraldo Riviera 35
Terrible. I think a doctor cut off a bunch of shaft meat from my ding-dong, and I don't know why. I had no goddamn choice.
Posted by Geraldo Riviera on June 16, 2010 at 8:48 PM
An extremely minor point, but: If you're studying anything other than medicine at Cornell, this isn't happening on your campus in Ithaca. It's happening five hours away from your campus in New York City.
Posted by Big Red on June 16, 2010 at 8:49 PM
These girls weren't having their phalli mutilated instead of leaving them alone. They were having them probably slightly less mutilated, then tested so that future procedures will be proposed with accurate benefits, rather than having the standard-issue mutilation. For what it's worth. The paper describes pretty well how much gender-standardization surgeries totally suck right now and how weak research on sexual function has been. These guys might be child molesters, or they might be the only surgical team that actually gives a hoot whether the cosmetic clits they build work. Or both. Whatever.

The paper says "Phallus length was 1.0 to 4.5 cm (average 2.4)." I don't think that's enough to justify modifying a girl's genitalia, even if you've got an intense belief that surgery is justified to help kids fit in. I don't see how an inch-long clit/penis is going to affect your life much before you're sexually active.
Posted by Orsh on June 16, 2010 at 8:50 PM
Canuck 38
@30, thanks, Matt, will treat her as *unregistered.*

This gets even worse when you read the links, the doctor is the one deeming their little bodies "too big," and is performing the surgery at 3-6 months! Babies often seem to have somewhat exaggerated genitals, relative to their bodies, how could you even make a diagnosis at that age? I was reading a blog just now by a woman who identifies as intersex, and she says the medical community is so eager to put everyone into boxes, absolute male/absolute female, when there is plenty of gender *fluidity* out there. As with looking for a *cause* for gayness, this smacks of the arrogance of identifying something as needing fixing simply because it doesn't fit into an expected category. SO sad.
Posted by Canuck on June 16, 2010 at 8:50 PM
JvstinPhoenix 39
He was doing this to kids? That's creepy, messed up shit...
Posted by JvstinPhoenix on June 16, 2010 at 9:02 PM
Reverse Polarity 40

* shudder *
Posted by Reverse Polarity on June 16, 2010 at 9:05 PM
You can email the Dean of Weill Medical College, Antonio Gotto:
Or Dr. Poppas himself:
You can also email University President, David Skorton:

You can find phone numbers and email addresses for all Cornell faculty here:…
Posted by Norym on June 16, 2010 at 9:08 PM
Neptune 42
It absolutely boggles my mind that any parent would allow their child to endure that.

When parents mistakenly make the decision to allow doctors to operate on an obviously intersexed newborn's genitals, I can understand how and why they might come to that decision (especially with doctors assuring them that it's "the way it's done"). But THIS? How any parent could knowingly take their young daughter into a building where a strange man was going to cut out chunks of her normally developed crotch and then annually rub it? Fuck that. No brochure or pamphlet could make that shit sound ok.

Shocking and disgusting. This asshole better be jobless ASAP. On my way to check if there's a page about ending this malpractice on Facebook.
Posted by Neptune on June 16, 2010 at 9:10 PM
Neptune 43
Update: I couldn't find any pages about this on Facebook. If anyone finds one or decides to make one, please link us!
Posted by Neptune on June 16, 2010 at 9:23 PM
brandon 44

I thought they stopped doing this shit 40 years ago when all those quack surgeons tried to turn boys into girls cuz their penis's were too small, or were accidentally damaged? Theres even been a bunch of Dateline's, 20/20's, and 60 minutes on this shit!

And its happening at CORNELL?!?!?

Fuck the doctor, i want to know what the hell is going on in the ethics department and with the administration for allowing this shit to even be THOUGHT of, let alone practiced!

Doctors and administrators asses need to be on silver platters.
Posted by brandon on June 16, 2010 at 9:26 PM
petey 45
interesting how large penises in our society are glorified yet females who have "larger then average" clitorises need to be surgically altered to minimize the appearance. What's wrong with a larger then average clit?

I'm also a bit confused at how cutting someone's genitalia for purely aesthetic reasons somehow amounts to promoting "natural" growth. Promoting natural growth would be letting their clit grow as long and large as it pleases, that's natural.
Posted by petey on June 16, 2010 at 9:32 PM

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