Feeling the heat, Clitoraid goes on the offensive
Clitoraid have officially responded to questioning of their organisation and the controversial ‘adopt a clitoris’ fundraising scheme (a summary of discussions to date on this topic can be found here).
In a press release on April 21 2010 and a more frank statement on their website they argue their critics are anti sex; state questioning Clitoraid equals denying women treatment; and claim critics of the organisation are condoning Female Genital Mutilation/Cutting (FGM/C).
I would recommend reading both responses from Clitoraid which you may also wish to respond to. I will deal with a few of their points from both press release and statement which still require clarification. If you are a journalist I would strongly recommend you follow up these questions.
In their press release the organisation states:
“Millner and other critics following her lead have questioned the safety and validity of Clitoraid’s reconstructive surgery and expressed concerns about where the donated funds are going. And they say Clitoraid didn’t do an impact study to see how repairing the women’s genitals would affect their local communities”.
This would easily be answered if full financial records were disclosed. Clitoraid has been collecting money for its ‘pleasure hospital’ in Burkina Faso since 2006. How much money has been raised and has the hospital been built?
Any impact study and full evaluation of the published literature on FGM/C as well as working closely with the local community is essential in any intervention. Clitoraid need to produce all documentation to indicate clearly what impact study they have undertaken. To date, no evidence has been produced.
“In response, here is a written statement received at Clitoraid today from a woman born in West Africa. (She now lives in what she described as “a Western country.”)”
The press release provides a compelling statement from a woman who has had reconstructive surgery. We should not ignore or dismiss women’s voices, but we do need to be careful that one compelling story does not obscure other information. Specifically how many women have undergone reconstructive surgery via Clitoraid’s scheme and what success rates have been observed?
Also the women in this case is now living in a Western country where clitoral reconstruction will be interpreted in a different context to an African one where FGM/C is practised. We have no clear evidence from Clitoraid about what work they have been doing to enable women who have undergone reconstructive surgery to be accepted by their wider communities.
The woman quoted in the statement does make the important point that having undergone FGM/C does prevent women accessing healthcare for fear of judgement from healthcare staff. This has been noted extensively in the literature, but that is why many organisations are working to overcome FGM/C and also educate healthcare providers to more appropriate working practices to support women who have had FGM/C. Indeed many of those questioning Clitoraid are actively involved in such ventures.
“It’s very clear to us at Clitoraid that the criticism we receive is mainly from individuals who don’t consider sexual activity important,” declared Dr. Brigitte Boisselier, head of Clitoraid”.
This is an interesting and challenging statement. I would like to see the evidence of this from Clitoraid and Dr Boisselier. If you look to the Facebook group created to question Clitoraid you will note many of those who are supporting it are well known, sex positive activists and educators. There is certainly no suggestion the reason for questioning Clitoraid has been about denying why sexual activity is important. Indeed many of the resulting discussions between practitioners have been about reframing and reflecting on female pleasure and the importance of sexual activity within different cultural contexts.
“The Raelian Movement, thanks to its pleasure-embracing philosophy, is the only religion working to restore sexual pleasure, and we will continue to do so no matter what opposition stands in our way. We owe it to the 135 million FGM victims who have no other recourse.”
This is a bold statement. It appears Clitoraid claim to be the only organisation offering reconstructive surgery or pleasure-focused initiatives with women. We know this is not the case.
“Regarding the lack of scientific data often mentioned by critics, Boisselier said the surgical technique was developed more than 20 years ago by Dr. Pierre Foldes in France and published in a peer review journal, and that it is now practiced by many other surgeons trained by Foldes. Numerous testimonies from women praise his practice”.
Citing an established surgery from a journal is fine, but this alone is not adequate evidence of practice. While it does indicate reconstructive surgery is feasible, other research also shows surgery alone is not effective without wider cultural and social interventions and community involvement and support.
Again, we are faced with a lack of concrete data – ‘numerous testimonies from women’ do not tell us precisely how many women have been specifically treated by Clitoraid – or what the outcomes of their reparative surgery have been. Particularly for those not living in Western countries. If we are invited to send money to fund a clinical initiative it is not unreasonable to ask for this information, and any reputable practice should be able to provide this data.
“Nadine Gary, Clitoraid’s international head of operations, said the French health care system has been covering this common surgical procedure in France for years, and that Clitoraid’s head volunteer surgeon, Dr. Marci Bowers, MD, “a brilliant gender reassignment surgeon, will gladly and reliably clarify the steps and results of this surgery for anyone concerned about the validity and safety of this medical procedure.””
Myself and others asked Clitoraid for this information. They did not provide it. Within this press release they still have not given specific figures on what surgeries they have undertaken and how those have gone. There is already good evidence about the validity and safety of the procedure which is being used within Africa and elsewhere. The question for Clitoraid is what have they done and it is worrying that no concrete information appears forthcoming.
“Gary said anyone concerned about how Clitoraid’s funds are used should visit http://www.clitoraid.org, where the organization’s tax return statements are posted”.
But this still does not tell us whether the hospital they have been requesting money for has been built.
Meanwhile in the statement of 19 April from the Clitoraid website the organisation responds ‘This baseless smear campaign is costing genitally mutilated women the valuable support they need to get corrective surgery.’
Asking questions about practice, community involvement, efficacy and impact is not a ‘baseless smear campaign’. It is standard practice within evidence based healthcare. It is also worth noting among the criticism of Clitoraid has come calls for suggestions of established organisations and hospitals to support, to offer women the opportunity to get corrective surgery and to contribute to educational programmes tackling FGM/C.
“Professor Wanjiru Kamau-Rutenberg, assistant professor of politics at the University of San Francisco, and Caille Millner, a columnist for the San Francisco Chronicle, spearheaded what CLITORAID representative Nadine Gary called “a vicious attack of misinformation and distortion of truth.”
“Their statements, especially in Millner’s April 14 article “Wrong Approach to Genital Mutilation,” led to an online petition that cost CLITORAID the participation of its fundraising partner,” Gary said, adding that adult toys retailer Good Vibrations of San Francisco “was bullied into canceling its summer fundraising campaign on behalf of CLITORAID after receiving a petition signed by over 200 people.”
“The funds from Good Vibrations would have purchased medical equipment for our new hospital in Burkina Faso,” Gary said. “Now that won’t happen. It’s so unfair. The allegations are baseless – and some are just plain stupid.”
This states there is a hospital in Burkina Faso, for which medical equipment would be purchased. Yet questions asked of Clitoraid have failed to clarify if the hospital has been built. It is worrying that reasonable questions asked about one’s practice are dismissed, publicly, as ‘just plain stupid’.
In responding to the questioning of the ‘adopt a clitoris’ scheme, Clitoraid replied:
“not even one woman awaiting clitoral repair surgery through CLITORAID has complained about the slogan. In fact, none of them have ever even mentioned it!”
Yet what evidence do we have women were told of this scheme? And were they listened to? We do know in top down approaches to healthcare people very often don’t feel empowered to speak out or question. And if someone is offering to help you, do you turn them down? Certainly it does appear the community did object to the naming of the ‘pleasure hospital’ being built in Burkina, and the Realians threatened a forum discussing this complaint with legal action.
The statement continues:
““Brutal, violent acts like female genital mutilation don’t call for sensitivity,” she said. “They demand immediate action, and that’s what CLITORAID is doing.”
She likened the call for sensitivity toward those in Africa who perpetuate and condone FGM to those who were “sensitive” toward slave owners or Nazis.
“Slave owners in the American South thought Northerners were insensitive to their needs,” Gary said. “And it wasn’t considered polite in Nazi Germany to ask what was happening to the Jews. Both situations demanded blunt, effective, immediate opposition, not sensitivity toward the perpetrators and their supporters.””
This is offensive and misleading. At no point during discussions of Clitoraid has anyone condoned FGM/C. Indeed many of those questioning the organisation are actively involved in educational programmes and other development initiatives to overcome the practice. It is a wilful misrepresentation to suggest questioning the effectiveness of a programme means endorsing FGM/C – and particularly upsetting when combined with emotive suggestions that those doing so are akin to Slave owners or Nazis.
“This is a senseless, horrible act that causes excruciating pain and sexual deprivation for millions,” Gary said. “While other organizations just discuss and wring their hands, CLITORAID acts. Our first hospital dedicated to clitoral repair surgery will open in Burkina Faso in 2011”
Yet previously in the statement it claimed that the withdrawal of Good Vibrations would result in equipment not being purchased for the hospital, yet here it seems the hospital is not yet built and won’t be for at least another year. This is the same hospital where funds have been collected since 2006.
Again, we need clarification on how much has been collected for the hospital and what is the progress of the build. Why is an organisation collecting for medical supplies for a hospital that is not built yet?
“Gary said Larry Ashley, Ph.D., a University of Nevada, Las Vegas, university professor and sexual trauma counselor, sees each Clitoraid-sponsored patient, and that renowned sexual therapist Dr. Betty Dodson created the post-surgery sexual therapy program that complements the procedure. “This great team of volunteer professionals is made up of non-Raelians who have chosen to work with Clitoraid,” Gary said. “I notice our critics neglected to mention them.”
This is not correct. Those supporting Clitoraid were also invited to reflect on their involvement. Betty Dodson remains committed to the organisation. Discussions relating to non-Realian supporters are summarised and linked to here.
“Gary said critics of Clitoraid should practice what they preach. Millner and Professor Kamau-Rutenberg say Good Vibrations should have exercised due diligence before associating with Clitoraid, but they didn’t do their own. These two women should have known better. They turned the truth about Clitoraid completely upside down out of their own prejudice and a lot of ill-founded assumptions. In the process, they hurt many good people. And those they’ve hurt most are the FGM victims on our waiting list.”
We have continued to ask questions and we are still awaiting answers. Rather than there being ill founded assumptions we have witnessed a collection of practitioners from all over the world asking questions about Clitoraid, and doing this transparently through blogs to ensure fair practice and evidence based reflection and appraisal.
It is disappointing when any organisation, wherever they are based and whoever they are funded by, refuses to engage in discussions about the efficacy and acceptability of their initiative. It is standard practice within healthcare and education, and while it can feel threatening and difficult at times, is worthwhile to ensure those we are working with are not harmed or exploited.
Clearly we cannot hope to get the Raelians or Clitoraid to engage in the kinds of debates and reflections one might expect in standard healthcare practice, which is a pity. It is equally sad that reasonable questions about practice have been met with unpleasant accusations. Not least the singling out of one African critic, rather than focusing on a global questioning of an organisation which has been steadily growing for the past four years.
We should continue to ask questions of Clitoraid because to date answers to specific questions about fundraising and activity have not been adequately answered.