Female genital mutilation, systematic abuse at Cornell?

I am not thinking up a witty title, because I’m in a state of shock. I’ve just seen on Twitter that a paediatric urologist going by the name of Dix Poppas, at Weill Medical College of Cornell University, is systematically cutting the clitoris of prepubescent girls, allegedly to reduce them to a ‘normal’ size. He then “follows up” by stimulating these girls to show they still have sensation in the clitoris. Using a vibrator on them, in other words. Once a year.

Words fail me.

Rather than add anything to this, please check the details for yourself at

Warning, you’ll need a strong stomach. It is truly horrifying.

(H/T mjrobbins at http://www.layscience.net/)

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  1. Andrew Spong says:

    I’m reeling at this. Words fail me.

  2. Yah. I feel sick.

  3. From the paper:

    A total of 51 patients 4 months to 24 years old (mean age

  4. Claire says:

    How did this ever make it through an IRB? How could a committee look at this and pass it? Did the parents actually give informed consent for this to happen to their daughters?

    • belle says:

      Therein lies the issue. According to the Hastings Center post, it seems there was IRB approved retrospective chart review, but no mention of IRB approval of postop “sensory testing”. There is a good argument that the latter was specifically for gathering data for research, thus requiring IRB approval. Now the question is whether it was ever sought or given.

  5. PF Anderson says:

    Nerve sparing ventral clitoroplasty: analysis of clitoral sensitivity and viability.
    Yang J, Felsen D, Poppas DP.
    J Urol. 2007 Oct;178(4 Pt 2):1598-601. Epub 2007 Aug 16.
    PMID: 17707043 [PubMed – indexed for MEDLINE]

    Nerve sparing ventral clitoroplasty preserves dorsal nerves in congenital adrenal hyperplasia.
    Poppas DP, Hochsztein AA, Baergen RN, Loyd E, Chen J, Felsen D.
    J Urol. 2007 Oct;178(4 Pt 2):1802-6; discussion 1806. Epub 2007 Aug 17.
    PMID: 17707008 [PubMed – indexed for MEDLINE]

    However, remember that this is a standard treatment for a clinical condition.

    I don’t know much about it myself, but what seems to be happening is that this is a LESS INVASIVE alternative to the standard treatment. That is important to keep in mind. This brand new article yields additional insights, but obviously this information was not available when Dr. Poppas was working on the 2007 articles.

    Sexual Function and Surgical Outcome in Women with Congenital Adrenal Hyperplasia Due to CYP21A2 Deficiency: Clinical Perspective and the Patients’ Perception.
    J Clin Endocrinol Metab. 2010 May 13. [Epub ahead of print]
    “Little is known about how these women feel that the disease has affected their lives regarding surgery and psychosexual adaptation. … Conclusion: Our data show that the null genotype group was considerably more affected by the condition than the other groups and should be regarded as a subgroup, both psychologically and from a surgical perspective. Genotyping adds clinically valuable information.”

    • Well, it’s only a ‘medical condition’ because certain (probably male) doctors claim it is.

      It comes down to whether you believe large, small or ‘ambiguous genitalia’ are a problem.
      I don’t have access to the JCEM article you cite, and it’s a poorly written abstract so I can’t comment, except what does
      “There were discrepancies between the patients’ perception of the impact of the condition on their sexual life and what health professionals would assume from clinical examination” mean? The women actually thought they were fine and the clinicians said they weren’t? Or the other way round?

      And are they following up on the psychological state of these girls (many of whom, by the way, are too young to answer questionnaires on sexual performance or anything else) following their abuse by Poppas?

  6. Karen James says:

    I am full of outrage.

    You should all follow Dr Petra Boynton on twitter for updates and commentary on this as it unfolds: http://twitter.com/drpetra

  7. AIC Intern says:

    Advocates for Informed Choice is a non-profit organization advocating for the legal and human rights of children with intersex conditions or differences of sex develoment, like the ones in this story. We work in collaboration with bioethicists, doctors, parents, affected adults, and many others. If you are interested in taking action to help protect these children, and to be sure that possible human rights violations are investigated, please join our Facebook page at http://ow.ly/20wTY or sign up for our Twitter feed at http://twitter.com/aiclegal. You can also donate to support our work at http://aiclegal.org/we-need-your-support/

    – AIC Intern

  8. There’s a followup article in Nature here: http://blogs.nature.com/nm/spoonful/2010/06/clitoroplasty_and_dex_studies_1.html
    and a piece on BoingBoing saying that the original procedure is actually unsupported by evidence: