In this reflection, I argue that to achieve equitable health care, it is necessary to listen to all the agencies within a population. I use agency in this context to mean the different perspectives about a health issue within a population. Using Darby & Svoboda’s (2007) argument about the framing of male and female circumcision as a basis for my argument, I argue that presenting only a particular line of argument may inhibit equitable health care services in that it may lead to the formulation of policies that may not be representative. In addition, I argue that the presentation of a particular agency as seen in the Nigerian context with respect to circumcision symbolizes the role of structure in shaping policy decisions. By structure, I mean the social system that allocates resources within the society. I begin by looking at circumcision in the Nigerian context. Following this, I invoke the author’s findings to show how the framing of female circumcision symbolizes a hegemonic structure.
Darby & Svoboda’s (2007) critical examination of the framing of the two forms of circumcision, the male and the female strikes me as interesting because of the prominence the issue occupies in Nigeria. Many Non Governmental Organizations have become advocates of the eradication of female circumcision often described as female genital mutilation (FGM). Consequently, several efforts are geared towards eradicating the procedure. The central argument is that FGM decreases the erotic sensation of the women; therefore it is described as injustice to the women. Policies to support the eradication of FGM are being crafted in different states. Interestingly, no attention is paid to the circumcision of the men (MGA).
But in their study, Darby & Svoboda (2007) make startling revelation about the similarity between both procedures (FGM & MGA). By juxtaposing FGM and MGA, the authors argue that both procedures are similar in that they entail the removal of sexual erotic parts of the body. Additionally, the authors flaw the notion that FGM decreases sexual pleasure of the women. Quoting a Nigerian study, the authors state: “Okonofua and colleague in 2002 examined 1836 Nigerian women who had been subjected to either FGA type 1(71 percent) or type 2 (24 percent). They found no significant differences between cut and uncut women in their frequency of reported intercourse in the preceding week, or month, the frequency of reports of early arousal during intercourse. There was also no difference between cut and uncut women in their reported ages of menarche, first intercourse” (Darby & Svoboda, 2007, p.310). This revelation considerably weakens the arguments by advocates who describe FGM as injustice. Based on the above quotation, it is also reasonable to conclude that the argument that FGM is injustice to the women is unfounded.
Darby & Svoboda’s (2007) interrogation of the privileging of female circumcision over male circumcision is thought provoking. From a Critical Cultural lens, it raises a fundamental question about social structure. It also raises an epistemic question. For instance, how did female circumcision get to be framed as injustice against women? Or better still, whose agency does this point of view represent. Is it representative of all the agencies? At the same time, it gives us interesting clue about how policies are made.
My intent here is not to sound as a male chauvinist, nor to dismiss FGM as trivial, but from a Critical Cultural lens to illustrate how a particular structure or agency could influence public values and consequently lead to the articulation of policies. For example, the sea of interventions geared towards eradicating FGM emerge from the values that have been attached to FGM due to the framing of female circumcision as injustice. The question is that if the both procedures are similar as illustrated by the authors in their argument, why female circumcision should be privileged over male circumcision, food for thought.