Originally a comment by Artymorty on There’s no shame, no apology.

I have a sickening feeling that one reason the medical interference has been seen as okie doke is because so many people were doing it at the same time. There’s a “community” being built, and when there’s a “community,” well at least you won’t be lonely with your ruined body, you’ll be able to find other people in the same boat. Once that stops being the case, the interference stops looking quite so progressive. What does this mean? That much of the fervid proselytizing for medical interference has been recruitment – so that people who have already trashed their bodies will have a pool of potential fellow-miserables. A circle of horror.

That’s the flawed premise at the heart of the Cass review: you can’t really tell how well gender medicine “works” if you don’t even try to address the mechanism through which it supposedly operates. It’s not enough to just look at mental health outcomes over the short and medium term. (And the Cass report wasn’t even able to do that, because the culprit clinicians banded together to withhold the follow-up data, which is where we’d expect to find the really incriminating evidence.) There’s no clear hypothesis to test!

I know that the subject of FGM is very sensitive to some because it’s so awful. But there’s an apt comparison here. The practice is, per UNICEF (via Wikipedia):

usually initiated and carried out by women, who see it as a source of honour, and who fear that failing to have their daughters and granddaughters cut will expose the girls to social exclusion.

Is this not also a circle of horror? Compare that sentiment to this one about “gender medicine,” quoted in the Guardian, and cited here at B&W last week:

I would much rather my child was growing up in a way in which [she] wasn’t sticking out like a sore thumb and potentially going to end up dead.

With the benefit of an outside perspective we can see very clearly that there’s no direct medical necessity to remove parts of women & girls’ clitorises and labia, and that whatever supposed mental health benefits this practice confers to such victims — I will never call them “patients” or “subjects” or any other word besides victims, no matter how “medicalized” these atrocities are presented to be — it’s entirely dependent on the cultural/social landscape: the domain of social hierarchies and taboos and superstitions and rituals, and the foul effluvium of woman-hatred that enshrouds the senses of those within it.

Now, imagine there was a report that analyzed the efficacy of female genital mutilation strictly in terms of short-to-medium term self-reported mental health outcomes without ever addressing the question of why the practice had begun in the first place. Outrageous! To be clear, I’m not trying to say that the Cass report is outrageous — far from it; I think it’s a powerful and necessary report, which is already proving to be greatly beneficial to the struggle to put this scandal behind us. But it’s a sign of how outrageous our current social climate is, how mired in the bog we are, that such a report can’t be allowed to step all the way back to show us the true horror of the big picture.

No human female is born with an innate medical condition in which she is doomed to suffer unless otherwise healthy parts of her genitals are sliced off of her body. This is self-evident.

Likewise, no human of either sex is born with an innate medical condition in which they will suffer from such dire psychological distress they might die of suicide unless their otherwise healthy breasts and reproductive organs are removed, their puberty suppressed, a host of other cosmetic medical treatments are given, and all of society is compelled to band together and suppress all evidence of the sex of these poor innocents. Again, this is self-evident.

The gender mess is ultimately a battle on cultural grounds, and as much as systematic reviews of mental health outcomes are one piece of evidence we can use to put an end to it, they will never be the smoking gun, because the guilty party is the cultural climate that fosters mental distress in vulnerable people who don’t medicalize their bodies, and which (at least temporarily) showers those who do go under the scalpel with praise and social rewards.

The supposedly “positive” mental health outcomes of victims of gender medicine are as dubious and precarious as the supposedly “positive” outcomes of the victims of FGM: if the circle of horror ever stops, the fog that dulls the senses will lift and the pain will be acute.

Here’s a report about FGM in the Guardian from last month:

Reports have also emerged recently of resurgences in the central Kenya region of Murang’a, where women over 30 are opting to undergo the cut as a ‘return to culture’.

See again how clearly the Guardian is able to report on these “procedures” as a cultural phenomenon instead of medical treatment — and a tragic and terrible one — because Kenya is way over there.

If only they could see clearly enough to report that the resurgence of sex stereotypes, in large part due to the rise of social media, is why so many women — and men, too — are choosing to undergo their own version of “the cut” right here in the Guardian readership’s own backyard, in Europe and North America.