The outpouring of western concern over the issue of female circumcision offers a case study in how well-intentioned efforts of Americans to improve the lot of oppressed people elsewhere in the world can have precisely the opposite effect. In at least some societies targeted, the practice has increased. Beginning with a critique of Alice Walker's novel, Possessing the Secret of Joy, the book employs in-depth anthropological study to decipher the cultural logic responsible for female circumcision. The study suggests that in fact the practice continues because traditional culture identifies procreation as the measurement of self-worth and links fertility with circumcision.

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