The health consequences of female circumcision: science, advocacy, and standards of evidence.

This two-part article addresses questions that have arisen in current debates on the health consequences of female circumcision. The first part responds to a critique of a 1999 article and focuses on three major points: the role of research and advocacy in discussions of harmful effects, the sort of evidence that is appropriate for measuring health effects, and the way in which different disciplines--demography, epidemiology, and anthropology--are brought together to analyze data on health consequences. The second part of the article reviews published sources and provides an update on their results. It shows that few studies are appropriately designed to measure health effects, that circumcision is associated with significantly higher risks of a few well-defined complications, but that for other possible complications the evidence does not show significant differences.