The American Academy of Pediatrics has released a report suggesting that it may be preferable to draw from girls’ genitals a physicially insignificant drop of blood to satisfy the wishes of mostly immigrant, Muslim families who normally enage in female genital mutilation. That fom of ritual cutting can excise the clitoris and much of the labia, leaving the girls vulnerable to horrible sexual, urinary, and obstetrical problems for the rest of their lives. I abhor genital mutilation, support the world-wide efforts to eliminate the practice and make it socially unacceptable, and understand the reaction of activists against this concession . The Academy argues that sometimes performing a tiny nick might save a girl from being sent back to the home country for a dangerous, invasive procedure. The report itself presents nuanced arguments both for acceding in this way, and for holding the line against any acceptance of this ritual – it cites a study from Scandinavia that found criminalizing this procedure and threatening the loss of custody of one’s children led the immigrant Somali community to largely abandon it. But what comes through in the report is the agony of pediatricians worried that girls in their care might be mutilated unless a doctor performs this small act, and I think the report makes a persuasive case.