Like a few other posters, I've been thinking about the fact that Sahl is now a nurse, and yet she still maintains a positive--or at least proud view of her circumcision.
As a nurse, and a resident of both Canada and the United States, certainly Sahl realizes that it is possible for culture and tradition to evolve over time. Practices can change as we learn. It is ok to be proud of honoring your family and long held traditions, while also admitting the tradition is harmful, which appears to be what Sahl is saying here as she states she will not be carrying on this tradition with her children. (Help with page reference please. I've already loaned out the book!)
I volunteer in a Mexican town about 4 hours from the border with Arizona. This past June, there was unprecedented violence. Yet, when a Mexican friend of mine was interviewed by local reporters, she refused to say that she was scared or changing her routines. She told me that she was scared, but didn't want to admit it--as she didn't want people to think bad things about her town, her state, or her country. It was more important to present the situation in a positive light. I think this must in some way be tied to self worth and how wrapped up it is in personal history and place.
Another interesting thing I think this brings up is whether or not it is acceptable EVER to criticize the behavior/traditions/culture of your country. Can you be a good citizen and still not agree with behaviors????