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Female Genital Mutilation (FGM)

  1. What is Female Genital Mutilation?

  2. Who is affected by Female Genital Mutilation?

  3. How does Female Genital Mutilation affect health?

  4. Why is Female Genital Mutilation practiced?

  5. What should be done about Female Genital Mutilation?

  6. How can I take action against Female Genital Mutilation?


I. What is Female Genital Mutilation?

Female Genital Mutilation (FGM) is the set of procedures used to remove or cause injury to part or all of the external female genitals.1

FGM is also called Female Circumcision (FC).1-4 The difference in name is not a superficial one, as it often belies the writer's convictions; the term FGM is most often used by authors fighting against the practice, while Female Circumcision is used when the author supports the practice.

My choice to use the term FGM is not a random one. However, I hope to adequately address both sides of this issue and welcome criticism as well.

Types of Female Genital Mutilation1,4-6

  1. "Sunna" circumcision: Consists of the removal of the tip of the clitoris and/or the prepuce (the covering of the clitoris).
  2. Clitoridectomy/excision: Consists of the removal of the entire clitoris (both prepuce and glans), and the removal of the adjacent labia.
  3. Infibulation: Consists of the removal of the clitoris and the adjacent labia (majora and minora), followed by stitching together the scraped sides of the vulva across the vagina. A small opening is kept to allow passage of urine and menstrual blood.
  4. Unclassified: Other forms of FGM include:
    • Pricking, piercing or incising of the clitoris and/or labia;
    • Stretching of the clitoris and/or labia;
    • Cauterization by burning of the clitoris and surrounding tissue;
    • Scraping of tissue surrounding the vaginal orifice or cutting of the vagina;
    • Introduction of corrosive substances or herbs into the vagina to cause bleeding or for the purpose of tightening or narrowing it.

The majority of mutilations are of types I and II (80-85%), while infibulation (type III) accounts for 15%.1,7

II. Who is affected by Female Genital Mutilation?

Women and girls of all ages are at risk for being genitally mutilated.1,7 However, the procedure most often is practiced on girls aged four to eight.7

The World Health Organization estimates that over 130 million girls and women have been genitally mutilated, and about 2 million more are at risk each year.1 Most of the girls who have been circumcised are from one of 28 practicing countries in Africa; however, FGM is also practiced in Asia, the Middle East, and in immigrant populations in industrialized countries such as Australia and the United States.1,7 In the African countries of Djibouti, Eritrea, Sierra Leone, Somalia, and Sudan, nearly 90% of women are estimated to have been genitally mutilated.8

The actual method of the female genital mutilation procedure varies between countries, ethnic groups, urban and rural areas, and people of different socio-economic status.7 The procedure is often carried out by a designated older woman or a midwife.1,4,7-9 In some urban areas, the procedure takes place in hospitals and is conducted by a health professional.1,7,8

In the film Warrior Marks, Alice Walker and Pratibha Parmar document the experience of female genital mutilation by the girls of one village.9 In this village, circumcision is a celebrated event, and a festival with much eating takes place the night before. The next morning a group of young girls, aged between four and ten, go to the hut of the woman performing the excision. The family of one girl tells her that the procedure will not hurt, but she has seen the pain and fear of other girls and is afraid. The girl's mother approves of the excision, because it is an important tradition in the village. Another, more in depth description of the experience is available from Jomo Kenyatta in Facing Mount Kenya.10

Although this is the experience of some girls who are circumcised, this is not the experience of all girls. Some girls know much about what will happen to them, while others are completely unaware that the circumcision will take place. Some girls are circumcised with other girls of similar age, while others are circumcised alone. Some circumcisions are celebrated with festivals, while other circumcisions are done in secret. Some girls will be given an anesthetic, while other girls are given nothing to reduce the pain. Some girls are circumcised by unclean knives or shards of glass, while other girls are cut with sterilized instruments. These variations (and probably more) are experienced by circumcised girls; it is important to remember that not all experience FGM in the same way because the experience girls have colors their perceptions of the practice.

III. How does Female Genital Mutilation affect health?

Few clinical studies have been done to discern the long-term health consequences of FGM. Below I have reported all consequences, whether anecdotal or scientific, in an attempt to give fair time to both sides of the issue. No circumcized woman has all of these consequences, but presumably at least one woman has experienced each of these consequences as a perceived result of FGM. No information yet exists about how many women experience each of these consequences, or even if these consequences are truly caused by female circumcision. I have tried to be clear about where each of these sources came from, so that others can determine credibility for themselves.

  • Immediate Negative Physical Consequences can include:
  • Long-Term Negative Physical Consequences can include:
    • Anemia11
    • Intermittent bleeding7,11
    • Urinary tract infections1,7,11
    • Kidney damage7
    • Incontinence1,11
    • Reproductive tract infections7
    • Chronic pelvic infections7,11
    • Infertility1,7,11
    • Cysts1,11
    • Scars1,7,11
    • Permanent pain11
    • Painful sexual intercourse1,7,11
    • Problems in pregnancy and childbirth1,7,11
    • Increased risk of maternal or fetus death during childbirth1
    • Easier transmission of HIV during sexual intercourse11

  • Negative Psychological Consequences can include:
    • Sexual dysfunction in one or both partners7,11
    • Reduced sexual sensitivity7,11
    • Possible loss of trust in caregivers7,11
    • Feelings of incompleteness, anxiety, terror, depression, humiliation, or chronic irritability7,11
    • Increased docilitity7

  • Positive Physical Consequences can include:
    • Improved cleanliness13
    • Prevention of vaginal cancer5
    • Removal of a poisonous organ5,13
    • Removal of bad genital odors5
    • Prevention of nervous habits5
    • Increased beauty5
    • Increased fertility12,13
    • Decreased female sex drive, to better match her husband5
    • Enhances sexuality12
    • Prevention of sexual neuroses5
    • Prevention of rape12,13

  • Positive Psychological Consequences can include:
    • Acceptance into society2,7,13
    • Freedom from psychologocial consequences of rejection from society7
    • Positive feelings from attention, gifts, and celebrations2,7
    • Eligibility for marriage, considered an important role in society2,7,13
    • Increased docility7

IV. Why is Female Genital Mutilation practiced?

"It's tradition"

In Warrior Marks, Alice Walker asks the women in a village why they allow their daughters to be mutilated. The answer always comes back: "It's tradition."9 What does this tradition mean to the women in this culture?

Circumcision defines who is in the cultural group.7 In societies where most women are circumcised, those who are not are seen as outsiders or otherwise socially unacceptable.2,7 Uncircumcised women are seen as unmarriageable, and many societies have no place for unmarried women.2,7,11

Belonging to part of a group is desirable for most humans; we depend on our association with others, such as our family and friends. It is difficult to break with tradition, as it often causes us to become outcasts from our chosen groups. Breaking with the tradition of FGM in these societies is not a simple choice for women, so many continue to follow tradition even when the pain dictates otherwise.


"Allah says so"

FGM is often associated with Islam, as some societies that practice FGM are Muslim and use religious sayings to support the practice.2,5,7 However, FGM is not a Muslim tradition. FGM is not practiced by the majority of Muslims, and some Christian, Jewish, and Animist societies do practice FGM.2,5,7 This practice predates Islam, although the exact date of the first recorded circumcision varies between 1400 and 4000 years ago.2,5

However, many who practice FGM still do so because they believe it is a Muslim tradition. Although the Qur'an (the Muslim holy book) does not specifically mention female circumcision, other sayings attributed to the Prophet Mohammed seem to support circumcision, at least sunna circumcision.5,7 Some Muslims who oppose the practice use parts of the Qur'an to conclude that circumcision is wrong.5 Dissent still exists within the Islamic faith about the status of female circumcision; however those who support it still use religious freedom as an important reason to continue the practice.


"Uncircumcised women are unclean"

Improved cleanliness is one of the claimed benefits of female circumcision.5,7,11,13 In some societies, the word for female circumcision also refers to "purification" or "cleansing."7 Local custom has dictated that uncircumcised women cannot handle food or water, and may be poisonous to men or babies that come into contact with the clitoris.5,7 The use of clitoridectomy to relieve health problems was also used into the twentieth century in the United States, often to alleviate hysteria or excessive masturbation.7,14 Despite the perception that uncircumcised women are unclean or unhealthy, many consequences such as infections, scars, and infertility supposedly result from FGM as well. The difference in perceptions needs to be challenged by locally based information seeking about the consequences of FGM.


"It makes her a woman"

In some societies, female circumcision marks the entrance into womanhood.7 The clitoris and labia are considered the "male" parts of the female body, and thus must be removed for a girl to fully become a woman.2,7 In these societies, male circumcision also takes place to help the boys become men.2


"It ensures her chastity"

The practice of infibulation, where a woman's genitals are sown together, helps to ensure virginity in young girls, and fidelity in wives.2,7,11 Women who are uncircumcised are not trusted to be in control of their own sexuality.7 In strongly patriarchal societies, it is important that the identity of a child's father is known, so that the father's wealth can be passed only to his children.


It is often easy for people of other cultures to dismiss these and other reasons for female circumcision as silly, outdated, or primative. However, in the United States, we use similar arguments to uphold the practice of male circumcision. Hanny Lightfoot-Klein has compiled a list of comparisons between female circumcision in Africa and male circumcision in North America.15 Although there are significant differences between female and male circumcision (as pictorally demonstrated by Anne Runeborg6 and discussed by the Director of the Female Genital Mutilation Network and Message Board16), a comparison of the reasons given for both types of circumcision can help place female circumcision in Africa within a context that people from the United States and elsewhere can better understand.


V. What should be done about Female Genital Mutilation?

There is little consensus about the continued practice of FGM in some countries. Many international organizations, such as the World Health Organization, the United Nations, and Amnesty International, call for the erradication of FGM as a human rights abuse.5,17-19 Supporters of FGM call for the consideration of FGM within a cultural framework much different than the cultural framework of the United States or Europe. For instance, Adeline Apena argues that addressing female circumcision as a travesty of individual human rights ignores the importance of community and group rights in African culture.3 Apena and Omofolabo Ajayi-Soyinka criticize Alice Walker and others of portraying circumcised women as helpless victims of human rights abuses, instead of subjects who can create their own solutions.3,20

Both sides of this issue have valid points. Female genital mutilation violates a female's right to bodily integrity and freedom from violence.19 FGM, especially as practiced to control a woman's sexuality or to initiate a woman into strictly defined gender roles, is a violent method of socializing women into a subordinate role in society. However, treating women as victims or as people without a culture only perpetuates the subordination of women -- they now must be subordinate to the desires of Westerners instead of men in their culture. Better solutions can be found that empower African women to create and implement their own solutions to female genital mutilation.


VI. How can I take action against Female Genital Mutilation?

Suggestions for action against FGM often focus on the role of other countries and international organizations in ending FGM. You can support these actions by encouraging your government to take a stance on these issues.

Calls for government action:

Amnesty International's Strategies for Change
http://www.amnesty.org/ailib/intcam/femgen/fgm8.htm

World Health Organization's Actions for Elimination
http://www.who.int/frh-whd/FGM/infopack/English/
fgm_infopack.htm#ACTIONS FOR ITS ELIMINATION

Organizations that fight FGM:

Rising Daughters Aware
http://www.fgm.org/

RAINBO
http://www.rainbo.org/

News, Education, and Ideas:

FGM Education and Networking Project.
http://www.fgmnetwork.org/index.html

Feminist News Stories on Female Genital Mutilation.
http://www.feminist.org/news/newsbyte/fgm.html

Gerry Mackie. A Way to End Female Genital Cutting.
http://www.fgmnetwork.org/articles/mackie1998.html



References:

  1. World Health Organization. (April 1997). Fact Sheet on FGM Fact Sheet N 153.
    Retrieved May 21, 2000 from the World Wide Web:
    http://www.who.int/inf-fs/en/fact153.html
  2. Matias, A.S. (Spring 1996). Female circumcision in Africa. Africa Update.
    Retrieved May 21, 2000 from the World Wide Web:
    http://www2.h-net.msu.edu/~africa/sources/clitorodectomy.html
  3. Apena, A. (Spring 1996). Female circumcision in Africa and the problem of cross-cultural perspectives. Africa Update.
    Retrieved May 21, 2000 from the World Wide Web:
    http://www2.h-net.msu.edu/~africa/sources/clitorodectomy.html
  4. Sarkis, M. (1995). Female Genital Mutilation: An Introduction
    Retrieved May 21, 2000 from the World Wide Web:
    http://www.fgmnetwork.org/intro/fgmintro.html
  5. Robinson, B.A. (March 13, 1998). Female Genital Mutilation (Female Circumcision): In Africa, The Middle East & Far East.
    Retrieved May 21, 2000 from the World Wide Web:
    http://www.religioustolerance.org/fem_cirm.htm
  6. Runeborg, A. (September 1999). Think first think twice think thrice: Which method of male genital surgery do you prefer? Awaken, 3.
  7. Amnesty International. What is female genital mutilation? Female Genital Mutilation - A Human Rights Information Report.
    Retrieved May 21, 2000 from the World Wide Web:
    http://www.amnesty.org/ailib/intcam/femgen/fgm1.htm
  8. World Health Organization. (August 1996). Estimated Prevalence of Female Genital Mutilation in Africa.
    Retrieved May 21, 2000 from the World Wide Web:
    http://www.who.int/frh-whd/FGM/infopack/English/
    fgm_infopack.htm#PREVALENCE AND DISTRIBUTION
  9. Walker, A. (Producer) and Pratibhua, P. (Producer and Director). (1993). Warrior Marks [Film]. (Available from Women Make Movies, 462 Broadway, 5th Floor, New York, NY 10013)
  10. Kenyatta, J. (1965). Chapter 6: Initiation of Boys and Girls. Facing Mount Kenya New York:Vintage Books. pp 125-149.
    Retrieved May 28, 2000 from the World Wide Web:
    http://www.fgmnetwork.org/kenyatta/index.html
  11. World Health Organization. (August 1996). Female Genital Mutilation: Health Consequences.
    Retrieved May 27, 2000 from the World Wide Web:
    http://www.who.int/frh-whd/FGM/infopack/English/
    fgm_infopack.htm#HEALTH CONSEQUENCES
  12. Iweriebor, I. (Spring 1996). Brief Reflections on Clitorodectomy. Africa Update.
    Retrieved May 27, 2000 from the World Wide Web:
    http://www2.h-net.msu.edu/~africa/sources/clitorodectomy.html
  13. World Health Organization. (August 1996). Female Genital Mutilation: The Practice.
    Retrieved May 27, 2000 from the World Wide Web:
    http://www.who.int/frh-whd/FGM/infopack/English/
    fgm_infopack.htm#THE PRACTICE
  14. Duffy, J. Clitoridectomy: A Nineteenth Century Answer to Masturbation.
    Retrieved May 28, 2000 from the World Wide Web:
    http://www.fgmnetwork.org/intro/duffy.htm
  15. Lightfoot-Klein, H. Similarities in Attitudes and Misconceptions toward Infant Male Circumcision in North America and Ritual Female Genital Mutilation in Africa.
    Retrieved May 28, 2000 from the World Wide Web:
    http://www.fgmnetwork.org/intro/mgmfgm.html
  16. Director, Female Genital Mutilation Network and Message Board. (1999). On Comparisons Between Male Circumcision and Female "Circumcision" (Female Genital Cutting/Mutilation).
    Retrieved May 28, 2000 from the World Wide Web:
    http://www.fgm.org/MalevFemCirc.html
  17. World Health Organization. (August 1996). Female Genital Mutilation: Actions for its elimination.
    Retrieved May 28, 2000 from the World Wide Web:
    http://www.who.int/frh-whd/FGM/infopack/English/
    fgm_infopack.htm#ACTIONS FOR ITS ELIMINATION
  18. World Health Organization. (August 1996). Female Genital Mutilation: United Nations action.
    Retrieved May 28, 2000 from the World Wide Web:
    http://www.who.int/frh-whd/FGM/infopack/English/
    fgm_infopack.htm#UNITED NATIONS ACTION
  19. Amnesty International. Female genital mutilation and international human rights standards. Female Genital Mutilation - A Human Rights Information Report.
    Retrieved May 28, 2000 from the World Wide Web:
    http://www.amnesty.org/ailib/intcam/femgen/fgm5.htm
  20. Ajayi-Soyinka, O. (March 21, 2000). Who is afraid of agency? Theorizing African women out of the victim syndrome. Paper presented at the conference African Women in Global Society: Issues & Perspectives, Athens, GA.

Dawn Haney, May 2000

Last Modified: 1/4/2001                           

Contact: Dawn Haney haneydaw@arches.uga.edu