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Female Genital Cutting/Mutilation: A Health and Human Rights Issue

[TRIGGER WARNING: Discussion of surgical procedures, social, and cultural practices pertaining to female genitalia]

Female genital cutting/circumcision/mutilation (depending on your politics) is something I learned about in any women’s studies or public health class I took in college. What is it and does it harm women? Is it different from male circumcision, and how?

I am not partial to the term mutilation, so at the outset, let us differentiate between female genital cutting, circumcision, and mutilation. According to womenshealth.gov, all three terms describe the procedure that cuts away part or all of the external female genitalia.1  The terminology mutilation, circumcision, and cutting are all quite political. Mutilation is used to convey the human rights violation that occurs when this happens to women. Cutting illustrates the procedure with less implied judgment. Referring to this procedure as a circumcision is an attempt to equate it with male circumcision, which is incorrect; there are a variety of cutting types. From here on, I’ll refer to this practice as FGM/C.

What is FGM/C?
The World Health Organization identifies FGM/C as any procedure that intentionally alters or causes injury to the female genital organs for non-medical reasons. Amnesty International defines it as the removal of part or all of the external female genitalia.3

Where is it practiced and on whom?
FGM/C is practiced mostly in the Middle East (i.e., Yemen, Saudi Arabia, Iraq, Jordan, Syria, Southern Algeria) and Africa (i.e., Kenya, Nigeria, Mali, Ivory Coast, Egypt, Sudan). It is NOT specifically an Islamic practice, and is performed cross-culturally and cross-religiously.4  Women of any age can go through this procedure.

Types of FGM/C
The World Health Organization identifies four types of FGM/C, ranging in severity.5

1. Clitoridectomy: partial or total removal of the clitoris and, in rare cases, only the prepuce (fold of skin surrounding the clitoris).

2. Excision: partial or total removal of the clitoris and the labia minora, with or without excision of the liabia majora.

3. Infibulation: narrowing of the vaginal opening through the creation of a covering seal. The seal is formed by cutting and repositioning the inner, or outer, labia with or without removal of the clitoris. In this instance, a small opening is kept to allow passage of urine and menstrual blood. An infibulated woman must be cut open to allow intercourse, after which the incision is closed again.

4. Other: all other harmful procedures to the female genitalia for non-medical purposes.

Why is it performed?
There are a number of social, cultural and religious reasons for FGM/C. Not surprisingly, it’s often associated with making a woman clean because the process removes “male” parts from women. Infibulation also takes away women’s abilities to have and enjoy sex, thereby ensuring fidelity and modesty. Family honor is another reason why girls (usually involuntarily) undergo this procedure. The practice has fairly deep-rooted history in many rural communities, and is looked at as a tradition most girls must experience.

There are a great many health risks associated with the procedure, especially in rural communities that do not have access to clean water and other means of sanitization. Infections can result from unhygienic procedures, and giving birth can be difficult and dangerous for an infibulated woman and her baby. Infibulation prevents adequate release of menstrual blood, which can be extremely painful. In addition to physical scars, women undergoing this procedure are affected psychologically. This event is traumatic and painful.

In response to growing international pressure from health and human rights organizations, a number of communities have begun asking doctors and surgeons to perform these procedures. This lessens the risk of infection, and enables the use of anesthesia.

One question that was always posed in any class that covered this subject was whether movements to eradicate FGM/C were acts of cultural imperialism. Are movements to stop FGM/C ignoring local customs in favor of Western ideals? This is easy for me to say, but I think this practice is a total violation of human rights. In most instances, women are involuntarily subjected to this procedure. Also, the belief that without FGM/C women would be unclean and impure temptresses is stigmatizing and discriminatory.

Is the opposition toward FGM/C imposing Western values on non-Western cultures? Or is this practice just a flat-out violation of human rights?  Does it compare to male circumcision in any way? Should that be eradicated, too?

______________________________________________________________

1. Female Genital Cutting Fact Sheet. 2009. http://www.womenshealth.gov/publications/our-publications/fact-sheet/female-genital-cutting.cfm#b

2. Female Genital Mutilation. 2012. http://www.who.int/mediacentre/factsheets/fs241/en/

3.  Violence Against Women: Female Genital Mutilation.  http://www.amnestyusa.org/our-work/issues/women-s-rights/violence-against-women/violence-against-women-information

4.  Female Genital Cutting (FGC): An Introduction. 2003. http://www.fgmnetwork.org/intro/fgmintro.php

5.  Female Genital Mutilation. 2012. http://www.who.int/mediacentre/factsheets/fs241/en/

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milly parkhurst

i would love to have a pet lamb.

One thought on “Female Genital Cutting/Mutilation: A Health and Human Rights Issue”

  1. I don’t know, this is something I really struggle with internally because FGM/C is obviously horrible but how to we effectively stop it without being paternalistic?

    In 2007 I spent a month in Tanzania.  This included an 8 day stay with a Maasai tribe.  A British woman had married into this tribe and part of her work included educating Massai midwifes on the dangers on FGM/C.  She had had some success with the midwives, but this ended up being mostly ineffective because the head guy in charge would just send the women to another midwife who was still willing to do it…which ultimately added more issues.  So what then?  It is  clear that the change needs to be primarily initiated by those of that culture (which is why she was focusing on the midwives), but how do you really make it stick?

    And is it really our place?  I really aim to be accepting of all cultures…. but there are just some things that are just wrong – a violation of one’s rights.  I’ve seen a woman that had her genitals excised give birth and it was awful.  Scar tissue just doesn’t stretch like it needs to for child birth.  And this was in the US, in an OR…so I cannot imagine the complications it produces during child birth elsewhere.

    I don’t want to be paternalistic, but I just can’t accept FGM/C.  For me, the answer is to talk about the specific dangers associated with it rather than how it’s just plain awful.  I could also do without calling it mutilation because that word is condescending and judgement is not going to lead to any effective change.  And lastly, since this practice is so ingrained in so many cultures, I think it’s important to find out what FGM/C means to each culture and find some sort of replacement.  The British woman mentioned this, that the midwives that had the most success in educating their tribe had  suggested other safer traditions.

    As for male circumcision…I honestly don’t know too much about it, but it doesn’t bother me in the same way.  I personally don’t like holding babies down when they’re being circumcised….but yeah, I need to go to bed.  I’m on the verge of making no sense.  I just worked twelve hours and my thoughts are officially jumbled mush.

     

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