Female genital mutilation

Anti-FGM campaign billboard in Uganda

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Female genital mutilation (FGM), also "female genital cutting" (FGC),[note 1] also known to those indulging in a particularly incapacitating dose of cultural relativism as "female circumcision", is a severe human rights violation that is done primarily in sub-Saharan and eastern Africa, though it is also done in parts of southeast Asia. It is also performed illegally in Western countries where immigrants and perhaps their descendants hack off their daughter's genitals in secret. The law on FGM is very strict in Western countries (and some developing countries), where it is illegal to transport a girl to another country to knowingly perform genital mutilation.

The specific procedure of FGC is classified into four different levels of child abuse which range from the least abusive form, the symbolic jamming and removal of a needle into or through the clitoris, to the most unspeakable form which involves hacking off the entire vulva.

The costs that the girl pays whilst growing up are great, depending on the severity of their mutilation. These range from serious infections (since the pesky Hippocratic Oath means this type of procedure is not usually performed by trained doctors or with well sterilized equipment), to difficulty urinating, severe pain, sexual dysfunction, a possible loss of all sexual stimulation, difficulty giving birth, and even the terrible inconvenience of dying. In some cases the mutilation is part of a cultural ritual or permanent anaphrodisiac meant to ensure sexual abstinence and bodily/sexual control. It may be performed by mother or father, grandparents, relatives or a local "expert" or even "professional". In some countries the practice seems untouchable while in others (notably Djibouti and Central African countries) it has shown some signs of a decrease in overall severity of the practice and the number of girls mutilated.

## Contents

* 1 Severity of mutilation
* 1.1 Other forms of FGM
* 1.2 Consequences
* 2 Description
* 2.1 WHO's definition
* 3 Historical context
* 4 FGM and religion
* 5 World practice
* 5.1 Legal status
* 5.2 Middle East and Africa
* 5.3 United States, Canada, UK, and Australia
* 6 Cultural relativists' defence of child abuse
* 6.1 Comparison to (male) circumcision
* 7 Other anthropological approaches
* 8 Reparative surgery
* 9 See also
* 10 External links
* 11 Notes
* 12 References

## Severity of mutilation[edit]

FGM has been categorized into four different levels of suffering. A clitoridectamy (type I) involves the painful removal of the clitoral prepuce. Excision (type II) involves the agonizing removal of the full outer genitalia including the clitoris and labia. If that level of butchery is not considered satisfactory an especially vicious mutilation awaits the victim known as Infibulation (level III). At this highest category of physical and sexual violence, the girl's clitoris and labia are hacked off and the vagina is partially sewn shut and left to heal over, resulting in a wall of tissue over the vagina with only a small orifice for menstruation (and subsequent medical complications). Infibulation in particular is used to enforce sexual abstinence, at least until marriage when the vaginal covering is broken before or during penetration.

As a way to maintain the ceremonial ritual yet not damage the child's body, in some countries (notably Eretrea and Djibouti) Type IV (nicking, scraping, piercing) is a symbolic prick on the labia or clitoris that is painful, but unlikely to cause lasting physical harm. It is seen by some as a compromise between tradition and a child's well being, however, it still involves a ritual where several adults (possibly family members) touch a little girl's private parts in a way that imparts that there is something dangerous/taboo about their sex organs. The severity of the vagina/clitoris chopping is different from country to country and family to family, so in some places type III full out butchery is rare. Thankfully type IV is becoming increasingly common, hopefuly as part of a path towards the end of FGM. While some forms of FGM may be notably more severe than others, it is unlikely that a girl would take much comfort in the fact that the slicing off of part of their genitals could have been worse if she lived somewhere else.

### Other forms of FGM[edit]

A fifth type also exists, which is in some ways the opposite of type III. This practice is known as introcision and it involves cutting or tearing the vagina with sticks, knives, or string in order to enlarge it. This is primarily found among at least two tribes in South America.[1] It was reportedly practiced in the past in remote parts of Australia and Africa though there is no evidence that it is practiced in the 21st century. It is usually performed on underage girls, sometimes forcibly and in conjunction with mass rape.

Vaginal steaming and other forms of "dry sex" (using plants and other astringents) are also sometimes classified alongside FGM, but are temporary. However, they have many health risks and are a major contributor to the spread of HIV in the region.

### Consequences[edit]

Consequences of female genital mutilation depend on the severity of the procedure, but can include inability of the woman to enjoy sex, genitourinary tract complications, increased risk of fatality during childbirth,[2] and the risk of infection or death from the unsanitary conditions under which the procedure is done.[2] Such an act would be considered manslaughter in civilised countries. Side effects and complications can be permanent, leaving the victim with life long physical and psychological problems if she survives.

## Description[edit]

### WHO's definition[edit]

The World Health Organization, in an attempt to bring focus to the issue and hopefully outlaw the practice worldwide, has provided the definition as "all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons."[3]

## Historical context[edit]

Female and male tribal markings, including genital markings, have long been a part of human culture as a way to say "you are part of our tribe, and not that tribe", as a way of acknowledging membership to the tribe via the sacrifice of flesh or blood, and as a way of marking ascension into adulthood with associated responsibilities.[4] From piercings and light scarification, to tattooing, circumcision and even castration, the body has been used throughout history by a variety of cultures to mark identity.

Cutting or scarification of the female genitals is known throughout the world, including Australian aboriginal tribes, ancient proto-Hindu cultures, and several South American tribes. In these cases, the goal is a sacrifice of the flesh and blood to the tribe or the gods, resulting in scarring and marking, but not impediment to sexual function or pleasure.[4]

Female circumcision as it is known in the Middle East is generally viewed to have begun with the Pharaohs of Egypt, as early as the 3rd Dynasty (3000-2800 BCE). Mummies have been found with Type I (removal of the clitoral hood), and type III (infibulation - total removal of the external genitalia, and suturing to a tiny hole which allows for urination, but must then be cut open for sex). The term "pharaonic circumcision" which is used throughout the Middle East to describe a full infibulation arose out of this practice. The Romans had a lovely ceremony where they pierced the outer labia of infant girls with a fibula (broach), that would be removed by the husband on the wedding night.[4]

While Judaism requires male circumcision, there is no indication anywhere in the Torah or commentaries that even contemplates female circumcision. However, the Ethiopian Jewish community (Beta Israel) practice FGC as part of their Ethiopian identity.[4] Though the religious body of Judaism asserts that at no time in Jewish history have any women been circumcised, S. Cohen claims to have found evidence for small communities who practice the rite. However, both during Pharaonic Egyptian era, and in the face of the Muslim wars beginning in 600 CE, there were strong cultural reasons to separate Jews from those who practiced this rite.[5]

Christianity, as it moved into Africa also adopted various form of, and rites associated with, circumcision.

## FGM and religion[edit]

The countries in which female genital cutting is a practice are mostly Muslim, but they are not exclusively so. Of the 29 countries tracked by UNICEF, 14 are home to more Christians than Muslims.[6]

In the modern Western world a lot of people believe female genital mutilation to be a mainly religious practice, but this is factually wrong.[4] Studies by the US Department of Health and the World Health Organization, among others, using the material from a host of anthropologists[note 2] have consistently stated that FGM is part of cultural rituals associated with tribal identity and tribal markings, and not with a particular religion.[7] In Africa and parts of the Middle East, the practice harms young girls regardless of the religion of the individuals. In Guinea, for example, over 90% of the population practice some Type of FGM — Christians and Muslims alike. Rural Israel reports incidents of cutting in the Coptic Jewish community as well as the Muslim communities.[8] In at least one case, FGC has taken place in a Christian church clinic in the United States.[9]

## World practice[edit]

Although the practice predates Islam by over a thousand years, the two have become associated due to the fact that many countries practising female genital mutilation are also majority-Muslim countries,[10] as well as due to some level of stereotype. Not all Muslim families practice FGM.

### Legal status[edit]

Many countries, including those where FGM is regularly practiced, have laws outlawing the procedure; however these can be difficult to enforce as the procedures usually take place locally, without medical supervision. Many Western organizations are working to pressure governments to pass additional laws and step up enforcement methods.[11]

As of 2011, 13 countries have fully outlawed any instance of FGM:

* Sweden (1982)
* Britain (1985), and the rest of the UK (2005)
* Most of Australia (1994 - Note: 2 states have not passed any legislation on FGM)
* New Zealand (1995)
* Norway (1995)
* Canada (1997)
* United States (1997)
* Belgium (2000)
* Cyprus (2003)
* Denmark (2003)
* Spain (2003)
* Italy (2005)
* France (2007) (though one of the last to catch up with specifically targeted legislation, they previously prosecuted those who practiced FGM on children using existing child abuse laws)

African nations, attempting to grapple with not only the moral and ethical issues of FGM, but also the AIDS crisis, have enacted a variety of laws to regulate such practices.

### Middle East and Africa[edit]

The UN/WHO study on FGM lists the following percentages of the female population from 15-49 years old who have undergone some level of FGM.[12]

* Burkina Faso - 76%
* Egypt \- 91%
* Ivory Coast - 38%
* Ethiopia - 74%
* Gambia - 76%
* Guinea - 96%
* Iraq - 8%
* Kenya \- 27%
* Liberia - 66%
* Mali \- 89%
* Nigeria - 27%
* Niger - 2%
* Sierra Leone - 88%
* Somalia \- 96%
* Northern Sudan - 80-90% (this is an approximation, as many people are tribal, and the studies consistently vary)
* Yemen - 23%

No official studies have been performed in the following countries, but FGM has been documented in scientific literature.[13]

* India
* Indonesia - 86-100%[14]
* Israel (the study cited by WHO was of Israel's Bedouin population)
* Malaysia
* United Arab Emirates

Countries that have had no studies conducted on the subject, but clearly still practice the procedure include:

* Saudi Arabia[15]
* Jordan[16]
* Syria
* Oman
* Australia

In these four non-African Muslim countries, the practice is considered to be undesirable, so estimates are between 5-25% of adult women are mutilated.

### United States, Canada, UK, and Australia[edit]

In the US, UK, and Canada, all forms of FGM are illegal, even the simple tribal markings of "nicking". In the UK, a BBC report on the ethics of "female circumcision" reports that 76,000 women living in the UK have not only been mutilated, but have undergone the procedure in the UK. Anywhere from 25,000-100,000 more women are mutilated either before they arrive in the UK, or in what can best be described as legal family supported "abductions" to countries where the procedure is performed, then returned home.[17]

The United States CDC has estimated that nearly 300,000 girls have undergone the surgery illegally in the US, and like the UK, they suspect that thousands more may have had the procedure done in other countries.[18]

In all three of these countries, laws have been proposed to allow medical professionals (surgeons) to do a form of tribal genital cutting, or removal of the clitoral hood as is done with male circumcision. After all, if boys can be butchered on the operating table, why not girls?

The argument is twofold. Firstly, professionals would be using aseptic conditions with specialized equipment, and would be less likely to botch the procedure. Secondly, if "something" were offered, perhaps the trend of total infibulation or removal of the clitoris would not be seen as necessary. However, none of these deranged proposals have gained much legal support.

## Cultural relativists' defence of child abuse[edit]

Some cultural relativists defend the use of female genital mutilation as part of a mystical spiritual journey that a young girl takes within the boundaries of tribal identity to make her body more beautiful and virtuous. This image is strikingly different to the reality of a girl being held down as an old woman nicks off her clitoris with a rusty knife.[citation needed]

A small minority of the most extreme "social constructivists" such as Carla Obermeyer and Fuambai Ahmadu write off arguments about the medical complications that result from female genital mutilation as highly exaggerated and lacking sound medical investigation. Considering the near lack of even rudimentary medical facilities in less-developed areas, combined with the fact that in some cases male doctors (often the only trained doctors in some regions) are not allowed to examine female genitalia, the lack of medical evidence is not exactly surprising. However there are documented cases of serious medical complications involved with the removal of a bodily organ by an untrained individual.[citation needed]

Others claim that a small nick as practised in many cases is harmless in comparison to full out removal of the vulva. However even slight damage to the clitoris will often result in a deprivation of sexual sensitivity. One wouldn't cut off the top 5 centimeters of a boys penis and claim that it is harmless compared to chopping the whole thing off.

A recent article by Janice Boddy claims that genital mutilation is a loaded term which only westerners use. According to the report, African women consider the procedure to be "beautification", "honorification" or "womanization". The outright force involved and lack of consultation with the girl, nor the ability to make a personal informed decision on her own accord, makes such idealistic adjectives seem absurd. A twenty-year-old woman can ask for the procedure if she likes, and we can call it "beautification", just as breast enlargement might be considered beautification, but the cutting-off of a girl's vulva under force is full-out irreversible genital mutilation.[citation needed]

Richard Shweder, a psychological-anthropologist with a psychopathic opinion on the subject, claims that westerners should not judge societies which perform female genital mutilation, but that they should instead "understand" the culture, believing that we are too quick to judge and view tribal societies through the unfair lens of barbarism and even imperialist attitudes. If asked whether the same principle should be applied to a culture that uses their children as sex slaves or cattle labor... that narrative suddenly becomes silent. If, as the vast majority of cultural relativists claim, we should not judge other cultures but understand them in their context, customs and meaning, then the West should not be judged by the same cultural relativists for its culture of free inquiry, openness to critiquing archaic ideas and to empathize with girls held down by adults while their vulvas are cut off with a rusty knife.[citation needed]

### Comparison to (male) circumcision[edit]

See the main article on this topic: Two wrongs don't make a right

If you don't have a problem with boys being circumcised, then what's the big deal with doing it to girls? Male circumcision is not comparable with FGM. The best response to this fallacy is to acknowledge that many people do have a problem with male circumcision along with all forms of genital butchery. What male and female circumcision share in common is that infants can't give consent to unnecessary surgery and that adults and genital butchers can strip a child naked, view, inspect, touch and apply violence to a young person's genitals and yet in some countries, not go to jail.

While the lowest category of female circumcision is similar to some degree with male circumcision (the cutting of the hood as with the cutting of the foreskin) they both have different effects on the health of the body and genitals, future sexual problems and possible complications. The worst category of female genital mutilation are completely above and beyond male circumcision. To remove most of the vulva and sew it up (the 3rd level of FGM) would be the equivalent of castrating a boy, penis and all.

Some men face serious physical and psychological problems after circumcision, especially problems with sexual function which is generally not well known and under-reported. Girls subjected to the first category of FGM may or may not face similar problems while girls subjected to the worst forms of FGM (especially category 3) face a guaranteed future of sexual dysfunction and physical and psychological misery.[19]

## Other anthropological approaches[edit]

The Restorers, a group of five students from Kenya who have developed an app for helping girls deal with female genital mutilation

Sensible anthropologists (the type who don't take cultural relativism to such an extreme) argue that while one's first instinct is naturally to smack the shit out of people who do this and throw them in prison, the best thing to do is to try to understand the cultural attitudes and work with locals to change local attitudes and educate people on the dangers of FGM, because the practice persists even in areas where there are laws against it.[20]

Another thing to note is that some Muslim practitioners of FGM are under the mistaken belief that Islam requires it. Ellen Gruenbeaum notes that the Islamic movement in Sudan is strongly critical of FGM, and that exposure to other Islamic cultures reinforces the emerging view in Sudan that it is not demanded by Islam.[21]

## Reparative surgery[edit]

It seems that the possibility for reparative surgery exists which is (not surprisingly, considering their extremely hedonistic focus on sensual and sexual pleasure) supported by the Raëlians.[22]

## See also[edit]

* Circumcision

## External links[edit]

* Eliminating female genital mutilation, a UN/WHO report

## Notes[edit]

1. ↑ The WHO has advocated the term "cutting" instead of mutilation, because the term "mutilation" brings along a host of social perceptions and assumptions that create political arguments which interfere with actually stopping the procedures.
2. ↑ Gollaher, RO Hayes, H. Lewis, AM Gibeau as examples have all studied and written about the history of FGM, and the core "tribal" identity that transcends religion

## References[edit]

1. ↑ Cultural Anthropology: Tribes, States, and the Global System. Bodley, J. H. 2011
2. ↑ 2.0 2.1 http://www.un.org/apps/news/story.asp?NewsID=18718&Cr=genital&Cr1=mutilation
3. ↑ http://www.who.int/mediacentre/factsheets/fs241/en/index.html
4. ↑ 4.0 4.1 4.2 4.3 4.4 Circumcision: a history of the world's most controversial surgery By David Gollaher, 2000.
5. ↑ Shayne D. Cohen, Why Aren't Jewish Women Circumcised?: Gender and Covenant in Judaism, 2005
6. ↑ Politifact
7. ↑ See "Female Genital Mutilation, World Health Organization's Handbook for frontline workers, 2000 as an example
8. ↑ http://www.womenshealth.gov/publications/our-publications/fact-sheet/female-genital-cutting.cfm
9. ↑ FGM happened to me in white, midwest America: A Christian doctor removed my clitoris when I was three years old as a ‘cure’ for masturbation by Dr A Renee Bergstrom (3 December 2016 08.50 EST) The Guardian.
10. ↑ Mustafa, A. Z. (1966), FEMALE CIRCUMCISION AND INFIBULATION IN THE SUDAN. BJOG: An International Journal of Obstetrics & Gynaecology, 73: 302–306.
11. ↑ http://reproductiverights.org/en/document/female-genital-mutilation-fgm-legal-prohibitions-worldwide
12. ↑ http://www.who.int/reproductivehealth/topics/fgm/prevalence/en/index.html
13. ↑ Also from the WHO document
14. ↑ http://www.theguardian.com/society/2012/nov/18/female-genital-mutilation-circumcision-indonesia
15. ↑ http://www.guardian.co.uk/science/blog/2008/nov/13/female-genital-mutilation-sexual-dysfunction
16. ↑ http://www.bbc.co.uk/ethics/femalecircumcision/femalecirc_1.shtml
17. ↑ UKs policy about what to do if things "go wrong" overseas, indicating that the UK government is aware of this fact, but can do little to prevent it.
18. ↑ Female Genital Mutilation, NCIB, 1997 (pg 372)
19. ↑ Does male circumcision affect sexual function, sensitivity, or satisfaction?--a systematic review
20. ↑ http://www.alluc.com/l/Female-genital-mutilation/jtwxlhh
21. ↑ Gruenbaum, Ellen.1996. The Cultural Debate over Female Circumcision: The Sudanese Are Arguing This One out for Themselves. Medical Anthropology Quarterly. 10 (4): 449-695.
22. ↑ High hopes: the UFO cult 'restoring' the victims of female genital mutilation - the Guardian