Female genital mutilation (FGM) comprises 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. The practice is found in Africa, Asia, and the Middle East, and within communities from countries in which FGM is common. In 2016 UNICEF estimated that 200 million women living today in 30 countries — 27 African countries, Indonesia, Iraqi Kurdistan and Yemen — have undergone the procedures.
Typically carried out by a traditional circumciser using a blade, FGM is conducted from days after birth to puberty and beyond. In half of the countries for which national figures are available, most girls are cut before the age of five.
Procedures differ according to the country or ethnic group. There are four types, these are;
Also called clitoridectomy, involves partial or total removal of the clitoris and/or prepuce.
Also called excision, is the partial or total removal of the clitoris and the labia minora.
Also called infibulation, is the narrowing of the vaginal orifice with a covering seal. The seal is formed by cutting and re-positioning the labia minora and/or the labia majora. Later in life, infibulated women may be cut open on the first night of marriage and/or before childbirth.
This is any other harmful procedure to the female genitalia for non-medical purposes, such as pricking, piercing, incising, scraping or cauterization.
Types I and II are most prevalent, but variation exists within countries and communities. Type III – infibulation – is experienced by about 10 per cent of all affected women.
FGM has serious implications for the sexual and reproductive health of girls and women. Complications may occur in all types of FGM, but are most frequent with infibulation.
Immediate complications include severe pain, shock, hemorrhage, tetanus or infection, urine retention, ulceration of the genital region and injury to adjacent tissue, wound infection, urinary infection, fever, and septicemia. Hemorrhage and infection can be severe enough to cause death.
Long-term consequences include complications during childbirth, anemia, the formation of cysts and abscesses, keloid scar formation, damage to the urethra resulting in urinary incontinence, dyspareunia (painful sexual intercourse), sexual dysfunction, hypersensitivity of the genital area, and increased risk of HIV transmission, as well as psychological effects.
Infibulation, or type III FGM, may cause complete vaginal obstruction resulting in the accumulation of menstrual flow in the vagina and uterus.
Infibulation creates a physical barrier to sexual intercourse and childbirth. An infibulated woman, therefore, has to undergo gradual dilation of the vaginal opening before sexual intercourse can take place. Often, infibulated women are cut open on the first night of marriage (by the husband or a circumciser) to enable the husband to be intimate with his wife. At childbirth, many women also have to be cut again because the vaginal opening is too small to allow for the passage of a baby. Infibulation is also linked to menstrual and urination disorders, recurrent bladder and urinary tract infections, fistulae and infertility.
FGM may have lasting effects on women and girls who undergo the procedure. The psychological stress of the procedure may trigger behavioral disturbances in children, closely linked to loss of trust and confidence in caregivers. In the longer term, women may suffer feelings of anxiety and depression. Sexual dysfunction may also contribute to marital conflicts or divorce.
The origins of the practice are unclear. It predates the rise of Christianity and Islam. It is said some Egyptian mummies display characteristics of FGM. Historians such as Herodotus claimed that, in the fifth century BC, the Phoenicians, the Hittites and the Ethiopians practiced circumcision. It is also reported that circumcision rites were practiced in tropical zones of Africa, in the Philippines, by certain tribes in the Upper Amazon, by women of the Arunta tribe in Australia, and by certain early Romans and Arabs. As recent as the 1950s, clitoridectomy was practiced in Western Europe and the United States to treat perceived ailments including hysteria, epilepsy, mental disorders, masturbation, nymphomania and melancholia. In other words, the practice of FGM has been followed by many different people and societies across the ages and continents.
FGM is practiced in Africa, Asia, the Middle East, Eastern Europe, South America and in many western countries too.
FGM is usually carried out by elderly people in the community (usually, but not exclusively women) designated to perform this task or by traditional birth attendants. Among certain populations, FGM may be carried out by traditional health practitioners, (male) barbers, members of secret societies, herbalists or sometimes a female relative. In some cases, medical professionals perform FGM.
FGM is carried out with special knives, scissors, scalpels, pieces of glass or razor blades. Anesthetics and antiseptics are generally not used unless the procedure is carried out by a medical practitioner. In communities where infibulation is practiced, the girls’ legs are often bound together to immobilize them for 10 – 14 days, allowing the formation of scar tissue.
In every society in which it is practiced, female genital mutilation is a manifestation of deeply entrenched gender inequality.
Where it is widely practiced, FGM is supported by both men and women, usually without question, and anyone that does not follow the norm may face condemnation, harassment and ostracism. It may be difficult for families to abandon the practice without support from the wider community. In fact, it is often practiced even when it is known to inflict harm upon girls because the perceived social benefits of the practice are deemed higher than its disadvantages.
FGM is carried out as a way to control women’s sexuality, which is sometimes said to be insatiable if parts of the genitalia, especially the clitoris, are not removed. It is thought to ensure virginity before marriage and fidelity afterward, and to increase male sexual pleasure.
FGM is seen as part of a girl’s initiation into womanhood and as an intrinsic part of a community’s cultural heritage. Sometimes myths about female genitalia (e.g., that an uncut clitoris will grow to the size of a penis, or that FGM will enhance fertility or promote child survival perpetuates the practice).
In some communities, the external female genitalia are considered dirty and ugly and are removed, ostensibly to promote hygiene and aesthetic appeal.
Although FGM is not endorsed by either Islam or Christianity, supposed religious doctrine is often used to justify the practice.
In many communities, FGM is a prerequisite for marriage. Where women are largely dependent on men, economic necessity can be a major driver of the procedure. FGM sometimes is a prerequisite for the right to inherit. It may also be a major source of income for practitioners.
No religion promotes or condones FGM. Still, more than half of girls and women in four out of fourteen countries where data is available saw FGM as a religious requirement. And although FGM is often perceived as being connected to Islam, perhaps because it is practiced among many Muslim groups, not all Islamic groups practice FGM, and many non-Islamic groups do, including some Christians, Ethiopian Jews, and followers of certain traditional African religions.
FGM is thus a cultural rather than a religious practice. In fact, many religious leaders have denounced it. Culture and tradition provide a framework for human wellbeing, and cultural arguments cannot be used to condone violence against a person, male or female.
Aisha, 33 Ghana (names have been changed) * Cosmopolitan
What I vividly remember is my sister and I were playing, and a woman came and took us. This was in The Gambia, and I was 6 and my sister was 3 at the time. This woman was known in the village, and she told us she was taking us somewhere to see something. Like little kids do, we tagged along. We went into a home, and immediately women grabbed and blindfolded us and tied us to some thick bushes.
I could smell the leaves, the dirt, everything around us. I knew we were no longer in a home setting, but outside somewhere. There was loud drumming and older women were singing songs, which I was too young to understand. I could hear other kids crying out in pain, but I didn’t know why.
I was dragged to a fence covered in leaves, and they took the blindfold off. I could see the other girls bleeding and sobbing in pain. I saw an old woman holding a knife so sharp I could see the drops of blood sliding down the edge. It was the blood of the other girls.
Three other women were holding down my arms and legs, and another was sitting on my chest, covering my mouth. They try to put pressure on you, so you don’t cry for the next girl to hear. I can still feel the weight of her today. I can still visualize all their faces as I talk about this. I can see what each one of them looks like and the emotions that they had — so empty, like they didn’t see me as a human being.
The cutting happens very fast. What the cutter does is hold on to your clitoris to make sure she gets that and scrapes everything else that comes along with it — all of the labia, if they can. I fought the whole time, and as a result, only my clitoris and part of my left labia were cut. The other side is still intact. My mother told me recently that when this happens they will often wait until the girl has a child. Then they will finish the job, cutting off everything they didn’t get the first time.
After all the girls in my group were cut, we were left to bleed into little dirt holes for hours. Finally, when it became dark, we were taken to the home of the woman who did the cutting and crowded into one room to heal. We were there for three months ate out of one shared bowl we shared.
In the morning, we would wake up, line up, and receive our “treatment.” They took dried leaves and placed them on the wound and that would stay on for two to three days. Then they would rip the leaves off and put another one on until the tissue began to scar. Every morning a woman came in to teach us songs, and if we didn’t memorize the words, she would beat us. We were also taught every day, that if we ever talked about this, if we even mentioned it, they would kill us.
I became friends with these girls. We bonded and ended up going to school together. I learned two of them later died in childbirth, because it was too difficult for them because of FGM. They bled to death.
At the end of the three months, there was a ceremony to celebrate that we had gone through the rite of passage. My mother came to pick us up, and I kept asking: “Why did they do this to me? Where were you?”
She just responded: “They told you not to say anything, right? Then don’t talk about it.” I never got an explanation until years later.
I work in the healthcare industry now, and I have so many questions about my health that has to do with something so significant regarding my genitalia. So I pressed my mother again. She finally said she did it to protect me. She said, “If I were to take you out of that equation, you would be regarded as an outcast, an unclean person. You would not be a part of us. And I don’t want anyone to be an outcast in our society. This is who we are.”
She also admitted that she couldn’t be there when they took us — even though she arranged it — because it was too painful for her.
I know one hundred women I am related to who will all be cut. My uncle’s wife took over in our village, and she’s the one who has the knife. All my nieces and any girl born in my family will be cut.
My sister went to the U.S. for her education, and she was the one who helped me come here as well. She cannot have kids as a result of her FGM. I have two daughters now and had to be cut open again to have each one. But I had them here, with a doctor. Back in Gambia, I could have died. My girls will be the only ones in my family who will never have to go through FGM. I know if I had given birth to my daughters in Gambia, they will do to them what they did to me. My mother assured me of this. I will never take them back. My family will never see them!
Abdo, 40 Sudan
“I was infibulated when I was five years old. It hurt so much that I cried and cried. When I was nearly twelve, one day my aunts examined me.
They declared that I was not closed enough. They took me to the midwife who lived a few streets away. When I noticed where they were taking me, I tried to run away, but they held me tight and dragged me into the midwife’s house. I screamed for help and tried to free myself but I was not strong enough. They held me down and put a cover over my mouth so I could not scream. Then they cut me again and this time, the woman who operated on me made sure that I was closed.
I don’t know how many days I was lying there. The pain was terrible. I was tied up and could not move. I could not urinate, my stomach became all swollen. I was terribly hot one moment, and shook with cold the next. Then the midwife came again. I screamed as hard as I could, as I thought she was going to cut me again. Then I lost consciousness. I woke up in a hospital ward. I was terrified – I did not know where I was. I was in terrible pain my genital area was all swollen and hurt all the time. Later I was told that the infibulation had been cut open to let the urine and pus out. I was terribly weak, and I did not care anymore. I wanted to die.
It is years later now. The doctors told me that I could never have children because of the infibulation. Therefore, no one will marry me as no one wants a wife who cannot have a child. I sit at home alone and cry a lot. I look at my mother and my aunts, and I ask them: “Why did you do this terrible thing to me?”
Fran P. Hosken: The Hosken Report – Genital and sexual mutilation of females. Winnews, 1993, S. 108.
To provide even more context into the gruesomeness of the practice it must be noted that the clitoris is a structure about the size of a pea located at the top of a woman’s vulva, above the urethral opening.
The clitoris is extremely sensitive to being touched for sexual stimulation. It is responsible for feelings of sexual pleasure when stimulated, and for many women, clitoral stimulation is how they are able to experience an orgasm. FGM removes the clitoris to prevent the woman from feeling sexual pleasure. This type of mutilation is often performed when a girl reaches puberty so that it may reduce the chances of her cheating on her partner as sex is no longer as pleasurable as it would be with a clitoris that is intact.
Mutilated women have negative sexual experiences and specifically adverse changes in desire, arousal and satisfaction.
In addition to all the other physical and mental effects of FGM on women, it also strips the most basic human pleasure derived from sexual intercourse presenting the woman as less than human and undeserving of this basic pleasure enjoyed even by animals.
It is 2020 folks! It’s the 21st century! We are still telling women how to look, what to wear, how to speak, how to do or not do their jobs and we’re still cutting her up and telling her she cannot enjoy sex, scarring her for life both emotionally and physically.
This is not an ethnical or a religious problem, this is a global war that we all have to come out and fight, men and women alike.
Human rights are for everyone – our daughters, mothers, sisters and friends – what are you going to do about it?
Najda Khan is an ardently Proactive Kenyan passionate about the empowerment, mentorship and education of women and youth. Spending nearly a decade as a senior HR and Marketing specialist at international corporates, she also worked extensively in the NGO’s, offering training, mediation and facilitation of women’s programs including FGM, HIV/Aids and women’s rights.
She is also the producer and host of “The Big Fat Talk Show” on YouTube that is a series of candid conversations with extraordinary women discussing important societal topics aimed at creating a platform to promote sensitization, healing, self-reflection, encouragement and empowerment.
Najda is currently finalizing her MSc in Human Resource Management and Training at the University of Leicester.
Article Written by Najda Begum Khan
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