Have you ever dreamed that you were laying down on a makeshift bed with your legs held wide open on either side, while a woman with a blade in her hand was preparing to cut off parts of your genitals? Obviously, you must have been having a nightmare. But consider that female genital cutting or FGM, short for Female Genital Mutilation, is a practice that is performed on about 6000 girls every day globally!

Introduction

FGM is mostly practiced in Africa, Asia and the Middle East where typically, a circumciser uses a blade to cut off certain parts of a girl’s genitalia, usually without the use of anesthesia! The circumcised are usually anywhere between 4 years old and puberty but can be “cut” a few days after they are born or even as an adult woman. Stemming from the inequality of the genders and centered on an effort to control the sexuality of women but also seen as a symbol of modesty, purity and beauty, it is usually performed by women who see it as a way to gain honor but also because of a fear that a lack of performing the cut will result in a girl’s social exclusion.

Surgery tools!
Surgery tools!
Health risks and dangers, depending on the kind of cut performed, include infections, the partial inhibition of menstrual flow and urine, chronic pains, problems or utter inability of conception, difficulties during childbirth and even bleeding to death. To date, there are no known advantages. In most countries where FGM is practiced it has been outlawed due to the health problems involved but unfortunately, the law is most times not enforced, preferring to turn a blind eye in favor of respect towards the practice’s cultural roots.

The circumcision is often performed using unsterilized tools that include knives, razor blades, scissors, glass, rocks that have been sharpened and even fingernails. Although it is usually performed by elderly women or in some cases, the community barber who may also be in charge of health work, in some nations, it is done by medical personal using local, complete or total lack of anesthesia.

Types

The World Health Organization (WHO) has categorized the mutilations caused by this practice in accordance to the amount of flesh removed from the genitalia:

Type I is known as clitoridectomy and comprises two different sub-types with type Ia consisting of removing only the clitoral hood which is rarely done alone. It is a lot more common to completely or partially remove the clitoral glans which is what can actually be seen of the clitoris or its tip and the clitoral hood. This second sub-type is known as type Ib.

Type II or excision, involves the cutting and removal of the inner labia (IIa), the removal of the clitoral glans and inner labia (IIb) and the removal of clitoral glans, inner and outer labia (IIc).

Types of FGM
Types of FGM
Type III, also known as infibulation or pharaonic circumcision is where the external genitalia is removed, cutting out the inner and outer labia, sometimes removing the clitoral glans while others, not so. The wound is then closed by pulling together the two sides of the labia majora, making sure that the cut edges approximate each other and then stitched together or closed by applying thorns. A hole, 2 to 3 mm wide is left so that urine and menstrual liquids may exit the body and the legs of the girl are tied together for up to 6 weeks as to help in the closing of the wound. If after the whole procedure is finished the girl’s family believes that the hole is too big, it is repeated!

The hole is again opened wider for intercourse and wider yet, for childbirth, after which it is again closed. If the husband is incapable of entering, a midwife cuts it open with a knife in extreme secrecy since this has a negative impact on how the husband’s potency is perceived. Some husbands, in an effort to not involve the midwife, will cut the woman using what is known as the “little knife”, and then tear the rest open to the point where his penis enters.

Type IV characterizes all other forms of FGM that include piercing, scarring, pricking, scraping and burning of the genitalia. Substances may also be introduced to the vagina in order to tighten it while labia stretching may also be encouraged in some countries to enhance the husband’s pleasure.

Effects

The effects that FGM has on a woman very much depends on the type practiced, the practitioner’s medical education, the sterilization or not of the instruments used and in case of Type III intervention, if surgical thread was used to close the wound or thorns. Also, in this last type of FGM, a lot has to do with the amount of times the procedure has been performed (a small or large hole that has to be corrected).

Needless to say, there are all kinds of short and long term complications that can and probably do lead to death in some cases. Unfortunately, there aren’t many studies to consult and it is known that there is under-reporting involved. The list of the various dangers that have been reported extends to include problems in childbirth and the endangering of the baby’s health and survival according to the type of cut practiced.

There have been few studies on the psychological effects of FGM and of sexual functions of women who have undergone the procedure. Nevertheless, anxiety, depression and post-traumatic stress disorder as well as lack of sexual desire and painful intercourse, have been reported.

In general, there is a tendency of reduction in the percentage of girls who undergo cutting of any type although, even if this rate was to continue downward the actual numbers will continue to rise in the future because of population growth. FGM has been found to be more common in rural areas and less so in wealthier families and better educated parents with exceptions being Sudan and Somalia where the tendency was reversed.

FGM by age and country
FGM by age and country

History

Historically, FGM has its roots to pre-Muslim times and is not mentioned in the Quran. It has been most likely been associated with Muslims because of the importance given to chastity and seclusion among the female population. Neither is there any mention of it in the Bible but it is practiced among Christian girls to a relatively large extent in African nations.

In Europe, the clitoris was in some cases removed as a treatment to insanity and masturbation during the 19th century. Isaac Baker Brown, an English gynecologist of the time removed the clitoris to treat masturbation as he believed that it was the cause of idiocy, mania and even death. After publishing his views in 1866, he was denounced as a quack and was expelled from the Obstetrical Society.

His work was pursued in the United States by J. Marion Sims and A. J. Bloch in the 19th century and clitoridectomy or the removal of the clitoris was practiced to treat hysteria, erotomania and lesbianism in the 1960s. James Burt who was a gynecologist from Ohio, performed “love surgery” which consisted of the repositioning of the vagina and urethra to accommodate it better for sexual intercourse. The procedure involved the removal of the clitorial hood. After complaints were filed, he was banned from practicing in the U.S. in 1989!

After many books, essays and reports in opposition of FGM and the WHO which refused the UN’s request to investigate the matter on grounds that it was not a medical matter, in 1959, The United Nations did include FGM in its resolution 48/104, “Declaration of the Elimination of Violence Against Women” in 1993 and in 2003, declared the 6th of February as “International Day of Zero Tolerance for Female Genital Mutilation”. All in all, despite failed efforts to reduce the practice in Africa on grounds of having unrealistic goals, some UN bodies have recognized FGM as a human-rights violation.

There have been some voices raised in change.org but unfortunately, most of them are petitions to ban FGM, not in the world, nor in the U.S. as a whole but in various states. Some are petitioning a ban in India, Asia, etc and there has been at least one petition in Spanish but unfortunately, it didn’t get too far. Nevertheless, I have been able to find a worldwide petition with 38 signatures! Not having anything better to present, I am placing the link here for those that want to sign and spread the word:

 

Petition to stop FGM
Please! Sign the petition.

 

Opposition Criticism

The truth is that FGM is far from being eradicated with 513,000 women in the U.S. reported as having experienced or in danger of experiencing the practice in 2012 and 500,000 in Europe since 2009. There is criticism of the opposition within Africa as “cultural colonialism” and a disrespect of human rights, with accusations of failing to appreciate the cultural context of FGM and describing parents as mutilators.

FGM has also been compared to cosmetic surgery such as breast enhancement and in fact, labiaplasty and clitoral hood reduction have not been defined as being a part of FGM by the WHO. The practice has been banned in regard to minors in the U.S. and Canada with a few countries like Sweden and the U.K. expanding it to the whole population.

Epilogue

Female genital cutting is a polemic subject. It is based on ethnic, cultural, social and religious factors of the groups that practice it, though not necessarily for the same ones. What are your thoughts and stand on the matter? Is FGM an atrocity performed on women or is it part of cultural and/or social beliefs that should be respected at all cost? I would love to read your point of view and invite you to state it in the comments area of this post.