Female Genital Mutilation

FEMALE GENITAL MUTILATION

World Health Organization Fact Sheet N°241
Updated February 2014

Key Facts

• Female genital mutilation (FGM) includes procedures that intentionally alter or cause injury to the female genital organs for non-medical reasons.
• The procedure has no health benefits for girls and women.
• Procedures can cause severe bleeding and problems urinating, and later cysts, infections, infertility as well as complications in childbirth and increased risk of newborn deaths.
• More than 125 million girls and women alive today have been cut in the 29 countries in Africa and Middle East where FGM is concentrated (1).
• FGM is mostly carried out on young girls sometime between infancy and age 15.
• FGM is a violation of the human rights of girls and women.

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 mostly carried out by traditional circumcisers, who often play other central roles in communities, such as attending childbirths. However, more than 18% of all FGM is performed by health care providers, and the trend towards medicalization is increasing.

FGM is recognized internationally as a violation of the human rights of girls and women. It reflects deep-rooted inequality between the sexes, and constitutes an extreme form of discrimination against women. It is nearly always carried out on minors and is a violation of the rights of children. The practice also violates a person's rights to health, security and physical integrity, the right to be free from torture and cruel, inhuman or degrading treatment, and the right to life when the procedure results in death.

No health benefits, only harm

FGM has no health benefits, and it harms girls and women in many ways. It involves removing and damaging healthy and normal female genital tissue, and interferes with the natural functions of girls' and women's bodies.

Immediate complications can include severe pain, shock, haemorrhage (bleeding), tetanus or sepsis (bacterial infection), urine retention, open sores in the genital region and injury to nearby genital tissue.

Long-term consequences can include:

• recurrent bladder and urinary tract infections;
• cysts;
• infertility;
• an increased risk of childbirth complications and newborn deaths;
• the need for later surgeries. For example, the FGM procedure that seals or narrows a vaginal opening (type 3 above) needs to be cut open later to allow for sexual intercourse and childbirth. Sometimes it is stitched again several times, including after childbirth, hence the woman goes through repeated opening and closing procedures, further increasing and repeated both immediate and long-term risks.

Who is at risk?

Procedures are mostly carried out on young girls sometime between infancy and age 15, and occasionally on adult women. In Africa, more than three million girls have been estimated to be at risk for FGM annually.

More than 125 million girls and women alive today have been cut in the 29 countries in Africa and Middle East where FGM is concentrated (1).

The practice is most common in the western, eastern, and north-eastern regions of Africa, in some countries in Asia and the Middle East, and among migrants from these areas.

Cultural, religious and social causes

The causes of female genital mutilation include a mix of cultural, religious and social factors within families and communities.

• Where FGM is a social convention, the social pressure to conform to what others do and have been doing is a strong motivation to perpetuate the practice.
• FGM is often considered a necessary part of raising a girl properly, and a way to prepare her for adulthood and marriage.
• FGM is often motivated by beliefs about what is considered proper sexual behaviour, linking procedures to premarital virginity and marital fidelity. FGM is in many communities believed to reduce a woman's libido and therefore believed to help her resist "illicit" sexual acts. When a vaginal opening is covered or narrowed (type 3 above), the fear of the pain of opening it, and the fear that this will be found out, is expected to further discourage "illicit" sexual intercourse among women with this type of FGM.
• FGM is associated with cultural ideals of femininity and modesty, which include the notion that girls are “clean” and "beautiful" after removal of body parts that are considered "male" or "unclean".
• Though no religious scripts prescribe the practice, practitioners often believe the practice has religious support.
• Religious leaders take varying positions with regard to FGM: some promote it, some consider it irrelevant to religion, and others contribute to its elimination.
• Local structures of power and authority, such as community leaders, religious leaders, circumcisers, and even some medical personnel can contribute to upholding the practice.
• In most societies, FGM is considered a cultural tradition, which is often used as an argument for its continuation.
• In some societies, recent adoption of the practice is linked to copying the traditions of neighbouring groups. Sometimes it has started as part of a wider religious or traditional revival movement.
• In some societies, FGM is practised by new groups when they move into areas where the local population practice FGM.

International response

In December 2012, the UN General Assembly adopted a resolution on the elimination of female genital mutilation.

In 2010 WHO published a "Global strategy to stop health care providers from performing female genital mutilation" in collaboration with other key UN agencies and international organizations.

In 2008 WHO together with 9 other United Nations partners, issued a new statement on the elimination of FGM to support increased advocacy for the abandonment of FGM. The 2008 statement provides evidence collected over the past decade about the practice. It highlights the increased recognition of the human rights and legal dimensions of the problem and provides data on the frequency and scope of FGM. It also summarizes research about on why FGM continues, how to stop it, and its damaging effects on the health of women, girls and newborn babies.

The new statement builds on the original from 1997 that WHO issued together with the United Nations Children’s Fund (UNICEF) and the United Nations Population Fund (UNFPA).

Since 1997, great efforts have been made to counteract FGM, through research, work within communities, and changes in public policy. Progress at both international and local levels includes:

• wider international involvement to stop FGM;
• international monitoring bodies and resolutions that condemn the practice;
• revised legal frameworks and growing political support to end FGM (this includes a law against FGM in 24 African countries, and in several states in two other countries, as well as 12 industrialized countries with migrant populations from FGM practicing countries);
• in most countries, the prevalence of FGM has decreased, and an increasing number of women and men in practising communities support ending its practice.

Research shows that, if practicing communities themselves decide to abandon FGM, the practice can be eliminated very rapidly.

Female Genital Mutilation: Why Egyptian Girls Fear the Summer

ByNick Thompson, CNNUpdated 1:22 PM ET, Thu June 25, 2015

Cairo, Egypt (CNN)Summer days: They're what childhood memories are made of, glorious afternoons of unchecked freedom to frolic with friends in the sun, unshackled from the earthly obligations of a math class that never seemed further away.

But for millions of schoolgirls in Egypt, this time of year represents something much darker: the start of the female genital mutilation (FGM) season.

Mona Mohamed was 10 years old when she underwent what's also known as a female circumcision on a hot summer day in her village in Upper Egypt.

"I was terrified," she said. "They tied me down, my mother on one hand and my grandmother on the other."

As Mona thrashed around, pinned by her loved ones to the living room floor, a doctor injected her with anesthesia.

Mona remembers being given a piece of bubble gum to chew on before she finally passed out. It wasn't until she woke up that she realized she had been mutilated.

Egypt: The FGM capital of the world

Stories like Mona's are far from rare in Egypt, where "cutting" has been a brutal rite of passage for young girls since the time of the pharaohs.

Of themore than 125 million girlsand women alive today who have undergone the procedure, one in four live in Egypt. That's more than any other country in the world, according to the U.N.

Ninety-two percent of married Egyptian women aged 15 to 49 have been subjected to FGM, according to agovernment report released in May. That figure is down from97% in 2000, but the practice is still the norm here.

Most girls are cut between the ages of nine and 12, and the operations usually take place during the summer school break so the girls can recover at home.

U.N. officials say FGM has no medical benefits and can cause lifelong physical and emotional trauma for the women forced to undergo the procedure.

"This is a gross human rights violation," Jaime Nadal-Roig, the U.N. Population Fund representative in Cairo, told CNN. "It doesn't add anything to the life of the girl, and there are no medical or religious grounds whatsoever."

A celebrated tradition

The most common FGM procedure in Egypt is Type 1, the partial or full removal of the clitoris. It's what Mona Mohamed -- and her older sisters -- endured years ago.

Compared to her sisters, Mona was lucky, given that her procedure was performed by a doctor. Her sisters were circumcised with a razor blade by a traditional (non-medical) midwife who put dust on their wounds to stop the bleeding.

Mona, now 47, recalls asking her mother why getting circumcised was so important. "Usually girls at your age get 'excited,' and this operation takes care of that," her mother replied.

FGM has been illegal in Egypt since 2008, but the practice remains woven into the very fabric of Egyptian society, where many see cutting as a way to "purify" a girl and make her marriage material.

"People used to have a party after a girl was circumcised, they'd celebrate and exchange gifts," Nadal-Roig said. "So for them to turn from there and say, 'look this is a crime or this is a sin or this is not allowed by religion' means confronting a lot of beliefs and social norms."

Campaigners go on the offensive

But progress is being made. The percentage of girls aged 15 to 17 who have had the procedure has dropped from74.4% in 2008to61% in 2014-- a clear sign that the drive to end FGM is working, campaigners say.

Last week Egypt announced a plan to reduce FGM by 10-15% in the next five years. If it works, it will mean that for the first time in decades, "uncut" girls would outnumber those who have had the procedure.

"It's an ambitious plan, but now I think that the political atmosphere is supporting us and we can reach our goal," said Vivian Fouad, the National Population Council official leading the government's charge to eradicate FGM.

"For years we were on (the) defense, but now we're on the offensive."

The fight to eradicate FGM in Egypt is unfolding on a number of fronts, from the courts to the places of worship to the streets of the highest-risk towns.

In January adoctor was sentencedon charges related to mutilating a girl -- the first conviction of its kind since the 2008 ban went into effect.

The verdict was a victory for the anti-FGM campaign, but Fouad says too many doctors are still willing to take the money from families and look the other way when it comes to the law.

"It's a good income for doctors," Fouad said. "And some doctors have social and cultural backgrounds where FGM is supported."

Fouad classifies the battle against female circumcision as a fight for the middle class: "If doctors, judges, prosecutors, and teachers are supporting FGM, how are we going to convince poorer women not to have it?"

Campaigners are also trying to persuade local religious leaders to stop preaching the alleged benefits of FGM to mothers. It's often a tough sell in a country where more than half of women still believe, falsely, that cutting is required by religion, according to themost recent survey.

"You need to make people not want to do it for their daughters," said UNFPA program officer Germain Haddad. "You need to work on people's convictions."

To that end, theUNFPA has hired a theater groupto perform comedic skits in the streets of communities across the country to foster debate -- and doubt -- about the necessity of FGM.

"Many of these people are shy," said Haddad. "When we used to do seminars on FGM it was very difficult to get people to speak up and ask questions.

"These plays act as an icebreaker that opens up the subject like magic," she said. "And women get to see in a comedic way that FGM is ridiculous."

"I hate the man that did this to me"

But it remains an uphill struggle. Around six in 10 women think the practice should continue, according to the most recentgovernment survey.

"It's tradition, and there's no escape," says Sarah Abulaziz Mohamed, who was circumcised at 12 in her village of Mansour.

"It hurt my dignity -- I was forced to do this act that I didn't want to do," she said. "I hate the man that did this to me."

Sarah is 40 now and has two young daughters of her own. She says FGM left her with lifelong psychological trauma, but at least it taught her a valuable lesson.

"I definitely wouldn't do it to my daughters by any means," she said. "To this day I still have pain, and what's gone is gone ... that part of me can never be given back again."

Discussion Questions – Answer these questions and then discuss with a partner.

1. When reading about FGM, how do you feel? Describe your perspective from an ethnocentric stance.

1. How could you explain FGM to others from a cultural relativist perspective? Use the information about FGM in Egypt as an example.

1. Sociologists assert it is important to view other societies’ customs from a cultural relativist point of view to understand their way of life. In this case, how might retaining an ethnocentric perspective be beneficial?

Contemporary Social Issues: Unit 2 – Culture