What is Being Done to Stop FGM?

The Defense of FGM

Is FMG a Voluntary Procedure?

Is There Really a Religious Background?

Health Risks and Consequences

There are many negative physical and psychological problems associated with FGM and there are no known health benefits, contrary to claims by those who defend the procedure (as I will show in a later entry, these claims are based on tradition and superstition, not scientific evidence). The severity and frequency of complications involved with female excision vary according to the type of procedure.(1) Excision is rarely performed in a medical facility, which increases the risk of infection. The sort of tools used to cut the women and girls vary in quality, ranging from broken glass to surgical knives.(2)


Photo: Blades used to perform FGM. http://noslavesofallahinamerica.blogspot.com/2008/02/truth-about-islamic-genital-mutilation.html

Numbing agents are almost never used during the procedure and the tools are rarely sterilized.(3) The WHO has compiled a list of health risks that result from FGM. These results have been gathered from various medical facilities where women and girls have gone to receive treatment for complications caused by the procedure. Due to the fact that the only data on the subject is taken from hospitals, the majority of complications are not reported.(4) It is logical, however, to assume that complications are common outside the medical setting, especially in the bush.

Photo 1: A former excisor, who gave up the practice, shows the knife she used to cut the girls. World Vision UK. http://www.worldvision.org.uk/server.php?show=nav.2224
Photo 2: This young girl has her legs bound in preparation for the healing process of FGM, which could take weeks. Amnesty International. http://www.amnesty.cz/svaw/english/clanky-eng/fgm-nig-070131-eng.htm

As you can see in the photo, (above right) the women performing the procedure are not wearing surgical gloves and the patient is on the floor.

The health risks associated with the less severe type of FGM, type I, include pain, bleeding, infection, and psychological trauma.(5) The girls are forcibly held down during the procedure and it can be a terrifying experience.
The more severe the FGM, the more numerous and severe the health problems. The long-term effects include: chronic pain, infection, decreased sexual enjoyment, infertility (caused by infection of the vagina that spreads in to the ovaries and uterus), and post-traumatic stress disorder.(6) WHO officials are also concerned about the possible spread of HIV due to non-sterilized epuipment, but this is not very likely due to the young age of most FGM sufferers and the fact that mass excisions are rare.(7)
Type II and III excision have also been linked to complications during childbirthing to the mother and infant. Type II and III excision require the partial or total stiching up of the vaginal opening, which makes childbirthing extrememly difficult. Many of these women require caesarean sections in order to deliver the child. Post-partum haemorrhage is another serious problem because it can result in the death of the mother from blood loss. Type II and III FGM has also been linked to an increase in the infant mortality rate. According to a study by the WHO, the infant mortality rate among women who have undergone some form of FGM is significantly higher than among women who have not:
Type I: 15% higher infant mortality
Type II: 32% higher infant mortality
Type III: 55% higher infant mortality.
The WHO estimates that one to two more per 100 infants die as a result of FGM.(8) The WHO has no definitive evidence, but they estimate that these figures are much higher outside the hospital setting to those without access to medical assistance.



This video, produced by the Clitoraid organization, provides a brief overview of FGM, the risks, and efforts to end the practice.

Notes:
1. WHO. "Eliminating Female Genital Mutilation". 11.
2. Maria Marzano. "Universalism and Cultural Specificity". 51.
3. Marzano, "Universalism...". 51.
4. WHO. "Eliminating Female...". 27.
5. WHO. "Eliminating Female...". 11.
6. Ibid., 33-5.
7. Ibid., 33.
8. Ibid., 11. The whole section discussing the health risks of type II and III FGM is taken from the same page of the same source.

Where is FGM Practiced?

The WHO has documented female genital mutilation in 28 African countries.(1) FGM is practiced in several Asian, Middle Eastern, and South American countries as well, but the highest concentration is found on the African continent. The earliest recorded instance of female excision dates back to the fifth century B.C.E. in Egypt.(2) The practice appears to have spread along the slave trade routes east-west across the continent, but did not spread as widely in the south.(3)

Map: WHO. "FGM Prevalence in African Countries" In "Eliminating Female Genital Mutilation".

This map shows which countries practice FGM and the percentage of women who have undergone excision. Keep in mind that the percentage within countries depending on the area and the ethnic group located there.(4) For example, there may be places in Egypt (which has a 95% prevalence nation-wide) where very few women have been excised, but in the next city over, all the women have undergone FGM.

Notes:
1. WHO. "Eliminating Female Genitalia Mutilation". 4.
2. Chantal Zabus. Between Rites and Rights. Stanford: Stanford University Press, 2007. 133
3. Zabus. Between Rites. 133.
4. WHO. "Eliminating Female...". 5.

What is Clitoridectomy?

Clitoridectomy is a procedure done to external female genitalia. The term, in reality, should not be used to refer to female excision in the collective sense, because it is also used to identify a certain type of procedure. There are actually four separate types of female excision and the World Health Organization has opted to refer to them as either 'female genital mutilation' and/or 'female genital cutting'(1). Some groups consider the term "mutilation" to be offensive to those who have undergone the procedure, but the WHO feel it's appropriate given the severity of the issue.

This video shows the circumcision practices of one African tribe. From what I can tell, the excisor is describing the second type, clitoridectomy. This video also shows the superstition surrounding the practice; this tribe is not unique in it's thinking. In addition, you can see the lack of medical equipment or safety.
These terms refer to "all procedures involving partial or total removal of the external genitalia or other injury to the female organs for non-medical reasons"(2). FGM is most commonly performed on girls aged 0 to 15 years, but is also performed on married or unmarried adult women. The age of the girls/women vary by location and culture, but it has been observed that the overall age at the time of the procedure is falling(3). The type of procedure also varies by ethnicity. Ethnicity, not religion, is the most decisive factor when considering the prevalence in a given area(4).

The four types of FGM are: 1. "ritualistic circumcision"- the least severe of the four types 2. "sunna"- a Muslim term used to describe this moderate form 3. "clitoridectomy"- the most common form 4. "infibulation"- the most severe form in which all external genitalia are removed and the vagina is sewn shut(5).

Diagram: The 3 types of FGM. Everyday Life in Iberia. From Alexa and Marta's blog. lifeiniberia.blogspot.com/2008_05_01_archive.html

Notes:
1. WHO. "Eliminating Female Genital Mutilation". Geneva: WHO Publishing, 2008. 3.
2. WHO, "Eliminating Female...", 1.
3. Ibid., 4.
4. Ibid.
5. Maria Michela Mazano. "Universalism and Cultural Specificity: Female Circumcision, Intrinsic Dignity, and Human Rights". In Human Rights and Military Intervention. Aldershot: Ashgate Publishing Limited, 2002. 51.