GRSJ224/femalegenitalmutilation

Female Genital Mutilation

Introduction

Female genital mutilation (FGM) is the practice of altering or causing injury to the female genital organs for non-medical purposes. The reasons behind this practice are varied but are typically linked to a patriarchal religion due to the inherent sexism of the practice despite no religion specifically mandating female genital mutilation. For some, it is believed that it is a necessary requirement for marriage and is used to control women’s sexuality. FGM is also seen as a practice to beautify and cleanse girls by removing the unclean parts of their genitals . Typically, the practice is performed between the ages of 6 and 12 and often, parents believe that this practice will ensure the successful marriage of their daughters and thus prevent social ostracization. There are four types of female genital mutilation. Type 1 or clitoridectomies involve the partial or complete removal of the clitoris. Type 2 or excision is the partial or complete removal of the clitoris and the labia minora that may or may not include the excision of the labia majora. Type 3 or infibulation, is the narrowing of the vaginal opening through stitching. Type 4 is a general category to include all other harmful, non-medical procedures on female genitalia such as pricking, piercing and scraping. These procedures are typically carried out by midwives or trained circumcisers that travel between villages and use no anesthesia, antibiotics or sterile equipment during the procedure.

Prevalence

FGM is practiced in 28 African countries and at least 200 million girls and women alive today having undergone FGM. It is also known to be practiced to a lesser extent in some Asian, Middle Easter, South American and Eastern European countries. Prevalence varies significantly however and within a nation, some areas may have never heard of FGM while other communities practice it as high as 90% of girls. Egypt, Sudan, Somalia, Mali, Guinea and Sierra Leone have the highest rates of FGM, with a 2013 UNICEF report estimating it to be above 80% in girls and women.

Complications

There are a vast number of complications that frequently result from FGM and are relative to the severity of the procedure performed. Complications that can occur immediately include excessive bleeding, swelling, fever, infections and death. Some examples of long-term consequences include urinary problems, vaginal problems, increased risk of childbirth complications and a need for corrective surgeries. A consequence that is common in cases of FGM is psychological trauma. In a study of 204 adolescent girls in Egypt, in which over half had endured FGM, girls who had experienced FGM were shown to have significantly higher levels of psychological problems such as somatization, depression, anxiety and hostility than non-FGM girls.

Resistance

FGM is recognized as a violation of human rights, a form of torture and an extreme example of violence against women. Eighteen countries in Africa have implemented laws against FGM along with twelve industrialized countries that are home to immigrants from countries where FGM is common. In 1997, the World Health Organization along with UNICEF and the United Nations Population Fund released a statement condemning the practice of FGM. Since then, these groups and other international organizations have been actively working towards ending the practice through research, reports, campaigns, strategies/guidelines, political support, and changes in public policy. In 2012, the UN General Assembly added eliminating FGM to the global agenda. There are also a multitude of grassroots activists working to end the practice of FGM in their communities.

Medicalization Movement

The medicalization of FGM refers to FGM being performed by a health-care provider like a nurse or a doctor in clinics or outside of healthcare settings. About 18% of FGM is carried out by healthcare workers but this estimate varies greatly between regions. Proponents for the medicalization of FGM argue that this offers a method of harm reduction in that the use of sterile equipment, trained staff and anaesthetics could reduce the possibility of dangerous complications. Those in opposition to the medicalization of FGM argue that it violates the medical principle of “first do no harm,” as it is a procedure that conveys no benefits and only risks. Additionally, many view the medicalization of FGM as a means to legitimize the practice as being medically valid and can directly contradict efforts to end FGM.