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What Is Female Genital Mutilation? Why Does It Occur? What Are Its Health And Wellbeing Impacts?

January 15, 2013

STOP FGMFemale genital mutilation (FGM) is a horrific act, agreed by all the major global humanitarian and legal organisations, and by many nations, to be a gross violation of human rights.  But still it continues, perpetrated often on small girls and young women under barbaric conditions.   What follows is an attempt to describe and ‘explain’ this act.   Possible consequences for those who have it are also listed.
NB: The ** material below is very distressing to read**, but knowledge of FGM is essential to eradicating the practice.

Why does FGM happen?

  • FGM may be an early marker of belonging to a particular group, perhaps carried out when the child is only a few days or weeks old. (Similarly, ex-pat groups may adopt it as a way of indicating difference from their host community.)
  • In some communities FGM is seen as a rite of passage, an initiation to adulthood, occurring as the girl approaches puberty and ‘becomes a woman’.
  • FGM is sometimes required to ‘preserve’ family ‘honour’.
  • It may be done in order to ‘cleanse’ a girl, in the belief that it is more hygienic and will stop unpleasant genital secretions and odours as the child develops to maturity.
  • FGM may be deemed a beautifying procedure, to remove ‘masculine’ aspects of a girl’s or woman’s body.
  • Some communities believe men’s sexual pleasure will be enhanced by FGM.
  • Excision of the clitoris may be believed to ensure women will not be like men in regard to sexual appetite or aggression.
  • Fear of the clitoris may be a factor, with the belief that it must be excised because otherwise it will grow into a ‘third leg’ (c.f. a penis, only perhaps longer), and / or will cause the girl discomfort when she becomes a woman.
  • Fear of the clitoris, and its consequent excision, is also a rationale in communities which believe a man – or baby – will die if they come into contact with it during intercourse or birth.
  • Excision of the clitoris is believed to reduce a woman’s sexual pleasure or desire, thus reducing the likelihood that she will become sexually active with anyone other than her husband.
  • And, often in addition to any or all of these convictions, FGM is a way to ensure that a girl or woman is ‘pure’; she may be sewn up almost completely as she approaches puberty, when she reaches marriageable age, or even after each birth, so that sexual intimacy is almost impossible unless on her husband’s say-so.

~ ~ ~

Types of female genital mutilation

 

Type I:

~ partial or total removal of the clitoris and/or the prepuce (clitoridectomy).

Subgroups:

type Ia – removal of the clitoral hood or prepuce only;

type Ib – removal of the clitoris with the prepuce.

Type II:

~ partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora (excision).

Subgroups:

type IIa – removal of the labia minora only;

type IIb – partial or total removal of the clitoris and labia minora;

type IIc – partial or total removal of the clitoris, labia minora and labia majora.

Type III:

~ narrowing of the vaginal orifice with creation of a covering seal by cutting and appositioning the labia minora and/or the labia majora, with or without excision of the clitoris (infibulation).

Subgroups:

type IIIa – removal and apposition of the labia minora;

type IIIb – removal and apposition of the labia majora.

Reinfibulation is covered under this definition. This is a procedure to recreate an infibulation, for example after childbirth when defibulation is necessary.

Type IV:

~ unclassified – all other harmful procedures to the female genitalia for nonmedical

purposes, for example, pricking, piercing, incising, scraping and cauterization.

Source:   Global strategy to stop health-care providers from performing female genital mutilation, World Health Organisation  (2010)

~ ~ ~

What health and well-being impacts does FGM have?

Impacts of FGM on physical health: immediate (up to 10 days)

  • Severe pain
  • Haemorrhage
  • Shock (sometimes death)
  • Infection of the wound
  • Acute urinary retention (with pain and burning)
  • Urinary track infection
  • Abscesses and ulcers
  • Fever
  • Septicaemia
  • Tetanus
  • Gangrene

Impacts of FGM on physical health: medium and longer-term (after 10 days)

  • Delay in wound healing due to infection, malnutrition and anaemia
  • Anaemia (and failure to thrive if malnourished child)
  • Chronic pelvic infection
  • Fibrosis (scarring at site of cutting)
  • Cheloids (abnormal growth of scar tissue)
  • Synechia (abnormal fusion of labia)
  • Tissue rotation (abnormal scarring and retraction of anatomical zones)
  • Chronic back and pelvic pain
  • Urinary problems / incontinence / kidney failure
  • Bladder calculus / stone formation
  • Hypersensitivity of entire genital area, including neuroma on the dorsal nerve of the clitoris
  • Dysmenorrhoea / menstrual problems
  • Haematocolpos (accumulation internally of menstrual blood)
  • Pain at sexual intercourse
  • Recto/vaginal fistulae (?and subsequent ostracization by the community)
  • Unwillingness to seek general medical advice, in case FGM becomes evident
  • Hepatitis and other infections (because of poorly healed wounds)

Impacts of FGM on sexual health

  • Dysparenuia / discomfort / spasm / pain during intercourse
  • Anxiety resulting in vaginal dryness
  • Less sexual satisfaction / difficult to reach orgasm
  • Less (reported) sexual desire / lack of arousal
  • Shame or embarrassment about intimacy
  • Greater risk of HIV (because of cuts which bleed)
  • Medical checks (e.g. smear tests) difficult, and may be avoided, so early prognoses of ill-health are missed
  • Morbidity due to anal intercourse, where vaginal access is difficult
  • Infertility

Impacts of FGM on psychological health (girls &  women – specifics may depend on age)

  • Psychological vulnerability
  • Anger
  • Fear
  • Anxiety
  • Depression
  • Confusion
  • Lack of trust
  • Post-traumatic stress disorder
  • Psychosexual problems
  • Hyper-arousal
  • Hyper-vigilance
  • Psychological disturbance
  • Behavioural problems
  • Relationship difficulties or disorders
  • Emotional distance
  • Sense of helplessness
  • Somatization
  • Phobia
  • Sleep disorders
  • Low self-esteem and / or sense of self-entitlement
  • Social isolation / dependent on group disconnected from the mainstream
  • Flashbacks
  • Cognitive dissonance (where norms of FGM are not shared)
  • Rejection by others (e.g. not allowed to handle food or water, not permitted adult status – or even acknowledged as a mother)
  • Stigma

Impacts of FGM obstetrically: maternal

  • Difficulties in performing good pelvic examination during labour (resulting in inadequate management of delivery)
  • Prolongation of second stage of labour
  • Tearing and recourse to episiotomy
  • Caesarian section (sometimes unnecessary because obstetrician unprepared)
  • Perineal lacerations
  • Torn uterus
  • Post-partum haemorrhage
  • Perineal wound infections
  • Post-partum sepsis
  • Repeated pregnancies because of infant mortality (presumably?)

Impacts of FGM obstetrically: paediatric

  • Stillbirth
  • Need for resuscitation
  • Neonatal distress and / or mortality
  • Failure to thrive
  • Cerebral palsy / brain damage
  • Death or serious incapacity of mother, so high risk also to child

Many women believe that FGM is necessary to ensure acceptance by their community; they are unaware that FGM is not practised in most of the world.” Quote: FORWARD

~ ~ ~ ~ ~

FURTHER INFORMATION AND ACTION

Readers are invited to support these two FGM e-petitions:

UK Government: Enforce the UK law which forbids FGM (Female Genital so-called ‘Cutting’)    .. and

FGM abolitionists internationally: Support the Feminist Statement on Female Genital Mutilation

[See also HM Government e-petition, No. 35313, to STOP Female Genital Mutilation (FGM / ‘cutting’) in Britain  (for UK citizens and residents - now closed).]

There is a free FGM hotline for anyone in the UK: 0800 028 3550, or email: fgmhelp@nspcc.org.uk

The #NoFGM Daily News carries reports of all items shared on Twitter that day about FGM – brings many organisations and developments into focus.

For more on FGM please see here.

Twitter accounts: @NoFGM1  @NoFGMBookUK  @FGMStatement  [tag for all: #NoFGM]

Facebook page: #NoFGM – a crime against humanity

More info on FGM in the UK here.

Email contact: NoFGM email

** Hilary Burrage is currently writing a book, Eradicating Female Genital Mutilation: A UK Perspective

6 Comments leave one →
  1. January 16, 2013 20:02

    Thank you for this extensive list of complications from FGM. I hope that this practice will be eradicated in my lifetime to stop this useless suffering and death of girls and women.

  2. March 31, 2013 13:17

    Your work on the topic of FGM is very encouraging and hopefully it will be eradicated in Britain at least soon. However do we in the west have the right to tell another culture in the south, to stop a practice that has been a rite of passage long before colonialism?
    What about the women who want to have the FGM done?
    I am also running a blog for a university project, http://genderhcp.wordpress.com/

    • April 1, 2013 23:30

      Thanks for the nice comment!

      In reply to your question, I have no doubt at all that everyone must work however they can to get FGM stopped everywhere. There are significant numbers of people from the most affected nations who have devoted their lives to just that end, and they need 100% support.

      Additionally, there is the ‘disinterested’ (and in my view clinching) argument that torture of any kind – but even more especially of course to children – must be opposed by every means possible, wherever it occurs.

      There are always some people who, for a vast range of ‘reasons’, will demand that they be left to continue the practices of ‘their’ communities. This position has been promulgated over the centuries in defence of all sorts of atrocities but cruelty is cruelty.

      Another issue is that FGM is usually inflicted on children who obviously cannot give consent in any meaningful way; and since it has NO positive health impacts, there cannot be any rationale which suggests others, as parents or guardians, may give consent on behalf of the child.

      And yes, of course some adult women want FGM for themselves (though many vociferously don’t), but there is no medical or health reason for any practitioner to carry out the procedure, and the prime rule of good medical practice is ‘do no harm’. It might be suggested that there is a rationale in terms of individual psychological ‘benefit’, but that has to be weighed against the commonality of interest of everyone (which is why the ‘just a nick to observe traditions options’ is ruled out by the law and most professionals).

      And yes, too, there is the difficult issue in the West of designer vaginas, but that’s a matter of commercial medicine and (at least in skilled hands) is done hygienically and does not actually impair vital functions – though it is to be brutally frank a very worrying development because it suggests that even the most intimate parts of women’s bodies need to be sculpted to look ‘attractive'; not a position most women would adopt.

      So to my mind this is absolutely not a question of western imperialism or anything remotely like it. It’s an issue about, amongst other things, the protection from a horrifying experience (and outcomes) for children, the sovereignty of healthy bodies and the resistance of patriarchy and subservience to male domination of vulnerable women.

      I have on the website likened FGM to the dreadful instance of Baby P. I don’t see it as a matter of white or black girls, of western or traditional ways. I see it as the grimmest of cruelties which often has life-long and extremely damaging impact on girls who are forced to undergo it (please see list of impacts as above).

      In December 2012 the UN / WHO at last managed to secure a resolution (statement) representing every nation to the effect that FGM is simply unacceptable and must be stopped…. which is good enough for me.

      Having said that, however, I do believe ways must be found to give status and the right to individual development to girls and women in (previously) FGM-practising communities – my post above on the Sande Society explains this issue further. That shift to girls’ and women’s self-determination won’t happen whilst they are married off very young, passed from father to husband (who may well also have other wives) as items for sale.

      To be autonomous girls need education and women need personal dignity and ways to earn a living without becoming ‘circumcisers’.

      PS Thanks, too, for signing my e-petition to Stop FGM in Britain. We very much need to keep up the pressure. You may like to follow this to get extra info (free) for your own blog: #NoFGM Daily News (and there are more posts on FGM here). Our Twitter feed is @NoFGM1.

  3. June 24, 2013 09:51

    Breakthrough! >> *NSPCC FGM HELPLINE* set up today, 24 June 2013

    Call: 0800 028 3550
    Email: fgmhelp@nspcc.org.uk

    Female Genital Mutilation is child abuse. If you are worried a child may be a victim, or at risk of female genital mutilation don’t wait until you’re certain, contact the NSPCC immediately.

    In the UK, people from the following communities are most at risk of FGM:
    Bohra-Dawoodi (Pakistani and Indian)
    Egyptian
    Eritrean
    Ethiopian
    Ghanaian
    Indonesian
    Kenyan
    Kurdish
    Nigerian
    Sierra Leonean
    Somali
    Sudanese
    Tanzanian
    Yemeni

    Don’t let socio-cultural pressures get in the way of protecting children.

    FGM is a harmful “cultural” practice, but it is not a religious one. Carrying out this practice has been a criminal offence in the UK since 1985. However, there has not been a single prosecution to date.

    As with other forms of child abuse, these crimes often remain hidden and unreported, as children are too ashamed or afraid to speak out.

    You can call the NSPCC helpline on 0800 028 3550 and send emails to fgmhelp@nspcc.org.uk, text on 88858 or use the NSPCC Helpline online form: .https://www.nspcc.org.uk/Applications/Forms/HelplineConcern/the-helpline-online-form.aspx

    More information on female genital mutilation here: http://hilaryburrage.com/tag/fgm/

  4. June 19, 2014 07:05

    I have read with interest the good work you are doing on FGM. I am in Kenya and this practice is quite rampant especially in the Rift Valley, some parts of Eastern and Northern areas. There are also pockets of other areas affected. The government has put some effort in trying to stop the practice, but these efforts have been frustrated by the local leaders such as chiefs and elected politicians. One of the strategies that can be used to boost this fight against FGM would be to educate the local populations against this practice, especially the parents and guardians. I am sure majority of them do not have access to the kind of information you have here. The effects of FGM are truly horrific and unacceptable. Innocent children are forced to undergo FGM by their parents and guardians. Some men insist on marrying only women who have undergone FGM, leading to many women and parents engaging in this horrific act. In fact, it would seem like the women engage in the act to please men, not themselves. The best weapon against FGM, in my opinion, is to concentrate on educating parents about the dangers and effects that you have enumerated here. Educating such men and parents can be done through selected local leaders, local hospitals and clinics. Since teachers command some respect in the rural areas, selected local schools can also be engaged to pass the message and reach out to parents. Another strategy would be to engage local religious leaders and churches. Religion plays a very important role in the lives of humans and it would be a good idea to work closely with religious leaders to educate the local population on the dangers of FGM.

  5. Sally Box. permalink
    July 22, 2014 13:07

    This is a totally outrageous act plus it shows how stupid men can be. For heavens sake surely if the woman receives sexual pleasure think how much better she can respond to her husband but then I suppose these primitive communities don’t think that way.

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