Patriarchs And Proxy Perpetrators? Men And Female Genital Mutilation (FGM)

I visited St Antony’s College Middle East Centre, Oxford University, today (5 February 2020) as guest of Dr Soraya Tremayne, to give a presentation in the run-up to International Zero Tolerance for FGM Day tomorrow. My theme was the necessity to ensure that men are brought onside as activists to #EndFGM. I looked at ways in which, traditionally, men have been mostly unengaged in the realities of FGM (beyond their economic interests and an insistence on ‘purity’) and perhaps how, drawing on recent studies of masculine nurturative behaviour in Egypt, this might be changed.

My write-up of the presentation is below:

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Patriarchs and Proxy Perpetrators?  Men and Female Genital Mutilation

What is FGM?  Why is it damaging?
Female genital mutilation (FGM) is the collective term for a wide range of non-accidental harm to women and girls’ external genitals (and, if further damage such as fistula arises collaterally later on from the original harm, eg during childbirth, also internal organs).

The term FGM includes, but is not only, ‘genital cutting’ and other euphemisms; ‘Mutilation’ is the preferred term of the United Nations and most other global organisations. This naming is important because FGM is always harmful and a crime – usually at national and well as international levels of jurisdiction – and other terms may seemingly trivialise its significance as an assault and breach of human rights.  In Middle Eastern use it seems that ‘female circumcision’ may translate as ‘purification’… which tell us much more about location-specific social perceptions of this act, than it does about the real, personal (and often enduring) impact of those who undergo it.

In most societies FGM is enacted by women, usually on girls (but sometimes also on other women).  The ‘procedure’ is often accompanied by ceremony, although less frequently in Middle Eastern communities than in African ones.

There are instances where a man is the ‘cutter’,  (see e.g, Karima Amin’s account of her experience in Yemen: Female Mutilation, p.74) but not often.  The after care of victims (for such they are at the time of the act, albeit later they may choose to become, if anything, ‘survivors’) is almost always by women, the very large majority of whom will themselves have experienced FGM.

The United Nations, the Global Health Organisation and others such as UNICEF categorise FGM as from 1 to 3 in respect of severity, with another category, 4, for unspecified and alternative types.  Type 1 is ‘just a nick’ and similar (e.g. ‘sunna’), Type 2 includes scraping away various parts of the labia and clitoris, and Type 3 indicates extensive cutting away, and / or infibulation – the sewing up or otherwise sealing of the external genitals, leaving only a small hole for the excretion of body fluids. Type 4 includes mutilations such as labia pulling / extension. All ‘types’ are harmful; and often the person who has had FGM is not fully aware of what ‘type’ she has had – which can make for difficulties later in her gynaecological and/or obstetric life.

Only rarely in traditional methods of FGM is anaesthetic used or any attempt made to counter infection, even though the same instruments (knives, blades, shells, fingernails…) may be employed for many people.  Another major contemporary concern of the UN, WHO, UNICEF etc is however the increasing ‘medicalisation’ of FGM, when clinicians – fully qualified or otherwise – provide the ‘service’ using modern methods of pain and infection control.  Medicalisation is now common in e.g. Egypt, and increasingly in some more ‘developed’ African nations such as Kenya.

It is important to note also that FGM (like male circumcision, which continues) has until quite recently also been practised via various ‘medical’ rationales in Western nations such as the USA and UK.  One justification for such ‘treatments’ is that they are safer and less intrusive than traditional methods of operation.  These claims are not substantiated.  Further, the opportunity by trained clinicians to monetise medical knowledge and skills is particularly attractive in places where clinicians are poorly paid, or, in much wealthier countries, are able to operate in a private practice setting.

The physical, psychological and socio-economic impacts of FGM can be huge. FGM increases the chance that childbirth will be dangerous for both the woman and her child; it can lead to a lifetime of recurrent infection; it causes obstetric fistulae and thereby often social rejection; it is a fundamental cause of lack of interpersonal / social trust and increasingly recognised as an important cause in some communities of post-traumatic stress disorder (PTSD); it severely damages children’s life chances when their mother is ill or dies; it harms local economies when women – often the farmers – are unwell and cannot function optimally; it disenfranchises any women not ‘cut’, who may be refused ‘adult’ status and forbidden to own land; it costs regions and nations substantial sums in e.g. medical and social care, policing and administration.

In ‘traditional’ communities there may be no awareness that FGM need not happen.  In diaspora communities it can become a proxy for adherence to heritage and traditional ways of doing things, another marker of original cultural identity, and part of a barrier between the host society and the diaspora group, almost inevitably to the disadvantage of the latter.  The list goes on…

Men at the interface with FGM
As we have noted, men are only infrequently directly involved with FGM. They are often the ultimate purchasers of the ‘service’, and they almost always have a view on it; but their actual knowledge of what it comprises is typically very limited.  As we shall see, however, many of them do have very firm views on the need for women and girls to be demonstrably ‘pure’.

Men’s typical ignorance about FGM – until they are told and asked to engage – arises from a number of factors.

Importantly, neither women nor men in most traditional or closed societies have much idea about either the form or the functioning of normal female genitals.  In societies (and some diaspora communities) with little formal education there is a general lack of knowledge of human anatomy and physiology, or knowledge of the dangers of FGM.  There is also an overall lack of awareness of ‘psychological’ issues in the first world sense – our Western understandings of connection and the workings of the mind do not resonate in communities where social solidarity and cohesion are prime requirements for survival.

But this lack of knowledge about how the human body works is not the only obstacle to communication about matters of human intimacy.  In many communities men and women do not converse on such issues.  Sometimes a form of omerta on sexual issues operates overtly; in other cases the issues simply do not arise for discussion between women and men.  There may not even be a shared vocabulary for such conversations, and both men and women would consider such talk, even simply about body functions let alone sexual feelings, indelicate and improper.

It is therefore unsurprising that when boys and men are told the facts of FGM, perhaps at community meetings arranged by local health workers, or at school, they are often shocked.  In some instances they may have seen the act performed during a ceremonial event – perhaps only a public precursor to the substantial harm later perpetrated e.g. in the deep bush – but they are unlikely to have observed the details of their sisters’ and daughters’ recoveries.

In other cases, the men simply don’t know that a woman or girl has undergone FGM.  It happens in private and is never openly discussed.  And in many instances neither sex knows what the other thinks about it.

Traditionally, secrecy about the practice of FGM has been even more likely in Middle Eastern than in African settings, but with the introduction in many countries of legal sanctions for FGM perpetrators, greater privacy when imposing it, maybe under cover of night, has become more usual in African communities, and also in diasporas.

All this means that for many FGM is a reality but also a mystery.  Community members often have little grasp of how their bodies are shaped and function, and the vocabulary and mode of discourse to explain such matters may not even exist.  It would be deemed improper in the extreme for these matters to be discussed openly, a disablement exacerbated further by the impossibility in most traditional societies of framing the issues also in terms of human experience and feelings.

The survival of the group matters; the personal experience or feelings of individuals within it is less important, especially when those experiences and feelings relate to women and girls.  There is in such contexts little need or inclination for men to ponder such things.  In the absence of any contrary need, these matters remain ‘women’s business’.

Economics and power
There is however another vital but rarely debated way in which FGM and ‘men’s business’ collide:  daughters and wives are financial collateral for most men. They have economic value to their fathers as commodities.

Unlike sons, daughters will be sold or bartered for economic advantage when they reach (what is judged) to be a suitable marriageable age. The ‘purity’ of girls is therefore a significant factor in their ‘value’.  FGM may be deemed evidence that such purity has been maintained, and in some communities it (FGM) is conducted almost immediately before betrothal and bride price (or, conversely, dowry – payment to the future husband) is established.  Tragically, these transactions may be conducted even before the girl child reaches her teens.

In effect, in many communities girls are reared to be sold as brides – perhaps one of a number to one man – and thereby provide not only domestic and sexual services, but also via their own families (and children) some level of care in old age.  These are powerful motivations for men to maintain the status quo; they have little incentive to investigate the means whereby purity and bride price achieved.

Further, any woman who is believed not to have undergone FGM may be forbidden to own land (to produce food and maybe earn money for herself and her children, as a small-holder) and may not even be permitted to prepare meals or mix in their community, because she is ‘unclean’.  The prospect of such isolation and poverty is a powerful factor, for women too, in the continuation of FGM.  (Sadly, there is also another prospect, rarely recognised or considered: extreme poverty and isolation can likewise occur if a woman suffers obstetric fistula, which may arise alongside child marriage and / or FGM.)

Conversely, but more positively, nor is there much discussion of the psycho-social dissonances which may now apply to ‘cut’ mothers whose daughters don’t have FGM.

It is important to recognise that unquestioning compliance by women, especially in the absence of perceived connections between FGM and future harm (it’s spirits or whatever cause illness and death, not FGM), is the norm.  No-one wants to believe that her mother  (or other family member/s) inflicted unnecessary suffering on her; but many women will welcome the additional authority and influence ‘permitted’ by male community leaders (and perhaps also the revenue) which comes with conducting FGM.  ‘Cutters’ are women generally accorded high status, operating in the context of a wider patriarchal hegemony.

In short, there are many powerful vested interests in continuing FGM without question or debate; these interests mitigate strongly against change.  Women are aware of the personal pain which accompanies FGM – but may well not perceive connections between FGM and its longer-term impacts – and men do not see (or try to avoid) any reasons for change.  Traditional societies, led largely by men, seek to maintain the status quo, not to move away from it. The hazards of divergence are in any case too great. In some places the ‘belief trap’ – curses by grandparental spirits etc – to which observers such as McKie (1996) refer is too substantial for any but the most dare-devil or already ostracised to challenge.

Further, and critically, FGM is big business – in its most florid social presentations it involves barter or cash exchanges, party organisers, feasts, ‘cutters’ who require payment, new clothing, nursing care and much else.  It is solidly built into the economy of some places where it occurs.

Breaching the barriers: FGM is an epidemic
FGM is a ‘social’ epidemic. There are those who claim it is not an epidemic at all, but we must then wonder what, if not a harm inflicted person-to-person on 3 million girls and women annually – 800 every day, might comprise such a phenomenon.

All epidemics are passed on from one agent (person) to another, whether directly or via e.g. infected water or food.  The difference with FGM is that, if people stopped doing it, the danger would also stop immediately.  No longer would we have 200 million women and girls globally with FGM. Over time that number would reduce to zero.  But the number is still rising because, despite some good eradication initiatives, there are more girls and young women alive and vulnerable to FGM now than in previous times, so this is a race against demographic shifts.

FGM will, like all other epidemics, stop if the causative behaviours stop; and in this case we don’t need also to combat invisible physical contagion as well as observable contacts.  But we do have to challenge deeply held, often unarticulated, taken-as-given, beliefs.  This is particularly difficult when it comes to matters such as ‘human rights’ and ‘individual autonomy’ – notions sometimes as alien to traditional thought as ideas about unmoveable collective mores, with no regard to individual consequence, may be to modern educators, social entrepreneurs and clinicians.

[We all carry unrecognised, unreasoned, assumptions of course, and especially in regard to gender and sex; but the task here is to disentangle what precipitates direct harm, from what does not.  At least initially, there may not be agreement between those seeking to stop FGM and those who want it to continue, about what constitutes ‘harm’; there is significant potential here for unintended further harm to be the upshot of well-meaning moves towards eradication.]

But there are several ways forward, including perhaps one or two which have not as yet been much explored.  One of these routes is to challenge the idea that FGM is indeed ‘women’s business’.

Engaging men in FGM eradication
It would be both untrue and unfair to suggest that all men are detached from efforts to stop FGM.

Inevitably, the issues are complicated by the simple fact that many – almost all in some cases – men in whose communities FGM occurs have themselves been ‘circumcised’ (an act which some of us refer to as MGM…).  Yes, MGM can main and kill, especially in traditional communities, just as FGM can.  And yes, MGM too can be a marker of adulthood.  It confers status just as FGM often does.  There are many reasons why some EndFGM campaigners choose not to acknowledge the parallels between FGM and MGM; and the same applies conversely.  It might however be more fruitful to see both as forms of physical and human rights abuse, as many thoughtful observers have said. (For the record it is this writer’s belief that neither will disappear completely until the other does; but that is a debate for another day.)

But let’s put aside these FGM / MGM tensions and focus for the present on male positions specifically re FGM.

Firstly, some men benefit substantially from the practice of FGM.  It provides income (bride price), sometimes land, and social support, and it gives status and power via social standing (multiple wives, and earlier on access to sexual favours via future marriage arrangements etc).  FGM is strongly associated with patriarchy.

On the other hand, in every community there are both boys and men who are not powerful – rather, they are the subjects of other’s power – and there are boys and men who know about and dislike the impacts of FGM on their sisters, girlfriends and wives.  There are reports of this concern in different locations – and it is evidenced by the increasing numbers of e.g. boys both in traditional communities and in the western diaspora, who after learning the facts via education or other information interventions seek to protect their sisters or other girls from undergoing FGM.

Likewise, there are now numerous instances of adult men, including professionals and graduates – teachers, social workers, clinicians, law enforcers, community leaders – in the ‘developing’ world who make it their objective to root out FGM in traditional communities. Compassion and respect for human rights (however framed) are not sentiments confined only to Westerners.   It is however less dangerous for those of us safely in the ‘first world’ to demonstrate these concerns.

The challenge then is how to bring onside many more than just the brave men in communities where FGM occurs who currently speak out against it.  To an extent, this will vary according to the contexts and customs / culture of the particular community.

Different places, different pathways?
Factors which may persuade men that FGM is their ‘business’, as well as a women’s concern, range from the macro-economic to the intensely personal.

Economic costs
The economic impacts of FGM are many.  Whilst at a local level they will include individual financial benefit, they also encompass loss – as in Hazel Barrett’s example (Female Mutilation, pp.162-4) of the women who permitted their profitable small holding, a well-established business providing for local hotels, to go to ruin whilst they indulged in a fortnight of FGM ‘celebrations’. More routinely, such losses may include even the economic cost of workers whose health is compromised by the upshots of FGM.

On a wider scale, FGM costs local and national governments significant sums and resources which must be allocated to the medical, educational and legal provisions which FGM remediation and prevention incur. (Three girls in Egypt are known to have died from medialised FGM since 2016.)

Even those – often men in positions of power – with less concern for the health and human rights of women and girls can sometimes be persuaded that the economic costs of FGM are important considerations.

Human costs
There is increasingly a sense, especially amongst young and better informed men in practising communities, both original and diaspora, that FGM is not of benefit to their intimate lives.  They may be alarmed about the pain that their wives and girlfriends experience during sex.  They may even chose to go outside their marriage for ‘comfort’, to a prostitute who has been ostracised because she is not ‘cut’.  Or, indeed, the braver and better informed ones may Speak Out.

Older men, as Kameel Ahmady has demonstrated, may also be uncomfortable once they are asked to consider FGM openly.  They may seek to avoid consideration of the harm done, once this is understood.  This unwillingness by elders to discuss matters directly may give younger men an opportunity to challenge and articulate their own concerns.

Masculinity and pride: Egypt as an example
Even less explored than the matters above is what we might term men’s ‘psychological disposition’ – probably a rather vague term, but by which is meant how they see and respond to the issues around them ‘as men’.  (Caveat:  I am not a man; and I am a Westerner.  Nor have I ever myself visited the Middle East.)

The literature on masculinity is largely (in Western society; it rarely features elsewhere) about men in Western society; but there are also glimpses available of what ‘being a man means’ in other societies.  Amongst these reports are two which, alongside Ahmady in Iran, focus on men in recent and/or modern Egypt (Naguib, 2015, and Morrison, 2015).

These reports make it clear that men leading their normal lives as husbands, fathers and citizens are often not the wooden characters assumed in the traditional male stereotype.  The Muslim Brotherhood, for instance, was founded in Egypt in 1928 by a male primary school teacher, Hassan al-Banna, who wanted – amongst other things – to serve the poor (quite literally, by the giving of bread – which continued as a symbol of oppression resisted, and of protest, right up to the 2011 Tahrir Square uprisings).  Likewise, in downtown Cairo we read in Naguib (above) about present-day men who take pride in providing the best food and care they can afford for their wives and families.

Here is not the arrogant male distancing from emotion that is sometimes assumed, but rather a willingness by men to speak warmly about their care for these dependents.  These are real men in the everyday real world, still proud of their masculinity, but also open to valuing their role as nurturers and carers.

And so we have a situation in which men, as links in the patriarchy, are undoubtedly the power driving the continuation of FGM:  they may not realise their role in upholding FGM, or even want it except by tradition and expectation, but they perpetrate FGM.  Mostly women actually impose FGM on their daughters, but men are the behind-the scenes-perpetrators by proxy.  It remains patriarchy incarnate.

On the other hand, however, we know that there are parts of societies, communities, in which men remain proud of their masculinity, but also proud of their care and nurturing of their families.

Is this openness and concern to nurture a way in which to broach the very difficult issue of FGM in some Middle East communities?  Would greater attention to the need to stop FGM by working with ‘ordinary’ men in these communities, assist in consolidating the message (often ignored) from legislators that FGM must not be tolerated?  How might this come about?

Would acceptance by men of the need to end FGM in their communities make it easier for their leaders –‘strong’ men and overt patriarchs – to enforce the legislation they may have introduced to prohibit FGM, but choose largely, perhaps because of traditional views and associated electoral considerations, to ignore?

Read more about FGM and Economics

Read more about FGM as Patriarchy Incarnate

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