Female Genital Mutilation (FGM) in Context: A Guest Editorial
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I am pleased that this brief overview of the complexities of ending FGM was today published as a Guest Editorial in the Journal EC Gynaecology.
Many talented, brave and committed people continue to work for the eradication of FGM, but we are not by any means there as yet.
Below I explore a few possible aspects of this continuing challenge.
You can read this website in the language of your choice via Google Translate.
Female Genital Mutilation (FGM) in Context
Citation: Hilary Burrage. “Female Genital Mutilation (FGM) in Context”. EC Gynaecology 13.11 (2024): 01-03.
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For the past two decades female genital mutilation and its eradication has taken much of my attention. In a world where some 230 million women and girls still have to live with this abusive damage every day of their lives, it is impossible not to think about FGM once one starts exploring its ‘meaning’ and the mystery of why it continues to resonate.
But why is making female genital mutilation history so difficult? I suggest there are at least three essentials for any long-term effective eradication of FGM:
• Committed, supported advocates ‘on the ground’ who can talk with direct experience of FGM, as survivors, family members, or (‘even’) past ‘cutters’ who have now realised what FGM really entails; and add to that, where possible, the advice of teachers and clinicians working in the community.
• A legal system in which it is clear that FGM (and other violence against women and girls) is illegal and will actually be punished.
• And, very importantly, a socio- economic system which enables women to conduct their lives as adults, autonomously, with education, their own (adequate) income and freedom to make their own choices.
It is this third element which, despite a rapidly growing understanding at least of the criticality of proper education, is perhaps most often missing from the eradication equation.
Much energy is rightly invested by advocates in communities spreading the word, insisting that FGM is a blight on women’s lives, a condition which results in girls both abandoning their education and adhering to the time-honoured, often religious, tradition of early marriage and multiple pregnancies. There is good reason to refer to FGM and other VAWG (violence against women and girls) as Patriarchy Incarnate – the imposition of (some) men’s wills on the minds and bodies of girls and women [1].
And the law in many nations is now rightly aligned with the UN and WHO positions – FGM is never, ever acceptable. It is however more difficult to apply that law than to see it into the statute books; and implementation of the law can sometimes produce its own backlash, as we saw recently in one focus of this text, The Gambia [2].
Which leads to my third necessary provision, a socio-economic system in which girls can grow up as independent adults, free to make their own choices about their lives. This has to start with greater autonomy and respect for the independence of women, both mothers and other community members, who will guide their daughters into the teenage years and beyond.
To achieve such independent status for women and girls requires engagement of the whole community, men as well as women. There are many ways leaders of goodwill (and with financial good sense) can support and help to engineer the autonomy and well-being of female as well as male members of their communities [3] – everything from exploiting the potential of low- and medium-technologies properly administered, to implementing fair governance, service and administrative policies, and insisting that their daughters attend school and their sons understand that the demand to marry a ‘cut’ girl is in reality a requirement to subject women to pain and long-term suboptimal health.
There is a need to attend not ‘only’ to health/clinical and legal aspects of FGM, essential as these are, but also to widen the scope of eradication efforts. Inclusive consideration of public health and wider economic issues is also critical [4].
To illustrate the point: In one recent instance a community of women, subsistence farmers in The Gambia who were strongly opposed to the cessation of FGM, were asked what they most needed to make their lives easier. The definitive answer was: chairs [5].**
This choice, admittedly surprising to some of us, illustrates how important it is to consult with community members respectfully, and to listen to what they say. These women have to walk long distances to meet for discussion of business and community matters, but when they arrive they have to sit like children on the ground for lack of proper seating. Adults considering matters of importance in their community require at the very least the comfort and dignity of chairs; and dignity is essential for independent adulthood.
Does FGM coincide with a lack of autonomy as a woman, an individual? Probably at least sometimes it does, but more work is needed to find out how various factors play out, and to identify the optimal ways to improve this situation.
Another example: in some parts of the world (mostly) women and girls spend huge amounts of time collecting water – in total about 200 millions hours a day. In one part of the Maasai Mara there are sixty tribes, and all but two practice FGM [6]. The two tribes that don’t are near a river and have no need to waste hours a day on water collection, or face enormous problems maintaining personal hygiene. Is this significant? We don’t know, because the research findings are very meagre. Is there a requirement in possible locations for scientists to identify aquifers, and politicians to install them? Such initiatives surely would pay dividends in many respects.
Or, in a wider context, there is ample evidence that FGM increases the risk of problems in pregnancy, delivery and beyond, for both mother and child. But has anyone asked if FGM – both the biological fact, and the socio-economic context – may in fact produce more children who are ‘stunted’, and then themselves perpetuate this condition via further ill-health, multiple difficult pregnancies and continuing sub-optimal maternity experiences [7]?
Is this another factor underwriting the many reasons why FGM must be ended? Given that stunting is a serious issue in the development of many children across the globe – and thereby also a serious issue for their nation’s economic well-being – could investigating FGM as a causative factor be given greater focus anyway?
The valiant and enduring efforts by many, from many different perspectives, to eradicate FGM are as important as ever; they must continue at pace. Similarly, those who bravely seek to ensure FGM becomes and remains illegal everywhere need serious and sustained support; their task is never finished, easy or comfortable [8, 9].
But maybe the time has come to consider also the wider contexts in which FGM occurs. And there are a lot of matters in such contexts to which men as leaders and good partners can attend, without having to talk overtly about things they find embarrassing, or on which they feel ill-informed [10].
This is not a research report with significant new findings. It is an opinion piece which I would like to think will encourage more attention to the settings in which FGM has traditionally occurred. I want to ask, do these settings of themselves sometimes become enabling of the practice? To that end I append below some freely available papers I have written which consider these issues in more detail.
The next challenge in the fight to eradicate FGM is I believe to identify issues which, despite so much heroic effort and despite huge steps forward, remain obstacles to complete success. I hope the questions and ideas I have explored here will be useful in that task.
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** This is the Chairs appeal: https://www.gofundme.com/f/chairs-for-hardworking-gambian-women-farmers-meetings
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Bibliography
1. A hierarchy of harms and agency in patriarchy incarnate (2022).
2. Gibbi Mballow, Gambian politician protecting women (2024).
3. Eradicating female genital mutilation: Looking at practical and low-tech ways forward (2024).
4. Hilary Burrage. “The route to end FGM: Moving from ‘multi-agency’ via multi-disciplinary to public health and economics”. EC Gynaecology 11.10 (2022): 51-56.
5. FGM and dignity – For want of a chair? My talk to the world bank about FGM in the Gambia (2024).
6. World Water Day – And why it matters for #EndFGM (2024).
7. Stunted children: A global tragedy. Does FGM amplify it? (2024).
8. Respect the Gambian women who have fought to outlaw FGM for decades (2024).
9. Ending FGM in the Gambia needs real action as well as words (2024).
10. Men as policy-makers must support #EndFGM – Enable women to gain respect as adults via fair social and economic contexts (2024).
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Paper received: October 23, 2024; Published: November 04, 2024
Citation: Hilary Burrage. “Female Genital Mutilation (FGM) in Context”. EC Gynaecology 13.11 (2024): 01-03. [Volume 13 Issue 11 November 2024]
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Books by Hilary Burrage on female genital mutilation
https://orcid.org/0000-0002-6684-2740
A free internet version of the book Female Mutilation is available here. It is hoped that putting these many global narrations onto the internet will enable people to read them in whatever language they choose.
Hilary has published widely and has contributed two chapters to Routledge International Handbooks:
Female Genital Mutilation and Genital Surgeries: Chapter 33,
in Routledge International Handbook of Women’s Sexual and Reproductive Health (2019),
eds Jane M. Ussher, Joan C. Chrisler, Janette Perz
and
FGM Studies: Economics, Public Health, and Societal Well-Being: Chapter 12,
in The Routledge International Handbook on Harmful Cultural Practices (2023),
eds Maria Jaschok, U. H. Ruhina Jesmin, Tobe Levin von Gleichen, Comfort Momoh
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PLEASE NOTE:
The Inter-African Committee on Traditional Practices Affecting the Health of Women and Children, which has a primary focus on FGM, is clear that in formal discourse any term other than ‘mutilation’ concedes damagingly to the cultural relativists. ‘FGM’ is therefore the term I use here – though the terms employed may of necessity vary in informal discussion with those who by tradition use alternative vocabulary. See the Feminist Statement on the Naming and Abolition of Female Genital Mutilation, The Bamako Declaration: Female Genital Mutilation Terminology and the debate about Anthr/Apologists on this website.
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This article concerns approaches to the eradication specifically of FGM. I am also categorically opposed to MGM, but that is not the focus of this particular piece, except if in any specifics as discussed above.
Anyone wishing to offer additional comment on more general considerations around male infant and juvenile genital mutilation is asked please to do so via these relevant dedicated threads.
Discussion of the general issues re M/FGM will not be published unless they are posted on these dedicated pages. Thanks.
Hilary Burrage 