Overview
“More than 230 million girls and women alive today have undergone female genital mutilation (FGM) in 30 countries in Africa, the Middle East and Asia.”
The practice of female genital mutilation is etched deep in ancient cultural, traditional and sometimes religious beliefs.
It has no health benefits for women and is considered a way for women to express honour, beauty, and purity.
It is also believed to control the sexuality of women, keeping them chaste.
FGM can cause physical and mental problems for young women, and the complications begin to manifest depending on the nature and degree (type) of circumcision or mutilation much further in the adult lives of women when they start reaching adulthood and early puberty and want to start having children.
The practice of FGM is obsolete and has been deemed harmful and a violation of girls’ and women’s fundamental human rights, including their rights to health, security and dignity.
It is illegal and banned in many regions of the world.
What Is Female Genital Mutilation?
Female genital mutilation (FGM) refers to the partial or total removal of the female external genitalia or other injury to the female genital organs for non-medical reasons.
Types Of Female Genital Mutilation
The World Health Organisation has classified FGM into four different types.
- Type 1: Clitoridectomy. This procedure involves partly or entirely removing the sensitive part of the female genitals, known as the clitoral glans and/or the fold of skin surrounding it called the prepuce or clitoral hood.
- Type 2: Excision. The removal of part or all of the clitoral glans and the inner folds of the vulva (labia minora), with or without removing the outer folds of skin (labia majora).
- Type 3: Infibulation is the narrowing of the vaginal opening, which involves creating a seal by cutting and repositioning the labia (sometimes using stitching). The clitoral prepuce/clitoral hood and glans are also affected in some cases.
- Type 4: This includes all other harmful procedures to the female genitalia for non-medical purposes, e.g., pricking, piercing, incising, scraping and cauterising the genital area for non-medical reasons.
Complications Of Female Genital Mutilation
“Treatment of the health complications of FGM is estimated to cost health systems US$ 1.4 billion per year, a number expected to rise unless urgent action is taken towards its abandonment.”
There are no health benefits of FGM, and it can lead to serious, long-term (sometimes life-threatening) complications.
The practice of FGM involves removing healthy vaginal tissues that can interfere with the normal biological and reproductive functions of girls and women’s reproductive systems.
Complications of FGM can include:
- Severe Pain: In almost all cases, FGM is practised with no form of anaesthesia, putting young girls in severe pain that can lead to shock. Surgical methods are crude and brutal.
- Excessive Bleeding: Under crude circumstances, there are no adequate procedures in place to control excessive bleeding (haemorrhage) during female genital mutilation (FGM). Girls who undergo FGM are at increased risk of excessive bleeding, which, if not treated quickly, can lead to other complications such as hypovolemic shock, anaemia, and even death.
- Genital Tissue Swelling: Post-procedural trauma can lead to painful genital swelling that causes severe discomfort for young girls.
- Infections: Local women who do these procedures on young girls do not have adequate knowledge of practising asepsis during mutilation, thereby exposing young girls to infections like tetanus and other blood-borne infections like HIV, Hepatitis and even Sepsis.
- Urinary Problems: Depending on the extent of mutilation, in some cases, damage can be done to the urinary orifice, giving rise to urination problems.
- Wound Healing Problems: Due to the crude methods employed, wounds might not heal properly because of infections and poor surgical procedures and techniques. Structural damage and scar formations (keloids) can have longstanding effects when wounds don’t heal properly.
- Increased Risk Of Childbirth Complications: Non-medical alterations to normal vaginal tissues can lead to childbirth complications in future.
- Sexual Problems: Like painful intercourse, decreased satisfaction due to the partial or total removal of the clitoris.
- Psychological And Mental Problems: Young girls who have undergone the horror and torture of FGM can later be plagued with psychological problems like depression, anxiety, post-traumatic stress disorder, and low self-esteem.
- Increased risk of neonatal death for babies born to mothers having undergone female genital mutilation.
- Other Reproductive Problems And Complications: Menstrual problems and vaginal problems.
Prevalence
“Nigeria has the third highest burden of FGM globally and accounts for 10% of the 200 million women and girls’ survivors of FGM globally, estimated at nearly 20 million.”
- The practice of female genital mutilation (FGM) is highly concentrated in specific countries in Africa, the Middle East, and Asia, with prevalence ranging from almost universal in countries like Somalia, Guinea, and Djibouti to affecting a smaller percentage of girls and women in countries like Cameroon and Uganda.
- Evidence shows that FGM also exists in Colombia, India, Malaysia, Oman, Saudi Arabia, and the United Arab Emirates.
- The practice is also found in pockets of Europe, Australia, and North America, which have been destinations for migrants from countries where it has still occurred for the last several decades.
Why Female Circumcision?
The practice of FGM is rooted in ethno-cultural and social beliefs and practices.
Here are some reasons why FGM is practised in most societies and communities.
- In most communities, tribes and regions, FGM is considered a part of raising a girl and a way of preparing girls for adulthood and marriage.
- They believe that female circumcision can help control a girl’s sexuality, which can, in turn, promote premarital virginity and marital fidelity and enhance male sexual pleasure.
- Acceptance and conformity are also strong reasons why most communities subscribe to FGM. They believe that for a girl to be accepted into the community, she has to be circumcised.
- Perceived health benefits, a rite of passage into womanhood, community status, and protection of family honour are most of the significant reasons why communities uphold the practice of FGM.
Global Response
According to a Unicef report conducted in 29 countries in Africa and the Middle East, FGM is still widely practised despite the fact that 24 of these countries have legislation or some form of decree against it.
The WHA61.16 resolution passed by the World Health Assembly in 2008 on the elimination of FGM globally emphasises the need for concerted action in all sectors towards the total elimination of FGM in all regions of the world where the practice is prevalent.
By developing guidance and resources for health workers to prevent FGM and manage its complications and by supporting countries to adapt and implement these resources, the WHO’s approach and response are holistic and consider all sectors of the healthcare ecosystem.
The WHO also generates evidence to improve the understanding of FGM through research, advocacy and outreach programmes designed to create awareness and end the harmful practice of FGM.
There’s a global war against FGM (non-medical and medical FGM), and the WHO has developed global strategies to combat this practice and help those affected recover and live normal lives.
There have also been very recent reports of some parents practising FGM on their young children in places like the United Kingdom. And what makes it disturbing is that the children affected can not complain.
Learn More
Related
- Commentary: It’s our job as health workers to “do no harm”
- Global strategy to stop healthcare providers from performing female genital mutilation
- Eliminating female genital mutilation. An interagency statement
News
The Gambia’s decision to uphold ban on FGM critical win for girls’ and women’s rights. July 15 2024
Putting survivors at the forefront of the global movement to end female genital mutilation. February 6 2024
UN special programme for research on sexual and reproductive health celebrates 50 years. April 25 2023
Feature stories
Survivor, nurse, advocate: Catherine Meng’anyi, from Kenya, shares how she’s working to end female genital mutilation in her lifetime. February 2 2023
In Somalia, health workers, girls and women are experts in preventing female genital mutilation. February 4 2021
Working towards zero tolerance for female genital mutilation in Sudan. February 6 2018
Selected References
- Standing with Survivors to End Female Genital Mutilation in Nigeria. (n.d.). https://www.unicef.org/nigeria/press-releases/standing-survivors-end-female-genital-mutilation-nigeria.
- UNICEF. (2024, March 8). Female Genital Mutilation (FGM) Statistics – UNICEF data. UNICEF DATA. https://data.unicef.org/topic/child-protection/female-genital-mutilation/?_gl=1*1f203q7*_ga*MzAxNTkyMTMyLjE3MjYwMDI3ODY.*_ga_9ZKVYH4DTE*MTcyNjAwMjc4Ni4xLjAuMTcyNjAwMjc4Ni4wLjAuMA..*_ga_ZEPV2PX419*MTcyNjAwMjc4Ni4xLjAuMTcyNjAwMjc4Ni42MC4wLjA.
- World Health Organization: WHO. (2024, February 5). Female genital mutilation. https://www.who.int/news-room/fact-sheets/detail/female-genital-mutilation
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