It was Halima Bashir’s poignant memoir ‘Tears of the Desert’ that first intrigued me about this brutal rite of passage. She describes in disturbing detail the traumatic ritual she was subjected to at the early age of eight – not by some stranger, but by her own grandmother. ‘The pain was so great I will never forget it’, she says. In her grandmother’s hut, Halima was pinned down by women while one of them cut away all external genitalia with a razor blade, stitching the area closed afterwards to leave only a small hole for menstrual blood and urine. There was no anesthetic.
What is FGM?
Female genital mutilation (FGM), also known as ‘female genital cutting’ (FGC) or ‘female circumcision’ refers to all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons. The practice is extremely painful and has serious immediate and long-term health consequences.
The World Health Organization has classified FGM into four different types:
- Cliteridectomy: the partial or total removal of the clitoris;
- Excision: the partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora;
- Infibulation: narrowing of the vaginal opening through the creation of a covering seal by cutting and repositioning the labia minora and/or the labia majora, with or without excision of the clitoris. Also known as pharaonic circumcision, it is the most severe form of FGM;
- Other: all other harmful procedures to the female genitalia for non-medical purposes including piercing, incising, pricking, scraping and cauterizing the genital area.
The procedure usually takes place in the girl’s home, or the home of a neighbor or relative. It is often performed by traditional practitioners such as midwives or barbers. The girl undergoing the procedure is held down, usually by older women. Genital mutilation may be carried out using a razor blade, a knife, scissors, broken glass, a tin lid or some other cutting instrument. When infibulation takes place, thorns or stitches may be used to hold the two sides of the labia majora together and the legs may be bound together for up to forty days. Usually no steps are taken to reduce the pain.
FGM gravely violates the basic human rights of girls and women including the right to health, the right to protection from inhuman practices and torture, the right to physical integrity, the right to security and protection from all forms of physical or mental violence, injury, abuse or maltreatment, as well as the right to life when the procedure results in death. FGM constitutes an extreme form of discrimination against women and is a violation of the rights of children.
“Usually it is a gruesome ordeal with a lot of crying from the girl, and even with the child’s screams no one does anything about it and her screams are ignored”.
Who is affected?
The procedure is carried out at a variety of ages, but most commonly occurs between the ages of 4 and 8. In Africa, 3 million girls are at risk of FGM each year. Between 100 and 140 million girls and women worldwide are living with the consequences of FGM. In Africa, about 92 million girls age 10 years and above are estimated to have undergone FGM.
FGM is practiced extensively in Africa and is common in some countries in the Middle East and Asia. With increased immigration, FGM has become a global problem as it has spread to Europe, Australia and North America.
Percentage of women 15-49 years old who have been cut
Source: UNICEF global databases, 2011. Based on DHS, MICS and other national surveys, 1997-2010
Percentage of women 15-49 years old who have been cut and the percentage of women 15-49 years old with at least one daughter circumcised, in selected countries with available data
Source: UNICEF global databases, 2011. Based on DHS, MICS and other national surveys, 1997-2010
Why is FGM practiced?
FGM predates most modern religions, including Islam and Christianity, but has acquired a religious dimension. It is endorsed by the community and supported by loving parents with what is believed to be the best interests of the girl.
The practice is deeply embedded in the social norms of the community and there is immense social pressure on all young girls to conform. A girl who does not undergo FGM is likely to be severely penalized by her community, and is often despised, taunted, ostracized and made the target of ridicule.
FGM-practicing communities view the rite as normal and wrongly justify it under the guise of:
- Custom and tradition;
- Preservation of virginity and chastity;
- Curtailing the woman’s sexuality and preventing her from being oversexed;
- Enhancing the girl’s feminity, often synonymous with docility and obedience;
- Social acceptance, especially for marriage;
- Family honor;
- Enhancing fertility;
- Increasing the man’s sexual pleasure;
- Hygiene, aesthetics, purification, cleanliness and health;
It is important to note that many FGM-practicing groups come from patriarchal societies, where a woman’s access to land and resources is exclusively through her husband. In order for a woman to be eligible for marriage it is essential that she is a virgin. The association between virginity and FGM is so strong, that a girl who has not undergone the procedure has virtually no chance of marriage, hence her main means of survival and access to resources will be denied her.
While the practice of FGM remains in the female sphere and women are commonly considered the perpetrators of the practice, the underlying role of men cannot be over emphasized. FGM is universally recognized as a traditional custom resulting from male-dominated societies and the subsequent powerlessness of women. It is a deeply rooted tradition which serves as a complex form of social control of women’s sexual and reproductive rights.
FGM is a cruel and harmful practice which interferes with the ordinary functions of girls’ and women’s bodies. The practice is such a powerful social norm that families have their daughters cut even when they are aware of the harm it can cause.
Immediate health complications may include:
- severe pain and shock;
- excessive bleeding;
- infection, including HIV and Hepatitis B and C;
- urine retention;
- open sores in the genital region and injury to adjacent tissues;
Long-term consequences may include:
- chronic pain
- chronic vaginal and pelvic infections;
- recurrent bladder and urinary tract infections;
- cysts and abscesses;
- menstruation difficulties;
- damage to the reproductive system, including infertility;
- kidney damage;
- sexual dysfunction;
- pain during sex and lack of pleasurable sensation;
- increased risk of HIV and other sexually transmitted diseases;
- the need for later surgeries. For example, when infibulation occurred, the vaginal opening has to be cut open later to allow for sexual intercourse and childbirth. Sometimes it is stitched again several times, including after childbirth, hence the woman goes through repeated opening and closing procedures, further increasing both immediate and long-term health risks.
Case histories and personal accounts taken from women indicate that FGM is an extremely traumatic experience for women and girls, which stays with them for the rest of their lives. Young women receiving psychological counseling report feelings of betrayal by parents, incompleteness, regret and anger. Research shows that women who have undergone FGM have the same levels of Post Traumatic Stress Disorder (PTSD) as adults who have been subjected to early childhood abuse, and that 80 per cent of the women suffer from mood and anxiety disorders. A number of emotional problems have been reported, including:
- a sense of loss, including loss of sexual pleasure;
- lack of sexual desire;
- long-lasting painful memories of being circumcised, including panic attacks;
- ongoing resentment and bitterness towards family members responsible for FGM;
- flashbacks during pregnancy and childbirth.
How to end FGM
While the practice has persisted for over a thousand years, evidence shows that FGM can end in one generation. Considered a sensitive issue, it has been widely viewed as a private act by individuals and family members rather than state actors. But the health and psychological consequences of the practice, as well as its underlying causes, make it imperative for societies, governments and the entire international community to take action towards ending FGM.
Education of both boys and girls is a powerful tool and a major step towards eradicating this horrendous custom. Though outlawing FGM may not immediately end the practice, implementing and applying laws against it would certainly deter at least some parents from performing this harmful and dangerous ritual on their daughters. Awareness campaigns are also essential in educating the parents and the community about the disastrous long term consequences on the girls’ physical and mental health.
Overall, the prevalence of FGM has declined. Steps have been taken at international level to end this brutal practice and many countries have enforced laws against FGM. In most industrialized countries, FGM is forbidden. Sadly, the ritual is still practiced extensively in some countries in Africa and the Middle East. In countries where FGM is forbidden by law, it is sometimes carried out behind closed doors or abroad.
‘I now understand this should never have been done to me. I realize my mum and grandma are poor people with simple beliefs, who inherited the custom from previous generations, but sometimes I blame them. They should have thought for themselves. I have lost something – a loss of womanhood – for you have no sensitivity left.’ (Halima Bashir)
FORWARD (2009) FGM is always with us: Experiences, Perceptions and Beliefs of Women Affected by Female Genital Mutilation in London: Results from a PEER Study
UNICEF 2011 State of the World’s Children
WHO (2000), ‘Female Genital Mutilation’, Fact Sheet No. 241.
United Nations Convention on the Rights of the Child
UN Convention on the Elimination of All Forms of Discrimination against Women
African Charter on the Rights and Welfare of the Child
UN General Assembly resolution 56/128 on Traditional or Customary Practices Affecting the Health of Women and Girls
African Union Protocol on the Rights of Women in Africa (2003)
WHO, UNICEF and UNFPA (1997), Female Genital Mutilation: A joint statement, World Health Organization, Geneva