Female Genital Mutilation/Cutting: What’s All the Fuss About?

Hi all,

 

At the end of my last blog, I said that I was going to talk more about one of the topics discussed at the panel discussion I attended, namely female genital mutilation. Before I get on to that, I just want to take a moment to say that I will not be ranting or preaching – I am going to be setting down the facts on the practice, and providing further information if anybody wants to find out more. I’ve compiled a resource list, which you’ll find at the end of this mammoth post, and you can take your own interest in whichever direction you so choose.

I’ll be referring to the practice as ‘FGM/C’ – female genital mutilation/cutting. This is because the term ‘mutilation’ carries very strong violent connotations, and as we will come to see during the course of this discussion, parents who perform the operation on their children do not do so because they are inherently bad people intent on abusing their child. Not at all. It is therefore more accurate to give the practice this dual moniker, which reflects the dual perspectives on the practice.

I’ve divided the post into the following sections, so feel free to skip to whatever takes your fancy:

–          Why am I interested?

–          What is FGM/C?

–          Why is it practiced?

–          What are the effects of FGM/C?

–          What can be done?

–          Resources/Further Reading

 

Why am I interested?

I distinctly remember sitting in the living room of my little Gerba house one evening when everyone was out, flicking through the Lonely Planet I brought with me. And I suddenly came across a section about harmful traditional practices carried out in some parts of Ethiopia. I sat reading about the various challenges that girls faced: child marriage, bride abduction, and this other thing, ‘female genital mutilation’. I looked it up in more detail when I was next at Samrat, and my heart sunk. One report I read claimed that between 75 and 90% of women in the region surrounding Dire Dawa had undergone the practice.

How many of the wonderful, bright and caring women that I’d met had undergone this? When had it happened? And why did it need to happen? I was full of questions, but I knew that it was impossible for me to ask anyone about it – like all harmful traditional practices, the discussion of FGM/C is hugely taboo.

The only time I ever heard it mentioned in three months was at an HIV awareness day run by JeCCDO. The facilitator asked the audience (nearly all female) to shout out all the ways that HIV could be transmitted. One girl shyly asked if it was true that it could be passed on when you were circumcised. When the answer was positive, there was a very uncomfortable silence in the room, and no more was said on the subject.

When I came home, I started reading, and the more I found out, the more I wanted to know. Why were little girls being cut? Who was doing this? Had anyone other than the big bad ‘West’ spoken out against it – were there any African or Middle Eastern opponents? How can we protect girls from it?

The thought of this happening to anyone shocked and upset me, not because I was outraged at the ‘barbaric practices of an alien culture’, but because people were harming their girls, the most vulnerable group in society. And there didn’t seem to be any benefit.

As a result, I’m writing my Masters dissertation on FGM/C and the international law surrounding it, and whether we could protect more girls from the practice if we looked at it through a slightly different lens. My assumption is that the human rights framework isn’t really working, and that we need a new tactic to encourage governments and communities to phase the procedure out. But enough about that. I’m going to give you a (hopefully) in-depth but broad overview of FGM/C now, starting with what it actually is.

 

What is FGM/C?

It is estimated that somewhere around 140 million women and girls are at risk of FGM/C every year globally. The practice itself is ancient, pre-dating any religion, and is practiced by certain Muslim, Christian, Jewish, animist and non-religious communities alike: there is no requirement for the practice in any religious text, regardless of what many may believe (and what some religious leaders preach).

FGM/C is not confined to one geographic area. It is practiced in around 28 countries in Africa, as well as certain parts of the Middle East and Asia, and is increasingly becoming apparent in the diaspora of these countries, particularly in Western Europe and the USA. The reality is that this is no longer a problem happening ‘far away’: it is happening in the UK. We have to accept it.

At this stage, it is important to note that the spread of FGM/C within a country is likely to be very varied. For example, in Country X, Cultural Group A may require FGM/C of all their girls, while Cultural Group B may not require it at all. It’s very important not to make overgeneralisations; saying every girl in Nigeria has been mutilated is completely untrue, and simply reaffirms the ‘Western’ attitude that is likely to widen divide between the women we genuinely want to help and ourselves. We’ll talk about that a little later on. Just bear it in mind for the time being.

FGM/C is a catch-all term for a whole variety of alterations. The World Health Organisation has categorised these, and the following terms have become widely used to describe the particular operations which have taken place.

Type I (cliterodectomy):removal of the hood and/or prepuce of the clitoris

Type II (excision): removal of the clitoris and labia minora (and sometimes the labia majora)

Type III (infibulation): removal of the clitoris, labia minora and majora. The raw surfaces of the wound are then stitched together, leaving a small hole for the passage of urine and menstrual fluid

Type IV: all other types of trauma to the genitals, including pricking, piercing, cauterising, scraping or incising

These operations are traditionally carried out by older women in the community, whose role it is to ‘circumcise’ girls. They may cut the girl with a razor blade, glass, sharp stones, or (as I discovered reading Waris Dirie’s books), even teeth. In the case of the most radical type, infibulation, the cutter may use spines to make holes in the wound for the girl to be sewn up. All of this is performed without any anaesthetic on girls ranging in age from a few weeks old to marriage age.

As you can probably imagine, many of the places where this is carried out are extremely unhygienic. Health concerns (the problems of infection) were the first to be put forward in attempts to end FGM/C. Unfortunately, this dialogue only led to the medicalization of the practice, with many doctors being bribed into carrying out operations out-of-hours, despite laws restricting it. This is a very important lesson to bear in mind. We cannot predict the outcomes of good intentions on another culture, and with FGM/C, it appears that where there’s a will, there’s a way.

All types of intervention cause immense pain and suffering, regardless of whether the girl is cut in the middle of the desert or in a doctor’s surgery in Cairo.

 

Why is it practiced?

There are a lot of reasons why FGM/C continues to be performed on women and girls globally, and as we will see, these factors are not easy to resolve. They are closely tied to ideas of community, tradition, culture, and what it means to be a woman at a deep-seated level. Regardless of whether we agree or disagree with these reasons, stomping in and telling people to ‘stop it because it’s wrong’ is not going to work. Therefore, it’s important to understand what motivates the continuation of the practice. Here are the most common reasons I’ve come across in the course of my own research:

We’ve always done it/Tradition

FGM/C is thousands of years old. The Western argument of ‘this is bad’ comes across as a bit ridiculous, given that women have undergone the procedure and survived long enough to still be cutting girls in the 21st century. The process is the same from grandmother to mother to daughter to granddaughter, and when every female around you has undergone the surgery, it must be taken for granted that it is a ‘normal’ thing to go through.

Coming of age ritual

I have yet to find a community who only ‘circumcise’ their girls. More often than not, both boys and girls have to go through some form of coming of age ceremony involving genital surgery. The problem is that this is far more extreme, and far more dangerous for the girls – some commentators have compared it to castration. Girls often look forward to the procedure, because they will be the centre of attention for the day, being showered with gifts and getting all the best food; this is unlikely to happen again until they are married. Many girls in communities who practice FGM/C want to undergo the ritual, because then they will be able to take part in community activities. An uncircumcised girl is often not allowed to marry; when economic stability depends on having a husband to survive, the need to marry cannot be overstated. This is the reason why, regardless of whether she wants her daughter cut or not, a mother may feel that it’s the best thing for her child. Is it worse to cut her daughter and guarantee her future or leave her intact and outcast from the community?

Marriageability

The marriage argument goes both ways. Just as uncut girls are not allowed to marry, men in an FGM/C-practicing community may not want a girl who has not been cut; it is unusual, and as far as the community is concerned, abnormal. There is also a belief that an uncut girl is not an appropriate partner for a respectable man. This is changing, though, and recent UNICEF and WHO studies in Africa have shown that men who have had the reality of FGM/C explained to them are less likely to demand a cut girl for a wife. (It’s not all bad news, I promise).

Perceived health benefits

All types of FGM/C remove the clitoris, with some communities believing that it will poison men or kill babies in childbirth if left in place. There is an association between being intact and being ‘unclean’ – this can be a huge insult in many communities, where cleanliness is truly next to godliness. Removal of the clitoris is also believed to put an end to any female urges, and therefore stop them going off and sleeping about. This is the reason that uncut girls are often seen as unsuitable wives – who knows where they’ve been. In many communities, there is an association between prostitution and a girl who has not undergone the procedure – this can be an extremely difficult idea to break. But before European readers get up in arms about how terrible and horrific this ideology is (which it may well be), it would serve to remember that during the 19th century, European and American doctors were carrying out cliterodectomies to treat ‘female hysteria’, a mysterious condition which could mean anything from lesbianism to epilepsy. So just think about that for a moment before you go yelling at people to stop being inhumane. Our own past isn’t that great either. I’m not defending FGM/C, I’m simply saying that there is a need to look at these social constructs across the board. Women who are free in Europe and America weren’t always so.

Maintaining chastity

Female virtue is often at the root of the argument. This is partly because purity is a direct reflection on the family, and maintaining the family honour is extremely important. A girl who has undergone FGM/C is a good girl, and a good prospect for a potential husband. The most extreme form of FGM/C, infibulation, guarantees virginity at marriage, because the girl physically cannot have intercourse and remain intact. This unfortunately means that the girl has to be ‘opened’ before her wedding night, and again at childbirth – she is usually then reinfibulated.

Social and family pressure

As Catherine Ojo demonstrated with her story of the 8 day old baby, it can be extremely difficult for parents to prevent FGM/C if the extended family want it done. Respect for elders (often combined with threats like ‘you’ll never see her again’) mean that a couple may be put under horrendous pressure to hand their daughter over for the operation. Family members may cite all the reasons given here (and more) to convince parents that it’s a good idea.

Religious beliefs

Ah, this old chestnut. Despite having no basis whatsoever in the Bible, Torah or Koran, FGM/C is still justified as a religious requirement. Earlier this month, 13 year-old Suhair al Bata’a died in Egypt as a result of FGM/C gone wrong. Her parents believed it was ‘God’s will’ that she died as a result of the operation. Add this to people like the charming Sheikh Yussef al-Badri at the bottom of the page, who firmly believes FGM/C is necessary from a religious standpoint, and it becomes clear how difficult untangling these two forces is. This is the most difficult justification to disprove, but could hold the key to ending the practice in the majority of communities.

Lack of knowledge

Think about this logically. If you grew up in a community where every single girl is cut in some form or another, you would have no way of knowing that not all women undergo the procedure. You wouldn’t know that the reasons given for FGM/C may not really pass muster. Much of the continuation of the practice comes down to superstition, and fear of change.

 

What are the problems?

Now that we know what FGM/C is, and why it’s practiced, we can move onto what the effects of it are. The information I’m about to provide comes from a whole host of sources: academic articles, Waris Dirie’s books (see the resource section at the end) and general bits and bobs I’ve picked up from lots and lots of reading. One thing that did stick in my head was a message that kept popping up from some of the female Egyptian authors that I’ve read: gathering a group of cut women together and telling them about all the awful things that could happen to them as a result of FGM/C when they are for the most part, perfectly healthy, comes across as patronising. Not every woman who has undergone this procedure will suffer all of these effects, but equally, some women can die as a result of complications. I’m going to list the side-effects and problems that I’ve come across most – interpret it realistically.

Physical Problems (immediately post-procedure)

Death

Blood loss

Scarring

Nerve damage

Extreme pain (generally and more when passing fluid)

Infection (gangrene is not an unknown problem)

HIV transmission (shared cutting tools)

Body may go into shock

Physical problems (long-term)

Kleoid formation

Difficulty passing fluids

Extremely painful periods, abdominal blockages, abdominal infections caused by retention of menstrual blood (inflibulation)

Loss of sensation

Painful intercourse

Childbirth difficulties (may result in death of mother and/or baby)

Psychological Trauma

Flashbacks

Nightmares

Feelings of depression, anxiety, suicidal thoughts.

Feelings of helplessness – women in diaspora communities in particular, who feel ‘trapped’ by an alien society

Fear of pain (may lead to a fear of intimacy and relationships)

Trauma

Loss of trust in family members

Social difficulties

Particularly in poorer areas, FGM/C is part and parcel of a wider set of problems facing girls:

Child marriage

Early withdrawal from education (if they were attending at all)

Early childbirth and multiple pregnancies, which may be unwanted

Lack of control over their own decisions and the knowledge that they will be put under severe pressure to repeat the process with their own daughters

If 90% of women in a country have undergone the procedure, where does that leave the country’s development? How can you improve a nation where 50% of the potential workforce and social innovators have undergone the trauma of FGM/C?

 

What can be done?

There are a number of strategies which have been put forward from various sources (both in the developed and developing world) to combat FGM/C. The most promising (I think) can be found below.

Law and its enforcement

The majority of countries have outlawed FGM/C in some form or another, sometimes with a specific piece of legislation (e.g. UK Female Genital Mutilation Act 2003), or by bringing it under wider child abuse laws. But this legislation is usually ineffective at bringing prosecutions, because it relies on a child testifying against her parents, or a health worker recognising FGM/C, and risking being called racist if they question it. A lack of prosecutions leads to a lack of legal precedent, and courts may be unsure how to prosecute cases brought before them. No case law also means that there is no threat hanging over those considering FGM/C. In many places, the law is also not effectively disseminated among the population – if people do not know that their activities are illegal, then what is there to dissuade them from continuing?

Education

If people do not realise that their activities are damaging, and ultimately, unnecessary, they will have no reason to question why they are doing it. It’s extremely important to place the responsibility for ending FGM/C through education in the hands of the locals. Nobody in their right mind would listen to a foreigner with no idea of their daily life and its pressures telling them to stop something. One very successful strategy in East Africa has been educating cutters about the impacts of their job, and employing them as anti-FGM/C campaigners. Their standing in the community helps to convince people to reconsider their actions, and come up with alternative, non-invasive ways of marking the transition into womanhood. A lot of education is about de-stigmatising the practice. It happens, and there’s no point pretending otherwise.

Involving men

As with the need to involve more women in society in a variety of roles, men are absolutely critical to ending FGM/C. As the Panel at the London debate said: men are 50% of the solution, not 50% of the problem. If they are able to support their sisters, wives, daughters and nieces a lot could be achieved.

Breaking the link with religion

This goes hand in hand with the need for education. We need priests, ministers, imams and rabbis to stand up with community leaders and tell their congregations that the practice is not a religious requirement. This has proved very successful in Ethiopia in particular, with Orthodox priests teaming up with local imams to reduce FGM/C in their communities.

Support and communication

The internet has the potential to provide a safe, anonymous space for women who have undergone FGM/C to find one another and share their experiences with people who actually understand what has happened to them. We need to find a way to put affected women in touch with people who can offer them support and integrated health services.

It’s not cultural heritage: it’s abuse

Just as Western critics may be quick to call FGM/C a barbaric practice, and not want to engage with the emotional reasons behind the procedure, it is unfair to shoot down outsiders who really want to help by calling them interfering, or claiming that they are simply part of a neo-colonial project. Challenging the ‘it’s my culture’ assertion does not make an outsider racist. It also does not mean that they disrespect the rest of a culture. I love Ethiopian culture, the warmth of the people and acceptance I found there. But I hate that little girls are being kidnapped, married and mutilated in the name of tradition – not all of them, but some. As Waris Dirie says in Desert Children, if this was happening to little white girls, we’d all be up in arms. I hate to play the race card, but it’s the truth. I don’t want to offend anyone. But I also don’t want children to needlessly bleed to death in the name of tradition.

I really hope that this blog post has made you think about this issue. It’s the tip of the iceberg – women the world over are subjected to so many difficult situations and choices, and this is another burden for them to carry. The last month of news reports have brought home to many of us how unequal the world is for girls – from the FGM/C death related above to the missing girls in Nigeria, the apostasy case in Sudan and the hangings, beatings, stonings and rapes in Asia and Southeast Asia. But the reality is that thousands of women endure violence every day, and it is never reported. And not just violence to the extreme, but emotional and domestic abuse – this is a global problem. I want to finish with a quote from an article I read recently. The rest of the piece was a bit aggressive, and I’m not sure I really liked the author’s approach. But I think her opening section perfectly explains why we should all be concerning ourselves with helping to ease the troubles of the world’s women:

“No matter how many terms one conjures to lessen the impact of the horror visited upon women in the name of culture, mutilation is mutilation; it cannot be diminished by semantics. In addition, I am’ my sisters’ keeper; their pain is my pain. I have an obligation to use my words to speak truth to power in their name.” (Patricia A Broussard, 2008)

 

Resources and Further Reading

This is in no means an exhaustive list of further information: it’s a headstart for those who may want to keep reading. I hope you find what you are looking for.

General reading and information

World Health Organisation’s FGM/C page

What is FGM/C?

FGM/C Map

Prevalence of FGM/C by country (I know it’s Wikipedia. But it’s a good place to start)

UNICEF Report: Statistical overview and dynamics of change 

Inter-African Committee on Traditional Practices

UNFPA FGM

UNFPA Interactive Map

How to tackle child marriage and FGM/C

The Guardian’s Anti-FGM/C campaign

Anti-FGM/C Organisations

Tostan

Forward 

DARF

28 Too Many

The Orchid Project (founded by a Returned VSO Volunteer who went to Ethiopia and had the same experience as I did with a Lonely Planet)

Waris Dirie Desert Flower Foundation – Waris Dirie is my inspiration at the moment. Her story is absolutely incredible: beginning life as a nomad in Somalia, she was ‘discovered’ by Terence Donovan in a McDonalds in London, and became a supermodel. She is now an anti-FGM campaigner and UN spokesperson, having undergone the practice at a very young age. You can find her foundation here, and her wonderful books here: she’s a fantastic writer. I read each book in a single sitting.

Books

Sex and the Citadel: Intimate Life in a Changing Arab World. Author Shereen El Feki gets under the covers with women in the Middle East, looking at the problems affecting them in the present day:

Google Books FGM: A Practical Guide to Worldwide Laws and Practices 

Google Books Female ‘circumcision’ in Africa: Culture, Controversy and Change

You could also try using Google Scholar to search for academic and medical articles surrounding FGM/C if you want to find out more about it. Some of these are open access – check to see if there is an option to directly download a PDF version of the article, which should display to the right hand side of the search results pane.

Documentaries

The Cruel Cut, 4oD 

The Day I Will Never Forget, 4oD

 

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3 thoughts on “Female Genital Mutilation/Cutting: What’s All the Fuss About?

  1. Pingback: https://diredawaics2013.wordpress.com/2014/06/05/female-genital-mutilationcutting-whats-all-the-fuss-about/ | Doodles' doodles.

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