Female genital cutting (FGC) is a procedure performed on female children as young as infants through puberty. FGC is also called ‘female circumcision’ or female genital mutilation (FGM). FGC is very different from male circumcision. There are no possible health benefits, and it is far more harmful. There are three types of cutting procedures that vary regionally and by the amount of external genitalia removed. Type III, the most severe, requires the child to be sewed shut. Sometimes, the women will be cut open again on their wedding night. Women in the community typically perform the procedure; the job of ‘cutter’ is very respectable, and the responsibility is inherited. In some cultures, this is one of the only occupations available to women. The term female genital cutting is preferable to female genital mutilation because mutilation is not the intention of the cutters. Cultural sensitivity is required to understand why FGC has persisted for generations.
FGC has lifelong health consequences for the women who survive the initial procedure. The typical surgical instrument is a razor blade, without anesthetic and in unsanitary conditions. Some communities lack clean water, and razor blades are reused on several patients. Cutters often use traditional medicine and herbs, making the conditions even more unsanitary. The procedure can cause extreme bleeding, hemorrhaging, swelling, infection, and even death (Agboli et al., 2022). In the long term, women who have been cut experience chronic urinary tract infections, menstrual issues, cramping, pain, childbirth complications, infertility, and painful sex. Discussing the tradition is taboo and women may not realize the negative consequences of FGC procedures because many women in their community share the same complications. Improving the conditions for cutting procedures would eliminate some complications, but not the lifelong medical consequences. Women who are cut can also experience severe psychological issues, especially if they were not cut during infancy and remember the procedure.
Africa, Asia, and the Middle East have the highest concentrations of FGC procedures (UNICEF, 2024). However, FGC is practiced by small communities that have migrated to the United States and Europe. Globally, more than 230 million women and girls have been cut. Over 500,000 American women and children have been cut or are at risk of being cut (UNICEF, 2024).
FGC is labeled by major governmental organizations and non-governmental organizations (NGOs) like World Vision and the United Nations as an act of violence against women and a human rights crisis. FGC is a human rights crisis, but placing harsh labels on an ancient and profoundly ingrained practice does not help eradicate FGC. FGC has existed for at least 2000 years, and its origins are unknown (FGM National Clinical Group, 2015). Some communities practice FGC because of a misconception that Islam requires it. Islam does not require FGC, and Imams (Islamic spiritual leaders) are not known to advocate for the practice. Discussing FGC is so taboo that Imams do not feel comfortable discussing Islam’s stance on the procedure unless asked by a woman. There is a Western misconception that the patriarchy/male providers are primarily responsible for FGC — this is sometimes the case, but not always. In some countries, including Senegal, FGC is actively performed and perpetuated by women. Women have their daughters cut as an act of love. In some situations, women who are not cut are shunned by their community and will not be able to secure a reliable husband. In Senegal, after communities began discussing discontinuing FGC, husbands admitted they wished their wives were not cut and wanted them to be without pain and enjoy sex.
The United Nations is committed to ending the practice of FGC internationally. The 2030 Substantial Development Agenda aims to eradicate FGC by 2030 (United Nations, n.d.). The United Nations action plans focus on female empowerment and health education. The United Nations website says abandonment of the practice can hopefully be accomplished using official measures like stricter laws, monitoring/data collection, and investing in resources that strengthen laws. The plans also focus on enhancing educational resources and providing health resources for women that have been cut. However, government efforts to end FGC have been unsuccessful, and the progress towards eradication is slow. Many communities that practice FGC are intertwined with other communities in the region; all the intertwined villages must agree upon decisions such as ending the practice. Communities that practice FGC do not feel their governments understand the tradition and the laws are viewed as an overstep that results in retaliation. Some critics of the anti-FGC laws blame the laws themselves for why the practice continues to be prevalent (LP, 2020).
Education on the rights of women and female anatomy has been much more successful at convincing villages to stop cutting children. Tostan, an international organization started by Molly Melching in Senegal, has successfully educated communities. The Tostan model is human rights-based and aims to be respectful, inclusive, holistic, and sustainable. Courses are taught in women’s native languages and sometimes by Senegalese women. Due to Tosatan’s efforts, more than 5.7 million people live in villages that have publicly declared their intention to cease FGC (Tostan, n.d.).
Female genital cutting is a deeply rooted cultural practice with significant health risks, often unfamiliar to those in the United States. While the practice presents serious concerns, approaching it with respect and understanding rather than condemnation can foster positive change. Organizations like Women's Health Advocacy can play a crucial role by educating themselves and others about the complex realities surrounding FGC. Achieving lasting change will require global collaboration, education, and support for communities currently practicing FGC, empowering them to consider safer alternatives.
References
Agboli, A., Richard, F., Botbol-Baum, M., Brackelaire, J.-L., D’Aguanno, A., Diallo, K., Mikolajczak, M., Ricadat, E., & Aujoulat, I. (2022). Changing attitudes towards female genital mutilation. From conflicts of loyalty to reconciliation with self and the community: The role of emotion regulation. PLOS ONE, 17(6), e0270088. https://doi.org/10.1371/journal.pone.0270088
FGM National Clinical Group. (2015). FGM National Clinical Group - Historical & Cultural. Fgmnationalgroup.org. http://www.fgmnationalgroup.org/historical_and_cultural.htm
LP. (2020, July 14). Issues & critiques linked to anti-FGM laws - CoP FGM-MGF %. CoP FGM-MGF. https://copfgm.org/issues-critiques-linked-to-anti-fgm-laws/
Reid, K. (2018, February 1). 6 facts about female genital mutilation (FGM). World Vision. https://www.worldvision.org/child-protection-news-stories/female-genital-mutilation-fgm-facts
Tostan. (n.d.). Home. Tostan. Retrieved October 17, 2024, from https://tostan.org
UNICEF. (2024, March). Female Genital Mutilation. UNICEF Data; UNICEF. https://data.unicef.org/topic/child-protection/female-genital-mutilation/
United Nations. (n.d.). Frequently asked questions: Female genital mutilation. UN Women – Headquarters. Retrieved October 17, 2024, from https://www.unwomen.org/en/what-we-do/ending-violence-against-women/faqs/female-genital-mutilation
Note:
While this article primarily uses terms like "female" and "women" to reflect the traditional understanding of individuals affected by female genital cutting (FGC), it’s important to acknowledge that people of varied gender identities, including non-binary and intersex individuals, may also experience FGC. Official sources, including UNICEF and WHO, use "girls and women" to highlight that this practice predominantly affects female individuals from childhood into adulthood. However, inclusive language like "individuals affected by FGC" can broaden understanding of this complex issue. Our aim is to respect cultural contexts while acknowledging diverse identities within discussions of health and human rights.
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