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Frequently Asked Questions on Female Genital Mutilation/Cutting
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- What is female genital mutilation/cutting
(FGM/FGC)?
- What are the different types of FGM/FGC?
- Which type is the most common?
- Different terms are used to describe FGM/FGC. What do they mean?
- What is deinfibulation?
- What is reinfibulation?
- Where does the practice come from?
- Who performs FGM/FGC?
- What instruments are used to perform FGM/FGC?
- At what age is FGM/FGC performed?
- In which countries is FGM/FGC practiced?
- Why is FGM/FGC performed?
- How many women and girls are affected?
- How does FGM/FGC affect women's health?
- Is there a link between FGM/FGC and the risk of HIV/AIDS infection?
- What are the psychological effects of FGM/FGC?
- Is FGM/FGC required by certain religions?
- Can FGM/FGC be condoned if it is carried out by medical professionals under hygienic circumstances?
- Since FGM/FGC is part of a cultural tradition, can it still be condemned?
- In which countries is FGM/FGC banned by law?
- Which international legal instruments can be used for the eradication of FGM/FGC?
- What terms do people who practice FGM/FGC use to describe the procedure?
- What do women who underwent FGM/FGC have to say about it themselves?
- What does the ICPD Programme of Action say about FGM/FGC?
- What was said about FGM/FGC during the ICPD+5 review?
- What is UNFPA's approach to FGM/FGC?
- Sources
FGC/FGM refers to all procedures
involving partial or total removal of the external female
genitalia or other injury to the female genital organs
for cultural or other non-medical reasons.
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The World Health Organization (WHO)
has identified four types:
Excision of the prepuce, with or without excision of
part or all of the clitoris.
Excision of the clitoris with partial or total excision
of the labia minora
Excision of part or all of the external genitalia and
stitching/narrowing of the vaginal opening (infibulation).
Sometimes referred to as pharaonic circumcision.
Others, such as pricking, piercing or incising, stretching, burning
of the clitoris, scraping of tissue surrounding the
vaginal orifice, cutting of the vagina, introduction
of corrosive substances or herbs into the vagina to
cause bleeding or to tighten the opening.
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Types I and II are the most common,
with variation among countries. Type III, infibulation,
constitutes about 20 per cent of all affected women and is most
likely in Somalia, northern Sudan and Djibouti.
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refers to making cuts in the clitoris, cutting free
the clitoral prepuce, but also relates to incisions
made in the vaginal wall and to incision of the perineum
and the symphysis.
refers to partial or total removal of the clitoris
refers to the removal of the clitoris and partial or
total removal of the labia minora. The amount of tissue
that is removed varies widely from community to community.
refers to the removal of the clitoris, partial or total
removal of the labia minora and stitching together of
the labia majora.
this is a collective name that is used to describe a
variety of practices involving the cutting of the female
genitalia. It often refers to operations that fall under
type I FGM/FGC. This term is considered as confusing by
some since it seems to equate male circumcision with
FGM/FGC. However, the only form that anatomically is comparable
to male circumcision is that form in which the clitoral
prepuce is cut away. This form seldom occurs. It is
sometimes argued that the term circumcision obscures
the serious physical and psychological effects of genital
cutting on women.
this is also a collective name to
describe procedures that involve partial or total removal
of the external female genitalia or other injury to
female genital organs whether for cultural or other
non-medical reasons. This term is used by a wide range
of women's health and human rights organizations and
activists, not just to describe the various forms but also to indicate that the practice is considered a mutilation
of the female genitalia and as a violation of women's
basic human rights. Since 1994, the term has been used
in several United Nations conference documents, and
has served as a policy and advocacy tool.
Some organizations have opted
to use the more neutral term 'female genital cutting'.
This stems from the fact that communities that practice
FGC often find the use of the term 'mutilation' demeaning,
since it seems to indicate malice on the part of parents
or circumcisers. The use of judgmental terminology bears
the risk of creating a backlash, thus possibly causing
an alienation of communities that practice FGM/FGC or even
causing an actual increase in the number of girls being
subjected to FGM/FGC. In this respect it should be noted
that the Special Rapporteur on Traditional Practices
(ECOSOC, Commission on Human Rights) recently called
for tact and patience regarding FGC eradication activities
and warned against the dangers of demonizing cultures
under cover of condemning practices harmful to women
and girls.
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Infibulation creates a physical
barrier to sexual intercourse and childbirth. An infibulated
woman therefore has to undergo gradual dilation of the
vaginal opening before sexual intercourse can take place.
Often, infibulated women are cut open on the first night
of marriage (by the husband, or a circumciser), in order
to enable the husband to be intimate with his wife. At childbirth,
many women also have to be cut again, because the vaginal
opening is too small to allow for the passage of a baby.
Attempts at forcible penetration may cause rupture of
scars and sometimes perineal tears, dyspareunia, and
vaginismus. Excessive penile force during first intercourse
can cause severe bleeding, shock and infection.
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In some communities, the raw edges
of the wound are sutured again after childbirth, recreating
a small vaginal opening. This is referred to as re-infibulation.
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The origins of the practice are
unclear. It predates the rise of Christianity and Islam.
There is mention made of Egyptian mummies that display
characteristics of FGM/FGC. Historians such as Herodotus
claim that in the fifth century BC the Phoenicians,
the Hittites and the Ethiopians practised circumcision.
It is also reported that circumcision rites were practised
in tropical zones of Africa, in the Philippines, by certain tribes in the Upper
Amazon, and in Australia by women of the Arunta tribe.
It also occurred among the early Romans and Arabs. As
recent as the 1950s, clitoridectomy was practised in
Western Europe and the United States to treat 'ailments' in women
as diverse as hysteria, epilepsy, mental disorders,
masturbation, nymphomania, melancholia and lesbianism.
In other words, the practice of FGM/FGC has been followed
by many different peoples and societies across the ages
and the continents.
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FGM/FGC is usually carried out by elderly
people in the community (usually, but not exclusively,
women) who have been specially designated for this task,
or by traditional birth attendants. These people receive
a fee from the girls' family members, in money or in
kind. In some cases, medical personnel perform the operation
as well, for a fee. Among certain populations, FGM/FGC may
be carried out by traditional health practitioners,
(male) barbers, members of secret societies, herbalists,
and sometimes by a female relative.
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FGM/FGC is carried out with special
knives, scissors, scalpels, pieces of glass or razor
blades. Anaesthetic and antiseptics are not generally
used except when carried out by medical practitioners.
In communities where infibulations is practised, the
girls' legs are often bound together to immobilize her
for a period of 10 - 14 days, to allow formation of
scar tissue.
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The age at which FGM/FGC is performed varies. In some areas it is carried out during infancy (as early as a couple of days after birth), in others during childhood, at the time of marriage, during a woman's first pregnancy or after the birth of her first child. The most typical age is 7 - 10 years or just before puberty, although reports suggest that the age is dropping in some areas.
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The practice is common in parts
of Africa, Asia and in some Arab Countries. It is practiced
among communities in : Benin, Burkina Faso, Cameroon,
Central African Republic, Chad, Cote d'Ivoire , Democratic
Republic of Congo, Djibouti, Egypt, Ethiopia, Eritrea,
Gambia, Ghana, Guinea, Guinea-Bissau, Kenya, Liberia,
Mali, Mauritania, Niger, Nigeria, Senegal, Sierra Leone,
Somalia, Sudan, Tanzania, Togo, Uganda.
FGM/FGC is also practiced among certain
ethnic groups in a number of Asian countries (India,
Indonesia, Malaysia, Pakistan); among some groups in
the Arabian Peninsula (in Oman, United
Arab Emirates, Yemen);
Iraq; occupied Palestinian territories and among certain immigrant communities
in Europe, Australia, Canada and the United States.
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Cultural practices such as FGM/FGC are rooted in a set of beliefs, values, cultural and social behaviour patterns that govern the lives of people in society. There are many reasons given for practicing FGM/FGC. These can be categorised under five headings:
Psychosexual reasons:
FGM/FGC is carried out as a means to control women’s sexuality (which is argued to be insatiable if parts of the genitalia, especially the clitoris, are not removed). It is thought to ensure virginity before and fidelity after marriage and/or to increase male sexual pleasure.
Sociological and cultural reasons:
FGM/FGC is seen as part of a girl’s initiation into womanhood and as an intrinsic part of a community’s cultural heritage/tradition. Various myths exist about female genitalia (e.g. that if uncut the clitoris will grow to the size of a penis; FGM/FGC would enhance fertility or promote child survival, etc) and these serve to perpetuate the practice.
Hygiene and aesthetic reasons:
In some communities, the external female genitalia are considered dirty and ugly and are removed ostensibly to promote hygiene and aesthetic appeal.
Religious reasons:
Although FGM/FGC is not sanctioned by either Islam nor by Christianity, supposed religious prescripts (e.g. the mention of ‘Sunna” in the Koran) are often used to justify the practice.
Socio-economic factors:
In many communities, FGM/FGC is a prerequisite for marriage. Where women are largely dependent on men, economic necessity can be a major determinant to undergo the procedure. FGM/FGC sometimes is a prerequisite for the right to inherit. FGM/FGC may also be a major income source for practitioners.
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It is estimated that from 100 to 140 million
girls and women have undergone some form of genital
mutilation/cutting, and at least 3 million girls are at risk of
undergoing the practice every year.
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The effects of FGM/FGC depend on the
type performed, the expertise of the circumciser, the
hygienic conditions under which it is conducted, the
amount of resistance and general health condition of
the girl/woman undergoing the procedure. Complications
may occur in all types of FGM/FGC, but are most frequent
with infibulation.
FGM/FGC has both immediate and long-term
consequences to the health of women.
These include severe pain, shock,
haemorrhage, tetanus or infection, urine retention, ulceration
of the genital region and injury to adjacent tissue,
wound infection, urinary infection, fever and septicaemia.
Haemorrhage and infection can be of such magnitude as
to cause death.
These include anemia, the formation
of cysts and abscesses, keloid scar formation, damage
to the urethra resulting in urinary incontinence, dyspareunia
(painful sexual intercourse) and sexual dysfunction,
hypersensitivity of the genital area. Infibulation can
cause severe scar formation, difficulty in urinating,
menstrual disorders, recurrent bladder and urinary tract
infection, fistulae, prolonged and obstructed labour
(sometimes resulting in fetal death and vesico-vaginal
fistulae and/or vesico-rectal fistulae), and infertility
(as a consequence of earlier infections). Cutting of
the scar tissue is sometimes necessary to facilitate
sexual intercourse and/or childbirth. Almost complete
vaginal obstruction may occur, resulting in accumulation
of menstrual flow in the vagina and uterus. During childbirth
the risk of hemorrhage and infection is greatly increased.
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Because the procedure is coupled
with the loss of blood and use is often made of one
instrument for a number of operations, the risk of HIV/AIDS
transmission is increased by the practice. Also, due
to damage to the female sexual organs, sexual intercourse
can result in lacerations of tissues, which greatly
increases risk of transmission. The same is true for
childbirth and subsequent loss of blood.
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Genital mutilation/cutting may leave a lasting
mark on the life and mind of the woman who has undergone
the procedure. The psychological stress may trigger
behavioural disturbances in children, closely linked
to the loss of trust and confidence in care-givers.
In the longer term, women may suffer feelings of anxiety,
depression, and frigidity. Sexual dysfunction may also
be the cause for marital conflicts and eventual divorce.
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No. The practice of FGM/FGC is not prescribed
by Islam, nor in the Bible. In fact, the practice predates
Islam, and many religious leaders have denounced it.
The practice cuts across religions and is practiced
by Muslims, Christians, Ethiopian Jews, Copts, as well
as by followers of certain traditional African religions.
FGM/FGC is thus more a cultural than a religious practice.
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No. FGM/FGC in any form should not be
practised by health professionals in any setting - including
hospitals or other health establishments. Unnecessary
bodily mutilation cannot be condoned by health providers.
FGM/FGC is harmful to the health of women and girls and
violates their basic human rights and medicalization
of the procedure does not eliminate this harm. On the
contrary, it reinforces the continuation of the practice
by seeming to legitimize it. Health practitioners should
provide all necessary care and counseling for complications
that may arise as a result of FGM/FGC.
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Yes. The function of culture and
tradition is to provide a framework for human well-being;
cultural arguments can never be used to condone violence
against persons, male or female. Moreover, culture is
not static, but constantly changing and adapting. Nevertheless,
activities for the elimination of FGM/FGC should be developed
and implemented in a way that is sensitive to the cultural
and social background of the communities that practice
it. Behaviour can change when people understand the
hazards of certain practices and when they realize that
it is possible to give up harmful practices without
giving up meaningful aspects of their culture.
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Benin, Burkina Faso, Central African Republic, Chad, Cote d'Ivoire, Djibouti, Egypt (Ministerial decree), Ghana, Guinea, Kenya, Niger, Nigeria (multiple states), Senegal, Tanzania, Togo. In Sudan only the most severe form of FGM/FGC is forbidden by law.
Australia, Belgium, Canada, Denmark, New Zealand, Norway, Spain, Sweden, United Kingdom, United States (federal law, and specific state laws).
Penalties range from a minimum of six months to a maximum of life in prison. Several countries also include monetary fines in the penalty. As of June 2000, there have been prosecutions or arrests in Burkina Faso, Egypt, Ghana, France and Senegal. Belgium. Benin, Nigeria, and Uganda are proposing laws to ban the practice of FGM/FGC.
In September 2001, the European
Parliament adopted a resolution on Female Genital Mutilation
. The resolution calls on the member states of
the European Union to pursue, protect and punish any
resident who has committed the crime of FGM even if
committed outside the frontier ("extraterritoriality")
and calls on the Commission and the Council to take
measures in regard to the issuing of residence permits
and protection for the victims of the practice. The
resolution also calls on the member states to recognise
the right to asylum of women and girls at risk of being
subject to FGM/FGC.
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Most governments in countries where
FGM/FGC is practised have ratified international conventions
and declarations that make provisions for the promotion
and protection of the health of women and girls. These
include, inter alia:
The
Universal Declaration of Human Rights proclaims the
right of all human beings to live in conditions that
enable them to enjoy good health and health care (art.
25).
The International Covenants on Civil and Political Rights
and on Economic, Social and Cultural Rights condemn
discrimination on the grounds of sex, and recognize
the universal right to the highest attainable standard
of physical and mental health (art. 12).
The Convention on the Elimination of All Forms of Discrimination
against Women requires State Parties to : "take all
appropriate measure to modify or abolish customs and
practices which constitute discrimination against women
" (art. 2f). "modify social and cultural patterns of
conduct of men and women, with a view to achieving the
elimination of prejudices and customary and all other
practices which are based on the idea of the inferiority
or the superiority of either of the sexes" (art 5a).
General recommendation 24 (1999) to article
12 of the Convention (on women and health) emphasizes
that certain cultural or traditional practices such
as FGM/FGC carry a high risk of death and disability and
recommends that State parties should ensure the enactment
and effective enforcement of laws that prohibit FGM/FGC.
General recommendation 14 (1990)
pertains particularly to FGM/FGC. It recommends that State
parties take appropriate and effective measures to eradicate
female circumcision; to collect and disseminate basic
data on traditional practices; to support women's organization
at the national and local levels that work for the elimination
of harmful practices; to encourage politicians, professionals,
religious and community leaders to co-operate in influencing
attitudes; to introduce appropriate educational and
training programmes; to include appropriate strategies
aimed at eradication of female circumcision into national
health policies; to invite assistance, information and
advice from the appropriate organization of the United
Nations system; to include in their reports to the Committee
under articles 10 and 12 of the Convention information
about measures taken to eliminate female circumcision.
The Convention on the Rights of the Child protects against
all forms of mental and physical violence and maltreatment
(art 19.1); to freedom from torture or cruel, inhuman
or degrading treatment (art 37a), and requires States
to take all effective and appropriate measures to abolish
traditional practices prejudicial to the health of children
(art 24.3)
The Vienna Declaration and the Programme of Action of
the World Conference on Human Rights expanded the international
human rights agenda to include gender-based violence
including FGM/FGC.
The Programme of Action of the International Conference
on Population and Development.
The Platform for Action of the Fourth World Conference
on Women includes a section on the girl child and urges
governments, international organization and non-governmental
groups to develop policies and programmes to eliminate
all forms of discrimination against the girl child,
including female genital cutting.
The African Charter on Human and Peoples' Rights, article
4 on integrity of the person, article 5 on human dignity
and protection against degradation, article 16 on the
right to health, article 18 (3) on protection of the
rights of women and children.
The Addis Ababa Declaration. At
the Council of Ministers during its sixty-eighth Session
in July 1998, the Organization of African Unity (OAU)
adopted the Addis Ababa Declaration on violence against
Women. This Declaration was later endorsed by the Assembly
of heads of State and Governments. The Declaration serves
as an important step towards the formulation of an African
charter on violence against women, providing the framework
for national laws against FGM/FGC.
The Banjul Declaration. The Inter-African committee
on Traditional Practices Affecting the Health of Women
and Children in collaboration with the Gambian committee
on Traditional Practices (GAMCOTRAP) organized a symposium
for religious leaders and medical personnel in Banjul,
Gambia, from 20 to 24 July 1998. Participants agreed
that FGM/FGC is not prescribed by any religion and unequivocally
condemned the use of religion to justify the practice,
emphasizing the importance of information campaigns
to put and end to them. At the close of the symposium
they issued a communique, a declaration and recommendations
condemning and demanding eradication of FGM/FGC and other
harmful traditional practices.
The United Nations Social, Humanitarian and Cultural
Committee (Third Committee of the General Assembly) approved a resolution that
calls upon States to implement national legislation
and policies that prohibit traditional or customary
practices affecting the health of women and girls, including
FGM/FGC. It also calls upon States to prosecute perpetrators
of practices that negatively affect the health of women
and girls, and to intensify efforts to raise awareness
and mobilize international and national opinion on the
harmful effects of such practices.
The Ouagadougou Declaration. A workshop
on concerted action against the practice of FGM/FGC in the
West African Economic and Monetary Union (UEMOA) was
organized in Ouagadougou from 4 to 6 May 1999. Participants
made three recommendations : a) the preparation of an
African charter on FGM/FGC; b) the adoption of specific
legislation against FGM/FGC in all UEMOA States and ratification
by these of regional and international instruments relating
to the protection of women and girls; and c) the establishment
of sub-regional networks of traditional and religious
leaders and modern and traditional communicators to
support the national committees in their campaign against
FGM/FGC. A declaration known as the Declaration of Ouagadougou
was adopted at the end of the workshop.
Key Actions for the Further Implementation
of the Programme of Action of the International Conference
on Population and Development. It calls for governments
to promote human rights of women and girls and freedom
from coercion, discrimination, violence, including harmful
practice, and sexual exploitation and to review national
legislation and amend those that discriminate against
women and girls. It also calls for governments to ensure
supervision of health providers to make sure that they
are knowledgeable and trained to serve clients who have
been subjected to harmful practice.
Further Actions and Initiatives to Implement the Beijing
Declaration and Platform for Action. While it recognses
the progress made in the national legislation process
to ban the practice of FGM/FGC, it points out that discriminatory
attitudes and norms persist that makes girls and women
more vulnerable to gender-based violence including FGM/FGC.
It calls for national governments' actions to combat
and eliminate violence against women that are incompatible
with the dignity and worth of the person.
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Since FGM/FGC is practiced in different
countries and cuts across ethnic groups, there are many
different names used to describe different forms of
FGM/FGC. For instance:
Sunna: Sunna means 'precept' or
'tradition' in Arabic and it refers to a range of practices
that follow the teachings of Islam. It is used in various
communities to refer to different types of FGM/FGC, varying
from incisions in the clitoris to intermediate forms.
References to the term 'sunna' in the Koran are often
used to justify FGM/FGC as being a religious obligation.
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In the following quotation Zainab
(22) tells us that she was infibulated at the age of
8:
"My two sisters, myself and our
mother went to visit our family back home. I assumed
we were going for a holiday. A bit later they told us
that we were going to be infibulated. The day before
our operation was due to take place, another girl was
infibulated and she died because of the operation. We
were so scared and didn't want to suffer the same fate.
But our parents told us it was an obligation, so we
went. We fought back; we really thought we were going
to die because of the pain. You have one woman holding
your mouth so you won't scream, two holding your chest
and the other two holding your legs. After we were infibulated,
we had rope tied across our legs so it was like we had
to learn to walk again. We had to try to go to the toilet,
if you couldn't pass water in the next 10 days something
was wrong. We were lucky, I suppose, we gradually recovered
and didn't die like the other girl. But the memory and
the pain never really goes". (WHO)
Do you want to know more?
Some useful links to other sites
on FGM/FGC: Rainbo, at www.rainbo.org, PATH, at www.path.org,
WHO, at www.who.org
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The Programme of Action of the International
Conference on Population and Development recognizes
that violence against women is a widespread phenomenon.
It states that : "In a number of countries, harmful
practices meant to control women's sexuality have led
to great suffering. Among them is the practice of female
genital cutting, which is a violation of basic rights
and a major lifelong risk to women's health (para 7.35).
The Programme of Action urges "Governments
and communities (to). urgently take steps to stop the
practice of female genital cutting and protect women
and girls from all such similar unnecessary and dangerous
practices. Steps to eliminate the practice should include
strong community outreach programmes involving village
and religious leaders, education and counseling about
its impact on girls' and women's health, and appropriate
treatment and rehabilitation for girls and women who
have suffered cutting. Services should include counseling
for women and men to discourage the practice." (para
7.40)
In Chapter 4 (Gender Equality, Equity
and Empowerment of Women) the following paragraphs pertain
to FGM/FGC:
Para 4.4: "Countries should
act to empower women and should take steps to eliminate
inequalities between men and women as soon as possibly
by :
c) Eliminating all practices that
discriminate against women; assisting women to establish
and realize their rights, including those that relate
to reproductive and sexual health".
Para 4.9: "Countries should take
full measure to eliminate all forms of exploitation,
abuse, harassment and violence against women, adolescents
and children".
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The Report of the Ad Hoc Committee
of the Whole of the Twenty-first Special Session of
the General Assembly, indicates key actions for the
further implementation of the Programme of Action of
the International Conference on Population and Development.
It states that :
Para 42: "Governments should promote
and protect the human rights of the girl child and
young women, which include economic and social rights
as well as freedom from coercion, discrimination and
violence, including harmful practices and sexual exploitation."
Para 43: "Governments and civil
society should take actions to eliminate attitudes and
practices that discriminate against and subordinate
girls and women and that reinforce gender inequality."
Para 48: "Governments should give
priority to developing programmes and policies that
foster norms and attitudes of zero tolerance for harmful
and discriminatory attitudes, including son preference,
which can result in harmful and unethical practices
such as prenatal sex selection, discrimination and violence
against the girl child and all forms of violence against
women, including female genital mutilation, rape, incest,
trafficking, sexual violence and exploitation."
Para 52 f: "Governments, in collaboration
with civil society, including non-governmental organizations,
donors and the United Nations system, should : Ensure
that sexual and reproductive health programmes, free
of any coercion, provide pre-service and in-service
training and supervision for al levels of health-care
providers to ensure that they maintain high technical
standards, including for hygiene; respect the human
rights of the people they serve; are knowledgeable and
trained to serve clients who have been subjected to
harmful practices, such as female genital mutilation
and sexual violence."
Para 52 g: "Promote men's understanding
of their roles and responsibilities with regard to respecting
the human rights of women; .. and promoting the elimination
of harmful practices, such as female genital mutilation,
and sexual and other gender-based violence, ensuring
that girls and women are free from coercion and violence."
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UNFPA addresses the practice of
FGM/FGC not only because of its harmful impact on the reproductive
and sexual health of women, but also because it is a
violation of women's fundamental human rights. The basis
for a rights approach is the affirmation that human
well-being and health is influenced by the way a person
is valued, respected and given the choice to decide
on the direction of her/his life without discrimination,
coercion or neglect of attention. UNFPA addresses FGM/FGC
in a holistic manner, within its cultural and religious
context; however cultural arguments can not be used
to condone harmful practices such as FGM/FGC.
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PROMOTING GENDER EQUALITY: FAQs on Female Genital Mutilation/Cutting
