What is female genital mutilation?

Female genital mutilation (FGM), often referred to as 'female circumcision', comprises all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs whether for cultural, religious or other non-therapeutic reasons.
FGM can be performed as early as infancy and as late as age thirty.

Types of FGM

There are different types of female genital mutilation known to be practiced today. They include:
  • Type I - excision of the prepuce, with or without excision of part or all of the clitoris;
  • Type II - excision of the clitoris with partial or total excision of the labia minora;
  • Type III - excision of part or all of the external genitalia and stitching/narrowing of the vaginal opening (infibulation);
  • Type IV - pricking, piercing or incising of the clitoris and/or labia; stretching of the clitoris and/or labia; cauterisation by burning of the clitoris and surrounding tissue; scraping of tissue surrounding the vaginal orifice (angurya cuts) or cutting of the vagina (gishiri cuts); introduction of corrosive substances or herbs into the vagina to cause bleeding or for the purpose of tightening or narrowing it; and any other procedure that falls under the definition given above.

The most common type of female genital mutilation is excision of the clitoris and the labia minora, accounting for up to 80 percent of all cases; the most extreme form is infibulation, which constitutes about 15 percent of all procedures.

Incision:
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.

Clitoridectomy (also known as Sunnah):
Refers to partial or total removal of the clitoris.

Excision:
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.

Infibulation (also known as “Pharaonic Circumcison”):
Refers to the removal of the clitoris, partial or total removal of the labia minora and stitching together of the labia majora.

Circumcision:
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 FGC. This term is considered as confusing by some since it seems to equate male circumcision with 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.

Female genital mutilation:
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 organisations and activists, not just to describe the various forms of FGC, but also to indicate that FGC 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.

Female genital cutting:
Recently, some organisations 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 FGC or even causing an actual increase in the number of girls being subjected to 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 demonising cultures under cover of condemning practices harmful to women and girls (E/CN.4/Sub.2/1999/14).

The Health Consequences of FGM

The health consequences of FGM are both immediate and long term. The extent and duration of the consequences depend on the extent of the cutting, the skill of the practitioner, the nature of the tools and the environment and the physical condition of the girl or woman. The physical side effects are much better understood than the effects on mental or sexual health. FGM/C does irreparable harm. It can result in death through severe bleeding leading to haemorrhagic shock, neurogenic shock as a result of pain and trauma, and severe, overwhelming infection and septicaemia. It is routinely traumatic. Many girls enter a state of shock induced by the severe pain, psychological trauma and exhaustion from screaming.

Short-term effects include pain, injury to adjacent tissue, severe bleeding (haemorrhage, a potentially life threatening complication), shock, acute urine retention, fractures or dislocations (when a struggling girl is restrained), infection (depending on the cleanliness of the instruments, the substances applied to wounds, and the bindings used on the legs or cut surfaces) and failure to heal.

Long-term complications can include difficulty in passing urine, recurring urinary tract infections, pelvic infections, infertility (from deep infections), scarring, difficulties in menstruation, fistulae (holes or tunnels between the vagina and the bladder or rectum), painful intercourse, sexual dysfunction, and problems in pregnancy and childbirth (the need to cut the vagina to allow delivery and the trauma that results, often compounded by re-stitching).

Sources:
- WHO "Female Genital Mutilation: Report of a WHO Technical Working Group, Geneva, 17-19 July 1995." Geneva. 1996. – Female Genital Mutilation
- FGM Network "Female Genital Cutting (FGC): An Introduction" Marianne Sarkis, FGM Network
- CRLP "Female Genital Mutilation (FGM): Legal Prohibitions Worldwide. Center for Reproductive Rights".
- UNFPA. "Frequently Asked Questions about Female Genital Cutting".
- UNICEF "Child Protection: Female genital mutilation"
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