Female Genital Mutilation The Facts

Compiled by Laura Reymond, Asha Mohamud, and Nancy Ali. Funding was provided by the Wallace Global Fund.

Female Genital Mutilation (FGM) is the partial or total removal of the female external genitalia.1 External genitals include the clitoris, labia, mons pubis (the fatty tissue over the pubic bone), and the urethral and vaginal openings.

The practice of FGM is often called "female circumcision" (FC), implying that it is similar to male circumcision. However, the degree of cutting is much more extensive, often impairing a woman's sexual and reproductive functions.2

Newborns, Children, Adolescents, and Young Adults Are Affected

FGM is Practiced Globally

There Are Four Types of FGM

In 1995, the World Health Organization (WHO) developed four broad categories for FGM operations.15

Type 1

Excision (removal) of the clitoral hood with or without removal of part or all of the clitoris.

Type 2

Removal of the clitoris together with part or all of the labia minora.

Type 3 (infibulation)

Removal of part or all of the external genitalia (clitoris, labia minora, and labia majora) and stitching and/or narrowing of the vaginal opening leaving a small hole for urine and menstrual flow.

Type 4 (unclassified)

All other operations on the female genitalia, including:

Type I and Type II operations account for 85 percent of all FGM. Type III (infibulation) is common in Djibouti, Somalia and Sudan and in parts of Egypt, Ethiopia, Kenya, Mali, Mauritania, Niger, Nigeria, and Senegal.16

Complications Are Common and Can Lead to Death

The highest maternal and infant mortality rates are in FGM-practicing regions.17 The actual number of girls who die as a result of FGM is not known. However, in areas in the Sudan where antibiotics are not available, it is estimated that one-third of the girls undergoing FGM will die.18 Conservative estimates suggest that more than one million women in Centrafrican Republic (CAR), Egypt, and Eritrea, the only countries where such data is available, experienced adverse health effects from FGM.19 One quarter of women in CAR and 1/5 of women in Eritrea reported FGM-related complications.20 Where medical facilities are ill-equipped, emergencies arising from the practice cannot be treated. Thus, a child who develops uncontrolled bleeding or infection after FGM may die within hours.21

Immediate Physical Problems

 

Immediate FGM-Related Complications in Four Kenyan Districts

Immediate FGM-Related Complications in Four Kenyan Districts

A 1991 survey of 1,222 women in four Kenyan districts indicated that 48.5% of the women experienced hemorrhage, 23.9% infection, and 19.4% urine retention at the time of the FGM operation.23

 

Long-Term Complications

 

Chronic FGM-Related Complications Encountered by Health Providers in Kenya

Chronic FGM-Related Complications Encountered by Health Providers in Kenya

The chronic health problems encountered by 49.1% of health providers surveyed in Kenya are bleeding (29.1%); delivery complications (25.5%); infections (12.7%); low libido (3.6%); and fear and depression (1.8%).43  

 

Complications Often Need Medical Attention

FGM May Impede Women's Sexuality

Reasons for Supporting FGM Vary

Reasons for supporting FGM include the beliefs that it is a "good tradition", a religious requirement(s), or a necessary rite of passage to womanhood; that it ensures cleanliness or better marriage prospects, prevents promiscuity and excessive clitoral growth, preserves virginity, enhances male sexuality, and facilitates childbirth by widening the birth canal.

 

Reasons for Supporting FGM in Egypt, Mali, Central African Republic, and Eritrea

Reasons for Supporting FGM in Egypt, Mali, Central African Republic, and Eritrea

Today, the most common reason evoked for supporting FGM is the belief that the practice is a "good tradition".47 Other reasons include religious requirement(s); rite of passage to womanhood; cleanliness; prevention of promiscuity among girls; preservation of virginity; better marriage prospects; enhancement of male sexuality; prevention of excessive clitoral growth; and facilitation of childbirth by widening the birth canal.48

 

More Women Are Using Medical Staff, But Traditional Practitioners Are Still Active

Attitudes Are Gradually Changing

Global Efforts to Stop FGM Are Increasing

Programs

Human Rights Efforts

FGM violates human rights conventions that protect women and children from cruelty and violence and ensure them "bodily integrity" and access to health care, education, and self-realization.67 Some of these conventions are:

FGM eradication has also been included in resolutions and action plans at various international conferences, including the 1995 International Conference on Population and Development and the 1995 Fourth World Conference on Women. FGM is recognized as a human rights violation in the U.S. State Department's annual country reports.

Policy and Legislation

The U.S. Congress Passed Legislation Against FGM

References

  1. World Health Organization. (1995). "Female Genital Mutilation: Report of a WHO Technical Working Group". Geneva: World Health Organization; pp. 9.
  2. Toubia, N. (1993). Female Genital Mutilation: A Call for Global Action. New York: Women, Ink; pp. 9.
  3. Ibid., pp. 5.
  4. Demographic and Health Survey - Egypt. (1995). Calverton, MD: Macro International Inc. pp.175.
  5. Hosken, F.  (1993). The Hosken Report: Genital and Sexual Mutilation of Females, fourth edition. Lexington, MA: Women's International Network; pp. 35.
  6. Ibid.
  7. Toubia, N. (1993). Female Genital Mutilation: A Call for Global Action. New York: Women, Ink; pp. 42.
  8. Demographic and Health Survey - Egypt. (1995). Calverton, MD: Macro International Inc. pp. 171.
  9. Demographic and Health Survey - Eritrea. (1995). Calverton, MD: Macro International Inc. pp. 166.
  10. Demographic and Health Survey - Mali. (1995). Calverton, MD: Macro International Inc. pp. 186.
  11. Demographic and Health Survey - Sudan. (1989-1990). Calverton, MD: Macro International Inc. pp. 118.
  12. Demographic and Health Survey - Central African Republic. (1995). Calverton, MD: Macro International Inc. pp. 201.
  13. Toubia, N. (1993). Female Genital Mutilation: A Call for Global Action. New York: Women, Ink; pp. 44.
  14. Ibid., pp. 21.
  15. Ibid., pp. 11.
  16. Hosken, F.  (1993). The Hosken Report: Genital and Sexual Mutilation of Females, fourth edition. Lexington, MA: Women's International Network; pp. 3.
  17. 1Ibid., pp. 37.
  18. Women's Policy, Inc. (July 12, 1996). "Female Genital Mutilation". Women's Health Equity Act of 1996: Legislative Summary and Overview. Women's Policy, Inc. pp. 48.
  19. "Female Genital Cutting: Findings from the Demographic and Health Surveys Program". (1997). Calverton, MD: Macto International Inc. pp. 39.
  20. Ibid.
  21. Koso-Thomas, O. (1987). The Circumcision of Women: A Strategy for Eradication. London: Dotesios Ltd.; pp. 29.
  22. Koso-Thomas, O. (1987). The Circumcision of Women: A Strategy for Eradication. London: Dotesios Ltd.;  pp. 54.
  23. 23Maendeleo Ya Wanawake Organization and the Program for Appropriate Technology in Health. (1993). "Quantitative Research Report on Female Circumcision in Four Districts in Kenya". Nairobi: Maendeleo Ya Wanawake Organization.
  24. Hosken, F. (1993). The Hosken Report: Genital and Sexual Mutilation of Females, fourth edition. Lexington, MA: Women's International Network. pp. 253.
  25. Institute for Development Training. (1986). "Health Effects of Female Circumcision: A Training Course in Women's Health". Chapel Hill, NC: Institute for Development Training; pp. 15.
  26. Rushwan, H. (1996). "Female Genital Mutilation: Overview and Framework for the Integration of Activities into UNFPA Three Core Program Areas". Unpublished working paper for UNFPA technical consultation on female genital mutilation; pp.9.
  27. Ministry of Health - Somalia. (1985). Fertility and Family Planning in Urban Somalia 1983. Somalia: Westinghouse Public Applied Systems; pp. 95.
  28. Rushwan, H. (1996). "Female Genital Mutilation: Overview and Framework for the Integration of Activities into UNFPA Three Core Program Areas". Unpublished working paper for UNFPA technical consultation on female genital mutilation; pp. 10.
  29. World Health Organization. (1993). "Female Genital Mutilation: World Health Assembly Calls for Elimination of Harmful Traditional Practices". Press Release. Geneva: World Health Organization; pp.1.Koso-Thomas, O. (1987). The Circumcision of Women: A Strategy for Eradication. London: Dotesios Ltd.; pp. 27.
  30. Warsame, Mohamed. (1989). "Medical and Social Aspects of Female Circumcision in Somalia," in Female Circumcision: Strategies To Bring About Change by the Italian Association for Women in Development and the Somali Women's Democratic Organization. Rome: The Italian Association for Women in Development; pp. 97.
  31. World Health Organization. (1986). "A Traditional Practice that Threatens Health: Female Circumcision". WHO Chronicle. Vol. 40 (1): pp. 31-36
  32. Koso-Thomas, O. (1987). The Circumcision of Women: A Strategy for Eradication. London: Dotesios Ltd.; pp. 27-28.
  33. Toubia, N. (1993). Female Genital Mutilation: A Call for Global Action. New York: Women, Ink; pp. 19.
  34. Ibid., pp. 13.
  35. Koso-Thomas, O. (1987). The Circumcision of Women: A Strategy for Eradication. London: Dotesios Ltd.; pp. 29.
  36. Hosken, F.  (1993). The Hosken Report: Genital and Sexual Mutilation of Females, fourth edition. Lexington, MA: Women's International Network; pp. 48.
  37. Toubia, N. (1993). Female Genital Mutilation: A Call for Global Action. New York: Women, Ink.; pp. 17.
  38. Rushwan, H. (1996). "Female Genital Mutilation: Overview and Framework for the Integration of Activities into UNFPA Three Core Program Areas". Unpublished working paper for UNFPA technical consultation on female genital mutilation; pp. 10.
  39. Dareer, A. (1981). "An Epidemiological Study of Female Circumcision in the Sudan". Khartoum, Sudan: University of Khartoum; pp. 81.
  40. Hosken, F. (1993). The Hosken Report: Genital and Sexual Mutilation of Females, fourth edition. Lexington, MA: Women's International Network; pp. 39-40.
  41. Koso-Thomas, O. (1987). The Circumcision of Women: A Strategy for Eradication. London: Dotesios Ltd.; pp. 57.
  42. Program for Appropriate Technology in Health and Seventh Day Adventist-Rural Health Services. (1996). "Qualitative Research Report on Health Workers' Knowledge and Attitudes About Female Circumcision in Nyamira District, Kenya". Nairobi: PATH; pp. 8.
  43. Demographic and Health Survey - Egypt. (1995). Calverton, MD: Macro International Inc. pp. 182.
  44. Kheir, H.M., Kumar, S. and Cross, A. "Female Circumcision: Attitudes and Practices in Sudan". pp. 7.
  45. Demographic and Health Survey, Sudan. (1989/90). Calverton, MD: Macro International Inc. pp. 121.
  46. Demographic and Health Survey Egypt. (1995). Calverton, MD: Macro International Inc. pp. 173.
  47. Toubia, N. (1993). Female Genital Mutilation: A Call for Global Action. New York: Women, Ink; pp. 21.
  48. Demographic and Health Survey - Egypt. (1995). Calverton, MD: Macro International Inc. pp. 173.
  49. Maendeleo Ya Wanawake Organization and the Program for Appropriate Technology in Health. (1991). "Qualitative Research Report on Female Circumcision in Four Districts in Kenya". Nairobi: Maendeleo Ya Wanawake Organization; pp. 10.
  50. Demographic and Health Survey - Sudan. (1989-1990). Calverton, MD: Macro International Inc. pp. 124.
  51. "Female Genital Cutting: Findings from the Demographic and Health Surveys Program". (1997). Calverton, MD: Macto International Inc. pp. 9.
  52. Ibid., pp. 37.
  53. Hosken, F. (1993). The Hosken Report: Genital and Sexual Mutilation of Females, fourth edition. Lexington, MA: Women's International Network; pp. 3.
  54. Demographic and Health Survey - Egypt. (1995). Calverton, MD: Macro International Inc. pp. 176.
  55. Maendeleo Ya Wanawake Organization and the Program for Appropriate Technology in Health. (1991). "Qualitative Research Report on Female Circumcision in Four Districts in Kenya". Nairobi: Maendeleo Ya Wanawake Organization; pp. 18.
  56. Kheir, H.M., Kumar, S. and Cross, A. Female Circumcision: Attitudes and Practices in Sudan. pp. 5.
  57. Maendeleo Ya Wanawake Organization and the Program for Appropriate Technology in Health. (1991). "Qualitative Research Report on Female Circumcision in Four Districts in Kenya". Nairobi: Maendeleo Ya Wanawake Organization; pp. 18.
  58. Kheir, H.M., Kumar, S. and Cross, A. "Female Circumcision: Attitudes and Practices in Sudan". pp. 15.
  59. Ibid., pp. 7.
  60. "Female Genital Cutting: Findings from the Demographic and Health Surveys Program". (1997). Calverton, MD: Macto International Inc. pp. 7.
  61. Koso-Thomas, O. (1987). The Circumcision of Women: A Strategy for Eradication. London: Dotesios Ltd.; pp. 57.
  62. Njeru, E. and the Program for Appropriate Technology in Health. (1996). "Female Circumcision in Nyeri, Embu and Machakos Districts of Kenya: Report on Key Informant Interviews". Nairobi: Program for Appropriate Technology in Health; pp. 42-43.
  63. Demographic and Health Survey - Egypt. (1995). Calverton, MD: Macro International Inc. pp. 172.
  64. Kiragu, K. (1995). "Female Genital Mutilation: A Reproductive Health Concern". Population Reports Supplement. Baltimore, MD: John Hopkins Population Information Program; pp. 3.
  65. "Female Genital Cutting: Findings from the Demographic and Health Surveys Program". (1997). Calverton, MD: Macto International Inc. pp. 9.
  66. Ministry of Foreign Affairs - Danida. (1995). "Report from the Seminar on Female Genital Mutilation". Copenhagen: Axel Nielsen & Son; pp. 17.
  67. Toubia, N. (1993). Female Genital Mutilation: A Call for Global Action. New York: Women, Ink; pp. 44.
  68. Kiragu, K. (1995). "Female Genital Mutilation: A Reproductive Health Concern". Population Reports Supplement. Baltimore, MD: John Hopkins Population Information Program; pp. 4.
  69. Toubia, N. (1993). Female Genital Mutilation: A Call for Global Action. New York: Women, Ink; pp. 44.
  70. Congressional Record -House. (September 28, 1996). H11829 / SEC. 645. Criminalization of Female Genital Mutilation.
  71. Center for Reproductive Law and Policy. (1997). "Legislation on Female Genital Mutilation in the United States". New York, NY: In Focus. pp. 5.
  72. Ibid.
  73. Ibid.
  74. Center for Reproductive Law and Policy. (1997). "Legislation on Female Genital Mutilation in the United States". New York, NY: In Focus. pp. 4-7.