Breaking the Silence: Female Genital Mutilation
Female Genital Mutilation (FGM) is a procedure that intentionally alters or causes injury to the female genital organs for non-medical reasons. This practice is recognized internationally as a violation of the human rights of girls and women and reflects deep-rooted inequality between the sexes. It is mainly carried out on young girls between infancy and age 15.
FGM has no health benefits and harms girls and women in many ways. It involves removing and damaging healthy and normal female genital tissue and interferes with the natural functions of girls and women’s bodies. The immediate complications can include severe pain, shock, haemorrhage, tetanus or sepsis (bacterial infection), urine retention, open sores in the genital region and injury to nearby genital tissue.
No health benefits, only harm...
Repeated FGM procedures can occur, as practitioners may not achieve the desired result the first time, or throughout a woman’s life to “close” or “re-open” the wound. Particularly severe forms of FGM can lead to prolonged bleeding, infection, infertility and even death.
FGM is a deeply entrenched social norm, perpetuated by the fact that families often believe it is necessary for social acceptance, and often for marriage. The practice is mostly carried out by traditional circumcisers, who often play other central roles in communities, such as attending childbirths.
Worldwide, efforts are increasing to eliminate this practice, including education and advocacy targeting practitioners and communities, to demonstrate that FGM has severe health risks and no benefits.
The immediate complications of FGM:
- Severe pain
- Excessive bleeding (haemorrhage)
- Genital tissue swelling
- Fever
- Infections e.g., tetanus
- Urinary problems
- Wound healing problems
- Injury to surrounding genital tissue
- Shock
- Death
Long-term complications of FGM:
- Urinary problems (painful urination, urinary tract infections)
- Vaginal problems (discharge, itching, bacterial vaginosis and other infections)
- Menstrual problems (painful menstruations, difficulty in passing menstrual blood, etc.)
- Scar tissue and keloid
- Sexual problems (pain during intercourse, decreased satisfaction, etc.)
- Increased risk of childbirth complications (difficult delivery, excessive bleeding, caesarean section, need to resuscitate the baby, etc.) and newborn deaths
- Need for later surgeries: for example, the sealing or narrowing of the vaginal opening (type 3) may lead to the practice of cutting open the sealed vagina later to allow for sexual intercourse and childbirth (deinfibulation). Sometimes genital tissue is stitched again several times, including after childbirth, hence the woman goes through repeated opening and closing procedures, further increasing both immediate and long-term risks
- Injury to surrounding genital tissue
- Psychological problems (depression, anxiety, post-traumatic stress disorder, low self-esteem, etc.).
Who is at risk?
Cultural and social factors for performing FGM
The reasons why FGM is performed vary from one region to another as well as over time and include a mix of sociocultural factors within families and communities.
- Where FGM is a social convention (social norm), the social pressure to conform to what others do and have been doing, as well as the need to be accepted socially and the fear of being rejected by the community, are strong motivations to perpetuate the practice.
- FGM is often considered a necessary part of raising a girl, and a way to prepare her for adulthood and marriage. This can include controlling her sexuality to promote premarital virginity and marital fidelity.
- Some people believe that the practice has religious support, although no religious scripts prescribe the practice. Religious leaders take varying positions with regard to FGM, with some contributing to its abandonment.
Reasons for medicalised FGM
There are many reasons why health-care providers perform FGM. These include:
- the belief that there is reduced risk of complications associated with medicalised FGM as compared to non-medicalised FGM;
- the belief that medicalisation of FGM could be a first step towards full abandonment of the practice;
- health care providers who perform FGM are themselves members of FGM- practising communities and are subject to the same social norms; and
- there may be a financial incentive to perform the practice.
However, with WHO’s support and training, many health care providers are becoming advocates for FGM abandonment within the clinical setting and with their families and communities.
“When You circumcise a girl child, you affect her womanhood”- Joseph Osuigwe
Types of FGM
Female genital mutilation is classified into 4 major types:
- Type 1: This is the partial or total removal of the clitoral glans (the external and visible part of the clitoris, which is a sensitive part of the female genitals), and/or the prepuce/clitoral hood (the fold of skin surrounding the clitoral glans).
- Type 2: This is the partial or total removal of the clitoral glans and the labia minora (the inner folds of the vulva), with or without removal of the labia majora (the outer folds of skin of the vulva).
- Type 3: Also known as infibulation, this is the narrowing of the vaginal opening through the creation of a covering seal. The seal is formed by cutting and repositioning the labia minora, or labia majora, sometimes through stitching, with or without removal of the clitoral prepuce/clitoral hood and glans.
- Type 4: This includes all other harmful procedures to the female genitalia for non-medical purposes, e.g., pricking, piercing, incising, scraping and cauterising the genital area.
Getting help and support
All women and girls have the right to control what happens to their bodies and the right to say no to FGM.
Help is available if you have had FGM or you’re worried that you or someone you know is at risk.
- If someone is in immediate danger, contact the police immediately by dialling 999.
- If you’re concerned that someone may be at risk, contact the NSPCC helpline on 0800 028 3550 or email fgmhelp@nspcc.org.uk.
- If you’re under pressure to have FGM performed on your daughter, ask a GP, your health visitor or another healthcare professional for help, or contact the NSPCC helpline.
- If you have had FGM, you can get help from a specialist NHS gynaecologist or FGM service – ask a GP, your midwife or any other healthcare professional about services in your area.