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'''Female genital cutting''' (FGC) (also known as '''female genital mutilation''' (FGM) or '''female circumcision''') refers to "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."<ref name="WHO-2006-10-02" /> It is not the same as the procedures used in [[Sex reassignment surgery|gender reassignment surgery]] or the [[genital modification]] of [[intersexual]]s. FGC is practiced throughout the world, but the practice is concentrated more heavily in Africa, Indonesia, and the Middle East. The [[World Health Organization]] (WHO) separates FGC procedures into four categories: Type I, II, III, and IV. There is much controversy surrounding Type III (Infibulation) due to concerns regarding the safety and consequences of the procedure. In the past several decades, there have been pushes by global health organizations, such as the WHO, to end the practice of FGC. However, due to its importance in traditional and religious life, the practice remains in many societies.
<s>Strike-through text</s>'''Female genital cutting''' (FGC), also known as '''female genital mutilation''' (FGM) or '''female circumcision''', refers to "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."<ref name="WHO-2006-10-02" /> It is not the same as the procedures used in [[Sex reassignment surgery|gender reassignment surgery]] or the [[genital modification]] of [[intersexual]]s. FGC is practiced throughout the world, but the practice is concentrated more heavily in Africa, Indonesia, and the Middle East. The [[World Health Organization]] (WHO) separates FGC procedures into four categories: Type I, II, III, and IV. There is much controversy surrounding Type III (Infibulation) due to concerns regarding the safety and consequences of the procedure. In the past several decades, there have been pushes by global health organizations, such as the WHO, to end the practice of FGC. However, due to its importance in traditional and religious life, the practice remains in many societies.


==History of terminology==
==History of terminology==

Revision as of 01:00, 24 January 2008

Strike-through textFemale genital cutting (FGC), also known as female genital mutilation (FGM) or female circumcision, refers to "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."[1] It is not the same as the procedures used in gender reassignment surgery or the genital modification of intersexuals. FGC is practiced throughout the world, but the practice is concentrated more heavily in Africa, Indonesia, and the Middle East. The World Health Organization (WHO) separates FGC procedures into four categories: Type I, II, III, and IV. There is much controversy surrounding Type III (Infibulation) due to concerns regarding the safety and consequences of the procedure. In the past several decades, there have been pushes by global health organizations, such as the WHO, to end the practice of FGC. However, due to its importance in traditional and religious life, the practice remains in many societies.

History of terminology

Different terms are used to describe female genital surgery. The procedures were commonly referred to as female circumcision, but the terms female genital mutilation (FGM) and female genital cutting (FGC) are now dominant throughout the international community. Opponents of the practice often use the term female genital mutilation, whereas groups that oppose the stigma of the word "mutilation" prefer to use the term female genital cutting. A few organizations have started using the combined term female genital mutilation/cutting (FGM/C).

Female circumcision

Several dictionaries, including medical dictionaries, define the word circumcision as applicable to procedures performed on females.[2][3][4] The word circumcision has been used in this way in scientific journals,[5][6][7] and at least one prominent newspaper.[8] Cook states that historically, the term female circumcision was used, but that "this procedure in whatever form it is practised is not at all analogous to male circumcision."[9] Shell-Duncan states that the term female circumcision is a euphemism for a variety of procedures for altering the female genitalia.[10] Toubia argues that the term female circumcision "implies a fallacious analogy to nonmutilating male circumcision".[11]

Female genital mutilation

The term female genital mutilation gained growing support in the late 1970s. The word "mutilation" not only established clear linguistic distinction from male circumcision, but it also emphasized the gravity of the act. In 1990, this term was adopted at the third conference of the Inter-African Committee on Traditional Practices Affecting the Health of Women and Children (IAC) in Addis Ababa. In 1991, the World Health Organization (WHO), a specialized agency of the United Nations (UN), recommended that the UN adopt this terminology; subsequently, it has been widely used in UN documents.[12]

In this context, the term female circumcision was thus predominantly replaced by the term female genital mutilation:

The extensive literature on the subject, the support of international organizations, and the emergence of local groups working against the continuation practices appear to suggest that an international consensus has been reached. The terminology used to refer to these surgeries has changed, and the clearly disapproving and powerfully evocative expression of "female genital mutilation" has now all but replaced the possibly inaccurate, but relatively less value laden-term of "female circumcision".[13]

Female genital cutting

Because the term female genital mutilation has been criticized for increasing the stigma associated with female genital surgery, some groups have proposed an alteration, substituting the word "cutting" for "mutilation." According to a joint WHO/UNICEF/UNFPA statement, the use of the word "mutilation" reinforces the idea that this practice is a violation of the human rights of girls and women, and thereby helps promote national and international advocacy towards its abandonment. They state that, at the community level, however, the term can be problematic; and that local languages generally use the less judgmental "cutting" to describe the practice. They also feel that parents understandably resent the suggestion that they are "mutilating" their daughters. In this spirit, in 1999, the UN Special Rapporteur on Traditional Practices called for tact and patience regarding activities in this area and drew attention to the risk of "demonizing" certain cultures, religions, and communities. As a result, they claim, the term "cutting" has increasingly come to be used to avoid alienating communities.[14]

In 1996, the Uganda-based initiative REACH (Reproductive, Educative, And Community Health) began using the term female genital cutting, observing that female genital mutilation may "imply excessive judgment by outsiders as well as insensitivity toward individuals who have undergone some form of genital excision."[15] While some international organizations, such as the UN and the WHO, continue to use the earlier term of female genital mutilation, a number of agencies, like UNICEF, now use the term female genital mutilation/cutting (FGM/C).[16] [17]

World Health Organization categorization

There are several distinct practices of FGC that range in severity, depending on how much genital tissue is cut away. Four major types have been categorized by the WHO[18] (see Diagram 1), although there is some debate as to whether all common forms of FGC fit into these four categories, as well as issues with the reliability of reported data.[19]

Diagram 1:This image shows the different types of FGC and how they differ to the normal female anatomy.

Type I

The WHO defines Type I female genital mutilation as the removal or splitting of the clitoral hood, termed "hoodectomy" (or "clitorodotomy"), with or without excision of the clitoris, see Diagram 1B. The clitoral hood is homologous to the foreskin of the penis which is removed during circumcision.

Type II

The WHO's definition of Type II FGC is the "excision of the clitoris with partial or total excision of the labia minora."[1] This type of FGC is also called khafd, meaning reduction in Arabic.[citation needed]

Type III: Infibulation with excision

The WHO defines Type III FGC as "excision of part or all of the external genitalia and stitching/narrowing of the vaginal opening (infibulation)."[1] It is the most extreme form of FGC, and accounts for about 15% of all FGC procedures.[20] Infibulation is also known as "pharaonic circumcision."[21]

In a study (Pieters, 1977) of infibulation in the Horn of Africa, Pieters observed that the procedure involves extensive tissue removal of the external genitalia, including all of the labia minora and the inside of the labia majora. The labia majora are then held together using thorns or stitching. In some cases the girl's legs have been tied together for two to six weeks, to prevent her from moving and to allow the healing of the two sides of the vulva. Nothing remains but the walls of flesh from the pubis down to the anus, with the exception of an opening at the inferior portion of the vulva to allow urine and menstrual blood to pass through, see Diagram 1D. Generally, a practitioner deemed to have the necessary skill carries out this procedure, and a local anesthetic is used. However, when carried out "in the bush," infibulation is often performed by an elderly matron or midwife of the village, with no anesthesia used.[22]

A reverse infibulation can be performed to allow for sexual intercourse or when undergoing labor, or by female relatives, whose responsibility it is to inspect the wound every few weeks and open it some more if necessary. During childbirth, the enlargement is too small to allow vaginal delivery, and so the infibulation must be opened completely and restored after delivery. Again, the legs are sometimes tied together to allow the wound to heal. When childbirth takes place in a hospital, the surgeons may preserve the infibulation by enlarging the vagina with deep episiotomies. Afterwards, the patient may insist that her vulva be closed again.[22]

This practice increases the occurrence of medical complications due to a lack of modern medicine and surgical practices.[citation needed]

A five-year study of 300 women and 100 men in Sudan found that "sexual desire, pleasure, and orgasm are experienced by the majority of women who have been subjected to this extreme sexual mutilation, in spite of their being culturally bound to hide these experiences."[23]

Most advocates of the practice continue to perform the procedure in adherence to standards of beauty that are very different from those in the west.[citation needed] Many infibulated women will contend that the pleasure their partners receive due to this procedure is a definitive part of a successful marriage and enjoyable sex life.

Type IV: Other types

There are other forms that are collectively referred to as Type IV and may not involve any tissue removal at all. This includes a diverse range of practices, including pricking the clitoris with needles, burning or scarring the genitals as well as ripping or tearing of the vagina or introducing herbs into the vagina to cause bleeding and a narrowed vaginal opening.[18] Type IV is found primarily among isolated ethnic groups as well as in combination with other types.[citation needed]

Prevalence

Amnesty International estimates that over 130 million women worldwide have been affected by some form of FGC with over 2 million procedures being performed every year.

Female genital cutting is today mainly practiced in African countries. It is common in a band that stretches from Senegal in West Africa to Somalia on the East coast, as well as from Egypt in the north to Tanzania in the south; see Map. It is also practiced by some groups in the Arabian peninsula. The country where FGC is most prevalent is Somalia, followed by Egypt, Sudan, Ethiopia, and Mali. Among ethnic Somali women, infibulation is traditional and nearly universal. Recent figures estimate that 90 percent of Egyptian women have undergone FGC. Egypt recently passed a law banning FGC.[24]

Map: Estimated Prevalence of Female Genital Cutting (FGC) in Africa. Data based on uncertain estimates.

Whilst FGC is widely practiced out in the open by Africans of all faiths, it is practiced in secrecy in some parts of the Middle East. In the Arabian peninsula, Sunna circumcision is usually performed, especially among Arabs (ethnic groups of African descent are more likely to prefer infibulation). The practice occurs particularly in northern Saudi Arabia, southern Jordan, and Iraq. In the Iraqi village of Hasira, a recent study found that 60 percent of the women and girls reported having had the procedure. Prior to the study, there had been no solid proof of the procedure's prevalence. There is also circumstantial evidence to suggest that FGC is practiced in Syria, western Iran, and southern Turkey.[25] In Oman, a few communities still practice FGC; however, experts believe that the number of such cases is small and declining annually. In the United Arab Emirates and Saudi Arabia, it is practiced mainly among foreign workers from East Africa and the Nile Valley.

The practice can also be found among a few ethnic groups in South America and very rarely in India (Dawoodi Bohra community[26]). In Indonesia, the practice is fairly common among the country's Muslim women; however, in contrast to Africa, almost all are Type I or Type IV, the latter usually involving the symbolic pricking of blood release.[27]

Due to immigration, the practice has also spread to Europe, Australia and the United States. Some tradition-minded families have their daughters undergo FGC whilst on vacation in their home countries. As Western governments become more aware of FGC, legislation has come into effect in many countries to make the practice of FGC a criminal offense. In 2006, Khalid Adem became the first man in the United States to be prosecuted for mutilating his daughter.

Cultural and Religious Aspects

The traditional cultural practice of FGC predates both Islam and Christianity. A Greek papyrus from 163 B.C. mentions girls in Egypt undergoing circumcision and it is widely accepted to have originated in Egypt and the Nile valley at the time of the Pharaohs. Evidence from mummies have shown both Type I and Type III FGC present.[28] While the spread of the practice of FGC is unknown, the procedure is now practiced among Muslims, Christians, and Animists.[29]

Although FGC is practiced within particular religious sub-cultures, FGC transcends religion as it is primarily a cultural practice.[30][31][32] UNICEF stated that when "looking at religion independently, it is not possible to establish a general association with FGM/C status."[33] The arguments used to justify FGC vary; they range from health-related to social benefits:[34]

  • maintenance of cleanliness
  • maintenance of good health
  • preservation of virginity
  • enhancement of fertility
  • prevention of promiscuity
  • increase of matrimonial opportunities
  • pursuance of aesthetics
  • improvement of male sexual performance and pleasure
  • promotion of social and political cohesion


Medical justifications offered by cultural tradition are regarded by scientists and doctors as unsubstantiated. Some African societies consider FGC part of maintaining cleanliness as it removes secreting parts of the genitalia. Vaginal secretions, in reality, play a critical part in maintaining female health. The Mossi of Burkina Faso and the Ibos of Nigeria believe that babies die if they touch the clitoris during birth[citation needed]. In some areas of Africa, there exists the belief that a newborn child has elements of both sexes. In the male body the foreskin of the penis is considered to be the female element. In the female body the clitoris is considered to be the male element. Hence when the adolescent is reaching puberty, these elements are removed to make the indication of sex clearer.[35]

Social justifications similarly lack scientific evidence. FGC advocates have claimed the practice cures females of a myriad of psychological diseases including depression, hysteria, insanity and kleptomania. FGC is often used as a means of control over female virtue. FGC is often used as a means of preservation and proof of virginity, and is regarded in many societies as a prerequisite for honorable marriage. Type III FGC is often used in these societies, and the husband will sometimes cut his bride's scar tissue open after marriage to allow for sexual intercourse. Heavy stigma lies on men who marry an uncircumcised woman. Women who have had genital surgeries are often considered to have higher status than those who have not and are entitled to positions of religious, political and cultural power.[34] Removal of the clitoris is often cited as a means of discouraging promiscuity, as it eliminates the motivating factor of sexual pleasure. Feminists and human rights activists disapprove of this practice because it presupposes that women lack the self control or the right to decide when and with whom they engage in sexual activity.

Aesthetic reasons are also cited. Some societies believe that FGC enhances beauty. This stems from their belief that male foreskin is removed for aesthetic reasons, and that the clitoris thus should be removed for the same reason since it is the counterpart to the penis. FGC is believed to prolong sexual pleasure of men, because it is believed that the clitoris increases sexual stimulation.[citation needed]

There are no scientific or medical studies that support any of these viewpoints. While there is a correlation between FGC prevalence and religions like Islam and Christianity, prevalence rates vary by culture. These variances preclude an unequivocal link between religion and FGC.[31] However there is debate as to whether or not FGC constitutes a religious practice in particular religious sub-cultures.

Islam

Ambiguity and Debate

FGC is not a formal Islamic religious practice, though advocates will quote hadith that mention its practice. The meaning and legitimacy of such mentions are disputed within the Islamic community.[36] Whether FGC is mandatory, permitted, optional, or forbidden in Islam is ambiguous and a matter of debate. FGC predates Islam.[31] In Saudi Arabia, in the area known as the Hijaz, where Islam originated, FGC was already being practiced during the lifetime of Muhammad. To call a man a "circumciser of women" was an insult among the pagan Arabs at the time. Female genital cutting is not commanded by the Qur'an.[37] FGC is not practiced by the majority of Muslims[31], however there is much debate amongst Islamic scholars over whether FGC is permitted or forbidden. Al-Sabbagh states, "no evidence from religious sources proves that it is either an obligation or a sunna [recommended]."[38]

Sects that Advocate FGC

One of the four Islamic schools of religious law, the Shafi'i school, rules that clitoridectomy is mandatory.[39] Other sects are adament about the practice. In 1994, Egyptian Mufti Sheikh Jad Al-Hâqq 'Ali Jad Al-Hâqq issued a fatwa stating, "Circumcision is mandatory for men and for women. If the people of any village decide to abandon it, the village imam must fight against them as if they had abandoned the call to prayer."[40] The Al-Azhar University in Cairo has issued several fatwas endorsing FGC, in 1949, 1951 and 1981.[41]

Shi'ite Opposition

In the Shi'ite tradition of Islam, the practice of female circumcision has never been practiced. This procedure is outlawed by all leading Shi'ite Marjas that interpret Sharia traditions and is considered a custom left over from pre-Islamic times. In general the Islamic clergy do not support the practice; Shaykh Faraz Rabbani states "As for excision, FGM, or other harmful practices, which have become culturally widespread, none of these are in any way permitted."[42]

Scholarly and Religious Debate

According to Muhammad Lutfi As-Sabbagh, Professor in Islamic Studies in Riyadh University, sayings of Muhammad[citation needed] supporting the legitimacy of FGC were rejected by the majority of Medieval scholars, noting "the two great Imams, Abu Dawud and Al-`Iraqi, have judged this Hadith to be da`if (weak). Shams Ed-Din Al-Haq Al-`Azim Abadi explains the legal import of such weakness, "[t]he Hadith of female circumcision has been reported through so many ways all of which are weak, blemished and defective, and thus it is unacceptable to prove a legal ruling through such ways."[43] and accepted by only a clear minority of Islamic scholars, states that "a woman used to perform circumcision in Medina. Muhammad said to her, 'Do not cut severely as that is better for a woman and more desirable for a husband.'"[44] Majority of scholars hold that this hadith does not require anyone to perform or undergo a circumcision. Other pro-FGC readings say this indicates that the procedure should not cut so far as to threaten health. Some scholars, however, go further and hold that, as "games of chance" (maysir) are prohibited in the Qur'an, the rather unspecified term "severely" intentionally inherits the risk of a cut being deemed as too severe by Muhammad and/or God so that the tradition could easily be abolished later on.

While some scholars, such as Sheikh Sayyid Sabiq, reject hadiths that refer to FGC on grounds of inauthenticity, other scholars argue that authenticity alone does not confer legitimacy. One of the sayings used to support FGC practices is the`hadith (349) in Sahih Muslim: Aishah narrated an authentic Hadith that the Prophet said:"When a man sits between the four parts (arms and legs of his wife) and the two circumcised parts meet, then ghusl is obligatory." Dr. Muhammad Salim al-Awwa, Secretary General of the World Union of the Muslim Ulemas states that while the hadith is authentic, it is not evidence of legitmacy. He states that the Arabic for "the two circumcision organs" is a single word used to connote two forms; however the plural term for one of the forms is used to denote not two of the same form, but two different forms characterized as a singular of the more prominent form. He goes on to state that, while the female form is used to denote both male and female genitalia, it is identified with the prominent aspect of the two forms, which, in this case, is the male circumcised organ. He further states that the connotation of circumcision is not transitive. Dr. al-Awwa concludes that the hadith is specious because "such an argument can be refuted by the fact that in Arabic language, two things or persons may be given one quality or name that belongs only to one of them for an effective cause." [43] [e.g. the usage in "Qur'an in Surah Al-Furqan(25):53" bahrayn is the dual form of bahr (sea) meaning "sea (salty and bitter) and river (sweet and thirst-allaying) (not "two seas"); sometimes the word with the female gender is chosen to make the dual form, such as in the expression "the two Marwas", referring to the two hills of As-Safa and Al-Marwa (not "two hills, each called Al-Marwa") in Mecca][45]

In March 2005, Dr Ahmed Talib, Dean of the Faculty of Sharia at the Al-Azhar University, stated: "All practices of female circumcision and mutilation are crimes and have no relationship with Islam. Whether it involves the removal of the skin or the cutting of the flesh of the female genital organs... it is not an obligation in Islam.[46] Both Christian and Muslim leaders have publicly denounced the practice of FGC since 1998.[47]

Some Muslim scholars believe FGC is practiced as a result of ignorance and misconceived religious fervor rather than for reasons of true religious doctrine. A recent conference at the Al-Azhar University in Cairo (December, 2006) brought prominent Muslim clergy to denounce the practice as not being necessary under the umbrella of Islam.[48] Although there was some reluctance amongst some of the clergy, who preferred to hand the issue to doctors, making the FGC a medical decision, rather than a religious one, the Grand Mufti Ali Jumaa of Egypt, signed a resolution denouncing the practice.[49]


Judaism and Christianity

The Oxford Dictionary of the Jewish Religion states that female circumcision was never allowed in Judaism.[50] Toubia (1995) states that female circumcision is not even mentioned in any religious text.[51] FGC is practiced by the minority Ethiopian Jewish community (Beta Israel), formerly known as Falasha, most of whom now live in Israel. The operation may only be performed by a Jewish female. Those Ethiopian Jews who have emigrated to Israel no longer practice FGC. [52] In general, traditional Judaism maintains that the body of a person belongs not to the person but to God.[53] Any permanent modification of the body which does not serve the purpose of correcting a deformity is considered to be a defacement of God's property; thus, tattoos and body modifications are forbidden, with the exception of male circumcision, which is mandated.

Christianity's lack of FGC tradition is inherited from Judaism. FGC has never been part of Christianity as a faith system. There are no scriptural or doctrinal documents existing within the larger Christian tradition that even address the issue. The only contemporary examples of Christians practicing FGC are in Africa. As FGC rituals predated the missionaries work in North Africa, many African tribes continue the practice as a matter of cultural tradition, unrelated to religious belief.

FGC advocation by Christians has been rare and isolated to extremist groups. In the United States, as recently as 1938, FGC was advocated by Reverend Oscar Lowry as a method of preventing masturbation: "While incest and illicit commerce of the sexes is abominable, there is another even more so—if that be possible—that is, the heinous sin of self-pollution or masturbation... In some cases where there may be impingement of the clitoris, a slight operation may be necessary to relieve the tension and irritation..."[54]

Medical consequences

Among practicing cultures, FGC is most commonly performed between the ages of four and eight, but can take place at any age from infancy to adolescence. Prohibition has led to FGC going underground, at times with people who have had no medical training performing the cutting without anesthetic, sterilization, or the use of proper medical instruments. The procedure, when performed without any anesthetic, can lead to death through shock from immense pain or excessive bleeding. The failure to use sterile medical instruments may lead to infections.

Other serious long term health effects are also common. These include urinary and reproductive tract infections, caused by obstructed flow of urine and menstrual blood, various forms of scarring and infertility. The first time having sexual intercourse will often be extremely painful, and infibulated women will need the labia majora to be opened, to allow their husband access to the vagina. This second cut, sometimes performed by the husband with a knife, can cause other complications to arise.

A June 2006 study by the WHO has cast doubt on the safety of genital cutting of any kind.[1] This study was conducted on a cohort of 28,393 women attending delivery wards at 28 obstetric centers in areas of Burkina Faso, Ghana, Nigeria, Kenya, Senegal and The Sudan. A high proportion of these mothers had undergone FGC. According to the WHO criteria, all types of FGC were found to pose an increased risk of death to the baby (15% for Type I, 32% for Type II, and 55% for Type III). Mothers with FGC Type III were also found to be 30% more at risk for cesarean sections and had a 70% increase in postpartum hemorrhage compared to women without FGC. Estimating from these results, and doing a rough population estimate of mothers in Africa with FGC, an additional 10 to 20 per thousand babies in Africa die during delivery as a result of the mothers having undergone genital cutting.

In cases of repairing the damage resulting from FGC, called de-infibulation when reversing Type III FGC, this is usually carried out by a gynecologist. See also Pierre Foldes, French surgeon, who developed modern surgical corrective techniques.

A 12 year-old Egyptian girl, Badour Shaker, died in June, 2007 during or soon after a circumcision, prompting the Egyptian Health Ministry to ban the practice. She died from an overdose of anesthesia. The girl's mother, Zeniab Abdel Ghani, paid $9.00 [or 5 British pounds] to a female doctor, in an illegal clinic in the southern town of Maghagh, for the operation. The mother stated that the doctor tried to give her $3,000 to withdraw a lawsuit, but she refused.[55]

Sexual consequences

The effect of FGC on a woman's sexual experience varies depending on many factors. FGC does not eliminate sexual pleasure for all women who undergo the procedure. Although sexual excitement and arousal for a woman during intercourse involves a complex series of nerve endings being activated and stimulated in and around her vagina, vulva (labia minora and majora) and clitoris, psychological response and mind-set are also important.

In the early 1980s, Hanny Lightfoot-Klein traveled throughout Sudan (where Type III is the prevalent form of FGC, ~90%) asking women who had undergone FGC how often they had experienced orgasm during intercourse.[56] Many of the women had no idea what an orgasm was. Others interviewed (especially if the surgery excised less tissue) not only insisted that they did achieve orgasm, ranging from 90% of the time when they were young to 10% of the time once they had children, but were open to talking about their experiences. The women were able to describe in great detail exactly what an orgasm meant to them.

A study[57] in 2007 found that in some infibulated women, some erectile tissue fundamental to producing pleasure had not been completely excised. Defibulation of subjects revealed that a part of or the whole of the clitoris was underneath the scar of infibulation. The study found that sexual pleasure and orgasm are still possible after infibulation, and that they rely heavily on cultural influences — when mutilation is lived as a positive experience, orgasm is more likely. When FGC is experienced as traumatic, its frequency drops. The study suggested that FGC women who did not suffer from long-term health consequences and are in a good and fulfilling relationship may enjoy sex, and women who suffered from sexual dysfunction as a result of FGC have a right to sex therapy.

A study by Anthropologist Rogaia M. Abusharaf, found that "circumcision is seen as 'the machinery which liberates the female body from its masculine properties'[58] and for the women she interviewed, it is a source of empowerment and strength" [59]

Attempts to end the practice of FGC

Despite laws forbidding the practice, FGC remains an enduring tradition in many societies and cultural groups. Political leaders have found FGC difficult to eliminate on the local level because of its cultural and sometimes political importance.[60] For instance, prohibition by the British of the procedure among tribes in Kenya significantly strengthened the tribes' resistance to British colonial rule in the 1950s and increased support for the Mau Mau guerrilla movement.

Because the practice holds much cultural and marital significance, FGC opponents recognize that in order to end the practice it is necessary to work closely with local communities. In order to leave no individuals handicapped, as what happened with the rapid abandonment of foot binding among the Chinese early in the 20th century,[61] members of a marriage network must all give up the practice simultaneously.

Despite the close tie between FGC and cultural and, sometimes, religious tradition, there are cases where attempts at ending FGC have been successful. One example is in Senegal, where initiative was taken by native women working at the local level in connection with the Tostan Project.[62] Since 1997, 1,271 villages (600,000 people), some 12% of the practicing population in Senegal, have voluntarily given up FGC and are also working to end early and forced marriage. This has come about through the voluntary efforts of locals carrying the message out to other villages within their marriage networks in a self-replicating process. By 2003, 563 villages had participated in public declarations, and the number continues to rise. By then, at least 23 villages in Burkina Faso had also held such community wide ceremonies, marking "the first public declaration to end FGC outside of Senegal and showing the replicability of the Tostan program for large-scale abandonment of this practice". Molly Melching of TOSTAN believes that in Senegal the practice of female genital mutilation could be ended within 2–5 years. She credits education, instead of cultural imperialism, for the rapid and significant changes which have occurred in Senegal.

Some countries which have prohibited FGC still experience the practice in secrecy. In many cases, the enforcement of this prohibition is a low priority for governments. Other countries have tried to educate practitioners in order to make it easier and safer, instead of outlawing the practice entirely. However, with pressure from the WHO and other groups, laws are being passed in regards to FGC. On June 28, 2007 Egypt banned female genital cutting after the death of 12-year old Badour Shaker during a genital circumcision. The Guardian of Britain reported that her death "sparked widespread condemnation" of the practice.[55] However, Britain has had its own problem confronting cases of FGC, as immigrants from Africa have been known to send their daughters to their home nations to undergo the procedure before returning to Britain.

Laws and prevalence

The countries where FGC is commonly practiced were identified by the US State Department.[63] Other information in this section is from Skaine (2005), Appendix I.[28]

Burkina Faso (71.6% prevalence, Type II)
A law prohibiting FGC was enacted in 1996 and went into effect in February 1997. Even before this law, however, a presidential decree had set up the National Committee against excision and imposed fines on people guilty of excising girls and women. The new law includes stricter punishment. Several women excising girls have been handed prison sentences.[64]
Central African Republic (43.4% prevalence, Type I and II)
In 1996, the President issued an Ordinance prohibiting FGC throughout the country. It has the force of national law. Any violation of the Ordinance is punishable by imprisonment of from one month and one day to two years and a fine of 5,100 to 100,000 francs (approximately US$8-160). No arrests are known to have been made under the law.
Côte d'Ivoire ( 44.5% prevalence, Type II)
A December 18, 1998 law provides that harm to the integrity of the genital organ of a woman by complete or partial removal, excision, desensitization or by any other procedure will, if harmful to a women's health, be punishable by imprisonment of one to five years and a fine of 360,000 to two million CFA Francs (approximately US$576-3,200). The penalty is five to twenty years incarceration if a death occurrs during the procedure and up to five years' prohibition of medical practice, if this procedure is carried out by a doctor.
Djibouti (90-98% prevalence, Type II)
FGC was outlawed in the country's revised Penal Code that went into effect in April 1995. Article 333 of the Penal Code provides that persons found guilty of this practice will face a five year prison term and a fine of one million Djibouti francs (approximately US$5,600).
Egypt (78-97% prevalence, Type I, II and III)
Egypt's Ministry of Health and Population has banned all forms of female genital cutting since 2007. The ministry's ban order declared it is 'prohibited for any doctors, nurses, or any other person to carry out any cut of, flattening or modification of any natural part of the female reproductive system'. Islamic authorities in the nation also stressed that Islam opposes female circumcision. The Grand Mufti of Egypt, Ali Gomaa, said that it is "Prohibited, prohibited, prohibited."[65] The June 2007 Ministry ban eliminated a loophole that allowed girls to undergo the procedure for health reasons. [66] There had previously been provisions under the Penal Code involving "wounding" and "intentional infliction of harm leading to death," as well as a ministerial decree prohibiting FGC. In December 1997, the Court of Cassation (Egypt's highest appeals court) upheld a government banning of the practice providing that those who did not comply would be subjected to criminal and administrative punishments. This law had proved ineffective and in a survey in 2000, a study found that 97% of the country's population still practiced FGC. In light of the widespread practice of FGC, even after the ban in 1997, some Egyptian villages decided to voluntarily give up the practice, as was the case with Abou Shawareb, which vowed in July of 2005 to end the practice.[citation needed] However, it remains a culturally accepted practice, and a 2005 study found that over 95% of Egyptian women have undergone some form of FGC.[67].
Eritrea (90-95% prevalence, Type I, II and III)
Eritrea has outlawed all forms of female genital cutting since 2007[68]. There have been no arrests made yet under the new law.
Ghana (9-15% prevalence, Type I,II and III)
In 1989, the head of the government of Ghana, President Rawlings, issued a formal declaration against FGC. Article 39 of Ghana's Constitution also provides in part that traditional practices that are injurious to a person's health and well being are abolished.
Guinea (98.6% prevalence, Type I, II and III)
FGC is illegal in Guinea under Article 265 of the Penal Code. The punishment is hard labor for life and if death results within 40 days after the crime, the perpetrator will be sentenced to death. No cases regarding the practice under the law have ever been brought to trial. Article 6 of the Guinean Constitution, which outlaws cruel and inhumane treatment, could be interpreted to include these practices, should a case be brought to the Supreme Court.[citation needed] A member of the Guinean Supreme Court is working with a local NGO on inserting a clause into the Guinean Constitution specifically prohibiting these practices.[citation needed]
Indonesia (No national prevalence figures avail., Type I and IV)
Officials are preparing to release a decree banning doctors and paramedics from performing FGC. FGC is still carried out extensively in Indonesia, the worlds largest Muslim nation. Azrul Azwar, The director general of community health, stated that, "All government health facilities will also be instructed to spread information about the decision as well as the redundancy of female circumcision."[69]
Nigeria (25.1% prevalence, Type I, II and III)
There is no federal law banning the practice of FGC in Nigeria. Opponents of these practices rely on Section 34(1)(a) of the 1999 Constitution of the Federal Republic of Nigeria that states "no person shall be subjected to torture or inhuman or degrading treatment" as the basis for banning the practice nationwide. A member of the House of Representatives has drafted a bill, not yet in committee, to outlaw this practice.
Senegal (5-20% prevalence, Type II and III)
A law that was passed in January 1999 makes FGC illegal in Senegal. President Diouf had appealed for an end to this practice and for legislation outlawing it. The law modifies the Penal Code to make this practice a criminal act, punishable by a sentence of one to five years in prison. A spokesperson for the human rights group RADDHO (The African Assembly for the Defense of Human Rights) noted in the local press that "Adopting the law is not the end, as it will still need to be effectively enforced for women to benefit from it."
Somalia (90-98% prevalence, Type I and III)
There is no national law specifically prohibiting FGC in Somalia. There are provisions of the Penal Code of the former government covering "hurt", "grievous hurt" and "very grievous hurt" that might apply. In November 1999, the Parliament of the Puntland administration unanimously approved legislation making the practice illegal. There is no evidence, however, that this law is being enforced.
Sudan (91% prevalence, Type I,II and III)
Currently there is no law forbidding FGC, although Sudan was the first country to outlaw it in 1946, under the British. Type III was prohibited under the 1925 Penal Code, with less severe forms allowed. Outreach groups have been trying to eradicate the practice for 50 years, working with NGO's, religious groups, the government, the media and medical practitioners. Arrests have been made but no further action seems to have taken place.
Tanzania (17.6% prevalence, Type II and III)
Section 169A of the Sexual Offences Special Provisions Act of 1998 prohibits FGC. Punishment is imprisonment of from five to fifteen years or a fine not exceeding 300,000 shillings (approximately US$380) or both. There have been some arrests under this legislation, but no reports of prosecutions yet.
Togo (12% prevalence, Type II)
On October 30, 1998, the National Assembly unanimously voted to outlaw the practice of FGC. Penalties under the law can include a prison term of two months to ten years and a fine of 100,000 francs to one million francs (approximately US$160 to 1,600). A person who had knowledge that the procedure was going to take place and failed to inform public authorities can be punished with one month to one year imprisonment or a fine of from 20,000 to 500,000 francs (approximately US$32 to 800).
Uganda (<5% prevalence, Type I and II)
There is no law against the practice of FGC in Uganda. In 1996, however, a court intervened to prevent the performance of this procedure under Section 8 of the Children Statute, enacted that year, that makes it unlawful to subject a child to social or customary practices that are harmful to the child's health.

See also

  • Breast ironing - a practice of flattening the breasts of girls
  • Foot binding - an old, primarily Chinese, practice of constricting feet
  • Labiaplasty - a recently developed cosmetic practice

References

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  2. ^ "American Heritage Dictionary".
  3. ^ "Merriam Webster's Online Dictionary".
  4. ^ "Medilexicon".
  5. ^ "Circumcision and infibulation of females: a general consideration of the problem and a clinical study of the complications in Sudanese women". PubMed.
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  9. ^ Cook, Rebecca J. (2003). Reproductive Health and Human Rights: Integrating Medicine, Ethics, and law. Oxford University Press. p. 262. ISBN 0199241333. The terminology used to describe this procedure varies. The term 'female circumcision' has been used historically. However, as the harm that such procedures caused to girls and women became increasingly recognized, and because this procedure in whatever form it is practised is not at all analogous to male circumcision, the term 'female circumcision' gave way to the term 'female genital mutilation'. The term 'female genital mutilation' has been adopted by many women's health organizations, sudh as the Inter-African Committee on Traditional Practices Affecting the Health of Women and Childre, and intergovernmental organizations, such as the World Health Organization. However, the use of the term may offend women who have undergone the procedure and do not consider themselves mutilated or their families as mutilators. {{cite book}}: Unknown parameter |coauthors= ignored (|author= suggested) (help); line feed character in |coauthors= at position 19 (help)
  10. ^ Shell-Duncan, Bettina (2001). "The medicalization of female "circumcision":harm reduction pr promotion of a dangerous practice?". Social Science & Medicine. 52 (7): 1013–1028. The term "female circumcision" is a euphemistic description for what is really a variety of procedures for altering the female genitalia. While numerous terms have been used to describe the wide range of procedures, there are generally four commonly recognized forms of genital cutting. {{cite journal}}: |access-date= requires |url= (help); Unknown parameter |month= ignored (help)
  11. ^ Toubia, N (1995). "Female Genital Mutilation". In Peters, J; Wolper, A (ed.). Women's Rights, Human Rights: International Feminist Perspectives. p. 226. ISBN 0415909953.{{cite book}}: CS1 maint: multiple names: editors list (link)
  12. ^ Alexia Lewnes, ed. (2005). "Changing a harmful social convention: female genital cutting/mutilation" (PDF). Innocenti Digest. Florence, Italy: Giuntina: 1–2. ISBN 88-89129-24-7. Retrieved 2007-12-24. The expression "female genital mutilation (FGM) gained growing support in the late 1970s. The word "mutilation" not only establishes a clear linguistic distinction with male circumcision, but also, due to its strong negative connotations, emphasizes the gravity of the act. In 1990, this term was adopted at the third conference of the Inter African Committee on Traditional Practices Affecting the Health of Women and Children (IAC) in Addis Ababa. In 1991, WHO recommended that the United Nations adopt this terminology and subsequently, it has been widely used in UN documents. {{cite journal}}: Cite has empty unknown parameters: |month= and |coauthors= (help)
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  15. ^ "Dispatches -- New from UNFPA, the United Nations Population Fund". United Nations Population Information Network (POPIN). March, 1996. Retrieved 2007-12-22. {{cite web}}: Check date values in: |date= (help)
  16. ^ Nirit Ben-Ari (May 2003), "Changing tradition to safeguard women: Villagers join campaigns against female genital mutilation", Africa Recovery, 17 (1): 4, Official UN documents use FGM, the earlier term, while some UN agencies, such as the UN Population Fund, use both FGM and female genital cutting.{{citation}}: CS1 maint: date and year (link)
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  45. ^ Abbas Hassan, An-nahw al-wafi, I, 118–19
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  51. ^ Nahid, Toubia (1995). "Female Circumcision -- Dr. Toubia replies". New England Journal of Medicine. 332: 188–90. Retrieved 2007-12-23. Male circumcision is an absolute requirement of Islam and Judaism, whereas female circumcision is not even mentioned in any religious text. However, scholars of African cultures would testify that on our continent traditional and tribal rituals commonly supersede religion. {{cite journal}}: Unknown parameter |month= ignored (help)
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Further reading

Bibliography

  • Al-Qaradawi, Y. (2004, February 7). Islamic ruling on female circumcision. Retrieved March 29, 2006.
  • Al-Qaradawi, Y. (2004, December 13). Circumcision: Juristic, medical & social perspectives. Retrieved March 29, 2006.
  • Boyle, E. H. (2002). Female genital cutting: Cultural conflict in the global community. Baltimore: Johns Hopkins University Press. ISBN 978-0-8018-7063-7.
  • Dettwyler, Katherine A. (1994). Dancing skeletons: life and death in West Africa. Prospect Heights, Ill.: Waveland Press. ISBN 0-88133-748-X.
  • Ferguson, I and Ellis, P. (1995). Female Genital Mutilation: a Review of the Current Literature Department of Justice, Canada. Working document
  • Gruenbaum, E. (2001). The female circumcision controversy. Philadelphia: University of Pennsylvania Press. ISBN 978-0-8122-1746-9.
  • Hoffman, B. (2002). Womanhood and Circumcision: Three Maasai women have their say. Berkeley: Berkeley Media.
  • Johnson, Michelle C. (2000). Becoming a Muslim, Becoming a person: Female 'circumcision', religious identity, and personhood in Guinea-Bissau. In B. Shell-Duncan & Y. Herlund (Eds.), Female circumcision in Africa: Culture, controversy, and change. Boulder: Lynne Rienner Publishers.
  • Kandela, P. (1995, January). Egypt sees U turn on female circumcision. British Medical Journal, 310, 12.
  • Kassindja, F. (1998). Do they hear you when you cry. New York: Delacorte Press. ISBN 0-38531-832-4.
  • Obermeyer, Carla Makhlouf (2003). The health consequences of female circumcision: Science, advocacy, and standards of evidence. Medical Anthropology Quarterly, 17(3), 394-412. PMID 12974204. doi:10.1525/maq.2003.17.3.394
  • Pieters, G., & Lowenfels A. B. (1977). Infibulation in the horn of Africa. New York State Journal of Medicine, 77(5), 729-31. PMID 265433.
  • Research papers from medical gynecologists, judges, linguistics, and social scientists on the subject (1994). University of Khartoum, Sudan. Umm Atteya Organization website (Arabic). Retrieved March 29, 2006.
  • UNICEF (1999). Consultation on the elimination of female genital mutilation: 14 December-16 December 1998. New York: Author. 40 pp.
  • World Health Organization. (1996). Female genital mutilation: Report of a WHO Technical Working Group (unpublished document WHO/FRH/WHD/96.10). Geneva: World Health Organization. Retrieved 2007-02-21.

Print

  • Aldeeb, Sami (2000). Male and Female Circumcision in the Jewish, Christian and Muslim Communities, Religious debate. Beirut, ISBN 1855134063.
  • Daw, E. (1970). Female circumcision and infibulation complicating delivery. Practitioner, 204(222), 559-63. PMID 5443542.
  • Dewhurst, C.J., & Michelson, A. (1964). Infibulation complicating pregnancy. British Medical Journal, 2(5422), 1442. PMID 14209371.
  • Dirie, Waris (2001). Desert Flower. Autobiography of a Somali woman's journey from nomadic tribal life to a career as a fashion model in London and to the post of special ambassador at the United Nations. Dirie recounts her personal experience with female genital mutilation that began with circumcision at age five.
  • Leonard, Lori (2000). We did it for pleasure only: Hearing alternative tales of female circumcision. Qualitative Inquiry, 6(2), 212-228.
  • Mernissi, Fatima. Beyond the veil: Male-female dynamics in a modern Muslim society. Cambridge, MA: Schenkman Pub. Co. ISBN 0-470-59613-9.
  • Mustafa, Asim Zaki (1966). Female circumcision and infibulation in the Sudan. Journal of Obstetrics and Gynaecology of the British Commonwealth, 73(2), 302–306. doi:10.1111/j.1471-0528.1966.tb05163.x.
  • Robinett, Patricia (2006). The rape of innocence: One woman's story of female genital mutilation in the USA. N.p.: Aesculapius Press. ISBN 1-878411-04-7.
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