What is it?

What is Female Genital Mutilation (FGM)?

Female genital mutilation (FGM), also known as female circumcision or female genital cutting, is defined by the World Health Organisation (WHO) as "all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs for nonmedical reasons".
The World Health (WHO) classifies FGM into four types: Type I

involves the excision of the prepuce with or without excision of part or all of the clitoris.
Type II

excision of the prepuce and clitoris together with partial or total excision of the labia minora.
Type III

excision of part or all of the external genitalia and stitching or narrowing of the vaginal opening, also known as infibulation. This is the most extreme form and constitutes 15 per cent of all cases. It involves the use of thorns, silk or catgut to stitch the two sides of the vulva. A bridge of scar tissue then forms over the vagina, which leaves only a small opening (from the size of a matchstick head) for the passage of urine and menstrual blood.
Type IV

includes pricking, piercing or incision of the clitoris and/or the labia; stretching of the clitoris and or the labia; cauterisation or burning of the clitoris and surrounding tissues, scraping of the vaginal orifice or cutting (Gishiri cuts) of the vagina and introduction of corrosive substances or herbs into the vagina.

Clitoridectomy: partial or total removal of the clitoris (a small, sensitive and erectile part of the female genitals) and, in very rare cases, only the prepuce (the fold of skin surrounding the clitoris). Excision: partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora (the labia are "the lips" that surround the vagina). Infibulation: narrowing of the vaginal opening through the creation of a covering seal. The seal is formed by cutting and repositioning the inner, or outer, labia, with or without removal of the clitoris. Other: all other harmful procedures to the female genitalia for non-medical purposes, e.g. pricking, piercing, incising, scraping and cauterizing the genital area.

How is it done?
The procedure is traditionally carried out by an older woman with no medical training. Anaesthetics and antiseptic treatment are not generally used and the practice is usually carried out using basic tools such as knives, scissors, scalpels, pieces of glass and razor blades. Often iodine or a mixture of herbs is placed on the wound to tighten the vagina and stop the bleeding. Where is it practiced?

The majority of cases of FGM are carried out in 28 African countries. In some countries, (e.g. Egypt, Ethiopia, Somalia and Sudan), prevalence rates can be as high as 98 per cent. In other countries, such as Nigeria, Kenya, Togo and Senegal, the prevalence rates vary between 20 and 50 per cent. It is more accurate however, to view FGM as being practised by specific ethnic groups, rather than by a whole country, as communities practising FGM straddle national boundaries. FGM takes place in parts of the Middle East, i.e. in Yemen, Oman, Iraqi Kurdistan, amongst some Bedouin women in Israel, and was also practised by the Ethiopian Jews, and it is unclear whether they continue with the practice now that they are settled in Israel. FGM is also practised among Bohra Muslim populations in parts of India and Pakistan, and amongst Muslim populations in Malaysia and Indonesia. As a result of immigration and refugee movements, FGM is now being practiced by ethnic minority populations in other parts of the world, such as USA, Canada, Europe, Australia and New Zealand. FORWARD estimates that as many as 6,500 girls are at risk of FGM within the UK every year.
To whom is it practiced? Procedures are mostly carried out on young girls sometime between infancy and age 15, and occasionally on adult women. http://www.who.int/mediacentre/factsheets/fs241/en/

Why does it exist?

Justifications of FGM
The roots of FGM are complex and numerous; indeed, it has not been exactly possible to determine when or where the tradition of FGM originated. The justifications given for the practise are multiple and reflect the ideological and historical situation of the societies in which it has developed. Reasons cited generally relate to tradition, power inequalities and the ensuing compliance of women to the dictates of their communities

Reasons include: 1. 2. 3. 4. 5. 6. 7. 8. 9. custom and tradition religion; in the mistaken belief that it is a religious requirement preservation of virginity/chastity social acceptance, especially for marriage hygiene and cleanliness increasing sexual pleasure for the male family honour a sense of belonging to the group and conversely the fear of social exclusion enhancing fertility

Many women believe that FGM is necessary to ensure acceptance by their community; they are unaware that FGM is not practised in most of the world. Copyright 2002-2013 FORWARD All rights reserved Registered Charity No. 292403 Website artwork by Gabrielle Pool Web development and hosting by BRAINBOX www.forwarduk.org.uk/key-issues/fgm Why a violation? The United Nations considers female genital mutilation a human rights violation because of the physical and psychological impact this unnecessary procedure has on women. FGM is recognized internationally as a violation of the human rights of girls and women. It reflects deeprooted inequality between the sexes, and constitutes an extreme form of discrimination against women. It is nearly always carried out on minors and is a violation of the rights of children. The practice also violates a person's rights to health, security and physical integrity, the right to be free from torture and cruel, inhuman or degrading treatment, and the right to life when the procedure results in death. http://www.who.int/mediacentre/factsheets/fs241/en/ What are the consequences? Depending on the degree of mutilation, FGM can have a number of short-term health implications: 1. 2. 3. 4. 5. severe pain and shock infection urine retention injury to adjacent tissues immediate fatal haemorrhaging

Long-term implications can entail: 1. extensive damage of the external reproductive system 2. uterus, vaginal and pelvic infections

3. 4. 5. 6. 7. 8.

cysts and neuromas increased risk of Vesico Vaginal Fistula complications in pregnancy and child birth psychological damage sexual dysfunction difficulties in menstruation

In addition to these health consequences there are considerable psycho-sexual, psychological and social consequences of FGM.
www.forwarduk.org.uk/key-issues/fgm No health benefits, only harm

FGM has no health benefits, and it 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.
http://www.who.int/mediacentre/factsheets/fs241/en/

International response

In December 2012, the UN General Assembly accepted a resolution on the elimination of female genital mutilation. In 2010 WHO published a "Global strategy to stop health care providers from performing female genital mutilation" in collaboration with other key UN agencies and international organizations. In 2008 WHO together with 9 other United Nations partners, issued a new statement on the elimination of FGM to support increased advocacy for the abandonment of FGM. The 2008 statement provides evidence collected over the past decade about the practice. It highlights the increased recognition of the human rights and legal dimensions of the problem and provides data on the frequency and scope of FGM. It also summarizes research about on why FGM continues, how to stop it, and its damaging effects on the health of women, girls and newborn babies. The new statement builds on the original from 1997 that WHO issued together with the United Nations Childrens Fund (UNICEF) and the United Nations Population Fund (UNFPA). Since 1997, great efforts have been made to counteract FGM, through research, work within communities, and changes in public policy. Progress at both international and local levels includes:

wider international involvement to stop FGM; international monitoring bodies and resolutions that condemn the practice;

revised legal frameworks and growing political support to end FGM (this includes a law against FGM in 24 African countries, and in several states in two other countries, as well as 12 industrialized countries with migrant populations from FGM practicing countries); in most countries, the prevalence of FGM has decreased, and an increasing number of women and men in practising communities support ending its practice.

Research shows that, if practicing communities themselves decide to abandon FGM, the practice can be eliminated very rapidly.
WHO response

In 2008, the World Health Assembly passed a resolution (WHA61.16) on the elimination of FGM, emphasizing the need for concerted action in all sectors - health, education, finance, justice and women's affairs. WHO efforts to eliminate female genital mutilation focus on:

strengthening the health sector response: guidelines, training and policy to ensure that health professionals can provide medical care and counselling to girls and women living with FGM; building evidence: generating knowledge about the causes and consequences of the practice, how to eliminate it, and how to care for those who have experienced FGM; increasing advocacy: developing publications and advocacy tools for international, regional and local efforts to end FGM within a generation.

WHO is particularly concerned about the increasing trend for medically trained personnel to perform FGM. WHO strongly urges health professionals not to perform such procedures.