Female Genital Mutilation -- a Review and Analysis How prevalent is the practice of female genital mutilation throughout the world? Why is it done, where is it done, and what are the human rights and morality implications? This paper will examine those questions, and provide information that supplements those issues.

The Literature on Female Genital Mutilation

There are four types of female genital mutilation (FGM), according to an article in the British Journal of Midwifery (Momoh 2004, p. 631): 1) Type 1 is called clitoridectomy, in which the "excision of the clitoral prepuce may also involve the excision of all or part of the clitoris"; 2) Type 2 is the cutting away from the body of the clitoris, but may also involved the excision of "all or part of the tabia minora"; 3) Type 3 is called infibulation, and it involves "excision of part or all of the external genitalia and the stitching or narrowing of the vaginal opening"; 4) and Type 4 alludes to all other procedures in which a female's genitals are cut.

How many females have been subjected to FGM -- in any of the four types mentioned above? Momoh writes that it worldwide it affects "more than 120 million women" and in addition, "an estimated two million girls are circumcised each year." According to another article in the British Journal of Midwifery (Sihwa and Baron, 2004, p. 717), "an estimated 100-130 million girls and women in the world have undergone FGM," and around 2 million girls are "at risk" annually.

Beyond those initial numbers provided by Sihwa, she writes that "the practice of FGM and its consequences affect an estimated 80 million women in the world" and the places where FGM is most common include Africa, Southeast Asia and the Middle East.

Where is FGM practiced? Meanwhile, FGM is also practiced in regions of western countries where immigrants from Africa, Southeast Asia and the Middle East settle; in London recently, a doctor was banned from practicing after he was videotaped "agreeing to circumcise an eight-year-old girl," and agreeing to "stitch two older girls." An English law (the Female Genital Mutilation Act 2005) makes it an offense to "excise, infibulate or otherwise mutilate the whole or any part of the labia majora or labia minora or clitoris" of a female.

"More needs to be done" to educate and train midwives," Sihwa asserts, pointing out in the article that at a recent conference in London, "less than five" of 50 midwives in attendance were aware of the Prohibition of Female Circumcision 1985 Act, notwithstanding the fact that it had been in place for 20 years.

How is FGM carried out in practice? The country that has the highest incidence of FGM is Somalia, Momoh writes; some 98% of women undergo FGM to one degree or another, due to "entrenched cultural beliefs." Momoh suggests that the "nomadic existence" of many Somalis reduces the possibility of widespread education regarding the barbaric nature of the practice. What is more troubling -- beyond the fact that 98% of females are cut -- "the practice is largely conducted by people untrained in surgery (parents, grandparents, and traditional birth attendants, using unsterile utensils)."

The crude, unskilled nature of those procedures inevitably leads to complications and long-term health problems, Momoh continues; following the surgical procedure, the female's wound is often rubbed with herbs, salt water, sugar, and "camel feces" -- and the legs are then "bound together" for several days. Often these procedures are carried out without anesthesia -- and quite frequently the procedures are performed on girls "too young to give consent."

What are the complications associated with procedures that cut or mutilate or remove a female's genitals? Sihwa's article explains that a female may experience "hemorrhage, infections" and even death, in the short-term. In the long-term, complications include genital malformations, chronic pelvic complications, "recurrent urinary retention and obstructed labour."

What are the justifications for FGM? Sihwa writes that some cultures believe "that the clitoris is poisonous and dangerous and will cause a man to sicken or die" if the clitoris comes into contact with the penis; another belief is that an "unmodified clitoris" leads to lesbianism; still another belief is that FGM "makes a woman's face more beautiful and prevents vaginal cancer," Sihwa explains.

Momoh writes that in Somalia, there are several justifications for FGM: "maintaining cultural, traditional and religious norms"; making sure that females "remain pure until they get married"; and increasing the "marriage eligibility of daughters" (including a higher dowry...

There are also parents who have FGM procedures performed on their daughters because they wish to protect the young girls from "being raped by men" or from participating in "illegal sex" prior to marriage.
According to the Web site Religious Tolerance.org, FGM is a "social custom, not a religious practice." That said, in Muslim countries where FGM (alluded to as "sunna") is practiced, and has been practiced (originally in the time period "al-gahilyyah," which means "the era of ignorance") for perhaps as long as 2,000 years, there are two passages from the Prophet Mohammed -- which are considered questionable at best and inaccurate at worst in scholarly communities -- that appear to promote FGM.

And although the Qur'an, the Old Testament, and the New Testament offer no insights on the subject of FGM, the "Sunnah" -- reportedly the words and deeds of the Prophet Mohammed -- does offer several references to FGM. In a Sunnah story about a woman performing infibulation on slaves, she is said to have commented to Mohammed that she would continue the procedure unless it is "forbidden and you order me to stop doing it." Mohammed replied, "Yes it is allowed. Come closer so I can teach you: if you cut, do not overdo it, because it brings more radiance to the face and it is more pleasant for the husband." On another occasion, Mohammed is alleged to have said (to the Ansars' wives), "Cut slightly without exaggeration, because it is more pleasant for your husbands."

Meanwhile, the Muslim Women's League quotes renowned scholar Sayyid Sabiq as saying all such quotations are "non-authentic." Indeed, many Muslims, according to the Web site, believe the Qur'an "promotes the concept of a husband and wife giving each other pleasure during sexual intercourse. In 2:187 of the Qur'an: "It is lawful for you to go in unto your wives during the night preceding the (day's) fast: they are as a garment for you and you are as a garment for them."

From the perspective of international human rights issues, the World Health Organization (Dorkenoo and Mohammed 1998, pp. 4-6) takes the position that FGM is "the single most extreme, violent and painful practice causing physical, psychological and emotional problems and even the death of girls and women in some societies." Also, the WHO representative goes on, "FGM comprises all procedures involving partial or total removal of the external genitalia or other injury to the female genital organs." Beside the health problems alluded to earlier in this paper, which may result from FGM, the WHO's experts say that women and girls may also suffer from tetanus, HIV, infertility and depression.

The practice of FGM is "no longer confined to the 26 sub-Saharan African countries where it has been prevalent for centuries," the authors explain. It now has moved into most western nations, albeit, there are laws against FGM in Canada, the U.S., Sweden, Switzerland, Britain and France, among other nations.

And there is a "technical difference" between male and female genital mutilation, the article continues. In a female, the simple removal of the clitoral prepuce (known as female circumcision) is indeed "equivalent to male circumcision," albeit that procedure constitutes "less than 1% of all female genital mutilations." In over 95% of the cases of female genital mutilation, the WHO article explains, "the clitoris, the labia minora, and (often) the labia majora are excised and the vulva is sewn up."

The biological equivalent for a male would be to "be partial to almost two-thirds removal of the male sexual organ, including in some cases removal of tissue from the scrotum, followed by stitching up the remaining tissue."

The position of the WHO has consistently been to "recommend that governments adopt clear national policies to abolish FGM," and to strengthen educational programs so that the public knows that FGM is a "serious health hazard" and also know that FGM "reinforces the inequality suffered by women in their communities."

An article in WHO (Nybro 1998, p. 6-7) reflects what it is like to be a midwife in Denmark, working with Somali women living in Denmark; Ms. Nybro needs to show great care and sensitivity to pregnant Somali women, so the Somali women develop a trust with the Danish midwife. That trust, the article continues, could lead to the expectant mother turning away from the "savage custom" of FGM, and deciding not to have her new daughter cut into.

An empirical study of 522 FGM cases in South-Western Nigeria. A research article in the Journal of Obstetrics and Gynaecology (Dare, et al. 2004, pp. 281-283) reports on a study conducted at three teaching hospitals in…