FGM: a ‘manifestation of deeply entrenched gender inequality’

Photo source: Amnesty International

Female genital mutilation has no health benefits but a plethora of negative health consequences and seeing as an estimated 200 million girls and women currently alive today have experienced some form of FGM it begs the question of why is it still common practice in some countries and what is being done to prevent it?

What is FGM?

FGM ‘involves the partial or total removal of external female genitalia or other injury to the female genital organs for non-medical reasons.’ It is most commonly carried out on young girls from infancy to 15 years old and it is estimated that more than 3 million girls are at risk of experiencing a form of FGM every year. Unless undertaken by medical practitioners it is normally carried out without anaesthetic and antiseptics through the use knives, scissors, scalpels, pieces of glass or razor blades.

There are currently 4 types of FGM with Types I and II being the most commonly practiced:

Type I – Clitoridectomy:

Involves the partial or total removal of the clitoral glad which is the visible and external part of the clitoris and/or prepuce

Type II – Excision

Partial or total removal of the clitoris and the labia minora with or without the removal of the labia majora.

Type III – Infibulation

Narrowing the vaginal orifice with the creation of a covering seal by cutting and appositioning the labia minor and/or the labia majora with or without excision of the clitoris

Type IV

All other harmful procedures to the female genitalia for non-medical purposes for example pricking, piercing, cauterising (burning), scraping as well as others.

Where is FGM practiced?

FGM is predominantly practiced in sub-Saharan Africa and Arab States with select countries in Eastern Europe, Latin America and Asia practicing FGM. In addition to this, some migrant populations throughout western countries such as Australia, Canada, New Zealand, the US and the UK that commonly practice FGM.

Photo source: CNN

Why is it practised?

The history and origin of FGM remains largely unknown and there are various beliefs as to why it was practised. What is known is that FGM is the ‘manifestation of deeply entrenched gender inequality’ and the UNFPA lists 5 different categories of reasoning:

1. Psychosexual reasons: FGM is seen as a way of controlling a woman’s sexuality and sexual behaviour in order to prepare for marriage, fidelity and to increase a man’s sexual pleasure.

2. Sociological and cultural reasons: Myths such as if the clitoris remains it will grow to a size of a penis and that FGM enhances fertility that continue to promote the practice of mutilating genitalia as an initiation of young girls into womanhood.

3. Hygiene and aesthetic reasons: Some see the external parts of female genitalia as ugly and dirty.

4. Religious reasons: Many communities that practice FGM see it as a religious requirement even though no religion promotes or condones the mutilation of young girls and women. The lack of basis for religious reasoning is why many religious leaders have spoken against the practice.

5. Socio-economic factors: FGM is seen as a prerequisite for marriage and/or inheritance.

Psychological Consequences

28 Too Many is an organisation that has compiled research and resources regarding FGM and their article on ‘The Psychological effects on Female Genital Mutilation’ lists the following research.

In 2008 the WHO reported that the pain, shock and use of force can result in immediate psychological trauma. Keel (2014) found that with 80% of women suffering from mood or anxiety disorders with some long-term consequences being PTSD, anxiety, depression and memory loss (Behrendt and Mortiz 2005). Other psychological effects can also include sleeping disorders, social and emotional distancing and flashbacks.

Vloeberghs et al (2012) discovered that the women who suffered FGM could be classified into 3 different types.

1. Adaptives: Women who are overcoming their experiences and are able to communicate about what is bothering them.

2. Disempowered: These women are often angry and defeated and are too ashamed or feel too alone and disempowered to talk about their experiences.

3. Traumatised: Women who are classified as traumatised suffer a lot from pain and sadness. They can experience flashbacks, issues with sleep and stress. Those who do experience this are likely to isolate themselves and struggle with anxiety and depression.

The purpose of separating out the different types of experiences are so that different emotional and societal needs can be recognised and worked towards as not all victims of FGM experience the same type of FGM nor the same emotions (Memon 2014).

Physical consequences

The WHO has created a list of the immediate and long-term negative health effects of FGM:

Immediate

• Severe pain

• Excessive bleeding

• Swelling

• Fever

• Infection

• Urinary problems

• Shock

• Death

• Increased risk of HIV transmission

Long-term consequences:

• Urinary problems (painful urination, urinary tract infections)

• Vaginal problems (discharge, itching, bacterial vaginosis and other infections)

• Menstrual problems (painful menstruation, difficulty passing menstrual blood)

• Scar tissue and keloid

• Sexual problems (pain during intercourse, increased chances of lacerations)

• Increased risk of childbirth complications and new-born deaths (difficult delivery, need to resuscitate baby, excessive bleeding)

• Need for surgeries later

• Increased risk of HIV transmission

A global responsibility

There are multiple reasons why the issue of FGM is a global responsibility to help and try to prevent; two reasons are listed below:

Due to globalisation and migration the practices are no longer geographically isolated and are becoming increasingly common in communities that travel to countries such as the US. In 2012, the US Centers for Disease Control and Prevention found that around 513,000 women and girls in the US are at risk of experiencing FGM. The US is not the only country that faces a rise in young girls and women being subjected to FGM within their own borders as the UK, Australia and New Zealand also face similar statistics. It is therefore fundamental to human rights and equality between genders that states work together to reduce the number of victims.

Not only does it pose a risk to human rights, global health and international relations of countries but it also poses a financial burden as the cost of treating health complications caused by FGM is expected to increase by 68% to 2.3 million in 30 years unless countries abandon FGM which could lead to a 60% decrease in the next 30 years. The impact of FGM is so wide reaching that if human rights abuses are not enough to lead to firmer action being taken then it will also become a financial burden as numbers continue to rise.

Photo source: Euro Babble