The International Day of Zero Tolerance for Female genital mutilation (FGM) was marked across the globe on Monday.
FGM, which is also known as female genital cutting and female circumcision, is the ritual removal of some or all of the external female genitalia.
FGM is recognized internationally as a violation of the human rights of girls and women. It reflects deep-rooted inequality between the sexes, and constitutes an extreme form of discrimination against women.
On 20 December 2012, the UN General Assembly adopted Resolution A/RES/67/146 in which it “Calls upon States, the United Nations system, civil society and all stakeholders to continue to observe 6 February as the International Day of Zero Tolerance for Female Genital Mutilation and to use the day to enhance awareness- raising campaigns and to take concrete actions against female genital mutilations”.
Female genital mutilation (FGM) comprises all procedures that involve altering or injuring the female genitalia for non-medical reasons and is recognized internationally as a violation of the human rights of girls and women.
The practice also violates their rights to health, security and physical integrity, their right to be free from torture and cruel, inhuman or degrading treatment, and their right to life when the procedure results in death.
The promotion of the abandonment of FGM requires coordinated and systematic efforts, which must engage whole communities and focus on human rights and gender equality. These efforts also need to emphasize societal dialogue and the empowerment of communities to act collectively to end the practice.
Society must also address the sexual and reproductive health needs of women and girls who suffer from its consequences.
UNFPA, jointly with UNICEF, leads the largest global programme to accelerate the abandonment of FGM. They are currently implement FGM programmmes by focusing on 17 African countries and also supports regional and global initiatives.
- Globally, it is estimated that at least 200 million girls and women who are alive today have undergone some form of FGM.
- Girls 14 and younger represent 44 million of those who have been cut, with the highest prevalence of FGM among this age in Gambia at 56 per cent, Mauritania 54 per cent and Indonesia where around half of girls aged 11 and younger have undergone the practice.
- Countries with the highest prevalence among girls and women aged 15 to 49 are Somalia 98 per cent, Guinea 97 per cent and Djibouti 93 per cent.
- FGM is mostly carried out on young girls sometime between infancy and age 15.
- FGM cause severe bleeding and health issues including cysts, infections, infertility as well as complications in childbirth increased risk of newborn deaths.
- FGM is a violation of the human rights of girls and women.
- The Sustainable Development Goals in 2015 calls for an end to FGM by 2030 under Goal 5 on Gender Equality, Target 5.3 Eliminate all harmful practices, such as child, early and forced marriage and female genital mutilation.
- The elimination of FGM has been called for by numerous inter-governmental organizations, including the African Union, the European Union and the Organization of Islamic Cooperation, as well as in three resolutions of the United Nations General Assembly.
Types of FGM
Female genital mutilation is classified into four types:
- Type I: Also known as clitoridectomy, this type consists of partial or total removal of the clitoris and/or its prepuce.
- Type II: Also known as excision, the clitoris and labia minora are partially or totally removed, with or without excision of the labia majora.
- Type III: The most severe form, it is also known as infibulation or pharaonic type. The procedure consists of narrowing the vaginal orifice with creation of a covering seal by cutting and appositioning the labia minora and/or labia majora, with or without removal of the clitoris. The appositioning of the wound edges consists of stitching or holding the cut areas together for a certain period of time (for example, girls’ legs are bound together), to create the covering seal. A small opening is left for urine and menstrual blood to escape. An infibulation must be opened either through penetrative sexual intercourse or surgery.
- Type IV: This type consists of all other procedures to the genitalia of women for non-medical purposes, such as pricking, piercing, incising, scraping and cauterization.
Recent estimates indicate that around 90% of cases include clitoridectomy, excision or cases where girls’ genitals are “nicked” but no flesh removed (Type IV), and about 10% are infibulations (WHO).
Consequences of FGM
Immediate consequences of FGM include severe pain and bleeding, shock, difficulty in passing urine, infections, injury to nearby genital tissue and sometimes death.
The procedure can result in death through severe bleeding leading to haemorrhagic shock, neurogenic shock as a result of pain and trauma, and overwhelming infection and septicaemia, according to Manfred Nowak, UN Special Rapporteur on Torture and other Cruel, Inhuman or Degrading Treatment or Punishment.
Almost all women who have undergone FGM experience pain and bleeding as a consequence of the procedure. The event itself is traumatic as girls are held down during the procedure. Risk and complications increase with the type of FGM and are more severe and prevalent with infibulations.
“The pain inflicted by FGM does not stop with the initial procedure, but often continues as ongoing torture throughout a woman’s life”, says Manfred Nowak, UN Special Rapporteur on Torture.
In addition to the severe pain during and in the weeks following the cutting, women who have undergone FGM experience various long-term effects – physical, sexual and psychological.
Women may experience chronic pain, chronic pelvic infections, development of cysts, abscesses and genital ulcers, excessive scar tissue formation, infection of the reproductive system, decreased sexual enjoyment and psychological consequences, such as post-traumatic stress disorder.
Additional risks for complications from infibulations include urinary and menstrual problems, infertility, later surgery (defibulation and reinfibulation) and painful sexual intercourse. Sexual intercourse can only take place after opening the infibulation, through surgery or penetrative sexual intercourse. Consequently, sexual intercourse is frequently painful during the first weeks after sexual initiation and the male partner can also experience pain and complications.
When giving birth, the scar tissue might tear, or the opening needs to be cut to allow the baby to come out. After childbirth, women from some ethnic communities are often sown up again to make them “tight” for their husband (reinfibulation). Such cutting and restitching of a woman’s genitalia results in painful scar tissue.
A multi-country study by WHO in six African countries, showed that women who had undergone FGM, had significantly increased risks for adverse events during childbirth, and that genital mutilation in mothers has negative effects on their newborn babies. According to the study, an additional one to two babies per 100 deliveries die as a result of FGM.
Sources: End FGM European Network and United Nations.