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Sexual and Reproductive Rights

Female Genital Mutilation (FGM)

Anne Khisa, White Ribbon Alliance for Safe Motherhood, Kenya

Definition

The World Health Organization fact sheet defines Female Genital Mutilation (FGM) as “all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons”.  WHO classifies FGM into four main types:

  1. Clitoridectomy (partial or total removal of the clitoris and, in rare cases, only the prepuce).
  2. Excision (partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora).
  3. Infibulation (narrowing of the vaginal opening through the creation of a covering seal by cutting and repositioning the labia minora or labia majora, with or without removal of the clitoris).
  4. Other (all other harmful procedures to the female genitalia for non-medical purposes).

Prevalence

FGM is practiced in 28 African countries and in 5 Asian and Middle Eastern countries. Part of the female migrants in European countries are affected or threatened by FGM as well: the Desert Flower Foundation estimates their number to be 500,000. In 2008 Measure Demographic and Health Surveys estimated that 130-140 million girls and women had been subjected to FGM worldwide and that, each year, 3 million girls would undergo the practice.

Why FGM is practiced

Reasons given to perform FGM vary amongst different communities that practice it. In a publication on the socio-cultural motivations for FGM, WHO shows that the practice is often regarded as an ethnic cultural requirement. In some communities FGM is almost universally practiced, stigmatizing those who want to defy it.

Why ending FGM

FGM causes severe immediate and long-term effects on the health of women who undergo the practice. The negative effects of FGM are both physical and mental and affect a next generation by poor obstetric outcomes of mutilated women (see the outcomes of the WHO study group on female genital mutilation and obstetric outcome and the systematic review of quantitative FGM studies by the Norwegian Knowledge Centre for the Health Services).

FGM has an economic impact because the health problems resulting from the practice prevent many women from fully participating in the economic workforce and place an additional burden on the health care system. An Equality Now publication argues that FGM is often accompanied by school drop-out and early marriage and hence denies girls and women additional socio-economic opportunities.

The practice has also been known to cause complications in men’s sexual and reproductive health, as shown in a publication by the Karolinska Institute.

Ending FGM

Concerns for the health effects of FGM have led to the medicalization of the practice, with health care providers being motivated to uphold and respect the communities’ culture of FGM/C while ‘minimizing risk’ of the health effects. From the standpoint that FGM should be eradicated completely, WHO developed a strategy to stop health care providers from performing FGM.

Several approaches to abandon FGM have been documented, for example in a PATH publication. FGM is deeply rooted in the culture of those who practice and may not be eradicated by simply changing the immediate environment, as seen in cases of immigrant communities in Ireland where FGM is practiced (documented in a publication by the Women’s Health Council).

Why FGM violates women’s rights

FGM is arguably the most sophisticated form of gender-based violence since most women who undergo the practice are unaware of their rights to refuse it, unwilling to pursue justice and, as in most cases, may face stigma and loss of honor in their communities if they refuse. Moreover the majority of victims are children whose mutilation is performed under the responsibility of their parents.

A rights-based approach to eliminating FGM/C and achieving related sexual and reproductive health rights requires formulating legislation and building capacity to enforce these laws. The target populations must be involved in the process, initially by participating in defining the legislation as well as stepping out to claim their rights. A rights-based approach may be coupled with other approaches to induce abandonment of FGM/C, as argued by the Inter-Parliamentary Union.

Important recent efforts to abandon FGM include:

The international community has been involved in making key international rights commitments that are relevant to protect the rights of women and children against FGM. Some of the international treaties that have been signed and ratified include:

Open access documents

GFMER documents