Female Genital Mutilation (FGM) 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 rocedures in!ol!ing artial or total remo!al of the e"ternal female genitalia or other in#ury to the female genital organs for non$medical reasons"% "Mama tied a blindfold o!er my eyes% &he ne"t thing ' felt my flesh was being cut away% ' heard the blade sawing back and forth through my skin% &he ain between my legs was so intense ' wished ' would die%" Waris Dirie, UNFPA Goodwill Ambassador and spokesperson on FGM 't is estimated that a ro"imately ())$(*) million +frican women ha!e undergone FGM worldwide and each year, a further , million girls are estimated to be at risk of the ractice in +frica alone% Most of them li!e in +frican countries, a few in the Middle -ast and +sian countries, and increasingly in -uro e, +ustralia, .ew /ealand, the 0nited 1tates of +merica and 2anada% &he rocedure is traditionally carried out by an older woman with no medical training% +naesthetics and antise tic treatment are not generally used and the ractice is usually carried out using basic tools such as kni!es, scissors, scal els, ieces of glass and ra3or blades% Often iodine or a mi"ture of herbs is laced on the wound to tighten the !agina and sto the bleeding% &he age at which the ractice is carried out !aries, from shortly after birth to the labour of the first child, de ending on the community or indi!idual family% &he most common age is between four and ten, although it a ears to be falling% &his suggests that circumcision is becoming less strongly linked to uberty rites and initiation into adulthood% FGM types and terms &he World Health Organisation has classified FGM into four ty es% +s well as the term Female Genital Mutilation, there are a number of other terms or names used to describe the ractice, erha s most common, female circumcision or female genital cutting (FG2)% FO4W+45 chooses to use the term Female Genital Mutilation (FGM) as we belie!e that it is the term that most accurately de icts the true nature of FGM% For definitions of the different types of FGM, and a list of the different terms used to refer to FGM click here.

Where is FGM Practised? &he ma#ority of cases of FGM are carried out in 67 +frican countries% 'n some countries, (e%g% -gy t, -thio ia, 1omalia and 1udan), re!alence rates can be as high as 87 er cent% 'n other countries, such as .igeria, 9enya, &ogo and 1enegal, the re!alence rates !ary between 6) and :) er cent% 't is more accurate howe!er, to !iew FGM as being ractised by s ecific ethnic grou s, rather than by a whole country, as communities ractising FGM straddle national boundaries% FGM takes lace in arts of the Middle -ast, i%e% in ;emen, Oman, 'ra<i 9urdistan, amongst some =edouin women in 'srael, and was also ractised by the -thio ian >ews, and it is unclear whether they continue with the ractice now that they are settled in 'srael% FGM is also ractised among =ohra Muslim o ulations in arts of 'ndia and ?akistan, and amongst Muslim o ulations in Malaysia and 'ndonesia% +s a result of immigration and refugee mo!ements, FGM is now being racticed by ethnic minority o ulations in other arts of the world, such as 01+, 2anada, -uro e, +ustralia and .ew /ealand% FO4W+45 estimates that as many as @,:)) girls are at risk of FGM within the 09 e!ery year% Consequences of FGM ependin! on the de!ree of mutilation, FGM can ha"e a num#er of short$term health implications% A se!ere ain and shock A infection A urine retention A in#ury to ad#acent tissues A immediate fatal haemorrhaging &on!$term implications can entail% A e"tensi!e damage of the e"ternal re roducti!e system A uterus, !aginal and el!ic infections A cysts and neuromas A increased risk of Besico Baginal Fistula A com lications in regnancy and child birth A sychological damage A se"ual dysfunction A difficulties in menstruation 'n addition to these health conse<uences there are considerable sycho$se"ual, sychological and social conse<uences of FGM% 'ustifications of FGM

&he roots of FGM are com le" and numerousC indeed, it has not been e"actly ossible to determine when or where the tradition of FGM originated% &he #ustifications gi!en for the ractise are multi le and reflect the ideological and historical situation of the societies in which it has de!elo ed% 4easons cited generally relate to tradition, ower ine<ualities and the ensuing com liance of women to the dictates of their communities (easons include% A custom and tradition A religionC in the mistaken belief that it is a religious re<uirement A reser!ation of !irginityDchastity A social acce tance, es ecially for marriage A hygiene and cleanliness A increasing se"ual leasure for the male A family honour A a sense of belonging to the grou and con!ersely the fear of social e"clusion A enhancing fertility Many women belie!e that FGM is necessary to ensure acce tance by their communityC they are unaware that FGM is not ractised in most of the world% (htt EDDwww%forwarduk%org%ukDkey$issuesDfgm)

Female !enital mutilation Fact sheet .F6*( 0 dated February 6)(*

)ey facts A Female genital mutilation (FGM) includes rocedures that intentionally alter or cause in#ury to the female genital organs for non$medical reasons%

A &he rocedure has no health benefits for girls and women% A ?rocedures can cause se!ere bleeding and roblems urinating, and later cysts, infections, infertility as well as com lications in childbirth and increased risk of newborn deaths% A More than (6: million girls and women ali!e today ha!e been cut in the 68 countries in +frica and Middle -ast where FGM is concentrated (()% A FGM is mostly carried out on young girls sometime between infancy and age (:% A FGM is a !iolation of the human rights of girls and women% Female genital mutilation (FGM) com rises all rocedures that in!ol!e artial or total remo!al of the e"ternal female genitalia, or other in#ury to the female genital organs for non$medical reasons% &he ractice is mostly carried out by traditional circumcisers, who often lay other central roles in communities, such as attending childbirths% Howe!er, more than (7G of all FGM is erformed by health care ro!iders, and the trend towards medicali3ation is increasing% FGM is recogni3ed internationally as a !iolation of the human rights of girls and women% 't reflects dee $rooted ine<uality between the se"es, and constitutes an e"treme form of discrimination against women% 't is nearly always carried out on minors and is a !iolation of the rights of children% &he ractice also !iolates a ersonHs rights to health, security and hysical integrity, the right to be free from torture and cruel, inhuman or degrading treatment, and the right to life when the rocedure results in death% Procedures Female genital mutilation is classified into four ma#or ty es% A 2litoridectomyE artial or total remo!al of the clitoris (a small, sensiti!e and erectile art of the female genitals) and, in !ery rare cases, only the re uce (the fold of skin surrounding the clitoris)% A -"cisionE artial or total remo!al of the clitoris and the labia minora, with or without e"cision of the labia ma#ora (the labia are "the li s" that surround the !agina)% A 'nfibulationE narrowing of the !aginal o ening through the creation of a co!ering seal% &he seal is formed by cutting and re ositioning the inner, or outer, labia, with or without remo!al of the clitoris% A OtherE all other harmful rocedures to the female genitalia for non$medical ur oses, e%g% ricking, iercing, incising, scra ing and cauteri3ing the genital area% *o health #enefits, only harm FGM has no health benefits, and it harms girls and women in many ways% 't in!ol!es remo!ing and damaging healthy and normal female genital tissue, and interferes with the natural functions of girlsH and womenHs bodies% 'mmediate com lications can include se!ere ain, shock, haemorrhage (bleeding), tetanus or se sis (bacterial infection), urine retention, o en sores in the genital region and in#ury to nearby genital tissue%

Iong$term conse<uences can includeE A recurrent bladder and urinary tract infectionsC A cystsC A infertilityC A an increased risk of childbirth com lications and newborn deathsC A the need for later surgeries% For e"am le, the FGM rocedure that seals or narrows a !aginal o ening (ty e , abo!e) needs to be cut o en later to allow for se"ual intercourse and childbirth% 1ometimes it is stitched again se!eral times, including after childbirth, hence the woman goes through re eated o ening and closing rocedures, further increasing and re eated both immediate and long$term risks% Who is at risk? ?rocedures are mostly carried out on young girls sometime between infancy and age (:, and occasionally on adult women% 'n +frica, more than three million girls ha!e been estimated to be at risk for FGM annually% More than (6: million girls and women ali!e today ha!e been cut in the 68 countries in +frica and Middle -ast where FGM is concentrated (()% &he ractice is most common in the western, eastern, and north$eastern regions of +frica, in some countries in +sia and the Middle -ast, and among migrants from these areas% Cultural, reli!ious and social causes &he causes of female genital mutilation include a mi" of cultural, religious and social factors within families and communities% A Where FGM is a social con!ention, the social ressure to conform to what others do and ha!e been doing is a strong moti!ation to er etuate the ractice% A FGM is often considered a necessary art of raising a girl ro erly, and a way to re are her for adulthood and marriage% A FGM is often moti!ated by beliefs about what is considered ro er se"ual beha!iour, linking rocedures to remarital !irginity and marital fidelity% FGM is in many communities belie!ed to reduce a womanHs libido and therefore belie!ed to hel her resist "illicit" se"ual acts% When a !aginal o ening is co!ered or narrowed (ty e , abo!e), the fear of the ain of o ening it, and the fear that this will be found out, is e" ected to further discourage "illicit" se"ual intercourse among women with this ty e of FGM% A FGM is associated with cultural ideals of femininity and modesty, which include the notion that girls are JcleanK and "beautiful" after remo!al of body arts that are considered "male" or "unclean"% A &hough no religious scri ts rescribe the ractice, ractitioners often belie!e the ractice has religious su ort% A 4eligious leaders take !arying ositions with regard to FGME some romote it, some consider it irrele!ant to religion, and others contribute to its elimination%

A Iocal structures of ower and authority, such as community leaders, religious leaders, circumcisers, and e!en some medical ersonnel can contribute to u holding the ractice% A 'n most societies, FGM is considered a cultural tradition, which is often used as an argument for its continuation% A 'n some societies, recent ado tion of the ractice is linked to co ying the traditions of neighbouring grou s% 1ometimes it has started as art of a wider religious or traditional re!i!al mo!ement% A 'n some societies, FGM is ractised by new grou s when they mo!e into areas where the local o ulation ractice FGM% +nternational response 'n 5ecember 6)(6, the 0. General +ssembly ado ted a resolution on the elimination of female genital mutilation% 'n 6)() WHO ublished a "Global strategy to sto health care ro!iders from erforming female genital mutilation" in collaboration with other key 0. agencies and international organi3ations% 'n 6))7 WHO together with 8 other 0nited .ations artners, issued a new statement on the elimination of FGM to su ort increased ad!ocacy for the abandonment of FGM% &he 6))7 statement ro!ides e!idence collected o!er the ast decade about the ractice% 't highlights the increased recognition of the human rights and legal dimensions of the roblem and ro!ides data on the fre<uency and sco e of FGM% 't also summari3es research about on why FGM continues, how to sto it, and its damaging effects on the health of women, girls and newborn babies% &he new statement builds on the original from (88L that WHO issued together with the 0nited .ations 2hildrenMs Fund (0.'2-F) and the 0nited .ations ?o ulation Fund (0.F?+)% 1ince (88L, great efforts ha!e been made to counteract FGM, through research, work within communities, and changes in ublic olicy% ?rogress at both international and local le!els includesE A wider international in!ol!ement to sto FGMC A international monitoring bodies and resolutions that condemn the racticeC A re!ised legal frameworks and growing olitical su ort to end FGM (this includes a law against FGM in 6* +frican countries, and in se!eral states in two other countries, as well as (6 industriali3ed countries with migrant o ulations from FGM racticing countries)C A in most countries, the re!alence of FGM has decreased, and an increasing number of women and men in ractising communities su ort ending its ractice% 4esearch shows that, if racticing communities themsel!es decide to abandon FGM, the ractice can be eliminated !ery ra idly% W,- response

'n 6))7, the World Health +ssembly assed a resolution (WH+@(%(@) on the elimination of FGM, em hasi3ing the need for concerted action in all sectors $ health, education, finance, #ustice and womenHs affairs% WHO efforts to eliminate female genital mutilation focus onE A strengthening the health sector res onseE guidelines, training and olicy to ensure that health rofessionals can ro!ide medical care and counselling to girls and women li!ing with FGMC A building e!idenceE generating knowledge about the causes and conse<uences of the ractice, how to eliminate it, and how to care for those who ha!e e" erienced FGMC A increasing ad!ocacyE de!elo ing ublications and ad!ocacy tools for international, regional and local efforts to end FGM within a generation% WHO is articularly concerned about the increasing trend for medically trained ersonnel to erform FGM% WHO strongly urges health rofessionals not to erform such rocedures% (% 0.'2-F% Female Genital MutilationD2uttingE a statistical o!er!iew and e" loration of the dynamics of change, 6)(,%

(htt EDDwww%who%intDmediacentreDfactsheetsDfs6*(DenD) What is FGMN

Female Genital Mutilation (often referred to as FGM) is a destructi!e o eration, during which the female genitals are artly or entirely remo!ed or in#ured with the goals of inhibiting a womanMs se"ual feelings% Most often the mutilation is erformed before uberty, often on girls between the age of four and eight, but recently it is increasingly erformed on nurslings who are only a cou le of days, weeks or months old% Where does FGM ha enN Female Genital Mutilation ha ens rimarily in +frica, in articular in .orth$-astern, -astern and Western +frica% Howe!er, it also takes lace in the Middle -ast, in 1outh$ -ast +sia O and also among immigrants in -uro e% +ccording to estimates by the World Health Organisation (WHO) (:) million women are affected by FGM world$wide% 'n -uro e, the number of mutilated women or girls and women threatened by FGM amounts u to :)),)))% What different ty es of FGM are thereN

&he WHO differentiates between four different ty es of Female Genital MutilationE (% -"cision of the clitoris re uce (J1unna$circumcisionK) and of the clitoris or arts thereof% 6% -"cision of the clitoris re uce, the clitoris and the inner li s or arts thereof% ,% &y e ( and 6 are the most common ty es of FGME eighty ercent of the affected women ha!e gone through these rocedures% *% -"cision of art of or all of the e"ternal genitals (JinfibulationK, also referred to as J?haraonic 2ircumcisionK)% +fterwards the remaining arts of the outer li s are sewn together lea!ing a small hole for urine and menstrual flow% :% &he scar need to be o ened before intercourse or gi!ing birth, which causes additional ain% @% 'nfibulation is mainly s read in the Horn of +frica and its neighbouring areas O in 1omalia, 5#ibouti and -ritrea, as well as in the northern art of 1udan and in the southern art of -gy t% 't is the most se!ere form of FGM and affects (: ercent of the women% L% ?ricking, iercing, cutting or stretching of the clitoris or the labia, also burning or scarring the genitals as well as ri ing of the !aginal o ening or the introduction of corrosi!e substances or herbs into the !agina in order to tighten it% ?lusE any other rocedure, which in#ures or circumcises the female genitalia% Who erforms FGMN FGM is usually erformed by rofessional circumcisers, women who are en#oying a high re utation in their societies% 't is also erformed by traditional midwi!es and occasionally by healers, barbers or nurses or doctors trained in Western medicine% &he rocedure is usually erformed without anaesthetic and under catastro hic hygienic circumstances% 9ni!es, scissors, ra3or blades or ieces of broken glass are used as instruments among others% ?re!alence and legal status &he Waris 5irie Foundation has ut together a collection of data on the estimated re!alence of female genital mutilation and the current legal situation concerning FGM in a selection of countries where FGM is racticed% &he table combines data from the 0nited .ations 5i!ision for the +d!ancement of Women, the World Health Organisation (WHO), the 01 5e artment of 1tate, FGM .etwork, W+5', &he 'nter arliamentary 0nion ('?0) and se!eral national studies and sur!eys% ;ou can download the table here%

Waris 5iries friend +yaan Hirsi +liMs foundation has ublished an o!er!iew of the facts and the legal situation regarding FGM in the 09 and the 0nited 1tates, which can be accessed here% (htt EDDwww%desertflowerfoundation%orgDenDwhat$is$fgmD)