The four types of agony (FGM/C)
Updated: Jun 19, 2020
According to the WHO, there are currently still about 200 million women who have undergone genital mutilation. Every year, nearly 3 million girls are at risk of having to undergo this procedure. This practice is mainly practiced in 28 African countries and among Asian minority groups. But there is also this in Egypt, Oman, Yemen, Saudi Arabia, Indonesia, and Malaysia. Even in western countries like Germany, there are known cases, albeit very few - but every girl is one too many.
There is no uniform practice, and each ethnic group has its own rules. These range from the use of tools, from razor blades, scissors, and broken glass to fingernails. To treat the wound, acacia thorns, twine, sheep intestines, horsehair, or iron rings are used. The mostly older women try to stop the bleeding with ashes, herbs, and plant juices. Basically, the wounds need several weeks to heal. For this purpose, the girls' legs are tied together, and they should not move if possible. The older women usually also work as obstetricians and are respected members of the community. Through this practice, they have a regular income. (cf. Terre de Femmes)
Overview of the topic (WHO Key facts)
- FGM includes procedures that intentionally injure–for non-medical reasons.
- It has no health benefits.
- Numerous complications during the procedure.
- The women have to cope with lifelong consequences.
- FGM is usually performed from infancy until about 15 years of age, but also on adult women.
- FGM is a violation of human rights.
Historical information (Terre des Femmes)
"It is assumed that already in the time of the Pharaohs women in ancient Egypt were mutilated at their genitals. The historian Herodotus (ca. 484 - 425 BC) mentions the practice as follows: 'Other peoples leave the genitals as they are; only the Egyptians and those who learned it from them circumcise them.'
On a papyrus dated 163 BC, it is explicitly mentioned that girls were genitally mutilated. The geographer Strabo (64/63 B.C. - 23 A.D.) reports in his description of the earth: "The boys circumcise them, and the maids cut out the shawls of the maids." However, these testimonies do not allow any conclusions to be drawn about the way in which it was carried out and which girls and women were affected.
The Greek-Roman doctor Galen (129 - ca. 200 A.D.) also mentions FGM as a practice in Egypt. Only the Byzantine physician Aetios of Amida (ca. 1st half of the 6th century AD) describes the procedure and states that it was performed in Egypt on young women before marriage to reduce their sexual desire. A hypothesis about the spread of FGM assumes that Muslims adopted the practice after their conquest of Egypt and spread it on their further expansion".
Europe and North America, have also been affected since the Middle Ages. The last known clitoridectomy was performed in the USA in 1953 on a 12-year-old girl.
FGM is not a practice by country or religion. It is an ethnic problem. "Research among migrants in Europe has shown that about one third of the respondents adhere to the practice of genital mutilation. Some of the girls are subjected to FGM illegally in their parents' country of origin or in a European country. (Terre des Femmes)
What are the differences?
Female genital mutilation is classified into four major types (WHO):
• Type 1: Often referred to as clitoridectomy, this is the partial or total removal of the clitoris (a small, sensitive and erectile part of the female genitals), and in very rare cases, only the prepuce (the fold of skin surrounding the clitoris).
• Type 2: Often referred to as excision, this is the partial or total removal of the clitoris and the labia minora (the inner folds of the vulva), with or without excision of the labia majora (the outer folds of skin of the vulva ).
• Type 3: Often referred to as infibulation, this is the narrowing of the vaginal opening through the creation of a covering seal. The seal is formed by cutting and repositioning the labia minora, or labia majora, sometimes through stitching, with or without removal of the clitoris (clitoridectomy).
• Type 4: This includes all other harmful procedures for female genitalia for non-medical purposes, e.g., pricking, piercing, incising, scraping, and cauterizing the genital area.
Deinfibulation refers to the practice of cutting, open the sealed vaginal opening in a woman who has been infibulated, which is often necessary for improving health and well-being as well as to allow intercourse or to facilitate childbirth.
Types I and II are used to about 80%. In e.g., Eritrea, Djibouti, and Somalia, all girls are subjected to type 3.
The use of different names by the public and institutions:
- Female Genital Cutting
- Female Genital Mutilation
- Female circumcision
FGM is the term that shows the practice of intervention for what it is: a senseless and painful violation of human rights. The term FGC seems more "harmless," but leaves no doubt about what is behind it. However, the term FC is misleading, trivialized, as it suggests that the cutting of female genitalia is the same practice as the cutting of male genitalia. This is not given in any of the forms.
However, many of those affected prefer to use the term FC or FGC, as they do not want the term FGM to be perceived by the public as mutilated.
What are the effects (WHO)?
The possible health consequences can be divided into acute, chronic, psychological, or psychosomatic consequences, as well as consequences for sexuality and complications during pregnancy and birth.
Immediate complications can include:
• severe pain
• excessive bleeding (haemorrhage)
• genital tissue swelling
• fever • infections, e.g., tetanus
• urinary problems
• wound healing problems
• injury to surrounding genital tissue
Long-term consequences can include:
• urinary problems (painful urination, urinary tract infections);
• vaginal problems (discharge, itching, bacterial vaginosis, and other infections);
• menstrual problems (painful menstruations, difficulty in passing menstrual blood, etc.);
• scar tissue and keloid;
• sexual problems (pain during intercourse, decreased satisfaction, etc.);
• increased risk of childbirth complications (difficult delivery, excessive bleeding, cesarean section, need to resuscitate the baby, etc.) and newborn deaths;
• need for later surgeries: for example, the FGM procedure that seals or narrows a vaginal opening (type 3) needs to be cut open later to allow for sexual intercourse and childbirth (deinfibulation).
The WHO assumes that about 10% of those affected, and 25% from the long-term complications are dying from the acute consequences of FGM.
Why are these practices maintained?
- Customs and tradition
- Controlling sexuality
- Social pressure
- Lack of education
- The view that is a threat to the traditions and a disturbance of the established order.
- Lack of attention
- Fear of controversy
What possibilities are there for changing cultural practices?
Many countries are already taking action against FGM, but 3 million girls are still at risk every year. Sierra Leone, among many others, signed CEDAW in 1988 but has done nothing against FGM so far. 95% of girls continue to be subjected to the procedure. (Isha Daramy). In contrast, the number of annual FGM in Côte d'Ivoire further and further back. In Chad, Guinea, and Sierra Leone, more men than women now oppose FGM (Unicef).
So a lot happens, but every girl who has to undergo this procedure is one too many. To make a lasting impact, education and information are urgently needed.
Above all: people must learn to talk about it:
Make voices loud! (Unicef)
Everyone can help here - whether affected or not.
Two questions should be asked:
1. Why do countries get away with not having to pass national laws? The health of women is a human right! Why does the International Court of Human Rights not intervene with governments such as Sierra Leone?
2. What if we gave the families and the women who perform the circumcisions money if they don't cut?