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Prevalence of FGM in Africa and Yemen (women aged 15 - 49)
Frequently Asked Questions

What is Female Genital Mutilation/Cutting (FGM/FGC)?

FGC/FGM refers to all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs for cultural or other non-medical reasons.


Source: UNFPA (http://www.unfpa.org/gender/practices2.htm#1)

What are the different types of FGM/FGC?

The World Health Organization (WHO) has identified four types:

Type 1:
Excision of the prepuce, with or without excision of part or all of the clitoris.

Type 2:
Excision of the clitoris with partial or total excision of the labia minora

Type 3:
Excision of part or all of the external genitalia and stitching/narrowing of the vaginal opening (infibulation). Sometimes referred to as pharaonic circumcision.

Type 4:
Others, such as pricking, piercing or incising, stretching, burning of the clitoris, scraping of tissue surrounding the vaginal orifice, cutting of the vagina, introduction of corrosive substances or herbs into the vagina to cause bleeding or to tighten the opening.


Source: UNFPA (http://www.unfpa.org/gender/practices2.htm#2)

Which type is the most common?

Types I and II are the most common, with variation among countries. Type III, infibulation, constitutes about 20 per cent of all affected women and is most likely in Somalia, northern Sudan and Djibouti.


Source: UNFPA (http://www.unfpa.org/gender/practices2.htm#3)

Different terms are in use to describe FGM/FGC. What do they mean?

Incision:
refers to making cuts in the clitoris, cutting free the clitoral prepuce, but also relates to incisions made in the vaginal wall and to incision of the perineum and the symphysis.

Clitoridectomy:
refers to partial or total removal of the clitoris

Excision:
refers to the removal of the clitoris and partial or total removal of the labia minora. The amount of tissue that is removed varies widely from community to community.

Infibulation:
refers to the removal of the clitoris, partial or total removal of the labia minora and stitching together of the labia majora.

Circumcision:
this is a collective name that is used to describe a variety of practices involving the cutting of the female genitalia. It often refers to operations that fall under type I FGM/FGC. This term is considered as confusing by some since it seems to equate male circumcision with FGM/FGC. However, the only form that anatomically is comparable to male circumcision is that form in which the clitoral prepuce is cut away. This form seldom occurs. It is sometimes argued that the term circumcision obscures the serious physical and psychological effects of genital cutting on women.

Female genital mutilation:
this is also a collective name to describe procedures that involve partial or total removal of the external female genitalia or other injury to female genital organs whether for cultural or other non-medical reasons. This term is used by a wide range of women's health and human rights organizations and activists, not just to describe the various forms but also to indicate that the practice is considered a mutilation of the female genitalia and as a violation of women's basic human rights. Since 1994, the term has been used in several United Nations conference documents, and has served as a policy and advocacy tool.

Female genital cutting:
Some organizations have opted to use the more neutral term 'female genital cutting'. This stems from the fact that communities that practice FGC often find the use of the term 'mutilation' demeaning, since it seems to indicate malice on the part of parents or circumcisers. The use of judgmental terminology bears the risk of creating a backlash, thus possibly causing an alienation of communities that practice FGM/FGC or even causing an actual increase in the number of girls being subjected to FGM/FGC. In this respect it should be noted that the Special Rapporteur on Traditional Practices (ECOSOC, Commission on Human Rights) recently called for tact and patience regarding FGC eradication activities and warned against the dangers of demonizing cultures under cover of condemning practices harmful to women and girls.


Source: UNFPA (http://www.unfpa.org/gender/practices2.htm#4)

What is de-infibulation?

Infibulation creates a physical barrier to sexual intercourse and childbirth. An infibulated woman therefore has to undergo gradual dilation of the vaginal opening before sexual intercourse can take place. Often, infibulated women are cut open on the first night of marriage (by the husband, or a circumciser), in order to enable the husband to be intimate with his wife. At childbirth, many women also have to be cut again, because the vaginal opening is too small to allow for the passage of a baby. Attempts at forcible penetration may cause rupture of scars and sometimes perineal tears, dyspareunia, and vaginismus. Excessive penile force during first intercourse can cause severe bleeding, shock and infection.


Source: UNFPA (http://www.unfpa.org/gender/practices2.htm#5)

What is re-infibulation?

In some communities, the raw edges of the wound are sutured again after childbirth, recreating a small vaginal opening. This is referred to as re-infibulation.


Source: UNFPA (http://www.unfpa.org/gender/practices2.htm#6)

Where does the practice come from?

The origins of the practice are unclear. It predates the rise of Christianity and Islam. There is mention made of Egyptian mummies that display characteristics of FGM/FGC. Historians such as Herodotus claim that in the fifth century BC the Phoenicians, the Hittites and the Ethiopians practised circumcision. It is also reported that circumcision rites were practised in tropical zones of Africa, in the Philippines, by certain tribes in the Upper Amazon, and in Australia by women of the Arunta tribe. It also occurred among the early Romans and Arabs. As recent as the 1950s, clitoridectomy was practised in Western Europe and the United States to treat 'ailments' in women as diverse as hysteria, epilepsy, mental disorders, masturbation, nymphomania, melancholia and lesbianism. In other words, the practice of FGM/FGC has been followed by many different peoples and societies across the ages and the continents.


Source: UNFPA (http://www.unfpa.org/gender/practices2.htm#7)

Who performs FGM/FGC?

FGM/FGC is usually carried out by elderly people in the community (usually, but not exclusively, women) who have been specially designated for this task, or by traditional birth attendants. These people receive a fee from the girls' family members, in money or in kind. In some cases, medical personnel perform the operation as well, for a fee. Among certain populations, FGM/FGC may be carried out by traditional health practitioners, (male) barbers, members of secret societies, herbalists, and sometimes by a female relative.


Source: UNFPA (http://www.unfpa.org/gender/practices2.htm#8)

What instruments are used to perform FGM/FGC?

FGM/FGC is carried out with special knives, scissors, scalpels, pieces of glass or razor blades. Anaesthetic and antiseptics are not generally used except when carried out by medical practitioners. In communities where infibulations is practised, the girls' legs are often bound together to immobilize her for a period of 10 - 14 days, to allow formation of scar tissue.


Source: UNFPA (http://www.unfpa.org/gender/practices2.htm#9)

At what age is FGM/FGC performed?

The age at which FGM/FGC is performed varies. In some areas it is carried out during infancy (as early as a couple of days after birth), in others during childhood, at the time of marriage, during a woman's first pregnancy or after the birth of her first child. The most typical age is 7 - 10 years or just before puberty, although reports suggest that the age is dropping in some areas.


Source: UNFPA (http://www.unfpa.org/gender/practices2.htm#11)

In which countries is FGM/FGC practiced?

he practice is common in parts of Africa, Asia and in some Arab Countries. It is practiced among communities in : Benin, Burkina Faso, Cameroon, Central African Republic, Chad, Cote d'Ivoire , Democratic Republic of Congo, Djibouti, Egypt, Ethiopia, Eritrea, Gambia, Ghana, Guinea, Guinea-Bissau, Kenya, Liberia, Mali, Mauritania, Niger, Nigeria, Senegal, Sierra Leone, Somalia, Sudan, Tanzania, Togo, Uganda.

FGM/FGC is also practiced among certain ethnic groups in a number of Asian countries (India, Indonesia, Malaysia, Pakistan); among some groups in the Arabian Peninsula (in Oman, United Arab Emirates, Yemen); Iraq; occupied Palestinian territories and among certain immigrant communities in Europe, Australia, Canada and the United States.


Source: UNFPA (http://www.unfpa.org/gender/practices2.htm#12)

Why is FGM/FGC performed?

Cultural practices such as FGM/FGC are rooted in a set of beliefs, values, cultural and social behaviour patterns that govern the lives of people in society. There are many reasons given for practicing FGM/FGC. These can be categorised under five headings.

Psychosexual reasons:
FGM/FGC is carried out as a means to control women’s sexuality (which is argued to be insatiable if parts of the genitalia, especially the clitoris, are not removed). It is thought to ensure virginity before and fidelity after marriage and/or to increase male sexual pleasure.

Sociological and cultural reasons:
FGM/FGC is seen as part of a girl’s initiation into womanhood and as an intrinsic part of a community’s cultural heritage/tradition. Various myths exist about female genitalia (e.g. that if uncut the clitoris will grow to the size of a penis; FGM/FGC would enhance fertility or promote child survival, etc) and these serve to perpetuate the practice.

Hygiene and aesthetic reasons:
In some communities, the external female genitalia are considered dirty and ugly and are removed ostensibly to promote hygiene and aesthetic appeal.

Religious reasons:
Although FGM/FGC is not sanctioned by either Islam nor by Christianity, supposed religious prescripts (e.g. the mention of ‘Sunna” in the Koran) are often used to justify the practice.

Socio-economic factors:
In many communities, FGM/FGC is a prerequisite for marriage. Where women are largely dependent on men, economic necessity can be a major determinant to undergo the procedure. FGM/FGC sometimes is a prerequisite for the right to inherit. FGM/FGC may also be a major income source for practitioners.


Source: UNFPA (http://www.unfpa.org/gender/practices2.htm#13)

How many women and girls are affected?

It is estimated that from 100 to 140 million girls and women have undergone some form of genital mutilation/cutting, and at least 3 million girls are at risk of undergoing the practice every year.


Source: UNFPA (http://www.unfpa.org/gender/practices2.htm#14)

How does FGM/FGC affect women's health?

The effects of FGM/FGC depend on the type performed, the expertise of the circumciser, the hygienic conditions under which it is conducted, the amount of resistance and general health condition of the girl/woman undergoing the procedure. Complications may occur in all types of FGM/FGC, but are most frequent with infibulation.

FGM/FGC has both immediate and long-term consequences to the health of women.

Immediate complications:
These include severe pain, shock, haemorrhage, tetanus or infection, urine retention, ulceration of the genital region and injury to adjacent tissue, wound infection, urinary infection, fever and septicaemia. Haemorrhage and infection can be of such magnitude as to cause death.

Long term consequences:
These include anemia, the formation of cysts and abscesses, keloid scar formation, damage to the urethra resulting in urinary incontinence, dyspareunia (painful sexual intercourse) and sexual dysfunction, hypersensitivity of the genital area. Infibulation can cause severe scar formation, difficulty in urinating, menstrual disorders, recurrent bladder and urinary tract infection, fistulae, prolonged and obstructed labour (sometimes resulting in fetal death and vesico-vaginal fistulae and/or vesico-rectal fistulae), and infertility (as a consequence of earlier infections). Cutting of the scar tissue is sometimes necessary to facilitate sexual intercourse and/or childbirth. Almost complete vaginal obstruction may occur, resulting in accumulation of menstrual flow in the vagina and uterus. During childbirth the risk of hemorrhage and infection is greatly increased.


Source: UNFPA (http://www.unfpa.org/gender/practices2.htm#15)

Is there a link between FGM/FGC and the risk of HIV/AIDS infection?

Because the procedure is coupled with the loss of blood and use is often made of one instrument for a number of operations, the risk of HIV/AIDS transmission is increased by the practice. Also, due to damage to the female sexual organs, sexual intercourse can result in lacerations of tissues, which greatly increases risk of transmission. The same is true for childbirth and subsequent loss of blood.


Source: UNFPA (http://www.unfpa.org/gender/practices2.htm#16)

What are the psychological effects of FGM/FGC?

Genital mutilation/cutting may leave a lasting mark on the life and mind of the woman who has undergone the procedure. The psychological stress may trigger behavioural disturbances in children, closely linked to the loss of trust and confidence in care-givers. In the longer term, women may suffer feelings of anxiety, depression, and frigidity. Sexual dysfunction may also be the cause for marital conflicts and eventual divorce.


Source: UNFPA (http://www.unfpa.org/gender/practices2.htm#17)

Is FGM/FGC required by certain religions?

No. The practice of FGM/FGC is not prescribed by Islam, nor in the Bible. In fact, the practice predates Islam, and many religious leaders have denounced it. The practice cuts across religions and is practiced by Muslims, Christians, Ethiopian Jews, Copts, as well as by followers of certain traditional African religions. FGM/FGC is thus more a cultural than a religious practice.


Source: UNFPA (http://www.unfpa.org/gender/practices2.htm#18)

Can FGM/FGC be condoned if it is carried out by medical professionals ...

No. FGM/FGC in any form should not be practised by health professionals in any setting - including hospitals or other health establishments. Unnecessary bodily mutilation cannot be condoned by health providers. FGM/FGC is harmful to the health of women and girls and violates their basic human rights and medicalization of the procedure does not eliminate this harm. On the contrary, it reinforces the continuation of the practice by seeming to legitimize it. Health practitioners should provide all necessary care and counseling for complications that may arise as a result of FGM/FGC.


Source: UNFPA (http://www.unfpa.org/gender/practices2.htm#19)

Since FGM/FGC is part of a cultural tradition, can it still be condemn...

Yes. The function of culture and tradition is to provide a framework for human well-being; cultural arguments can never be used to condone violence against persons, male or female. Moreover, culture is not static, but constantly changing and adapting. Nevertheless, activities for the elimination of FGM/FGC should be developed and implemented in a way that is sensitive to the cultural and social background of the communities that practice it. Behaviour can change when people understand the hazards of certain practices and when they realize that it is possible to give up harmful practices without giving up meaningful aspects of their culture.


Source: UNFPA (http://www.unfpa.org/gender/practices2.htm#20)

In which countries is FGM/FGC banned by law?

Africa:
Benin, Burkina Faso, Central African Republic, Chad, Cote d'Ivoire, Djibouti, Egypt (Ministerial decree), Ghana, Guinea, Kenya, Niger, Nigeria (multiple states), Senegal, Tanzania, Togo. In Sudan only the most severe form of FGM/FGC is forbidden by law.

Others:
Australia, Belgium, Canada, Denmark, New Zealand, Norway, Spain, Sweden, United Kingdom, United States (federal law, and specific state laws).

Penalties range from a minimum of six months to a maximum of life in prison. Several countries also include monetary fines in the penalty. As of June 2000, there have been prosecutions or arrests in Burkina Faso, Egypt, Ghana, France and Senegal. Belgium. Benin, Nigeria, and Uganda are proposing laws to ban the practice of FGM/FGC.

In September 2001, the European Parliament adopted a resolution on Female Genital Mutilation . The resolution calls on the member states of the European Union to pursue, protect and punish any resident who has committed the crime of FGM even if committed outside the frontier ("extraterritoriality") and calls on the Commission and the Council to take measures in regard to the issuing of residence permits and protection for the victims of the practice. The resolution also calls on the member states to recognise the right to asylum of women and girls at risk of being subject to FGM/FGC.

Source: UNFPA (http://www.unfpa.org/gender/practices2.htm#21)

What terms do people who practice FGM/FGC use to describe the procedur...

Since FGM/FGC is practiced in different countries and cuts across ethnic groups, there are many different names used to describe different forms of FGM/FGC. For instance:

Sunna: Sunna means 'precept' or 'tradition' in Arabic and it refers to a range of practices that follow the teachings of Islam. It is used in various communities to refer to different types of FGM/FGC, varying from incisions in the clitoris to intermediate forms. References to the term 'sunna' in the Koran are often used to justify FGM/FGC as being a religious obligation.

Source: UNFPA (http://www.unfpa.org/gender/practices2.htm#23)