Female Genital Cutting – Understanding and Eliminating a Rite of Passage

To the billions of people who don’t adhere to the harmful traditional practice, female genital cutting (also called female genital mutilation and female circumcision) is unthinkable, brutal, and incomprehensible.  Many of us have daughters and can’t imagine putting them through anything so violent and painful, so permanently destructive to their physical integrity, health and wellbeing.  But to the approximately 140 million women around the world who have undergone FGC, it’s a necessary tradition that’s been handed down for generations.  What’s unthinkable for them is the idea of not cutting their daughters.  That is, until they learn more about the damage it does.

The sensitive nature of this custom is apparent even in the words we use to name it.  It’s sometimes referred to as Female Genital Mutilation, but the women and cultures that accept this tradition as a normal part of womanhood don’t consider it mutilation and find that term to be judgmental and demeaning.  Female Genital Circumcision is also controversial because of natural comparisons to male circumcision, which has its own cultural roots and controversies, but doesn’t inflict the same amount of harm.  That’s why some organizations working to eliminate the practice call it Female Genital Cutting (FGC), as a respectful compromise to avoid labeling women as “mutilated.” 

According to the World Health Organization, FGC is practiced on up to three million women and girls each year and is prevalent in 28 countries in Africa, as well as areas of the Middle East and Asia and among immigrant populations in Europe, the United States, and other countries.  Traditional circumcisers with no medical training almost always do the cutting, but mothers, aunts and other women in the community are frequently involved to subdue and restrain the girl and to create rituals and celebrations that support the custom.  The crude, unsterilized instruments include razor blades, broken glass or knives and they’re often used on multiple girls without anesthesia or any other medical equipment to prevent infection, hemorrhage or tetanus. Healthcare professionals perform approximately 18% of FGCs and that statistic is increasing. 

There are no health benefits to having the procedure done, and there are many health hazards created by the procedure, including infection, shock, hemorrhage, tetanus, HIV/AIDS, urinary tract infections, and vaginal infections.  Those risks are compounded when the vagina is cut open later in life to facilitate sex and childbirth.   For many girls and women FGC is deadly and for many others, the complications are severe and last a lifetime.  As for maternal and newborn health, studies show dramatically increased risks for labor complications including hemorrhage, infection, obstructed labor, fistula, increase need for cesarean sections and increased need for resuscitation and risk of newborn brain damage and death.  That’s because scarred vaginal tissue won’t stretch adequately to allow a baby safe passage at birth.  When a baby is trapped in the birth canal it can result in oxygen deprivation for baby and a mother who is badly torn and often permanently damaged.  And we haven’t even touched on the severe emotional and psychological trauma these girls and women experience.   

The personal stories and descriptions of girls being cut are invariably grueling and we won’t include them here.  For those who want to know more about what girls and women live through, visit the website for the Campaign Against Female Genital Mutilation (CAGeM).  It’s all there and it’s hard to look at and that might be why this practice has continued for so many generations - because the rest of the world has looked away.   The increasing focus on women, girls and human rights however, means looking away is no longer an option.  Instead, it’s time to scrutinize the custom and cultures that promote FGC and the factors that contribute to this dangerous tradition. 

What may be the most startling contributor is that parents subject their daughters to FGC because they love them, want the best for them and can’t imagine forcing them to endure life without being cut. Women in these cultures who are not cut are considered unclean and unmarriageable. Family members won’t accept food or water from them, sit or live near them. Many become outcasts from their families and communities.  And despite the brutality of the procedure, millions of women who have gone through it consider it a necessary rite of womanhood that’s associated with femininity, cleanliness and modesty.

In many parts of the world, concepts like germ theory, basic hygiene and birth physiology aren’t part of the community’s knowledge base.  Women’s rights to basic health, education, employment and safety from violence are brand new ideas.  Changing ingrained cultural practices isn’t easy and doesn’t happen quickly, but over time, as people learn that the reason why their daughters die is because of infection, not “spirits” and why they bleed to death in childbirth is because of scarring, they begin to understand and change.  

Tostan is an international nonprofit organization headquartered in Dakar, Senegal, dedicated to empowering African communities to bring about sustainable development and social transformation based on respect for human rights.  They’re among the organizations focused on eliminating FGC as part of the complicated issues impacting women and poverty. Using their award-winning Community Empowerment Program, they’ve successfully gotten communities to abandon FGC through multifaceted education that covers a broad spectrum of human rights subjects.

Gannon Gillespie, Tostan’s Director of Strategic Development, says, “Among communities where FGC is widely accepted, the decision to abandon it only comes after many community-wide discussions on the topic. Communities talk about the relevancy of the practice, its health consequences, and whether or not they feel it supports their human rights. It requires a lot of discussion, but over time, the concepts start to resonate. Since FGC is a social norm and connected with marriage ability, it is essential to include all invested people in the decision-making process—only then can the practice truly be abandoned. Tostan community members engage with neighboring and inter-marrying villages to share the information they learned and build consensus on the need to abandon FGC. Through that process we’ve seen the shift to abandon FGC really happen. 1997 marked the first community in Senegal to officially abandon FGC.  Today, there are more than 6000 communities that have publicly declared an end to this practice.” 

CAGeM approaches FGC elimination with strategic projects focused on education, creation of alternative coming-of-age rituals, economic empowerment, rescue programs for girls and affordable treatment programs to help girls and women recover from physical and mental health complications and provide reconstructive surgery. 

It’s challenging for many people to understand a custom like FGC, but eliminating it requires that we abandon our judgment and embrace the power of knowledge, education, compassion, empowerment and respect. As the poet, Maya Angelou said, “When people know better, they do better.” 

What can you do?

Learn more about FGC through the World Health Organization. CAGeM, Tostan and Half the Sky.

Support organizations working to empower women and girls including Every Mother Counts, CARE, CAGeM and Tostan.