2024: 1930 Chronology: Appendix 36: Female Genital Mutilation

Appendix 36

Female Genital Mutilation

Female genital mutilation (FGM) (also known as female genital cutting, female genital mutilation/cutting (FGM/C) and female circumcision) is the ritual cutting or removal of some or all of the vulva. The practice is found in some countries of Africa, Asia and the Middle East, and within their respective diasporas. As of 2023, the United Nations Internation Children's Education Fund (UNICEF) estimates that "at least 200 million girls... in 31 countries"—including Indonesia, Iraq, Yemen, and 27 African countries including Egypt — had been subjected to one or more types of FGM.

Typically carried out by a traditional circumciser using a blade, FGM is conducted from days after birth to puberty and beyond. In half of the countries for which national statistics are available, most girls are cut before the age of five. Procedures differ according to the country or ethnic group. They include removal of the clitoral hood and clitoral glans; removal of the inner labia; and removal of the inner and outer labia, and closure of the vulva. In this last procedure, known as infibulation, a small hole is left for the passage of urine and menstrual fluid; the vagina is opened for intercourse and opened further for childbirth. The practice is rooted in gender inequality, attempts to control women's sexuality, and ideas about purity, modesty, and beauty. It is usually initiated and carried out by women, who see it as a badge of honor, and who fear that failing to have their daughters and granddaughters cut will expose the girls to social exclusion. Adverse health effects depend on the type of procedure. They can include recurrent infections, difficulty urinating and passing menstrual flow, chronic pain, the development of cysts, an inability to get pregnant, complications during childbirth, and fatal bleeding. There are no known health benefits.

There have been international efforts since the 1970s to persuade practitioners to abandon FGM, and it has been outlawed or restricted in most of the countries in which it occurs, although the laws are often poorly enforced. Since 2010, the United Nations has called upon healthcare providers to stop performing all forms of the procedure, including reinfibulation after childbirth and symbolic "nicking" of the clitoral hood. The opposition to the practice is not without its critics, particularly among anthropologists, who have raised questions about cultural relativism and the universality of human rights. According to the UNICEF, international FGM rates have risen significantly in recent years, from an estimated 200 million in 2016 to 230 million in 2024, with progress towards its abandonment stalling or reversing in many countries.

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Female genital cutting (FGC) is a ritual surgical procedure that is traditional in some societies. FGC has been practiced by a wide variety of cultures and as a result includes a number of related procedures and social meanings.

The term female genital cutting refers to a wide continuum of procedures that range from a symbolic nick to the removal of a great deal of tissue from the genital area. The World Health Organization (WHO) has defined four categories of FGC:

1. Clitoridectomy. Type 1 FGC involves the partial or total removal of the clitoris. In some cases, the prepuce (clitoral hood) is also removed.

2. Excision. Type 2 FGC involves the partial or total removal of the clitoris and the labia minora. It can also include the removal of the labia majora.

3. Infibulation (also called Pharoanic circumcision). The vaginal opening is reduced by removing all or parts of the external genitalia (the clitoris, labia minora, and labia majora) and sewing, pinning, or otherwise causing the remaining tissue to fuse together during the healing process.

4. Those procedures that cause genital trauma but do not fit Types 1–3. Type 4 FGC may involve nicking, piercing, scraping, or cauterizing the genitalia, placing caustic substances in the vagina, or other practices.  The physiological repercussions of FGC generally increase with the amount of cutting.  Girls subject to Type 3 FGC experience larger numbers of, and more-serious, consequences than do girls subject to less-invasive procedures. Short-term consequences can include severe bleeding, tetanus and other infections, debilitating pain, and death. Long-term consequences can include difficulty expelling urine and menstrual blood, painful sexual intercourse, urethral scarring or closure, and long delays during childbirth that can lead to the death of the mother or the child. In some groups that practice infibulation, notably those in Sudan, women are reinfibulated after the birth of each child. In other groups, such as those from Somalia, postpartum reinfibulation is not common.

In anthropological terms FGC is “polythetic,” a phenomenon that carries multiple, sometimes conflicting, meanings within a culture and when viewed in cross-cultural comparison. Because many cases of forcible FGC were recorded during the late 20th and early 21st centuries, the practice became the focus of international debates about the relative value of individual rights versus cultural traditionalism. Responses to this debate have been equivocal; even within a given culture, some people may see FGC as an empowering procedure that makes “silly girls” into “real women,” and others may see it as a brutal method of control.

Cultural analyses of the phenomenon are complicated by the variability of the procedure and by the characteristics of the informants (their age, sex, religion, marital status, and the like). Such studies are also susceptible to research bias, especially when background factors predispose the investigator to view FGC outside its cultural context (a circumstance referred to colloquially as the “ick factor”).

At one end of the spectrum of meaning, the procedure is viewed as one of several steps undertaken by young women, typically in their teens but sometimes in their 20s or 30s, on a journey that also includes marriage, motherhood, and recognition as fully competent persons (usually, but not always, in that order). Under these circumstances the age and voluntary participation of the young women may render the surgery as a positive undertaking.  Indeed, in cultures that imbue FGC with these meanings, young women who have been denied the procedure have been known to attempt to perform it on themselves.

At the opposite end of the spectrum, FGC is viewed as a method of control through which elders guard a girl’s virginity, reduce her sexual desire, and permanently mark her as a second-class citizen. In such cases the procedure is most often performed in infancy or childhood. Under these circumstances the age and forced participation of the girl can render the surgery a terrifying experience. In such cultures, it is increasingly common for girls or some of their relatives to resist or delay the surgery, even to the point of requesting political asylum. 

A 2008 interagency statement issued by WHO and several other United Nations agencies called for an end to FGC. The statement noted 39 countries in which it was reportedly practiced. However, FGC was actually more widespread than this, as the list excluded countries where migrant communities engaged in FGC but in which it was not widely accepted. In 2012, the United Nations General Assembly unanimously passed a nonbinding resolution that exhorted member countries to ban FGC.

A WHO report (2000) attempting to enumerate the extent of FGC had estimated that between 100 million and 140 million women and girls had undergone some form of the procedure, more than 90 million of them living in Africa. On that continent, the procedure was thought to be performed on approximately 3 million girls each year. The report also estimated that approximately 90 percent of all FGC procedures worldwide were of Types 1, 2, or 4. Infibulation was common mainly in Sudan, Somalia, and Nigeria. Most of the remaining FGC loci were in the Middle East and South and Southeast Asia.