Female Genital Mutilation

Overview :

Female circumcision includes a wide range of procedures. The simplest form involves a small cut to the clitoris or labial tissue. A Sunna circumcision removes the prepuce (a fold of skin that covers the clitoris) and/or the tip of the clitoris. A clitoridectomy removes the entire clitoris and some or all of the surrounding tissue; this procedure occurs in approximately 80% of cases. The most extreme form of genital mutilation is excision and infibulation, in which the clitoris and all of the surround tissue are cut away and the remaining skin is sewn together. Only a small opening is left for the passage of urine and menstrual blood. Infibulation accounts for approximately 15% of FGM procedures.

The World Health Organization (WHO) estimates that between 100 million and 140 million girls and women have undergone some form of FGM. As a very deeply rooted cultural and religious tradition still practiced in over 28 African and Asian countries, up to two million girls per year are at risk. The following countries have the highest number of occurrences of FGM: Djibouti (98%), Egypt (97%), Eritrea (95%), Guinea (99%), Mali (94%), Sierra Leone (90%), and Somalia (98-100%). As more people move to Western countries from countries where female circumcision is performed, the practice has come to the attention of health professionals in the United States, Canada, Europe, and Australia.

In an effort to integrate old customs with modern medical care, some immigrant families have requested that physicians perform the procedure. While trying to be sensitive to cultural traditions, health care providers are sometimes put in the difficult position of choosing to perform this procedure in a medical facility under sanitary conditions, or refusing the request, knowing that it may be done anyway with no medical supervision. Some families who are intent on having this procedure done will take their daughters back to the country they immigrated from in order to have the girls circumcised.

Many national and international medical organizations including the American Medical Association (AMA), Canadian medical organizations, and WHO oppose the practice of female genital mutilation. The United Nations (UN) considers female genital mutilation a violation of human rights. WHO has undertaken a number of projects aimed at decreasing the incidence of FGM. These include the following activities:

• publishing a statement addressing the regional status of FGM and encouraging the development of national policy against its practice,
• organizing training for regional community workers,
• developing educational materials for local health care workers,
• providing alternative occupations for individuals who perform FGM procedures.

KEY TERMS

Circumcision—A procedure, usually with religious or cultural significance, where the prepuce or skin covering the tip of the penis on a boy, or the clitoris on a girl, is cut away.

Clitoridectomy—A procedure where the clitoris and possibly some of the surrounding labial tissue at the opening of the vagina is cut away.

Infibulation—A procedure where the tissue around the vagina is sewn shut, leaving only a small opening for the passage of urine and menstrual blood.




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