Violence Against Women: Female Genital Mutilation

– – Related Post – “FGM”: The Latest Attempt to Dehumanise Muslims, by Dr Salman Butt – –

Violence Against Women Part 1: Female Genital Mutilation (FGM)

Note: this article contains some explicit descriptions of violence against women and girls, and as such may be unsuitable for some readers.

In light of the recent furore around the concept of “Female Genital Mutilation” (FGM), it has become necessary to outline some of the practices that occur when a female undergoes this procedure, and why it is, in fact, considered a form of violence and abuse against women, and a form of child abuse. Another article recently outlined briefly the types of female “circumcision” that occur; this one will go into more detail and discuss some of the after-effects of undergoing the procedure.

More commonly and less precisely referred to as ‘female circumcision’[i], and more recently as Female Genital Cutting or Female Genital Surgery, FGM has been defined by the American Medical Association[ii] as the medically uncalled for alteration of female genitals, for non-therapeutic reasons[iii], and by the World Health Organisation (WHO) as

“procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons[iv].”

There are four types of circumcision classified by the WHO, the first of which consists of a small cut made to the hood of the clitoris, and this is the least severe, least invasive and least mutilating form. This first type is the one referred to as the “Sunnah” method. When discussing FGM, this article does not refer to this first type of circumcision, and refers only to the second, third and fourth type, which will be outlined below.

The WHO estimates that 125 million women and girls alive today have undergone FGM[v], and according to a paper published by the International Centre for Reproductive Health[vi], and by UNICEF[vii], at least 3 million girls are at risk of undergoing the procedure every year. According to Dorkenoo[viii], and the ICRH[ix], the majority of these women and girls are reported to live in northern, western and eastern Africa, in twenty-eight different countries, as well as along the Persian Gulf, in southern parts of the Arabian Peninsula, and by immigrant groups in Canada, United States, Australia, and in Europe. Approximations of the occurrence of FGM in the UK by FORWARD[x] and by the NHS[xi] state that at least 66,000 women and girls are living with the effects of FGM today, with 24,000 girls under age 15 at risk, although the figures could be much higher due to its hidden nature. FGM is illegal in the United Kingdom under the Prohibition of Female Circumcision Act (1985) and it is illegal to arrange to have someone taken on ‘holiday’ abroad to get it done under the Female Genital Mutilation Act 2003.

As mentioned previously, there are four types of circumcision: the second type involves a total removal of the clitoris, the third type a removal of the prepuce (the fold of skin surrounding the clitoris), as well as the clitoris, upper labia minora and perhaps the labia majora[xii]. The last and most invasive, traumatic type is known as infibulation, in which almost all the external genitalia are cut away, the remaining flesh from the outer labia are sown together[xiii], and the girl’s legs are sometimes bound from waist to ankle for several weeks while scar tissue closes up the vagina almost entirely[xiv]. A small hole is usually left for urination and menstruation, sometimes created by inserting a twig or straw into the incision[xv].

In areas where FGM is carried out on almost the entire population of females, the procedure is performed routinely by trained midwives in small clinics in urban areas, and by untrained midwives in the outlying areas[xvi] in which the procedure brings in supplementary income[xvii]. In countries such as Britain and the US, where parents might have trouble finding a person to perform the procedure, the girl is sent away abroad to Africa or elsewhere on a ‘holiday’ to have the procedure performed[xviii].

In cases where an untrained midwife is hired to perform the ‘surgery’, the procedure is usually undergone without anaesthesia of any kind, and the instruments used may include sharp stones, razor blades, broken glass, scissors, kitchen knives or even the teeth of the midwife[xix]. The infibulations are usually broken on the woman’s wedding day, in which the bridegroom tears open the scar tissue either through penetration, the use of a small knife, razor, or sometimes even acid[xx] if the scar tissue is too hard to be broken by penetration. In some cases, the family may ‘open up’ the woman a few days before the wedding takes place, although sometimes the bridegroom prefers to do it himself[xxi].

The reasons for infibulation are numerous, apart from it being part of tradition in some cultures: some cultures believe that if left uncut, the genitalia will grow long and dangle between the legs, that not cutting causes sexual promiscuity or infertility, that it is done for cosmetic reasons, and that it increases femininity[xxii]. The short and long term consequences of FGM are severe: it causes agonising pain, trauma, psychological damage[xxiii], can cause tetanus, sepsis, excessive bleeding and infection, open sores, HIV, Hepatitis B and C, urinary tract infections, incontinence, damage to nearby organs including the bowels, kidney damage and failure, prolonged and extremely painful labour, cysts, infertility, haemorrhage, and even death[xxiv]. It also increases the need for later surgeries, as it needs to be cut open for intercourse and childbirth, and then re-sewn, which can occur multiple times, especially after childbirth[xxv]

FGM is one of an array of geographically or culturally specific forms of violence against women[xxvi], defined by the United Nations Declaration on the Elimination of Violence Against Women as:

“…any act of gender-based violence that results in, or is likely to result in, physical, sexual or psychological harm or suffering to women.”[xxvii].

Other forms of geographically and culturally specific forms of violence against women include acid throwing, honour killings, dowry deaths, and so on. These forms of violence are targeted specifically towards women and girls, in which violence is used as a means and expression of power, and in the majority of societies, power is socially gendered, in which political, economic, interpersonal and social power remains with men[xxviii]. An extension of this is when violence is used as a form of subordination[xxix]; a means of seeking and exerting control[xxx], and FGM can be used as a vivid example of this. According to Denney & Quadagno[xxxi], and Lightfoot-Klein[xxxii], in some cultures FGM is used to differentiate reputable women from slaves and prostitutes, and according to Davis[xxxiii], it is in order prevent women from getting pleasure out of intercourse, and hence lessening the likelihood of their having an adulterous relationship. This is akin to Heidensohn’s[xxxiv] observation of the duality of analyses about women, in which they are described as both virtuous and immoral or evil, mothers and prostitutes. It would appear then, that FGM is performed in the belief that it would promote the former, and prevent the latter—make women virtuous and mothers, instead of immoral and prostitutes. According to research, men in societies that practice FGM prefer women who have been infibulated because it ensures the dampening of their sexual desires[xxxv], and ensures that the woman will not only be a virgin when she gets married, and hence will belong only to her husband, but she will also not have adulterous relationships because it is believed that circumcision takes away any pleasure that can be achieved from intercourse[xxxvi]. Studies talk of the abject terror the bride feels on the night following her wedding day[xxxvii], when she has to be ready to face the intense pain and agony, the physical and psychic trauma that is to come in the ‘opening’ of her, in which she would have to rely on the compassion and gentleness of the bridegroom, and hope that he would not be too brutal. In each case, it would be the groom’s prerogative whether he would be gentle or not, what weapon he would use to de-infibulate if the scar tissue from infibulation were too strong to be broken by attempted penetration; whether he would be gentle and attempt penetration over an extended period of time, or attempt to do it all in one go[xxxviii].

The concept of FGM and the reasons why women participate in the practice are complex, and deeply rooted, including within them conceptions of patriarchy and the oppression of women. Society, in general, is perceived as a stable system supported by consensual principles and standards and into which ordinary people are socialised[xxxix]. The system only works and is preserved if there is successful socialisation, and there is general consensus in that society of what constitutes ‘normal’ or conventional behaviour, and ‘abnormal’ or deviant behaviour[xl]. Women are defined in terms of their roles as wives and mothers, and in terms of their family relationships and in this kind of system, the family is considered the major area of socialisation[xli]. Perhaps this is the reason FGM is most commonly carried out within the family and is usually overseen by the family women, who hold the woman or child immobile while the midwife performs the procedure[xlii].

Within cultures in which FGM is carried out, patriarchy is usually a predominant part of the culture, in which family honour is the highest of societal values, and the highest measure of a family’s honour is the degree of sexual purity of its women[xliii] where the women’s worth is measured by their virginity[xliv]. The main objective of FGM within such a society[xlv] would be to diminish a woman’s sexual desire, and hence guarantee her virginity when she is married. The procedure, usually performed at puberty, or sometimes even younger, as young as infancy[xlvi], is considered a rite of passage, and is celebrated greatly within communities and families. The day of a woman’s infibulation is considered the most important day of her life, more important, even, than her wedding day[xlvii], because, it can be argued, it is the day her chastity, her virginity, and her ‘honour’ is secured, and, by association, her family’s honour. In some cases, the potentially serious bridegroom will demand to see the bride’s infibulation before marriage to assure him of her chastity and virginity[xlviii].

The suturing of the vagina is also believed to intensify the husband’s enjoyment of the sexual act[xlix]. In some cases, the operation also obtains a good bride price, and the tighter the infibulation, the greater the bride price that can be demanded[l]. However, these aren’t the only reasons given; women cited in the literature believe that it is required by their religion, and by God, that female genitals are ugly and need to be cut in order to make them more aesthetically appealing[li]; while others believe that men want only to have sex with infibulated women and do not find un-infibulated women attractive, or sexually appealing[lii].

According to Lightfoot-Klein[liii], an un-infibulated woman in a society where infibulation is paramount is unmarriageable (known as the Schelling-Convention hypothesis[liv]), and in these societies, an unmarried woman has extremely limited, if any, economic recourse, no status, and no value, and faces derision, ridicule, and stigmatisation. The practice is therefore a self-enforcing convention[lv], in which women are forced by such dependence to undergo FGM or face economic and financial instability or poverty and destitution due to the substantive inequalities that exist between the genders. A link can be made here between FGM and Intimate Partner Violence, in which social and economic dependence and dominance is a means by which to control, overpower, and keep women ‘in their place’, by forcing them to either undergo the torture, or face losing everything and having nothing. There is therefore significant pressure on the women themselves to harness their sexuality in order preserve family and men’s honour, and to ensure legitimacy of heirs[lvi], as well as to protect and maintain their own and their children’s positions in society by controlling that part of the body that they believe is responsible for jeopardising all of this. Women’s participation can almost be considered inevitable, when viewed in light of the societal beliefs and consequences that without it, a woman faces social, economic and financial instability and rejection.

There is an unmistakable element of power and coercion in the idealisation of FGM. Women believe that it is only infibulated women who are attractive to men, and the demand men place on women to undergo the procedure in order that they be chaste, beautiful, and marriageable does little to dispel this notion, hence women undergo it in order to fit into cultural definitions of beauty and acceptance through submission. Sexuality and intercourse, or the curbing of it in this case, is used as a means of control and dominance by the man over the woman. The violence perpetrated at each stage, from the requirement that the woman be cut so that she no longer is a sexual being, to the submitting of the woman to whichever means that the man uses in order to achieve penetration, to the expectation that this is the way that women should be, is a clear method of exerting and maintaining power over the woman.

The concept of generational hierarchy used in research on wife abuse[lvii] can be adapted and used as a factor in addition to gender inequality in the case of FGM, in the way that this hierarchy interacts with gender to shape infibulated women’s experiences of violence. It is often not just the men who demand infibulation, but also female members of his family and her own, all of whom can be seen as participating either directly, as oppressors (such as when the woman’s family demand and perform infibulation so as to make certain she would remain ‘pure’ and please her husband or to ‘save’ her from stigma and derision), or indirectly, as instigators (such as when the women in a man’s family demand that the woman to be married must have undergone the procedure or be rendered unsuitable or unmarriageable). The women who have had it done then demand their own daughters go through it, and the same process is repeated in all families, from grandmother to mother to daughter and so on, from generation to generation. Women’s participation in FGM can therefore also be seen to arise, not only from a need for economic stability, but also from the interaction of life cycle-based hierarchy and gender[lviii].

Final Thoughts and Conclusion

Characterised as a form of violence against women, and even as a form of child abuse[lix], it is hard to deny that FGM is an action that, even in the best of conditions, often ends in permanent physical mutilation, and alteration of body function[lx], because it involves the removal and re-arrangement of healthy genital tissue[lxi]. It is acknowledged that violence is a social construction, and the way it is defined will depend and vary greatly in accordance with the values of the one doing the defining[lxii]. With all the research cited above, it is clear that the women subjecting their children to FGM believe that they are doing it for the welfare of their child, in order to protect them from the horrible physical, moral and psychological things that they believe will happen to them if they are left uncircumcised (such as infertility, aggressive sexuality, promiscuity, extra long genitalia), and also from the stigmatisation, derision and ridicule they would face from other members of their community. With infibulation the woman becomes marriageable, and her family’s honour is preserved through the preservation of her chastity and her virginity, broken only on her wedding day. The fact that parents get desperate enough to send their children abroad to get the procedure done if no exciser exists in an immigrant country is an indicator of the degree of importance placed on the procedure. The topic is a highly controversial and complex one, as it carries social, symbolic and spiritual connotations for those that practice it. It is tied to socially created meanings of beauty and personhood and an individual’s sense of belonging to that community, and also as a practice of faith, and an embracement of duty[lxiii]. When looked at in this manner, the practice, barbaric as it may seem to others outside of that fold, is justified to those that practice it.

All this does not make it acceptable, however, from a moral perspective, or from a medical perspective. The short and long term physical consequences of it alone are staggering. Although FGM is a practice deeply embedded in tradition and cultural values, this cannot be the deciding factor in whether FGM is seen as violence against women or not. Culture does not, cannot, and should not define whether violence against women is acceptable or not[lxiv]. It is undeniable that the indirect consequence of FGM is a means of exerting and maintaining power and control over women, both economic and social, a result of unequal gender power relations, enforced through the imposition of gender roles in the ways in which FGM strongly links culturally rooted ideas about what constitutes femininity and what women’s roles are[lxv].

A deeper understanding of the social and cultural contexts in which the practice is undertaken is required in order to better grasp its meaning and its requirement, and for more effective social policies and reforms to be employed. The costs of FGM are simply too high. Change for women having to undergo the procedure needs to come, not from harsh laws prohibiting the practice, but from a change in behaviours and attitudes towards it, not from fear of it as something punishable by law, but from an understanding of the harm that it causes, the absence of necessity in it, the irreparable damage, violation of bodily integrity, and permanent change that it brings to young girls’ lives.

Please Note: Although strongly associated with Muslims, FGM is NOT Islamic, and in fact predates Islam, having been found in Egyptian mummies dating back to 200 BC.[lxvi]

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[i]               Barstow, D.G. (1999). “Female Genital Mutilation: The Penultimate Gender Abuse.” Child Abuse & Neglect, Vol. 23, No. 5, pp. 501–510, Dorkenoo, E. (Spring – Summer, 1999). “Combating Female Genital Mutilation: An Agenda for the Next Decade.” Women’s Studies Quarterly, Vol. 27, No. 1/2, Teaching About Violence Against Women pp. 87-97, FORWARD, 2009, Rawlings-Anderson, K. And Cameron, J. (2000). Female Genital Mutilation: A Global Perspective. British Journal of Midwifery, Vol. 8(12). Pp. 754 – 760

[ii]             American Medical Association, Council on Scientific Affairs (1995) ‘Council Report: Female Genital Mutilation’, Journal of the American Medical Association Vol. 274, pp 1714–16.

[iii]            Terry, L. and Harris, K. (2013). Female genital mutilation: a literature review, Nursing Standard Vol 28(1), pp 41-47;

[iv]   WHO (2014). Female Genital Mutilation. Available at: http://www.who.int/mediacentre/factsheets/fs241/en/

[v]    WHO (2014)

[vi]            International Centre for Reproductive Health (2009). Responding to Female Genital Mutilation in Europe: Striking the Right Balance between Prosecution and Prevention –A Review of Legislation. Co-ordinated by Leye, E. And Sabbe, A. Available at: http://www.icrh.org/files/ICRH_rapport2009_def – high resolution.pdf

[vii]           UNICEF. Female Genital Mutilation/Cutting: a statistical overview and exploration of the dynamics of change, 2013.

[viii]         Dorkenoo (1999)

[ix]            ICRH (2009)

[x]             Dorkenoo (2007)

[xi]   NHS (2012),   Female Genital Mutilation. Available at: http://www.nhs.uk/Conditions/female-genital-mutilation/Pages/Introduction.aspx

[xii]  WHO (2014)

[xiii] WHO (2014)

[xiv]         Arbesman, M., Kahler, L., & Buck, G. M. (1993). Assessment of the impact of female circumcision on the gynaecological, genitourinary and obstetrical health problems of women from Somalia: Literature review and case studies. Women & Health, Vol. 20, pp. 27–42, Barstow (1999), Burstyn, L. (1995). Female Genital Mutilation Comes to America. The Atlantic Monthly, October, 28-35.

[xv]           Barstow (1999)

[xvi]         Lightfoot-Klein (1989)

[xvii]        Barstow (1999), Burstyn (1995), Lightfoot-Klein (1989)

[xviii]       Burstyn (1995)

[xix]         Barstow (1999), Burstyn (1995), Gibeau, A. M. (1998). Female genital mutilation: When a cultural practice generates clinical and ethical dilemmas. Journal of Obstetric, Gynecologic and Neonatal Nursing, January/February, pp. 85–91, and Joseph, C. (1996). Compassionate accountability: An embodied consideration of female genital mutilation. The Journal of Psychohistory, Vol. 24, pp. 2–17.

[xx]           Arbesman et.al, (1993)

[xxi]         Burstyn (1995)

[xxii]        Barstow (1999), WHO (2014)

[xxiii]        NHS (2012),   Female Genital Mutilation. Available at: http://www.nhs.uk/Conditions/female-genital-mutilation/Pages/Introduction.aspx

[xxiv]       Arbesman et.al, (1993), Barstow (1999), Black and Debelle, 1995, Burstyn (1995), Denney, N., & Quadagno, D. (1992). Human sexuality (2nd ed.). St. Louis: Mosby Yearbook, Gibeau (1998), Heyzer, N. (1998). ‘Working Towards a World Free from Violence against Women: UNIFEM’s Contribution. Pages 17- 27. In Violence against Women, Vol. 6, Issue 3. Sweetman, C. (Ed.). Oxford: Oxfam., Joseph (1996), Lightfoot-Klein (1989), NHS (2012) and WHO (2014).

[xxv]         WHO (2014). Female Genital Mutilation. Available at: http://www.who.int/mediacentre/factsheets/fs241/en/

[xxvi]       Watts, C. and Zimmerman C. (2002). Violence Against Women: Global Scope and Magnitude. The Lancet. Vol. 359, pp. 1232 – 1237

[xxvii]     Cited in Watts and Zimmerman (2002)

[xxviii]    Sen, P. (1998). ‘Development Practice and Violence against Women.’ Pages 7-16. In Violence against Women, Vol. 6, Issue 3. Sweetman, C. (Ed.). Oxford: Oxfam.

[xxix]       Watts and Zimmerman (2002)

[xxx]        Sen (1998)

[xxxi]       Denney & Quadagno, (1992)

[xxxii]     Lightfoot-Klein (1989)

[xxxiii]    Davis (1985)

[xxxiv]    Heidensohn, F. (1985). Women and Crime. London: Macmillan. Cited in Mooney, J. (2000), Gender, Violence, and the Social Order. Houndmills: Macmillan Press

[xxxv]     Barstow (1999), Black and Debelle (1995), Burstyn (1995), Fourcroy (1983), Gibeau (1998), Joseph (1996), and Lightfoot-Klein (1989)

[xxxvi]    Barstow (1999) and Black and Debelle (1995)

[xxxvii]   Barstow (1999), Burstyn (1995), Lightfoot-Klein (1989)

[xxxviii] Lightfoot-Klein (1989)

[xxxix]    Mooney, J. (2000). Gender, Violence, and the Social Order. Houndmills: Macmillan Press

[xl]   Ibid

[xli]           Mooney, (2000)

[xlii]         Barstow (1999)

[xliii]        Lightfoot-Klein (1989)

[xliv]        Barstow (1999)

[xlv]         Black and Debelle (1995), Barstow (1999), and Fourcroy (1983),

[xlvi]        Lightfoot-Klein (1989), WHO (2014)

[xlvii]       Lightfoot-Klein (1989)

[xlviii]     Barstow (1999)

[xlix]        Black and Debelle (1995) and Shrage, L. (1994). Moral dilemmas of feminism: Prostitution, adultery, and abortion. New York: Routledge. Cited in Barstow, D.G. (1999). “Female Genital Mutilation: The Penultimate Gender Abuse.” Child Abuse & Neglect, Vol. 23, No. 5, pp. 501–510

[l]               Black and Debelle (1995)

[li]             Bishop (2004), WHO (2014)

[lii]            Bishop (2004)

[liii]           Lightfoot-Klein (1989)

[liv]           Mackie,(1996)

[lv]            Schelling, (1960)

[lvi]           Abraham (1999)

[lvii]         Fernandez (1997)

[lviii]        Fernandez (1997)

[lix]           Schroeder, P. (1994). Female genital mutilation—a form of child abuse. The New England Journal of Medicine, Vol. 331, pp. 739–740

[lx]            Barstow (1999)

[lxi]           ICRH (2009)

[lxii]         Mooney, (2000)

[lxiii]        Bishop (2004)

[lxiv]        Sen, P., Humphreys, C. and Kelly, L. (2003). Violence against Women in the UK. London: Womankind Worldwide

[lxv]         Heger, B.E., Songora, F. and Foss, G. (2001) International Discourse and Local Politics: Anti-female Genital Cutting Laws in Egypt, Tanzania, and the United States’, Social Problems Vol. 48, No. 4, Pp. 524–44.

[lxvi] Fox, E.F, Ruiter, A de, and Bingham, J.S (1997). Female Genital Mutilation. International Journal of STD and AIDS, Vol. 8, pp. 599-601