Female Genital Mutilation

We all know that Female Genital Mutilation (FGM) has no benefits and is in no way beneficial to the female being subjected to it. As a result FGM has been illegal since 1997. Last year the penalties were increased in NSW from 7 years to 21 years in gaol, no matter if the procedure was done here in Australia or overseas. The Minister for Family and Community Services, Pru Goward said “These changes send the message loud and clear that no matter whether you are the doctor holding the scalpel, or the parent buying the plane ticket, the penalty will be the same…The NSW government is making it very clear the practice is simply not acceptable”.1

There are four (4) different classifications or degrees of FGM performed on females in many cultures; the practice is performed in areas such as central Africa, the Southern Sahara, and parts of the Middle East.2 The World Health Organization (WHO), United Nations Population Fund (UNFPA) and United Nations Children’s Fund (UNICEF) in a joint statement outlined the four (4) classifications (with subdivisions) of FGM as:

  • Type I— Partial or total removal of the clitoris and/or the prepuce (clitoridectomy).When it is important to distinguish between the major variations of Type I mutilation, the following subdivisions are proposed:
    • Type Ia, removal of the clitoral hood or prepuce only;
    • Type Ib, removal of the clitoris with the prepuce.
  • Type II— Partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora (excision).When it is important to distinguish between the major variations that have been documented, the following subdivisions are proposed:
    • Type IIa, removal of the labia minora only;
    • Type IIb, partial or total removal of the clitoris and the labia minora;
    • Type IIc, partial or total removal of the clitoris, the labia minora and the labia majora.Note also that, in French, the term ‘excision’ is often used as a general term covering all types of female genital mutilation.
  • Type III— Narrowing of the vaginal orifice with creation of a covering seal by cutting and appositioning the labia minora and/or the labia majora, with or without excision of the clitoris (infibulation).
    • Type IIIa, removal and apposition of the labia minora;
    • Type IIIb, removal and apposition of the labia majora.
  • Type IV— All other harmful procedures to the female genitalia for non-medical purposes, for example: pricking, piercing, incising, scraping and cauterization.3

It is believed that FGM is performed for many reasons, some being; psychosexual reasons, reducing the woman’s sexual desires to preserve her virginity before marriage and to deter her from fidelity as well as increasing the males sexual pleasure. Sociological reasons, being able to identify with their cultural heritage and as a rite of passage into womanhood. Hygiene and aesthetic reasons, the female genitalia is considered dirty and unsightly and so should be removed to promote hygiene and be aesthetically appealing to men. Myths of enhanced fertility and promotion of child survival. And religious reasons being that Muslims, Christians (Catholics, Protestants, Copts), animists and nonbelievers in a range of areas. It has been carried out in Muslim communities in the genuine belief that it is demanded by the Islamic faith. Although there is no evidence that it is a religious requirement of Islam as the practice of FGM predates Islam.4

It would seem there is no acknowledgement or acceptance in these cultures (by the general community) that FGM can and will significantly deter the woman’s health, put her life at risk when giving birth as well as that of her unborn child (if type III FGM has been performed) plus many other risks that can affect a female immediately after the procedure has happened and later in life.

In the joint statement by WHO, UNFPA and UNICEF the health complications are detailed to be the following-

Immediate complications are:

  • Severe pain
  • Shock
  • Hemorrhage
  • Infection
  • Tetanus or sepsis
  • Urine retention
  • Ulceration of the genital region and injury to adjacent tissue
  • Possible transmission of HIV due to use of one instrument in multiple operations.

Complications that can appear later in life are:

  • Cysts and abscesses
  • Keloid scar formation (a result of an overgrowth of granulation tissue (collagen type 3) at the site of a healed skin injury which is then slowly replaced by collagen type 1. Keloids are firm, rubbery lesions or shiny, fibrous nodules, and can vary from pink to flesh-coloured or red to dark brown in colour.)5
  • Damage to the urethra resulting in urinary incontinence
  • Dyspareunia (painful sexual intercourse) and sexual dysfunction
  • Difficulty in urinating
  • Bladder and urinary tract infections
  • Infertility
  • Cutting open the skin bridge created by the labia major during intercourse and child birth causing an increase in the chances of maternal death and stillbirth.
  • Increased chance of hemorrhage and infection during and after childbirth.6

It is easy to see why FGM is illegal here in Australia, as not only does it violate human rights, FGM also puts the person being subject to this at high risk of complications now and later in life.

It is debatable as to whether or not FGM can be reversed. A French physician Dr. Foldes claims to have pioneered clitoral reconstructive surgery. Dr. Foldes and his colleagues published a study in The Lancet in 2012 which claims positive results. Over 11 years Dr. Foldes and his team operated on close to 3,000 women all whom had been subjected to FGM. At a one (1) year follow up (of which 866 women attended) 95% noted an improvement, or at the very least no increase in pain, 94% said that they had experienced clitoral pleasure and sensation and an astonishing 50% experienced orgasms!

Critics of Dr. Foldes sent a letter to The Lancet claiming that such results are anatomically impossible. Cliroraid volunteer Dr. Harold J. Henning, M.D., disagrees saying “I challenge the medical community to take another look at this subject and not approach it with blinders on.” Whom himself has performed the surgery “When a patient in tears cries joyfully to you that she has for the first time in her life experienced sexual pleasure, no further scientific proof is necessary.”7

Even though there is the possibility that FGM could be reversible, there is still no excuse for it. FGM is a human rights violation and the only one deciding on whether or not a surgery/procedure or cultural ritual should be performed on someone is the person herself, the one whom the body or vagina belongs to.

References

­­1 http://www.smh.com.au/nsw/female-genital-mutilation-penalties-tripled-in-nsw-20140205-320gq.html

2 https://www.womenshealth.gov/publications/our-publications/fact-sheet/female-genital-cutting.html

3 http://www.who.int/reproductivehealth/topics/fgm/overview/en/

5 http://en.wikipedia.org/wiki/Keloid

4, 6 http://www.childinfo.org/files/fgmc_WHOUNICEFJointdeclaration1997.pdf

7 http://www.clitoraid.org/news.php?item.142.2