Changing a harmful social convention: FGM/cutting

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Changing a harmful social convention
FGM/cutting

• A report by United Nations Childrens Fund
• (UNICEF)

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FGM/cutting

• Every year three million females are subject to
  genital mutilation/cutting
• This procedure is dangerous and potentially life
  threatening
• FGM violates basic human rights because it denies
  them of their physical and mental integrity

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• It is a global concern
• Occurs mainly in 28 countries
• Also is present in immigrant communities
  throughout the world

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FGM/cutting

• Local languages generally use the less judgmental
  term cutting
• Parents understandably resent the suggestion that
  they are mutilating their daughters
• UN called for tact and patience regarding this
  and includes this term to avoid alienating
  communities

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Social Dynamics

• It is an important part of girls and womens
  cultural gender identity
• Imparts a sense of
• Pride
• Of coming of age
• A feeling of community membership

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If it is not done

• Stigmatizes and isolates the girls and their
  family
• Results in loss of social status
• Female will have difficulty finding a husband
• Female will be seen as unclean

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FGM/C ensures

• A females status
• Marriageability
• Chastity
• Health
• Beauty
• Family honor

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Virginity

• FGM/C preserves a girls virginity
• Which is often a prerequisite for marriage
• For example, in Nigeria, mothers-in-law use FGM
  to verify virginity of the bride

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Types of FGM/cutting

• Specific form of FGM/C can vary widely from
  community to community
• Difficulties associated with any classification
  system
• Females may not be certain of which procedure was
  performed on them

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• There is significant variation in the extent of
  cutting
• Procedure is commonly carried out without
  anesthetic
• Poorly lit conditions
• Girls often struggle to resist

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Type I

• Refers to the excision of the prepuce with
  partial or total excision of the clitoris

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Type II

• Partial or total excision of the labia minora
• Includes the stitching or sealing of it, with or
  without the excision of part or all of the
  clitoris

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Type III

• Excision of part or most of the external
  genitalia
• Stitching/narrowing or sealing of the labia
  majora
• AKA infibulation

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Type III (continued)

• Most common is the following countries
• Sudan
• Eritrea
• Djibouti
• Somalia

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Type III (continued)

• In Somalia and Sudan this type is carried out for
  the express purpose of making the girls
  physically clean

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Type IV

• Makes specific reference to a range of
  miscellaneous or unclassified practices
• Includes stretching of the clitoris and/or labia
• Cauterization by burning of the clitoris and
  surrounding tissues

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Type V

• Symbolic practices that involve the nicking or
  pricking of the clitoris
• To release a few drops of blood
• However, this practice does not address the
  gender-based inequalities that drive the demand
  for this
• May actually inhibit progress toward the
  abandonment of the practice

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According to World Health Organization (WHO)

• 100-140 million women girls have undergone some
  form of FGM/C
• Although it is done mainly in 28 countries
• Nearly half of these are from two countries
• Egypt Ethiopia

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FGM/C in the Middle East

• Some communities on the Red Sea coast of Yemen
  practice FGM/C
• Reports, but no clear evidence, of it in
• Jordan, Oman,
• the Occupied Palestinian Territories (Gaza),
• and some Kurdish communities in Iraq

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Has also been reported in

• India
• Indonesia
• Malaysia

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Age when cut

• Egypt 90 are cut between the ages of 5-14
• Ethiopia, Mali and Mauritania 60 are cut
  before their 5th birthday
• Yemen 76 are cut in the 1st 2 weeks of life

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Medicalization

• In some countries FGM/C is performed in hospitals
  and health clinics by medical professionals
• Fact that medical professions are known to be
  involved may contribute to a general
  misconception to FGM/C is somehow acceptable

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• According to WHO, FGM of any form should not be
  practiced by health professionals in any setting
• However, this has not stopped Egypt
• 61 of cases there have been done by medical
  professionals

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• Medicalization of FGM/C is on the rise
• Especially in Egypt, Guinea and Mali

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Reasons why it continues

• It is the norm that has to be fulfilled. The
  girl must be circumcised to protect her honor and
  the familys honor, especially now girls go to
  universities outside the village and may be
  exposed to lots of intimidating situations.
• From an interview with a woman in Upper Egypt

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Similar to footbinding in China

• Footbinding is thought to have evolved in the
  context of a highly stratified empire
• The emperor and his elite used the practice to
  control the fidelity of their many female
  consorts
• With time this practice was adopted by families
  from lower strata

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• This way their daughters could marry into the
  higher strata
• Eventually footbinding became essentially signs
  in marriageability throughout China

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Six key elements for change

• A non-coercive and non-judgmental approach whose
  primary focus if the fulfillment of human rights
  and the empowerment of girls and women
• Despite taboos regarding the discussion of FGM/C
  the issue emerges because group members are aware
  of the harm it causes

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• An awareness on the part of the community of the
  harm caused by the practice
• Must be non-judgmental and non-directive public
  discussion and reflection
• Costs of FGM/C will become more evident when
  people share their stories

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• The decision to abandon the practice as a
  collective choice of a group that intramarries or
  is closely connected in other ways
• Most affective when community is acting together,
  rather than individuals acting on their own

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• An explicit, public affirmation on the part of
  communities of their collective commitment to
  abandon FGM/C
• May take various forms
• Either joint public declaration in a large public
  gathering or an authoritative written statement

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• A process of organized diffusion to ensure that
  the decision to abandon FGM/C spreads rapidly
  from one community to another and is sustained
• Where there was social pressure to perform FGM/C,
  there must now be social pressure to abandon it

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• An environment that enables and supports change
• The media is crucial in this step

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Physical damage

• Severe pain and bleeding are the most common
  immediate consequences of all forms of FGM/C
• Most done without anesthetic, so female may be in
  a state of medical shock

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• Infection is another common consequence
• Risk of infection can be increased by traditional
  practices, such as binding the legs or applying
  traditional medicines to the wound

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• FGM/C may be a contributory or causal factor in
  maternal death

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Psychological damage

• Since most girls are conscious when performed for
  many there is acute pain, and fear and confusion
• Often psychosomatic disorders exist, too
• Disturbances in eating and sleeping habits
• Recurring nightmares
• Panic attacks
• PTSD
• Difficulties in learning or concentration

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• Urine retention is another common consequence
• Deinfibultion the procedure to re-open the
  orifice after it has been stitched
• Reinfibulation to re-stitch the vagina, usually
  performed after each birth