Female Genital Mutilation: A Call to Protect Women and Girls

Female Genital Mutilation (FGM) is a grave human rights violation that infringes the rights to health, security, and bodily integrity of millions of women and girls worldwide.[1] The international community has unequivocally condemned FGM, enshrining its prohibition in various legal instruments such as the 1979 Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW) among others.[2] However, despite this consensus, recent political developments in Gambia have raised concerns among activists and observers as reports suggest the potential introduction of a new bill aimed at overturning the existing nationwide ban on FGM.[3] Allegedly, the supporters of the repeal argue that such a measure is necessary for cultural preservation and community autonomy, contending that the ban undermines longstanding traditional practices and community rights.[4]

In light of these developments, it is apparent that international law and advocacy have become increasingly crucial for the preservation of the rights as well as dignity of women and girls on a global scale. Therefore, this article aspires to contribute to the ongoing efforts against FGM and encourage discussions that promote gender equality. It emphasizes that advocating against the practice not only safeguards fundamental human rights, but also challenges deep-rooted cultural norms that perpetuate gender discrimination and justify harm. In the framework of international law, such advocacy underscores the urgency of promoting a comprehensive human rights agenda that will bring the world closer to a future where every individual can live free from violence and discrimination.

What is Female Genital Mutilation?

FGM, also known as female circumcision or female genital cutting, is a practice deeply rooted in certain cultural, religious, and social traditions.[5] To clarify, it refers to the partial or total removal of external female genitalia or other injuries to the female genital organs for non-medical reasons. It is typically carried out on young girls, often between infancy and adolescence, and can result in a range of physical, psychological, and sexual health complications.[6] The World Health Organization (WHO) identifies four major types of FGM. [7] Type 1 is clitoridectomy which involves either the complete or partial removal of the clitoral glans, which is the visible and sensitive part of the clitoris, and/or the removal of the clitoral hood, the skin fold that covers the clitoral glans.[8] Type 2 is excision which entails the removal of the clitoral glans, the inner folds of the vulva known as the labia minora, and possibly the outer folds of the vulva, known as the labia majora, either partially or completely.[9] Type 3, known as infibulation, is characterized by the narrowing of the vaginal opening by creating a seal. This seal is made by altering and repositioning the labia minora or labia majora, sometimes with stitches. It may also involve removing the clitoral hood and glans, depending on the procedure.[10] Last but not least, type 4 refers to any other non-medically necessary procedures on female genitalia, including activities like pricking, piercing, incising, scraping, and cauterizing in various forms.[11]

Based on data from national studies and indirect estimates, FGM has been reported in 92 countries to date.[12]Therefore, since FGM goes beyond geographical boundaries, motivations vary significantly among different regions and cultures, often reflecting diverse social as well as traditional beliefs.[13] For instance, in certain communities, FGM is perceived as a crucial rite of passage marking a girl's transition into womanhood. This ceremonial aspect is deeply ingrained, emphasizing cultural identity and continuity through generations.[14] Furthermore, FGM is sometimes viewed as a means to uphold female purity and chastity, ensuring that a woman remains "clean" for her future husband. This belief stems from the notion that reducing a woman's sexual desire and pleasure will help maintain fidelity within marriage and preserve family honor. Many families adhere to these beliefs, convinced that FGM enhances their daughters' marriage prospects and secures their future within the community.[15]

In addition to cultural and social reasons, economic factors may also influence the prevalence of FGM as a practice. In some communities, where suitability for marriage is closely tied to economic stability and social status, the procedure is seen as an essential prerequisite for a girl to be considered eligible for marriage. Moreover, in certain cultures FGM might even be obligatory for a woman to receive inheritance.[16] Nevertheless, it is worthy to note that the continuation of the practice is also due to the perpetuation of harmful myths about female genitalia, such as the idea that itching, odor, or abnormal growth of the clitoris necessitates cutting for health benefits or fertility.[17] There are instances, though, where healthcare providers themselves perform FGM.[18] This can be influenced by several reasons, such as the misconception that medicalized FGM carries fewer health risks compared to traditional methods.[19] Some practitioners may also view medicalization as a potential step towards the eventual abandonment of the practice, believing that offering safer procedures could eventually lead to the cessation of more harmful forms of FGM.[20]

Health Consequences of Female Genital Mutilation

Nonetheless, FGM regardless of whether it is conducted by medical professionals or traditional practitioners can have tremendous consequences on the physical health of women and girls. In fact, there is no scientific evidence supporting any therapeutic benefits of FGM.[21] Immediately following the procedure, individuals may suffer from severe pain, excessive bleeding (hemorrhage), genital tissue swelling, fever, infections (e.g., tetanus), wound healing problems, injury to surrounding genital tissue, and shock. In some tragic cases, these complications can lead to death.[22]In the long term, complications may include urinary problems such as painful urination and urinary tract infections, vaginal problems like discharge, itching, and bacterial vaginosis, menstrual issues such as painful menstruations and difficulty in passing menstrual blood, formation of scar tissue and keloids. Sexual problems are also reported namely pain during intercourse and decreased satisfaction.[23] During childbirth, complications resulting from FGM can create substantial risks for both the mother and child. These include challenging deliveries, increased bleeding, higher chances of needing a cesarean section, and the necessity for subsequent surgeries like deinfibulation (the procedure to open the sealed vaginal opening, often required multiple times throughout a woman's life). Additionally, there is a risk of newborn death.[24]

Psychological effects are also commonly reported among women who have undergone the procedure. The experience includes intense pain inflicted during the procedure, exacerbated by the physical restraint imposed by caregivers whom the girl may have trusted. This trauma extends to secondary complications like infections and urinary issues, impacting bladder and bowel control.[25] Psychological effects are pervasive, potentially leading to post-traumatic stress disorder (PTSD), characterized by intrusive thoughts, dissociation, and heightened sensitivity to triggers such as medical examinations or specific sensory stimuli. The procedure's aftermath, including vaginal discharge and odor, can severely impact self-esteem and social confidence.[26] Additionally, as previously mentioned, there are implications for relationships, including distrust and challenges in sexual intimacy, which can further exacerbate feelings of worthlessness and depression. Women may also experience somatic symptoms, anxiety disorders, and in severe cases, thoughts of self-harm or suicide. Thus, the psychological toll of FGM encompasses a spectrum of debilitating effects that endure long after the physical wounds have healed.[27]

Advocating for the Eradication of Female Genital Mutilation

Taking into account the detrimental impact of FGM on the health of women and girls, it is no secret that it constitutes a violation of multiple rights enshrined in a number of international legal instruments. The 1948 Universal Declaration of Human Rights (UDHR) asserts that everyone has the right to life, liberty, and security (Article 3). FGM contravenes this by subjecting women and girls to extreme physical and psychological harm.[28] The CEDAW also further emphasizes the need to eliminate cultural practices that perpetuate discrimination against women.[29] Regionally, the 2005 African Charter on Human and Peoples' Rights (Maputo Protocol) specifically mandates under Article V the prohibition of FGM and calls for legal action against perpetrators.[30] Moreover, various international organizations explicitly condemn FGM. The WHO classifies it as a violation of the rights of children and women. The United Nations (UN) has passed multiple resolutions urging member states to enact and enforce laws against FGM. For instance, the UN General Assembly Resolution 69/150 calls for intensified global efforts to eliminate the practice.[31]

However, despite the critical role that these instruments and organizations play, the enforcement of policies, laws and regulations remains weak.[32] This weakness can be attributed to several factors. Firstly, cultural traditions and deep-rooted social norms such as FGM often perpetuate harmful practices, making communities resistant to change.[33] Secondly, there is frequently a lack of awareness and education about the adverse effects of FGM, both among the general population and within local authorities.[34] Additionally, in many regions, there are insufficient resources and training for law enforcement and judicial personnel to effectively implement and uphold anti-FGM laws.[35] Corruption and lack of political will further undermine enforcement efforts. In some cases, local leaders and officials may themselves support the practice or fear backlash from their communities if they actively work against it.[36] Furthermore, in remote and rural areas, the reach of government and non-governmental organizations (NGOs) is often limited, making it challenging to monitor and intervene in FGM practices.[37]

Hence, advocating against FGM is a critical step in upholding fundamental rights. Advocacy efforts not only raise awareness about the severe health risks and human rights violations associated with FGM, but also empower communities to challenge and change harmful traditions. By fostering dialogue and education, advocates can dismantle the cultural and social norms that perpetuate FGM, promoting gender equality and the protection of women and girls. Furthermore, robust advocacy can pressure governments and international bodies to strengthen legal frameworks, allocate necessary resources, and ensure rigorous enforcement of anti-FGM laws. Ultimately, sustained advocacy is essential for creating a global environment where the rights of women and girls are fully respected, and where harmful practices like FGM are eradicated once and for all.

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Reference List:

[1] Türkkan Tuğba and Odacı Hatice, ‘Violence Against Women: A Persistent and Rising Problem’ (2024) 16 Psikiyatride Güncel Yaklaşımlar 214.

[2] Crews Ruby, ‘Female Genital Mutilation in International Law: Approaches of International and Regional Legal Frameworks.’ (2020) 48 Denver Journal of International Law and Policy 93-101.

[3] Jawo Kaddy, ‘Over My Dead Body’, Say Gambian Mothers amid Efforts to Lift FGM Ban’ (Al Jazeera) <https://www.aljazeera.com/features/2024/3/28/mothers-fight-to-protect-daughters-as-the-gambia-considers-unbanning-fgm> accessed 14 June 2024. (hereafter ‘Kaddy’)

[4] Kaddy.

[5] United Nations Population Fund (UNFPA), ‘Female Genital Mutilation (FGM) Frequently Asked Questions’ <https://www.unfpa.org/resources/female-genital-mutilation-fgm-frequently-asked-questions> accessed 14 June 2024. (hereafter ‘UNFPA’)

[6] Committee on the Elimination of Discrimination against Women (CEDAW) and Committee on the Rights of the Child (CRC), Joint General Recommendation No 31 of the Committee on the Elimination of Discrimination against Women/General Comment No 18 of the Committee on the Rights of the Child on Harmful Practices, CEDAW/C/GC/31-CRC/C/GC/18, 21 October 2014, para. 19.  

[7] World Health Organization (WHO), ‘Female Genital Mutilation’ <https://www.who.int/news-room/fact-sheets/detail/female-genital-mutilation> accessed 14 June 2024. (hereafter ‘WHO’)

[8] Lisa Caroline, ‘What Is FGM?’, Talking About Female Genital Mutilation, vol 1 (1st edn, Routledge 2023) 13-15.

[9] Lisa.

[10] Lisa, 14.

[11] Lisa, 15.

[12] UNFPA.

[13] 28 Too Many, ‘FGM Model Law’ (2020) 9 <https://www.trust.org/contentAsset/raw-data/0742fb19-6673-47d6-8665-28495f0dda8f/file> accessed 14 June 2024.

[14] Proudman Charlotte, ‘Women’s Stories of Female Genital Mutilation’ in Charlotte Proudman (ed), Female Genital Mutilation: When Culture and Law Clash (Oxford University Press 2022), 32. (hereafter ‘Proudman’)

[15] Proudman, 33.

[16] United Nations Children's Fund (UNICEF), ‘Annual Report To The U.S. Department Of State – Eliminating Female Genital Mutilation’ (2021) 15.

[17] Lisa Caroline, ‘Why Is FGM Carried Out?’, Talking About Female Genital Mutilation, vol 1 (1st edn, Routledge 2023) 28, 29.

[18] WHO.

[19] WHO.

[20] WHO.

[21] Yaya Sanni and Ghose Bishwajit, ‘Female Genital Mutilation in Nigeria: A Persisting Challenge for Women’s Rights’ (2018) 7 Social Sciences 244 1.

[22] Kandala Ngianga-Bakwi and Komba Paul Nzinga, ‘Health Consequences of FGM/C’, Female Genital Mutilation around The World: Analysis of Medical Aspects, Law and Practice (Springer International Publishing AG 2018) 99-102. (hereafter ‘Kandala and Komba’)

[23] Kandala and Komba.

[24] Berg Rigmor C. and Underland Vigdis, ‘The Obstetric Consequences of Female Genital Mutilation/ Cutting: A Systematic Review and Meta-Analysis’ [2013] Obstetrics and Gynecology International 10-12.

[25] Knipscheer Jeroen and others, ‘Mental Health Problems Associated with Female Genital Mutilation’ (2015) 39 BJPsych Bulletin 276. (hereafter ‘Knipscheer and others’)

[26] Knipscheer and others.

[27] Lisa Caroline, ‘How FGM Affects Girls and Women’, Talking About Female Genital Mutilation, vol 1 (1st edn, Routledge 2023) 37,38.

[28] UN General Assembly, Universal Declaration of Human Rights (adopted 10 December 1948 UNGA Res 217 A(III)) Article 3.

[29]  United Nations General Assembly, Convention on the Elimination of All Forms of Discrimination Against Women (adopted 18 December 1979, entered into force 3 September 1981) 1249 UNTS 13 Article 2.

[30] African Union, Protocol to the African Charter on Human and Peoples' Rights on the Rights of Women in Africa (adopted 11 July 2003, entered into force 25 November 2005) CAB/LEG/66.6 Article V - Elimination Of Harmful Practices.  

[31] United Nations General Assembly, 'Intensifying Global Efforts for the Elimination of Female Genital Mutilations' (18 December 2014) UN Doc A/RES/69/150 para. 2.

[32] Organisation for Economic Co-operation and Development (OECD), 'Building Holistic and Effective Systems to Tackle Gender-Based Violence' in Breaking the Cycle of Gender-Based Violence: Translating Evidence into Action for Victim/Survivor-Centred Governance (OECD Publishing 2023) 70.

[33] Crews, 102.

[34] Ackah Josephine Akua and others, ‘Circumcising Daughters in Nigeria: To What Extent Does Education Influence Mothers’ FGM/C Continuation Attitudes?’ (2022) 2 PLOS Global Public Health 5-12.

[35] Tholaine Matadi M. and Calvino Lizelle Ramaccio, ‘Addressing Gender-Based Violence Epidemic Through Criminal Justice: A Case Study of South Africa and the DRC’ in Emma Charlene Lubaale and Ashwanee Budoo-Scholtz (eds), Violence Against Women and Criminal Justice in Africa: Volume I: Legislation, Limitations and Culture (Springer International Publishing 2022) 55.

[36] Tholaine and Calvino.

[37] Youssouf Traore and others, ‘Does Non-Governmental Organizations Sensitization Have Positive Impact on Rural Community Awareness, Prevalence and Complications of Female Genital Mutilation/Cutting? Analyze of the Practice in Rural Setting in Mali’ (2019) 9 Journal of The Society of Obstetricians and Gynaecologists of Pakistan 143-145.