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What
is female genital mutilation?
Female genital
mutilation (FGM), often referred to as 'female
circumcision', comprises all procedures involving
partial or total removal of the external female genitalia or
other injury to the female genital organs whether for
cultural, religious or other non-therapeutic reasons. There
are different types of female genital mutilation known to be
practised today. They include:
- Type I
- excision of the prepuce, with or without excision of
part or all of the clitoris;
- Type II
- excision of the clitoris with partial or total
excision of the labia minora;
- Type
III - excision of part or all of the external genitalia
and stitching/narrowing of the vaginal opening (infibulation);
- Type IV
- pricking, piercing or incising of the clitoris and/or
labia; stretching of the clitoris and/or labia;
cauterization by burning of the clitoris and surrounding
tissue;
-
scraping of tissue surrounding the vaginal orifice (angurya
cuts) or cutting of the vagina (gishiri cuts);
-
introduction of corrosive substances or herbs into the
vagina to cause bleeding or for the purpose of
tightening or narrowing it; and any other procedure that
falls under the definition given above.
The most
common type of female genital mutilation is excision of
the clitoris and the labia minora, accounting for up to
80% of all cases; the most extreme form is
infibulation, which constitutes about 15% of all
procedures.
Health
consequences of FGM
The
immediate and long-term health consequences of female
genital mutilation vary according to the type and severity
of the procedure performed.
Immediate
complications include severe pain, shock, haemorrhage,
urine retention, ulceration of the genital region and injury
to adjacent tissue. Haemorrhage and infection can
cause death.
More
recently, concern has arisen about possible transmission of
the human immunodeficiency virus (HIV) due to the use
of one instrument in multiple operations, but this has not
been the subject of detailed research.
Long-term
consequences include cysts and abscesses, keloid scar
formation, damage to the urethra resulting in urinary
incontinence, dyspareunia (painful sexual intercourse) and
sexual dysfunction and difficulties with childbirth.
Psychosexual and psychological health: Genital
mutilation may leave a lasting mark on the life and mind of
the woman who has undergone it. In the longer term, women
may suffer feelings of incompleteness, anxiety and
depression.
Who
performs FGM, at what age and for what reasons?
In cultures
where it is an accepted norm, female genital mutilation is
practiced by followers of all religious beliefs as well as
animists and non believers. FGM is usually performed by a
traditional practitioner with crude instruments and without
anaesthetic. Among the more affluent in society it may be
performed in a health care facility by qualified health
personnel. WHO is opposed to medicalization of all the types
of female genital mutilation.
The age at
which female genital mutilation is performed varies from
area to area. It is performed on infants a few days old,
female children and adolescents and, occasionally, on mature
women.
The
reasons given by families for having FGM performed
include:
-
psychosexual reasons: reduction or elimination of the
sensitive tissue of the outer genitalia, particularly
the clitoris, in order to attenuate sexual desire in the
female, maintain chastity and virginity before marriage
and fidelity during marriage, and increase male sexual
pleasure;
-
sociological reasons: identification with the cultural
heritage, initiation of girls into womanhood, social
integration and the maintenance of social cohesion;
- hygiene
and aesthetic reasons: the external female genitalia are
considered dirty and unsightly and are to be removed to
promote hygiene and provide aesthetic appeal;
- myths:
enhancement of fertility and promotion of child
survival;
-
religious reasons: Some Muslim communities, however,
practise FGM in the belief that it is demanded by the
Islamic faith. The practice, however, predates Islam.
Prevalence and distribution of FGM
Most of the
girls and women who have undergone genital mutilation live
in 28 African countries, although some live in Asia and the
Middle East. They are also increasingly found in Europe,
Australia, Canada and the USA, primarily among immigrants
from these countries.
Today, the
number of girls and women who have been undergone female
genital mutilation is estimated at between 100 and 140
million. It is estimated that each year, a further 2 million
girls are at risk of undergoing FGM.
Current WHO
activities related to FGM
-
Advocacy and policy development
A joint
WHO/UNICEF/UNFPA policy statement on FGM and a Regional Plan
to Accelerate the Elimination of FGM were published
to promote policy development and action at the global,
regional, and national level. Several countries where FGM is
a traditional practice are now developing national plans of
action based on the FGM prevention strategy proposed by WHO.
A major
objective of WHO's work on FGM is to generate knowledge,
test interventions to promote the elimination of FGM.
Research protocols on FGM have been developed with a network
of collaborating research institutions as well as biomedical
and social science researchers with linkages to appropriate
communities. WHO has reviewed programming approaches for the
prevention of FGM in countries and has organized training
for community workers to strengthen their effectiveness in
promoting prevention of FGM at the grassroots level.
-
Development of training materials and training for
health care providers
WHO has
developed training materials for integrating the prevention
of FGM into nursing, midwifery and medical curricula as well
as for in-service training of health workers. Evidence based
training workshops, to raise the awareness of health workers
and to solicit their active involvement as advocates against
FGM, have also been developed for nurses and midwives in the
African and Eastern Mediterranean region.
For more information contact:
WHO Media
centre
Telephone: +41 22 791 2222
E-mail:
mediainquiries@who.int
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