By Jessica Sutton.
This article contains graphic details which may be distressing to readers.
“It is what my grandmother called the three feminine sorrows. She said the day of circumcision, the wedding night, and the birth of a baby are the triple feminine sorrows.”
Last year, Nada Hassan Abdel-Maqsoud bled to death on an operating table. She was 12 years old. Her parents and aunt had taken her for a procedure known as female genital mutilation (FGM), despite the practice being criminalised in Egypt since 2008. The violent attack on Nada was carried out without anaesthesia by a doctor who has since been arrested.
On International Day of Zero Tolerance for Female Genital Mutilation, we see that stories like Nada’s are horrifyingly common. Female genital mutilation or female genital cutting is a violent procedure that mutilates female genitalia for non-medical reasons. The majority of victims of FGM are aged between infancy and 15 years of age. FGM is one of the most shocking manifestations of sexism and misogyny. It violates a wide variety of human rights, including the right to be free from torture, and the right to life when the procedure leads to the death of the girl involved.
What is FGM?
The World Health Organization classifies FGM in four categories:
Type I FGM, also known as clitoridectomy, involves partial or total removal of the clitoris. This is a highly common form of FGM, which prevents women from experiencing sexual pleasure.
Type II FGM, also known as excision, involves partial or total removal of both the clitoris and the labia minora. This is also a very frequently performed form of FGM, which excludes the possibility of sexual pleasure.
Type III, or infibulation, involves removing the clitoris and the inner and outer labia, and suturing the vagina closed. The vagina may be opened forcefully after marriage or for the purposes of childbirth. Approximately 10% of women who have experienced FGM have full infibulation.
Type IV, involves all other violence to the female genitalia for non-medical purpose, such as burning, stretching, cutting, and application of corrosive substances.
FGM is often described differently in countries where FGM is practised, including using terms such as female circumcision. Use of this term should generally be discouraged as it makes a false analogy to male circumcision, a far less harmful procedure.
It is estimated that 200 million women and girls have experienced FGM worldwide. 3 million are at risk of this form of violence each year. Although FGM is typically associated with Africa and the Middle East, FGM persists globally, including in Asia, North America, Europe, and Australasia. FGM has become common in more countries as migration has increased and the refugee crisis has worsened. It took until 2016 for UNICEF to acknowledge that FGM occurs widely outside of sub-Saharan Africa, and general understandings of FGM still do not encompass the practice’s global scope.
Why does FGM persist?
FGM may date back as far as 5th Century BC. Often the practice is carried out in order to control the ability of women and girls to experience sexual pleasure. Women who have suffered FGM struggle to engage in sexual intercourse due to inability, pain, or lack of pleasure. This is seen as securing the sexual “purity” of girls for marriage. Having the procedure is often regarded as a sign of good morals and appropriate upbringing. The practice is also perpetuated by societal views that natural female genitalia is unattractive and unhygienic. Both men and women are complicit in FGM practices. Women may feel that imposing the procedure on their daughters will allow them to make a good marriage, while men may wish to control the sexuality of female family members.
Damaging myths about FGM are also common, including claims that the procedure is endorsed by religious texts, helps to prevent HIV, and enhances fertility. There is no evidence for these claims.  FGM is not explicitly promoted by any religious text, and the continued belief that FGM is a religious imperative hinders eradication of the practice.
FGM may be performed by traditional practitioners, male barbers, and occasionally female relatives. The procedure typically occurs in unsanitary conditions and without anaesthesia. And while FGM is being performed increasingly by health professionals, the procedure is still extremely unsafe when conducted professionally. Survivors of FGM may experience extreme chronic pain, haemorrhages, chronic infections, urination and menstruation problems, childbirth trauma, HIV, and severe psychological harm. FGM is inescapably harmful to health.
How do we end FGM?
Many countries prohibit FGM in their domestic law. Out of the 28 countries with the highest rates of FGM, 22 have criminalised FGM. Sudan is the most recent country to prohibit FGM, enacting a ban in April 2020. FGM was criminalised in New Zealand in 1996, but continues to impact women here, particularly women from Ethiopian, Eritrean, Sudanese, and Somali communities.
Additionally, international law instruments agree that FGM is a violent and dangerous practice which must be eradicated to secure the human rights of women and girls. The Convention on the Rights of the Child requires prevention of FGM under multiple articles. Article 2 provides that countries must protect the rights of children without discrimination on the basis of sex, religion, ethnicity, social origin, or race. Article 19.2 requires countries to support and protect children who experience physical violence while in the care of a legal guardian. Article 24 provides that countries must recognise and protect children’s rights to access health care. Article 24.3 requires countries to take all appropriate measures to abolish traditional practices that harm children’s health. Article 37 prohibits subjecting children to torture or other degrading or inhuman punishment or treatment.
Another relevant instrument is the Convention on the Elimination of All Forms of Discrimination Against Women, which prohibits discrimination against women. Discrimination has been interpreted to include violence such as FGM. Article 5 provides that all appropriate measures must be taken to alter social and cultural behaviours that cause prejudice against women. Article 12 also states that countries must prevent discrimination against women in healthcare.
Despite these admirable legal developments, FGM is a stubborn practice which continues to harm women and girls worldwide. Even in countries where FGM is prohibited, families may either take girls abroad for the procedure or fly FGM practitioners into the country to perform FGM. Nada lost her life despite Egypt having prohibited FGM years earlier.
Thanks to the work of activists, the rates of FGM dropped significantly up to 2019. However, the practice has gained in strength during the COVID-19 crisis. Women and girls are more vulnerable under the conditions of lockdown, and former FGM practitioners that have lost employment during the pandemic are turning back to FGM to earn a meagre living.
Yet, the World Health Organization has found that the thousand-year scourge of FGM could be ended in a single generation. All that is needed is a change in cultural views and a recognition that ending FGM is about making sure young girls are protected from violence, have control over their own bodies, and can live healthy lives.
FGM simply cannot be justified as a cultural practice. Tradition is not an excuse for violence. The wellbeing of women and girls is paramount, and their right to be free from violence supersedes any cultural imperatives. In any case, cultural traditions are always in flux. As recognition of the human rights of women and girls increases globally, violently misogynist practices such as FGM need to come to an end through dedicated activism and legal developments.
 Dahabo Ali Muse “Feminine Pain” (Somalia).
Image by UN Women.