Gambia’s parliament recently approved a bill banning female genital mutilation (FGM) and setting high penalties of imprisonment and fines for offenders. The passage of the law came shortly after Gambian President Yahya Jammeh had condemned the practice for not being commanded in the Quran. According to a 2010 report, 63 percent of Gambian woman and children aged from 14 to 49 have been subject to FGM.

FGM was defined in 1997 by the WHO, UNICEF and UNFPA as the “partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons.” Procedures for circumcision differ according to the ethnic group, but they include removal of the clitoral hood and clitoral glands, removal of the inner labia, and in the most severe form (known as infibulation) removal of the inner and outer labia and closure of the vulva. In this last procedure, a small opening is left for the passage of urine and menstrual fluid; the vagina is opened for intercourse and opened further for childbirth. FGM is conducted from days after birth to puberty and beyond.

FGM is prevalent in 29 African countries, Yemen, Iraqi Kurdistan, and elsewhere in Asia, the Middle East, and other scattered communities around the world. However, of the more than 125 million girls and women alive today who have undergone the procedure, one in four live in Egypt. That is more than any other country in the world. According to a government report released in May 2015, 92% percent of married Egyptian women aged 15 to 49 have been subjected to FGM. This figure is down from 97% in 2010, probably because FGM has been illegal in Egypt since 2008. However, the practice remains woven into the very fabric of Egyptian society, where many see cutting as a way to “purify” a girl and to show she is ready for marriage.

The practice of FGM has been the subject of international concern and is considered to be a global health issue. FGM has no medical benefits and can cause lifelong physical and emotional trauma for the women who have undergone the procedure. The UN has consistently campaigned for an end to FGM, labeling the practice, among other things, gender-based discrimination, torture, an affront to human dignity and an irreparable, irreversible abuse of the human rights of women and girls. However, FGM has proven to be difficult to eradicate.

Experts that have studied the issue point out that part of the difficulty in the campaigns attempting to eliminate the practice is the common misconceptions around FGM. One misconception is that it is men that force FGM on women. In fact, elderly women often do the most to perpetuate the custom. Many women undergo circumcision voluntarily, and joyfully partake in the ritual. For young girls circumcision becomes a way to prove that they are worthy of the challenge of being a woman. Female circumcision is part of demarcating insider and outsider status. By being circumcised girls become members of a group of elder women who have more power in their community. So, even though the argument is being made that FGM is about the control of women and their sexuality and sexual pleasure, data shows that across Africa, the support for the practice is stronger among women than among men. Women who support the practice justify its perpetuation by saying that FCM is women’s business. As in, it is for women to decide this. In the U.S., adult women are capable of giving consent for surgical procedures, some of which are arguably similar in nature as FGM, consider for instance, a breast reduction, a surgical procedure common in the US and other Western countries. The issue is one of free will. What would it take to get a woman in an African country to be in the same position of being able to give consent? Social pressures in the nations that practice FGM are so strong that no woman could ever opt out. Thus, women who undergo the procedure, even those who seem willing and even proud to participate, might not be doing it really because they want to, but because they feel that to be respected members of the community they have to comply with this custom.

The argument about the lack of free will of those being circumcised is even more powerful in cases where children are forced to have the procedure. In half the countries for which national figures are available, most girls are cut before the age of five. Arguing against suggested similarities between FGM and body shaping in Western countries, philosopher Martha Nussbaum has stated that a key difference is that FGM is often conducted on children using physical force.

It is important to note that FGM is not an individual behavior, such as it could be the decision to undergo a certain surgical procedure for cosmetic reasons. Deciding not to circumcise a daughter is not an individual behavior. That decision would have to be explained to the immediate family (husband, siblings, etc.), to the extended family (the in-laws), and the in-laws would have to answer to their friends throughout the community, which makes the decision particularly difficult to make given the societal pressure.

Perhaps the best strategy to eliminate FGM is to warn about the negative health consequences to the women who undergo the procedure. The dangers and lifelong health problems that women experience after the procedure are particularly serious in communities where the traditional way of circumcision does not include sterilized instruments, antibiotics, and other measures to minimize health complications. So far, it appears that these are the arguments that are most effective in persuading those who believe in tradition that there are some traditions that must be ended, and there has been some progress in the drive to end FGM.

So far, 24 of the 29 countries where FGM is concentrated have enacted legislation against FGM. In the countries were FGM is a common practice, the percentage of girls aged 15 to 17 that have had the procedure has dropped from 74.4% in 2008, to 56% in 2015. In May 2015, as one of his final acts as president, Goodluck Jonathan banned the procedure in Nigeria. Somalia recently announced that it will introduce a law that will ban FGM, as well. This is a significant step in the right direction as Somalia has one of the highest rates of female genital mutilation in the world. Egypt has announced a plan to reduce FGM by 10-15% in the next five years. If it works, it will mean that for the first time in decades, “uncut” girls would outnumber those who have had the procedure.

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