Female genital mutilation


There are public campaigns to stop female genital circumcision, but it is still practised in many countries. - File pix

Dear Dr G,  

I am really sorry to put you on the spot, but I am quite interested to find out about the practice of female circumcision and what harm is it to women.  

In conjunction with the International Women’s Day recently, I have come across an article condemning the practice of female circumcision.  

I am just curious to find what exactly is female circumcision and how is it different from male circumcision?  

How common is such a practice?

What exactly is done for this procedure and is it just a simple ritual?  

I look forward to hearing from you.  

Regards

Les  

Female circumcision is a practice more commonly known as female genital cutting or female genital mutilation (FGM). According to Unicef estimates, such a practice affected 200 million women worldwide, ranging from Africa, Middle East and Asia.  

Such ritual is often accepted within a community as it is perceived as a source of honour, and the failure to comply will expose the girls to social exclusion.  

As this is considered a social norm in some countries, it has become a strong motivation to perpetuate the practice. Though there is no religious script prescribing FGM, many practitioners still argue the practice has religious support.  

FGM essentially is a procedure, carries no health benefits, but intentionally alter the female genital organs surgically.  

The traditional circumciser, who holds central roles in the communities, mostly performs the practice.  

Although the ritual is varied between differing communities, the mutilation usually involves the cutting of clitoral hood and glans, inner and outer labial and the closure of valve.  

As the intervention is carried out on girls from birth to puberty, this can potentially result in small passage genitalia adequate only for the passage of urine and menstruation.  

The medical community has recognised FGM to be classified into four subtypes.  

The type 1 FGM is often referred as clitoridectomy. This is the partial or complete removal of the clitoris. The type 2 FGM is also synonymous as genital excision.  

In this practice, the inner folds of the vulva are either partially or completely excised and the outer folds of the skin of the vulva are left unaffected.  

Type 3 FGM is often called infibulation. This is the narrowing of the vaginal opening created by cutting and stitching of the labial minora.  

And lastly, the type 4 FGM is also noted to mutilate the child’s genitalia by incising, scraping and cauterising of the genital area. It is difficult not to feel sad that such practice is still prevalent in modern society.  

Of course, with such degree of dismemberments of the genitalia, there will be short-term and long-term consequences. 

The common immediate adversity can include pain, swelling, bleeding and infection.  

In the long run, apart from permanent disfigurement, the women are also known to encounter urinary tract infections, bacterial vaginosis, painful menstruations; difficulties in intercourse and increase risk of childbirth complications.  

Many advocates of FGM argue, in the moral and medical standpoints, there is little difference between male and female circumcisions.  

In May 2016, the World Health Organization in collaboration with Unicef launched the evidence-based research and guidelines, highlighting the best available evidence on health interventions for women with FGM.  

In reality, the health benefits and adversity of male circumcision measured against the female genital cutting are incomparable.  

Medicine has progressed in quantum leap since the dark days of Isaac Baker Brown, an English gynecologist, who believed that masturbation of the clitoris, can cause hysteria, fits, idiocy, mania and death in women.  

Brown performed clitoridectomies between 1859 and 1866, and published his work on the curability of certain form of insanity, epilepsy, catalepsy and hysteria in women.  

Rightly so, Brown was expelled from the Obstetrical Society by his peers, accused of quackery.  

It is hard to believe, even in the 21st century, parents who love their own daughters, still perceive that mutilation of genital cutting is a necessary part of raising a girl and a way to prepare her for adulthood and marriage.  

In the spirit of International Women’s Day, shouldn't  we be aware that such mutilation is still affecting 200 million girls worldwide and actively condemned it to the historic past? 

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