Female Genital Mutilation(FGM) and its impact: an overview

Context:

• Positive developments are taking place with regard to female genital mutilation(FGM).

Why in news?

• The group of Dawoodi Bohra women, who were subject to female genital mutilation (FGM) ,recently began speaking about it publicly, has “shone a light” upon the often debilitating, secretive process in India.
• A newly formed association of women from the community described it as khatna, khafz, or female circumcision.
• khatnais often done by the traditional cutters, some of whom have performed several thousands of procedures, a fact that would be consistent with the number of known cases of botched procedures.

What is female genital mutilation (FGM)?

• Female genital mutilation(FGM), also known as female genital cutting and female circumcision, is the ritual cutting or removal of some or all of the external female genitalia.
• The practice is found in Africa, Asia and the Middle East, and within communities from countries in which FGM is common.
• UNICEF estimated in 2016 that More than 200 million girls and women alive today have been cut in 30 countries in Africa, the Middle East and Asia where FGM is concentrated.
• FGM is mostly carried out on young girls between infancy and age 15.

Reasons for performing FGM:

Cultural and social factors:

. The most commonly cited reasons are:

• Where FGM is a social convention (social norm), the social pressure to conform to what others do and have been doing, as well as the need to be accepted socially and the fear of being rejected by the community.
• FGM is often considered a necessary part of raising a girl, and a way to prepare her for adulthood and marriage.
• FGM is often motivated by beliefs about what is considered acceptable sexual behaviour.
• It aims to ensure premarital virginity and marital fidelity.
• FGM is in many communities believed to reduce a woman’s libido and therefore believed to help her resist extramarital sexual acts.
• FGM is associated with cultural ideals of femininity and modesty.
• Though no religious scripts prescribe the practice, practitioners often believe the practice has religious support.
• In most societies, where FGM is practised, it is considered a cultural tradition, which is often used as an argument for its continuation.
• In some societies, recent adoption of the practice is linked to copying the traditions of neighbouring groups. Sometimes it has started as part of a wider religious or traditional revival movement.

Impacts of female genital mutilation on the health of women:

FGM harms girls and women in many ways:

• Female genital mutilation (FGM) includes procedures that intentionally alter or cause injury to the female genital organs for non-medical reasons.
• Procedures can cause severe bleeding and problems urinating, and later cysts, infections, as well as complications in childbirth and increased risk of newborn deaths.
• FGM is a violation of the human rights of girls and women.
• It involves removing and damaging healthy and normal female genital tissue, and interferes with the natural functions of girls’ and women’s bodies.

Immediate complications can include:

• severe pain
• excessive bleeding (haemorrhage)
• genital tissue swelling
• fever
• infections e.g., tetanus
• urinary problems
• wound healing problems
• injury to surrounding genital tissue
• shock
• death

Long-term consequences can include:

• urinary problems (painful urination, urinary tract infections);
• vaginal problems (discharge, itching, bacterial vaginosis and other infections);
• Menstrual problems (painful menstruations, difficulty in passing menstrual blood, etc.);
• scar tissue and keloid;
• Sexual problems (pain during intercourse, decreased satisfaction, etc.);
• increased risk of childbirth complications (difficult delivery, excessive bleeding, caesarean section, need to resuscitate the baby, etc.) and newborn deaths;
• Psychological problems (depression, anxiety, post-traumatic stress disorder, low self-esteem, etc.).

Why this practice consider as violation of fundamental and human rights:

• FGM is recognized internationally as a violation of the human rights of girls and women.
• It reflects deep-rooted inequality between the sexes, and constitutes an extreme form of discrimination against women.
• It is nearly always carried out on minors and is a violation of the rights of children.
• The practice also violates a person’s rights to health, security and physical integrity, the right to be free from torture and cruel, inhuman or degrading treatment, and the right to life when the procedure results in death.

International efforts to curb this problem:

• WHO strongly urges health professionals not to perform such procedures.
• In 1997, WHO issued a joint statement against the practice of FGM together with the United Nations Children’s Fund (UNICEF) and the United Nations Population Fund (UNFPA).

• In 2007, UNFPA and UNICEF initiated the Joint Programme on Female Genital Mutilation/Cutting to accelerate the abandonment of the practice.
• In 2008, WHO together with 9 other United Nations partners, issued a statement on the elimination of FGM to support increased advocacy for its abandonment, called: “Eliminating female genital mutilation: an interagency statement”.
• In 2010, WHO published a “Global strategy to stop health care providers from performing female genital mutilation” in collaboration with other key UN agencies and international organizations.
• In December 2012, the UN General Assembly adopted a resolution on the elimination of female genital mutilation.
• In 2016 UNICEF launched an updated report documenting the prevalence of FGM in 30 countries, as well as beliefs, attitudes, trends, and programmatic and policy responses to the practice globally.
• In May 2016, WHO in collaboration with the UNFPA-UNICEF joint programme on FGM launched the first evidence-based guidelines on the management of health complications from FGM. The guidelines were developed based on a systematic review of the best available evidence on health interventions for women living with FGM.

Solutions:

• Emphasizing the need for concerted action in all sectors – health, education, finance, justice and women’s affairs.
• Strengthening the health sector response: guidelines, tools, training and policy to ensure that health professionals can provide medical care and counselling to girls and women living with FGM;
• Building evidence: generating knowledge about the causes and consequences of the practice.