The inner or outer labia are cut and repositioned. This practice may or may not include the removal of the clitoris. Other procedures include cauterizing, scraping, incising, pricking, or piercing the genital area, for reasons other than medical purposes. The WHO describes this type as "all other harmful procedures to the female genitalia for non-medical purposes" and includes practices including pricking, piercing, incising, scraping, and cauterizing the genital area. Removing normal, healthy genital tissue does not provide any health benefits, and undermines a woman's natural functions.
It can also lead to complications. The exact number of fatalities due to FGM is not known, but in parts of Somalia where there are no antibiotics , it has been suggested that 1 in 3 girls who undergo the operation die because of the practice. If the opening has been narrowed, it will need to be reopened before marriage to enable sexual intercourse and childbirth. In some cultures, this opening and narrowing is done several times throughout a female's life. In some places, FGM is a relatively new practice that communities have adopted from neighboring communities.
In some cases, it is the revival of an old custom. Immigrants to places where FGM is not practiced may take the custom with them, and people who move into a location where it is practiced may adopt it. In Africa alone, it is believed that approximately 92 million girls aged 10 years and over have undergone FGM procedures.
Approximately 3 million girls in Africa are thought to undergo FGM each year. In eight countries, the prevalence is 80 percent. There is no medical reason for FGM. The practice occurs for a combination of reasons, based on cultural, social, and religious practices. In societies with low literacy rates, social convention says, "it is what others do, and what we have always done.
In some communities, women who have not undergone FGM are not allowed to handle food and water because they are unclean, and seen as posing a health risk to others. For these societies, it is the "proper" thing to do as a part of the female upbringing. It is said to prepare a girl for marriage and adult life. In some cultures, people believe that an uncut clitoris will grow to the size of a penis, or that FGM makes a woman more fertile.
To some, FGM represents decent sexual behavior. FGM is often linked to virginity and being faithful during marriage. The damage to the genitalia means the chance of a woman having illicit sexual relations is reduced - because her libido is decreased, and the opening is too narrow.
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Femininity and modesty can be a factor. In some societies, a woman is perceived to be cleaner and more beautiful if her genitals are cut. Some body parts, such as the clitoris, which protrudes, are seen as male and unclean. None of the major religions prescribes female circumcision. People in some communities, especially where there are low levels of literacy, may have heard that the practice is a religious one.
Over time, religions have tolerated, encouraged, and condoned the practice; but, today, many religious leaders are against FGM and are involved in the movement to eradicate its practice. If the people with power and authority in a place believe and agree that FGM should prevail, it is difficult to prevent it. People who may insist on its continuing include local chiefs, religious leaders, practitioners of FGM and circumcision, and some healthcare professionals. Most countries in the world consider FGM a violation of a woman's human rights and an extreme form of discrimination against females in the community.
As most procedures are carried out on young girls, it is also a violation of children's rights. The WHO write:. In , the World Health Assembly passed a resolution on the elimination of FGM, calling for action by all those involved in justice, women's affairs, education, finance, and health. In , the United Nations adopted a resolution banning FGM worldwide , stating that "All necessary measures, including enacting and enforcing legislation to prohibit FGM and to protect women and girls from this form of violence, and to end impunity.
While the intervention is somewhat safer when carried out by a doctor, the WHO urges health professionals not to perform FGM. The drive to ban it has not significantly reduced its incidence. More recently, some researchers have proposed softening the approach and reclassifying it to what they call "female genital alteration. In order to respect cultural differences while protecting women's health, they propose classifying interventions according to their effect rather than the procedure that is involved.
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They suggest accepting minimal procedures that do not entail long-term health risks. They say that this approach is "culturally sensitive, does not discriminate on the basis of gender, and does not violate human rights. Article last updated on Mon 15 May All references are available in the References tab. Arora, K.
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Female genital mutilation: A compromise solution. The Journal of Medical Ethics. Female genital cutting. Reymond, L. Female genital mutilation - the facts.
United Nations UN. International day of zero tolerance to female genital mutilatilation. Female genital mutilation FGM frequently asked questions. Female genital mutilation. Female genital mutilation - Trends in FGM in countries where the practice is concentrated. MLA Novakovic, Alex. MediLexicon, Intl.
APA Novakovic, A. MNT is the registered trade mark of Healthline Media.
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Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional. Privacy Terms Ad policy Careers. These efforts have met with limited success and some cultural groups have decried the trampling of their traditions. Some bioethicists support harm-reduction strategies in which a minor type of female genital cutting is used in medical practice to ensure safety and prevent use of more severe forms of the procedure. Examples include the Harborview hospital compromise and the policy statement of the American Academy for Pediatrics.
The AAP clarified that it considered a nick to be less invasive than male circumcision. These proposals were met with vociferous objections and generated so much controversy that both parties eventually walked back their statements. They propose a zero-tolerance strategy prohibiting all forms of the practice, including the nick.
Allowing any type of it within the scope of medicine is thought to add undeserved legitimacy to them. This strategy has been adopted by leading international public health institutions, such as the WHO and the United Nations.
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There is a dire need for a reasoned dialogue and open debate over female genital cutting and the ethical responsibilities of physicians. As a society, we need to understand the issues at stake, carefully weigh the harms to individuals and communities, and then use law and policy to regulate the boundaries of this practice. Informed discussion can only take place when we use language that does not marginalize and pre-judge, that opens dialogue rather than obstructs it.
Thus, like others before us, we believe that the term female genital mutilation, or FGM, should be discarded in favor of more neutral terminology. No doctor willfully seeks to mutilate. As we ask others to reexamine their rituals, we should reevaluate our use of language. For the terminology we use might reveal our unconscious biases, and a neutral stance is needed to allow the voices of those who engage in the practice to be heard.
Next, we require an accurate understanding of the procedures and data about their harms. To have a productive conversation about harm-reduction we need to understand all of the harms involved, both when the procedure is performed and when it is not. Thus, the medical data on harms and complications post-FGC; information about the social and psychological harms that accrue when these procedures take place and, importantly, when they are not performed; and anthropological data about the significance of these procedures in their cultural contexts all need to be brought to the dialogue.
We need to objectively and critically examine both what we do and do not know before making moral assessments and delineating a path forward. In sum, we call for a reasoned public dialogue about how best to eradicate harmful forms of female genital cutting through education, policies, and laws.
We also encourage debate in the bioethics academy about how doctors can fulfill their ethical responsibilities while acknowledging the religious traditions of their patients. Aasim I. Follow their work on Twitter Initiative4IM. Why do you begin by confidently describing what Nagarwala did reportedly to hundreds of girls as a mere nick?
How do you know what she has been doing? And under what perverse regime could you equally confidently describe the motivations of the people who do this as having to do with gender equity? Nagarwala, as well as the parents and their daughters, are all part of the Dawoodi Bohra community.