Sunday, 25 July 2010

Female Genital Mutilation in Britain

Female Genital Mutilation (FGM) is sometimes referred to as female circumcision although it is far more severe than the male version and should always be referred to as what it is - mutilation.

FGM has no health benefits. It involves removing and damaging healthy and normal female genital tissue, and interferes with the natural functions of girls' and women's bodies. It's done to ensure that the girls' future husbands can guarantee their bride is a virgin and to ensure fidelity. The causes are a complex mix of religious, social and cultural factors. Girls who are not cut can face being outcast from their societies and unable to find a husband. In essence, it is a way of controlling women's bodies and sexuality. It's said to reduce their libido, to be a sign of femininity and that women who are unmutilated are 'unclean' amongst other lies.

According to Forward UK, an anti-FGM charity, it's estimated that approximately 100-140 million African women have undergone FGM worldwide and each year, a further 3 million girls are estimated to be at risk in Africa alone. FGM also happens in the Middle East and Asian countries, and increasingly in Europe, Australia, New Zealand, the USA and Canada. Forward estimates that as many as 6,500 girls in the UK are at risk of FGM every year. The summer holidays are when many mutilations happen as they give the victims time to recover before going back to school in the autumn.

There are four types identified by the World Health Organisation, ranging from partial to total removal of the external female genitalia.

1. Clitoridectomy: partial or total removal of the clitoris and, in very rare cases, only the prepuce (the fold of skin surrounding the clitoris).

2. Excision: partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora.

3. Infibulation: narrowing of the vaginal opening through the creation of a covering seal. The seal is formed by cutting and repositioning the inner, or outer, labia, with or without removal of the clitoris.

4. Other: all other harmful procedures to the female genitalia for non-medical purposes, e.g. pricking, piercing, incising, scraping and cauterizing the genital area.

However, an article in the BMJ questions the usefulness of these classifications, saying that 'The WHO classification fails to relate the defined forms to the severity of the operation'. For example: 'WHO classifies all forms that involve suturing as type III, regardless of whether the labia minora or majora have been cut. Therefore classification as type III does not indicate the extent of the mutilation that has been done. This is important, especially in investigations of FGM and complications'. Another problem is that 'Almost all studies about the prevalence and trends of ... (FGM) have been based on women self reporting their form of FGM. How this reported form corresponds to reality is unknown'. It concludes that 'The WHO should revise its classifications to relate the different forms more to the anatomical extent of the operation.' Far more research needs to be done to get useful statistics and to get rid of the ignorance, secrecy and silence around this subject.

FGM is traditionally done by an older woman with no medical training. Anaesthetics and antiseptic treatment are not generally used and cutting is usually done with basic tools like knives, scissors, scalpels, pieces of glass and razor blades. Often iodine or a mixture of herbs are placed on the wound to tighten the vagina and stop the bleeding. There have been cases of UK doctors willing to carry out the procedure. When caught, they have been struck off.

The most common age is between four and ten, although it appears to be falling. Some of the girls are taken abroad, some are mutilated in the UK. In some cases, there are 'cutting parties' with groups of girls mutilated together to save money.

Immediate risks are death from blood loss and infection, urinary and menstrual problems. Longer-term effects include extensive damage of the external reproductive system, uterus, vaginal and pelvic infections, cysts and neuromas, increased risk of Vesico Vaginal Fistula, complications in pregnancy and child birth, psychological damage, sexual dysfunction, difficulties in menstruation. Period blood can build up and clot, leading to serious, life-threatening infection. There are currently 16 clinics in the UK to deal with the damage.

None of the major world religions demands mutilation. Some religious leaders condemn it while others either turn a blind eye or endorse it. FGM is not limited to Muslims as it is practised in Christian communities too. It is thought to pre-date both religions and to have started in Egypt; type 3 mutilation (according to WHO classification) is also known as pharaonic circumcision. There is nothing in the Koran requiring FGM but there are hadeeths about it. For example: 'Circumcision is a commendable act for men (Sunnah) and is an honorable thing for women (Makromah)' and 'Prophet Muhammad is reported to have passed by a woman performing circumcision on a young girl. He instructed the woman by saying: "Cut off only the foreskin (outer fold of skin over the clitoris; the prepuce) but do not cut off deeply (i.e. the clitoris itself), for this is brighter for the face (of the girl) and more favorable with the husband'. While many Islamic scholars and leaders question these hadeeths, for anyone who wants an excuse, they can provide it.

The UK Prohibition of Female Circumcision Act 1985 makes it an offence to carry out FGM or to aid, abet or procure the service of another person. The Female Genital Mutilation Act 2003, makes it against the law for FGM to be performed anywhere in the world on UK permanent residents of any age and carries a maximum sentence of 14 years imprisonment. To date, no prosecutions have been made.

The UN Convention on the Rights of the Child (1989) requires 'all states to take all appropriate measures with a view to abolishing traditional practices prejudicial to the health of children' and Article 2 of the UN Declaration on the Elimination of Violence Against Women states that 'all violence against women shall be understood to include FGM and other traditional practices harmful to women'.

The UK police have set up Project Azure to combat the crime but have so far taken a soft approach. In 2007, the Met offered a £20,000 reward for information leading to arrest, with no success. Part of the problem is lack of research and the reliance on anecdotal evidence or statistics from doctors treating the after-effects because of the secrecy surrounding the procedure and successive governments' timidity in taking on 'cultural' issues. There have been debates about whether attempts to end the practice are Western cultural imperialism imposing its values on other cultures and whether cultural relativity means that the West has no right to comment on or condemn other people's traditions. Although there needs to be sensitivity in dealing with the subject, especially to avoid stigmatizing the women, this should not be an excuse for doing nothing. This is not some quaint 'ethnic' tradition, it's a non-consensual human rights violation

The West has its own history of fear and loathing of female genitals and sexuality. Freud stated in Sexuality and the Psychology of Love that the 'elimination of clitoral sexuality is a necessary precondition for the development of femininity', for example. In some extreme cases, clitorectomy was practised to prevent women masturbating or as a cure for hysteria and lesbianism.

More recently, women who have been made to feel there is something 'wrong' with their genitals are offered cosmetic surgery, to 'correct' large or assymetrical labia for example. According to one website, 'Many women dislike the large protuberant appearance of their labia. This may cause severe embarrassment with a sexual partner. Surgical labial reduction can greatly improve the aesthetic appearance of the abnormally enlarged labis.' One UK site says that 'It's not unusual for a woman to feel dissatisfied with her labia'.

Surgery is touted because it is a woman's 'right' to have beautiful genitalia - but also her duty if she wants to avoid shame and embarrassment. Although this in no way compares with the forced mutilation of girls and young women, it is an indicator that no society is immune from the pressure on women to conform to artificial norms of what are acceptable genitalia, creating yet another dissatisfaction with their bodies.

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