Mutilation of Female Genitalia

In a family or culture, abuse is a rampant incidence. Domestic abuse ranges from racism, abuse and abuse to female genital mutilation (FGM). The key cause of violence is society. Culture. For instance, FGM is still practiced in many countries across various continents despite the continued awareness campaign (Rigmor, Denison, and Fretheim, 6). FGM is an inhumane act that leads to a good understanding of society. FGM involves all procedures for the complete or partial removal without medical reasons of external female genitalia. The definition also includes any other form of injury to the female genital organs (WHO, 1).

FGM can be categorized into four groups namely the clitoridectomy, excision, infibulation and others. Clitoridectomy is a procedure done either partial or total removal of the clitoris or in other cases; it involves the removal of the prepuce of the clitoris. The excision involves partial or complete removal of the clitoris, prepuce and the labia minora with or without removal of the labia majora. Infibulation refers to the procedure done to narrow the vagina. It involves the removal of the external genitalia then stitching the inner and the outer labia. Any other procedure, done on the female genitalia for a non-medical reason and do not fall into the first three categories fall into the last category - Others (WHO, 1). 

Families, societies, and cultures where FGM is practiced have different reasons for doing so. The most common reason across many cultures is that FGM ensures girls and women conform to certain cultural norms including sexual restraint, earning respect, proving femininity and as a sign of maturity. Unlike other forms of gender-based violence against women, FGM has women not only as victims but also as perpetrators. In most cases, a girl’s female family members would arrange for FGM to be performed by a traditional exciser although in some cases medical personnel may perform it. Owing to the support FGM is getting from both men and women in societies, the practice became a supported gender-based violence against women (WHO, 11). Generally, FGM is performed on girls and women between the ages of 4 to 12 or just before marriage (Feldman-Jacobs and Clifton 2). In some cultures, it may be performed as earlier as a few days after birth. 

Consequences of FGM

Health

FGM procedures damage healthy female genital organs without any medical reason to do so. The procedures interfere with the biological functionality of the female body. These procedures are carried out by mostly non-medical professionals and without the use of anesthetics. It is estimated that medical practitioners have carried out only 18% of all FGM. All the forms of FGM can cause pain and bleeding. Additionally, FGM carries the risk of infection. Research conducted by WHO found that women who have undergone FGM were at a higher risk of experiencing complications during childbirth such as postpartum hemorrhage or difficulty in giving birth thus prompting procedures such as caesarean section. Furthermore, infant mortality, during or immediately after birth was higher in women who have undergone FGM (WHO 11). 

Other health consequences of FGM include pain during sexual intercourse and decline in sexual satisfaction. It is reported that women who have undergone FGM have a 1.5 likelihood of experiencing pain during sexual intercourse while still having the lower sexual urge and less likely to have sexual satisfaction. 

Social consequences

FGM is mainly carried out based on the sociological ground. Culturally, the practice qualifies one as feminine, respectable, or mature depending on the culture. In cultures that practice FGM, failure to conform would result in exclusion, discrimination or harassment. The greatest problem with the legal challenge against FGM is that failure to comply with the practice of FGM in the society far much outweighs legal restrictions. (WHO, 3)

Economic consequences

FGM strains the community or society financially. A study by WHO found that medical cost of managing obstetric complications following FGM is equivalent to 0.1-1% of government expenditure on women and reproduction. In Nigeria, it is estimated that the cost of medical treatment of post-FGM complication is around $120 per girl in a pediatric clinic. A study in Gambia showed that one in every three women seeking gynecological treatment had FGM complications. 

Prevalence of FGM

On the global scale, 100-140 million females have undergone one or more forms of FGM and are living with its consequences (Feldman-Jacobs and Clifton 1). Every year, an estimated 3.3 million girls are at risk of undergoing through FGM. Africa topped the list of continents where FGM is rampant with FGM being common in 27 of African countries out of the 53 states. Africa and Yemen alone contribute more than 70% of the population of girls and women having undergone FGM. Some Asian, European, and Middle Eastern countries also practice FGM. Other countries with incidences of FGM include Australia, Canada, New Zealand and the USA (WHO, 2). Few population in the Latin America practice FGM. 

The population of girls and women at risk of FGM in the US has doubled in the last ten years with more than 500,000 girls and women being at risk or have undergone the procedure. The figure includes more than 160,000 victims who are under the age of 18. Immigration from African countries is the greatest propellant of FGM in the US today. Around 41% of African immigrants in the US are victims or at risk of FGM. Egypt tops the list with one in five girls being at risk of FGM in the US. With 56,872 at risk of FGM, California State leads other states. New York follows closely with 48,418 at risk and Minnesota with 44,293. Hawaii is an exception with 0% of girls and women at risk of FGM (Westcott). The US passed a law that illegalizes FGM in 1996. 

Following the illegalization, most parents and relatives took their girls for what is commonly referred to as vacation cutting. In 2012, the law was amended to illegalize vacation cutting. Compared to Egypt, the US is close to eradicating FGM. In Egypt, 92% of married women have undergone FGM. In rural areas, the prevalence is 95% for married women. The figures cover the age ranging from 15 to 49. Most girls who undergo the procedure are between the ages of 9 and 12. The procedures are not only facilitated by traditional excisers but also by health-care providers. Around 30% of married women in Egypt would like to have the tradition banned. However, more than half of the married women are in favor of FGM (Robinson). In Egypt, it has been illegal to carry out FGM since 2007 although the practice remains to be widespread. Comparing the adherence to the law against FGM, the US has a tighter grip on the matter than Egypt. 

A trend known as medicalization is emerging in Egypt. Medicalization refers to substituting the traditional exciser with a medical practitioner in an attempt to reduce the risk of injuries and infections from FGM. Although this may be the case, the long-term risk of FGM will still exist. The Egyptian government still holds it stand against FGM. The US, on the other hand, has no such trend.   

Approaches to ending FGM

Several approaches have been employed to prevent FGM, but the effectiveness of these approaches varies. The use of these approaches and strategies over the last two decades have shown some success, but they demand long-term commitment, and broad-based mitigations approach to bring FGM to an end.

Decision-making and social dynamics form one of the approaches use to end FGM. In many communities, decision-making process lies beyond an individual or family. They are community-based or otherwise group dynamics. Such implies that any approaches or strategies employed to curb FGM at individual or family level will most likely prove to be futile. A good example of community-based decision-making can be drawn from a study conducted in Gambia and Senegal. The study found out that FGM decision-making involved the extended family. The study also found that mothers were supportive of FGM compared to fathers while the father often played a crucial role in those decisions. 

Working with the community to end FGM could have positive impacts. Such is true because working against the community has in many cases been perceived as an attack against the culture by the outsiders and at the end leading to mass-FGM initiatives and open support of the practice (WHO, 6). Due to the defensive reactions from the community following campaigns against FGM, supporting positive cultural practices could go a long way in ending FGM. 

Targeting FGM from local level to international level has proven to be very effective in ending the practice. Since grass-root initiatives targeting ethnic groups have proven to work, joint co-ordination could further help in eradication FGM because some ethnic groups span the national borders. At the national level, legal actions are the mostly employed although law alone cannot achieve the objective of eradicating FGM because it is impossible to have 100 percent adherence to the law (WHO, 6). 

The final approach or technique of ending FGM is the rights-based approach. The comprehensive human rights-based approach includes aiming at a reduction in gender discrimination and ensuring social justice as a way of supporting human rights and empowering women and girls (Rao, 7). As indicated by WHO, a combination of various approaches to combat FGM is the most efficient way compared to the campaign focusing on a single target. Regarding women empowerment, education has played a great role. Such is true because education enables members of the community to analyze their beliefs and practices and relate the same to the rest of the world. Additionally, education provides a platform for sharing of experience and ideas and hence sharing of the inner feeling and the attitude towards FGM. 

Conclusion

In conclusion, FGM is one of the domestic violence that exists in all the continents of the world. Africa is the most affected continent with around 100 million out of the 140 million victims of FGM being African women and girls. Culture is the main propellant of the practice in many communities. Cultural propulsion has prompted the emergence of trends to medicalize FGM. Egypt is an example of a country where the trend is emerging. FGM has many effects including health risks, social effects, and economic effects. FGM has been seen as a way of conformation to femininity, maturity and even earning respect. Such cultural view embedded in the idea behind FGM make eradication an uphill task for stakeholder intending to end FGM. Despite the big setbacks experienced in attempting to bring FGM to a stop, some progress has been made. 

Works Cited

Alston, Philip, and Ryan Goodman. International Human Rights. Oxford University Press, 2012. 
Berg, Rigmor C., Eva Marie-Louise Denison, and Atle Fretheim. "Psychological, social and sexual consequences of female genital mutilation/cutting (FGM/C): a systematic review of quantitative studies." Obstet Gynecol Int., 2013.
Feldman-Jacobs, Charlotte, and Donna Clifton. "Female Genital Mutilation/Cutting: Data and Trends Update 2014." Population Reference Bureau, 2014.
Gupta, Geeta Rao. "Female Genital Mutilation/Cutting: A statistical overview and exploration of the dynamics of change." Reproductive Health Matters 21.42, 2013, pp. 184-190.
Robinson, Julian. Shocking figures reveal 92 per cent of married women in Egypt have suffered female genital mutilation. 11th May 2015. 30th April 2017. <http://www.dailymail.co.uk/news/article-3076518/Shocking-figures-reveal-92-cent-married-women-Egypt-suffered-female-genital-mutilation.html>.
Westcott, Lucy. Female Genital Mutilation on the Rise in the U.S. 2nd June 2015. 30th April 2017. <http://www.newsweek.com/fgm-rates-have-doubled-us-2004-304773>.
World Health Organization. "Eliminating female genital mutilation: An interagency statement–OHCHR, UNAIDS, UNDP, UNECA." 2013.
World Health Organization. "Understanding and addressing violence against women: Intimate partner violence." 2012.