FGC is ending…

Through the work of programmes that are based on education and empowerment. Bringing about a change in communities where FGC is practised involves a shift in social norms, and has to be felt throughout the entire community. This kind of change can come slowly at first, but once one community abandons the practice there is plenty of evidence to suggest that other communities follow, bringing about real change in a relatively short period of time.

The most important thing when trying to effect change in communities where FGC is carried out is to be non-judgmental and non-directive. Ending the practice is much more likely to happen when, instead of issuing directives, programmes open up a dialogue and a conversation that involves the entire community, including men and women, girls and boys, and religious and community leaders. This opening up of a conversation leads to self-directed questioning of the practice, so that eventually the community members begin to question the health and humanitarian issues surrounding FGC, which in turn leads ultimately to abandonment of the practice.

A big part of this comes from the acknowledgment that FGC is a constructed norm, and is not in fact, a useful or positive part of people’s lives or their communities. When a community publicly denounces the practice they are not only declaring to themselves, but to other communities, that they have abandoned FGC, which then helps in paving the way for other communities – especially those with which they regularly inter-marry – to do the same.

To learn more about the abandonment of FGC please read more about our work with our grassroots partners in Kenya, Senegal and India.

 

FGC could end within the next generation…

As stated by the UN. Here at Orchid Project we also believe that FGC can and should end within the next generation, and that this aim is entirely achievable. At this point in time there is more attention being paid to FGC at a local, regional, national, and international level than ever before. This momentum has built up gradually, but we have recently reached an unprecedented moment in the history of FGC.

The movement to end FGC within a generation has been inspired by the successful end to footbinding in China, which happened within 20 years. Where once footbinding was practically universal among some groups in the country, it is now non-existent, despite dating back to the tenth century. The fact that footbinding was also a social convention means that the movement to end FGC can utilise the same strategy to change social norms as a way to bring about an end to the practice of FGC.

 

For FGC to end…

There needs to be wider awareness of the issue itself and its scale and impact. Awareness leads to a better understanding of the practice, and a realisation that FGC needs to end. In turn stakeholders contribute to an environment and a movement that allows for the changes and progress needed in order to bring about an end to FGC.

For change to happen, it needs to happen most importantly at a community level. Communities must bring about this change themselves, and one of the ways this is most likely to happen is through human rights based education. There is also a need for health education and a community’s understanding of all the impacts of FGC whether physical, emotional, and mental is often crucial to their decision to abandon the practice, in addition to deeper understanding of their human rights. Health education alone is not enough, however, and should always be combined with human rights based education and an opening up of the conversation around religion where relevant.

FGC is not linked to any one religion, and while the influence of religious leaders in certain areas and regions is important to the successful end of the practice, it is also important to stress the fact that the procedure is not a religious requirement. Read more about FGC and religion here.

FGC is most likely to end when a community realises that it is not a positive tradition, and is in fact harmful. Where FGC is in decline it is often due to this combination of non-judgmental, non-directive education that is based in human rights, health, and awareness raising.

 

Over 12,000 communities have abandoned FGC…

According to the UNFPA/UNICEF Joint Programme, with communities in countries such as Senegal, the Gambia, Guinea, Burkina Faso, Kenya, Ethiopia, and Mali being at the forefront of this movement for change. Even in countries such as Somalia and Sierra Leone, where the rates of FGC are very high, attitudes towards the practice are changing. It is this shift that needs to be harnessed in order to bring about real change and an end to FGC.

Since 1997, when the first community in Senegal declared their abandonment of FGC, over 5,500 villages in the country have followed suit. In fact, West Africa has led the way for change in the rest of the continent and throughout the world, providing other communities, regions, and countries with the encouragement needed to end FGC and change the lives of millions of girls worldwide. Since 1997, when the people of Malicounda Bambara, the first village to abandon, publicly declared their abandonment of FGC, other communities in Guinea, Burkina Faso, Mali and the Gambia have all publicly declared their commitment to abandon the practice. For a deeper understanding of how change has come to over 7,700 communities in West Africa, learn more about our partner Tostan’s efforts in the area.

 

FGC is a social norm…

Not a religious requirement. It pre-dates all main organised religions including Christianity, Islam, and Judaism, and is instead a tradition, sanctioned by social norms. What this means is that it is held in place by an entire community, making it in some ways harder to destabilize and bring to an end, and in other ways easier to change by working with the whole community. Because it is part of most practising communities’ traditions, and has existed for generations, FGC is supported by men and women alike, often unquestioningly. Even when mothers are aware of the pain and other attendant issues that FGC can cause, and even if both parents are aware of the health risks involved, they will often still allow their daughter to undergo FGC due to the social sanctions in place.

These social sanctions include marriage, respect, and acceptance into the community. Many parents fear that a girl who remains uncut will not marry well, will be seen as dirty, and may even be ostracised by their community, or be viewed as promiscuous, and in some cases, even as potentially less fertile. All of these things can lead to uncut girls and women not marrying, and in some cases to social exclusion.

However, because cultures are constantly in flux, it is also possible for social norms to change, and there are communities around the world which are choosing to shift the norm from cutting to not-cutting, for example following participation in programmes delivered by our partner Tostan.

 

FGC is not a religious requirement…

And despite common misconceptions, it is not actually prescribed by any religion. It is not supported by any religious text, and a guideline for the cutting of female genitals does not appear in any religious texts whether Muslim, Christian, or Jewish. In fact, in Islam for example, Sharia law protects the rights of the child, and The Muslim Women’s League upholds that the practice of FGC is in strict violation of the Qu’ran (MWL 1999).

Just because FGC is not inherently a religious requirement does not mean it isn’t also supported by certain religious leaders such as priests or imams. This contradiction makes the work to end FGC even harder, but does not make it insurmountable. The work done so far in bringing an end to the practice shows that harnessing the power held by religious leaders can in fact prove crucial to the success in ending FGC. In Senegal, for example, religious leaders have been at the forefront of progress to end FGC, and Somalia has also benefitted from the influence of religious leaders in inspiring change. Read more about FGC and Islam.

 

FGC is thought to have originated…

In 2,200 BC, before the advent of either Christianity or Islam. The exact origins of the practice are unknown, although in all likelihood it originated in an area now known to us as Sudan. It’s possible that infibulation may have originally been carried out as part of imperial polygyny (the practice of a man being married to more than one woman), as a way to ensure paternity.

In 25 BC, the Greek philosopher Strabo wrote about the practice of FGC after visiting Egypt. In his Geographica, he writes about the custom of circumcision in boys, and excision of girls that is carried out around their fourteenth birthdays, as being one of the most ‘zealously pursued’ customs in the area. Reference to the practice also appears in the writing of Greek physician Aetitius of Amida in the fifth-sixth century, in his Sixteen Books of Medicine, which refers specifically to the practice being performed as a way to inhibit arousal in women, as well as being linked to the girls’ preparation for matrimony.

The practice is almost certainly also linked to slavery, although this came later in its history. In 1609, the Portuguese missionary Joao dos Santos found that women being sold into slavery in the area just inland from Mogadishu were being cut in order to ensure their virginity and chastity, thereby making them more attractive to slave owners, and thus worth more.

 

FGC is often linked to Early and forced Marriage…

And although there haven’t been enough studies carried out to firmly establish a link between the two, it is widely acknowledged that FGC and Early and Forced Marriage (EFM) are indeed linked. This conclusion has been arrived at as a result of 22 of the 30 countries where FGC is carried out also being recorded as countries where EFM happens at a much higher rate than elsewhere, according to the UNFPA.

This kind of correlation shouldn’t really come as a surprise, considering the similarities in social beliefs, pressures, and norms that lead to both FGC, and EFM. For example, rather than religious reasons being behind the continuation of FGC in many areas, it is instead seen as a safeguard against premarital sex, and as a way to control and promote female virginity. The same can also be said for incidences of EFM. Although this isn’t the case in every country or community where FGC is practised, it is for example, in the Maasai areas of Kenya and Tanzania where the procedure is carried out. Here, a girl is considered ‘mature’ once FGC has been carried out, which is usually between the ages of seven and 14, and is then married off quickly as a way to secure a dowry.

 

The physical impacts of FGC…

Can be incredibly harmful to a girl’s health, and can often lead to issues throughout her life. The most extreme consequence is death. In such cases when a girl dies as a direct result of FGC it is due to either a haemorrhage or from contracting tetanus during the procedure and dying in the ensuing weeks. Girls who have the procedure performed in situations where more than one girl is cut using the same, unsterilized tool may also be at risk of contracting HIV.

Those who have been infibulated (also known as Type 3, when the entrance to the vagina is sewn almost completely closed) are also likely to have trouble passing urine, which can lead to bladder infections. This happens when the urethra is blocked and urine cannot easily escape. FGC also causes issues when girls who have had the procedure start to menstruate. Menstrual blood passing through the sewn up hole can cause severe pelvic pain and painful periods, with stagnant menstrual blood causing a build-up of bacteria that leads to pelvic inflammation and severe abdominal cramps. This can cause monthly, even daily pain for the girl and can at times even lead to internal infection which can then lead to death. Problems with urination and menstruation can also be associated with other types of FGC, for example Type 2, as after the labia minora have been cut, they may knit together as they heal.

FGC is also known to cause infertility. This occurs when the build-up of stagnant menstrual blood and other vaginal secretions leads to the inflammation of the pelvis, in turn affecting the womb. Shorter term, but no less upsetting implications of FGC include open sores, cysts and keloid scarring, as well as shock.

 

The emotional and psychological impacts of FGC…

Still remain largely unknown. There is a wealth of anecdotal evidence to suggest that FGC has a long lasting effect on a woman’s mental well-being, however, and can even cause post-traumatic stress. Recent studies that have been carried out have supported this anecdotal evidence. It is not only the trauma and memory of being cut – which evidence suggests is a memory many girls and women carry with them and which can cause feelings of fear, helplessness, horror, and severe pain – but the ongoing effects of FGC throughout a girl’s life that can lead to emotional distress.

Difficulties resulting from painful periods, and further pain during sex and childbirth can cause girls and women to experience further trauma, as well as lower self-esteem, an increased likelihood of depression and anxiety, and in some cases personality disorders. Women and girls who have undergone the procedure have also been known to experience memory loss, and blackouts as a result of post-traumatic stress. Not only that, but if a girl has undergone Type 3 cutting, otherwise known as infibulation, she will literally have to re-live the procedure when she is cut open and re-sewn for sexual intercourse, and later childbirth if she becomes pregnant.

Although studies on the emotional and psychological impacts of FGC are not quite as widely available as the physical effects, a 2010 study from a group of girls in Iraqi Kurdistan found that:

“All circumcised participants remembered the day of their circumcision as extremely frightening and traumatizing. Over 78% of the girls described feelings of intense fear, helplessness, horror, and severe pain, and over 74% were still suffering from intrusive re-experiences of their circumcision.”

 

Other side effects of FGC include…

A detrimental effect on a girl’s socio-economic opportunities. FGC also increases the likelihood of leaving school at a young age. This is often caused by the multiple absences that come as a result of painful periods as well as bleeding throughout the month, which is a common physical side effect of FGC in girls and women. The knock-on effects of leaving school at a young age are well-documented and include earning less, and having less control and agency over life choices including marriage, pregnancy, and family planning.

FGC is also linked to child marriage and instances of early first pregnancy when the girl’s body is not physically mature enough for pregnancy and birth which in turn can lead to its own set of both physical and psychological problems. The effects of dealing with painful sexual intercourse and/or infertility caused by FGC can also lead to even further psychological and emotional damage, as well as causing difficulties in relationships and marriage, even in some cases leading to divorce or abandonment.

 

FGC can lead to an increased risk of childbirth complications…

And is a major contributing factor to maternal mortality. According to the WHO, women who have experienced the most extreme form of FGC (infibulation) are 70% more likely to experience post-partum haemorrhage, and 30% more likely to require a caesarean section. As such it is not all that surprising to find that those regions where FGC is practised are also the regions where the highest infant and maternal mortality rates are found. For example, there are one to two more infant deaths per 100 births among women who have undergone FGC of any type (Type 1, 2, or 3) than among uncut women.

Complications both in childbirth and in the collection of data also occur when we take into consideration all the births that occur outside of hospitals. The research undertaken by the WHO was done amongst women giving birth in hospital, but as it stands currently only 46% of women living in Sub-Saharan Africa give birth with a skilled assistant as an attendant, and we must therefore presume that the numbers of both infant and maternal mortality, as well as the incidences of complications during childbirth as a result of FGC are actually much higher than we know.

A 2013 study from the Norwegian Knowledge Centre for the Health Services which collated findings from a large number studies, found that women who had undergone FGC (regardless of type), were twice as likely as women who had not been cut to experience difficult labour.

 

FGC can impact the experience of sexual intercourse…

By being both painful and traumatic. For those women who have undergone Type 3, otherwise known as infibulation, the pain is even worse, as a hard plug of scar tissue is formed over where there was once the soft opening of the vagina. Some women will have to be physically cut open in order to allow penetration, in which case the procedure is known as de-infibulation. Even if the woman is not cut open medically, the hole will be too small to be opened without force.

For many women, it is not only the first instance of sexual intercourse that causes pain. The scar tissue around the vaginal orifice will continue to cause pain and discomfort during sex throughout a woman’s lifetime, and often this not only affects her, but also her partner who may well experience discomfort and stress at being the one to cause pain during sex.

 

 

FGC is…

The partial or complete removal of a girl’s external genitals. There are no known health benefits, and in fact the girl’s body is physically harmed and damaged as a result of the practice and the removal of healthy tissue when her genitals are cut away.

The effects on girls and women who have had FGC carried out are long lasting and wide ranging, and for many will cause problems, including physical and psychological damage, throughout their lives. FGC may also be referred to as female genital mutilation, or FGM and contravenes human, women’s and child rights. Read more about why Orchid Project uses FGC rather than FGM.

 

More than 200 million girls and women…

Are living with the consequences of FGC around the world, and a further 3.9 million girls are at risk of being cut each year. National data exists for 30 countries, the majority in Africa as well as in Iraq, Yemen and Indonesia. However FGC happens throughout the Middle East and Asia, including in Iran, Russia, India and Malaysia, but little to no data are available in these countries.

It’s important to note that FGC also happens in diaspora communities including in Europe, North America, and Australasia. It is estimated that there are currently 500,000 women living with the consequences of FGC in Europe for example.

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The act of FGC entails…

The full or partial removal of a girl’s genitals including part or all of her labia, part or all of her clitoris, and part or all of the clitoral hood (the prepuce). The female external genital organ is called the vulva and is comprised of the labia majora (the outer lips), the labia minora (the inner lips), and the clitoris, which includes the hood known as the prepuce. In many instances the cutting will all happen in very basic conditions, without the use of anaesthesia, and with rudimentary tools which will probably not be sterilized.

The most extreme form of FGC includes the complete removal of all of a girl’s external genitals. In such situations and under the harshest conditions, FGC can also include the sewing closed of the wound with thorns or string. This is known as infibulation. A small hole is then left for menstrual blood and urine, and the wound eventually heals over, with the scar tissue forming a ‘seal’ for the vagina. This ‘seal’ will then be cut open to allow for sexual intercourse, before being cut open even further upon going into labour if the girl becomes pregnant. In some situations girls and women are often re-sewn after labour and cut again for every further labour, which in some practising countries can be numerous.

 

There are four different types of FGC…

These are determined by the severity of each girl’s case and are classified by the World Health Organization (WHO) as follows:

Type I: The clitoris or clitoral hood is partially or fully removed (also known as clitoridectomy).

Type II: As well as the clitoris, the labia minora are partially or fully removed. The labia majora may also be cut.

Type III: The clitoris, labia minora and labia majora are cut away, and the remaining skin is sewn or sealed together leaving a tiny hole for menstrual blood and urine. This is commonly known as infibulation.

Type IV: All other harmful procedures to the female genitals including pricking, piercing, rubbing, scraping and the use of herbs or other substances.

In addition to this the WHO has developed sub-divisions for each type:

Type I — Partial or total removal of the clitoris and/or the prepuce (clitoridectomy).

When it is important to distinguish between the major variations of Type I cutting, the following subdivisions are proposed: Type Ia, removal of the clitoral hood or prepuce only; Type Ib, removal of the clitoris with the prepuce.

Type II — Partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora (excision).

When it is important to distinguish between the major variations that have been documented, the following subdivisions are proposed: Type IIa, removal of the labia minora only; Type IIb, partial or total removal of the clitoris and the labia minora; Type IIc, partial or total removal of the clitoris, the labia minora and the labia majora. Note also that, in French, the term ‘excision’ is often used as a general term covering all types of female genital cutting.

Type III — Narrowing of the vaginal orifice with creation of a covering seal by cutting and appositioning the labia minora and/or the labia majora, with or without excision of the clitoris (infibulation).

Type IIIa, removal and apposition of the labia minora; Type IIIb, removal and apposition of the labia majora.

Type IV — All other harmful procedures to the female genitalia for non-medical purposes, for example: pricking, piercing, incising, scraping and cauterization.

 

The majority of girls were cut…

under the age of five years old.  The age at which a girl is cut is completely dependent on the specific cultural context of each girl, with some girls being cut in infancy, and others as a teenager. In some areas of Ethiopia, for example, girls are often cut at just nine days old, and in half the countries in which FGC is practised most girls undergo the procedure before the age of five.

However, in the Central African Republic, Egypt, Chad, and Somalia about 80% of girls are cut between five and 14, often in relation to coming-of-age rituals and the marking of their passage into adulthood. Research does suggest that there may be a global move towards cutting girls at a younger age.

26% of women who’ve undergone FGC – totaling nearly 15 million women – report having been cut by a medical professional.

 

FGC is a violation of women’s and girl’s human rights…

And contravenes the Universal Declaration of Human Rights, as well as the Convention on the Rights of the Child, Convention on the Elimination of All Forms of Discrimination against Women (CEDAW), the African Charter on Human and People’s Rights (Banjul Charter) including its protocol on the Rights of Women, and the African Charter on the Rights and Welfare of the Child.

The severe health issues caused by FGC contravene the universal right to health, and also violate human rights on the principles of inequality and discrimination on the basis of sex and as such impacts, increases and perpetuates inequality. FGC is also viewed as a way of forcibly controlling women’s sexuality and attempting to ensure a woman will be faithful to her partner. Human rights are also one of the most successful routes into ending FGC and you can read more about the human rights based education approach to end the practice that is carried out by our partner Tostan.