By: Foluke Akinwalere. Freelance Health Writer. Medical review and editorial support provided by the DLHA Team
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Female Genital Mutilation: Activists protesting together. Background image from Freepik
Introduction
Female genital mutilation (FGM) is a deeply rooted practice affecting millions of women and girls across Africa. It involves the partial or total removal of the external female genitalia for non-medical reasons. This practice is recognised internationally as a violation of the human rights of girls and women.
Despite global efforts to eliminate FGM, it persists in many communities due to its strong cultural, social, and sometimes religious foundations. To effectively address and combat FGM, it is crucial to understand the cultural contexts and motivations that sustains this practice.
The purpose of this article is to delve into the complex and varied nature of FGM in Africa. By exploring the cultural, social, and religious reasons behind the practice, we aim to provide some insights on why FGM continues to persist.
According to the World Health Organisation, female genital mutilation is defined as all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons. [1] FGM is mostly done on young girls between infancy and 15 years old, often before they reach puberty.
The practice is primarily done by traditional circumcisers, who often have other important roles in communities, such as assisting with childbirth. In some cases, healthcare providers may also perform FGM because they mistakenly believe it is safer when done in a medical setting. WHO strongly advises health professionals against performing these procedures.[1] FGM is considered a culturally harmful practice. [2]
The World Health Organisation classifies FGM into four main types: [3]
Type 1: Often referred to as Clitoridectomy, this is the partial or total removal of the clitoris (a small, sensitive and erectile part of the female genitals), and in very rare cases, only the prepuce/clitoral hood (the fold of skin surrounding the clitoris).
Type 2: Also known as Excision, this is the partial or total removal of the clitoris and the labia minora (the inner folds of the vulva), with or without excision of labia majora (the outer folds of skin of the vulva).
Type 3: Also known as Infibulation, this is the narrowing of the vaginal opening through the creation of a covering seal by cutting and repositioning the labia minora or labia majora, with or without removal of the clitoris.
Type 4: This includes all other harmful procedures to the female genitalia for non-medical purposes, e.g. pricking, piercing, incising, scraping and cauterising the genital area.
The precise origins of female genital mutilation (FGM) are still uncertain. Some researchers suggest that Ancient Egypt (modern-day Sudan and Egypt) may have been where it originated, pointing to the finding of circumcised mummies dating back to the fifth century BC. Alternatively, other scholars propose that the practice may have spread along the slave trade routes, stretching from western coast or the Red Sea to southern and western Africa, or from the Middle East to Africa through Arab traders. [4]
Throughout history, FGM has been practiced by various ethnic groups across the African continent, each with its unique cultural justifications. It is important to note that FGM exists earlier than major world religions like Islam and Christianity, suggesting that its roots are more cultural than religious. Despite its ancient origins, the practice has persisted into modern times, maintained by deeply entrenched social norms and beliefs.
Female genital mutilation in Africa by country (2022). Source: Statista
The practice is most common in the western, eastern, and northeastern regions of Africa, particularly in the countries such as Somalia, Guinea, Djibouti, Egypt, and Mali, where the prevalence rates exceed 90%. [5]
It is crucial to get to the bottom of these cultural justifications in order to create successful strategies to eradicate FGM. Initiatives aimed at stopping the practice should take into account these cultural backgrounds, all the while advocating for the health and human rights of women and girls.
Female genital mutilation is surrounded by various beliefs and myths that preserve its practice. In many communities, FGM is seen as a necessary rite to ensure a girl’s purity, modesty, and cleanliness. Myths often suggest that FGM prevents promiscuity and infidelity, making it a crucial practice for maintaining family honor and social standing. Some believe that an uncut woman will face social exclusion or be deemed unworthy of marriage, which places immense pressure on families to conform to these practices.
FGM often plays a central role in rites of passage, marking the transition from girlhood to womanhood. hese ceremonies are important events that reinforce community bonds and cultural identity. Girls who undergo FGM are usually celebrated and honored, as the procedure is seen as a way to prepare them for adult responsibilities, particularly marriage and motherhood. The communal nature of these rites promotes a sense of belonging and social connection, making it difficult for individuals to reject or stop the practice.
Despite overwhelming medical evidence to the contrary, some communities believe that FGM has health and hygiene benefits. It is commonly believed FGM promotes cleanliness by removing parts of the body considered unclean. Additionally, some myths claim that it improves fertility and makes childbirth easier, but these claims lack scientific basis and are contradicted by the many health risks associated with the practice.
Patriarchal structures and the desire to control female sexuality are key factors in the continuation of FGM. The practice is frequently defended as a way to diminish a woman’s sexual desire, ensuring her chastity before marriage and fidelity afterward. This control over female sexuality is deeply rooted in gender inequality and the belief that women’s bodies need to be controlled to uphold family and societal values. FGM is therefore a reflection of wider patriarchal standards that aim to gain control over women and restrict their independence.
Some countries have sought to encourage performance of less severe form of FGM by qualified medical professionals.
Medicalisation of FGM occurs when healthcare providers perform FGM, whether in a medical setting or elsewhere, using surgical instruments, anesthesia, and antiseptics to reduce immediate risks. [6] It includes reinfibulation, which involves reclosing of the external genitalia of a woman who has been deinfibulated to allow for childbirth, sexual intercourse, or other therapeutic gynecological procedures.
There are various reasons why healthcare providers engage in performing FGM. These include: [3]
Nevertheless, with the assistance and training provided by WHO, many healthcare providers are now promoting the abandonment of FGM within their clinical practice and among their families and communities.
In many communities, FGM is viewed as a religious duty or as a tradition supported by religious customs. This perception is particularly strong in parts of Africa where Islam and certain Christian denominations are prevalent. [7] However, it is important to acknowledge that FGM existed before the advent of both Islam and Christianity, suggesting that its roots are more cultural than religious. [8]
While some people believe that this practice is supported by religion, there are no religious texts that specifically prescribe it, which is the reason why some religious leaders have differing opinions on FGM, with some actively working towards it abandonment. [2]
Many scholars argue that FGM is a cultural practice that has been mistakenly linked to religious obligations over time. Efforts to distinguish between cultural practices and religious mandates are essential for clarifying misconceptions and reducing the practice. Educating communities about the authentic teachings of their faiths can help dispel misconceptions and encourage the abandonment of FGM.
Perspectives of Religious Leaders and Community
Religious leaders play a crucial role in shaping the views and practices of their communities. Their support can be pivotal in efforts to eradicate FGM. Many religious leaders and organisations have publicly condemned FGM, emphasising that it is not a religious requirement and highlighting the health risks and human rights violations associated with the practice. For instance, prominent Muslim clerics and scholars have issued fatwas (Islamic legal opinions) against FGM, and Christian missionaries in Africa have also spoken out against it. [7]
In communities where religious leaders and government support anti-FGM campaigns, there has been significant progress in reducing the practice. For instant, Gambia government upheld the ban on FGM recently to reaffirm the country’s commitments to human rights, gender equality, and protecting the health and well-being of girls and women.
Such efforts between religious leaders, governments, and non-government organisations (NGOs) are crucial for creating sustainable change and ensuring that message against FGM reaches and hopefully influences change in everyone.
Female genital mutilation (FGM) is a complex and varied issue that is deeply ingrained in the cultural, social, and religious fabric of many African communities. Despite the severe health risks and human rights violation associated with the practice, FGM continues to persist due to the complex interplay or tradition, social norms, and religious beliefs. By getting to the bottom of the complexities of this harmful practice, we can contribute to a future where it is eradicated, and the rights of all girls and women not to be traumatised are upheld.
1. World Health Organisation, Female Genital Mutilation [Internet, n.d.] Accessed July 24, 2024. Available from here.
2. Ezeike A. Social Factors Shaping African Women’s Health. Datelinehealth Africa. [Internet]. 2024 June 23. Cited 2024 July 24. Available from here.
3. World Health Organisation. Female genital mutilation. [Internet] 2024 Feb. 5. Accessed July 25, 2024 Available from here.
4. Llamas J. Female Circumcision: The History, The Current Prevalence and the Approach to a Patient, [Internet] 2017 April. Accessed July 25, 2024] Available from here.
5. Statista, Prevalence of female genital mutilation (FGM) among women and girls in Africa in 2022, by country. [Internet]. Accessed July 30, 2024] Available from here.
6. Kimani S, Shell-Duncan B. Medicalized Female Genital Mutilation/Cutting: Contentious Practices and Persistent Debates. Curr Sex Health Rep. 2018;10(1):25-34. doi: 10.1007/s11930-018-0140-y. Available from here.
7. Wikipedia contributors. Religious views on female genital mutilation. In Wikipedia, The Free Encyclopedia. [Internet]. Last updated 2024, July 20. Accessed August 5, 2024, Available from here.
8. Black JA, Debelle GD. Female genital mutilation in Britain. BMJ. 1995 Jun 17;310(6994):1590-2. doi: 10.1136/bmj.310.6994.1590. Available from here.
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