|
Definition
| Defined in 1997 by the
WHO
,
UNICEF
and
UNFPA
as the "partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons."
[1]
|
---|
Areas
| Estimated in 2013 to be most common in 27 countries in
Africa
, as well as in
Yemen
and
Iraqi Kurdistan
[2]
|
---|
Numbers
| 133 million in those countries as of 2014
[3]
|
---|
Age
| Days after birth to puberty
[4]
|
---|
Female genital mutilation
(
FGM
) is cutting off part or all of the
female
genitals
that are outside of the body. FGM is also called
female genital cutting
and
female
circumcision
. It is done for traditional reasons, as part of a
ritual
, not for medical reasons.
FGM is most common in 27
African
countries, as well as
Yemen
and Iraqi
Kurdistan
. However, it also happens in other countries in
Asia
, the
Middle East
and around the world.
[5]
Usually, FGM is not done by a
doctor
or in a
hospital
.
[6]
It is often done with a
razor
blade or other sharp instruments, in many cases without
anesthesia
.
Different
ethnic groups
do different kinds of FGM. They also do FGM at different ages. Some groups do FGM when
infants
are only a few days old. Others do it when girls reach
puberty
, or are older. In about half the countries where FGM happens, most girls have FGM before they are five years old.
[4]
FGM can cause serious health problems, like
infections
,
chronic
pain
, trouble getting
pregnant
and
giving birth
,
bleeding
so bad that it can kill.
[7]
FGM does not make a person's health better in any way.
[8]
FGM is
illegal
in most of the countries where it happens.
[9]
However, these laws are often ignored.
[10]
Since the 1970s, many countries have tried to stop FGM. In 2012, the
United Nations General Assembly
said that FGM is a
human rights
problem, and
voted
to try harder to stop it.
[11]
The
World Health Organization
and the "Maputo Protocol" to the
African Charter on Human and Peoples' Rights
also say that FGM must be stopped.
Types of female genital mutilation
[
change
|
change source
]
There are many different types of female genital mutilation. The World Health Organization (WHO) has created four basic
categories
of FGM, called Types 1-IV.
[12]
In Type I FGM, part or all of the
clitoris
is cut off. The clitoris is the female
organ
that makes sex feel good for women. Without it, a woman usually cannot have an
orgasm
.
[13]
There are a few forms of Type II FGM. All of them involve cutting off part or all of the
inner labia
, the two flaps of skin on the sides of the opening to the
vagina
. The forms of Type II FGM are:
[14]
- Type IIa: The inner labia are cut off.
- Type IIb: The inner labia and part of the clitoris are cut off.
- Type IIc: The inner labia and part of the clitoris are cut off. So is the
outer labia
, the folds of skin that protect the genitals.
Type III FGM is usually called
infibulation
. It is the most severe form of FGM. The genitals outside a woman's body are cut off and the
wound
is
sewn
shut with
thread
and
thorns
.
[15]
The different types of infibulation are:
[14]
- Type IIIa: The inner labia are cut off and sewn closed.
- Type IIIb: The outer labia are cut away and sewn closed.
When the labia are sewn shut, one small hole is left open so the girl can
urinate
and
menstruate
. The hole is kept open by putting something like a twig into the wound.
[16]
[17]
To help the wound close, the girl's legs are tied together, often from
hip
to
ankle
, for up to six weeks.
[15]
[18]
After the woman gets
married
, her vagina is cut open so she can have
sex
. A
midwife
might cut open the vagina with a knife, or the woman's husband might tear it open with his
penis
.
[19]
If the woman gets pregnant, the vagina is opened more for childbirth, and then often sewn back up afterward (this is called re-infibulation).
[20]
Type IV FGM is anything else that is done to hurt the genitals, like scraping, burning, scarring, or cutting the genitals without cutting them off. This procedure will be heartbreaking for women, when they get to know about this in later life.
[1]
[21]
In many countries where FGM is common, almost every woman and girl in the country has had FGM. In other countries, millions of women and girls have had FGM over many years.
In 25 countries in Africa and the Middle East, over 125 million women and girls have had FGM. This includes:
[6]
In some of these same 25 countries, FGM is very common. It is most common in these countries:
[6]
However, in other countries, FGM is not as common. For example, of the 25 countries where FGM happens most often, it is least common in these countries:
[6]
FGM can hurt women's physical and
mental health
throughout their lives.
[22]
[23]
The type of
complications
that a girl or woman might have from FGM depend on many things, like:
[7]
- The type of FGM
- Whether the FGM was done by someone with medical training
- Whether
antibiotic
medicines
were used
- Whether
sterile
(clean and safe) tools were used
"Short-term complications" are health problems caused by FGM soon after the FGM happened. Common short-term complications include:
[24]
More serious short-term complications can cause
symptoms
that can kill a woman. They include:
[7]
[23]
[25]
Nobody knows how many girls and women die from FGM.
[26]
[27]
Late complications happen later on after FGM is done. For example:
[7]
[28]
[28]
[29]
[30]
Painful periods
are common because it is very difficult for the monthly menstrual blood to get out of the tiny hole left by infibulation. Blood can fill the vagina and uterus, and stay there without moving. If the vagina gets completely blocked, the vagina and uterus can fill up completely with menstrual blood.
[7]
Because women with this problem do not menstruate, and blood builds up in their abdomen (making it swell), it can be confused with pregnancy.
FGM may increase a woman's
risk
of having problems during pregnancy and childbirth.
[7]
For example, women who had infibulations are more likely to:
[7]
[31]
FGM also raises the risk that a woman's baby will
die soon after it is born
. In 2008, the WHO
estimated
that 10?20 babies out of every 1,000 die because their mothers had FGM. All types of FGM were found to raise babies' risk of death, which was:
[32]
[33]
- 15 percent higher for Type I FGM;
- 32 percent higher for Type II; and
- 55 percent for Type III.
Effects on mental health & sexual function
[
change
|
change source
]
There is not much information about the effects of FGM on women's and girls' mental health. However, a few small studies have found that women with FGM often have
anxiety
,
depression
, and
post-traumatic stress disorder (PTSD)
.
[27]
Studies on how FGM affects women's ability to have sex have also been small.
[27]
In total, in 2013, there had been 15 studies involving 12,671 women from seven countries. When all the information from these studies was put together,
researchers
found that:
[34]
- Women with FGM were twice as likely than other women to say they never felt like having sex
- Women with FGM were 52% more likely than other women to have
dyspareunia
(pain during sex)
- One-third of women with FGM had less sexual feelings than before their FGM.
- ↑
1.0
1.1
"Classification of female genital mutilation". The
World Health Organization
. 2016.
- ↑
Female Genital Mutilation/Cutting: A Statistical Overview and Exploration of the Dynamics of Change
Archived
2015-04-05 at the
Wayback Machine
, New York: United Nations Children's Fund, July 2013 (hereafter UNICEF 2013), pp. 5, 26?27.
- ↑
Female Genital Mutilation/Cutting: What Might the Future Hold?
, New York: UNICEF, 22 July 2014 (hereafter UNICEF 2014), pp. 3, 6.
- ↑
4.0
4.1
UNICEF 2013
Archived
2015-04-05 at the
Wayback Machine
, p. 50.
- ↑
UNICEF 2013
Archived
2015-04-05 at the
Wayback Machine
, pp. 2, 26-27
- ↑
6.0
6.1
6.2
6.3
UNICEF 2013
Archived
2015-04-05 at the
Wayback Machine
, pp. 2, 44?46
- ↑
7.0
7.1
7.2
7.3
7.4
7.5
7.6
Jasmine Abdulcadira, et al,
"Care of women with female genital mutilation/cutting"
Archived
2016-07-18 at the
Wayback Machine
,
Swiss Medical Weekly
, 6(14), January 2011.
doi
:
10.4414/smw.2011.13137
PMID 21213149
- ↑
"Female genital mutilation"
, New York: World Health Organization, February 2014.
- ↑
UNICEF 2013
Archived
2015-04-05 at the
Wayback Machine
, p. 8
- ↑
UNFPA?UNICEF 2012
, p. 48.
- ↑
"67/146. Intensifying global efforts for the elimination of female genital mutilation"
, United Nations General Assembly, adopted 20 December 2012.
- ↑
WHO 2014
;
WHO 2008
- ↑
Kammerer-Doak D; Rogers RG 2008 (2008).
"Female Sexual Function and Dysfunction"
.
Obstetrics and Gynecology Clinics of North America
.
35
(2): 169?183.
doi
:
10.1016/j.ogc.2008.03.006
.
PMID
18486835
.
{{
cite journal
}}
: CS1 maint: multiple names: authors list (
link
) CS1 maint: numeric names: authors list (
link
)
- ↑
14.0
14.1
WHO 2014
.
- ↑
15.0
15.1
Kelly and Hillard 2005
, p. 491
- ↑
Abdulcadira et al. 2011
Archived
2016-07-18 at the
Wayback Machine
.
- ↑
Momoh, Comfort (2005).
Female Genital Mutilation
. Radcliffe Publishing Ltd. p.
7
.
ISBN
1-85775-693-2
.
- ↑
Ismail 2009
Archived
2017-09-09 at the
Wayback Machine
, p. 14.
- ↑
Abdalla 2007, pp.
191
,
198
- ↑
Kelly and Hillard 2005
, p. 491.
- ↑
WHO 2008
, p. 24;
UNICEF 2013
Archived
2015-04-05 at the
Wayback Machine
, p. 7.
- ↑
Rigmor C. Berg, et al.,
"Effects of female genital cutting on physical health outcomes: a systematic review and meta-analysis"
,
BMJ Open
, 4(11), 2014: e006316.
PubMed
doi
:
10.1136/bmjopen-2014-006316
- ↑
23.0
23.1
Dan Reisel, Sarah M. Creighton,
"Long term health consequences of Female Genital Mutilation (FGM)"
,
Maturitas
, 80(1), January 2015 (pp. 48?51), p. 49.
PubMed
doi
:
10.1016/j.maturitas.2014.10.009
- ↑
Rigmor C. Berg, Vigdis Underland,
"Immediate health consequences of female genital mutilation/cutting (FGM/C)"
Archived
2015-09-06 at the
Wayback Machine
,
Kunnskapssenteret
(Norwegian Knowledge Centre for the Health Services), systematic review no. 8, 2014, pp. 4?5 (
full text
Archived
2016-12-30 at the
Wayback Machine
).
ISBN
978-82-8121-856-7
- ↑
Christos Iavazzo, Thalia A. Sardi, Ioannis D. Gkegkes,
"Female genital mutilation and infections: a systematic review of the clinical evidence"
,
Archives of Gynecology and Obstetrics
, 287(6), June 2013, pp. 1137?1149.
PubMed
doi
:
10.1007/s00404-012-2708-5
- ↑
UNICEF 2005
, p. 16.
- ↑
27.0
27.1
27.2
Reisel and Creighton 2015
, p. 50.
- ↑
28.0
28.1
Kelly and Hillard 2005
, pp. 491?492
- ↑
29.0
29.1
Amish J. Dave, Aisha Sethi, Aldo Morrone,
"Female Genital Mutilation: What Every American Dermatologist Needs to Know"
,
Dermatologic Clinics
, 29(1), January 2011, pp. 103?109.
PubMed
doi
:
10.1016/j.det.2010.09.002
- ↑
Hamid Rushwan,
"Female genital mutilation: A tragedy for women's reproductive health"
,
African Journal of Urology
, 19(3), September 2013, pp. 130?133.
doi
:
10.1016/j.afju.2013.03.002
- ↑
Rashid and Rashid 2007
, p. 97.
- ↑
Emily Banks, et al,
"Female genital mutilation and obstetric outcome: WHO collaborative prospective study in six African countries"
,
The Lancet
, 367(9525), 3 June 2006, pp. 1835?1841.
PubMed
doi
:
10.1016/S0140-6736(06)68805-3
- ↑
"New study shows female genital mutilation exposes women and babies to significant risk at childbirth"
, World Health Organization, 2 June 2006.
- ↑
Rigmor C. Berg, Eva Denison,
"A Tradition in Transition: Factors Perpetuating and Hindering the Continuance of Female Genital Mutilation/Cutting (FGM/C) Summarized in a Systematic Review"
,
Health Care for Women International
, 34(10), March 2013.
PubMed
Template:PMC
doi
:
10.1080/07399332.2012.721417