Wednesday 6th February marked the 13th International Day of Zero Tolerance for Female Genital Mutilation (FGM), an annual awareness day. Sponsored by the United Nations, it is part of the organization’s campaign to fully eradicate the procedure. FGM is the practice of removing all or partial female genitalia for non-medical reasons. It is seen as a coming-of age ceremony in some communities and is most often performed to control a woman’s sexual enjoyment.

There are four commonly recognised types of FGM. The first one is clitoridectomy and involves the total or partial removal of the clitoris, which is hyper-sensitive due to the high volume of nerve endings. The second is excision, which involves the removal of the labia minora as well as the clitoris. The third, referred to as infibulation, involves the cutting of labia minora and labia majora, which are often stitched together, leaving a small gap allowing for menstrual fluid and urine. This means that before the woman enters a sexual relationship, the external opening must be widened. Nawal El Saadawi, an Egyptian women’s rights activist and a medical doctor, recalls treating patients who underwent infibulation in her book The Hidden Face of Eve with horror, noting that “when a Sudanese woman is divorced, the external opening is narrowed once more to ensure that she cannot have sexual relations. If she remarries, widening is done again”. The fourth type of FGM refers to any other form of genital mutilation that is not medically necessary, such as piercing, cauterizing and pricking.

The procedure causes multiple health hazards, such as immediate and ongoing risks of infection, permanent pain, painful sex and urination, and other complications. It also results in deep psychological consequences, often impairing women’s relationships and self-confidence. When speaking about her own experience with the procedure, Dr El Saadawi recounts not being able to “forget the painful incident that had made [her] lose [her] childhood once and for all, and that deprived [her] during [her] youth and for many years of married life from enjoying the fullness of [her] sexuality and the completeness of life that can only come from all-round psychological equilibrium.” If performed in developing countries, FGM is often carried out by local village practitioners who do not have medical qualifications or tools, and who sometimes use the same knife on several girls in the duration of one procedure. It also poses several death risks: to the young woman after the procedure from immediate complications; to the woman when giving birth and to the baby being born from asphyxiation. Hibo Wadere, raised in Somalia, where 98% of women between the ages of 15 and 49 have undergone forced mutilation, and residing in England today, remembers “… being held down, [her] legs yanked apart and [her] genitals literally ripped apart.” She “saw the cutter every time she brought her hands up. The blood was everywhere.”

Mrs. Wadere was six years old when her family hosted a party that she was told would make her a woman. In an interview with the BBC, she calls the procedure the “cruelest thing for a child to experience.” She commented on the permanent effects FGM has on her life, saying that it was “not only that day” and that “it stays with you for life. It’s a life sentence.” Her account of the procedure is staggeringly similar to El Saadawi’s, who also describes having “… [her] thighs … pulled wide apart,” and “each of [her] lower limbs … held as far away as possible, gripped by steel fingers that never relinquished their pressure.” In both instances the women recall having their families present and joyful over the occasion. A quick search of international organisations working to combat the practice reveals a plethora of nearly identical accounts. The World Health Organisation (WHO) estimates that over 200 million women worldwide have undergone the procedure and, despite the internationally recognised barbarity of the practice, it estimates that 3 million girls are at risk of undergoing the procedure each year.

Last year, in conjunction with #MeToo movement, an international campaign was started in Ireland in an attempt to raise awareness of FGM under the #MeTooFGM. In 2012, it became illegal to not only perform FGM in Ireland, but also to take a girl out of state to have the procedure carried out. However, the European Institute for Gender Equality’s report estimates that between 158 and 1632 girls in Ireland are still at risk of undergoing FGM. Across the pond, the situation is not much different. An estimated 137,000 women and girls in England are victims of FGM according to City University London.

On the 1st February of this year, the UK saw a historic conviction of a mother for performing FGM on her 3-year-old daughter. It was the first conviction since 1985, when the practice was made illegal. The number of convictions is disproportionately small. BBC’s Freedom of Information request revealed 939 calls made to emergency services in a five-year period regarding FGM, but the Crown Prosecution service has only had 36 referrals by the police since 2010. It was revealed that 1 in 4 FGM reports between 2015 and 2017 concerned girls aged 3 or less. Out of 17 reports made to the West Yorkshire police, the youngest girl was just one month old. The young age at which these procedures are performed is what makes it increasingly difficult for public authorities to detect the issue.

In France, a much tougher approach is taken. Children under the age of 6 undergo mandatory regular genital checks, and doctors are required to report cases of physical abuse. Linda Weil-Curiel, a lawyer responsible for more than 100 FGM convictions in France, identifies parents as the key perpetrators of the abuse, and tells the BBC that they are the ones who “want” the procedure done in the first place, “pay for it” and “bring the child to the cutter.” She faults the British system for “[expecting] a child to complain against her parents”. Many people do not report FGM out of fear of appearing racist, failing to realize that child abuse is not a cultural phenomenon but a crime. While often seen as a problem of the developing world, FGM is not contained to it and is performed in European countries and the US as well. 19th century British gynecologist Isaac Brown promoted the practice as a treatment for insanity, epilepsy and a number of illnesses. There is evidence suggesting US doctors practiced FGM until the 1960s. The Guardian learned that Renne Bergstrom raised in a Christian community in Mid-West America, was 3 years old when her mother “concerned that [Renee] was masturbating…, took [her] to a doctor who cut of [her] clitoris.” Similarly to the cases described above, Renee remembers the pain and her mother’s role in the procedure being carried out. The consequences of FGM meant that during childbirth Mrs. Bergstrom was at risk of dying without medical intervention. Dr El Saadawi also rejects the suggestion that FGM is a practice contained by customs or religion and sees it as part of a larger culture of containing female sexuality, referencing the European history of using chastity belts to the same effect.

It is clear that FGM is a harmful practice, causing many physical and mental health risks and death and that the forced mutilation of children must be stopped. Irish Family Planning Association provides free specialized medical care and counselling to women in Ireland who have experienced FGM.  

The IFPA can be reached on 085 877 1342 by call or text.