Female Genital Mutilation Research Paper

1. Extent And Distribution

Sources estimate that perhaps as many as 130 million women in the world today have been mutilated genitally (Toubia 1995). Since relatively little extensive statistical research has been conducted on the topic, prevailing figures quoted tend to vary. Figures usually are derived from approximate population censuses from areas where mutilation is known to be practiced.

As a cultural practice, female genital surgeries are particularly widespread on the African continent and to some extent on the Saudi Arabian peninsula, but are only sporadically documented from the rest of the world. Instances of genital mutilation are reported from selected communities in the Middle East and from Muslim Malaysia. In Europe and the USA, clitoridectomy was until the 1930s medically administered in diagnosis of excessive masturbation, nymphomania, and hysteria (cf., e.g., Roheim 1932, Bonaparte 1953). Cosmetic surgery of enlarged clitorises and labia minora has been reported recently both from the USA and Europe (cf. Walley 1997). In Europe and the USA, female genital mutilation was primarily a single instance phenomenon and not a social convention. During the last few decades of the twentieth century, however, large-scale immigration to Europe, the USA, and elsewhere from African countries where genital operations are mandatory, has extended the geographical location of female genital mutilation (cf. Lionnet 1992)

In Africa, the practice of genital surgeries is contained to certain regions only, most notably to the northeastern and eastern parts of the continent, from Egypt in the north to Tanzania in the south and across the continent along the Sahelian countries from Ethiopia to Senegal. It is practiced in some 28 countries and by a wide variety and number of ethnic groups. The extent and type of surgical intervention as well as its cultural meaning and social context vary considerably making it difficult to generalize across the societies in which female genital surgeries are the norm. Female genital mutilation occurs among Muslims, Christians (particularly among Copts), as well as adherents of traditional systems of belief, among agricultural and nomadic peoples alike and in rural as well as urban communities. The highest regional concentration, that is, where a majority of women in a particular area are mutilated, is in Northeast Africa; in the Horn (Somalia, Djibouti, and Eritrea), across Ethiopia, and into northern Sudan and Egypt. In Somalia and northern Sudan female genital mutilation is almost universal (Gruenbaum 1996). Elsewhere in Africa, genital surgeries as a cultural practice are scattered and alternate with ethnic affiliation, religious faith, economic class, and level of education. Within the same community, practices may even vary between subgroups and individual families, causing a situation where mutilated women live side by side with nonmutilated females.

As a general rule, where female genital mutilation is performed, male circumcision is also the norm. People themselves often draw a symbolic and social parallel between boys’ and girls’ circumcision. This is, among other things, reflected in a common term for the interventions in the local vernacular. While a number of societies in Africa and beyond practice male circumcision without cutting their women, the opposite, however, is never the case.

2. Operation Practices

Mutilation practices vary greatly. In some areas, such as Amharic Ethiopia, girls are operated upon within 40 days after birth, while in neighboring Somalia the operation usually is performed when the girls are between 6 and 8 years old (Hicks 1993, Talle 1993). In Kenya and Tanzania the girls are cut routinely just before puberty and often in association with elaborate initiation ceremonies (cf. Murray 1974). In a few, relatively exceptional cases reported among others from West Africa, the surgery is performed after puberty. It also has been reported that married women who have defied traditions and remained unmutilated, in cases of barrenness have undergone the surgery after being married in order to promote fertility. Not only the girl’s age, but also the surgical intervention, the performance context, and ritual elaboration exhibit substantial variations. In places in Egypt and among devoted Muslims in towns in the Sudan, for instance, only the prepuce or the tip of the clitoris is excised. This operation is referred to as sunna (‘duty’ in Arabic, i.e., to follow tradition). Surgically, sunna is the mildest form of mutilation and physiologically comparable to the removal of the foreskin at male circumcision. Although encouraged by religious leaders, health personnel, and opinion makers as a commendable mutilation form, it is still uncommon. What people label sunna, however, in practice is often really a clitoridectomy.

The most widespread form of female genital mutilation in fact is clitoridectomy, an intervention that implies removal of the whole or part of the clitoris, sometimes together with the labia minora. In the latter case the operation is also referred to as excision. Various forms of clitoridectomy-cum-excision are practiced from Senegal and Mauritania in West Africa, across Sahel to Egypt in the northeast, and southwards to Tanzania in East Africa. It is carried out across the whole area where female genital surgeries occur.

The surgically most severe form of operation is called infibulation (from Latin fibulae, clip) or Pharaonic circumcision. This is a form of surgery where the labia minora and parts of labia majora are excised wholly or partly, and often the clitoris; the sides of the vulva are then stitched together. A tiny orifice is left open serving as an outlet for urine and menstrual blood. The surgery transforms the genitals of a woman into a flattened, smoothed, and closed vulva with an oblong scar and a miniscule opening at the lower part. The practice of infibulation is particularly prevalent in the Horn of Africa, in the Sudan (Northern), and in southern (Nubian) parts of Egypt. It also occurs widely in Mali, in northern Nigeria, and among ethnic Somalis in other East African countries. The infibulated women are opened (defibulated) at marriage, either surgically—often by the practitioner who did the closing—or by the husband at penetration.

In medical and anthropological literature it is common to differentiate between four types of genital surgeries: sunna, clitoridectomy, excision, and infibulation. The types are classified by a gradient of surgical severity. Variations and modifications of the different types may occur over time as well in individual cases within the same geographical location. In the Sudan, for instance, an intermediate type, a compromise between excision and infibulation, sprung up during the colonial area as a local response to legislation against the practice imposed from outside (El Dareer 1982). The skills and techniques of the practitioners as well as the preferences of individual families may contribute to variation and differences in mutilation styles.

Genital operations usually are performed in the home of the girl and, as a rule, undertaken by an elderly woman skilled in the task. Often these women are local birth attendants as well. In Somalia, the practitioners belonged traditionally to a ritually ambiguous and despised subclan within the community. In other places, and these days even in Somalia, any adult woman with the necessary courage and skills may engage in the practice.

The operation normally is performed without any extensive form of anaesthetic or antiseptic precautions. Different herbs, animal fat, dung, or other substances believed to have homeostatic and cicatrizing properties are applied to the wound after the operation to prevent excessive bleeding and infection. Depending upon the routine, skills, and preference of the practitioner, the instruments used for the surgery are either a small knife prepared for that kind of work, or a razorblade. In the case of infibulation, the severed parts are stitched with thorns of the acacia species, or recently, with catgut. In urban areas, medically trained personnel or paramedics commonly perform ‘circumcision’ on both boys and girls. In addition to giving prophylactic antibiotics and tetanus injections, the urban practitioners normally apply local anesthetics when operating. Many parents prefer these modern operations as they tend to reduce the pain and minimize adverse effects, such as hemorrhaging or infection from the operation. With the medicalization of the genital surgeries, men have also become involved in operating on girls. Traditionally, men operated only on boys, while women operated on girls. The same-sex pair of circumcizer and circumcized reflected the thinking of male circumcision as an analogy of female circumcision.

Among peoples in Kenya and Tanzania and in large parts of West Africa, the surgical intervention is associated with elaborate rituals of initiation into adulthood (e.g., Murray 1974). In northeastern Africa, where infibulation is widespread, the operation, however, is not normally followed by any extensive ceremonial celebration. The operated girl is usually given a few presents and the family mark the day with some extra food and drinks, but the event is not a ceremony of great societal worth. In cases of physical cutting being part of some more significant rites of passage into adulthood, the waning of such traditions has not necessarily led to a decrease in the surgery itself. Instead of being part of a larger event, genital mutilation is now often a single act performed on girls at almost any age.

3. Historical Roots

The existence of female genital mutilation dates back to pre-Islamic and pre-Christian time. Although the practice as such does not stem from religious affiliation, many people make an association between circumcision and religious faith. This is particularly the case in West Africa where genital surgeries both in men and women are more common in Muslim than Christian communities (Koso-Thomas 1987).

The term Pharaonic circumcision originates from the folk legend that the pharaohs of ancient Egypt performed similar operations on their women. Whether the pharaohs actually infibulated their women or not will probably never be substantiated, but the term nonetheless indicates that we are dealing with a cultural phenomenon of great antiquity.

Greek merchants and travelers who crossed the Mediterranean in classical time mention that female genital mutilation occurred among Egyptians as well as among the peoples along the Red Sea. The sparse descriptions emanating from these travelers, however, do not allow us to ascertain whether it was infibulation or clitoridectomy, or both, people practiced in earlier times.

European travelers visiting Egypt much later reported on the occurrence of clitoridectomy (Browne 1799, Seligmann 1913). However, female slaves from the south (perhaps Nubians from the Sudan or southern Egypt), whom the wealthy Egyptians favored as mistresses, were infibulated (Widstrand 1964). Some authors held that these girls were mutilated upon arriving in the north by the slave merchants or by their masters to avoid loose living or unwanted pregnancies. This explanation is disputed as early reports suggest that infibulation occurred for some time among the peoples of the upper Nile in northern Sudan. Burckhardt who visited these areas early in the nineteenth century claimed that infibulated girls (‘virgins’) received a higher price on the Egyptian slave market than noninfibulated ones (Burckhardt 1819).

The beginning of female genital mutilation remains obscure. It has not been possible to determine whether mutilation originated in one area and from there spread to other areas or whether it originated independently in various places. With reference to the African continent, however, it is not unlikely that the practice arose in a culturally, commercially, central area and from there reached and influenced other parts of the continent. This assumption is based upon the fact that the practice of female genital mutilation appears to have had varying historical origins depending when people came into contact with each other (cf., e.g., Murray 1974). Historical and linguistic sources point to the Chusitic and Semitic-speaking peoples living along the Red Sea Coast as a core area of female genital mutilation (Seligmann 1913, Hicks 1993).

Recently, the practice of female genital mutilation is reported to have spread from one ethnic group to another in countries such as Chad, the Sudan, and Tanzania (cf. Leonard 2000, Gruenbaum 1996). In the Sudan, lower hierarchy groups often assimilate the practice of mutilation in order to be able to marry those of higher rank. Young girls in Chad are reported to perform clitoridectomy as a mark of modernity; since around 1980 the operation has become a kind of fashion in at least one reported area (Leonard 2000). Studies from places in West Africa suggest that the expansion of Islam is conducive to the spread of female genital mutilation. Among the ethnic Meru in Northern Tanzania, clitoridectomy has been revitalized as a sign of cultural pride and resistance against rapid modernization. These sketchy, contemporary examples show that the meaning of female genital surgeries may assume various values following shifts in social reality. To know its origin does not explain its present existence (Gruenbaum 1996). One distinguishable trait in the spread of female genital mutilation, however, appears to be the copying of cultural practices of higher status groups by people of lower rank (cf. Mackie 1995).

4. The Cultural Explanation

The practice of female genital mutilation is embedded deeply in cultural and moral preferences, gender identity and person forming, perceptions of body aesthetics, and ethnic marking. The unsuccessful attempts made by the British colonial administration during the 1930s and 1940s to abolish or modify the most severe types of female genital mutilation in the Sudan and in Kenya testify to the social importance of the practice (cf. Murray 1974, El Dareer 1982). Anthropologists and others often associate the tradition of female genital mutilation with a patriarchal social structure, practically and symbolically privileging female reproductive powers over female sexuality. (cf. Boddy 1982, Talle 1994).

People themselves give many explanations to defend the practice. For instance, the pastoral Maasai of Kenya and Tanzania claim that a girl can neither be married nor give birth to healthy children if she is not clitoridectomized. Should she deliver before she is operated upon, the child will die or be born disabled (Talle 1994). In the Sudan and Egypt, uncut female genitals are considered ugly and dirty. Men are reluctant to marry such girls because by not being ‘purified’ by genital excision, they are held to be immoral in the widest sense. For the Bantu-speaking Kikuyu in Kenya a girl must have her clitoris removed to be considered an adult and responsible person. And so on. People present a plethora of meanings and motives for upholding the practice. Although seldom elaborated on explicitly, the control of female sexuality is at stake. References to moral looseness, unmarriagability, and fertility failures speak strongly to the societal value of female chastity and of male control of female fertility and sexuality (cf., e.g., El Sadaawi 1980, Gordon 1991, Talle 1993).

In Somalia, where the practice of infibulation is particularly widespread, the operation is performed in two stages: the excision and the stitching. First, the clitoris is excised. This is considered an act of purification (xalaalays; from the Arabic xalaal, allowed by religion). The clitoris (kintir) is a part of the body which is associated with dirt and childhood. A girl who has not been operated on is referred to as kintirleey (childish, i.e., having clitoris) and teased by peers. To adult Somali women the word kinterleey has a very negative and somewhat embarrassing ring. Another Somali synonym for kintir is awle which means approximately ‘with (or having) father.’ This term suggest that the Somalis, as a number of other peoples performing genital surgeries, see the clitoris as a male part in the female body and thus held to be unclean. When excised, women become more feminine (Talle 1993).

Where infibulation is practiced, virginity is not held to be a natural condition in women but has to be forcibly implanted in girls while they are still young. The hymen of a woman, which attracts so much interest and attention in many other Muslim societies and evokes strong sanctions if broken before marriage, has little social or cultural significance among infibulation practicing people. To them a chaste girl means a ‘sewn’ girl. A tight infibulation is a sign of distinction and moral excellence. Symbolically, the closing is more important than the excision as the cutting of the flesh is irrevocable while the closing of the vulva can, in principle, be executed over and over again. Although never as tight as the first time, later surgeries (after childbirth and at divorce) return the woman’s body to its previous state by remaking her virginity (El Dareer 1987). Virginity under such circumstances is not an anatomical facticity but a social category (Hayes 1975).

The closing of her vulva is looked upon as a protection for the girl against indecency and immorality. A reason often given, for instance by Somalis, as to why originally they began to infibulate their girls was to prevent sexual assault of young girls while out herding alone. The infibulation, or the creation of the artificial virginity, is seen as a safeguard against unwanted pregnancies and unidentified paternity. Both in northern Sudan and in Somalia a nubile, ‘virgin’ daughter upholds and marks the moral standing of the partrilineal group (Hayes 1975, Kennedy 1980, Talle 1993). To leave a daughter or sister ‘uncut’ is held to be unnatural; the vision of such a woman is beyond comprehension, something which cannot even be expressed in words.

5. A Global Concern

During the feminist wave of the 1970s in Europe and the USA, female genital surgeries became a politicized issue. At the Copenhagen conference in 1980 during the United Nations Decade of Women (1975–85) the issue was brought to widespread international attention. Opponents of the practice asserted that female genital mutilation was a severe abuse of women’s and children’s rights and demanded legislation against it. The term ‘female circumcision’ was substituted by ‘female genital mutilation’ (Hosken 1982). This change of name from circumcision which is used for genital operations on men, was meant to draw attention to the severity of intervention, primarily in terms of health risks, on girls and women as compared with that of men (cf., e.g., Toubia 1995).

Legislation against female genital mutilation is on the agenda of international organizations such as Save the Children, Amnesty International, WHO, UNICEF, and other UN agencies. To prevent the spread of such surgeries into their countries, European governments are passing laws criminalizing all forms of genital mutilation (cf. Lionnet 1992). African countries, Egypt, the Sudan, and Kenya among others, have also passed legislation against female genital surgeries.

The global discourse on female genital mutilation has often been moralizing, racially prejudiced, and without sufficient understanding of the social and cultural context of the practice. Many African women have reacted to the paternalistic attitude that often permeates the global debate. The term female genital mutilation, which has received widespread acclaim, but which holds the implicit assumption that parents and kin deliberately intend to harm children, is contested (cf. Walley 1997). A more neutral term proposed recently is ‘female genital cutting’ (ShellDuncan and Hernlund 2000). African women— themselves frequently victimized by genital surgery— have, however, also been among the strongest opponents to the practice (e.g., Abdalla 1982). The latest voice in a string of personal testimonies of an excruciatingly painful intervention with lifelong suffering comes from an internationally celebrated Somali model, now a UN ambassador against female genital mutilation (Dirie and Miller1998).

Although opposition is growing everywhere, women continue to favor the practice. They do it not necessarily because they like it, but because they see no other alternative. Africans in exile, exposed to a majority society where mutilation is neither a norm nor an ideal and, additionally, relieved of the social pressure to perform it, may spearhead the eventual eradication of female genital mutilation.

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