Eliminating Female Genital Mutilation

4Eliminating Female Genital MutilationFemale genital mutilation—what it isand why it continuesFemale genital mutilation comprises all proceduresinvolving partial or total removal of the externalfemale genitalia or other injury to the female genitalorgans for non-medical reasons (WHO, UNICEF,UNFPA, 1997).The WHO/UNICEF/UNFPA Joint Statementclassified female genital mutilation into four types.Experience with using this classification over thepast decade has brought to light some ambiguities.The present classification therefore incorporatesmodifications to accommodate concerns andshortcomings, while maintaining the four types(see Annex 2 for a detailed explanation andproposed sub-divisions of types).How widely it is practicedWHO estimates that between 100 and 140 milliongirls and women worldwide have been subjectedto one of the first three types of female genitalmutilation (WHO, 2000a). Estimates based on themost recent prevalence data indicate that 91,5million girls and women above 9 years old in Africaare currently living with the consequences of femalegenital mutilation (Yoder and Khan, 2007). Thereare an estimated 3 million girls in Africa at risk ofundergoing female genital mutilation every year(Yoder et al., 2004).Types I, II and III female genital mutilation have beendocumented in 28 countries in Africa and in a fewcountries in Asia and the Middle East (see Annex 3).ClassificationType I: Partial or total removal of the clitoris and/orthe prepuce (clitoridectomy).Type II: Partial or total removal of the clitoris andthe labia minora, with or without excision of thelabia majora (excision).Type III: Narrowing of the vaginal orifice withSome forms of female genital mutilation have alsobeen reported from other countries, including amongcertain ethnic groups in Central and South America.Growing migration has increased the number of girlsand women living outside their country of origin whohave undergone female genital mutilation (Yoder etal., 2004) or who may be at risk of being subjected tothe practice.creation of a covering seal by cutting andappositioning the labia minora and/or the labiaThe prevalence of female genital mutilation has beenmajora, with or without excision of the clitorisestimated from large-scale, national surveys asking(infibulation).women aged 15-49 years if they have themselvesType IV: All other harmful procedures to thebeen cut. The prevalence varies considerably, bothfemale genitalia for non-medical purposes, forbetween and within regions and countries (seeexample: pricking, piercing, incising, scraping andFigure 1 and Annex 3), with ethnicity as the mostcauterization.decisive factor. In seven countries the nationalprevalence is almost universal, (more than 85%);Female genital mutilation is mostly carried outfour countries have high prevalence (60-85%);on girls between the ages of 0 and 15 years.medium prevalence (30-40%) is found in sevenHowever, occasionally, adult and married womencountries, and low prevalence, ranging from 0.6%are also subjected to the procedure. The age atto 28.2%, is found in the remaining nine countries.which female genital mutilation is performed variesHowever, national averages (see Annex 3) hide thewith local traditions and circumstances, but isoften marked variation in prevalence in differentdecreasing in some countries (UNICEF, 2005a).parts of most countries (see Figure 1).

5Eliminating Female Genital MutilationFigure 1. Prevalence of female genital mutilation in Africa and Yemen (women aged 15–49)The map shows the areas were FGM is practised, andsince that can vary markedly in different parts of anycountry, no national boundaries are shown.Data at the sub-national level are not available forZambia. Due to a discrepancy between the regionaldivisions used by DHS and the one adopted by DevInfo,it was not possible to include data at the sub-nationallevel for Yemen.Less than 10%10.1% – 25%25.1% – 50%50.1% – 75%75.1% or moremissing data or FGM not widely practicedSources: MICS, DHS and other national surveys, 1997–2006Map developed by UNICEF, 2007The type of procedure performed also varies,Where female genital mutilation is widely practised,mainly with ethnicity. Current estimates indicateit is supported by both men and women, usuallythat around 90% of female genital mutilation caseswithout question, and anyone departing from theinclude Types I or II and cases where girls’ genitalsnorm may face condemnation, harassment, andwere ‘nicked’ but no flesh removed (Type IV), andostracism. As such, female genital mutilation isabout 10% are Type III (Yoder and Khan, 2007).a social convention governed by rewards andpunishments which are a powerful force forWhy the practice continuesIn every society in which it is practised, femalegenital mutilation is a manifestation of genderinequality that is deeply entrenched in social,economic and political structures. Like the nowabandoned foot-binding in China and the practice ofdowry and child marriage, female genital mutilationrepresents society’s control over women. Suchpractices have the effect of perpetuating normativegender roles that are unequal and harm women.Analysis of international health data shows a closelink between women’s ability to exercise controlover their lives and their belief that female genitalmutilation should be ended (UNICEF, 2005b).continuing the practice. In view of this conventionalnature of female genital mutilation, it is difficultfor families to abandon the practice withoutsupport from the wider community. In fact, it isoften practised even when it is known to inflictharm upon girls because the perceived socialbenefits of the practice are deemed higher than itsdisadvantages (UNICEF, 2005a).Members of the extended family are usuallyinvolved in decision-making about female genitalmutilation, although women are usually responsiblefor the practical arrangements for the ceremony.Female genital mutilation is considered necessary

6Eliminating Female Genital Mutilationto raise a girl properly and to prepare her forthereby ensuring marital fidelity and preventingadulthood and marriage (Yoder et al., 1999;sexual behaviour that is considered deviant andAhmadu, 2000; Hernlund, 2003; Dellenborg,immoral (Ahmadu, 2000; Hernlund, 2000, 2003;2004). In some societies, the practice is embeddedAbusharaf, 2001; Gruenbaum, 2006). Femalein coming-of-age rituals, sometimes for entry intogenital mutilation is also considered to make girlswomen’s secret societies, which are considered‘clean’ and beautiful. Removal of genital partsnecessary for girls to become adult and responsibleis thought of as eliminating ‘masculine’ partsmembers of the society (Ahmadu, 2000; Hernlund,such as the clitoris (Talle, 1993; Ahmadu, 2000;2003; Behrendt, 2005; Johnson, 2007). GirlsJohansen, 2007), or in the case of infibulation, tothemselves may desire to undergo the procedureachieve smoothness considered to be beautifulas a result of social pressure from peers and(Talle, 1993; Gruenbaum, 2006). A beliefbecause of fear of stigmatization and rejection bysometimes expressed by women is that femaletheir communities if they do not follow the tradition.genital mutilation enhances men’s sexual pleasureAlso, in some places, girls who undergo the(Almroth-Berggren et al., 2001).procedure are given rewards such as celebrations,public recognition and gifts (Behrendt, 2005;In many communities, the practice may alsoUNICEF, 2005a). Thus, in cultures where it isbe upheld by beliefs associated with religionwidely practised, female genital mutilation has(Budiharsana, 2004; Dellenborg, 2004;become an important part of the cultural identityGruenbaum, 2006; Clarence-Smith, 2007; Abdi,of girls and women and may also impart a sense of2007; Johnson, 2007). Even though the practicepride, a coming of age and a feeling of communitycan be found among Christians, Jews and Muslims,membership.none of the holy texts of any of these religionsprescribes female genital mutilation and theThere is often an expectation that men will marrypractice pre-dates both Christianity and Islamonly women who have undergone the practice.(WHO, 1996a; WHO and UNFPA, 2006). The roleThe desire for a proper marriage, which is oftenof religious leaders varies. Those who support theessential for economic and social security as wellpractice tend either to consider it a religious act,as for fulfilling local ideals of womanhood andor to see efforts aimed at eliminating the practicefemininity, may account for the persistence of theas a threat to culture and religion. Other religiouspractice.leaders support and participate in efforts toeliminate the practice. When religious leaders areSome of the other justifications offered forunclear or avoid the issue, they may be perceivedfemale genital mutilation are also linked toas being in favour of female genital mutilation.girls’ marriageability and are consistent withthe characteristics considered necessary forThe practice of female genital mutilation is oftena woman to become a ‘proper’ wife. It is oftenupheld by local structures of power and authoritybelieved that the practice ensures and preservessuch as traditional leaders, religious leaders,a girl’s or woman’s virginity (Talle, 1993, 2007;circumcisers, elders, and even some medicalBerggren et al., 2006; Gruenbaum, 2006). In somepersonnel. Indeed, there is evidence of an increasecommunities, it is thought to restrain sexual desire,in the performance of female genital mutilation by

7Eliminating Female Genital Mutilationmedical personnel (see box ‘Health professionalsin adult women (Berggren et al., 2006). In periodsmust never perform female genital mutilation’,of change, female genital mutilation can give risepage 12). In many societies, older women whoto discussions and disagreement, and there arehave themselves been mutilated often becomecases in which some family members, againstgatekeepers of the practice, seeing it as essentialthe will of others, have organized the procedureto the identity of women and girls. This is probably(Draege, 2007). Furthermore, both individualsone reason why women, and more often olderand communities can change ideas and opinionswomen, are more likely to support the practice,several times (Nypan, 1991; Shell-Duncan andand tend to see efforts to combat the practice asHernlund, 2006). Decision-making is complex and,an attack on their identity and culture (Toubia andto ensure that families who wish to abandon theSharief, 2003; Draege, 2007; Johnson, 2007). Itpractice can make and sustain their decision soshould be noted that some of these actors also playthat the rights of girls are upheld, a wide group ofa key role in efforts to eliminate the practice.people have to come to agreement about endingthe practice (see section on ‘Taking action for theFemale genital mutilation is sometimes adoptedby new groups and in new areas after migrationand displacement (Abusharaf, 2005, 2007). Othercommunities have been influenced to adopt thepractice by neighbouring groups (Leonard, 2000;Dellenborg, 2004) and sometimes in religiousor traditional revival movements (Nypan, 1991).Preservation of ethnic identity to mark a distinctionfrom other, non-practising groups might also beimportant, particularly in periods of intensivesocial change. For example, female genitalmutilation is practised by immigrant communitiesliving in countries that have no tradition of thepractice (Dembour, 2001; Johansen, 2002,2007; Johnson, 2007). Female genital mutilationis also occasionally performed on women andtheir children from non-practising groups whenthey marry into groups in which female genitalmutilation is widely practised (Shell-Duncan andHernlund, 2006).Decisions to perform female genital mutilation ongirls involve a wide group of people who may havedifferent opinions and varying degrees of influence(Shell-Duncan and Hernlund, 2006; Draege, 2007).This is even true for the practice of reinfibulationcomplete elimination of female genital mutilation’,page 13).

8Eliminating Female Genital MutilationFemale genital mutilation is a violationof human rightsFemale genital mutilation of any type has beenThe Committee on the Elimination of All Formsrecognized as a harmful practice and a violationof Discrimination against Women, the Committeeof the human rights of girls and women. Humanon the Rights of the Child and the Human Rightsrights—civil, cultural, economic, political andCommittee have been active in condemning thesocial—are codified in several internationalpractice and recommending measures to combatand regional treaties. The legal regime isit, including the criminalization of the practice.complemented by a series of political consensusThe Committee on the Elimination of All Forms ofdocuments, such as those resulting from the UnitedDiscrimination against Women issued its GeneralNations world conferences and summits, whichRecommendation on Female Circumcision (Generalreaffirm human rights and call upon governmentsRecommendation No 14) that calls upon statesto strive for their full respect, protection andto take appropriate and effective measures withfulfilment.a view to eradicating the practice and requeststhem to provide information about measures beingMany of the United Nations human rights treatymonitoring bodies have addressed female genitalmutilation in their concluding observations onhow States are meeting their treaty obligations.taken to eliminate female genital mutilation intheir reports to the Committee (Committee on theElimination of All Forms of Discrimination againstWomen, 1990).International and regional sources of human rightsStrong support for the protection of the rights of women and girls to abandon female genital mutilation isfound in international and regional human rights treaties and consensus documents. These include, amongothers:International treaties Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or PunishmentCovenant on Civil and Political RightsCovenant on Economic, Social and Cultural RightsConvention on the Elimination of all Forms of Discrimination against Women (CEDAW)Convention on the Rights of the ChildConvention relating to the Status of Refugees and its Protocol relating to the Status of RefugeesRegional treaties African Charter on Human and Peoples’ Rights (the Banjul Charter) and its Protocol on the Rights of Womenin Africa African Charter on the Rights and Welfare of the Child European Convention for the Protection of Human Rights and Fundamental FreedomsConsensus documents Beijing Declaration and Platform for Action of the Fourth World Conference on WomenGeneral Assembly Declaration on the Elimination of Violence against WomenProgramme of Action of the International Conference on Population and Development (ICPD)UNESCO Universal Declaration on Cultural Diversity United Nations Economic and Social Council (ECOSOC), Commission on the Status of Women.Resolution on Ending Female Genital Mutilation. E/CN.6/2007/L.3/Rev.1.(See Annex 4 for full details of treaties and consensus documents).

9Eliminating Female Genital MutilationHuman rights violated by femalegenital mutilationFemale genital mutilation violates a series of wellestablished human rights principles, norms andstandards, including the principles of equality andnon-discrimination on the basis of sex, the right tolife when the procedure results in death, and theright to freedom from torture or cruel, inhumanor degrading treatment or punishment as well asthe rights identified below. As it interferes withhealthy genital tissue in the absence of medicalnecessity and can lead to severe consequencesfor a woman’s physical and mental health, femalegenital mutilation is a violation of a person’s rightto the highest attainable standard of health.The rights of the childBecause of children’s vulnerability and their need for care and support, human rights law grants themspecial protection. One of the guiding principles of the Convention on the Rights of the Child is the primaryconsideration of ‘the best interests of the child’. Parents who take the decision to submit their daughtersto female genital mutilation perceive that the benefits to be gained from this procedure outweigh the risksinvolved. However, this perception cannot justify a permanent and potentially life-changing practice thatconstitutes a violation of girls’ fundamental human rights.The Convention on the Rights of the Child refers to the evolving capacity of children to make decisionsregarding matters that affect them. However, for female genital mutilation, even in cases where there isan apparent agreement or desire by girls to undergo the procedure, in reality it is the result of social pressure and community expectations and stems from the girls’ aspiration to be accepted as full members ofthe community. That is why a girl’s decision to undergo female genital mutilation cannot be called free,informed or free of coercion.Legal instruments for the protection of children’s rights specifically call for the abolition of traditionalpractices prejudicial to their health and lives. The Convention on the Rights of the Child makes explicitreference to harmful traditional practices and the Committee on the Rights of the Child, as well as otherUnited Nations Human Rights Treaty Monitoring Bodies, have frequently raised female genital mutilationas a violation of human rights, calling upon State Parties to take all effective and appropriate measures toabolish the practice.

10Eliminating Female Genital MutilationFemale genital mutilation has been recognized asThe right to participate in cultural life and freedomdiscrimination based on sex because it is rooted inof religion are protected by international law.gender inequalities and power imbalances betweenHowever, international law stipulates that freedommen and women and inhibits women’s full andto manifest one’s religion or beliefs might beequal enjoyment of their human rights. It is a formsubject to limitations necessary to protect theof violence against girls and women, with physicalfundamental rights and freedoms of others.and psychological consequences. Female genitalTherefore, social and cultural claims cannotmutilation deprives girls and women from makingbe evoked to justify female genital mutilationan independent decision about an intervention that(International Covenant on Civil and Political Rights,has a lasting effect on their bodies and infringes onArticle 18.3; UNESCO, 2001, Article 4).their autonomy and control over their lives.

11Eliminating Female Genital MutilationFemale genital mutilation has harmfulconsequencesFemale genital mutilation is associated with aA striking new finding from the study is that genitalseries of health risks and consequences. Almostmutilation of mothers has negative effects onall those who have undergone female genitaltheir newborn babies. Most ser

Female genital mutilation is a violation of human rights 8 Female genital mutilation has harmful consequences 11 . modifications to accommodate concerns and shortcomings, while maintaining the .