Eliminating Female Genital Mutilation - WHO
EliminatingFemale genital mutilationAn interagency statementOHCHR, UNAIDS, UNDP, UNECA, UNESCO,UNFPA, UNHCR, UNICEF, UNIFEM, WHO
EliminatingFemale genital mutilationAn interagency statementOHCHR, UNAIDS, UNDP, UNECA, UNESCO,UNFPA, UNHCR, UNICEF, UNIFEM, WHO
WHO Library Cataloguing-in-Publication DataEliminating female genital mutilation: an interagency statement UNAIDS, UNDP, UNECA, UNESCO, UNFPA, UNHCHR, UNHCR,UNICEF, UNIFEM, WHO.1.Circumcision, Female. 2.Clitoris - surgery. 3.Cultural characteristics. 4. International cooperation. I.World Health Organization.ISBN 978 92 4 159644 2(NLM classification: WP 660) World Health Organization 2008All rights reserved. Publications of the World Health Organization can be obtained from WHO Press, World Health Organization, 20 AvenueAppia, 1211 Geneva 27, Switzerland (tel.: 41 22 791 3264; fax: 41 22 791 4857; e-mail: bookorders@who.int). Requests for permissionto reproduce or translate WHO publications – whether for sale or for noncommercial distribution – should be addressed to WHO Press, atthe above address (fax: 41 22 791 4806; e-mail: permissions@who.int).The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever onthe part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerningthe delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be fullagreement.The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by theWorld Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names ofproprietary products are distinguished by initial capital letters.All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication.However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for theinterpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising fromits use.Printed in
ContentsEliminating female genital mutilation: the imperative1Why this new statement?3Female genital mutilation—what it is and why it continues4Female genital mutilation is a violation of human rights8Female genital mutilation has harmful consequences11Taking action for the complete elimination of female genital mutilation13Conclusion21Annex 1: Note on terminology22Annex 2: Note on the classification of female genital mutilation23Annex 3: Countries where female genital mutilation has been documented29Annex 4: International and regional human rights treaties and consensus documents providing protectionand containing safeguards against female genital mutilation31Annex 5: Health complications of female genital mutilation33References36
1Eliminating female genital mutilationEliminating female genital mutilation:the imperativeThe term "female genital mutilation" (also called "female genital cutting" and "female genitalmutilation/cutting") refers to all procedures involving partial or total removal of the externalfemale genitalia or other injury to the female genital organs for non-medical reasons. Between 100and 140 million girls and women in the world are estimated to have undergone such procedures,and 3 million girls are estimated to be at risk of undergoing the procedures every year. Femalegenital mutilation has been reported to occur in all parts of the world, but it is most prevalent in:the western, eastern, and north-eastern regions of Africa, some countries in Asia and the MiddleEast and among certain immigrant communities in North America and Europe.Female genital mutilation has no known health benefits. On the contrary, it is known to be harmfulto girls and women in many ways. First and foremost, it is painful and traumatic. The removalof or damage to healthy, normal genital tissue interferes with the natural functioning of the bodyand causes several immediate and long-term health consequences. For example, babies bornto women who have undergone female genital mutilation suffer a higher rate of neonatal deathcompared with babies born to women who have not undergone the procedure.Communities that practise female genital mutilation report a variety of social and religious reasonsfor continuing with it. Seen from a human rights perspective, the practice reflects deep-rootedinequality between the sexes, and constitutes an extreme form of discrimination against women.Female genital mutilation is nearly always carried out on minors and is therefore a violation of therights of the child. The practice also violates the rights to health, security and physical integrity ofthe person, the right to be free from torture and cruel, inhuman or degrading treatment, and theright to life when the procedure results in death.Decades of prevention work undertaken by local communities, governments, and national andinternational organizations have contributed to a reduction in the prevalence of female genitalmutilation in some areas. Communities that have employed a process of collective decisionmaking have been able to abandon the practice. Indeed, if the practising communities decidethemselves to abandon female genital mutilation, the practice can be eliminated very rapidly.Several governments have passed laws against the practice, and where these laws have beencomplemented by culturally-sensitive education and public awareness-raising activities, thepractice has declined. National and international organizations have played a key role in advocatingagainst the practice and generating data that confirm its harmful consequences. The AfricanUnion’s Solemn Declaration on Gender Equality in Africa, and its Protocol to the African Charter onHuman and Peoples’ Rights on the Rights of Women in Africa constitute a major contribution to thepromotion of gender equality and the elimination of female genital mutilation.
2Eliminating female genital mutilationHowever, despite some successes, the overall rate of decline in the prevalence of female genitalmutilation has been slow. It is therefore a global imperative to strengthen work for the eliminationof this practice, which is essential for the achievement of many of the Millennium DevelopmentGoals.This Statement is a call to all States, international and national organizations, civil society andcommunities to uphold the rights of girls and women. It also call on those bodies and communitiesto develop, strengthen, and support specific and concrete actions directed towards ending femalegenital mutilation.On behalf of our respective agencies, we reaffirm our commitment to the elimination of femalegenital mutilation within a generation.Louise ArbourHigh CommissionerOffice of the United Nations High Commissionerfor Human Rights (OHCHR)Thoraya A. ObaidExecutive DirectorUnited Nations Population Fund (UNFPA)Peter PiotExecutive DirectorJoint United Nations Programme on HIV/AIDS (UNAIDS)António GuterresHigh Commissioner for RefugeesUnited Nations High Commissioner for Refugees (UNHCR)Kemal DervisAdministratorUnited Nations Development Programme (UNDP)Ann M. VenemanExecutive DirectorUnited Nations Children’s Fund (UNICEF)Abdoulie JannehUnder Secretary-General and Executive SecretaryUnited Nations Economic Commission for Africa (UNECA)Joanne SandlerExecutive Director, a.iUnited Nations Development Fund for Women (UNIFEM)Koïchiro MatsuuraDirector-GeneralUnited Nations Educational, Scientificand Cultural Organization (UNESCO)Margaret ChanDirector-GeneralWorld Health Organization (WHO)
3Eliminating female genital mutilationWhy this new statement?In 1997, the World Health Organization (WHO), theof the human rights and legal dimensions ofUnited Nations Children’s Fund (UNICEF) and thethe problem and provides current data onUnited Nations Population Fund (UNFPA) issuedthe prevalence of female genital mutilation. Ita Joint Statement on Female Genital Mutilationsummarizes findings from research on the reasons(WHO, UNICEF, UNFPA, 1997) which describedwhy the practice continues, highlighting that thethe implications of the practice for public healthpractice is a social convention which can only beand human rights and declared support for itschanged through coordinated collective action byabandonment.practising communities. It also summarizes recentresearch on its damaging effects on the healthSince then, much effort has been made toof women, girls and newborn babies. Drawing oncounteract female genital mutilation, throughexperience from interventions in many countries,research to generate further evidence on whichthe new statement describes the elements needed,to base interventions, through working withfor both working towards complete abandonmentcommunities, through advocacy and by passingof female genital mutilation, and caring for thoselaws. Progress has been made at both internationalwho have suffered, and continue to suffer, from itsand local levels. More United Nations agencies areconsequences.involved; human rights treaty monitoring bodiesand international resolutions have condemned theNote on terminologypractice; legal frameworks have improved in manyThe term "female genital mutilation" is used in thiscountries; and political support for ending femaleStatement as it was in the 1997 Joint Statement.genital mutilation is growing. Most significantly, inThe word "mutilation" emphasizes the gravity ofsome countries the prevalence of female genitalthe act. Some United Nations agencies use themutilation has declined, and an increasing numberterm "female genital mutilation/cutting" whereinof women and men in practising communities arethe additional term "cutting" is intended todeclaring their support for its abandonment.reflect the importance of using non-judgementalterminology with practising communities. BothIn spite of these positive signs, prevalence in manyterms emphasize the fact that the practice is aareas remains high and there is an urgent needviolation of girls’ and women’s human rights.to intensify, expand and improve efforts if femaleFor further explanation on this terminology, seegenital mutilation is to be eliminated within oneAnnex 1.generation. To reach this goal, both increasedresources and coordination and cooperation areneeded.This new Interagency Statement is written andsigned by a wider group of United Nations agenciesthan the previous one, to support advocacy forthe abandonment of female genital mutilation. Itis based on new evidence and lessons learnt overthe past decade. It highlights the wide recognition
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).ClassificationSome forms of female genital mutilation have alsobeen reported from other countries, including amongType I: Partial or total removal of the clitoris and/orthe prepuce (clitoridectomy).certain ethnic groups in Central and South America.Growing migration has increased the number of girlsType II: Partial or total removal of the clitoris andand women living outside their country of origin whothe labia minora, with or without excision of thehave undergone female genital mutilation (Yoder etlabia majora (excision).al., 2004) or who may be at risk of being subjected toType III: Narrowing of the vaginal orifice withthe 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 where 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 continuescontinuing the practice. In view of this conventionalIn every society in which it is practised, femalenature of female genital mutilation, it is difficultgenital mutilation is a manifestation of genderfor families to abandon the practice withoutinequality that is deeply entrenched in social,support from the wider community. In fact, it iseconomic and political structures. Like the now-often practised even when it is known to inflictabandoned foot-binding in China and the practice ofharm upon girls because the perceived socialdowry and child marriage, female genital mutilationbenefits of the practice are deemed higher than itsrepresents society’s control over women. Suchdisadvantages (UNICEF, 2005a).practices have the effect of perpetuating normativegender roles that are unequal and harm women.Members of the extended family are usuallyAnalysis of international health data shows a closeinvolved in decision-making about female genitallink between women’s ability to exercise controlmutilation, although women are usually responsibleover their lives and their belief that female genitalfor the practical arrangements for the ceremony.mutilation should be ended (UNICEF, 2005b).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 for aThe practice of female genital mutilation is oftenwoman 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’
and Cultural Organization (UNESCO) Thoraya A. Obaid Executive Director United Nations Population Fund (UNFPA) Louise Arbour High Commissioner Office of the United Nations High Commissioner for Human Rights (OHCHR) Marga
Ritual female genital mutilation: management of women during the reproductive years Introduction The term female genital mutilation (FGM), also called female genital cutting or female circumcision, includes all procedures . modifications were incorporated in order to avoid ambiguities
Female genital mutilation/cutting (FGM/C) is an umbrella term for any procedure of modification, partial or total removal or other injury to the female genital organs for non-medical reasons [1]. In 1990 the Inter-African Com-mittee on Traditional Practices Affecting the Health of Women and Children adopted the term 'female genital mutilation'.
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 .
Female Genital Mutilation (FGM) also known as Female Genital Cutting (FGC) is a severe violation of girl‟s and women‟s human rights. Waris Dirie –Desert Flower –“Female Mutilation has no cultural, no traditional and no religious aspect. It is a crime which seeks justice.” FGM is p
20 ‘‘(41) FEMALE GENITAL MUTILATION.—The 21 terms ‘female genital mutilation’, ‘female genital 22 cutting’, ‘FGM/C’, or ‘female circumcision’ mean the 23 intentional removal or infibulation (or both) of either 24 the whole or part of the external female genitalia for 25 non-medical reasons. External female
Female Genital Mutilation in gypt: ecent trends and projections 03 Female genital mutilation in the global development agenda FGM is a violation of human rights. Every girl and woman has the right to be protected from this harmful practice, a manifestation of entrenched gender inequality with devastating consequences. FGM is now firmly on the .
Promoting genital autonomy by exploring commonalities between male, female, intersex, and cosmetic female genital cutting J. Steven Svoboda*1 Attorneys for the Rights of the Child, Berkeley, CA, USA All forms of genital cutting – female genital cutting (FGC), intersex genital cutting,
Female Genital Surgeries in Africa By THE PuBlIC POlICy ADVISORy NETwORK ON FEMAlE GENITAl SuRGERIES IN AFRICA western media coverage of female genital modifications in Africa has been hyperbolic and one-sided, presenting them uniformly as mutilation and ignoring the cultural complexities that underlie these practices.
