Gender mutilation refers to the partial or total removal of external (usually female) genitals usually for cultural reasons. This is a common practice in different parts of the world and the reasons for its practice vary from country to country. Usually, it is carried out by traditional practitioners but there are documented reports of involvement of health workers. But this practice is strongly frowned upon by various national and international health institutions as the supposed health benefits of gender mutilations are all a façade with this practice having deleterious effects on health of women and girls affected.
The United Nations estimates that at least 200 million women and girls in 30 countries in Africa, the Middle East and Asia have undergone female genital mutilation (FGM), with 80% of them occurring in Africa. Somalia has the highest percentage of FGM in the world with 98% of the women there having undergone FGM while Egypt has the largest number of women who had undergone FGM (27.2 million).
Other high-ranking countries include Guinea, Djibouti and Sudan, with these countries having between 86-96% of their women having undergone FGM. The practice of FGM has been described to be prevalent geographically in Africa in a band that stretches from Senegal in West Africa to Ethiopia on the east coast, as well as from Egypt in the north to Tanzania in the south.
But immigration has resulted in the spread of FGM to Europe, Australia, and the United States with some families performing the act while on vacation in their country of birth.
While various laws have been put in place to prevent FGM, a lot of other factors have been responsible for this continuous practice in Africa. Social obligation/acceptance, poor access to information, religion, hygiene, preservation of virginity, marriageability, and enhancement of male sexual pleasure have been shown to be reasons behind the persistence of FGM.
It is interesting that despite FGM being suffered by women, it is women who organise all FGM procedures in countries where it practiced. This has been linked to the acceptance of FGM as a necessary “feminization” procedure necessary for every girl to attain womanhood. Also, the involvement of health workers in FGM is high in countries like Sudan, Egypt, Kenya, Nigeria, and Guinea. This is termed “medicalization” of FGM with wrong beliefs that the performance of FGM by health workers portend lesser risks than when performed by traditional practitioners.
The negative health consequences of FGM are so many; severe genital pain, excessive bleeding (haemorrhage), infections, urinary problems, and death from complications. Long-term complications include painful urination, recurrent bladder and vaginal infections, painful menstruations, pain during intercourse, decreased satisfaction from intercourse, increased risk of childbirth complications and need for later surgeries, psychological problems such as depression, anxiety, post-traumatic stress disorder, low self-esteem, etc.
In international law, there is a consensus that female genital mutilation is a human rights violation that needs to be criminalised and eradicated by all states with a focus on African countries due to the high prevalence in Africa.
Various international human rights instruments to that effect have been developed and include global and regional treaties, conventions, protocols, declarations, resolutions, and recommendations. Interestingly, a lot of countries where FGM was the norm have had the practice outlawed and are on the path of reversal of such heinous practices. But there remains a lot to be done for such laws to be enforced in those countries. As of September 2018, FGM was illegal in 22 of the 28 most FGM-prevalent countries in Africa with Sudan criminalising FGM in April 2020.
