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Female Genital mutilation (FGM)

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Female genital mutilation


Description: the TH partial or total no of the external female genitalia or other injury of the female genital organs for medical reasons

Zones in which it is practiced: Western, oriental and African, North and East, Middle East and Near East, Southeast Asia

Number affected: 135 million women and girls since 1997

Age is performed: A few days after his birth until age 15, occasionally in adulthood

Female genital mutilation (FGM), also known as female genital mutilation and female curette, is defined by the World Health Organization (who) as "all procedures consistent in not full or partial resection of the external female genitalia or other injury of the female genital organs for medical reasons".

genital mutilation is typically performed on girls in a few days of age at puberty.You can take place in a hospital, but usually anaesthesia of sin, is performed by a traditional circumcise with a knife, razor or scissors.According to the who, is practised in 28 countries, in the West, East and Northeast Africa, in some parts of Middle East, and in some communities of immigrants in Europe, North America, Australasia.Who believes that 100 million women and girls worldwide have undergone the procedure, including 92 million in Africa.Practice carried out by some communities who believe that reducing a woman's libido.

Who has offered four output of FGM.The three main ones are type I, the removal of the prepuce of the clitoris, almost invariably accompanied by the removal of the clitoris in Yes (clitoridectomy);Removal of the clitoris and the labia minora, type II, and type III (infibulation), th of all or part of the internal and external lips, usually the clitoris and the fusion of the wound, leaving a small hole for the passage of urine and menstrual blood melted wound opens for sexual intercourse and childbirth.Around 85 per cent of women undergo FGM completo de experiencia de types I and II, and 15 percent of the type III, although type III is the most common procedure in several countries, including Sudan, Somalia and Djibouti.Various miscellaneous acts are classified as type IV.These will from a symbolic puncture or piercing in the clitoris or the labia, cauterization of the clitoris, the cut in the vagina to widen it (gishiri cutting), and the introduction of corrosive substances to tighten.

opposition to FGM focuses on violations of human rights, the lack of informed consent, and health risks, including fatal hemorrhage, vaginal and recurrent urinary tract infections, Epidermoid cysts, chronic pain and obstetric complications.Since 1979, there has been a concerted effort by international bodies to put an end to the practice, as well as the sponsorship of the United Nations of the international day of zero tolerance to Female Genital mutilation, held each February since 2003 06.Sylvia Tamale, a Ugandan legal scholar, writes there is a great amount of research and activism in Africa itself is firmly opposed to FGM, but warns of some African feminists opposed to what she calls the imperialist infantilization of African women, and against the idea that FGM is not a brutal rejection of modernity.Tamale although there are cultural aspects and politicians for the continuation of the practice made opposition to a complex topic.

Fund

Terminology

Procedures known as FGM is known as the female curette until the 1980s, when the term "female genital mutilation" them in use.The term was adopted at the third Conference of the Inter-African Committee on traditional practices affecting the health of women and children in Addis Ababa, Ethiopia, and in 1991, the who recommends its use to the United Nations.Has since then become the dominant term in the international community and in the medical literature.Lewnes Alexia argued in a 2005 UNICEF report the word "mutilation" difference male curette procedure and emphasizes its severity.

Other terms are used, apart from the female curette, include female genital mutilation (FGM) and female genital modification of female genital surgeries, female genital excision, FGM alteration.Elizabeth Heger Boyle writes that some organizations refer to her as female genital mutilation, because this is the best received in the communities that the Team, does not look like the practice of mutilation, she writes the State-sponsored groups Tilting while call it private MGF groups used FGC.Other groups, such as UNFPA and USAID, uses the combined term "female genital mutilation / ablation" (to / FGM).

Local terms for the procedure include tahara in Egypt, tahur in Sudan, and bolokoli in Mali, writing Anika Rahman and Nahid Toubia son synonymous words with purification.Several countries refer to the type 1 FGM as sunna curette.Also known as kakia, and in Sierra Leone as bundu, after secret Bundu society.In type III FGM (infibulation) is known as "pharaonic curette" and "Sudanese curette" in Egypt, Sudan.Urologist Jean Fourcroy writes that women in countries FGM Team called one of the "three female pains": first pain is the same procedure, followed by the wedding night, when a woman with type III has to be opened, then when the birth she has to be cut back.

MGF the term does not apply to dental or elective, procedures such as vaginoplasty labioplasty, and or used them in sex reassignment surgery.According to the who, some practices regarded as legal in countries that have banned FGM fall under the category of type IV (see below), but the Organization decided to maintain a broad definition to avoid empty legal FGM could allow to continue.

History and cultural context

La FGM is considered by its practitioners to be an essential part of the upbringing of the nina-ninas is considered to have been cleaned by the separation of the "male" parts of the body.Ensures the virginity before marriage and inhibits sex outside of marriage, already reduces the libido of women.Of the re-opening of the vagina of women fear pain, and are afraid of being discovered if opened illegally.

The term "pharaonic curette" (type III) is derived from his practice in the ancient Egypt under the Pharaohs, and "fibula" ('infibulation') refers to the Roman practice of drilling of the labia with a brooch or fibula.Leonard Kouba and Muasher Judith write genitally mutilated women have been found in Egyptian mummies, and that Herodotus (c. 484 aC-. )( C 425 aC) referred to the practice when he visited Egypt. There is a reference in a Greek Papyrus of the 163 AC, the procedure that was conducted in girls in Memphis, the capital of ancient Egypt, and Strabo (c. 64 aC-. )C 23 CE), Greek geographer, said during his visit to Egypt on 25 before Christ.

Asim Mustafa Zaki holds the common attribution of the procedure Islam is unjust because it is a much older phenomenon.

Judaism requires curette for males, but not allowed for girls.The Islamic Writings have said that, while the male curette is a sunna, or religious obligation, female genital modification is not necessary, and several of them have issued a fatwa against FGM III.

Sudanese surgeon Nahid Toubia-President of RAINBO (network of research, action and information for the bodily integrity of women) - told the BBC in 2002 that the campaign against FGM involved trying to change the consciousness of women: "by allowing their genitals to be deleted [is perceived that] you are accentuated a maternity leave of the maternidad-a another level from the pure unpolluted by sexuality and why women what company to become in "matron, respected by everyone.To assume this practice, which is in the domain of women, what really gives them power." Is much more difficult to convince women to give a until, convince men. " Boyle writes that the Maasai of Tanzania will not call a woman "mother" when you have children if you are not circumcised.

According to Amnesty International, in certain societies, women who have not had the procedure are considered too impure to manipulate food and water, and there is the belief of the genitalia of a woman can continue to grow without FGM, even hanging between your legs.Some groups considered the clitoris as dangerous, capable of killing a man, touching the penis, or a baby if head comes in contact with her during childbirth, although Amnesty warns that the ideas about the power of the clitoris can be found in other places.Gynecologists in England and the United States withdrew during the 19th century to "cure" the madness, masturbation and nymphomania.Ablation of the clitoris for the first time in the West was conducted in 1822 by a surgeon in Berlin in a considerate teenager as an "imbecile" was masturbating.Isaac Baker Brown (1812-1873), a gynecologist English, was President of the medical society of London in 1865, believed the "natural irritation" caused clitoral epilepsy, hysteria, and mania, and is sufficiently "increasingly had the opportunity to do so," according to an obituary.Peter Lewis Allen writes his views caused performed — or, rather, his public expression of them they did and died Brown sinned a dime after being expelled from the obstetrical society.

Classification and implications for health

Age in the procedure varies.Comfort Momoh, a specialist in England matron, writes that in Ethiopia the falashas is performed when the child is a few days of life, the Amhara in the eighth day of the birth, while the Oromo of Adere and choose between four years and puberty.In Somalia between four and nine years ago.Other communities can wait until adulthood, writes, either just before the marriage or after first pregnancy.The procedure a single girl can be carried out in, or a group of girls at the same time.Is usually done by UN circumcise traditional, usually one older woman known as "Gedda," without anesthesia or sterile equipment, although the wealthiest families can afford instead of a nurse, midwife or physician services using local anesthesia.Can also be conducted by the mother or grandmother, or in some societies, such as Nigeria and Egypt by local male hairdresser.

Who divides the FGM in four categories (see image to the right for types I-III).Around 85 per cent of women by types I and II, and 15 percent for type III, while Martha Nussbaum writes type III, however, represents 80-90 percent of all procedures of this kind in countries such as Sudan, Somalia and Dijbouti.

Types I and II

Type I is the Elimination of the hood of the clitoris (type Ia), or the partial or total removal of the clitoris, UN clitoridectomy (type Ib).Type II, often called excision, is the partial or total TH of the clitoris and the labia minora or labia majora.Type IIa is the TH of the labia minora only; type IIb, partial or total HT of the clitoris and the labia minora, and IIC, partial or total HT of the clitoris and the labia minora and outer.

Type III

Type III, commonly called infibulation or pharaonic curette, is the removal of all external genitalia.The internal and external lips are cut, with o sin excision of the clitoris.Girl legs are tied together from the hip to the ankle during a maximum of 40 days to allow the wound to heal.Makes the immobility that labial tissue to unite, forming a wall of flesh and skin through the entire vulva, apart from a hole the size of a match for the passage of urine and menstrual blood, is created by the insertion of a salt branch or rock wound.There is another form of type III called matwasat, where the seam of the vulva is less extreme and the left hole is larger than.Momoh describe a procedure type III in La mutilation Genital female (2005):

On the type 3 excision or infibulation...women older, family and friends ensure the girl in the lithotomy position.A deep suture is made quickly on both sides of the root of the clitoris to the fork, and a single razor cut splits the clitoris and lips larger and labia minora.

bleeding is profuse, but is usually controlled by the application of the different poultices, threading on the edges of the skin with thorns, or joining them between the edges of a rod of division.A piece of twig is inserted between the edges of the skin to make an oval permeable for urine and menstrual flow.The lower limbs are tied together together for 2-6 weeks to promote hemostasis and promote the union of the two sides...

Healing is performed by first intention, and, as a result, the introitus is erased by a drum skin extends through the hole an except for a small hole.Circumstances in time may vary, the girl can fight fiercely, in which case the incisions may become uncontrolled and disorderly.The girl can be Assets with so much force the bones break.

Vulva is cut to have sexual intercourse and childbirth.Momoh writes that, in some communities, when a pregnant woman who has not undergone FGM place of confinement, the procedure is carried out before giving birth, because it is believed the baby may be born dead if you touch your clitoris.The risk of hemorrhage and death of FGM during childbirth is high, she writes.During three studies for six months in the 1980s, Hanny Lightfoot-Klein interviewed 300 Sudanese women and 100 Sudanese men, and described the penetration by the men of infibulation of their wives:

Penetration of infibulation of the bride takes between 3 or 4 days to several months.Some men are unable to penetrate their wives at all (in my study, more than 15%), and the task is often performed by a midwife in conditions of great secrecy, this already affects Brain Power man.Some of are unable to penetrate their wives get leaving them pregnant despite infibulation, and the vaginal passage of women is cut then open to allow for the birth to take place.Carries a large amount of anal intercourse civilian out in the cases in women not can be penetrated, as it is logical in a culture where homosexual anal intercourse is a resource commonly accepted not before marriage among men, but this is easy to discuss.The men who manage to penetrate their wives do so often, or perhaps always, with the help of the "small knife."This creates a tear that slowly RIP more and more until the opening is sufficient to support the penis.In some women, the scar tissue is so hardened and coated with keloid formations only can be cut with surgical scissors very strong, as it is reported by physicians relate to cases in broke scalpels in the attempt.

Type IV

A variety of procedures that are not collectively known as type IV, which the who defines as "all other harmful procedures of the female genitalia for non medical purposes, e.g. puncture, perforation, suture, scraping and Cauterization."This goes from Melle ritual of the clitoris, the main practice in Indonesia to stretch the clitoris or the lips, burns or scarring of the genitals, or the introduction of harmful substances into the vagina to tighten.Also include hymenotomy, considers the Elimination of a hymen too thick, and gishiri cutting, a practice in the previous pairs of the vagina with a knife cut it to enlarge.

The immediate and late complications

La FGM is carried out usually by traditional doctors, anesthesia of sin, using not sterile devices cut like knives, knives, scissors, cut glass, sharp rocks, and fingernails, and the application of suture as agave or acacia thorns.To the rich in urban environments can have the procedure is performed in a safe medical environment.

MGF has immediate and late complications.Immediate complications increase when FGM is performed in traditional way, and Sin access to medical resources: the procedure is very painful and hemorrhagic complication can be fatal.Other immediate complications include acute urinary retention, urinary tract infection, infection of the wound, tetanus, sepsis, and in the case of instruments not sterilized and reused, hepatitis and HIV.According to UNICEF Lewnes ' report, it is unknown how many girls and women die from the procedure that "few records are kept" and deaths caused by FGM "rarely are denounced as".Momoh says the rate of mortality in the short term is around 10 percent, due to complications such as infection, bleeding and hypovolemic shock.A movie shot in Lunsar, Sierra Leone, by Mariana van Zeller on 2007, analyzes how the girls bleed excessively are considered witches.

Late complications may vary according to the type of FGM performed.The formation of scars and Keloids can lead a stenosis, obstruction or urinary and genital tract Fistula formation.Urinary tract sequels include damage in the urethra and bladder infections and incontinence.Aftermath of the genital tract are vaginal and pelvic infections, dysmenorrhea, dyspareunia and infertility.The complete obstruction of the results in the vagina and hematometra hematocolpos.Other complications include cysts epidermoid can become infected, neuroma formation, typically involve nerves supply the clitoris, and pelvic pain.

MGF can complicate pregnancy and the place of women at increased risk of obstetric problems, which are more common with FGM procedures more spacious.Thus, in women with FGM type III which have developed vesicovaginal or rectovaginal fistula holes allow urine and feces seeping in the difficult vagina-es get clear urine specimens as part of antenatal care to make the diagnosis of certain conditions more difficult, pre-eclampsia like tales.Evaluation of the cervix during childbirth can be Arts, and work of prolonged labour.Wound of third grade, the damage to the anal sphincter and the emergency c-section are more common in women in the controls FGM.Neonatal mortality is higher in women with FGM.The who estimates an additional 10-20 children die per 1,000 deliveries, as result of FGM, the estimate was based on a 2006 study in 28.393 women seen in rooms of childbirth at 28 obstetric centers in Burkina Faso, Ghana, Kenya, Nigeria, Senegal and Sudan.All types of FGM was found in this setting have a higher risk of death for the baby:.15 Percent higher to type I, type II, 32 per cent and 55 per cent for type III

psychological complications relate to the cultural context, the damage can occur women undergo FGM especially when they are moving beyond their traditional circles and are facing a view of FGM is not the norm.Women with FGM tend to report sexual dysfunction and Dyspareunia (painful intercourse), but several researchers have written FGM does not have why destroy the sexual desire in women.Elizabeth Heger Boyle reported several studies during the years 1980 and 1990, where the women said that they were able to enjoy sex, although the risk of sexual dysfunction was greater with type III.

The MGF has argued is related to the high incidence of AIDS in some parts of Africa, since sexual intercourse with a circumcised woman is conducive to an exchange of blood.

reinfibulacion and defibulation

Women, reinfibulacion (RI) - the restoration of infibulation - after giving birth, a controversial topic may require, with surgeons perform the considered procedure behaving like little ethical and illegal probably.In Sudan, RI is known as El-Adel (re-curette or, literally, "put right" or "improve").Two cuts around the vagina, a continued, sutures are put in place to adjust it to the size of a pinhole.Vanja Bergrren writes that this effect simulates the virginity.RI also can be carried out just before the union, after divorce, or even advanced to fastened to death elderly women.

Defibulation or desinfibulacion, is a surgical technique to reverse the closure of the vaginal opening after a type III infibulation, and consists of a vertical cut to the opening of the normal access to the vagina.This may be accompanied by the Elimination of the SCAR and lip repair tissue.Procedures to repair the integrity of the clitoris, have been developed by Pierre Földes, urologist and French surgeon, and Marci Bowers, an American surgeon studied his work, but uses tissue from the clitoris intact from the inside of women's bodies to form a new clitoris.

The prevalence and attempts to put an end to the practice

Countries Team

The estimated prevalence of FGM in Africa

According to the who, 100 million women and girls living with FGM, including 92 million girls over the age of 10 in Africa.The practice persists in 28 African countries, as well as the Arabian Peninsula, where types I and II are most common.Is known they exist in the North of Saudi Arabia, Jordan to the South, the North of Iraq (Kurdistan), and Nicholas of Birch of The Christian Science Monitor says there is evidence of their existence in Syria, Western Iran and South Turkey.Also practiced in Indonesia, but largely symbolic by clicking the clitoris or the clitoral hood up bleeds.

Several African countries have enacted laws against it, including Burkina Faso, Central African Republic, Djibouti, Eritrea, Ethiopia, Togo and Uganda.El President Daniel Moi of Kenya issued a decree against it in December 2001.In Mauritania, where almost all girls in minority communities suffer from MGF, 34 Islamic Writings signed a fatwa in January 2010 the prohibition of practice.

In Egypt, the Ministry of health banned the MGF 2007 despite pressures from some (but not all) Islamic groups.Two themes in particular forced the hand of the Government.A 10 year-old girl, was photographed undergoing FGM in a barbershop in Cairo in 1995, and the images were disseminated by CNN, resulted in the prohibition of the practice in all parties except in hospitals.Then, in 2007, 12 years old, Badour Shaker died of an overdose of anesthesia during or after a procedure of FGM to the his mother had paid him a doctor at an illegal clinic the equivalent of $9.00.Islamic of Al - Azhar of the top Research Council, the highest religious authority in Egypt, issued a statement that FGM did not have no basis in Islamic law core, enabled it the Government to prohibit by full

Colonial opposition

Nahid Toubia of Anika Rahman and write attempts in the 20th century by colonial administrators an ending FGM only managed to cause the local ira.In Kenya, Christian missionaries in 1920 and 1930, forbade his followers of the practice, partly because of the medical consequences, but also because of the rituals are accompanied were viewed as highly sexualized, and as a result became a focal point for the independence movement among the kikuyu, the ethnic group of the main country.An American missionary, Hilda Stump, was murdered in January 1930 after speaking against it.Lynn M. Thomas, the American historian, writes that the period of 1929-1931 became in is known in historiography as the Kenyan controversy over female curette.Protestant missionaries make campaign against it tried to obtain the support of humanitarian and rights groups of women in London, where raised the issue in the House of Commons and in the own Kenya attitude of a person towards FGM became a test of loyalty, either for the Christian churches or the Kikuyu Central Association.Jomo Kenyatta (c. 1894-1978), who became the first Prime Minister of Kenya, in 1963, wrote in 1930:

The real argument lies not in the defence of the surgical operation general or its details, but in the understanding of a very important fact in the kikuyu tribal psychology, that is, this operation is still considered as the essence of an institution has enormous educational, social, moral and religious implications apart from the own operation.At the moment it is impossible that a member of the tribe of imagining an initiation Sin clitoridoctomy.Therefore the...abolition of the surgical in this item means wont...the abolition of the entire institution.

Also support wine of women themselves to practice.María E. Holding, a Methodist Missionary in Meru, Kenya, wrote in 1942 the ritual of the curette was an all-female affair, organized by the Councils of women known as kiama gia ntonye ("the Council to').Ritual not only saw the girls become women, but also allowed their mothers are contaminants in members of the Council, a position of some authority.

Similarly, the strengthened ban on the tribal resistance to the British in the early 1950s, and greater support for the Mau Mau (1952-1960) uprising.In 1956, under pressure from the British, the Council of elders of the male sex (Nchecke Njuri) in Meru, Kenya, announced the ban on the ablation of the clitoris.More than two thousand - mostly teenage girls but some only eight were charged during the next three years with having circumcised among themselves with razor blades, a practice came to be known as Ngaitana ("I'm going to circumcise"), so named because the girls claimed to have cut themselves to avoid naming friends.Sylvia Tamale argues this was done not only in the challenge of the cooperation of the Council with the colonial authorities, but also in protest against its Interferencia with decisions of women about their own rituals.Thomas describe as significant episode in the history of FGM, already clarified its apparent victims were in fact its central actors.

Since the 1960s

In 1960 and 1970, Rahman and Nahid Toubia writing, doctors in Sudan, Somalia, Nigeria and he began to speak about the health consequences of FGM, and the opposition accelerated during the United Nations Decade for women (1975-1985).In 1979, the American feminist writer Fran Hosken (1920-2006) presented a research in this respect, the Hosken report: Genital and sexual mutilation of females for the first seminar on traditional practices affect the health of women and children, sponsored by the who.Rahman and Toubia write women African by several countries at the Conference took a vote to put an end to this practice.

In 1980 and 1982 the medical feminist Nawal Saadawi and the asthma El Dareer wrote about FGM as a dangerous practice to control the sexuality of women.The Decade also saw the framing of FGM, together with other issues in the domestic sphere, as dowry deaths as a violation of human rights, and not as a health problem, and this academic interest encouraged, even among feminist lawyers.The Vienna World Conference on human rights agreed in June 1993 that FGM is a violation of human rights.

Part of the international opposition to FGM continues to attract a critics the.The Hosken report, in particular, was criticized for its alleged ethnocentrism, their negative statements about African society, and its insistence on Western intervention.Sylvia Tamale, wrote in 2011 some African feminists interpret traditional practices such as FGM in a postcolonial context which makes oppose them a complex topic.Although critical of FGM, oppose what flame to the infantilization imperialist Tamale of African women inherent in the idea of FGM is simply a brutal rejection of enlightenment and modernity.

Lynn Thomas writes that the ritual of FGM has been the context primary in some communities women come together.Because see it as a way to elevate themselves from girl to woman, and therefore a way to differentiate between each other, Thomas says to eliminate FGM is to eliminate the opportunity to earn authority.She writes that the "eradicationists" have responded to these criticisms through the approach to African communities and the strengthening of its relations with the locals in the fight against female genital mutilation activists.For example, one of the issues keeps MGF happening in some communities is the doctors have no other way of earning a living.Organizations working to eliminate it, therefore providing training of the women of some kind;.Teaching them how to be farmers, for example

From July 2011, 6,236 communities in seven countries have abandoned female genital mutilation.

Procedures followed


The type of mutilation, the age and the way in which female genital mutilation is practised vary according to several factors, including the ethnic group to which belongs the woman or the girl, the country where you live, if you are in a rural or urban area and its socio-economic origin.
The procedure is carried out at very different ages, ranging from shortly after birth and the first pregnancy, but generally female genital mutilation is practised between four and eight years. According to the World Health Organization, the average age is declining.
This indicates that the practice has become increasingly less associated with initiation into adulthood, apparently especially in urban areas.
Some girls suffer genital mutilation individually, but more often it is conducted in group, for example groups of sisters or women United by another close kinship, or groups of neighbors. Where female genital mutilation is part of an initiation ceremony, as it is the case of the societies of Western, central and Eastern Africa, there is more likely to be practice to all girls in the community that belong to a certain age group.
The procedure can be carried out in the domicile of the child or a relative or neighbour, in a health center, either, especially if it is associated with the initiation, in a specially designated place to the effect, for example next to a tree or river certain. The person who practices mutilation may be an elderly woman, a midwife or a traditional healer, a Barber or a midwife or a doctor qualified.
The degree of knowledge of the girls who are the subject of FGM on what is going to happen varies. The event is sometimes associated with festivities and gifts. Encourages girls to be brave. In cases in which the mutilation is part of an initiation rite, the festivities can be major events for the community. Generally, during the mutilation is supported only the presence of women.
He sometimes resorts to a midwife with knowledge that he administered a local anesthetic. In some cultures, is ordered to girls previously to sit in cold water to numb the area and reduce the likelihood that bleed. However, the most common is that no action should be taken to reduce the pain.
The girl is immobilized, usually by elderly women, with legs open. The mutilation is carried out using a broken glass, a tin lid, scissors, a razor blade or other cutting instrument. When it comes to an infibulation, thorns or points are used for joining both parts of the labia majora, and legs can remain tied up to 40 days. Sometimes apply antiseptic powders, or well, with greater frequency, ointments that contain herbs, milk, eggs, ash or manure and which are considered to be healing. It is possible that the girl carried it a chosen place to effect for their recovery where, if mutilation is practiced as part of an initiatory ceremony, traditional teachings are taught. In the case of the very rich, it is possible that the mutilation is carried out by a doctor qualified in a hospital using local or general anesthesia.

Geographical distribution of female genital mutilation


About 135 million girls and women worldwide have undergone genital mutilation, and each year two million are at risk of suffering it (some 6,000 a day). In Africa it is conducted in a generalized manner and is a common practice in some Middle East countries. It also occurs, especially in immigrant communities, in areas of Asia and the Pacific, North America, Latin America and Europe.
According to reports, female genital mutilation is practiced in more than twenty-eight African countries (see female genital cutting in Africa: country information.) AI Index: ACT 77/07/97/s). There are no figures on its frequency in Asia. There have been reports that indicate that it is conducted in Indonesia, Sri Lanka and Malaysia-Muslim populations, although very little is known about the practice in these countries. In India, a small Muslim sect, Daudi Bohra, practise FGM.
In Middle East, FGM is practiced in Egypt, Oman, Yemen and the United Arab Emirates.
There are reports indicating that female genital mutilation is carried out in certain indigenous groups of Central America and of the South, but the available information is scarce.
In industrialized countries, FGM is performed especially among immigrants from countries in which it is practiced. There have been reports about mutilation in Australia, Canada, Denmark, United States, France, Italy, Netherlands, United Kingdom and Sweden. Sometimes, girls or girls who live in industrialized countries are operated clandestinely by doctors in their own communities that reside there, but most often is that do come to the country to traditional doctors, either send the girls out of the country to practice them mutilation. There are no figures on the frequency of this practice in the populations of industrialized countries.

The physical and psychological effects of female genital mutilation


Physical effects


Genital mutilation can lead to death. In the moment in which it is carried out, headaches, concussion, bleeding and damage may occur in the organs that surround the clitoris and the labia.
You can then produce urinary retention and develop serious infections. The use of the same instrumental in several girls without sterilizing it may result in the spread of HIV.
Most often, chronic infections, intermittent bleeding, abscesses and small benign tumours of nerve that can cause the clitoridectomy and excision produce discomfort and extreme pain.
Infibulation can have even more serious long-term effects: infections Chronicles of the urinary tract, stones in the bladder and urethra, kidney disorders, infections of the genital tract as a result of the obstruction of menstrual flow, infections in the pelvis and infertility, excessive scar tissue, keloids (prominent and irregular scars that are enlarged gradually) and dermoid cysts.
The first sexual act can only be after the gradual and painful dilation of opening that has remained after the mutilation. In some cases, it is necessary to make a previous incision. In a study carried out in Sudan, 15 per cent of the women interviewed reported that it was necessary to make them the incision to make possible the penetracion1. Some newly married suffer serious injuries due to incisions made badly by their husbands. An additional problem that can cause all types of female genital mutilation is that lasting wound that occurs in the genital area may increase the risk of HIV transmission during sexual contact.
At birth, the scar tissue of women who have undergone excision can rip apart. Women subjected to infibulation, whose genitals are just opening, it is necessary to practice them a cut to allow the child to escape. If no one attending childbirth, it is possible that perineal tears or blockage of delivery occur. After childbirth, often return to women to practice infibulation so they are «close» for their husbands. The constant incisions and sutures of the genitalia of a woman with every birth can cause the formation of a strong scar tissue in the area of the genitals.
The secrecy surrounding the genital mutilation and the protection of those who carried out difficult the collection of data on the complications of such practice. When problems arise, are rarely attributed to the person who carried out the mutilation. It is more likely that they achaquen to alleged 'promiscuity' of the girl or the fact that parents not carried out sacrifices or rituals in an appropriate manner. Most of the information is collected retrospectively, often much that occurred after the facts. This implies that it should rely on the memory of women, in its own assessment of the severity of complications and their perception about whether health problems were related with mutilation.
Some facts about the medical effects in the short and long term female genital mutilation, including those associated with pregnancy, have been collected through studies in hospitals or clinics, what has been useful to acquire knowledge about the kind of health problems that can result from FGM. However, cannot be estimated reliably the incidence of these problems and deaths because of the mutilation. Advocates of this practice argue that complications and serious problems occur rarely, while those who oppose it say that they are frequent.

Effects on sexuality


Genital mutilation can make the first sexual act a terrible experience for women. It can be extremely painful and even dangerous if you must practice to women an incision. For some women, the sexual act is still always painful. Although it is not, the importance of the clitoris to experience sexual pleasure and get orgasms suggests that the mutilation which causes partial or total amputation of the clitoris should adversely affect sexual satisfaction. Clinical considerations and the majority of studies on the sexual enjoyment of women suggest that this is adversely affected by female genital mutilation. However, a study found that 90 percent of the infibuladas women who were interviewed said experiment orgasmos2. The mechanisms involved in sexual enjoyment and orgasm are not yet fully known, but it is believed that certain compensatory processes, some of them psychological in nature, can mitigate some of the effects of ablation of the clitoris and other sensitive parts of the genitalia.

Psychological effects


The psychological effects of female genital mutilation are more difficult to investigate scientifically than physicists. There have been reports of a few clinical cases of psychological diseases related with genital3 FGM. Despite the lack of scientific evidence, the personal stories of mutilation reveal feelings of anxiety, terror, humiliation and betrayal, all of which will probably have negative effects in the long term. Some experts suggest that the shock and trauma caused by the operation can help sharpen a described behavior as «quiet» and «docile», which is considered positive in societies that practise female genital mutilation.
Celebrations, gifts and special attentions that take place at the time of the mutilation can mitigate to some extent the experienced trauma, but the most important psychological effect suffered by a woman who has survived is the feeling of being accepted in their society, to respect the traditions of their culture, and the meet the requirements for contracting marriageoften the only role that is allowed to play. It is possible that a woman who does not submit to genital mutilation suffer psychological problems due to social rejection. He is believed that women belonging to minority communities that practice female genital mutilation are particularly vulnerable to psychological problems, being trapped between the social norms of their community and those of the majority culture.

Why female genital mutilation is practised



Cultural identity


Of course, I will do that they circunciden exactly as they circuncidaron to their parents, grandparents and sisters. It is our habit.
An Egyptian woman talking about her daughters pequenas4 custom and tradition are by far, the most invoked reasons for female genital mutilation. Along with other physical characteristics or behavior, female genital mutilation defines who belongs to the group. This is most evident when the mutilation is carried out as part of the initiation into adulthood.
Jomo Kenyatta, President of Kenya, he argued that female genital mutilation was inherent to the initiation, which constitutes an essential part of the identity of the kikuyus, to the extent of that your «abolition... destroy the tribal system» 5. A study carried out in Sierra Leone reported on a similar sentiment about the social and political cohesion promoted by Bundo and Sande, secret societies that carry out mutilations and initiatory teachings.
Many people who belong to societies that practice female genital mutilation, particularly in traditional rural communities, consider that it is a habit so normal that you can not imagine a woman who has not been subjected to mutilation. According to reports, others say that only the marginalized or foreign women are not mutilated genitally. In a society that practices female genital mutilation, a child cannot be considered adult unless subjected to this practice.

Sexual identity


Often female genital mutilation considers necessary so that a girl is fully considered as a woman, and practice marks the differentiation of sexes in regards to their future roles in life and marriage. It is believed that the ablation of the clitoris and lips - which some consider «male parts» body of women - increases femininity, term which often is synonymous with docility and obedience. It is possible that the trauma of mutilation has this effect on the personality of a girl. If the mutilation is part of an initiation rite, it is then accompanied by explicit teachings about the role of women in their society.

We are circumcised and we insist to circumcise our daughters so that there is no confusion between men and women... A non-circumcised woman is humiliated by her husband, who called it 'you, that of the clitoris'. People say that it is like a man. His body would hurt the man...

An Egyptian woman


Control of sexuality and reproductive functions of women


Circumcision makes women clean, promotes their virginity and chastity and protects young girls from sexual frustration to attenuate their sexual appetite.

Mrs Njeri, an advocate of female genital mutilation in Kenya


In many societies, an important reason that wields in favour of female genital mutilation is the belief that mitigates the sexual desire of women and, therefore, reduces the chances of having sexual intercourse outside marriage. Capacity of being faithful voluntarily not mutilated women he puts in doubt. In many societies that practice female genital mutilation is extremely difficult, if not impossible, that a woman get married if you have not undergone mutilation. In the case of infibulation, the woman «sewn it» and «open» only for her husband. Societies that practice infibulation are markedly patriarchal. Prevent that women have sexual contacts «illegitimate» and protect them from sexual intercourse unwanted, as it considered that this depends on the honor of the family is vital to. However, infibulation is no guarantee against "illegitimate" sexual relations, since it is possible to «open» and «close» again to women.
In some cultures, increasing the sexual pleasure of men is one reason that is invoked in favour of mutilation. However, merely anecdotal testimonies suggest that men prefer women without mutilating as sexual partners.

Beliefs about hygiene, aesthetics and health


Systematically cleaning and hygiene are invoked as reasons that justify genital mutilation. Popular to refer to mutilation terms are synonyms of purification (tahara in Egypt, tahur in Sudan), or cleaning (sili-ji among the bambarras, ethnic group of Mali). In some societies that practice female genital mutilation, not mutilated women regarded little clean and are not allowed to handle food or water.
In this respect it is the perception in the communities that practice female genital mutilation that women not mutilated genitals are ugly and bulky. In some cultures, there is a belief that the genitals of women can grow and be uncomfortable hanging between his legs, unless you remove the clitoris. Some groups believe that the woman's clitoris is dangerous and that if you touch a man's penis, it will die. Others believe that if the child's head touches the clitoris during childbirth, the child will die.
Ideas about the beneficial effects that have female genital mutilation on the health do not occur only in Africa. In England in the 19th century there were debates about whether FGM could cure women of «diseases» as hysteria and 'excessive' masturbation. In United States, FGM continued practiced for these reasons until well into the 20th century. However, the health benefits are not the reason that most claimed to justify the mutilation in societies that still practiced. But wherever they are, it is probably due to that mutilation is part of an initiation rite in which women are taught to be strong and resigned before the disease. Some societies in which female genital mutilation is practised believe that this increases the fertility, and even some think not mutilated women can not conceive. In some cultures it is believed that FGM makes childbirth safer.

Religion


The practice of FGM predates islam and is not common among the majority of Muslims, but has acquired a religious dimension. There where it is practiced by Muslims, often invoke religion as one of their reasons. Many of those who oppose the mutilation deny that there is any relationship between his practice and religion, but Islamic leaders do not appear unanimous in this respect. The Qur'an does not contain any appeal on behalf of female genital mutilation, but some hadith (Proverbs attributed to the Prophet Muhammad) refer to her. So for example, in response to a question that he formulated Um Attiyah (practitioner of female genital mutilation), the Prophet said: "Reduced but you do not destroy".
Mutilation has persisted among some converts to Christianity. Some Christian missionaries have attempted to curb this practice, but have fallen into the account that is too entrenched. In some cases, in order not to lose converts, have passed it by high and even approved.
Female genital mutilation was usual among the falashas (Ethiopian Jews), but is ignored if, after his emigration to Israel, has continued practicing. The rest of the communities that practice female genital mutilation practice traditional animist religions.

Testimony


I was subjected to genital mutilation at age 10. My deceased grandmother told me that I was going to the River to hold a ceremony and that they would then give me many things to eat. As a innocent girl who was, took me like a lamb to the slaughter.
When I went through the secret Bush, led me to a very dark room and I stripped.
They blindfolded me and left me completely naked. Later, two strong women led me to the place of operation. Four strong women forced me to knock me upside down; two of them abide me with strength in each leg. Another sat on my chest to prevent that you move the upper part of the body. They put me to force a rag in his mouth to stop shouting. Then I rasuraron.
When the operation began, I was opposed great resistance. The pain was unbearable and terrible.
During this struggle received severe cuts and lost much blood. All those who participated in the operation were half drunk. Others danced and sang and, worst of all, were naked.
They mutilated the genitals with a badly sharpened knife to me.
After the operation was not allowed that nobody helped me walk. What had gotten me into the wound apestaba and made me damage. I went so terribly wrong. Everytime I wanted to urinate, I had to put me foot. Urine stretched by the wound and caused me again a sharp pain in the area. I sometimes had to compel not urinate out of fear of the terrible pain. In operation do not put me anesthesia to alleviate the pain, nor gave me antibiotics to prevent infections.
Then I had bleeding and suffered anemia. This was attributed to a spell. For a long time I endured severe vaginal infections.

Hannah Koroma, Sierra Leone



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