Female Genital Mutilation: Historical Context, Modern Challenges & Cultural Norms.
This blog post discusses sensitive topics, including childhood trauma, sexual trauma, sexual abuse and genital mutilation. Some readers may find the content distressing or triggering. Please consider your emotional well-being and consider whether you feel comfortable proceeding. If you need support, consider contacting a trusted friend, family member, or someone like me to work through your emotions and personal trauma.
Welcome to my new blog on Female Genital Mutilation or FGM.
I approach this topic with cultural humility, acknowledging my perspective as a white, cisgender male in Western society. This blog explores various cultural aspects of female genital mutilation (FGM) while recognising the limitations of my background, whilst exploring current research and modern perspectives. As a Western sex therapist, I offer approaches to healing grounded in my professional education and training, but I emphasise the importance of each client guiding the therapeutic process based on their individual needs and cultural context.
Part 1- Female Genital Mutilation (FGM): Historical Context, Modern Challenges, and the Intersection of Cultural Norms.
FGM is a significant human rights and public health issue affecting an estimated 200 million girls and women worldwide (Jidha & Feyissa, 2023; Presler-Marshall et al., 2024). The global health costs associated with FGM are substantial, estimated at $1.4 billion USD annually (Byard & Behnia-Willison, 2024). This practice is deeply rooted in the traditions of communities across Africa, Asia, and the Middle East (Johnsdotter & Mestre i Mestre, 2017; Pashaei et al., 2016). Historically, it was primarily limited to Africa, but with increased migration, it has gained attention in Western societies, sparking debates about genital modification’s moral and ethical implications. FGM is known to cause obstetric, sexual, physical, and psychological harm to those who are inflicted (Sarayloo, Latifnejad Roudsari, & Elhadi, 2019), which has prompted legal action worldwide to combat harmful practices (Khosla et al., 2017; Johnsdotter & Mestre i Mestre, 2017).
Defining FGM
The World Health Organisation (WHO) defines FGM as any procedure that deliberately alters or causes injury to the external female genitalia for non-medical reasons, offering no health benefits (Nzinga et al., 2021). Klein et al. (2018) describe it as the manipulation or removal of external genital structures. Across various studies, a consensus exists that FGM involves the injury, damage, or removal of vulval structures in young girls and women (Jidha & Feyissa, 2023).
History and Ritual Practices of FGM
The origins of FGM remain unclear, with evidence dating back to the fifth century BC, including circumcised mummies (Llamas, 2017). Some theories link its spread to the African slave trade, while others suggest it was used in ancient Rome to prevent pregnancy (Llamas, 2017; Odukogbe et al., 2017). FGM was also practiced in the 1800s in Western Europe and the United States, purportedly to control female sexuality and “cure” conditions like masturbation, lesbianism, and hysteria (Odukogbe et al., 2017; Proudman, 2022). In many cultures, FGM is considered a rite of passage, tied to marriageability, social norms, and cultural preservation (ElMorally, 2023). Current alternatives to rites of passage can be found here.
Early anthropological studies by the United Nations and WHO referred to the practice as “female circumcision,” which normalised the procedure by likening it to male circumcision (Llamas, 2017). However, in the 1970s, feminist activists began using the term “mutilation” to emphasise the harm caused by the practice. This gave rise to the modern term “Female Genital Mutilation” (Llamas, 2017). In 2012, the United Nations General Assembly imposed a global ban on FGM (Llamas, 2017).
The individuals performing FGM often include cultural or religious figures, midwives, elders, or trained circumcisers, who typically use unsterile instruments such as blades or shards of glass to cut, prick, or bleed parts of the clitoris, clitoral hood, or labia (Johnsdotter & Mestre i Mestre, 2017; Matthews & Dallaston, 2020; Klein, 2018). These practices have been categorised by the WHO into four types of FGM (Matthews & Dallaston, 2020; Presler-Marshall et al., 2024).
The Four Types of FGM
The four types of FGM vary by region and practice (Llamas, 2017; Yount et al., 2020). Type 1 involves the partial or complete removal of the clitoris, a procedure known as clitoridectomy (Matthews & Dallaston, 2020; Sarayloo et al., 2019). Type 2 includes clitoridectomy, with the additional removal of the labia minora and sometimes the labia majora (Matthews & Dallaston, 2020; Sarayloo et al., 2019). Type 3, also known as infibulation, is regarded as the most severe form of FGM, involving the removal of labial tissue followed by the suturing of the vaginal opening, leaving only a small opening for urination and menstruation (Klein et al., 2018; Matthews & Dallaston, 2020). Type 4 includes less invasive practices, such as pricking, burning, scraping, cutting the genital area (Matthews & Dallaston, 2020). Infibulation is particularly prevalent in Ethiopia’s Somali region, where up to 80% of Type 3 cases occur (Llamas, 2017; Presler-Marshall et al., 2024). These regional variations reflect the sociocultural significance of FGM practices and the challenges of eradicating them.
Modern-Day Challenges and Strategies for the Eradication of FGM
Globally, governments and non-governmental organisations (NGOs) have recognised FGM as a public health issue, though there are still significant challenges to its eradication (Sweileh, 2016). Sweileh (2016) suggests that combating FGM requires spreading information and awareness through education, community-based programs, government health policies, and legislative enforcement. There has been a noticeable increase in research on the psychological and health impacts of FGM since the 1970s (Sweileh, 2016), and African women are increasingly opposing the practice as cultural norms evolve due to education and migration (Martínez-Linares et al., 2023).
Research by Yount et al. (2020) indicates that maternal attitudes play a significant role in the risk of daughters undergoing FGM. Communities where mothers resist genital modification see a decrease in the practice. Moreover, Shell-Duncan et al. (2018) and d’Adda et al. (2020) suggest that social norms heavily influence FGM practices, and targeting these norms is essential to changing harmful cultural practices.
Cultural Intersections, FGM, and the Law
The cultural aspects of FGM often clash with legal frameworks in countries where the practice is banned. Johnsdotter & Mestre i Mestre (2017) highlight how misinformation and sensationalised media coverage can stigmatise communities practicing FGM, leading to unbalanced risk assessments and increased tensions. However, an ongoing legal and cultural debate centers around the legality of Female Genital Cosmetic Surgery (FGCS), which is permitted in many Western countries (Proudman, 2022). FGCS involves genital modifications for aesthetic or psychological reasons, often influenced by cultural pressures to achieve a “normal” genital appearance (Proudman, 2022).
Some scholars argue that both FGM and FGCS are socially coercive practices, influenced by patriarchal structures (Proudman, 2022). However, others, such as Gruenbaum, Earp, & Shweder (2023), dispute the patriarchal nature of FGM, suggesting that matriarchal societies also practice genital modification. This contradicts the dominant Western narrative, which often frames FGM as a patriarchal attempt to control female sexuality.
Interestingly, the early feminist movement against FGM has been criticised for its association with the “white saviour complex,” where white feminists framed women of colour as helpless victims in need of saving (Breines, 2006; Ezaydi, 2023). This reflects broader tensions in how Western discourse frames cultural practices in non-Western communities.
Bodily Integrity and Human Rights
At the core of the debate around FGM is the issue of bodily integrity, human rights and sexual rights. Townsend (2023) argues that all children, regardless of cultural or religious background, have the right to an intact body and that society must prevent unnecessary genital modification. ElMorally (2023) acknowledges the importance of respecting cultural identity but emphasises that the harm caused by FGM cannot be justified under the guise of cultural preservation. Legally, philosophically, and ethically, the right to bodily integrity for children must take precedence over cultural or religious rites (Townsend, 2023; Klein et al., 2018).
Part 2-Healing from Female Genital Mutilation, trauma informed counselling and sex therapy – stay tuned, coming soon
References
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Breines, W. (2006). The trouble between us: An uneasy history of white and black women in the feminist movement. New York. Oxford University Press.
Byard, R. W., & Behnia-Willison, F. (2024). Female genital mutilation – An overview for forensic practitioners. Journal of Forensic and Legal Medicine, 101, 102624. https://doi.org/10.1016/j.jflm.2023.102624
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ElMorally, R. (2024). Decolonising female genital mutilation: A harmful yet identity-affirming practice. In M.P. Bhandari (Eds.), Women in Society: Chapter 3. IntechOpen. https://doi.org/10.5772/intechopen.109837
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