Female genital mutilation (FGM) comprises all procedures involving partial or total removal of the female external genitalia or other injury to the female genital organs for non-medical reasons as defined by the World Health Organisation (WHO).

It’s also known as “female circumcision” or “cutting”, and by other terms such as sunna, gudniin, halalays, tahur, megrez and khitan, among others.

FGM is usually carried out on young girls between infancy and the age of 15, most commonly before puberty starts. It is illegal in the UK and is child abuse.

It’s very painful and can seriously harm the health of women and girls. It can also cause long-term problems with sex, childbirth and mental health.

Although the practice of circumcising females is recognized internationally as a violation of rights of women, it is common in more than 27 African countries, as well as Yemen and Iraqi Kurdistan, and in Asian and the Middle East. Female circumcision before and after causes several changes in women and often create several health related issues as well. Keep reading to learn more about the issue.

Types of Female Genital Mutilation.

Female genital mutilation is classified into four types:

Types of Female Genital Mutilation

Types of Female Genital Mutilation

• Type I: Often known as clitoridectomy, this type involves partial or total removing of the clitoris and its prepuce.
• Type II: Also known as excision, the clitoris and elocuencia minora are partially or totally removed, with or without excision of the labia majora.
• Type III: The most severe form, it is also known as infibulation or pharaonic type. The procedure consists of narrowing the vaginal orifice with creation of a covering seal by cutting and appositioning the labia minora and/or labia majora, with or without removal of the clitoris. The appositioning of the wound edges consists of stitching or holding the cut areas together for a certain period of time (for example, girls’ legs are bound together), to create the covering seal. A small opening is left for urine and menstrual blood to escape. An infibulation must be opened either through penetrative sexual intercourse or surgery.
• Type IV: This type involves all other procedures to the genitalia of ladies for non-medical purposes, such as pricking, piercing, incising, scraping and cauterization.

Why Is Female Genital Mutilation Done?

You can find several images of female circumcision before and after and understand the amount of pain women have to handle during the procedures. The question is, “why do people decide for such gruesome techniques? ” People in several communities will vary reasons to practice FGM, require ‘excuses’ fall into five main categories:

Psychosexual Reasons: Various societies assume that FGM is a way to help women control their sex. Female circumcision before and after changes how women understand sex and intercourse. That they believe removing the clitoris is the only method to control a woman’s sexuality. That is also considered a way to ensure that a woman will stay virgin before marriage.

Sociological and Cultural Reasons: Various communities feel that FGM is a method to make a young girl part of a community, and they assume that this is a step a girl takes to become a woman. Some common myths in the communities also promote this practice – some assume that if kept uncut the clitoris will end up as large as a penis is.

Hygiene and Aesthetic Reasons: Some residential areas believe the external girl genitalia is dirty an ugly, so they use FGM for hygiene.

Strict Reasons: Many people use religious doctrine to rationalize this practice, but in reality, neither Islam neither Christianity sanctions FGM.

Socio-Economic Factors: In certain communities, it is obligatory for women to undergo FGM before they could get hitched. In societies where women are largely dependent on men, they should follow the norms and choose the process in order to get married.

Health risks of female genital mutilation

Women and girls living with FGM have experienced a harmful practice. Experience of FGM increases the short and long term health risks to women and girls and is unacceptable from a human rights and health perspective. While in general there is an increased risk of adverse health outcomes with increased severity of FGM, WHO is opposed to all forms of FGM and is emphatically against the practice being carried out by health care providers (medicalization).

Short-term health risks of FGM

• Serious pain: cutting the nerve system ends and sensitive penile tissue causes extreme pain. Proper anaesthesia is almost never used and, when used, is not always effective. The healing period is also painful.
• Excessive bleeding: (haemorrhage) can result if the clitoral artery or other blood vessel is cut during the procedure.
• Distress: can be caused by pain, infection and/or haemorrhage.
• Genital tissue swelling: due to inflammatory response or local infection.
• Infections: may spread after the use of contaminated instruments (e. g. use of same instruments in multiple penile mutilation operations), and during the healing period.
• Human immunodeficiency virus (HIV): the direct association between FGM and HIV remains unconfirmed, although the cutting of genital tissues with the same surgical instrument without sterilization could raise the publicity to possible transmission of HIV between girls who undergo female genital traumatisme together.
• Urination problems: these may include urinary preservation and pain passing a stream of pee. This may be credited to tissue swelling, pain or injury to the urethra.

• Impaired wound treatment: can lead to pain, infections and abnormal scarring damage
• Death: can be brought on by infections, including tetanus and haemorrhage that can result in shock.
• Psychological consequences: the pain, shock and the utilization of physical force by those performing the process are mentioned as reasons why a lot of women describe FGM as a traumatic event.

Long-term health risks from Types I, II and III (occurring at any time during life)

• Pain: due to tissue damage and scarring that may result in trapped or unprotected nerve endings.
• FGM and pregnancy: Some women with FGM may find it difficult to become pregnant, and those who do conceive can have problems in childbirth.
• Chronic genital infections: with consequent chronic pain, and vaginal discharge and itching. Cysts, abscesses and genital ulcers may also appear.
• Chronic reproductive tract infections: May cause chronic back and pelvic pain.
• Urinary tract infections: If not treated, such infections can ascend to the kidneys, potentially resulting in renal failure, septicaemia and death. An increased risk for repeated urinary tract infections is well documented in both girls and adult women.
• Painful urination: due to obstruction of the urethra and recurrent urinary tract infections.
• Menstrual problems: consequence from the obstruction of the vaginal opening. This may lead to unpleasant menstruation (dysmenorrhea), irregular menses and difficulty in passing menstrual blood, particularly among women with FGM type III.
• Keloids: there have been reports of excessive scar tissue formation at the site of the cutting.
• Human immunodeficiency virus (HIV): given that the transmission of HIV is facilitated through trauma of the vaginal epithelium which allows the direct introduction of the virus, it is reasonable to presume that the risk of HIV transmission may be increased due to increased risk for bleeding during intercourse, as a result of FGM.
• Female sexual health: removal of, or damage to highly sensitive genital tissue, especially the clitoris, may affect sexual sensitivity and lead to sexual problems, such as decreased sexual desire and pleasure, pain during sex, difficulty during penetration, decreased lubrication during intercourse, reduced frequency or absence of orgasm (anorgasmia). Scar formation, pain and traumatic memories associated with the procedure can also lead to such problems.
• Obstetric complications: FGM is associated with a heightened risk of Caesarean section, post-partum haemorrhage, recourse to episiotomy, difficult labour, obstetric tears/lacerations, a key component delivery, prolonged labour, and extended maternal hospital stay. The risks increase with the severity of FGM.
• Obstetric fistula: a direct association between FGM and obstetric fistula has not been established. However, given the causal relationship between prolonged and obstructed labour and fistula, and the fact that FGM is also associated with prolonged and obstructed labour it is reasonable to presume that both conditions could be linked in women living with FGM.
• Perinatal risks: obstetric complications can result in a higher incidence of infant resuscitation at delivery and intrapartum stillbirth and neonatal death.
• Psychological consequences: some studies have shown an increased likelihood of post-traumatic stress disorder (PTSD), anxiety disorders and depression. The cultural significance of FGM might not protect against psychological complications.

References

http://www.who.int/mediacentre/factsheets/fs241/en/
http://www.nhs.uk/Conditions/female-genital-mutilation/Pages/Introduction.aspx
http://www.who.int/reproductivehealth/topics/fgm/health_consequences_fgm/en/