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Policy Analysis on Female Genital Mutilation FGM

The policy on Female Genital Mutilation (FGM), adopted by the Human Rights Commission of Ontario, Canada, in 1996 (and further revised it in 2000) acknowledges the practice as an internationally recognized violation against women and girls' human rights and looks at the domestic implications of Canada's obligations as a signatory to international conventions and treaties which recognize FGM as a human rights violation. The policy's focus is on the practice of FGM in Canada by immigrant groups who have brought the practice to the country from their countries of origin in Africa and parts of the Middle East and Asia. The policy looks at human rights issues as well as health, social and criminal law concerns. The Ontario Commission acknowledges the complex social and cultural roots of FGM and the need for dialogue and education initiatives within the at-risk communities in Ontario and across Canada. However, it underlines that arguments based on a defence of cultural or religious values should not be accepted as justification for the practice, nor for discriminating against women who have been subjected to, or perceived to have been subjected to, genital mutilation. Significantly, immigrant groups and advocacy organizations in Canada have acknowledged the need to deal with FGM as an internationally recognized health and human rights concern.

This essay will first of all define FGM and look at the reasons the practice has survived in some regions despite international condemnation. It will also give a summary of the key elements of the Ontario Commission's policy, the arguments it uses to justify its actions and also show that in this case, the need to protect and promote the rights of women and girls is more important than concerns of "cultural imperialism."

The policy adopted by the Human Rights Commission of Ontario on FGM is based on the over-arching argument that the importance of good health to a woman's well-being - and that of her family and society - cannot be overstated. Without reproductive health and freedom, women cannot fully exercise their fundamental human rights, such as those relating to education and employment. Women's disproportionate poverty, low social status, and reproductive role expose them to high health risks, resulting in needless and largely preventable suffering and deaths. The benefits of eliminating the harmful and painful practice of FGM are easily demonstrated, yet the practice persists for cultural and traditional reasons.

FGM is a gender-specific violation of the rights of girls and women to physical integrity. Over the years, FGM has become recognized not only as a health hazard and a form of violence against women and girls, but also as a human rights issue under international law. Efforts at the international level, particularly by United Nations agencies, have placed FGM on women's health and human rights agendas.

FGM is practised by many ethnic groups, from the east to the west coast of Africa, in southern parts of the Arabian peninsula, along the Persian Gulf and among some migrants from these areas in Europe, Australia and North America. It has also been reported in some minority groups in India, Malaysia and Indonesia. In these societies, FGM is considered a rite of passage preparing young girls for womanhood and marriage. However, often performed without anaesthetic under septic conditions, FGM or "female circumcision" as it is sometimes called, can cause death or permanent health problems as well as severe pain. Despite these grave risks, its practitioners look on it as an integral part of their cultural and ethnic identity, and some perceive it as a religious obligation.

The most severe form of FGM, infibulation, which involves removal of the clitoris, results in trauma that is repeated after each childbirth. In many communities FGM is believed to reduce a woman's libido, and thereby is further believed to help her resist "illicit" sexual acts. Cultural ideals of femininity and modesty, which include the notion that girls are "clean" and "beautiful" is also another reason for which FGM is carried out (WHO).

The practice has been condemned in many international fora and by women's groups as a manifestation of gender inequality and an attempt by society to exert total control over women. In countries where FGM is widely practised, however, it is often supported by both men and women, usually without question, and anyone departing from the norm may face condemnation, harassment. It is often practised even when it is known to inflict harm upon girls because the perceived social benefits of the practice are deemed higher than its disadvantages (UNICEF, 2005a).

Though no religious scriptures prescribe the practice, practitioners often believe it has religious support. Religious leaders take varying positions with regard to FGM: some promote it, some consider it irrelevant to religion, and others contribute to its elimination. In most societies, the procedure is considered a cultural tradition, which is often used as an argument for its continuation (WHO). Local structures of power and authority, such as community leaders, religious leaders, circumciser's, and even some medical personnel can contribute to upholding the practice. The age at which the procedure is performed varies depending on the ethnic group and location. It is sometimes performed on babies, more commonly on girls between ages 4 and 8, but also in adolescence, or as late as the time of marriage or during the first pregnancy. Adult women are under pressure to submit to it in order to ensure the status which marriage and childbearing confer and to demonstrate solidarity with family and community. Younger women and girls have no choice at all (UNFPA).

The Human Rights Commission of Ontario has successfully and forcefully used several arguments to make its case against the practice of FGM among minority communities living on Canadian territory.

International Law: FGM has been condemned by numerous international and regional bodies including the United Nations Commission on Human Rights, the United Nations International Children Emergency Fund (UNICEF), the Organization of African Unity and the World Medical Association. In 1995, the Platform for Action of the World Conference on Women in Beijing included a section on the girl child and urged governments, international organizations and Non-governmental groups to develop policies and programmes to eliminate all forms of discrimination against the girl child including FGM. The United Nations Declaration on the Elimination of Violence Against Women defines "violence against women" as encompassing, inter alia, "female genital mutilation and other traditional practices harmful to women".

The Commission underlines that in various African countries where the procedure is performed, comprehensive action plans have been developed by women's groups to attempt to eliminate the practice- although overall progress has been slow. FGM has been outlawed in Sudan since 1946, but it continues to be widely practised. In Burkina-Faso and Egypt, resolutions were signed by the respective Ministers of Health in 1959, recommending that only partial clitoridectomy be allowed, and decreeing that it be performed only by doctors. In 1978, as a direct result of the efforts of the Somali women's movement, Somalia established a Commission to abolish infibulation.

In 1984, participants from twenty African countries, as well as representatives of international

organizations attending a seminar in Dakar, Senegal, on "Traditional Practices Affecting the Health

of Women and Children" and recommended that the practice be abolished. African states

acknowledged that there was a need to establish strong, on-going education programmes

for meaningful progress towards elimination of the practice.

Rights of the Child: The policy points to the link between FGM and the rights of the child, saying that the Convention on the Rights of the Child asserts that children should have the possibility to develop physically in a healthy and normal way, with adequate medical attention and be protected from all forms of cruelty. The Convention establishes the rights of children to gender equality, to freedom from all forms of mental and physical violence and maltreatment and to the highest attainable standard of health. An article of the Convention explicitly requires States to take all effective and appropriate measures to abolish traditional practices prejudicial to the health of children.

FGM and health rights: The physical and psychological health complications resulting from genital mutilation of women have been extensively documented. The partial or complete loss of sexual function constitutes a violation of a woman's right to physical integrity and mental health.

Domestic implications of international human rights law: the Commission argues that since Canada plays a prominent role in the international arena as a supporter and promoter of women's human rights and is a signatory to over twenty major international conventions and treaties, the province of Ontario would be in compliance with its obligations by taking steps to eradicate this practice.

Domestic or national courts are required to interpret implementing legislation in conformity with international convention insofar as the domestic legislation permits. This is also the case in Europe where legislation prohibiting the practice of FGM exists in Sweden, France and Great Britain where the procedure carries a penalty of imprisonment.

Criminal Law: The Criminal Code can be used to control the transportation of female children outside the country for the purpose of obtaining FGM. A memorandum was issued to all Chiefs of Police and the Commissioner of the Ontario Provincial Police, stating that FGM is a criminal offence. In 1997, FGM was included in the Criminal Code and put under "aggravated assault"- "any person who commits an aggravated assault is guilty of an indictable offence and liable to imprisonment for a term not exceeding fourteen years." If a parent is present and is in agreement with the act of FGM being performed on their child as well as if the parent performs the operation themselves can be convicted.

Duty to report: In Ontario, a duty to report FGM exists under the policy of the College of Physicians and Surgeons of Ontario (CPSO). Under the CPSO policy, the performance of female circumcision, excision, infibulation and/or reinfibulation by a physician licensed in Ontario, unless medically indicated, would be regarded as professional misconduct. Under Ontario's Child and Family Services Act,42 there is a duty to report information with respect to a child who is in need of protection. This duty exists despite the provisions of any other Act. If a person has reasonable grounds to suspect that a child is or may be in need of protection, the person is obliged to report the suspicion to appropriate authorities.

The Ontario Human Rights Code: The Ontario Human Rights Code, recognizes the inherent worth and dignity of every person in Ontario. The creation of a society in which all persons can live and work in an environment that is free from discrimination is central to the policy objectives of the Ontario Human Rights Commission in virtue of the Code. There are new immigrants to Canada who may not be aware that some of their traditional or culturally rooted attitudes and values may result in practices that are clearly in conflict with Canadian law, including the Ontario Human Rights Code. FGM is practised within certain immigrant groups- where the families might not consider the operation as a form of physical or sexual abuse. The Commission does recognise the need to treat such issues in a sensitive manner and to educate the public on human rights issues.

The need to work with communities: The Commission acknowledges the complex social and cultural roots of FGM and the need for dialogue and education initiatives within the at-risk communities in Ontario and across Canada. However, it is the Commission's view that arguments based on a defence of cultural or religious values should not be accepted as justification for the practice, nor for discriminating against women who have been subjected to, or perceived to have been subjected to, genital mutilation. The Commission is committed to working with members and organizations of the at-risk communities, as well as with other agencies in the public sector in

developing public education initiatives around FGM. The efforts of the Commission, together with those of the affected communities and concerned organizations, can help to create an environment in which people are encouraged to eradicate the practice, without imposing a threat to the dignity and cultural identity of the affected communities.

The Commission's focus is very correctly on eradicating FGM among immigrants in Toronto which are from the regions where FGM is practised. It is estimated that there are 70,000 immigrants and refugees from Somalia and 10,000 from Nigeria. Reliable statistics on the incidence of FGM are not available. However, based on discussions with members of the communities that are at risk, there is some evidence to indicate that FGM is practised in Ontario and across Canada and that in some cases, families from those communities send their daughters out of Canada to have the operation

performed.

The Commission is working with local non-governmental groups to spread the message. The National Organization of Immigrant and Visible Minority Women of Canada has prepared a workshop manual for health care workers and facilitators working with communities that have traditionally practised FGM. The aim is to educate participants about the health and legal consequences of FGM, to correct misperceptions and fallacies about the tradition and to support efforts to eradicate the practice.

As there were no co-ordinated efforts between various professionals and institutions, and no consistent policy in Canada regarding FGM, members of affected communities requested that the Minister Responsible for Women's Issues establish an Ontario FGM Prevention Task Force. The Task Force, an inter-ministerial/agency/community initiative, was mandated to develop and recommend strategies and policies designed to provide support for girls and women who have been subjected to FGM, to prevent the practice, and to support community work by, and for women affected by genital mutilation.

The focus is not on imposing a foreign value system (the concept of cultural imperialism) on societies in Africa etc. but asking immigrants and religious groups which have come to live in Canada to act in accordance with the country's concerns about the health of women and their reproductive rights. The policy is therefore based around the idea of the empowerment of women and of ensuring an end to discrimination.

The Commission's policy has had a direct impact on immigrant communities living in Ontario but also helped to publicise the problem in other parts of Canada and the world. In 1994, in a landmark ruling, Canada also became the first Western country to recognise FGM as grounds for granting asylum. The Human Rights Commission of Ontario has therefore taken a courageous and ground-breaking policy stance to tackle a serious violation of the rights of women.

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Female Genital Mutilation (FGM) Policy Analysis

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What is female genital mutilation ?
How many women and girls are affected?
How does female genital mutilation affect the health of women and girls?
What are the consequences for childbirth?
Is there a link between female genital mutilation and the risk of HIV infection?
What are the psychological effects of female genital mutilation?
What are the different types of female genital mutilation?
Which types are most common?
Why are there different terms to describe female genital mutilation, such as female genital cutting and female circumcision?
What terminology does UNFPA use?
Where does the practice come from?
At what age is female genital mutilation performed?
Where is female genital mutilation practiced?
Who performs female genital mutilation?
What instruments are used to perform female genital mutilation?
Why is female genital mutilation performed?
Is female genital mutilation required by certain religions?
Since female genital mutilation is part of a cultural tradition, can it still be condemned?
Does anyone have the right to interfere in age-old cultural traditions such as female genital mutilation?
What is the link between female genital mutilation and ethnicity?
What does the term "medicalization of female genital mutilation" mean?
Isn't it safer for female genital mutilation to be performed by a skilled health worker rather than by somebody without a medical background?
What is UNFPA's approach to female genital mutilation?
In which countries is female genital mutilation banned by law?
What does the ICPD Programme of Action say about female genital mutilation? Which international and regional instruments can be referenced for the elimination of female genital mutilation?
What is female genital mutilation?

Female genital mutilation (sometimes abbreviated as FGM or referenced by other names) refers to all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs for cultural or other non-medical reasons.

How many women and girls are affected?

An estimated 230 million girls and women alive today are believed to have been subjected to female genital mutilation; but the number of girls subjected to the practice will likely increase due toglobal population growth. Girls and women who have undergone female genital mutilation live predominately in sub-Saharan Africa and the Arab States, but it is also practiced in select countries in Asia, Eastern Europe and Latin America. It also occurs among int Europe, North America, Australia and New Zealand. ( See more.)

If the rates of female genital mutilation continue at current levels, 68 million girls be subjected to it between 2015 and 2030 in the 25 countries where female genital mutilation is routinely practiced.

A key challenge is not only protecting girls who are currently at risk but also ensuring that those to be born in the future will be free from the dangers of the practice. In 2023, UNFPA estimated that nearly 4.3 million girls were at risk of female genital mutilation that year, up from 4.1 million girls in 2019.

From 2020 through 2022, COVID-19 disrupted programmes to to prevent female genital mutilation and other harmful practices. UNFPA has estimated that, due to COVID-19, millions more cases of female genital mutilation could take place over the next decade unless action is scaled up.

How does female genital mutilation affect the health of women and girls?

Female genital mutilation increases the risks of immediate and long-term psychological, obstetric, genitourinary, sexual and reproductive health complications.

There is no health benefit from female genital mutilation.

Immediate complications include severe pain, shock, haemorrhage, tetanus or infection, urine retention, ulceration of the genital region and injury to adjacent tissue, wound infection, urinary infection, fever and septicemia. Haemorrhage and infection can be severe enough to cause death.

Long-term consequences include complications during childbirth, anaemia, the formation of cysts and abscesses, keloid scar formation, damage to the urethra resulting in urinary incontinence, dyspareunia (painful sexual intercourse), sexual dysfunction, hypersensitivity of the genital area and potentially increased trisk of HIV transmission, as well as psychological effects.

Infibulation, or type III female genital mutilation, is the most severe form. A covering seal is made by cutting and appositioning the labia minora or labia majora with or without excision of the clitoral prepuce and glans leaving a small opening for urine and menstrual blood. This type may result in urinary complications such as urination disorders or frequent urinary infections. In addition, infibulation may result in the accumulation of menstrual flow in the vagina and uterus leading to chronic pelvic pain and infertility. Because infibulation creates a physical barrier to sexual intercourse and childbirth, this would require re-opening of the vulvar scar (de-infibulation) before sexual intercourse can take place or during childbirth .

What are the consequences for childbirth?

Compared with women who had not been subjected to female genital mutilation, those who had undergone female genital mutilation faced a significantly greater risk of requiring a Caesarean section, an episiotomy and an extended hospital stay, and also of suffering post-partum haemorrhage.

Women who have undergone infibulation are more likely to suffer from prolonged and obstructed labour, sometimes resulting in stillbirth and early neonatal death.

Is there a link between female genital mutilation and the risk of HIV infection?

There is no clear direct association between female genital mutilation and HIV. Mechanisms that can potentially increase the risk of HIV infection include use of the same instrument among multiple girls or women when performing female genital mutilation. Similarly, HIV risk may increase due to laceration of scar tissue during sexual intercourse or use of unsafe blood transfusion to treat severe postpartum haemorrhage, a condition that is more likely among women subjected to female genital mutilation.

What are the psychological effects of female genital mutilation?

Female genital mutilation may result in immediate or prolonged psychological effects. The psychological effects include post-traumatic stress disorder, anxiety disorders, depression and somatic (physical) complaints such as aches or pain with no organic cause.

What are the different types of female genital mutilation?

The World Health Organization (WHO) has identified four types of female genital mutilation:

Type I, also called clitoridectomy: Partial or total removal of the clitoral glans and/or the prepuce.

Type II, also called excision: Partial or total removal of the clitoral glans and the labia minora, with or without excision of the labia majora. The amount of tissue that is removed varies widely from community to community.

Type III, also called infibulation: Narrowing of the vaginal orifice with a covering seal. The seal is formed by cutting and re-positioning the labia minora and/or the labia majora. This can take place with or without removal of the clitoral glans/prepuce.

Type IV: All other harmful procedures to the female genitalia for non-medical purposes, for example: Pricking, piercing, incising, scraping or cauterization.

Other terms related to female genital mutilation include incision, deinfibulation and reinfibulation:

Deinfibulation refers to a surgical procedure for people who have undergone type III female genital mutilation to improve health and well-being, or allow sexual intercourse or facilitate childbirth. The scar tissue covering the urethral and vaginal opening is cut and its edges are stitched to create an opening.

Reinfibulation is the practice of narrowing the vaginal opening again in a woman who has been deinfibulated. It is usually done after childbirth.

Which types are most common?

Types I and II are the most common globally, but there is variation in how it is performed between and within countries. Type III - infibulation - is experienced by about 10 per cent of all affected women and is practiced mostly in Somalia, Sudan and Djibouti.

Why are there different terms to describe female genital mutilation, such as female genital cutting and female circumcision?

The terminology used for this procedure has gone through various changes.

When the practice first came to international attention, it was generally referred to as "female circumcision." (In Eastern and Northern Africa, this term is often used to describe female genital mutilation type I.) However, the term "female circumcision" has been criticized for drawing a parallel with male circumcision and creating confusion between the two distinct practices. Adding to the confusion is the fact that health experts in many Eastern and Southern African countries encourage male circumcision to reduce HIV transmission; female genital mutilation, on the other hand, can potentially increase the risk of HIV transmission and has no known health benefit.

It is also sometimes argued that the term obscures the serious physical and psychological effects on women. UNFPA does not encourage use of the term "female circumcision" because the health implications of male and female circumcision are very different.

The term "female genital mutilation" is used by a wide range of women's health and human rights organizations. It establishes a clear distinction from male circumcision. Use of the word "mutilation" also emphasizes the gravity of the act and reinforces that the practice is a violation of women's and girls' basic human rights. This expression gained support in the late 1970s, and since 1994, it has been used in several United Nations conference documents and has served as a policy and advocacy tool. In Resolution 65/170, Member States clearly stated that female genital mutilation should be used to refer to this harmful practice.

In the late 1990s the term "female genital cutting" was introduced, partly in response to dissatisfaction with the term "female genital mutilation." There is concern that communities could find the term "mutilation" demeaning, or that it could imply that parents or practitioners perform this procedure maliciously. Some fear the term "female genital mutilation" could alienate practicing communities, or even cause a backlash, possibly increasing the number of girls subjected to the practice.

Some organizations embrace both terms, referring to "female genital mutilation/cutting" or FGM/C.

What terminology does UNFPA use?

UNFPA uses the term "female genital mutilation" because it embraces a human rights perspective on the issue. "Female genital mutilation" more accurately describes the practice from a human rights viewpoint.

Today, a greater number of countries have outlawed the practice, and an increasing number of communities have committed to abandoning it, indicating that the social and cultural perceptions of the practice are being challenged by communities themselves, along with national, regional and international decision-makers. Therefore, it is time to accelerate the momentum towards full abandonment of the practice by framing the issue from a human rights perspective.

Additionally, the term "female genital mutilation" is used in a number of UN and intergovernmental documents. One recent document is the 2016 UN Secretary General's Report ( A/71/209) on Intensifying global efforts for the elimination of female genital mutilations. Other documents using the term "female genital mutilation" include: Report of the Secretary-General on Ending Female Genital Mutilation, Communication from the Commission to the European Parliament and the Council: Towards the elimination of female genital mutilation, Protocol to the African Charter on Human and Peoples' Rights on the Rights of Women in Africa; Beijing Declaration and Platform for Action; and Eliminating female genital mutilation: An interagency statement. And each year on 6 February, the United Nations observes the " International Day of Zero Tolerance for Female Genital Mutilation. "

Where does the practice come from?

The origins of the practice are unclear. It predates the rise of Christianity and Islam. It is said some Egyptian mummies display characteristics of female genital mutilation. Historians such as Herodotus claim that, in the fifth century BC, the Phoenicians, the Hittites and the Ethiopians practiced circumcision. It is also reported that circumcision rites were practiced in tropical zones of Africa, in the Philippines, by certain tribes in the Upper Amazon, by women of the Arunta tribe in Australia and by certain early Romans and Arabs. As recent as the 1950s, removal of clitoral glans was practiced in Western Europe and the United States to treat perceived ailments including hysteria, epilepsy, mental disorders, masturbation, nymphomania and melancholia. In other words, the practice of female genital mutilation has been followed by many different peoples and societies across the ages and continents.

At what age is female genital mutilation performed?

It varies but most performed between 5 and 9 years old. In some areas, female genital mutilation is carried out during infancy - as early as a couple of days after birth. In others, it takes place during childhood, at the time of marriage, during a woman's first pregnancy or after the birth of her first child. Recent reports suggest that the ages when the practice is performed has been dropping in some countries.

Where is female genital mutilation practiced?

Female genital mutilation is currently documented in 92 countries around the world through either nationally representative data, indirect estimates (usually in countries where female genital mutilation is mainly practiced by diaspora communities), small-scale studies, or anecdotal evidence and media reports. This highlights the global nature of this harmful practice and the need for a global and comprehensive response to eliminate it.

In Africa, 33 countries generate female genital mutilation data from nationally representative data: Benin, Burkina Faso, Cameroon, Central African Republic, Chad, Cote d'Ivoire, Democratic Republic of Congo, Djibouti, Egypt, Eritrea, Ethiopia, Gambia, Ghana, Guinea, Guinea-Bissau, Kenya, Liberia, Malawi, Mali, Mauritania, Niger, Nigeria, Senegal, Sierra Leone, Somalia, South Africa, South Sudan, Sudan, Tanzania, Togo, Uganda, Zambia and Zimbabwe.

In the Middle East, the practice occurs in Oman, the United Arab Emirates and Yemen, as well as in Iraq, Iran, Jordan and the State of Palestine.

Asian countries with female genital mutilation practice include India, Indonesia, Malaysia, India, Sri Lanka, Bangladesh, Thailand, Brunei, Singapore, Cambodia, Vietnam, Laos, The Philippines, Afghanistan, Pakistan, and The Maldives.
Female genital mutilation is also reported in New Zealand and Australia.

In Europe, female genital mutilation practiced in Georgia the Russian Federation and the United Kingdom.

It is also reported in the United States, Canada and inColombia, Ecuador, Panama and Peru in South America.

Who performs female genital mutilation?

Female genital mutilation is typically carried out by elderly people in the community (usually, but not exclusively, women) designated to perform this task or by traditional birth attendants. Among certain populations, female genital mutilation may be carried out by traditional health practitioners, (male) barbers, members of secret societies, herbalists or sometimes a female relative.

In some cases, health workers perform female genital mutilation. This is referred to as the " medicalization" of female genital mutilation. According to recent UNFPA's estimates, around one in four girls and women between the ages of 15 and 49 who have undergone the practice(or 52 million) had undergone the practice by health personnel. (In some countries, this ratio can reach as high as three in four girls.) This proportion is twice as high among adolescents (34 per cent among those between the ages of 15 and 19) compared to older women (16 per cent among those between the ages of 45 and 49). According to estimates from demographic and health surveys and multiple indicator cluster surveys, the countries where the majority of female genital mutilation cases are performed by health workers are Egypt ( 38%), Sudan ( 67%), Kenya ( 15%), Nigeria ( 13%) and Guinea ( 15%).

What instruments are used to perform female genital mutilation?

Most of female genital mutilation is carried out with special knives, scissors, scalpels, pieces of glass or razor blades. Anaesthetic and antiseptics are generally not used unless the procedure is carried out by health workers. In communities where infibulation is practiced, girls' legs are often bound together to immobilize them for 10-14 days, allowing the formation of scar tissue..

Why is female genital mutilation performed?
1948
This social norm is driven by traditional beliefs that are passed on through generations often unquestioned and enforced by societal approvals such as marriage prospects and sanctions such as ostracism. These societal rules make it difficult for individuals or families to abandon the practice. The immediate or long-term health complications are overlooked as the perceived social benefits of the practice are deemed higher than its disadvantages.
1951
The reasons given for practicing female genital mutilation fall generally into four categories:
1966
Psychosexual reasons: Female genital mutilation is carried out as a way to control women's sexuality, which is sometimes said to be insatiable if parts of the genitalia, especially the clitoris, are not removed. It is thought to ensure virginity before marriage and fidelity afterward, and to increase male sexual pleasure.
1979
Sociological and cultural rites: Female genital mutilation is seen as part of a girl's initiation into womanhood and as a requirement for marriage.

Hygiene and aesthetic reasons: In some communities, the external female genitalia are considered dirty and ugly and are removed, ostensibly to promote hygiene and aesthetic appeal. Related myths about female genitalia (e.g., that an uncut clitoris will grow to the size of a penis, or that female genital mutilation will enhance fertility or promote child survival) also perpetuate the practice.

Religious reasons: Although female genital mutilation is not endorsed by either Islam or Christianity, supposed religious doctrine is often used to justify the practice.
1984
Is female genital mutilation required by certain religions?
1989
No religious text promotes or condones female genital mutilation. Still, more than half of girls and women in four out of 14 countries where data are available believe female genital mutilation is a religious requirement. And although female genital mutilation is often perceived as being connected to Islam, perhaps because it is practiced among many Muslim groups, not all Islamic groups practice female genital mutilation, and many non-Islamic groups do, including some Christians, Ethiopian Jews and followers of certain traditional African religions.
1993
Female genital mutilation is thus a cultural rather than a religious practice. In fact, many religious leaders have denounced it.
1994
Since female genital mutilation is part of a cultural tradition, can it still be condemned?
1995
Yes. Culture and tradition provide a framework for human well-being, and cultural arguments cannot be used to condone violence against people, male or female. Moreover, culture is not static, but constantly changing and adapting. Nevertheless, activities for the elimination of female genital mutilation should be developed and implemented in a way that is sensitive to the cultural and social background of the communities that practice it. Behaviour can change when people understand the hazards of certain practices and when they realize that it is possible to give up harmful practices without giving up meaningful aspects of their culture.
1996
Does anyone have the right to interfere in age-old cultural traditions such as female genital mutilation?
1997
Every child has the right to be protected from harm, in all settings and at all times. The movement to end female genital mutilation - often local in origin - is intended to protect girls from profound, permanent and completely unnecessary harm. The evidence shows that most people in affected countries want to stop cutting girls, and that overall support for female genital mutilation is declining even in countries where the practice is almost universal (such as Egypt and Sudan). Ending the practice will take intensive and sustained collaboration from all parts of society, including families and communities, religious and other leaders, the media, governments and the international community.
1998
What is the link between female genital mutilation and ethnicity?

There is no clear association between female genital mutilation and ethnicity. The practice is prevalent in countries that have multiple and diverse ethnicities.
1999
There are also anecdotal reports of increasing female genital cosmetic surgery in Canada and America which includes labiaplasty and removal of clitoral prepuce.

What do women and girls who have experienced female genital mutilation say about it themselves?

Women around the world are speaking out about their experiences and advocating for change.
2000
"It is what my grandmother called the three feminine sorrows: the day of circumcision, the wedding night and the birth of a baby." - From "The Three Feminine Sorrows", a Somali poem
2001
"My two sisters, myself and our mother went to visit our family back home. I assumed we were going for a holiday. A bit later they told us that we were going to be infibulated. The day before our operation was due to take place, another girl was infibulated and she died because of the operation. We were so scared and didn't want to suffer the same fate. But our parents told us it was an obligation, so we went. We fought back; we really thought we were going to die because of the pain. You have one woman holding your mouth so you won't scream, two holding your chest and the other two holding your legs. After we were infibulated, we had rope tied across our legs so it was like we had to learn to walk again. We had to try to go to the toilet. If you couldn't pass water in the next 10 days something was wrong. We were lucky, I suppose. We gradually recovered and didn't die like the other girl. But the memory and the pain never really go away." -Zainab, who was infibulated at the age of eight (from the WHO)
2003
"I will never subject my child to [female genital mutilation] if she happens to be a girl, and I will teach her the consequences of the practice early on." - Kadiga, Ethiopia
2007
"In my village there is one girl who is younger than I am who has not been cut because I discussed the issue with her parents. I told them how much the operation had hurt me, how it had traumatized me and made me not trust my own parents. They decided they did not want this to happen to their daughter." -Meaza, 15 years old
2010
What does the term "medicalization of female genital mutilation" mean?
2011
According to WHO, the medicalization of female genital mutilation is when the practice is performed by a health worker, such as a community health worker, midwife, nurse or doctor. Medicalized female genital mutilation can take place in a public or private clinic, at home or elsewhere. It also includes the procedure of reinfibulation at any point in time in a woman's life. In 2010, a joint interagency Global Strategy to Stop Health-Care Providers from Performing FGM was released. In 2016, the WHO also released guidelines on the management of health complications from female genital mutilation. This strategy reflects consensus between international experts, United Nations entities and the Member States they represent. In addition, the global commitment to eliminate all forms of female genital mutilation by 2030 is clearly stated in target 5.3 of the Sustainable Development Goals (SDG).

Isn't it safer for female genital mutilation to be performed by a skilled health worker rather than by somebody without a medical background?

Female genital mutilation can never be "safe". Even when the procedure is performed in a sterile environment and by a health worker, there can be serious health consequences immediately and later in life. Medicalizing the practice gives a false sense of safety. There are serious risks associated with all forms of female genital mutilation, including medicalized female genital mutilation.
2012
In addition, there is no medical justification for the practice. Advocating any form of harm to the genitals of girls and women, and suggesting that health workers should perform it is unacceptable from a public health and human rights perspective. Health workers who perform female genital mutilation are violating girls' and women's rights to life, physical integrity and health as well as violating the professional code of conduct of "do no harm."

Furthermore, the belief that female genital mutilation performed by health worker is less severe is unfounded. Several studies have shown that girls can be subjected to the practice repeatedly when members of their family or community are dissatisfied with the results of earlier procedures. Furthermore, studies have shown that women's reporting on less severe forms of female genital mutilation is often not clinically correct. One study from Sudan found that, among the women who claimed to have undergone less severe forms such as "nicking" or what is thought of "sunna type" about one third had actually been subjected to infibulation, and all had experienced the removal of their clitoral glans and labia minora.

When health workers perform female genital mutilation, they wrongly legitimize the practice as medically sound or beneficial for girls and women's health. And because health workers l often hold power, authority and respect in society, it can be seen as endorsing the practice.
2014
What is UNFPA's approach to female genital mutilation?
2015
UNFPA and UNICEF jointly lead the largest global programme to accelerate the elimination of female genital mutilation and to ensure that survivors receive the appropriate health, social and legal services to their needs.. This programme works with Governments, civil society organizations, networks of religious leaders, parliamentarians, youth and human rights activists academia and grass roots to:
The African Union has also developed

Support the development of policies and legislation, and ensure adequate resources, to end female genital mutilation;

Amplify interventions that expand collective knowledge about the harms of female genital mutilation and empower champions towards its elimination;

Facilitate girls' and women's movements to end practice;

Empower young people to end female genital mutilation in their communities;

Stop the medicalization of female genital mutilation through health policies, funded health sector interventions, building the knowledge and skills of health workers, strengthening monitoring and evaluation and accountability as well as creating supportive legislative and regulatory frameworks;

Integrate female genital mutilation responses into sexual and reproductive health, maternal and child health and child protection services as well as with humanitarian-development nexuses - areas that offer entry points for identifying and supporting girls and women who are at risk or have been subjected to the practice.

Mainstream information about female genital mutilation into health training programmes, mobilize doctors, nurses and midwives in support of prevention and survivor care, and empower health providers to serve as role models, counsellors and advocates in an effort to end the practice; and

Establish a global knowledge hub for the measurement and dissemination of social norms and good practices captured by the Joint Programme for policy-making and improved programming.

2018
The Joint Programme recognizes that eliminating FGM requires communities to make a collective and coordinated choice so that no single girl or family is disadvantaged by the decision.
2019
This approach has seen progress. Civil society organizations are implementing community-led education and dialogue sessions on human rights and health. These networks are helping a growing number of communities declare their abandonment of female genital mutilation. A shift has occurred among religious leaders, many of whom have gone from endorsing the practice to actively condemning it. There has been a growing number of public declarations unlinking female genital mutilation from religion and supporting abandonment of the practice.
2019
With UNFPA technical guidance and support, there has been a surge in activities to strengthen the role of public health services in preventing female genital mutilation and, wherever possible, in treating survivors of the practice and mitigating its negative effects on women's health. Health workers have been trained to treat complications caused by female genital mutilation, including the integration of survivor care into medical education curricula.
2020
Referral systems that build coordination between health providers and community actors and organizations have also been strengthened.

Several countries have passed new national legislation banning specifically female genital mutilation and developed national policies with concrete steps towards achieving the abandonment of the practice. Radio networks have aired call-in shows about the harm caused by female genital mutilation. The use of media to galvanize public opinion against the practice has helped change perceptions and transformed public perceptions of girls who remain uncut.

In which countries is female genital mutilation banned by law?

According to the 2021 edition of the World Bank's "Compendium of International and National Legal Frameworks on Female Genital Mutilation", 84 countries in the world have domestic legislation that either specifically prohibits the practice of female genital mutilation or allows it to be prosecuted through other laws, such as the criminal or penal code, child protections laws, violence against women laws or domestic violence laws.
2022 African Union Accountability Framework on Harmful Practices. 2023
Africa: Algeria (2015); Benin (2003); Burkina Faso (1996); Cameroon (2016); Central African Republic (1996, 2006); Chad (2002); Comoros (1982); Congo Republic (2002); Côte d'Ivoire (1998); Djibouti (1994, 2009); Democratic Republic of the Congo (2006); Egypt (2008); Eritrea (2007, 2015); Ethiopia (2004); The Gambia (2015); Ghana (1994, 2007); Guinea (1965, 2000, 2016); Guinea Bissau (2011); Liberia (2018, by one-year executive order); Kenya (2001, 2011); Malawi (2000); Mauritania (2005); Mozambique (2014); Niger (2003); Nigeria (2015); Senegal (1999); Sierra Leone (2007); Somalia (2001)*; South Africa (2005); Sudan (2020); South Sudan (2008); Tanzania (1998); Togo (1998); Uganda (2010); Zambia (2005, 2011); Zimbabwe (2006).

Others: Australia (6 out of 8 states between 1994-2006); Austria (1974, 2002); Bahrain (1976); Belgium (2000); Brazil (1984); Bulgaria (1968); Canada (1997); Colombia (2006, Resolution No. 001 of 2009 by indigenous authorities); Croatia (2013); Cyprus (2003); Czech Republic (2009); Denmark (2003); Estonia (2001); Finland (2013); France (1979); Hungary (2012); India (1860); Italy (2006); Iran (1991); Iraq (2011, only applicable in Kurdistan); Ireland (2012); Kuwait (2015); Georgia (Germany (2013); Greece (1951); Latvia (2005); Lithuania (2000); Luxembourg (on mutilations only, not specifically on 'genital' mutilation, 2008); Malta (1854); Mexico (2020); Netherlands (1881); New Zealand (1995); Norway (1995); Oman (2019), Pakistan (1860); Panama (2007); Peru (1991); Philippines (1930); Poland (2003); Portugal (2007); Romania (2017); Slovakia (2005); Slovenia (2008); Spain (2003); Sweden (1982,1998); Switzerland (2005, 2012); Trinidad and Tobago (2012); United Kingdom (1985; 2003); United States (1996).

Penalties range from a minimum of six months to a maximum of life in prison. Several countries also include monetary fines in the penalty.

*Somalia's Constitution expressly states that the "circumcision of girls is prohibited". However, there is no national legislation that expressly implements this Constitutional provision, and there are no known instances where female genital mutilation offenses have been prosecuted under general criminal provisions. The female genital mutilation bill has been stuck in the legislative process for several years.
Demographic Perspectives on Female Genital Mutilation. New York, UNFPA, 2015.
What does the ICPD Programme of Action say about female genital mutilation?

The Programme of Action of the International Conference on Population and Development (ICPD) recognizes that violence against women is a widespread phenomenon. It states, "In a number of countries, harmful practices meant to control women's sexuality have led to great suffering. Among them is the practice of female genital cutting, which is a violation of basic rights and a major lifelong risk to women's health" (para 7.35).

The Programme of Action calls for "Governments and communities [to] urgently take steps to stop the practice of female genital cutting and protect women and girls from all such similar unnecessary and dangerous practices. Steps to eliminate the practice should include strong community outreach programmes involving village and religious leaders, education and counselling about its impact on girls' and women's health, and appropriate treatment and rehabilitation for girls and women who have suffered cutting. Services should include counselling for women and men to discourage the practice". (para 7.40)

Chapter 4, para 4.4 states, "Countries should act to empower women and should take steps to eliminate inequalities between men and women as soon as possible by ... eliminating all practices that discriminate against women; assisting women to establish and realize their rights, including those that relate to reproductive and sexual health". Para 4.9, states, "Countries should take full measure to eliminate all forms of exploitation, abuse, harassment and violence against women, adolescents and children".

Which international and regional instruments can be referenced for the elimination of female genital mutilation?

Most governments in countries where female genital mutilation is practiced have ratified international conventions and declarations that make provisions for the promotion and protection of the health of women and girls. For example:

The Universal Declaration of Human Rights proclaims the right of all human beings to live in conditions that enable them to enjoy good health and health care (art. 25). Adopted by the General Assembly of the United Nations on 10 December 1948, the Universal Declaration of Human Rights has five articles which together form a basis to condemn female genital mutilation: Article 2 on discrimination, article 3 concerning the right to security of person, article 5 on cruel, inhuman and degrading treatment, article 12 on privacy and article 25 on the right to a minimum standard of living (including adequate health care) and protection of motherhood.

The Convention relating to the Status of Refugees defines who is a refugee, what their rights are, and explains the legal obligations of states. Those fleeing the threat of female genital mutilation qualify for refugee status.

The International Covenants on Civil and Political Rights and on Economic, Social and Cultural Rights condemn discrimination on the grounds of sex and recognize the universal right to the highest attainable standard of physical and mental health (art. 12).

The Convention on the Elimination of All Forms of Discrimination against Women requires State Parties to "take all appropriate measures to modify or abolish customs and practices which constitute discrimination against women" (art. 2f) and "modify social and cultural patterns of conduct of men and women, with a view to achieving the elimination of prejudices and customary and all other practices which are based on the idea of the inferiority or the superiority of either of the sexes" (art 5a).

General recommendation 24 (1999) of the Convention emphasizes that certain cultural or traditional practices, such as female genital mutilation, carry a high risk of death and disability and recommends that State parties should ensure laws that prohibit female genital mutilation.

General recommendation 14 (1990) recommends State parties take appropriate and effective measures to eradicate female genital mutilation; to collect and disseminate basic data on traditional practices; to support women's organizations that work for the elimination of harmful practices; to encourage politicians, professionals, religious and community leaders to co-operate in influencing attitudes; to introduce appropriate educational and training programmes; to include appropriate strategies aimed at ending female genital mutilation into national health policies; to invite assistance, information and advice from the appropriate organization of the United Nations system; and to include in their reports to the Committee, under articles 10 and 12 of the Convention, information about measures taken to eliminate female genital mutilation.

The Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment was adopted and opened for signature, ratification and accession by General Assembly resolution 39/46 (entered into force in 1990). The Committee against Torture clearly states in General Comment No. 2 that female genital mutilation falls within its mandate. The UN Special Rapporteur on violence against women and the UN Special Rapporteur on torture have both recognized that female genital mutilation can amount to torture under this Convention.

The Convention on the Rights of the Child protects against all forms of mental and physical violence and maltreatment (art 19.1); calls for freedom from torture or cruel, inhuman or degrading treatment (art 37a); and requires States to take all effective and appropriate measures to abolish traditional practices prejudicial to the health of children (art 24.3).

The Vienna Declaration and the Programme of Action of the World Conference on Human Rights expanded the international human rights agenda to include gender-based violence, including female genital mutilation.

The International Conference on Population and Development Programme of Action calls for governments to "urgently take steps to stop the practice of female genital cutting and protect women and girls from all such similar unnecessary and dangerous practices".

The Platform for Action of the Fourth World Conference on Women urges governments, international organizations and non-governmental groups to develop policies and programmes to eliminate all forms of discrimination against girls, including female genital cutting.

The United Nations General Assembly passed The Girl Child Resolution (A/RES/51/76), recognizing female genital mutilation as a form of "discrimination against the girl child and the violation of the rights of the girl child".

The African Charter on Human and Peoples' Rights highlights human rights. Article 4 focuses on integrity of the person, article 5 on human dignity and protection against degradation, article 16 on the right to health and article 18 (3) on the protection of the rights of women and children.

The Addis Ababa Declaration on Violence against Women serves as an important step towards the formulation of an African charter on violence against women, providing the framework for national laws against female genital mutilation. It was adopted at the Council of Ministers during its sixty-eighth Session in July 1998 by the Organization of African Unity (OAU). The Declaration was later endorsed by the Assembly of Heads of State and Governments.

The Banjul Declaration condemns female genital mutilation and demands its elimination.

The United Nations Social, Humanitarian and Cultural Committee approved a resolution that calls upon States to implement national legislation and policies that prohibit traditional or customary practices that damage the health of women and girls, including female genital mutilation.

The Ouagadougou Declaration of the Regional Workshop on the Fight against Female Genital Mutilation calls for networks and mechanisms to combat female genital mutilation.

Key Actions for the Further Implementation of the Programme of Action of the International Conference on Population and Development calls for governments to promote the human rights of women and girls and ensure their freedom from coercion, discrimination and violence, including harmful practices. It also calls for governments to ensure health providers are knowledgeable and trained to serve clients who have been subjected to harmful practices.

Further Actions and Initiatives to Implement the Beijing Declaration and Platform for Action recognizes the progress made in national efforts to ban female genital mutilation, and points out that discriminatory attitudes and norms continue to make girls and women vulnerable to gender-based violence, including female genital mutilation. It calls for governments to combat and eliminate violence against women.

The European Parliament adopted a resolution on female genital mutilation calling for measures to protect survivors of the practice and urging member states to recognize the right to asylum for women and girls at risk of being subject to female genital mutilation.

The Protocol to the African Charter on Human and Peoples' rights, on the rights of women in Africa, also known as the Maputo Protocol, calls for the "elimination of harmful practices".

United Nations General Assembly adopted The Girl Child Resolution (A/RES/62/140) stating it was "deeply concerned ... that female genital mutilation is an irreparable, irreversible harmful practice."

Commission of the Status of Women passed Resolution 54/7 on ending female genital mutilation.

African Union Assembly/AU/Dec. 383(XVII) produced a decision stating that "female genital mutilation (FGM) is a gross violation of the fundamental human rights of women and girls, with serious repercussions on the lives of millions of people worldwide, especially women and girls in Africa".

The Fifty-sixth session of the Commission on the Status of Women approved a draft decision, "Ending female genital mutilation". (E/CN.6/2012/L.1) The Secretary-General released a report, " Ending Female Genital Mutilation ", which summarized progress made on the implementation of 2010 CSW resolution 54/7.

The World Health Assembly passed Resolution WHA61.16 and Progress Report 2011 ( A64/2 6), both referring to female genital mutilation.

European Parliament Resolution of 14 June 2012 focused on ending female genital mutilation.

The United Nations General Assembly passed The Girl Child Resolution (62/140), stating it was "deeply concerned ... that female genital mutilation is an irreparable, irreversible harmful practice". The Secretary-General's Report on the Girl Child also included a special emphasis on female genital mutilation ( A/64/315, 2009 and A/66/257, 2012).

The United Nations General Assembly also passed Resolution 67/146 on intensifying global efforts to eliminate female genital mutilation, reaffirmed by Resolution 69/150 in 2014 and 71/168 in 2016.

The Human Rights Council produced a resolution calling for "Intensifying global efforts and sharing good practices to effectively eliminate female genital mutilation".

Female genital mutilation is included in the Sustainable Development Goals (SDGs) under Target 5.3, "Eliminate all harmful practices, such as child, early and forced marriage and female genital mutilation".

continental legal frameworks addressing the issue. The African Union Commission has aligned its Agenda 2063 aspirations to prioritize the end of violence and discrimination against women and girls with clear targets to "end all harmful social norms and customary practices against women and girls and those that promote violence and discrimination against women and girls by 2025". Decisions and fora include the following.

First International Conference on Ending Female Genital Mutilation in Ouagadougou, Burkina Faso.

The Declaration and Action Plan to End Cross-border Female Genital Mutilation, adopted at an inaugural regional inter-ministerial meeting held in 2019. The meeting, which was the first of its kind in the history of global efforts to eradicate female genital mutilation, reaffirmed the need for strong partnerships at all levels to end this harmful practice.

African Union General Assembly Decision on Elimination of Female Genital Mutilation. It endorsed and launched the implementation of the Saleema Initiative on the Elimination of Female Genital Mutilation on the continent.

Follow up 33rd Ordinary Session of the Assembly of the Union in 2020. Participants reaffirmed commitment to implement the recommendations from the report of the African Union Champion on the Eliminating Female Genital Mutilation.

The 44th Session, the Human Rights Council. Resolution 44/16 on elimination of female genital mutilation was adopted.

The Saleema Youth Victorious Ambassadors (SYVA) initiative. It was adopted and launched through AU Assembly Decision 737/ 2019.

2021-2023: The Spotlight Initiative Africa Regional Programme. This programme implemented by the African Union with the technical support of the United Nations and financial support of the European Union.

Second International African Union Conference On the Elimination of Female Genital Mutilation, in Dar es Salaam, Tanzania.

Joint General Comment on Eliminating Female Genital Mutilation, by the African Committee of Experts on the Rights and Welfare of the Child and the African Commission on Human and Peoples' Rights.

Sources

Female Genital Mutilation/Cutting: A Statistical Overview and Exploration of the Dynamics of Change. New York, UNICEF, 2013.

Askew I, Chaiban T, Kalasa B, et al A repeat call for complete abandonment of FGM Journal of Medical Ethics 2016;42:619-620

Implementation of the International and Regional Human Rights Framework for the Elimination of Female Genital Mutilation. New York, UNFPA, 2014.

Female Genital Mutilation: A Joint WHO/UNICEF/UNFPA Statement. WHO, 1997.

Eliminating Female Genital Mutilation: An interagency statement. WHO, 2008.

Global Strategy to Stop health-care providers from performing FGM. WHO, 2010.

Female Genital Mutilation: The Practice WHO Information Package. WHO, 1994.

Jacqueline Smith. Visions and Discussions on Genital Mutilation of Girls, An International Survey. 1995.

Nahid Toubia, Caring for women with circumcision. A technical manual for healthcare providers. Rainbo, 1999.

M. de Bruyn. Socio-cultural aspects of female genital cutting. KIT, 1998.

E. Leye, K. Roelens, M. Temmerman. Medical aspects of female genital mutilation. International Center for Reproductive Health, University of Gent. 1998.

Prof. H. Rushwan FGC management during pregnancy, childbirth and post-partum period. Background paper for WHO Consultation, Geneva, 1997.

S. Izett, N. Toubia. Learning about social change. A research and evaluation guidebook using female circumcision as a case study. Rainbo, 1999.

M. Hekmati. Towards the Eradication of Female Genital Mutilation in Egypt. 1999.

ECOSOC document E/CN.4/Sub.2/1999/14: "Third report on the situation regarding the elimination of traditional practices affecting the health of women and the girl child", by Ms. Halima Embarek Warzazi, pursuant to sub-commission resolution 1998/16

Committee on Economic, Social and Cultural Rights. General Comment No. 14. The right to the highest attainable standard of health. UN Doc. E/C. 12/2000/4. Committee on the Elimination of All Forms of Discrimination against Women. General Recommendation No. 14, Female circumcision. General Recommendation No. 19, Violence against women. General Recommendation No. 24, Women and health.

General Assembly document A/C.3/54/C.13. Traditional or customary practices affecting the health of women and girls.

Human Rights Committee. General Comment No. 20. Prohibition of torture and cruel treatment or punishment. General Comment No. 28. Equality of rights between men and women. CCPR/C/21/rev.1/Add.10.

Demographic and Health Surveys

Multiple Indicator Cluster Surveys

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Female genital mutilation (FGM) frequently asked questions

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The above dashboard shows female genital mutilation prevalence in the 17 countries where the UNFPA-UNICEF Joint