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CUT OFF
The Female Genital Cutting Controversy
By Sarah Cannon with contributions by Daniel Berman |
Female genital cutting (FGC) occupies an unusual position in the realm of worldwide public health dangers, in that attempts to eradicate the practice have met with considerable resistance by many of the affected women themselves. The procedure - also known by the more connotative terms female genital mutilation (FGM) and female circumcision - involves removing part or all of the female genitals, usually when the participant is young. While it is descried by many as a torturous and sex-based abuse, and often spoken of as a violation of widely-recognized human rights, a great number of its most ardent supporters have undergone FGC themselves and fully intend that their daughters do the same. The current debate over FGC integrates the issue of international public health standards into the conflict between cultural legitimacy and women's progress, and emphasizes how public health - often considered a universal good - cannot be separated from cultural and political concerns.
FGC can be roughly divided into three types of procedures: clitoridectomy, in which part or all of the clitoris is removed; excision, in which part or all of the labia minora are removed; and infibulation, the most invasive procedure, in which the previous two acts are combined with removal of at least the anterior two-thirds of the medial part of the labia majora, followed by the stitching together of the vulva so that only a small hole remains for urine and menstrual fluid.
While most FGC occurs in Africa and the Middle East, minorities in Asia and Latin America also practice versions of the custom, as do immigrants from practicing cultures who live in communities throughout the world. Most girls are operated on between the ages of four and eight, although FGC can occur as late as a young woman's first marriage.
In Sudan, the country with the highest rate of FGC in the world, an estimated 89% of girls are circumcised, a vast majority of whom are infibulated. Tools commonly used include knives, scissors, razors, and broken glass. The operation is typically performed by elderly women or traditional birth attendants, though increasing numbers of doctors are taking over these roles. And despite domestic and international efforts to eradicate the practice, its prevalence is increasing in certain areas of rural Sudan.
The motivations for FGC are varied: they include psycho-sexual, religious, sociological, aesthetic, and perceived hygienic causes. Despite this variation, FGC is united across practicing cultures in being a central part of a young woman's identity. It is tied to social definitions of femininity and attitudes towards women's sexuality. Advocates of the practice argue that it initiates young girls into society and their eventual role as mature women, prevents extramarital sex, and contributes to a young woman's eligibility for marriage. If they remain uncircumcised, many girls fear social mockery and exclusion from a communal identity. Uncircumcised girls are seen variously as unclean, unfit for marriage, sexually immoral, anti-traditional, ignorant, infertile, and unhealthy.
Furthermore, a wide range of myths has grown up around the ritual of circumcision: in many parts of Africa, for example, people believe that a child which touches the clitoris of its mother as it is born will not survive; others believe that contact between the clitoris and a man's penis will cause him to fall ill. Such myths may serve to perpetuate the practice in situations when its prevalence would otherwise decline.
Although hygiene is sometimes cited as a reason for FGC, the health consequences associated with the practice are actually harmful and severe. FGC can result in injury to neighboring organs, urine retention, abnormal scar tissue, cysts and abscess formation, excruciating pain during sex, increased susceptibility to HIV infection, painful menstruation, reproductive tract infections, complications during labor and delivery, shock, hemorrhage, and death. In addition, the psychological problems that result from FGC are not discussed openly and resources to help women cope with the emotional effects of the practice are largely non-existent.
While many in the developed world have condemned FGC, including such organizations as the United Nations, the World Health Organization (WHO), and Amnesty International, others have retorted that these organizations have no place judging the merits and demerits of a cultural practice. The issue of FGC, as practiced in Sudan and elsewhere, brings to the foreground the tension between cultural differences and the notion of universal human rights or public health standards.
The opinion of women in Sudan is certainly not uniform. Many women vehemently oppose genital cutting; others, however, are so adamant about its preservation that they have begun to circumcise themselves. According to demographic and health surveys, 79% of Sudanese women favor FGC, and it is women - rather than men - who have championed the practice against numerous attacks. Some Sudanese women who advocate the practice fear being stripped of cultural identity by an imposing outside world; others are concerned that no man will want to take an uncircumcised woman for a wife; yet others argue that circumcision helps a woman to be mistress of her own body. They argue that terming the practice "mutilation" misrepresents it in public discourse.
However, many women and girls in Sudan are willing to make serious personal sacrifices to avoid FGC. Young girls have run away from home to avoid being cut and women are seeking asylum in other countries in order to escape the procedure. Opposition to female genital cutting started as early as 1860, and Sudan has had more domestic activism against FGC than any other African country. The Sudanese Network for the Abolition of Female Genital Mutilation works to abolish the custom and ties FGC to broader goals of helping women to secure self-representation, political participation, literacy, legal rights, equal pay, child care, and better employment.
Outside Sudan and the other countries where it is practiced, female genital cutting has drawn the attention of women across the globe, many of whom have joined movements to abolish it. Aside from moral debate, a controversy surrounds whose role it is to speak out against FGC: is it a question for African women? For all Africans? All women? All people?
Most international assistance agencies have developed policies or programs to combat female genital cutting, and according to the WHO there is a "Western feminist tendency to see Female Genital Mutilation...as the gender oppression to end all oppressions." In a 1998 World Health Report, the WHO argued for complete eradication. Its resolution stated that "FGM is a deeply rooted, traditional practice. However, it is a form of violence against girls and women that has serious physical and psychological consequences which adversely affect health. Furthermore, it is a reflection of discrimination against women and girls." The WHO explains its intervention through its belief in universal human rights and its disapproval of the notion that cultural relativism justifies acts of sex-based violence. However, others have challenged the WHO's view. According to anthropologist Ellen Gruenbaum: "If these values are based on deeply held cultural values and traditions, can outsiders effectively challenge them without challenging the cultural integrity of the people who practice them?"
Many Sudanese women find the way in which Western women contribute to the anti-FGC movement to be offensive and counter-productive to their own efforts to eradicate the practice. They accuse Western women of failing to acknowledge the agency of African women by implying that they cannot speak for themselves. Also, Africans accuse Western women of sensationalizing FGC and in so doing creating a defensive reaction among practitioners who might otherwise be allies in the process of eradication.
Also, some African women feel betrayed by the single-minded focus on FGC exhibited by Western women as well as by some African scholars. While genital cutting has received significant attention around the world, other issues that significantly affect women's lives are ignored. Henry Louis Gates, the seminal scholar of African-American studies, wonders: "Is it, after all, unreasonable to be suspicious of Westerners who are exercised over female circumcision, but whose eyes glaze over when the same women are merely facing starvation?" Critics like Gates point out that action may seem misguided when it is based on sensationalism and ignores those needs which are greatest. As Ellen Gruenbaum articulates, "Instead of concern for the basic needs for Third World Women, like water supply, economic development, and peace, Western feminists are more concerned about veils, clitorises, and so on. What good is all this without our lives?"
Others resent what they see as Western cultural hypocrisy. Nahid Toubia, an Egyptian feminist, argues that "the thinking of an African woman who believes FGM is the fashionable thing to do to become a real woman is not so different from that of an American woman who has breast implants to feel more feminine." Women all over the world alter their physical appearances in a variety of ways, and yet FGC is uniquely characterized as barbaric and inhumane.
It is crucial, however, to identify several features of FGC which distinguish it from other forms of body modification. First, unlike male circumcision, FGC poses extremely serious health dangers - dangers which are exacerbated by the unhygienic and untrained manner in which the procedure is usually carried out. Second, FGC is substantially motivated by a desire to subjugate women and to compromise their liberty and their happiness - that it is a cultural practice in no way undermines this fact. Third, FGC is in most cases performed on girls far too young to give reasonable consent - in contrast, for example, to breast implantation in the United States and Europe.
As it is currently performed, female genital cutting significantly endangers the health of women and girls in Africa and throughout the world. But the dialogue surrounding FGC has the potential to be more divisive than unifying for advocates of women's rights and women's health. Anti-western sentiment is largely directed at priorities and tactics which are viewed as misguided, rather than at the goal of eradication itself. To counteract this problem, action against genital cutting must be linked to other relevant problems such as economic development, family planning and childrearing, education, and healthcare - all of which are crucial in improving general health in developing countries. Education about the medical consequences of FGC can reduce risks by preventing unclean and unsafe surgeries, and although some object that health education implicitly sanctions the practice, there is room to inform women objectively. Adult women should be able to choose if and how they want to modify their bodies.
Female genital cutting illustrates the complexity of any public health concern which comes into conflict with deep-seated cultural institutions. Unlike a disease that is universally despised, genital cutting has too many proponents and is too deeply ingrained in cultures to be eradicated by unilateral action. Norms must be changed as part of a larger process of addressing the unequal position of women, a form of injustice which significantly affects the health of half the population in many societies around the world.
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