By Fisayomi Aturamu

What is Female Genital Mutilation?

Female Genital Mutilation refers to any change/damage done to the female genitals (private parts) for non-medical reasons. ^[1]

Also known as FGM, Female Genital Cutting or Female Circumcision; it describes ‘any procedure that involves the part/total removal of the external female genitals, or any other injury to the female genital organs for non-medical reasons.^[2]  

There are no health benefits to FGM, so named because of the irreparable damage it causes.

Additionally, it is a barbaric act that is recognised internationally as a violation of the human rights of girls and women.^[1]

Approximately 200 million females alive today have undergone FGM.^[1]

FGM is a widespread cultural practice in several African countries, including Nigeria.

In 2013, the prevalence of FGM in Nigeria was 25%.^[2] This figure increases to 41% among adult females only.

Types of Female Genital Mutilation

According to the WHO, there are 4 different types of cutting in FGM:

• Type I: Clitoridectomy – This is where part or the whole of the clitoris is removed. Rarely the hood or prepuce-the fold of skin around the clitoris – can be removed.
• Type II: Excision – Here, there is part or total removal of the clitoris and labia minora (inner folds of the vulva); the labia majora (outer folds of the vulva) may or may not be involved.
• Type III: Infibulation – the vaginal opening is narrowed by the use of a covering seal; sometimes by stitching the labia together.
• Type IV: All other harmful procedures to the female genitals for non-medical purposes. They may involve piercing the clitoris, burning/cutting/stretching the vagina and introducing corrosive substances into the vagina to tighten it.^[2]

FGM is an archaic customary traditional practice in many African societies with some of the following myths associated with it:

• Rite of passage – the belief that it is a necessary part of raising a girl, preparing her for adulthood and marriage
• Prevents promiscuity – a belief that FGM reduces libido, so it encourages premarital virginity and marital fidelity.
• Associated with ideas of feminity and modesty – the belief that the clitoris is unclean/not necessary for a woman; so by its removal, the woman is made clean and beautiful.

What are the Effects of FGM?

Unfortunately, FGM has a serious negative impact on the sexual and reproductive health of girls and women.

Some of the complications of FGM are immediate, while others can result later in life.^[3

Immediate complications of FGM

• Pain: FGM is usually performed without anaesthesia
• Trauma: a lot of women and girls have vivid memories of their experience and have not been able to put it behind them
• Infection: the blades/knives used in cutting are not sterilized. Therefore, tetanus or blood-borne infections like HIV can be transmitted. Wounds may also become septic and potentially life-threatening if not properly or promptly treated.
• Death may occur as a result of complications from infections and excessive bleeding.

Long-term complications of FGM

• Sexual problems: FGM causes sexual dissatisfaction. Some women are uncomfortable with the appearance of their genitalia, which affects their sex lives. They may also experience pain or dryness during sexual intercourse.
• Psychological problems: FGM may cause low self-esteem, anxiety, depression, etc.
• Urinary problems: FGM Type 3 especially predisposes the individual to urinary tract infections. Repeated infections can cause scarring of the urinary tract and lead to kidney injury.
• Menstrual problems: Some women only have tiny openings meant to pass menstrual blood, and sometimes these openings are too small, causing painful and prolonged menses.
• Problems during childbirth due to scarring or other damage. Such women may experience prolonged labour and require an episiotomy or a Caesarean section. ^[3]

How Far We’ve Come in the War Against FGM

Although FGM is illegal in a lot of countries, including Nigeria (where a bill was passed against FGM in 2015), a few others, including West African countries like Mali, Liberia and Sierra Leone, currently do not have anti-FGM laws.^[4]

Most perpetrators of FGM reported in developed countries where it is illegal are usually migrants from countries where the practice is still widespread.

Reported recently, a Ugandan woman was convicted in the UK for mutilating her 3-year-old daughter. ^[5]

If culprits in Nigeria and other countries with a high prevalence of FGM are persecuted, the practice will be discouraged and soon eradicated.

The fight against FGM is a collective effort by international organisations like the UN, governments, religious institutions and NGOs.

In 2007, the UNFPA collaborated with UNICEF to form ‘Accelerating Change’ intended to combat FGM in several African countries. ^[2]

Since 2012, the UN has designated the 6^th of February annually as the International Day for Zero Tolerance for FGM to create awareness about FGM worldwide and bring it to an end by 2030^[2]

Zero Tolerance

In conclusion, apart from criminalising FGM, there is a need for a re-orientation and education on the health implications of FGM in our communities so that FGM is discouraged as a societal norm.

Some people still encourage FGM because of societal or family pressure and out of fear of becoming outcasts.

Once FGM is regarded as a taboo rather than a norm in our society, the practice would be eradicated.

 It is important to speak out and help end FGM.

More Reading:

• Preventing Ladies’ “Toilet Infections”.
• Referral Centres for Sexual Assault in Nigeria
• Urine Infections (I)- Common Reasons Women get them.
• Fungal Infections that Commonly happen in Adults
• IWD2019 – #BalanceForBetterNaija Part 2

References
1. International Day of Zero Tolerance for Female Genital Mutilation  
 2. The Epidemiology of Female Genital Mutilation in Nigeria - A Twelve Year Review, [pdf] Afrimedic Journal 6 (1), pp 1-10. 
3. Female genital mutilation or cutting.    
4. 28TooMany, September 2018. The Law and FGM. An Overview of African countries. [pdf]  
5. BBC News, February 2019. FGM: Mother guilty of genital mutilation of daughter. 

Editing By AskAwayHealth Team

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