Female Genital Mutilation - Essay Example

Female Genital Mutilation 2008 Female Genital Mutilation The tradition of female genital mutilation is rather old and practiced in different parts of the world. The origins of this ritual can be traced back to antiquity: the Phoenicians, Hittites, and ancient Egyptians are known to practice it as a part of their culture (Toubia, 1995: 21). As for geographic origin of this practice, it is believed to come from Egypt, and then, century by century, migrate from the tribes which populated the Red Sea coastal area to Arabs, and then to eastern Sudan (Chessler, 1997). The term 'female circumcision' is commonly used by clinicians whom work directly with women in the community, but the official documents and policy statements normally use another term: 'female genital mutilation' (FGM) or 'female genital cutting' (FGC). The term FGM was first used in one of the first international documents covering the problem of female circumcision - the Programme of Action adopted by the International Conference on Population and Development in Cairo in 1994 (Althaus, 1997). Therefore, within the framework of this study terms 'female circumcision' and 'female genital mutilation' will be considered interchangeable. Female genital mutilation is the partial or sometimes total cutting away of the external female genitalia. This specific tradition has been practiced for millennia as an important element of ceremony young girls had to pass to get prepared for marriage and womanhood. The primary concern associated with this ritual is severe consequences for health. Even these days, the surgery is done without any anesthetic or antiseptic precautions by persons whom dramatically lack knowledge of both medicine and human anatomy. As a result, this operation often causes death of the patient, entails serious health problems, and is always very painful. Despite these important risks, advocates of female circumcision consider this rite to be an integral part of their cultural, religious, and/or ethnic background (Althaus, 1997). Proponents of female circumcision emphasize social and cultural considerations of this practice (Shweder, 2002). However, the truth is that even though men believe this surgery keeps a woman's virginity, FGM should be banned in all countries because it's causing serious reproductive problems and other health complications in women. Although the practice of female circumcision remains unchanged for many centuries, debates about this ritual is relatively recent. Until the second half of the last century, the issue of FGM was barely known in the West, while in Africa it was rarely spoken about. Only about 50 years ago some European and American medical practitioners whom worked in Africa together with African activists expressed concern about FGM, and informed the United Nations, the World Health Organization (WHO), and other international organizations about the health risks associated with it (Platt, 2000). However, it was not until 1979 that the international community finally reacted to the problem of female circumcision: the only reasonable explanation for such delay was that the practice of female circumcision seemed so alien and strange to the Western countries that they did not even know how to react. Therefore, only in 1979 participants of a seminar organized by WHO in Khartoum and dedicated precisely to the issue of female circumcision and its implications for health issued a Statement recommending that governments of those African countries which practice female circumcision make efforts to eliminate the ritual (WHO, 1979). Nowadays, female circumcision is practiced in at least 28 countries located on African continent, namely in its northern part, although the prevalence rates across these countries range from 5% to 99%. Countries of Southern Africa and Arabic-speaking nations of the Northern Africa do not practice this ritual (Toubia, 1994). According to the most recent estimation, at least 100 million females are circumcised (Platt, 2000). Muslims, Animists, one Jewish sect, and followers of indigenous African religions - representatives of all these groups practice female circumcision, though many experts believe that neither of these religious traditions actually demands it (Althaus, 1997). Physiologically, female circumcision is more painful and damaging operation than male circumcision. Although the age of circumcision varies from culture to culture, normally girls undergo this operation between the ages of 4 and 10 years. However, in some cultures the ritual is performed on infants or is considered an element of marriage rites, or postponed until the birth of the first child (Tubia, 1994). FGM can take three major forms: infibulation, clitoridectomy, and sunna. Infibulation is normally addressed as the most severe form of FGM while sunna causes less negative consequences. Traditionally, FGM have been performed by birth attendants, but in recent years the surgery is done by traditional surgeons and specially trained midwives. However, the level of practitioners' training varies substantially by region and community. The surgery is also performed using a variety of surgical instruments though in the majority of cases they are crude and unsanitary (Chessler, 1997: 562). Regardless of patient's age, practitioner's professional level, or the method used, FGM often results in serious immediate and long-term physical and psychological problems. The list of typical immediate consequences includes pain, stress, infection, bleeding, urine retention, and shock, damage to the urethra or anus, and keloid scarring. Long-term complications include repeated urinary tract infections, urethra and bladder stones, keloid scarring and dermoid cysts. Infibulated women are often cut and restitched several times throughout their lives, which leads to additional health risks (Chessler, 1997: 563). The most common immediate problems associated with any type of FGM are hemorrhage and severe pain that may eventually result in serious shock and death. Even lesser but prolonged bleeding may result in severe anemia and negatively affect growth of a child. Infections of various types are also common including infection of the wound, abscesses, ulcers, delayed healing, septicemia, tetanus, and gangrene (Toubia, 1994: 716). Long-term health problems are more common with infibulation than with clitoridectomy because the former involves serious interference with the drainage of urine and menstrual blood. Chronic pelvic infection often leads to pelvic and back pain, dysmenorrhea, and greatly increases likelihood of infertility. Chronic urinary tract infections cause formation of urinary stones and kidney damage, but the most common long-term problem is due to the embedding of keratinized epithelial cells and sebaceous glands in the stitched area which leads to the formation of dermoid cysts in the line of the scar. Keloids are another serious complication of FGM that leads to shame, anxiety and fear in women: they start to think that their genitals are regrowing in monstrous shapes and often believe that such growth is due to cancer. When painful stitch neuromas develop as a result of the entrapment of nerve endings in the scar, the result is severe dyspareunia and interference with sexual intercourse (Toubia, 1994: 716). Infibulation also increases risks during childbirth, especially in areas where access to health services is limited. Unless deinfibulation is performed, the chances of exit of the fetal head are typically obstructed while strong contractions often result in perineal tears. And in case when contractions are weak and delivery of the head is delayed, "fetal death can occur and necrosis of the septum between the vagina and bladder can cause vesicovaginal fistula, a distressing condition of urinary incontinence for which women are often ostracized by their communities" (Toubia, 1994: 717). Traditional practices and techniques used in FGM vary substantially from culture to culture. Normally, this operation entails always painful partial or full incision and removal of a female's external genitalia (Platt, 2000). While numerous studies are available covering the physical and health implications of this practice, no studies are available up to day to comprehensively explain the cultural, sexual, and psychological aspect of the ritual. Multiple speculations over these aspects 'compensate' for such lack of serious scholarly research. Yet, the information available up to date suggests that the linkage between the practice of female circumcision and social, cultural, psychological, and sexual identity of women deserves serious consideration. First of all, FGM, as an established cultural/religious tradition, facilitates the process of socialization for young women. The community that puts much value and meaning in this ritual cultivates the belief that girls can become full members of their community only through FGM. Therefore, even the fear of pain and other complications associated with the surgery is a much less important concern: "the desire to gain social status, please parents, and comply with peer pressure is in conflict with the fear, trauma, and after-effects of the operation" (Toubia, 1994: 714). Furthermore, many authors admit difficulties tracing the linkage between psychic disorders in girls and women whom undergone the surgery and the practice of FGM: "Despite [little evidence that psychic disorders has anything to do with circumcision], it is widely believed that the absolute majority of girls and women does not suffer from serious psychological effects of the rite being primarily occupied by acceptance of social norms" (Tubia, 1994: 715). In other words, it is possible to assume that the researchers must focus upon the dynamics of women's acceptance of the ritual, and specifically upon cultural and social elements of that acceptance. The fact that even Nahid Toubia, one of the leading authorities in this field of FGM, has serious difficulties attempting to prove that the surgery entails severe psychological disorders/traumas is rather illustrative. Moreover, the same difficulties emerge with studying the influence of circumcision on female sexuality. For example, one study carried out by two Egyptian psychologists demonstrated that the effects of FGM on female sexuality are rather serious, and depend upon the severity of cutting (Karim & Ammar, 1965). However, the assumption that all women whom undertook the surgery have from sexual problems still lacks convincing support: "The linkage between the degree of anatomical damage and the ability of women to compensate for it through other sensory areas or emotions and fantasy is not well understood" (Tubia, 1994: 715). Despite enough evidence that religious and cultural value of FGM is exceptionally high for those societies which practice this ritual, the surgery continues to be a highly debatable issue. The root cause of the debate is apparent: on the one hand, there is sufficient evidence base that the cultural and social meaning of FGM in those communities that practice it is essential; on the one hand, the health problems reasonably associated with the ritual are exceptionally dangerous. As a result, those researchers who justify FGM focus upon dismissing the link between negative health consequences and the surgery, and strongly suggest analyzing it within the specific cultural, social and religious context (Guerbauch, 2000). By contrast, opponents of FGM stress the health risks associated with the ritual and claim that the cultural environment that practices the surgery relies on the unfair concept of women's inferiority. Thus, Richard A. Shweder, a well-known cultural scientist, believes that, under certain circumstances, "a liberal, pluralistic society, with a significant and growing immigrant population from Africa, should 'accommodate both circumcising and non-circumcising ethnic groups" (Shweder, 2000: 210). He argues that since male circumcision which implies only a minor surgical procedure, and enjoys broad cultural acceptance is approved by many cultures, it must also be possible to allow the same practice exist for women, however, under two basic conditions: 1. Only minor surgeries should be performed on girls below the age of informed consent, such as the small cut in the prepuce covering the clitoris practiced amongst some Somalis. 2. No major irreversible alterations of the body should be permitted without consent. However, someone who has reached the appropriate age for 'autonomous decision-making' should have the right to alter his or her body in substantial ways (Shweder, 2000: 213). However, the most popular western explanations of female circumcision are patriarchal theory and sexual control theory. According to this explanation, the patriarchal social structure survives because, historically, women are restrained by men from advancing in society. From this perspective, the ritual of FGM is used to maintain and further strengthen the patriarchal social structure providing men with an opportunity to prove their masculinity (Platt, 2000: 23). The sexual control theory which is also commonly used to explain the practice of female circumcision by western scientists provides that FGM is practiced to weaken or eliminate sexual desires of women. It is believed that controlling women's sexuality in such manner men establish and confirm their dominant position in the society (Babatunde, 1998). Since many communities that practice FGM are polygamous, a number of western scientists claim that a husband fears that his sexual potential will not suffice to satisfy all of his women, and forces his women to undertake circumcision in order to have their sexual desires reduced or eliminate. In such way, they say, the husband can avoid infidelity even in case he fails to satisfy all his wives (Platt, 2000). Although the arguments listed by representatives of both stances are solid, no cultural or religious tradition can be used as an acceptable justification for the unnecessary surgery that leads to serious health risks. Even though men in those communities that practice FGM believe this surgery keeps a woman's virginity, the ritual should be banned in all countries. The well-proven fact that FGM causes serious reproductive problems and sometimes lethal consequences suggests that prohibiting the practice or at least trying to reduce its incidence must be the only solution. Evidently, the cultural and religious norms are always difficult to modify, but this task is not impossible granted that sufficient time and resources are invested to achieve the goal. References Althaus, F. A. (1997). "Female Circumcision: Rite of Passage or Violation of Rights" International Family Planning Perspectives, 23(3): pp. 1-10 Babatunde, E. (1998). Women's Rights versus Women's Rite. Africa World Press Chessler, A. J. (1997). "Justifying the Unjustifiable: Rite v. Wrong". Buffalo Law Review 5(2): pp. 555-613 Guerbauch, E. (2000) Female circumcision controversy: An Anthropological Perspective. University of Pennsylvania Press Karim, M., & Ammar, R. (1965). Female circumcision and sexual desire. Cairo, Egypt: Ain Shams University Press Platt, J. (2000) "Female circumcision: religious practice vs human rights violation", The Rutgers Journal of Law and Religion Platt 3(1) [available online at http://www.camlaw.rutgers.edu/publications/law-religion/platt.pdf ] Shweder, R. (2002). What about "female genital mutilation" And why understanding culture matters in the first place Daedalus 129(4): pp. 209-232. Toubia, N. (1994). "Female Circumcision as a Public Health Issue". The New England Journal of Medicine, 11(331): pp. 712-716. World Health Organization (WHO) (1979). Khartoum Seminar on Traditional Practices Affecting the Health of Women and Children. Khartoum, Sudan. Read More