WHO defines female genital mutilation (FGM) as a practice that “comprises all procedures that involve partial or total removal of the external female genitalia.” It also includes other injuries to the female genital organs for non-medical reasons and often involves the removal or cutting of the labia and clitoris.
As reported by NPR in early December last year, Christine Ghati Alfons taught a menstrual hygiene class to a group of girls. The girls were around the age of ten to fifteen years old in the ethnic Kuria community in Migori County. This class was held in an impoverished, rural area in southwest Kenya. Normally, she says, the class has twenty-five students but one day, only seventeen girls showed up.
According to Alfons, the eight missing girls had all undergone “the cut” (FGM is also often called “the cut.”) Two of them had then been married off, the other six were home recovering. The remaining nine girls who attended the class had also been subjected to genital cutting in recent months, she says.
The Practice of Female Genital Mutilation (FGM)
FGM is mostly carried out by traditional circumcisers. These circumcisers often play other central roles in communities, such as attending childbirth. In many settings, health care providers perform FGM due to the belief that the procedure is safer when medicalized, but WHO strongly urges health care providers not to perform FGM.
The cruel practice of FGM is recognized internationally as a violation of the human rights of girls and women. It is nearly always carried out on minors and is a violation of the rights of children. It reflects deep-rooted inequality between the sexes.
FGM constitutes an extreme form of discrimination against women as well as violates a person’s rights to health, security, and physical integrity. The practice violates the right to be free from torture and cruel, inhuman, or degrading treatment and the right to life when the procedure results in death.
Female Genital Mutilation can cause physical and mental health problems that go on to affect women in later life. Bishara Sheikh Hamo, from the Borana Community in Kenya’s Isiolo County explains, “I underwent FGM when I was 11 years old.” “I was told by my grandmother FGM is a requirement for every girl, that it made us pure,” says Bishara who is now an anti-FGM campaigner.
However Hamo did not know that it would leave her with physical health problems such as irregular periods, bladder problems, and recurrent infections, and she was only able to give birth via Caesarean section.
Maasai girls arrive for the start of a social event advocating against harmful practices such as Female Genital Mutilation (FGM) at the Imbirikani Girls High School in Imbirikani, Kenya, April 21, 2016. REUTERS/Siegfried Modola/
The rise of FGM in the covid-19 lockdown
As per NPR, Ghati Alfons’ missing students are part of a massive wave of girls believed to have been subjected to FGM, since the start of the covid-19 pandemic. In many cases, they have been subsequently married off. This is not just happening in Kenya but across East and West Africa, according to a September report from the Orchid Project. Orchid Project is a London-based nonprofit that works with global partners to end FGM.
The practice occurs in many parts of the world though the Orchid Project’s report highlighted the pandemic-era surge in Africa and also attempted to gather information about parts of Asia where FGM is prevalent. However, it was unable to conclude because of a lack of systemic reporting.
Anti-FGM activists say lockdowns and school closures during the pandemic left many girls at home, vulnerable to the FGM procedure in communities that see the practice as a prerequisite for marriage, reports NPR. Girls who have not undergone genital cutting might be shunned by the community or considered not fit for marriage.
“The girls are normally protected and shielded by the fact of being in school, which is an alternative to marriage,” says Domtila Chesang. Chesang is the founder of I-Rep Foundation, a community-based group aimed at eradicating FGM in West Pokot County in Western Kenya.
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Financial problems played a huge role in this as economic pressures heightened by the pandemic have led many struggling parents to seek bride prices, according to NPR. Bride price is the payment of goods such as cattle to a family for a bride.
“These girls are not just being cut. They are also being forcibly married off,” says Nimco Ali, an activist who was born in Somaliland and subjected to FGM. “And a girl that has had FGM is worth more. It’s seen as an investment into the girl and her ability to be married off,” Ali added, who now lives in London, where she leads The Five Foundation, a global partnership to end FGM.
According to NPR, some former cutters or circumcisers in parts of West Africa who had abandoned Female Genital Mutilation have returned to the practice. Speaking of which, Ebony Riddell Bamber, head of policy and advocacy at the Orchid Project, says “because it was a way that they saw that they could obtain income at this difficult time.”
But the increase in the genital cutting practice is particularly startling in Kenya. This is because the country outlawed the practice in 2011, and was widely seen as making real strides and progress toward eradicating it, reports Maria Godoy for NPR.
According to NPR, Kenyan President Uhuru Kenyatta made an ambitious pledge to stamp out Female Genital Mutilation by 2022 but then came the pandemic. The Coronavirus pandemic redirected policing and other resources elsewhere, which allowed local traditional leaders to flout the law on the practice of the procedure.
What are the types of FGM?
According to WHO, FGM is classified into four major types described below:
Type 1: This is the partial or total removal of the clitoral glans (the external and visible part of the clitoris, which is a sensitive part of the female genitals) called Clitoridectomy. It also includes its surrounding skin and/or the prepuce/ clitoral hood (the fold of skin surrounding the clitoral glans).
Type 2: Excision is the partial or total removal of the clitoral glans and the labia minora (the inner folds of the vulva). This type may or may not include the removal of the labia majora (the outer folds of skin of the vulva).
Type 3: The third type of FGM is called Infibulation, in which the vaginal opening is made narrow through the creation of a covering seal by cutting and repositioning of the labia minora and the labia majora – the outer skin folds that surround the vagina. It often involves stitching, with or without removal of the clitoral prepuce/clitoral hood and glans.
This practice is not only extremely painful and distressing, but it’s also an ongoing infection risk. The closing over of the vagina and the urethra leaves women with a very small opening to pass menstrual fluid and urine, reports the BBC. Sometimes the opening can be so small that it needs to be cut open to allow sexual intercourse or birth. This often leads to complications that harm both mother and baby.
Type 4: This type of practice covers all other harmful procedures like pricking, piercing, incising, scraping, and cauterizing the clitoris or genital area.
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Deinfibulation refers to the practice of cutting open the sealed vaginal opening of a woman who has been infibulated (the procedure mentioned in the third type of FGM). This practice is often necessary for improving health and well-being and to allow intercourse or to facilitate childbirth.
An Egyptian woman is seen from a motorized rickshaw on a street, near the home of a 13-year-old who died undergoing the procedure of female genital mutilation in Dierb Biqtaris village, Egypt in November 2014. | Nariman El-Mofty/AP
A Horrifying and Excruciatingly Painful Procedure
Omnia Ibrahim, a blogger, and filmmaker from Egypt say, “You are an ice cube. You don’t feel; you don’t love; you don’t have desires.” She says FGM is distressing and damages women’s relationships and how they feel about themselves. She has struggled with the psychological impact of the practice all her adult life.
Omnia says her community taught her “that a body means sex and that sex is a sin. To my mind, my body had become a curse”. “I used to always ask myself: did I hate sex because I was taught to be afraid of it, or do I really not care for it?”
In Kenya, Bishara told the BBC FGM was carried out on her, together with four other girls, “I was blindfolded. Then she [the cutter]tied my hands behind my back. My legs were spread open and then they pinned down my labia.”
After a couple of minutes, she screamed and yelled when she felt a sharp pain, “but no one could hear me. I tried to kick myself free, but a vice-like grip held my leg,” Bishara continued.
She says it was “pathetic.” “It’s one of the most severe types of medical procedures, and so unhygienic. They used the same cutting tool on all of us girls”.
The only pain relief available there was a traditional remedy, as Bishara explained, “There was a hole in the ground, and they kept herbs in the hole. Then they tied my legs like a goat and rubbed the herbs on me. Then they said ‘next girl, next girl,’ and they took another girl…”
Where is Female Genital Mutilation Practised?
BBC reports that many of the women surveyed by Unicef and the WHO said it was taboo to even discuss FGM in their communities. They had a fear of attracting criticism from outsiders. In those places where the practice is illegal – for fear that it would lead to prosecution of family or community members and therefore figures are based on estimates.
It is estimated by the UN that Female Genital Mutilation is concentrated in thirty countries in Africa and the Middle East. However, it is also practiced in some countries in Asia and Latin America and amongst immigrant populations living in Western Europe, North America, Australia, and New Zealand, the UN says.
According to BBC, as per a Unicef report, FGM was carried out in twenty-nine countries in Africa and the Middle East. The practice is still being widely carried out, despite twenty-four of these countries having legislation or some form of decrees against Female Genital Mutilation.
In countries such as the UK, where the practice is illegal, expert and barrister Dr. Charlotte Proudman says it is increasingly being performed on babies and infants. As a result, it is “almost impossible to detect” as the girls are not in school or old enough to report it.
Why is FGM practiced?
As per UNICEF, in many of the countries where Female Genital Mutilation is performed, it is a deeply entrenched social norm rooted in gender inequality. It is practiced in places where violence against girls and women is socially acceptable.
The reasons behind the practice vary as in some cases, the procedure is seen as a rite of passage into womanhood and considered a prerequisite for marriage, while others see it as a way to suppress the sexuality of a woman. Many communities practice female genital mutilation in the belief that it will ensure a girl’s future marriage or family honor, whereas some others associate it with religious beliefs, although no religious scriptures require it.
Although there are no hygienic advantages or health benefits to female genital mutilation, practicing communities believe that women’s vaginas need to be cut. In such communities, women who have not undergone the procedure are regarded as unhealthy, unclean, or unworthy.
Often it is performed against their will. Health professionals worldwide consider it a form of violence against women, a violation of their human rights. When the procedure is inflicted on children, it is also seen as a form of child abuse.
Why is FGM a risk for girls and women?
This procedure has no health benefits as it involves removing as well as damaging healthy and normal female genital tissue. It interferes with the natural functions of girls’ and women’s bodies and often leads to long-term physical and psychological consequences.
Immediate complications can include severe pain, excessive bleeding (hemorrhage), genital tissue swelling, fever, infections e.g., tetanus, urinary problems, wound healing problems, injury to surrounding genital tissue, shock, and death, according to WHO.
Long-term complications can include urinary problems, vaginal problems, menstrual problems, scar tissue, and keloid, sexual problems (pain during intercourse, decreased satisfaction, etc.) and it can also lead to an increased risk of HIV transmission.
Women who have undergone FGM have an increased risk of childbirth complications such as difficult delivery, excessive bleeding, cesarean section, need to resuscitate the baby, etc., including postpartum hemorrhage, stillbirth, and early neonatal death.
Psychological impacts can range from a girl losing trust in her caregivers to longer-term feelings or problems of depression, anxiety, post-traumatic stress disorder, low self-esteem, etc., as a woman.
The report calls for policies that recognize the role of communities in eliminating FGM. Photograph: Pacific Press/LightRocket via Getty Images
Difficulties During Sex
John and Martha (Names changed by BBC to protect their identities) come from Kenya’s Marakwet community in western Kenya. “Anytime I go to Martha, she recoils, curling like a child. She cries, begging me to leave her alone. She doesn’t want to have sex anymore,” the 40-year-old says.
“John can barely remember a time when having sex with his wife did not end with her in tears” reports BBC, as it was just too painful because she had undergone female genital mutilation (FGM). Female Genital Mutilation is illegal in Kenya. However, girls in their community often undergo FGM between the ages of twelve and seventeen, as a rite of passage in preparation for marriage. Martha underwent the procedure when she was fifteen years old.
“It is painful when we have sex. I wish this practice would end,” she says.
Recounting their first sexual experience, the couple describes it as traumatizing, “I didn’t realize a part of her [vulva]had been stitched, leaving only the urethra and a tiny vaginal opening,” John tells the BBC. “I try to be very compassionate with my wife. I don’t want her to feel like I don’t respect her, yet we are a couple.”
According to BBC, Martha says she felt a lot of pain, it is not how she had imagined sex would be, and she had to ask her husband to stop. She added that FGM had also made childbirth very difficult for her.
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“They lived in agony with little hope that things would ever change – not just for them, but they feared for their young daughter as well,” BBC reported.
That was until John heard of an anti-FGM campaign meeting in his village targeting men, and he says it awakened him to the dangers the practice of FGM posed to women.
As per BBC, it changed his attitude and he learned that as a man, he could help stop it, “After all, it’s men who have a say about children and if I say my child will not be cut, then she won’t be.”
Another couple, also members of the Marakwet community, Moses and his wife Joesphine (names changed) married for close to twenty-five years. They also had a difficult sex life because of FGM as Josephine underwent the procedure at a young age and describes their sex life as an endurance test.
“It is always painful but I have learned to persevere through it.”
Josephine says the couple thought they were alone in their struggle until they met other couples who were struggling with similar challenges.
Discussing Sex and Fgm Related Topics a Taboo
Just like many other communities, discussing sex and related topics such as Female Genital Mutilation is still taboo in many Kenyan communities too, especially among men.
“No-one told me anything about having sex, especially with an FGM survivor. Even now, it is considered a private matter,” John says. He laughed at the suggestion that sex could be discussed openly in his community, according to BBC.
As per BBC men who speak against the practice of female genital mutilation can be seen as traitors, attacking a long-standing cultural practice.
In 2014, it was estimated that four million Kenyan women, around a fifth of the female population, had undergone some type of Female Genital Mutilation, reports Esther Ogola for BBC.
“In the olden days if one refused to undergo FGM, they would never find a husband,” Josephine said. She continued, “and if they did, they would never be fully accepted in that homestead. They would be returned to their family, bringing shame and ridicule to their people.”
Dr. Tamarry Esho, who researches FGM and campaigns against it says, “This is a deep-rooted cultural practice. A lot of people still feel like it’s their right.” Dr. Esho says that of Kenya’s forty-two recognized communities, only four have not historically practiced Female Genital Mutilation.
Photo: Luca Zordan for UNFPA
Although some communities in Kenya still practice the procedure, the attitudes in many communities have changed. The country is seen as being among the more progressive countries in Africa on the issue, reports BBC.
Just over one in ten adolescent girls aged between fifteen and nineteen are now estimated to have undergone Female Genital Mutilation. This means the number of girls undergoing FGM has reduced and down from almost 50% in 1974.
Tony Mwebia is the founder of the Men End FGM foundation. The foundation trains community champions to tackle FGM. Mwebia says that men can make a difference.
“In FGM-practising communities in Kenya, while it is women who cut fellow women, men are the decision-makers. However, they have no idea what is cut, how it’s done, and what damage is caused to women,” according to BBC.
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“Once [the men]understand the message, then it’s a big change. They have the platforms, they have the audience, they have the influence,” he says.
After attending the anti-FGM meeting, John decided that his daughter would not be cut (would not undergo FGM) and was also able to articulate something he says many men are not willing to admit, reports Esther Ogola.
“FGM affects men too. Many are in [emotional]pain but simply persevere. Some cultures say FGM reduces women’s alleged promiscuity. FGM only reduces the love between a man and his wife.”
For women like Josephine, having male allies makes all the difference, especially in a patriarchal society, as she explained, “We once felt powerless, not anymore. As a survivor, when my husband says he doesn’t want FGM for our daughters, I’m happy.”
“Our neighbors have also followed suit. They say their daughter won’t be cut.”
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Find More ‘Uncovered’ Stories From TFword: HERE
Featured image from Ademola Olajide’s (UNFPA Representative) Twitter.