To the Western world, female genital cutting appears shocking and outright uncivilized. The international humanitarian community has expressed adamant outrage that such a procedure still exists in the modern era. Organizations recite a laundry list of reasons why female genital cutting (FGC) violates human rights and promotes deep-rooted inequality between the sexes. But, few groups acknowledge the immense cultural and societal significance entrenched in the centuries-old procedure that will prevent cultures from ever completely discontinuing FGC. Recognizing this, there is no quick solution that will eradicate female genital cutting. Humanitarian efforts should focus on reshaping cultural values to view less severe forms of FGC as an acceptable substitute to the extreme types currently practiced. This can be done by educating and persuading medical health practitioners and midwives to refuse to perform infibulations and only agree to perform milder forms of FGC.

Female genital cutting is widespread, with three million girls at risk for FGC each year and an estimated one hundred forty million girls living with the consequences of the traditional practice. Young women, ages five to fifteen, are at the greatest risk, but the procedure is occasionally performed on adult women. FGC is most prevalent in African countries but also occurs in Asia, the Middle East, and some immigrant communities in North America and Europe (World Health Organization, 2008). FGC is also known as female circumcision and female genital mutilation, a debatable term because it “implies intentional harm and is tantamount to an accusation of evil intent” (Gruenbaum, 2001). In fact, FGC can be performed with minimal pain and consequence to the individual, if executed correctly.

The World Health Organization classifies FGC into four categories. The first is clitoridectomy, the “partial or total removal of the clitoris…and, rarely, the prepuce (the fold of skin surrounding the clitoris) as well”. Secondly, there is excision, the “partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora”. Thirdly, there is the most extreme form, infibulation, the “narrowing of the vaginal opening through the creation of a covering seal…with or without removal of the clitoris”. And finally, there is a category of other, including “all other harmful procedures to the female genitalia for non-medical purposes, e.g. pricking, piercing, incising, scraping and cauterizing the genital area” (World Health Organization, 2008).

These procedures, if done improperly, can lead to severe pain, infection, and hemorrhage. They can have long-term consequences, such as infertility, recurrent bladder and urinary tract infections, and increased childbirth complications. Infibulation, the most severe form, requires a second surgical procedure to open the vagina to allow for sexual intercourse and childbirth and is usually stitched closed again afterwards. The least severe form is when “a small part of the clitoral prepuce (‘hood’) is cut away, analogous to the foreskin removal of male circumcision” (Gruenbaum, 2001).  This small incision, when performed correctly, does not lead to any negative long term effects or health risks (Nichols). If medical professionals and midwives only agreed to perform this type of female circumcision, much of the pain and long term side effects associated with FGC would gradually disappear, while allowing communities to maintain the cultural importance of the tradition.

Many large humanitarian groups, such as the WHO and UNICEF, declare FGC to be a violation of human rights “to health, security and physical integrity, the right to be free from torture and cruel, inhuman or degrading treatment, and the right to life when the procedure results in death” as well as a reflection of the deep-rooted inequalities between the sexes in the countries that practice it (World Health Organization, 2008). UNICEF declares FGC to be “a main manifestation of gender inequality and discrimination…denying girls and women the full enjoyment of their rights and liberties” (2005). There are undeniable seeds of truth in these statements, but to completely ban FGC, even when it is completely consensual, would also deny women the human rights to freedom of expression and to participate in cultural life. It is illogical to present a solution to a violation of rights that violates another set of rights. These organizations fail to investigate this tradition deeper to fully understand the comprehensive cultural meaning and overarching purpose of FGC. Only after complete understanding can a successful solution be implemented.

Moral outrage at the hazardous practice of FGC has prompted media attention. But, the media tends to portray FGC inaccurately, emphasizing only the most graphic and alarming aspects of it and erasing the cultural significance and the fact that there are milder forms of the practice. It is common to think that FGC is forced upon women without consent and performed with broken glass and rusty knives. Unfortunately, this does happen and it is horrific and appalling. But, luckily, this is the minority and is not reason enough to completely erase a centuries old cultural tradition.

Female circumcision has immense cultural and societal significance and is often supported by both men and women in societies that practice it. FGC is “regarded as an essential coming-of-age ritual that symbolizes virginity, cleanliness, fertility, and enhances the beauty of a woman’s body” (Nichols). By removing the ‘male’ parts from a woman’s body, female circumcision makes a woman “fully female” (Nichols). It is viewed as a gender identity marker and is believed to enhance femininity. FGC is a traditional rite of passage that many women are proud to undergo because if they do not, they feel unwomanly or impure.

Social pressures, mostly created by other women, also create a strong desire to have female circumcision. It is the women of a society who teach young girls the varying negative associations with uncircumcised women, such as that they are unclean, unfit to marry, and are not good cooks, a vital skill to care for a family. Some believe that “if a woman’s clitoris is not removed, contact with it will kill a baby during childbirth” or that “without circumcision, the female genitalia will continue to grow” (Nichols). Surprisingly, men are barely involved with the circumcision of women, but are indirectly involved due to the “socially learned meanings associated with circumcision-purity, fertility, beauty, and womanhood-[that] are appealing to men” (Nichols). This shapes women’s attitudes towards circumcision because of their socioeconomic dependence on men.

Economic and social security are driving factors in the perpetuation of FGC seeing as uncircumcised women are less likely to marry, especially into prosperous families. A study performed in the African country of Burkina Faso found that “women who underwent female genital cutting married earlier and married into wealthier families. Thus, female genital cutting was viewed as a ‘premarital investment’ for families with daughters” (Rights, Law, and Culture: Female Genital Cutting, 2009). Infibulation, the severe form of FGC that creates a covered seal over the vaginal opening, is seen as a way to control promiscuity and pre-marital sex. It is a way to ensure a woman’s purity “when virginity is a prerequisite for marriage” (Gruenbaum, 2005). A survey in Egypt found that seventy-four percent of  women believed that males prefer circumcised women, and another study found that “the majority of male medical students [in Somalia] said that their family would consider them marrying an uncircumcised woman as equivalent to marrying a prostitute” (Chesnokova & Vaithianathan).  Parents allow their daughters to be circumcised because they want their daughters to have the greatest opportunities available to them in life. To refuse circumcision would be risking the chance of their daughter finding a husband, ensuring economic and social security.

The most effective solution to FGC will use existing cultural values to rethink and alter cultural practices. Female circumcision is so deeply entrenched in cultural values that an attempt to ban it completely with legislation, like some organizations want to, will just push the practice underground, making it more dangerous. One solution would be to educate young men about FGC in hopes that they will express a preference for either uncircumcised women or women who have not undergone infibulation. If the men do not desire a woman who is circumcised, significant change in cultural values and subsequently cultural practices may occur. But, changing a centuries old tradition like this is no easy task.

Luckily, as Ellen Gruenbaum points out, “it is a misunderstanding of culture to assume it is homogenous or unchanging” (2005). Culture does not prevent change; in fact, it is never static, it is always shifting. The World Health Organization, UN Children’s Fund, and UN Population Fund issued a joint statement regarding FGC embodying this idea:

“Human behavior and cultural values, however senseless or destructive they may appear from the personal and cultural standpoints of others, have meaning and fulfill a function for those who practice them. However, culture is not static but is in constant flux, adapting and reforming. People will change their behavior when they understand the hazards and indignity of harmful practices and when they realize that it is possible to give up harmful practices without giving up meaningful aspects of their culture,”(Amnesty International USA, 2009).

There is no way to eradicate FGC in one simple step, but by advocating for the practice of less severe forms in place of infibulation, incremental changes can be made. The best way to do this is to educate health professionals and midwives, the people who perform FGC the most, about the immediate and lasting dangers of severe types of FGC. Then, they can pass on the information and educate members of the greater community. It is extremely important to target midwives in this education campaign because a study in Egypt found that “79.3% of genital surgeries happened at home. Only 0.3% of the operations were done in hospitals” (Nichols). Most families in poor, rural areas cannot afford to go to a hospital or a doctor, but will ask a midwife, a respected member of the community, to perform female circumcision in their homes.

Health professionals and midwives should refuse to perform infibulations and only agree to carry out non-harmful FGC. By agreeing to and upholding this pledge, they have the power to shift the culture to accepting these mild forms as an acceptable substitute. In the Netherlands, doctors found female circumcision to be unethical and refused to perform infibulations, but the immigrant communities wanted to uphold their tradition. A compromise was made and doctors agreed to perform a milder form of female circumcision that resulted in no long-term negative health effects. This was accepted by both doctors who “did not feel unethical” and immigrants who “felt they were still able to practice their cultural traditions” (Nichols). When a solution like this is first introduced, some folks may adamantly refuse the substitute and attempt to perform the radical forms of FGC themselves, but this would most likely be the minority. Most people would eventually come to see milder forms of FGC as an adequate replacement, allowing for cultural traditions and values to be upheld, but protecting the short-term and long-term sexual health of women.

Opponents to this solution may feel that it forces Western ideology upon communities, refusing to allow an important cultural tradition to continue in its fullest form. But, most of these communities are open to change due to the fluid and shifting nature of culture. With knowledge of the consequences of FGC, some communities are autonomously choosing to abandon the practice. Educational campaigns have proven effective in reducing or eliminating FGC, the most successful being the Tostan Project, but they must be carefully designed to respect cultural values and autonomy. The Tostan Project “takes a respectful approach that allows villagers to make their own conclusions about FGC and to lead their own movements for change” and “rather than blaming or criticizing, the Tostan program places villagers in charge of decisions regarding the practice. Ending FGC is not a requirement for communities to participate in the education program” (Tostan, 2007). After being educated about the health risks and human rights violations of FGC, over 4500 communities throughout Africa have abandoned FGC since 1997 (Tostan, 2007). The autonomy of the community is preserved because it is the community members themselves who choose to abandon the practice.

The willingness of a society to reform FGC is the key to the success of any solution. Forced legislation outlawing FGC has proven unsuccessful and is actually in place in many of the countries that have the highest rates of the practice. Twenty one countries in sub-Saharan Africa have policies against FGC, yet the practice still occurs copiously (Human Rights, Law, and Culture: Female Genital Cutting, 2009). With culturally-sensitive public education campaigns about the harmful effects of FGC, societies may willingly choose to adopt the milder substitute for female circumcision or abandon the practice altogether. This, in conjunction with the cooperation of midwives and health practitioners, may be enough to create lasting change.

While the Western world is appalled by the practice of female genital cutting, the procedure holds an important place in the cultures and societies that perform it. There is little chance that the practice will be abandoned altogether. Therefore, any solution that reduces the harm that women experience associated with FGC is a great step forward. By educating communities about the risks of FGC and securing the cooperation of midwives and health professionals, the people who actually perform FGC, it is very likely that milder forms of female circumcision will eventually come to be seen as an adequate substitute in place of more harmful versions.

Works Cited

Amnesty International USA. (2009). Female Genital Mutilation. Retrieved October 12, 2009 from http://www.amnestyusa.org/violence-against-women/female-genital-mutilation-fgm/page.do?id=1108439

Chesnokova, T., & Vaithianathan, R. (n.d.). The Economics of Female Genital Cutting. BU/Harvard/MIT Health Economics Workshop, University of Melbourne and University of Adelaide.

Gruenbaum, E. (2001). The Female Circumcision Controversy: An Anthropological Perspective. Pennsylvania: University of Pennsylvania Press.

Gruenbaum, E. (2005). Socio-cultural dynamics of female genital cutting: Research findings, gaps, and directions. Culture, Health, & Sexuality. 7:5, p. 429-441.

Human Rights, Law, and Culture: Female Genital Cutting. (2009, May). Global Public Health Through a Human Rights Lens. Retrieved October 12, 2009, from http://stanford.edu/class/humbio129s/cgi-bin/blogs/humanrightslens/2009/05/07/human-rights-law-and-culture-female-genital-cutting/ Nichols, A. (n.d.). Female Circumcision. Retrieved October 11, 2008 from the Southern Illinois University at Edwardsville website: http://www.siue.edu/~jfarley/nicho490.htm

Tostan. (2007). Abandoning Female Genital Cutting (FGC). Retrieved October 19, 2009 from http://www.tostan.org/web/page/586/sectionid/547/pagelevel/3/interior.asp

UNICEF. (2005, November). Female Genital Mutilation/Cutting. Retrieved September 29, 2009 from http://www.unicef.org/publications/files/FGM-C_final_10_October.pdf

World Health Organization. (2008, May). Female Genital Mutilation. Retrieved September 29, 2009 from http://www.who.int/mediacentre/factsheets/fs241/en/