Debates about FGM in Egypt


Debates about FGM in Egypt

Quotation:

Excerpts from a book by Nawal El Saadawi: “The Hidden Face of Eve: Women in the Arab World.” She is an Egyptian novelist, MD and militant writer on Arab women‘s problems and their struggle for liberation.

“I just wept, and called out to my mother for help. But the worst shock of all was when I looked around and found her standing by my side. Yes. It was her, I could not be mistaken, in flesh and blood, right in the midst of these strangers, talking to them and smiling at them as though they had not participated in slaughtering her daughter just a few minutes ago.”

“Now we know where lies our tragedy. We were born of a special sex, the female sex. We are destined in advance to taste of misery, and to have a part of our body torn away by cold unfeeling, cruel hands. …”

When I returned to school after having recovered from the operation, I asked my classmates and friends about what had happened to me, only to discover that all of them without exception, had been through the same experience, no matter what social class they came from. …” 1

Status of FGM:

FGM is a social custom, not a religious practice. It is usually performed on pre-pubescent girls, often without anesthetic or precautions against infection. In those countries where the mutilation is common, it is practiced by Muslims, Christians, and followers of other religious groups.

Nawal El-Saadawi, a Muslim victim of infibulation, stated:

“The importance given to virginity and an intact hymen in these societies is the reason why female circumcision still remains a very widespread practice despite a growing tendency, especially in urban Egypt, to do away with it as something outdated and harmful. Behind circumcision lies the belief that, by removing parts of girls’ external genitals organs, sexual desire is minimized. ” 3

A 2005 report titled “Children in Islam: Their care, development and protection” issued by UNICEF and the International Islamic Center for Population Studies and Research atAl-AzharUniversity states:

Islam and female circumcision: From an Islamic perspective, the Quran says nothing relating explicitly or implicitly to female circumcision. The use of the general term ‘Sunnah Circumcision’ is nothing but a form of deceit to misguide people and give the impression that the practice is Islamic. As for the traditions attributed to the Prophet, peace be upon him, in this regard, past and present scholars have agreed that none of these traditions are authentic and should not be attributed to the Prophet.” 10

Sunna circumcision involves cutting of only the outer part of the clitoris.

An older meta-study on “female sexual castration” presented in 1989-MAR showed that five surveys conducted between 1977 and 1985 estimated that 80.5% of Egyptian women in Cairo and Alexandria had undergone FGM. The incidence is believed to be much higher in rural areas. 6

During 2007-JUN, Ahmad ‘Aliwa, a women’s rights activist, described one finding that shows the near universal practice of FGM inEgypt, noting:

“The Center for Social Studies conducted a survey which showed that 85% of the prostitutes in Egypt were circumcised. There is no relation between female circumcision and the girls’ behavior.” 2

A 2005 report by UNICEF suggested that 97% of Egyptian women between the ages of 15 and 49 who have never been married have undergone some form of FGM or circumcision. 7

A more recent study by the Egyptian government found that 50.3% of girls aged 10 to 18 have been circumcised. 7

FGM debate inEgypt:

Mohammed Sayyed Tantawi, head of the al-Azhar Islamic Institute, had stated during the 1990s that the practice is un-Islamic. The Health Minister ofEgypt, Ismail Sallam, announced a ban on FGM in 1996-JUL. This was upheld by a junior administrative court inCairo.

Sheik Youssef Badri, a Muslim fundamentalist, took the health minister to court. In 1997-JUN, an Egyptian court overturned the ban. Eight Muslim scholars and doctors had testified that the ban exceeded the government’s authority and violated the legal rights of the medical profession. Sheik Youssef Badri commented:

[Female] circumcision is Islamic; the court has said that the ban violated religious law. There’s nothing which says circumcision is a crime, but the Egyptians came along and said that Islam is a crime.”

In 1997-JUL, the German newsmagazine Der Spiegel interviewed Sheik Badri. He claimed that many Muslim women are pleased with this victory of Islam over its enemies. When it was pointed out to him that parents in Morocco and Algeria do not practice FGM, he replied that the clitoris in Egyptian girls was larger than in those countries and had to be cut back to a normal size. He quoted a French study which showed that circumcised girls are less likely to catch AIDS. [Author’s note: This may well be true; victims of FGM are probably less likely to be sexually active.] Badri believes that theUnited States is spreading misinformation on the health risks of FGM.

We have been unable to find any documentation to support Badri’s assertion about clitoris size.

The government appealed the case to Egypt’s Supreme Administrative Court. They ruled that the operation is not required by Islam, and that “female circumcision is not a personal right according to the rules of Islamic Sharia (law).” Thus, FGM is subject to Egyptian law. The government prohibited the procedure, even if it is done with the agreement of the child and her parents. However, gynecologists are still allowed to perform the surgery if it is needed for health reasons.

The BBC reported in 2007 that:

“Egypt’s first lady, Susanne Mubarak, has spoken out strongly against female circumcision, saying that it is a flagrant example of continued physical and psychological violence against children which must stop.” 5

A girl dies under the knife:

Budour Ahmed Shaker, aged 11 or 12 (sources differ), died on 2007-JUN at a private medical clinic in Minya province in Egypt. She allegedly died of an overdose of anesthetic during FGM. Her three sisters had already undergone the “purification” operation. The operation cost 50 Egyptian pounds ($9.00 US). The doctor is reported as having tried to bribe the parents to withdraw their complaint. The girl’s father has allegedly sued the doctor. 7

Human rights groups complained both to the medical profession and the government about the continued practice. The doctor has since been arrested. 5

Reactions of religious & political leaders to Budour’s death:

When interviewed about FGM, Ali Gum’a, the Mufti ofEgypt(a.k.a. Gomaa), said:

“We’ve warned time and again that this thing… It has become clear to us, in modern times, with all the medical information we have, that this is inappropriate, and that it causes severe damage from the medical, social, and human aspects. So we [decided] to refrain from performing this custom and to prevent it. We’ve said this once, twice, three times, and ten times… Not only now, but since 1954, we have been calling upon people to abandon this ugly custom.”  2

When the interviewer pressured the mufti by asking specifically whether Islam prohibits or permits FGM, Ali Gum’a replied:

“This issue, with these characteristics, in our times – is prohibited. If they want to know what the Mufti of Egypt has to say. I say this custom is prohibited.”

Mohamed Sayyed Tantawi, the Grand Sheikh ofCairo’s al-Azhar mosque, has repeated his assertion that the practice as un-Islamic. However, some other Muslim clerics have supported FGM.

UNICEF reports that:

“… Al-Azhar Supreme Council of Islamic Research, the highest religious authority in Egypt, issued a statement saying FGM/C has no basis in core Islamic law or any of its partial provisions and that it is harmful and should not be practiced.” 9

Coptic Pope Shenouda, the leader of Egypt’s minority Christian community, said that neither the Koran nor the Bible demand or mention female circumcision. 4

Su’ad Saleh of Al-Azhar University commented:

“After the [statement by the Mufti] there is nothing left for me to say. This is what I have been demanding from the Mufti and the religious scholars – a categorical ruling on such issues. But when some of them say that this is permitted ‘when necessary,’ and if a doctor performs it … It was a doctor who did this, and look at the result … Society as a whole is responsible for the death of this girl. This is tantamount to the custom of burying girls alive, before the advent of Islam. It is like the burying the girl in the physical and psychological sense.”

Reactions to Budour’s death:

According toFrance24:

“The Egyptian doctors’ syndicate has launched a probe into the girl’s death and warned doctors against performing the procedure either in homes or medical facilities, citing ‘detrimental health effects’ on girls.” 4

On 2007-JUN-28, the Egyptian Health Ministry announced that it has removed the health exception from the 1996 law. 2 Female genital mutilation is now banned throughout the country.  A spokesperson said that any circumcision: “… will be viewed as a violation of the law and all contraventions will be punished.” He noted that it is a “permanent ban”.

The ministry decree states that it is “… prohibited for any doctors, nurses, or any other person to carry out any cut of, flattening or modification of any natural part of the female reproductive system.8 That is confusing regulation. It could be interpreted as forbidding various non-mutilating medical procedures, tubal ligation, surgical removal of a hymen, and even performing an episiotomy during childbirth. Also, since the clitoris is not part of the reproductive system, the regulation would not restrict surgery on it.

A law is apparently required to fully enforce the ban. It is expected to face a tough debate in parliament. 4

UNICEF reports that:

“During the Third Regional Conference on Violence against Children, the First Lady Suzanne Mubarak dedicated a minute of silence for the recent child FGM/C victim. She announced the launch of a national campaign aimed at drawing more attention to the harmful practice and accelerating efforts to legally ban FGM/C. The First Lady also announced the amendment of the Child Law 1996, which in addition to banning FGM/C also addresses other child rights issues.” 9

References used:

The following information sources were used to prepare and update the above essay. The hyperlinks are not necessarily still active today.

  1. Nawal El-Saadawi, “The hidden face of Eve: Women in the Arab World,” translated and edited by Sherif Hetata, Zed Press,London, (1980), Pages 5-8.
  2. “Death of Girl During Circumcision Stirs Debate in Egyptand Prompts a Fatwa by Mufti of Egypt Banning this Practice,” Transcript of program on Al-Mihwar TV, 2007-JUN-24, at: http://www.memritv.org/
  3. “Egyptstrengthens ban on genital mutilation following girl’s death,” EITB 24, 2007-JUN-28, at: http://www.eitb24.com/
  4. “Egyptoutlaws all female circumcision,” AFP, 2007-JUN-28, at: http://www.france24.com/
  5. Magdi Abdelhadi, “Egyptforbids female circumcision,” BBC, 2007-JUN-28, at: http://news.bbc.co.uk/
  6. Mohamed Badawi, “Epidemiology of Female Sexual Castration in Cairo, Egypt,” Paper delivered at the First International Symposium on Circumcision, Anaheim, California,1989-MAR-1 &. Online at: http://www.nocirc.org/
  7. Ian Black, “Egyptbans female circumcision after death of 12-year-old girl,” Guardian Unlimited, 2007-JUN-30, at: http://www.guardian.co.uk/
  8. Maggie Michael,” Egyptoutlaws circumcision after girl dies,” Guardian Unlimited, 2007-JUL-01, at: http://www.guardian.co.uk/
  9. “Fresh progress toward the elimination of female genital mutilation and cutting in Egypt,” UNICEF, 2007-JUL-02, at: http://www.unicef.org/
  10. “Children in Islam: Their care, development and protection UNICEF and the International Islamic Center for Population Studies and Research of Al-Azhar University, 2005, at: http://www.unicef.org/ This is a PDF file. You may require software to read it. Software can be obtained free from:

References used:

The following information sources were used to prepare and update the above essay. The hyperlinks are not necessarily still active today.

  1. Position paper on Female Genital Mutilation/Female Circumcision,” Muslim Women’s League, at: http://www.mwlusa.org/
  2. Sami A. Aldeeb Abu-Sahlieh, “Religious arguments about male and female circumcision,” at: http://www.lpj.org/
  3. Nawal El-Saadawi, “The hidden face of Eve, Women in the Arab World,” translated and edited by Sherif Hetata, Zed Press,London, 1980, P. 33.
  4. United Nations, 26th Session of the Economic and Social Committee, 1029th Plenary Meeting, 1958-JUL-10.
  5. WHO, 12th World Health Assembly, 11th Plenary Meeting, 1959-MAY-28.
  6. WHO, Resolution of the Regional Committee forAfrica, 39th session, AFR/RC39/R9, 1989-SEP-13.
  7. UNICEF, Department of Information, “Position of UNICEF on Female Excision“, 1980-SEP-23, Page 1.
  8. Partial Translation of Sunan Abu-Dawud, Book 41: General Behavior (Kitab Al-Adab),” at: http://www.usc.edu/
  9. “Muslim scholars rule female circumcision un-Islamic,” The Age, 2006-NOV-24, at: http://www.theage.com.au/

Copyright © 1998 to 2007 by Ontario Consultants on Religious Tolerance
Originally written: 1998-MAR-13
Last update: 2007-JUL-07

Author: B.A. Robinson

Female Genital Mutilation
in North America & Europe

Summary:

Female Genital Mutilation is an invasive procedure that is usually performed on girls before puberty. It is occasionally performed within Aboriginal, Christian and Muslim families who have emigrated to the USor Canadafrom some predominately Muslim countries where it is practiced as a social tradition. It is also done at birth to some “inter-sex” infants for what are seen by some as justified for medical or psychological reasons.

Genital Mutilation among immigrants:

This operation is occasionally performed on children of immigrants from some Muslim countries of the Middle East, Africa, Indonesia and other Muslim countries in Asia. It is seen by some of its supporters as a religious duty, social custom, and/or a necessary operation for health reasons. It is criticized by those in opposition as a cruel mutilation of a young girl in order to reduce her sexual response after puberty.

In the West, the procedure is outlawed in

“Australia (six states), Burkina Faso, Canada, Central African Republic, Côte d’Ivoire, Djibouti, Ghana, Guinea, New Zealand, Nigeria (3 states), Norway, Senegal, Sweden, Tanzania, Togo, the United Kingdom, and the United States.

After 20 years of personal effort, Representative Patricia Schroeder (D-CO) saw a US federal bill, “Federal Prohibition of Female Genital Mutilation Act of 1995”  passed in 1996-SEP. The bill had been introduced by Sen. Harry Reid (D-Nevada). 3 The law provides for prison sentences of up to 5 years for anyone who “circumcises, excises, or infibulates the whole or any part of the labia majora or labia minora or clitoris of another person who has not attained the age of 18.” US representatives to the World Bank and similar financial institutions are required to oppose loans to countries where FGM is prevalent and in which there are no anti-FGM educational programs. The law took effect on 1997-MAR-30. The first charges under the law were made in late 2003 when a California couples was arrested in a FBI sting operation allegedly after having agreed to perform a FGM procedure on two fictitious girls. 5

FGM has also been criminalized at the state level in California, Minnesota, North Dakota, Rhode Island, and Tennessee, and other states. At least one FGM assistance, education and support group is operating in the U.S.among immigrants from countries that practice FGM. 1

Section 273.3 of the Canadian Criminal Code protects children who are ordinarily resident inCanada, (as citizens or landed migrants) from being removed from the country and subjected to FGM. In theUS andCanada, the very small percentage of Muslims who wish to continue the practice often find it impossible to find a doctor who will cooperate. The operation may then be done illegally in the home by poorly trained persons, under less than sterile conditions.

Specialists in Denver, CO, reported in 1998 that at least  6,000 immigrants have settled in the area from African countries which widely practice FGM. 2  Dr. Terry Dunn, director of a women’s clinic in that city commented: “I know of one patient where it was clear it was performed in this country.” About 4 FGM cases are seen each year at the clinic.

Legislation against FGM can be counter-productive in some cases. It might force the practice deeply underground. Women may not seek medical care later in life because their parents might be charged. The operation can be life threatening if performed by untrained individuals; if the operation is botched, the parents may be reluctant to take the child to a hospital out of fear of being criminally charged with child abuse. On the other hand, it does indicate that the government has taken a stand against FGM. This, and potential penalties, may well cause some parents to decide against having their daughter(s) mutilated.

On 1999-FEB-3, Hawa Greou went on trial in Franceon charges of “voluntarily bodily injury causing mutilation or permanent disability.” She is alleged to having mutilated the genitals of about 50 young girls. Also charged were 27 parents of the victims. The case was triggered by a complaint by a woman of Malian origin, Mariatou Koita. Both she and her sister were allegedly mutilated by Greou. Jean Chavais, the defendant’s lawyer, admits that the mutilations were carried out. He said : “If the trial can help bring about an end to this custom, then it will be useful. But punishment is not as effective as education and prevention…This is an African custom that has existed for centuries. It takes a long time to change habits.” Ms. Greou, known among the Malian community in Paris as “Mama Greou” had received a one year suspended sentence in 1994 for excising two girls. This time, she was given an 8 year jail sentence. Parents received sentences ranging from a 3 year suspended sentence to 2 years in prison.

Immigration lawyers:

Sacks & Kolken is law firm that has won a number of FGM-related asylum cases during 1999. Their website is at:  http://www.sackskolken.com/

References:

  1. M. Ramsey, “Forward USA/Ethiopia: Assistance, education and support for women and girls affected by female genital mutilation.” This group has disappeared from the Internet and may no longer exist. For support questions in theU.S. you might try contacting:

 African Women’s Health Center, Brigham and Women’s Hospital, Boston, MA, at: http://www.brighamandwomens.org/ This is the first and only African health practice in theUnitedState that focuses FGM.

 Research, Action and Information Network for the Bodily Integrity of Women (RAINBO)) at: http://www.rainbo.org/

The National Women’s Health Information Center, at: http://www.4woman.gov/

  1. Associated Press article, 1998-FEB-16, quoted in the Feminist Majority Foundation‘s web site at: http://feminist.org/
  2. Text of the “Federal Prohibition of Female Genital Mutilation Act of 1995” is online at: http://www.fgmnetwork.org/
  3. Legislation on Female Genital Mutilation in the United States,” Center for Reproductive Rights, at: http://www.reproductiverights.org/ This is a PDF file. You may require software to read it. Software can be obtained free from:
  4. Megan Costello, “Two in U.S. Accused of Genital Mutilation,” Womensenews, 2004-FEB-19, at: http://www.womensenews.org/

Copyright © 1998 to 2007 by Ontario Consultants on Religious Tolerance
Originally published: 1998-MAR-16

Last updated on 2007-MAR-10
Author: Bruce A Robinson

 

Intersexual Genital Mutilation

In North America &Europe

Summary:

This is an invasive procedure that is usually performed on “inter-sex” newborns for what some believe to be medical reasons. These are newborns whose genitals deviate significantly from conventional male or female design.

Similar operations are traditionally performed on non-intersex girls later in life in some African, Middle Eastern and Far Eastern countries Aboriginal, Christian and Muslim families who have emigrated to the US or Canada also practice it.

Genital alterations of infants:

Western society has traditionally oppressed sexual minorities. Every child is expected to be conceived with XX or XY chromosomes, grow up to be either a man or a woman, to have internal and external sexual organs which are clearly male or female, and to be sexually attracted to members of the “opposite” sex when they mature. For reasons of ignorance, religious teaching and fear, we have tended to force people into the traditional heterosexual male or female role. But, as in so many sexually related topics, a two-mode model is insufficient. Consider:

Homosexuals: male or female adults who are attracted to members of the same gender; about 5% of the population

Bisexuals: male or female adults who are attracted to persons of both/all genders; about 3% of the population.

Transgendered persons: male or female adults who appear like a typical male or female, but who are convinced that nature has played a terrible trick on them. They feel that they are a woman in a man’s body, or vice versa. They are rare, numbering only one in every tens of thousands of individuals.

Transexuals: Transgendered adults who have undergone hormone therapy and/or surgical procedures in order to make their body more closely resemble the sex that they believe they are.

Intersexuals: individuals who are born with anatomy or physiology which differ from cultural ideals of male and female.” 1

 

Anne Fausto-Sterling attempted to categorize intersexuality in a 1993 article. 2 She introduced three sexes in addition to male and female:

Herm refers to “true hermaphrodite” — a person born with both ovarian and testicular tissues and internal reproductive organs.

Merm is an intersexed person with a XY (nominally male) karyotype.

Ferm is an intersexed person with a XX (nominally female) karyotype.

 

These categories have not been well received by most intersexed people.

She has written of her vision of a more accepting future:

At birth, instead of hearing the inevitable pronouncement of “boy” or “girl” new parents might excitedly await a much expanded range of possibilities. Herms, ferms, and merms, being the rarer birth events might come to be seen as especially blessed or lucky, having as they do the best of all possible worlds, sexually speaking. Herms, merms and ferms might become the most desirable of all possible mates able as they are to pleasure their partners in a variety of ways. Furthermore, the existence of three additional sexes would open up possibilities for the rest of us. It would become difficult to maintain a clear conceptualization of homosexuality, for example, and perhaps its current contentious status would fade from view. If we envision the world in fives instead of twos, it would also be more difficult to hold onto rigid constructions of male and female sex roles. …Should we have only two sexes?–my answer would be a resounding no.”

Most physicians have recommended in the past that the ambiguous external genitals of intersex infants be carved up so that the child will grow up appearing to be a “normal” male or female. Some the infant have an enlarged or protruding clitoris; others will be born with a “micropenis”. In about 90% of cases, intersex infants undergo genital surgery to make them appear as a “normal” female. One surgeon explained: “You can make a hole, but you can’t build a pole.” 3 Surgery involves removal and remolding genital structures, and may involve the addition of parts taken from elsewhere on the body. Physicians now attempt to preserve structures that have concentrations of nerves, so that sexual feeling will remain. But they cannot guarantee that their patients will ever be able to have orgasms in later life. Such care was not always done in the past.

These operations are usually performed shortly after birth, at the age of 6 weeks to 15 months. 6 They are sometimes done later, during childhood or teen years. There is increasing opposition to these operations. Several activist and support groups by and for intersexuals have been formed. 1,4,5 They generally oppose genital surgery on intersexual people, particularly when it is done at an age where the individual cannot make an informed choice. Nathalie Angier 6 has written:

“The debate raises difficult questions about who has the right to decide what ranks as esthetically acceptable genitalia, whose interests are being served by surgical intervention and whether one’s sexual identity is so entwined with the appearance of one’s genitals that it is worth subjecting infants to a major operation to assure visual concordance between one and the other.”

The Federal Prohibition of Female Genital Mutilation Act does permit genital surgery if it is “necessary to the health of the person on whom it is performed.” Activists are now trying to modify the law, so that it cannot be performed without the informed consent of the individual. Cheryl Chase, founder of the Intersex Society of North America commented: 1

Africans have their cultural reasons for trimming girls’ clitorises, and we have our cultural reasons for trimming girls’ clitorises. It’s a lot easier to see what’s irrational in another culture than it is to see it in our own.

With regard to the proposed change in the law, she commented:

That would break the pediatricians’ argument that they do this to prevent psychological and mental trauma for the child…We don’t expect this to be finished up in six months, but we’re not going to go away, and we have more passion than they do.”

Some pediatricians defend the practice of infant genital surgery. Dr. Anthony A. Caldamone, head of pediatric urology at Hasbro Children’s Hospital inProvidence,RIsaid:

I don’t think it’s an option for nothing to be done. I don’t think parents can be told, this is a normal girl, and then have to be faced with what looks like an enlarged clitoris, or a penis, every time they change the diaper. We try to normalize the genitals to the gender to reduce psychosocial and functional problems later in life.”

Dr. Justine M. Schober, a pediatric urologist atHamotMedicalCenterinErie,Pa.has said:

The truth is, genital surgery is being done, but we don’t know what the outcome of it is, sexually or otherwise. We don’t have any long-term studies.”

David Thomas, a pediatric urologist at St. James’s UniversityHospitaland Infirmary in Leeds, UKconducted a scouting study. It involved only about a dozen intersexual individuals aged 11 to 15 who had been subjected to genital surgery. Results were not encouraging. 7 Dr. Thomas reports:

Every girl required some additional vaginal surgery…The results are indifferent and frankly disappointing.”

Estimates on the number of intersexuals inNorth Americarange from 1 in 50 to 1 in 1000. Intersexuality is sometimes caused by genetics, sometimes by rare hormonal levels during pregnancy, and sometimes by unknown causes.

Religious Attacks on Intersexuals:

One would hope that the unique challenges faced by intersexual individuals could be handled through an interaction of intersexuals, their families, physicians and other health professionals. Unfortunately, some conservative Christians have introduced religious objections to intersexuality, based on what they believe are literal interpretations of scripture. Some examples are listed below, along with responses from some liberal Christians and intersexed persons:

Genesis 1:27 states: “God created man in his own image…male and female he created them.” (NIV)
Many Conservative Christians interpret the verse (and similar Biblical passages) literally, and believe that there can be only two genders: male and female. If there were intersexual peoples, then God would have mentioned them. Thus, they reject the concept of gender as a continuum, with three or more varieties of intersexual genders.

One intersexual individual 8 cites an ancient Jewish tradition “that Adam was an hermaphrodite.”

Many Liberal Christian theologians interpret Genesis 1:27 to refer to God’s original creation of Adam and Eve as male and female. It would not necessarly refer to their descendants, who would have been male, female and intersexual. Religious liberals usually consider the Old Testament creation story to be a myth, similar to the creation stories of other religions.

Numbers 5:1-3 states: “The Lord said to Moses: ‘Command the Israelites to send away from the camp anyone who has an infections skin disease or a discharge of any kind, or who is ceremonially unclean because of [touching] a dead body. Send away male and female alike; send them outside the camp so that they will not defile their camp, where I dwell among them.'” (NIV)
Many Conservative theologians point out that the phrase “male and female alike” is a way of including everyone. Thus, God has implied that there are no intersexuals.

One intersexual individual pointed out: “The phrase which tends translated as ‘male and female’…reads ‘mi-zakhar ve-‘ad neqevah’, or ‘from male to female,’ in the original Hebrew. The form ‘from A to B’ suggests a continuum of some sort.” 8 The concept of male and female with three intermediate genders fits perfectly into the phrase in its original Hebrew. Numbers 5 appears to be one of many Biblical passages in which translators have created an English text that discriminates against minorities, even as the original Hebrew text is inclusive of all gender minorities.

Many liberal theologians interpret this passage in a different way. The authors of the book of Numbers lived in a pre-scientific age and were unaware of sex chromosomes, hermaphrodites, intersexuals, and other sexual minorities. They would have naturally assumed that there were only two genders when they wrote this passages as if it had been stated by God.

 

 

Chuck Colson has written a particularly insensitive attack on intersexuals. He states (in part):

The Bible teaches that the Fall into sin affected biology itself – that nature is now marred and distorted from its original perfection. This truth gives us a basis for fighting evil, for working to alleviate disease and deformity – including helping those unfortunate children born with genital deformities.

…for the Christian, nature is not our basis for determining normality. Scripture tells us how God created us before the Fall, and how he intended us to live: as males and females, reflecting His own image. We take our standards and identity from His revelation of our original nature.9

One cause of this attack on the reality of intersexuality is the desire by conservative Christians to delay as long as possible the recognition of gay and lesbian marriages. One method of continuing special rights for heterosexuals is the US Federal Defense of Marriage Act. DOMA has two main objectives:

restriction of the definition of “marriage” in federal legislation to unions between one male and one female,

allowing states to refuse to recognize marriages performed in other states that do not involve one man and one woman.

 

If it is shown that there are more than 2 genders, then DOMA could be ruled unconstitutional. The US Supreme Court has already declared aColoradoamendment to be unconstitutional because it singled out one group (homosexuals) for legalized discrimination. DOMA could be interpreted as singling out two groups (homosexuals and intersexuals) for such discrimination.

Thus, it is important for groups that are opposing same-sex marriage to maintain the fiction that there are only two genders, that intersexual people do not exist.

It would be unfortunate if the hatred expressed against homosexuality by many conservative Christians spreads and becomes widely directed against intersexuals.

References:

  1. The Intersex Society of North America maintains a home page at: http://www.isna.org/ They have a FAQ, which describes their newsletter and other materials on intersexuality.
  2. Anne Fausto-Sterling, “The Five Sexes: Why Male and Female are not enough”, The Sciences, 1993-MAR/APR, 1993:20-24. Responses were printed in the JUL/AUG issue. The article was reprinted on the New York Times Op-ed page on 1993-MAR-12.
  3. Melissa Hendricks, “Is it a Boy or a Girl?”, Johns Hopkins Magazine, 1993-NOV-10 to 16.
  4. Intersex Voices is a Web site supporting intersexual persons and their families. See: http://www.qis.net/~triea/inter.html (Apparently offline)
  5. Genital Mutilation Survivors’ Support Network (GMSSN) has a German and English web site at: http://www.sonic.net/~boedeker/gmssn/index.htm [Apparently a broken link]
  6. Nathalie Angier, New Debate Over Surgery on Genitals, New York Times, New York NY, 1997-MAY-13
  7. Anne Scheck, “Early Vaginal Reconstruction for All Intersex Girls?,” Urology Times of Canada, 1997-APR. Available at: http://www.doctoc.com/
  8. Sally Gross, “Intersexuality and Scripture” at: http://www.qis.net/ (Apparently offline)
  9. Charles Colson, “Blurred biology” is a Fundamentalist Christian attack on intersexuality. See: http://www.goodnewsmag.com/ Apparently offline
  10. Anne Fausto-Sterling, “The Five Sexes: Why Male and Female are not enough”, The Sciences, 1993-MAR/APR, 1993:20-24. Responses were printed in the JUL/AUG issue. The article was reprinted on the New York Times Op-ed page on 1993-MAR-12.
  11. Cheryl Chase, “Hermaphrodites with Attitude: Mapping the Emergence of Intersex Political Activism,” GLQ: Journal of Gay and Lesbian Studies 4 (2):189-211 (1998)
  12. A.D. Dreger, “Ethical Issues in the Medical Treatment of Intersexuality and ‘Ambiguous Sex,‘”HastingsCenter Report. (1998-MAY/JUN)
  13. Suzanne Kessler,  “Lessons from the Intersexed,“RutgersUniversity Press, (1998-AUG)

Copyright © 1998 to 2007 by Ontario Consultants on Religious Tolerance
Originally published: 1998-MAR-16

Last updated on 2007-MAY-31
Author: Bruce A Robinson

 

Female genital mutilation

What is female genital mutilation?

Female genital mutilation (FGM), often referred to as ‘female circumcision’, comprises all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs whether for cultural, religious or other non-therapeutic reasons. There are different types of female genital mutilation known to be practised today. They include:

  • Type I – excision of the prepuce, with or without excision of part or all of the clitoris;
  • Type II – excision of the clitoris with partial or total excision of the labia minora;
  • Type III – excision of part or all of the external genitalia and stitching/narrowing of the vaginal opening (infibulation);
  • Type IV – pricking, piercing or incising of the clitoris and/or labia; stretching of the clitoris and/or labia; cauterization by burning of the clitoris and surrounding tissue;
  • scraping of tissue surrounding the vaginal orifice (angurya cuts) or cutting of the vagina (gishiri cuts);
  • introduction of corrosive substances or herbs into the vagina to cause bleeding or for the purpose of tightening or narrowing it; and any other procedure that falls under the definition given above.

The most common type of female genital mutilation is excision of the clitoris and the labia minora, accounting for up to 80% of all cases; the most extreme form is infibulation, which constitutes about 15% of all procedures.

Health consequences of FGM

The immediate and long-term health consequences of female genital mutilation vary according to the type and severity of the procedure performed.

Immediate complications include severe pain, shock, haemorrhage, urine retention, ulceration of the genital region and injury to adjacent tissue. Haemorrhage and infection can cause death.

More recently, concern has arisen about possible transmission of the human immunodeficiency virus (HIV) due to the use of one instrument in multiple operations, but this has not been the subject of detailed research.

Long-term consequences include cysts and abscesses, keloid scar formation, damage to the urethra resulting in urinary incontinence, dyspareunia (painful sexual intercourse) and sexual dysfunction and difficulties with childbirth.

Psychosexual and psychological health: Genital mutilation may leave a lasting mark on the life and mind of the woman who has undergone it. In the longer term, women may suffer feelings of incompleteness, anxiety and depression.

Who performs FGM, at what age and for what reasons?

In cultures where it is an accepted norm, female genital mutilation is practiced by followers of all religious beliefs as well as animists and non believers. FGM is usually performed by a traditional practitioner with crude instruments and without anaesthetic. Among the more affluent in society it may be performed in a health care facility by qualified health personnel. WHO is opposed to medicalization of all the types of female genital mutilation.

The age at which female genital mutilation is performed varies from area to area. It is performed on infants a few days old, female children and adolescents and, occasionally, on mature women.

The reasons given by families for having FGM performed include:

  • psychosexual reasons: reduction or elimination of the sensitive tissue of the outer genitalia, particularly the clitoris, in order to attenuate sexual desire in the female, maintain chastity and virginity before marriage and fidelity during marriage, and increase male sexual pleasure;
  • sociological reasons: identification with the cultural heritage, initiation of girls into womanhood, social integration and the maintenance of social cohesion;
  • hygiene and aesthetic reasons: the external female genitalia are considered dirty and unsightly and are to be removed to promote hygiene and provide aesthetic appeal;
  • myths: enhancement of fertility and promotion of child survival;
  • religious reasons: Some Muslim communities, however, practise FGM in the belief that it is demanded by the Islamic faith. The practice, however, predates Islam.

Prevalence and distribution of FGM

Most of the girls and women who have undergone genital mutilation live in 28 African countries, although some live in Asia and theMiddle East. They are also increasingly found in Europe,Australia,Canadaand theUSA, primarily among immigrants from these countries.

Today, the number of girls and women who have been undergone female genital mutilation is estimated at between 100 and 140 million. It is estimated that each year, a further 2 million girls are at risk of undergoing FGM.

Current WHO activities related to FGM

  • Advocacy and policy development

A joint WHO/UNICEF/UNFPA policy statement on FGM and a Regional Plan to Accelerate the Elimination of FGM were published to promote policy development and action at the global, regional, and national level. Several countries where FGM is a traditional practice are now developing national plans of action based on the FGM prevention strategy proposed by WHO.

  • Research and development

A major objective of WHO’s work on FGM is to generate knowledge, test interventions to promote the elimination of FGM. Research protocols on FGM have been developed with a network of collaborating research institutions as well as biomedical and social science researchers with linkages to appropriate communities. WHO has reviewed programming approaches for the prevention of FGM in countries and has organized training for community workers to strengthen their effectiveness in promoting prevention of FGM at the grassroots level.

  • Development of training materials and training for health care providers

WHO has developed training materials for integrating the prevention of FGM into nursing, midwifery and medical curricula as well as for in-service training of health workers. Evidence based training workshops, to raise the awareness of health workers and to solicit their active involvement as advocates against FGM, have also been developed for nurses and midwives in the African andEastern Mediterraneanregion.

For more information contact:

WHO Media centre
Telephone: +41 22 791 2222
E-mail: mediainquiries@who.int

AFRICA: When culture harms the girls – the globalisation of female genital mutilation

NAIROBI, 1 March 2005 (IRIN In-Depth) –

 

(March 2005) – Female Genital Mutilation (FGM) is a surgical procedure performed on the genitals of girls and women in many parts of the world. The term FGM covers a range of procedures, which are also referred to as female circumcision and introcision.

FGM is found extensively in Africa and is also indigenous to other parts of the world. The age and time at which FGM is practised differs from community to community, and can be carried out from as early as a few days after birth, to immediately after the birth of a woman’s first child. One of the notable trends in global FGM today is the progressive lowering of the age at which girls undergo the practice.

Among communities that practise FGM, the procedure is a highly valued ritual, whose purpose is to mark the transition from childhood to womanhood. In these traditional societies, FGM represents part of the rites of passage or initiation ceremonies intended to impart the skills and information a woman will need to fulfil her duties as a wife and mother.

The function of this practice, whether mild or severe, is ultimately to reduce a woman’s sexual desire, and so ensure her virginity until marriage. The more extensive procedure, involving stitching of the vagina, has the same aim, but reducing the size of the vagina is also intended to increase the husband’s enjoyment of the sexual act.

Discussions, conducted for the purposes of this report, with women who have undergone the procedure, revealed that penetration was almost always difficult and painful, even for the man, when women had undergone the more extreme forms of FGM.

Certain communities carry out FGM for religious reasons, believing that their faith requires it; this is particularly true of Muslims who adhere to the practice. Other communities consider female genitalia to be ugly, offensive or dirty, and thus the removal of the external genitalia makes a woman more hygienic and aesthetically pleasing. Some subscribe to the notion that FGM enhances a woman’s fertility, and the chances of her children’s survival.

All members of communities practising FGM have a role in perpetuating it. Families of girls or women who undergo FGM support it because it makes their daughters marriageable – the operation ensures that their daughters will have ready suitors and a satisfactory bride price.

In these communities, no eligible man would consider marrying a girl who has not undergone the procedure, so FGM makes a woman culturally and socially acceptable. It is in this important way that female genital mutilation is supported and encouraged by men.

Women in the community have a role too, as it is they who arrange for and perform the operation. Typically, the procedure is arranged by the mother or grandmother and, in Africa, is usually performed by a traditional birth attendant, a midwife, or a professional circumciser.

In communities practising FGM there is literally no place for a woman who has not undergone the procedure. Such societies have sanctions, which are brought to bear on the woman and her family, ensuring that the woman’s relatives enforce compliance. Other circumcised girls will no longer associate with her. She is called derogatory names, and is often denied the status and access to positions and roles that ‘adult’ women in that community can occupy. Ultimately, an uncircumcised woman is considered to be a child.

In traditional societies that offer women few options beyond being a wife and a mother there is great pressure to conform. Women who lack the education to seek other opportunities are doubly constrained in terms of the choices open to them. These women also typically come from communities that do not have alternatives to the traditional economy and modes of production, such as farming, fishing or pastoralism.

Even educated women from such communities are often faced with the FGM dilemma for themselves and their daughters. In Kenya, a female member of parliament (MP) had to face her earlier decision not to be circumcised when she made the choice many years later to run for public office. Her opponents used the fact that she was not circumcised to challenge her eligibility to hold a position that “only adults” could occupy. The MP’s name is Linah Kilimo and today she is a minister in Kenya’s National Rainbow Coalition government.

FGM in a Global Society

In the modern world few places exist in isolation, untouched by other cultures. The creation of nation states, which brought together many communities within common borders, as well as the forces of globalisation, have contributed to the blurring of boundaries in all societies.

Institutions that bring new norms in religion, national policy and legislation, and on a more individual level, education and intermarriage, create new options for societies. Sociocultural clashes arise as communities, ideas and cultures attempt to blend.

The dilemma facing people in this newly globalised world is showcased by the experience of one Senegalese couple. The woman, from a non-circumcising community, married into a society whose FGM prevalence was 70 percent. From the outset, the couple agreed that they would not circumcise their two daughters. The man’s family, however, was insistent that the girls undergo the ritual and, realizing that this was no idle threat, the couple barred their daughters from visiting the man’s family unescorted, lest the girls be forcefully abducted and cut, as is common when parents reject the practice. An additional, chilling threat awaited the wife – her sisters-in-law vowed that though she remained uncircumcised in life, they would circumcise her in death.

Different Forms of FGM

1. Type I (commonly referred to as clitoridectomy)

Excision (removal) of the clitoral hood, with or without removal of all or part of the clitoris.

2. Type II (commonly referred to as excision)

Excision (removal) of the clitoris, together with part or all of the labia minora (the inner vaginal lips). This is the most widely practised form.

3. Type III (commonly referred to as infibulation)

Excision (removal) of part or all of the external genitalia (clitoris, labia minora and labia majora), and stitching or narrowing of the vaginal opening, leaving a very small opening, about the size of a matchstick, to allow for the flow of urine and menstrual blood. Also known as pharaonic circumcision.

4. Type IV (Unclassified/Introcision)

Pricking, piercing or incision of the clitoris and/or labia:

Stretching the clitoris and/or labia
Cauterisation by burning of the clitoris and surrounding tissues
Scraping of the vaginal orifice or cutting of the vagina
Introduction of corrosive substances into the vagina to cause bleeding, or introduction of herbs into the vagina to tighten or narrow it
Any other procedure that falls under the definition of female genital mutilation

Type 1 and type 2 operations account for 85 percent of all FGM. Type 3 is common in Djibouti, Somalia, Sudan and parts of Egypt, Ethiopia, Kenya, Mali, Mauritania, Niger, Nigeria, and Senegal. Type 3, also known as pharaonic circumcision, is extremely severe and involves binding a woman’s legs for approximately 40 days to allow for the formation of scar tissue. Many of these communities use adhesive substances such as sugar, eggs, and even animal waste on the wound to enable it to heal.

The excisor often has to reopen the vagina to allow for easier childbirth, and then re-stitch it after birth, leaving it as small as before, or slightly larger to reduce painful intercourse. Frequently the excisor is called on a girl’s wedding night to open her up so she is able to consummate her marriage.

Health complications associated with FGM

Although it is widely known that FGM can have devastating and harmful consequences for a woman throughout her life, because most communities practising it are very poor and do not have access to modern health facilities, medical emergencies arising from FGM are common, and often lead to death.
A doctor from theFistulaHospital talks about the immediate and the long term health consequences of FGM.Credit: IRIN

A doctor from the Fistula Hospital talks about the immediate and the long term health consequences of FGM.
Credit: IRIN

 

It is difficult to determine the actual numbers of women who die from FGM-related complications, given the highly guarded nature of the practice. Medical record-keeping systems are also rarely configured to record FGM and FGM-related complications as causes of death.

The health problems a girl can experience are largely dependent on three factors.

First, the severity of the procedure: girls and women who undergo type II and type III are likely to experience more severe health complications, but health consequences for type I have also been widely reported.

Discussions with a doctor on the possible medical effects of type I FGM found that complications were most evident during childbirth, due to the reduced elasticity of the vagina caused by scar tissue formed as a result of the surgery. To compensate for the reduced elasticity during childbirth, tiny tears are caused around the vagina. These are too small to stitch, and end up forming more scar tissue, compromising the vagina’s elasticity even further. Labour becomes longer and more painful with each subsequent birth. The tears themselves predispose the woman to infection, while her ability to experience sexual satisfaction is undermined, as the tearing leads to an ever-loosening vagina.

Second, the sanitary conditions in which the procedure is performed, and the competence of the person who performs it: most circumcisers are professionals with years of experience, but the tools and sanitary conditions of their trade are often rudimentary at best, with knife-like implements or razor blades used as the basic surgical instruments.

Close adherence to traditions that dictate what type of instrument is suitable do not allow for innovation, or the adoption of new, more suitable instruments that may be available. Typically, the circumcision ceremony takes place once a year and all eligible girls within a community are cut on the same day, using the same instrument – without the benefit of sterilisation between procedures – thus increasing the chances of infection, and the risk of exposure through such practices to HIV/AIDS.

Third, the health of the girl or woman undergoing the procedure, and her ability to heal and resist infection passed on by the procedure, is critical: if a woman is prone to infection, or has a poor immune system, she has a greater chance of becoming infected. Literally, only the strong survive.

The secret nature of FGM poses a great threat to the health of girls and women who undergo it. It is highly confidential, and outsiders are strictly prohibited from having any contact with the girls and women during and after the ceremony. Therefore, most of them have no access to a medical professional, should they need one during or after the procedure.

The 40-day isolation that characterises type III FGM, for example, means a woman might die of infection before she ever gets the chance to receive proper medical care. When qualified medical personnel perform FGM in the sanitary conditions of a hospital, the risk of infection may be reduced, but the long-term consequences remain.

Some immediate physical problems resulting from FGM are:

1. Bleeding (often haemorrhaging from rupture of the blood vessels of the clitoris), sometimes leading to death

2. Post-operative shock

3. Damage to other organs, resulting from the lack of surgical expertise of the person performing the procedure, and the aggressive resistance of the patient when anaesthesia is not used

4. Infections, including tetanus and septicaemia, through using unsterilised or poorly disinfected equipment

5. Urine retention caused by swelling and inflammation

Some longer-term consequences include:

1. Chronic infections of the bladder and vagina:
– in Type III, the urine and menstrual blood can only leave the body drop by drop
– the build-up inside the abdomen and fluid retention often cause infections and inflammation that can lead to infertility
– infections and inflammation that can lead to infertility

2. Dysmenorrhoea, or extremely painful menstruation

3. Excessive scar tissue at the site of the operation

4. Formation of cysts on the stitch line

5. Childbirth obstruction, which can result in:
– the development of fistulas
– tearing of the vaginal and/or bladder wall
– chronic incontinence

6. Risk of HIV infection. (There is a growing speculation of a potential risk of HIV/AIDS associated with the procedure, especially when the same unsterilised instruments are used on multiple girls, but this has yet to be scientifically proven.)

7. Reinfibulation must be performed each time a child is born. When infibulation (Type III) is performed, the opening left in the genital area is too small for the head of a baby to pass through. Failure to reopen this area can lead to death or brain damage of the baby, and death of the mother. The excisor must reopen the mother and re-stitch her again after the birth. In most ethnic groups the woman is re-stitched as before, leaving the same tiny opening. In other ethnic groups the opening is left slightly larger to reduce painful intercourse. (In most cases, not only must the woman be reopened for each childbirth, but also on her wedding night, when the excisor may have to be called in to open her so she can consummate the marriage.)

There is a dearth of scientific studies on the psychological effects of FGM on girls and women. In the course of conducting research for this study, discussions were held with some women who had undergone one or other form of FGM. This information does not claim to be scientific, nor is it a substitute for a scientific approach, but it does begin to provide some insights on the possible psychological impact of FGM on survivors.

Some of the psychological impacts of FGM appear to be pavlovian in nature and effect:

– women who have undergone any form of FGM or its attendant painful rituals are so traumatized that they can only associate their genitals with pain and possible death from childbirth, of which there is always a much higher possibility than with uncircumcised women
– the idea of sexual intercourse as a pleasurable activity is inconceivable for most of them

The complexity of the psychological effects of FGM on women is demonstrated by the stories of Jane and Hawa, who underwent type 2 (excision) and type 3 (infibulation) FGM respectively.

Jane’s Story

Jane comes from a community in Kenya which practises type II FGM (excision), where the compliance rate is 97 percent. She is from an educated family and has a PhD. Her husband is equally highly educated. They have two children.

According to the customs of her community, Jane underwent the procedure at the age of 14. She discussed how sex had always been an unpleasant chore for her, and although she no longer experiences any pain, she has no sexual response and sex has no meaning for her.

Jane also spoke of the difficult childbirth she experienced, which she attributes to the circumcision. She is grateful to have an understanding husband who does not demand more than the two children they have. Her experiences convinced both her and her husband that their daughter must not go through the procedure.

Hawa’s Story

Hawa comes from Eritrea, a country in the Horn of Africa with a 90 percent compliance rate, practising types 1, 2, and 3 FGM. She is from a community that performs type 3 (infibulation). Hawa has lived in the United States since the 1980s, when she fled political persecution in her homeland.

She is now a naturalised American citizen, holding a doctorate and teaching at a University in the US, where she is a widely published and respected scholar. Hawa is divorced from a fellow Eritrean and has one child, a six-year-old girl.

She told IRIN of the devastating psychological effects she believes FGM has had on her, commenting that although she retained the ability to experience sexual pleasure, she experienced it in a distant, muted form. The act of sex has never brought her enjoyment, and she believes this contributed to the breakdown of her marriage.

However, when questioned about whether or not she would circumcise her daughter, Hawa revealed an interesting ambivalence. Before she had borne a child, she was clear that FGM was a terrible practice, which should be eliminated. Today, as the single mother of a girl she is bringing up in America, she has tempered her opposition to FGM somewhat.

Her concern comes from what she perceives as the highly sexualised community in the US – everywhere there are images of sexual freedom and images that objectify the role of women as sexual beings. Among the African American community in particular, sexual freedom has been taken to an extreme in which young girls often have children with more than one father. Inevitably, their focus on achievement in other areas, such as education, career and so on, is compromised. Many of these teenage mothers swell the ranks of the welfare system.

Hawa wants everything for her daughter, and although she is not an indigenous African American, she and especially her daughter, are perceived as African American, and subject to many of the same pressures and limitations. Further, she feels, the image of African Americans has been glamorised in music, the media and film – “this community is probably the most imitated by young people the world over”.

In such an environment, the prospect of her daughter’s full-blown sexuality frightens Hawa. She sees it as a potential Achilles’ heel, which could lead her daughter down the path of low achievement, early pregnancy and welfare dependence. Incredible as it may seem, Hawa is adamant that an FGM procedure guaranteed to reduce her daughter’s sexual urges to a shadow looks attractive.

FGM and Religion

FGM is often associated with Islam, and there are people who believe that Islam sanctions it. The fact that type I is also called the ‘Sunna’ procedure (meaning ‘following the Prophet’s tradition’) is often used as evidence for this contention. However, it is found among both Muslim and Christian populations, and is a cultural practice that predates both religions. Type 3, or ‘infibulation’, also known in Sudan and Ethiopia as the ‘pharaonic procedure’, was most likely practised in ancient Egypt.

Prevalence of FGM

 

 

 

 

Debates about FGM in Egypt

Quotation:

Excerpts from a book by Nawal El Saadawi: “The Hidden Face of Eve: Women in the Arab World.” She is an Egyptian novelist, MD and militant writer on Arab women’s problems and their struggle for liberation.

“I just wept, and called out to my mother for help. But the worst shock of all was when I looked around and found her standing by my side. Yes. It was her, I could not be mistaken, in flesh and blood, right in the midst of these strangers, talking to them and smiling at them as though they had not participated in slaughtering her daughter just a few minutes ago.”

“Now we know where lies our tragedy. We were born of a special sex, the female sex. We are destined in advance to taste of misery, and to have a part of our body torn away by cold unfeeling, cruel hands. …”

When I returned to school after having recovered from the operation, I asked my classmates and friends about what had happened to me, only to discover that all of them without exception, had been through the same experience, no matter what social class they came from. …” 1

Status of FGM:

FGM is a social custom, not a religious practice. It is usually performed on pre-pubescent girls, often without anesthetic or precautions against infection. In those countries where the mutilation is common, it is practiced by Muslims, Christians, and followers of other religious groups.

Nawal El-Saadawi, a Muslim victim of infibulation, stated:

“The importance given to virginity and an intact hymen in these societies is the reason why female circumcision still remains a very widespread practice despite a growing tendency, especially in urban Egypt, to do away with it as something outdated and harmful. Behind circumcision lies the belief that, by removing parts of girls’ external genitals organs, sexual desire is minimized. ” 3

A 2005 report titled “Children in Islam: Their care, development and protection” issued by UNICEF and the International Islamic Center for Population Studies and Research atAl-AzharUniversity states:

Islam and female circumcision: From an Islamic perspective, the Quran says nothing relating explicitly or implicitly to female circumcision. The use of the general term ‘Sunnah Circumcision’ is nothing but a form of deceit to misguide people and give the impression that the practice is Islamic. As for the traditions attributed to the Prophet, peace be upon him, in this regard, past and present scholars have agreed that none of these traditions are authentic and should not be attributed to the Prophet.” 10

Sunna circumcision involves cutting of only the outer part of the clitoris.

An older meta-study on “female sexual castration” presented in 1989-MAR showed that five surveys conducted between 1977 and 1985 estimated that 80.5% of Egyptian women in Cairo and Alexandria had undergone FGM. The incidence is believed to be much higher in rural areas. 6

During 2007-JUN, Ahmad ‘Aliwa, a women’s rights activist, described one finding that shows the near universal practice of FGM inEgypt, noting:

“The Center for Social Studies conducted a survey which showed that 85% of the prostitutes in Egypt were circumcised. There is no relation between female circumcision and the girls’ behavior.” 2

A 2005 report by UNICEF suggested that 97% of Egyptian women between the ages of 15 and 49 who have never been married have undergone some form of FGM or circumcision. 7

A more recent study by the Egyptian government found that 50.3% of girls aged 10 to 18 have been circumcised. 7

FGM debate inEgypt:

Mohammed Sayyed Tantawi, head of the al-Azhar Islamic Institute, had stated during the 1990s that the practice is un-Islamic. The Health Minister ofEgypt, Ismail Sallam, announced a ban on FGM in 1996-JUL. This was upheld by a junior administrative court inCairo.

Sheik Youssef Badri, a Muslim fundamentalist, took the health minister to court. In 1997-JUN, an Egyptian court overturned the ban. Eight Muslim scholars and doctors had testified that the ban exceeded the government’s authority and violated the legal rights of the medical profession. Sheik Youssef Badri commented:

[Female] circumcision is Islamic; the court has said that the ban violated religious law. There’s nothing which says circumcision is a crime, but the Egyptians came along and said that Islam is a crime.”

In 1997-JUL, the German newsmagazine Der Spiegel interviewed Sheik Badri. He claimed that many Muslim women are pleased with this victory of Islam over its enemies. When it was pointed out to him that parents in Morocco and Algeria do not practice FGM, he replied that the clitoris in Egyptian girls was larger than in those countries and had to be cut back to a normal size. He quoted a French study which showed that circumcised girls are less likely to catch AIDS. [Author’s note: This may well be true; victims of FGM are probably less likely to be sexually active.] Badri believes that theUnited States is spreading misinformation on the health risks of FGM.

We have been unable to find any documentation to support Badri’s assertion about clitoris size.

The government appealed the case to Egypt’s Supreme Administrative Court. They ruled that the operation is not required by Islam, and that “female circumcision is not a personal right according to the rules of Islamic Sharia (law).” Thus, FGM is subject to Egyptian law. The government prohibited the procedure, even if it is done with the agreement of the child and her parents. However, gynecologists are still allowed to perform the surgery if it is needed for health reasons.

The BBC reported in 2007 that:

“Egypt’s first lady, Susanne Mubarak, has spoken out strongly against female circumcision, saying that it is a flagrant example of continued physical and psychological violence against children which must stop.” 5

A girl dies under the knife:

Budour Ahmed Shaker, aged 11 or 12 (sources differ), died on 2007-JUN at a private medical clinic in Minya province in Egypt. She allegedly died of an overdose of anesthetic during FGM. Her three sisters had already undergone the “purification” operation. The operation cost 50 Egyptian pounds ($9.00 US). The doctor is reported as having tried to bribe the parents to withdraw their complaint. The girl’s father has allegedly sued the doctor. 7

Human rights groups complained both to the medical profession and the government about the continued practice. The doctor has since been arrested. 5

Reactions of religious & political leaders to Budour’s death:

When interviewed about FGM, Ali Gum’a, the Mufti ofEgypt(a.k.a. Gomaa), said:

“We’ve warned time and again that this thing… It has become clear to us, in modern times, with all the medical information we have, that this is inappropriate, and that it causes severe damage from the medical, social, and human aspects. So we [decided] to refrain from performing this custom and to prevent it. We’ve said this once, twice, three times, and ten times… Not only now, but since 1954, we have been calling upon people to abandon this ugly custom.”  2

When the interviewer pressured the mufti by asking specifically whether Islam prohibits or permits FGM, Ali Gum’a replied:

“This issue, with these characteristics, in our times – is prohibited. If they want to know what the Mufti of Egypt has to say. I say this custom is prohibited.”

Mohamed Sayyed Tantawi, the Grand Sheikh ofCairo’s al-Azhar mosque, has repeated his assertion that the practice as un-Islamic. However, some other Muslim clerics have supported FGM.

UNICEF reports that:

“… Al-Azhar Supreme Council of Islamic Research, the highest religious authority in Egypt, issued a statement saying FGM/C has no basis in core Islamic law or any of its partial provisions and that it is harmful and should not be practiced.” 9

Coptic Pope Shenouda, the leader of Egypt’s minority Christian community, said that neither the Koran nor the Bible demand or mention female circumcision. 4

Su’ad Saleh of Al-Azhar University commented:

“After the [statement by the Mufti] there is nothing left for me to say. This is what I have been demanding from the Mufti and the religious scholars – a categorical ruling on such issues. But when some of them say that this is permitted ‘when necessary,’ and if a doctor performs it … It was a doctor who did this, and look at the result … Society as a whole is responsible for the death of this girl. This is tantamount to the custom of burying girls alive, before the advent of Islam. It is like the burying the girl in the physical and psychological sense.”

Reactions to Budour’s death:

According toFrance24:

“The Egyptian doctors’ syndicate has launched a probe into the girl’s death and warned doctors against performing the procedure either in homes or medical facilities, citing ‘detrimental health effects’ on girls.” 4

On 2007-JUN-28, the Egyptian Health Ministry announced that it has removed the health exception from the 1996 law. 2 Female genital mutilation is now banned throughout the country.  A spokesperson said that any circumcision: “… will be viewed as a violation of the law and all contraventions will be punished.” He noted that it is a “permanent ban”.

The ministry decree states that it is “… prohibited for any doctors, nurses, or any other person to carry out any cut of, flattening or modification of any natural part of the female reproductive system.8 That is confusing regulation. It could be interpreted as forbidding various non-mutilating medical procedures, tubal ligation, surgical removal of a hymen, and even performing an episiotomy during childbirth. Also, since the clitoris is not part of the reproductive system, the regulation would not restrict surgery on it.

A law is apparently required to fully enforce the ban. It is expected to face a tough debate in parliament. 4

UNICEF reports that:

“During the Third Regional Conference on Violence against Children, the First Lady Suzanne Mubarak dedicated a minute of silence for the recent child FGM/C victim. She announced the launch of a national campaign aimed at drawing more attention to the harmful practice and accelerating efforts to legally ban FGM/C. The First Lady also announced the amendment of the Child Law 1996, which in addition to banning FGM/C also addresses other child rights issues.” 9

References used:

The following information sources were used to prepare and update the above essay. The hyperlinks are not necessarily still active today.

  1. Nawal El-Saadawi, “The hidden face of Eve: Women in the Arab World,” translated and edited by Sherif Hetata, Zed Press,London, (1980), Pages 5-8.
  2. “Death of Girl During Circumcision Stirs Debate in Egyptand Prompts a Fatwa by Mufti of Egypt Banning this Practice,” Transcript of program on Al-Mihwar TV, 2007-JUN-24, at: http://www.memritv.org/
  3. “Egyptstrengthens ban on genital mutilation following girl’s death,” EITB 24, 2007-JUN-28, at: http://www.eitb24.com/
  4. “Egyptoutlaws all female circumcision,” AFP, 2007-JUN-28, at: http://www.france24.com/
  5. Magdi Abdelhadi, “Egyptforbids female circumcision,” BBC, 2007-JUN-28, at: http://news.bbc.co.uk/
  6. Mohamed Badawi, “Epidemiology of Female Sexual Castration in Cairo, Egypt,” Paper delivered at the First International Symposium on Circumcision, Anaheim, California,1989-MAR-1 &. Online at: http://www.nocirc.org/
  7. Ian Black, “Egyptbans female circumcision after death of 12-year-old girl,” Guardian Unlimited, 2007-JUN-30, at: http://www.guardian.co.uk/
  8. Maggie Michael,” Egyptoutlaws circumcision after girl dies,” Guardian Unlimited, 2007-JUL-01, at: http://www.guardian.co.uk/
  9. “Fresh progress toward the elimination of female genital mutilation and cutting in Egypt,” UNICEF, 2007-JUL-02, at: http://www.unicef.org/
  10. “Children in Islam: Their care, development and protection UNICEF and the International Islamic Center for Population Studies and Research of Al-Azhar University, 2005, at: http://www.unicef.org/ This is a PDF file. You may require software to read it. Software can be obtained free from:

References used:

The following information sources were used to prepare and update the above essay. The hyperlinks are not necessarily still active today.

  1. Position paper on Female Genital Mutilation/Female Circumcision,” Muslim Women’s League, at: http://www.mwlusa.org/
  2. Sami A. Aldeeb Abu-Sahlieh, “Religious arguments about male and female circumcision,” at: http://www.lpj.org/
  3. Nawal El-Saadawi, “The hidden face of Eve, Women in the Arab World,” translated and edited by Sherif Hetata, Zed Press,London, 1980, P. 33.
  4. United Nations, 26th Session of the Economic and Social Committee, 1029th Plenary Meeting, 1958-JUL-10.
  5. WHO, 12th World Health Assembly, 11th Plenary Meeting, 1959-MAY-28.
  6. WHO, Resolution of the Regional Committee forAfrica, 39th session, AFR/RC39/R9, 1989-SEP-13.
  7. UNICEF, Department of Information, “Position of UNICEF on Female Excision“, 1980-SEP-23, Page 1.
  8. Partial Translation of Sunan Abu-Dawud, Book 41: General Behavior (Kitab Al-Adab),” at: http://www.usc.edu/
  9. “Muslim scholars rule female circumcision un-Islamic,” The Age, 2006-NOV-24, at: http://www.theage.com.au/

Copyright © 1998 to 2007 by Ontario Consultants on Religious Tolerance
Originally written: 1998-MAR-13
Last update: 2007-JUL-07

Author: B.A. Robinson

Female Genital Mutilation
in North America & Europe

Summary:

Female Genital Mutilation is an invasive procedure that is usually performed on girls before puberty. It is occasionally performed within Aboriginal, Christian and Muslim families who have emigrated to the USor Canadafrom some predominately Muslim countries where it is practiced as a social tradition. It is also done at birth to some “inter-sex” infants for what are seen by some as justified for medical or psychological reasons.

Genital Mutilation among immigrants:

This operation is occasionally performed on children of immigrants from some Muslim countries of the Middle East, Africa, Indonesia and other Muslim countries in Asia. It is seen by some of its supporters as a religious duty, social custom, and/or a necessary operation for health reasons. It is criticized by those in opposition as a cruel mutilation of a young girl in order to reduce her sexual response after puberty.

In the West, the procedure is outlawed in

“Australia (six states), Burkina Faso, Canada, Central African Republic, Côte d’Ivoire, Djibouti, Ghana, Guinea, New Zealand, Nigeria (3 states), Norway, Senegal, Sweden, Tanzania, Togo, the United Kingdom, and the United States.

After 20 years of personal effort, Representative Patricia Schroeder (D-CO) saw a US federal bill, “Federal Prohibition of Female Genital Mutilation Act of 1995”  passed in 1996-SEP. The bill had been introduced by Sen. Harry Reid (D-Nevada). 3 The law provides for prison sentences of up to 5 years for anyone who “circumcises, excises, or infibulates the whole or any part of the labia majora or labia minora or clitoris of another person who has not attained the age of 18.” US representatives to the World Bank and similar financial institutions are required to oppose loans to countries where FGM is prevalent and in which there are no anti-FGM educational programs. The law took effect on 1997-MAR-30. The first charges under the law were made in late 2003 when a California couples was arrested in a FBI sting operation allegedly after having agreed to perform a FGM procedure on two fictitious girls. 5

FGM has also been criminalized at the state level in California, Minnesota, North Dakota, Rhode Island, and Tennessee, and other states. At least one FGM assistance, education and support group is operating in the U.S.among immigrants from countries that practice FGM. 1

Section 273.3 of the Canadian Criminal Code protects children who are ordinarily resident inCanada, (as citizens or landed migrants) from being removed from the country and subjected to FGM. In theUS andCanada, the very small percentage of Muslims who wish to continue the practice often find it impossible to find a doctor who will cooperate. The operation may then be done illegally in the home by poorly trained persons, under less than sterile conditions.

Specialists in Denver, CO, reported in 1998 that at least  6,000 immigrants have settled in the area from African countries which widely practice FGM. 2  Dr. Terry Dunn, director of a women’s clinic in that city commented: “I know of one patient where it was clear it was performed in this country.” About 4 FGM cases are seen each year at the clinic.

Legislation against FGM can be counter-productive in some cases. It might force the practice deeply underground. Women may not seek medical care later in life because their parents might be charged. The operation can be life threatening if performed by untrained individuals; if the operation is botched, the parents may be reluctant to take the child to a hospital out of fear of being criminally charged with child abuse. On the other hand, it does indicate that the government has taken a stand against FGM. This, and potential penalties, may well cause some parents to decide against having their daughter(s) mutilated.

On 1999-FEB-3, Hawa Greou went on trial in Franceon charges of “voluntarily bodily injury causing mutilation or permanent disability.” She is alleged to having mutilated the genitals of about 50 young girls. Also charged were 27 parents of the victims. The case was triggered by a complaint by a woman of Malian origin, Mariatou Koita. Both she and her sister were allegedly mutilated by Greou. Jean Chavais, the defendant’s lawyer, admits that the mutilations were carried out. He said : “If the trial can help bring about an end to this custom, then it will be useful. But punishment is not as effective as education and prevention…This is an African custom that has existed for centuries. It takes a long time to change habits.” Ms. Greou, known among the Malian community in Paris as “Mama Greou” had received a one year suspended sentence in 1994 for excising two girls. This time, she was given an 8 year jail sentence. Parents received sentences ranging from a 3 year suspended sentence to 2 years in prison.

Immigration lawyers:

Sacks & Kolken is law firm that has won a number of FGM-related asylum cases during 1999. Their website is at:  http://www.sackskolken.com/

References:

  1. M. Ramsey, “Forward USA/Ethiopia: Assistance, education and support for women and girls affected by female genital mutilation.” This group has disappeared from the Internet and may no longer exist. For support questions in theU.S. you might try contacting:

 African Women’s Health Center, Brigham and Women’s Hospital, Boston, MA, at: http://www.brighamandwomens.org/ This is the first and only African health practice in theUnitedState that focuses FGM.

 Research, Action and Information Network for the Bodily Integrity of Women (RAINBO)) at: http://www.rainbo.org/

The National Women’s Health Information Center, at: http://www.4woman.gov/

  1. Associated Press article, 1998-FEB-16, quoted in the Feminist Majority Foundation‘s web site at: http://feminist.org/
  2. Text of the “Federal Prohibition of Female Genital Mutilation Act of 1995” is online at: http://www.fgmnetwork.org/
  3. Legislation on Female Genital Mutilation in the United States,” Center for Reproductive Rights, at: http://www.reproductiverights.org/ This is a PDF file. You may require software to read it. Software can be obtained free from:
  4. Megan Costello, “Two in U.S. Accused of Genital Mutilation,” Womensenews, 2004-FEB-19, at: http://www.womensenews.org/

Copyright © 1998 to 2007 by Ontario Consultants on Religious Tolerance
Originally published: 1998-MAR-16

Last updated on 2007-MAR-10
Author: Bruce A Robinson

 

Intersexual Genital Mutilation

In North America &Europe

Summary:

This is an invasive procedure that is usually performed on “inter-sex” newborns for what some believe to be medical reasons. These are newborns whose genitals deviate significantly from conventional male or female design.

Similar operations are traditionally performed on non-intersex girls later in life in some African, Middle Eastern and Far Eastern countries Aboriginal, Christian and Muslim families who have emigrated to the US or Canada also practice it.

Genital alterations of infants:

Western society has traditionally oppressed sexual minorities. Every child is expected to be conceived with XX or XY chromosomes, grow up to be either a man or a woman, to have internal and external sexual organs which are clearly male or female, and to be sexually attracted to members of the “opposite” sex when they mature. For reasons of ignorance, religious teaching and fear, we have tended to force people into the traditional heterosexual male or female role. But, as in so many sexually related topics, a two-mode model is insufficient. Consider:

Homosexuals: male or female adults who are attracted to members of the same gender; about 5% of the population

Bisexuals: male or female adults who are attracted to persons of both/all genders; about 3% of the population.

Transgendered persons: male or female adults who appear like a typical male or female, but who are convinced that nature has played a terrible trick on them. They feel that they are a woman in a man’s body, or vice versa. They are rare, numbering only one in every tens of thousands of individuals.

Transexuals: Transgendered adults who have undergone hormone therapy and/or surgical procedures in order to make their body more closely resemble the sex that they believe they are.

Intersexuals: individuals who are born with anatomy or physiology which differ from cultural ideals of male and female.” 1

 

Anne Fausto-Sterling attempted to categorize intersexuality in a 1993 article. 2 She introduced three sexes in addition to male and female:

Herm refers to “true hermaphrodite” — a person born with both ovarian and testicular tissues and internal reproductive organs.

Merm is an intersexed person with a XY (nominally male) karyotype.

Ferm is an intersexed person with a XX (nominally female) karyotype.

 

These categories have not been well received by most intersexed people.

She has written of her vision of a more accepting future:

At birth, instead of hearing the inevitable pronouncement of “boy” or “girl” new parents might excitedly await a much expanded range of possibilities. Herms, ferms, and merms, being the rarer birth events might come to be seen as especially blessed or lucky, having as they do the best of all possible worlds, sexually speaking. Herms, merms and ferms might become the most desirable of all possible mates able as they are to pleasure their partners in a variety of ways. Furthermore, the existence of three additional sexes would open up possibilities for the rest of us. It would become difficult to maintain a clear conceptualization of homosexuality, for example, and perhaps its current contentious status would fade from view. If we envision the world in fives instead of twos, it would also be more difficult to hold onto rigid constructions of male and female sex roles. …Should we have only two sexes?–my answer would be a resounding no.”

Most physicians have recommended in the past that the ambiguous external genitals of intersex infants be carved up so that the child will grow up appearing to be a “normal” male or female. Some the infant have an enlarged or protruding clitoris; others will be born with a “micropenis”. In about 90% of cases, intersex infants undergo genital surgery to make them appear as a “normal” female. One surgeon explained: “You can make a hole, but you can’t build a pole.” 3 Surgery involves removal and remolding genital structures, and may involve the addition of parts taken from elsewhere on the body. Physicians now attempt to preserve structures that have concentrations of nerves, so that sexual feeling will remain. But they cannot guarantee that their patients will ever be able to have orgasms in later life. Such care was not always done in the past.

These operations are usually performed shortly after birth, at the age of 6 weeks to 15 months. 6 They are sometimes done later, during childhood or teen years. There is increasing opposition to these operations. Several activist and support groups by and for intersexuals have been formed. 1,4,5 They generally oppose genital surgery on intersexual people, particularly when it is done at an age where the individual cannot make an informed choice. Nathalie Angier 6 has written:

“The debate raises difficult questions about who has the right to decide what ranks as esthetically acceptable genitalia, whose interests are being served by surgical intervention and whether one’s sexual identity is so entwined with the appearance of one’s genitals that it is worth subjecting infants to a major operation to assure visual concordance between one and the other.”

The Federal Prohibition of Female Genital Mutilation Act does permit genital surgery if it is “necessary to the health of the person on whom it is performed.” Activists are now trying to modify the law, so that it cannot be performed without the informed consent of the individual. Cheryl Chase, founder of the Intersex Society of North America commented: 1

Africans have their cultural reasons for trimming girls’ clitorises, and we have our cultural reasons for trimming girls’ clitorises. It’s a lot easier to see what’s irrational in another culture than it is to see it in our own.

With regard to the proposed change in the law, she commented:

That would break the pediatricians’ argument that they do this to prevent psychological and mental trauma for the child…We don’t expect this to be finished up in six months, but we’re not going to go away, and we have more passion than they do.”

Some pediatricians defend the practice of infant genital surgery. Dr. Anthony A. Caldamone, head of pediatric urology at Hasbro Children’s Hospital inProvidence,RIsaid:

I don’t think it’s an option for nothing to be done. I don’t think parents can be told, this is a normal girl, and then have to be faced with what looks like an enlarged clitoris, or a penis, every time they change the diaper. We try to normalize the genitals to the gender to reduce psychosocial and functional problems later in life.”

Dr. Justine M. Schober, a pediatric urologist atHamotMedicalCenterinErie,Pa.has said:

The truth is, genital surgery is being done, but we don’t know what the outcome of it is, sexually or otherwise. We don’t have any long-term studies.”

David Thomas, a pediatric urologist at St. James’s UniversityHospitaland Infirmary in Leeds, UKconducted a scouting study. It involved only about a dozen intersexual individuals aged 11 to 15 who had been subjected to genital surgery. Results were not encouraging. 7 Dr. Thomas reports:

Every girl required some additional vaginal surgery…The results are indifferent and frankly disappointing.”

Estimates on the number of intersexuals inNorth Americarange from 1 in 50 to 1 in 1000. Intersexuality is sometimes caused by genetics, sometimes by rare hormonal levels during pregnancy, and sometimes by unknown causes.

Religious Attacks on Intersexuals:

One would hope that the unique challenges faced by intersexual individuals could be handled through an interaction of intersexuals, their families, physicians and other health professionals. Unfortunately, some conservative Christians have introduced religious objections to intersexuality, based on what they believe are literal interpretations of scripture. Some examples are listed below, along with responses from some liberal Christians and intersexed persons:

Genesis 1:27 states: “God created man in his own image…male and female he created them.” (NIV)
Many Conservative Christians interpret the verse (and similar Biblical passages) literally, and believe that there can be only two genders: male and female. If there were intersexual peoples, then God would have mentioned them. Thus, they reject the concept of gender as a continuum, with three or more varieties of intersexual genders.

One intersexual individual 8 cites an ancient Jewish tradition “that Adam was an hermaphrodite.”

Many Liberal Christian theologians interpret Genesis 1:27 to refer to God’s original creation of Adam and Eve as male and female. It would not necessarly refer to their descendants, who would have been male, female and intersexual. Religious liberals usually consider the Old Testament creation story to be a myth, similar to the creation stories of other religions.

Numbers 5:1-3 states: “The Lord said to Moses: ‘Command the Israelites to send away from the camp anyone who has an infections skin disease or a discharge of any kind, or who is ceremonially unclean because of [touching] a dead body. Send away male and female alike; send them outside the camp so that they will not defile their camp, where I dwell among them.'” (NIV)
Many Conservative theologians point out that the phrase “male and female alike” is a way of including everyone. Thus, God has implied that there are no intersexuals.

One intersexual individual pointed out: “The phrase which tends translated as ‘male and female’…reads ‘mi-zakhar ve-‘ad neqevah’, or ‘from male to female,’ in the original Hebrew. The form ‘from A to B’ suggests a continuum of some sort.” 8 The concept of male and female with three intermediate genders fits perfectly into the phrase in its original Hebrew. Numbers 5 appears to be one of many Biblical passages in which translators have created an English text that discriminates against minorities, even as the original Hebrew text is inclusive of all gender minorities.

Many liberal theologians interpret this passage in a different way. The authors of the book of Numbers lived in a pre-scientific age and were unaware of sex chromosomes, hermaphrodites, intersexuals, and other sexual minorities. They would have naturally assumed that there were only two genders when they wrote this passages as if it had been stated by God.

 

 

Chuck Colson has written a particularly insensitive attack on intersexuals. He states (in part):

The Bible teaches that the Fall into sin affected biology itself – that nature is now marred and distorted from its original perfection. This truth gives us a basis for fighting evil, for working to alleviate disease and deformity – including helping those unfortunate children born with genital deformities.

…for the Christian, nature is not our basis for determining normality. Scripture tells us how God created us before the Fall, and how he intended us to live: as males and females, reflecting His own image. We take our standards and identity from His revelation of our original nature.9

One cause of this attack on the reality of intersexuality is the desire by conservative Christians to delay as long as possible the recognition of gay and lesbian marriages. One method of continuing special rights for heterosexuals is the US Federal Defense of Marriage Act. DOMA has two main objectives:

restriction of the definition of “marriage” in federal legislation to unions between one male and one female,

allowing states to refuse to recognize marriages performed in other states that do not involve one man and one woman.

 

If it is shown that there are more than 2 genders, then DOMA could be ruled unconstitutional. The US Supreme Court has already declared aColoradoamendment to be unconstitutional because it singled out one group (homosexuals) for legalized discrimination. DOMA could be interpreted as singling out two groups (homosexuals and intersexuals) for such discrimination.

Thus, it is important for groups that are opposing same-sex marriage to maintain the fiction that there are only two genders, that intersexual people do not exist.

It would be unfortunate if the hatred expressed against homosexuality by many conservative Christians spreads and becomes widely directed against intersexuals.

References:

  1. The Intersex Society of North America maintains a home page at: http://www.isna.org/ They have a FAQ, which describes their newsletter and other materials on intersexuality.
  2. Anne Fausto-Sterling, “The Five Sexes: Why Male and Female are not enough”, The Sciences, 1993-MAR/APR, 1993:20-24. Responses were printed in the JUL/AUG issue. The article was reprinted on the New York Times Op-ed page on 1993-MAR-12.
  3. Melissa Hendricks, “Is it a Boy or a Girl?”, Johns Hopkins Magazine, 1993-NOV-10 to 16.
  4. Intersex Voices is a Web site supporting intersexual persons and their families. See: http://www.qis.net/~triea/inter.html (Apparently offline)
  5. Genital Mutilation Survivors’ Support Network (GMSSN) has a German and English web site at: http://www.sonic.net/~boedeker/gmssn/index.htm [Apparently a broken link]
  6. Nathalie Angier, New Debate Over Surgery on Genitals, New York Times, New York NY, 1997-MAY-13
  7. Anne Scheck, “Early Vaginal Reconstruction for All Intersex Girls?,” Urology Times of Canada, 1997-APR. Available at: http://www.doctoc.com/
  8. Sally Gross, “Intersexuality and Scripture” at: http://www.qis.net/ (Apparently offline)
  9. Charles Colson, “Blurred biology” is a Fundamentalist Christian attack on intersexuality. See: http://www.goodnewsmag.com/ Apparently offline
  10. Anne Fausto-Sterling, “The Five Sexes: Why Male and Female are not enough”, The Sciences, 1993-MAR/APR, 1993:20-24. Responses were printed in the JUL/AUG issue. The article was reprinted on the New York Times Op-ed page on 1993-MAR-12.
  11. Cheryl Chase, “Hermaphrodites with Attitude: Mapping the Emergence of Intersex Political Activism,” GLQ: Journal of Gay and Lesbian Studies 4 (2):189-211 (1998)
  12. A.D. Dreger, “Ethical Issues in the Medical Treatment of Intersexuality and ‘Ambiguous Sex,‘”HastingsCenter Report. (1998-MAY/JUN)
  13. Suzanne Kessler,  “Lessons from the Intersexed,“RutgersUniversity Press, (1998-AUG)

Copyright © 1998 to 2007 by Ontario Consultants on Religious Tolerance
Originally published: 1998-MAR-16

Last updated on 2007-MAY-31
Author: Bruce A Robinson

 

Female genital mutilation

What is female genital mutilation?

Female genital mutilation (FGM), often referred to as ‘female circumcision’, comprises all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs whether for cultural, religious or other non-therapeutic reasons. There are different types of female genital mutilation known to be practised today. They include:

  • Type I – excision of the prepuce, with or without excision of part or all of the clitoris;
  • Type II – excision of the clitoris with partial or total excision of the labia minora;
  • Type III – excision of part or all of the external genitalia and stitching/narrowing of the vaginal opening (infibulation);
  • Type IV – pricking, piercing or incising of the clitoris and/or labia; stretching of the clitoris and/or labia; cauterization by burning of the clitoris and surrounding tissue;
  • scraping of tissue surrounding the vaginal orifice (angurya cuts) or cutting of the vagina (gishiri cuts);
  • introduction of corrosive substances or herbs into the vagina to cause bleeding or for the purpose of tightening or narrowing it; and any other procedure that falls under the definition given above.

The most common type of female genital mutilation is excision of the clitoris and the labia minora, accounting for up to 80% of all cases; the most extreme form is infibulation, which constitutes about 15% of all procedures.

Health consequences of FGM

The immediate and long-term health consequences of female genital mutilation vary according to the type and severity of the procedure performed.

Immediate complications include severe pain, shock, haemorrhage, urine retention, ulceration of the genital region and injury to adjacent tissue. Haemorrhage and infection can cause death.

More recently, concern has arisen about possible transmission of the human immunodeficiency virus (HIV) due to the use of one instrument in multiple operations, but this has not been the subject of detailed research.

Long-term consequences include cysts and abscesses, keloid scar formation, damage to the urethra resulting in urinary incontinence, dyspareunia (painful sexual intercourse) and sexual dysfunction and difficulties with childbirth.

Psychosexual and psychological health: Genital mutilation may leave a lasting mark on the life and mind of the woman who has undergone it. In the longer term, women may suffer feelings of incompleteness, anxiety and depression.

Who performs FGM, at what age and for what reasons?

In cultures where it is an accepted norm, female genital mutilation is practiced by followers of all religious beliefs as well as animists and non believers. FGM is usually performed by a traditional practitioner with crude instruments and without anaesthetic. Among the more affluent in society it may be performed in a health care facility by qualified health personnel. WHO is opposed to medicalization of all the types of female genital mutilation.

The age at which female genital mutilation is performed varies from area to area. It is performed on infants a few days old, female children and adolescents and, occasionally, on mature women.

The reasons given by families for having FGM performed include:

  • psychosexual reasons: reduction or elimination of the sensitive tissue of the outer genitalia, particularly the clitoris, in order to attenuate sexual desire in the female, maintain chastity and virginity before marriage and fidelity during marriage, and increase male sexual pleasure;
  • sociological reasons: identification with the cultural heritage, initiation of girls into womanhood, social integration and the maintenance of social cohesion;
  • hygiene and aesthetic reasons: the external female genitalia are considered dirty and unsightly and are to be removed to promote hygiene and provide aesthetic appeal;
  • myths: enhancement of fertility and promotion of child survival;
  • religious reasons: Some Muslim communities, however, practise FGM in the belief that it is demanded by the Islamic faith. The practice, however, predates Islam.

Prevalence and distribution of FGM

Most of the girls and women who have undergone genital mutilation live in 28 African countries, although some live in Asia and theMiddle East. They are also increasingly found in Europe,Australia,Canadaand theUSA, primarily among immigrants from these countries.

Today, the number of girls and women who have been undergone female genital mutilation is estimated at between 100 and 140 million. It is estimated that each year, a further 2 million girls are at risk of undergoing FGM.

Current WHO activities related to FGM

  • Advocacy and policy development

A joint WHO/UNICEF/UNFPA policy statement on FGM and a Regional Plan to Accelerate the Elimination of FGM were published to promote policy development and action at the global, regional, and national level. Several countries where FGM is a traditional practice are now developing national plans of action based on the FGM prevention strategy proposed by WHO.

  • Research and development

A major objective of WHO’s work on FGM is to generate knowledge, test interventions to promote the elimination of FGM. Research protocols on FGM have been developed with a network of collaborating research institutions as well as biomedical and social science researchers with linkages to appropriate communities. WHO has reviewed programming approaches for the prevention of FGM in countries and has organized training for community workers to strengthen their effectiveness in promoting prevention of FGM at the grassroots level.

  • Development of training materials and training for health care providers

WHO has developed training materials for integrating the prevention of FGM into nursing, midwifery and medical curricula as well as for in-service training of health workers. Evidence based training workshops, to raise the awareness of health workers and to solicit their active involvement as advocates against FGM, have also been developed for nurses and midwives in the African andEastern Mediterraneanregion.

For more information contact:

WHO Media centre
Telephone: +41 22 791 2222
E-mail: mediainquiries@who.int

AFRICA: When culture harms the girls – the globalisation of female genital mutilation

NAIROBI, 1 March 2005 (IRIN In-Depth) –

 

(March 2005) – Female Genital Mutilation (FGM) is a surgical procedure performed on the genitals of girls and women in many parts of the world. The term FGM covers a range of procedures, which are also referred to as female circumcision and introcision.

FGM is found extensively in Africa and is also indigenous to other parts of the world. The age and time at which FGM is practised differs from community to community, and can be carried out from as early as a few days after birth, to immediately after the birth of a woman’s first child. One of the notable trends in global FGM today is the progressive lowering of the age at which girls undergo the practice.

Among communities that practise FGM, the procedure is a highly valued ritual, whose purpose is to mark the transition from childhood to womanhood. In these traditional societies, FGM represents part of the rites of passage or initiation ceremonies intended to impart the skills and information a woman will need to fulfil her duties as a wife and mother.

The function of this practice, whether mild or severe, is ultimately to reduce a woman’s sexual desire, and so ensure her virginity until marriage. The more extensive procedure, involving stitching of the vagina, has the same aim, but reducing the size of the vagina is also intended to increase the husband’s enjoyment of the sexual act.

Discussions, conducted for the purposes of this report, with women who have undergone the procedure, revealed that penetration was almost always difficult and painful, even for the man, when women had undergone the more extreme forms of FGM.

Certain communities carry out FGM for religious reasons, believing that their faith requires it; this is particularly true of Muslims who adhere to the practice. Other communities consider female genitalia to be ugly, offensive or dirty, and thus the removal of the external genitalia makes a woman more hygienic and aesthetically pleasing. Some subscribe to the notion that FGM enhances a woman’s fertility, and the chances of her children’s survival.

All members of communities practising FGM have a role in perpetuating it. Families of girls or women who undergo FGM support it because it makes their daughters marriageable – the operation ensures that their daughters will have ready suitors and a satisfactory bride price.

In these communities, no eligible man would consider marrying a girl who has not undergone the procedure, so FGM makes a woman culturally and socially acceptable. It is in this important way that female genital mutilation is supported and encouraged by men.

Women in the community have a role too, as it is they who arrange for and perform the operation. Typically, the procedure is arranged by the mother or grandmother and, in Africa, is usually performed by a traditional birth attendant, a midwife, or a professional circumciser.

In communities practising FGM there is literally no place for a woman who has not undergone the procedure. Such societies have sanctions, which are brought to bear on the woman and her family, ensuring that the woman’s relatives enforce compliance. Other circumcised girls will no longer associate with her. She is called derogatory names, and is often denied the status and access to positions and roles that ‘adult’ women in that community can occupy. Ultimately, an uncircumcised woman is considered to be a child.

In traditional societies that offer women few options beyond being a wife and a mother there is great pressure to conform. Women who lack the education to seek other opportunities are doubly constrained in terms of the choices open to them. These women also typically come from communities that do not have alternatives to the traditional economy and modes of production, such as farming, fishing or pastoralism.

Even educated women from such communities are often faced with the FGM dilemma for themselves and their daughters. In Kenya, a female member of parliament (MP) had to face her earlier decision not to be circumcised when she made the choice many years later to run for public office. Her opponents used the fact that she was not circumcised to challenge her eligibility to hold a position that “only adults” could occupy. The MP’s name is Linah Kilimo and today she is a minister in Kenya’s National Rainbow Coalition government.

FGM in a Global Society

In the modern world few places exist in isolation, untouched by other cultures. The creation of nation states, which brought together many communities within common borders, as well as the forces of globalisation, have contributed to the blurring of boundaries in all societies.

Institutions that bring new norms in religion, national policy and legislation, and on a more individual level, education and intermarriage, create new options for societies. Sociocultural clashes arise as communities, ideas and cultures attempt to blend.

The dilemma facing people in this newly globalised world is showcased by the experience of one Senegalese couple. The woman, from a non-circumcising community, married into a society whose FGM prevalence was 70 percent. From the outset, the couple agreed that they would not circumcise their two daughters. The man’s family, however, was insistent that the girls undergo the ritual and, realizing that this was no idle threat, the couple barred their daughters from visiting the man’s family unescorted, lest the girls be forcefully abducted and cut, as is common when parents reject the practice. An additional, chilling threat awaited the wife – her sisters-in-law vowed that though she remained uncircumcised in life, they would circumcise her in death.

Different Forms of FGM

1. Type I (commonly referred to as clitoridectomy)

Excision (removal) of the clitoral hood, with or without removal of all or part of the clitoris.

2. Type II (commonly referred to as excision)

Excision (removal) of the clitoris, together with part or all of the labia minora (the inner vaginal lips). This is the most widely practised form.

3. Type III (commonly referred to as infibulation)

Excision (removal) of part or all of the external genitalia (clitoris, labia minora and labia majora), and stitching or narrowing of the vaginal opening, leaving a very small opening, about the size of a matchstick, to allow for the flow of urine and menstrual blood. Also known as pharaonic circumcision.

4. Type IV (Unclassified/Introcision)

Pricking, piercing or incision of the clitoris and/or labia:

Stretching the clitoris and/or labia
Cauterisation by burning of the clitoris and surrounding tissues
Scraping of the vaginal orifice or cutting of the vagina
Introduction of corrosive substances into the vagina to cause bleeding, or introduction of herbs into the vagina to tighten or narrow it
Any other procedure that falls under the definition of female genital mutilation

Type 1 and type 2 operations account for 85 percent of all FGM. Type 3 is common in Djibouti, Somalia, Sudan and parts of Egypt, Ethiopia, Kenya, Mali, Mauritania, Niger, Nigeria, and Senegal. Type 3, also known as pharaonic circumcision, is extremely severe and involves binding a woman’s legs for approximately 40 days to allow for the formation of scar tissue. Many of these communities use adhesive substances such as sugar, eggs, and even animal waste on the wound to enable it to heal.

The excisor often has to reopen the vagina to allow for easier childbirth, and then re-stitch it after birth, leaving it as small as before, or slightly larger to reduce painful intercourse. Frequently the excisor is called on a girl’s wedding night to open her up so she is able to consummate her marriage.

Health complications associated with FGM

Although it is widely known that FGM can have devastating and harmful consequences for a woman throughout her life, because most communities practising it are very poor and do not have access to modern health facilities, medical emergencies arising from FGM are common, and often lead to death.
A doctor from theFistulaHospital talks about the immediate and the long term health consequences of FGM.Credit: IRIN

A doctor from the Fistula Hospital talks about the immediate and the long term health consequences of FGM.
Credit: IRIN

 

It is difficult to determine the actual numbers of women who die from FGM-related complications, given the highly guarded nature of the practice. Medical record-keeping systems are also rarely configured to record FGM and FGM-related complications as causes of death.

The health problems a girl can experience are largely dependent on three factors.

First, the severity of the procedure: girls and women who undergo type II and type III are likely to experience more severe health complications, but health consequences for type I have also been widely reported.

Discussions with a doctor on the possible medical effects of type I FGM found that complications were most evident during childbirth, due to the reduced elasticity of the vagina caused by scar tissue formed as a result of the surgery. To compensate for the reduced elasticity during childbirth, tiny tears are caused around the vagina. These are too small to stitch, and end up forming more scar tissue, compromising the vagina’s elasticity even further. Labour becomes longer and more painful with each subsequent birth. The tears themselves predispose the woman to infection, while her ability to experience sexual satisfaction is undermined, as the tearing leads to an ever-loosening vagina.

Second, the sanitary conditions in which the procedure is performed, and the competence of the person who performs it: most circumcisers are professionals with years of experience, but the tools and sanitary conditions of their trade are often rudimentary at best, with knife-like implements or razor blades used as the basic surgical instruments.

Close adherence to traditions that dictate what type of instrument is suitable do not allow for innovation, or the adoption of new, more suitable instruments that may be available. Typically, the circumcision ceremony takes place once a year and all eligible girls within a community are cut on the same day, using the same instrument – without the benefit of sterilisation between procedures – thus increasing the chances of infection, and the risk of exposure through such practices to HIV/AIDS.

Third, the health of the girl or woman undergoing the procedure, and her ability to heal and resist infection passed on by the procedure, is critical: if a woman is prone to infection, or has a poor immune system, she has a greater chance of becoming infected. Literally, only the strong survive.

The secret nature of FGM poses a great threat to the health of girls and women who undergo it. It is highly confidential, and outsiders are strictly prohibited from having any contact with the girls and women during and after the ceremony. Therefore, most of them have no access to a medical professional, should they need one during or after the procedure.

The 40-day isolation that characterises type III FGM, for example, means a woman might die of infection before she ever gets the chance to receive proper medical care. When qualified medical personnel perform FGM in the sanitary conditions of a hospital, the risk of infection may be reduced, but the long-term consequences remain.

Some immediate physical problems resulting from FGM are:

1. Bleeding (often haemorrhaging from rupture of the blood vessels of the clitoris), sometimes leading to death

2. Post-operative shock

3. Damage to other organs, resulting from the lack of surgical expertise of the person performing the procedure, and the aggressive resistance of the patient when anaesthesia is not used

4. Infections, including tetanus and septicaemia, through using unsterilised or poorly disinfected equipment

5. Urine retention caused by swelling and inflammation

Some longer-term consequences include:

1. Chronic infections of the bladder and vagina:
– in Type III, the urine and menstrual blood can only leave the body drop by drop
– the build-up inside the abdomen and fluid retention often cause infections and inflammation that can lead to infertility
– infections and inflammation that can lead to infertility

2. Dysmenorrhoea, or extremely painful menstruation

3. Excessive scar tissue at the site of the operation

4. Formation of cysts on the stitch line

5. Childbirth obstruction, which can result in:
– the development of fistulas
– tearing of the vaginal and/or bladder wall
– chronic incontinence

6. Risk of HIV infection. (There is a growing speculation of a potential risk of HIV/AIDS associated with the procedure, especially when the same unsterilised instruments are used on multiple girls, but this has yet to be scientifically proven.)

7. Reinfibulation must be performed each time a child is born. When infibulation (Type III) is performed, the opening left in the genital area is too small for the head of a baby to pass through. Failure to reopen this area can lead to death or brain damage of the baby, and death of the mother. The excisor must reopen the mother and re-stitch her again after the birth. In most ethnic groups the woman is re-stitched as before, leaving the same tiny opening. In other ethnic groups the opening is left slightly larger to reduce painful intercourse. (In most cases, not only must the woman be reopened for each childbirth, but also on her wedding night, when the excisor may have to be called in to open her so she can consummate the marriage.)

There is a dearth of scientific studies on the psychological effects of FGM on girls and women. In the course of conducting research for this study, discussions were held with some women who had undergone one or other form of FGM. This information does not claim to be scientific, nor is it a substitute for a scientific approach, but it does begin to provide some insights on the possible psychological impact of FGM on survivors.

Some of the psychological impacts of FGM appear to be pavlovian in nature and effect:

– women who have undergone any form of FGM or its attendant painful rituals are so traumatized that they can only associate their genitals with pain and possible death from childbirth, of which there is always a much higher possibility than with uncircumcised women
– the idea of sexual intercourse as a pleasurable activity is inconceivable for most of them

The complexity of the psychological effects of FGM on women is demonstrated by the stories of Jane and Hawa, who underwent type 2 (excision) and type 3 (infibulation) FGM respectively.

Jane’s Story

Jane comes from a community in Kenya which practises type II FGM (excision), where the compliance rate is 97 percent. She is from an educated family and has a PhD. Her husband is equally highly educated. They have two children.

According to the customs of her community, Jane underwent the procedure at the age of 14. She discussed how sex had always been an unpleasant chore for her, and although she no longer experiences any pain, she has no sexual response and sex has no meaning for her.

Jane also spoke of the difficult childbirth she experienced, which she attributes to the circumcision. She is grateful to have an understanding husband who does not demand more than the two children they have. Her experiences convinced both her and her husband that their daughter must not go through the procedure.

Hawa’s Story

Hawa comes from Eritrea, a country in the Horn of Africa with a 90 percent compliance rate, practising types 1, 2, and 3 FGM. She is from a community that performs type 3 (infibulation). Hawa has lived in the United States since the 1980s, when she fled political persecution in her homeland.

She is now a naturalised American citizen, holding a doctorate and teaching at a University in the US, where she is a widely published and respected scholar. Hawa is divorced from a fellow Eritrean and has one child, a six-year-old girl.

She told IRIN of the devastating psychological effects she believes FGM has had on her, commenting that although she retained the ability to experience sexual pleasure, she experienced it in a distant, muted form. The act of sex has never brought her enjoyment, and she believes this contributed to the breakdown of her marriage.

However, when questioned about whether or not she would circumcise her daughter, Hawa revealed an interesting ambivalence. Before she had borne a child, she was clear that FGM was a terrible practice, which should be eliminated. Today, as the single mother of a girl she is bringing up in America, she has tempered her opposition to FGM somewhat.

Her concern comes from what she perceives as the highly sexualised community in the US – everywhere there are images of sexual freedom and images that objectify the role of women as sexual beings. Among the African American community in particular, sexual freedom has been taken to an extreme in which young girls often have children with more than one father. Inevitably, their focus on achievement in other areas, such as education, career and so on, is compromised. Many of these teenage mothers swell the ranks of the welfare system.

Hawa wants everything for her daughter, and although she is not an indigenous African American, she and especially her daughter, are perceived as African American, and subject to many of the same pressures and limitations. Further, she feels, the image of African Americans has been glamorised in music, the media and film – “this community is probably the most imitated by young people the world over”.

In such an environment, the prospect of her daughter’s full-blown sexuality frightens Hawa. She sees it as a potential Achilles’ heel, which could lead her daughter down the path of low achievement, early pregnancy and welfare dependence. Incredible as it may seem, Hawa is adamant that an FGM procedure guaranteed to reduce her daughter’s sexual urges to a shadow looks attractive.

FGM and Religion

FGM is often associated with Islam, and there are people who believe that Islam sanctions it. The fact that type I is also called the ‘Sunna’ procedure (meaning ‘following the Prophet’s tradition’) is often used as evidence for this contention. However, it is found among both Muslim and Christian populations, and is a cultural practice that predates both religions. Type 3, or ‘infibulation’, also known in Sudan and Ethiopia as the ‘pharaonic procedure’, was most likely practised in ancient Egypt.

Prevalence of FGM

Posted on June 4, 2012, in Categorized and tagged , , , , , , , . Bookmark the permalink. 1 Comment.

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