Category: Research

Asia Network to End FGM/C calls for your participation

On By SahiyoIn Bangalore, Bohra Resolution Letters Against Khatna/FGC, India, Kerala, Malaysia, Mumbai Khatna research, News, Pakistan, Research, sexual health, Singapore, Somalia, Sri Lanka, survey, United Kingdom, United StatesLeave a comment

Malaysian NGO Asian Pacific Resource and Research Centre for Women (ARROW) and British charity Orchid Project are jointly developing a new Asia Network to End FGM/C, to strengthen movements to end the practice of FGC in Asian communities.

To shape this network and its priorities, all interested organisations, activists, and stakeholders working in the region on FGM/C or related issues in Asia are invited to fill out this consultation survey. The closing date for this survey will be 22nd December 2019.

Utilizing Participatory Storytelling to Educate – A session at APHA 2019

On By SahiyoIn conventions/conferences, Events, health, News, Research, Sahiyo staff, Sahiyo Stories, United States, Voices to End FGM/C, Workshops and seminarsLeave a comment

1On Nov 4, 2019, Sahiyo’s co-founder Mariya Taher took part in a round-table session at the American Public Health Association’s (APHA) Annual Conference in Philadelphia, Pennsylvania to discuss the Voices to End FGM/C project. Participants were able to view a sample of the digital stories created by survivors. They were also able to learn how by utilizing participatory storytelling methods, we can educate communities, health professionals, and policymakers on female genital cutting. For more information, visit APHA’s website.

The complexities of female genital cutting in Singapore: Part IV

On By SahiyoIn advocacy, Complexities of female genital cutting in Singapore, Complexities of FGC in Singapore, health, human rights, Malay, Research, Saza Faradilla, Singapore, Trauma1 Comment

Concluding thoughts on the practice in Singapore

By Saza Faradilla

Country of Residence: Singapore

This blog post is the fourth in a four-part series about female genital cutting (FGC) in Singapore. This fourth installment provides a final analysis and concrete methods of engaging with discourses on FGC at the individual, community, governmental and international levels. Read part one here. Read part two here. Read part three here. 

In this research, I have contextualised the type of cut, stakeholders involved, on-going discussions on FGC locally and internationally, and FGC’s hiddenness. I hope this allows for a deeper understanding of the specific and unique type of FGC and the situation surrounding it in Singapore. My discussion of the reasons for FGC in Singapore is also non-exhaustive, but to my interlocutors, cleanliness, religion, tradition, and the control of female sexuality, are some of the most pertinent to their lived experiences. To the best of my ability, I have tried to represent fairly the perspectives and opinions of the various people with whom I spoke. In her book, The Twilight of Cutting, Saida Hodzic accurately pointed out that “differently positioned women take a variety of political positions toward cutting/anti-cutting campaigns, and the larger governance of their lives.” In these concluding paragraphs, I will further explore the continuity of this practice, ways to encourage productive and meaningful discourse about it, as well as policy implications.

Photo by luizclas on Pexels.com

FGC has been an unquestioned tradition in Singapore for centuries. I believe we need to place a critical lens on FGC and question the motivations of this practice. While taking into account the possible individual, family and social meanings that have been attributed to FGC, it is also important to question its necessity and impact on a young girl. I end most interviews by asking interlocutors if they think FGC will continue, and 70% of my interlocutors answered in the negative. Conversations about FGC and debates on it have been ignited, and more young parents are questioning the cut’s necessity. Once parental pressure is no longer a factor and this procedure has skipped a generation, FGC will be much harder to revive or continue. Sometimes the type of FGC done in Singapore does not leave visible scars or markings. Those against FGC have said that they know of young parents who choose to say their daughter has been cut even if she hasn’t, and no one is any wiser.

It is also important to take note of the vernacular languages that are used when discussing FGC, and determining the appropriate ways to debate FGC in the Malay community. Currently, the debates on FGC happen amongst specific circles of young Malays who are highly educated. It is important to engage with the older generation and those who may not have access to tertiary education about this practice. It is only in sincere conversations, which aim to listen, engage in dialogue, and not necessarily debate that perspectives will shift. 

When I first found out about the FGC performed on me when I was a baby, and questioned my parents about it, they insisted that it was mandatory and that they did it for my own good. They said FGC was necessary for “religious and health reasons, and so I won’t be adulterous.” These are similar to the reasons my interlocutors shared as well. As I went about my research, and interviewed religious leaders, medical practitioners, and feminist activists, I slowly clarified my parents’ beliefs, and today they no longer see it as mandatory (“though still good to do”), but I do think chipping away at their long-held beliefs has been successful. Similar to my interlocutor’s sharing that the language of female sexuality, children’s rights and consent is foreign or even “Western,” I think it is important that we find the right language and vocabulary to discuss these issues in Malay so that it is more readily accessible.

I hope to see more people and stakeholders engaging in these conversations. In particular, I hope this blog post would encourage medical practitioners, religious leaders, religious bodies and health ministries to enter the conversation about FGC in Singapore. From my ethnography, there are various undercurrents and rumors of the perspectives and policy positions engaged by these stakeholders. For instance, a medical practitioner said that there is a register of doctors who perform it and who have informally agreed to abide by a set of guidelines in order to standardize the procedure. However, neither this guideline nor register is publicly available. Having them come out with actual statements would clear various misconceptions about FGC’s necessity and its health and religious implications. 

I would urge the Islamic Religious Council of Singapore (MUIS) to replace the fatwa it removed with a new one, so that religiously, the Muslim community can be assured of the ruling for FGC. The Ministry of Health (MOH) and Muslim Healthcare Professionals Association (MHPA) also have a responsibility to the larger Singapore community to ensure our safety and health. Because all doctors are registered and regulated under MOH, it is up to MOH to determine if FGC is aligned with the medical oath to do no harm. At the same time, it would be interesting to find out the positionality of medical practitioners performing FGC. Do they believe it to be necessary? Do they abide by the guidelines stated, especially given the spectrum of FGC that my interlocutors underwent? What are their specific reasons for performing FGC? Silence only breeds confusion. It is definitely time for the religious and health authorities to step up and clearly state their positions on FGC in Singapore. There is the very real fear that if FGC were banned in Singapore and practitioners disallowed from practicing it, this would lead to FGC being performed underground, where conditions are much less hygienic and can be more harmful. But, if the relevant authorities can counter the health, religious and female promiscuity reasons given for FGC, this practice will be regarded as unnecessary and might no longer be practiced here.

According to Hodzic, “Hahn and Inhorn testify to the persistence of one of the founding principles of applied medical anthropology, which is the notion that anthropology can and should provide cultural knowledge necessary for improving public health and health care.” I hope this research has provided a holistic, balanced, and informative understanding of the reasons for FGC in Singapore, and will be useful for religious leaders, medical practitioners, activists, and especially Malay women as we continue to critically analyze and discuss this practice.

Saza is a Senior Executive of service learning at Republic Polytechnic in Singapore. She recently graduated from Yale-NUS College where she spent much of her college life developing her thesis on female genital cutting in Singapore. A highly under-researched, misunderstood and personal issue, Saza sought to understand the reasons behind this practice. She ends her thesis by advocating for medical and religious leaders to step up and clarify the fatwas and medical criteria surrounding this procedure in Singapore. Saza is passionate about women’s rights and empowerment and seeks to assist marginalized populations. 

The complexities of female genital cutting (FGC) in Singapore: Part III

On By SahiyoIn advocacy, Complexities of female genital cutting in Singapore, Complexities of FGC in Singapore, health, human rights, Research, Saza Faradilla, SingaporeLeave a comment

Tradition and patriarchal elements of FGC  

By Saza Faradilla

Country of Residence: Singapore

This blog post is the third in a four-part series about female genital cutting (FGC) in Singapore. This third installment explains some of the reasons the interlocutors provided for practicing FGC, including tradition and the control of female sexuality within patriarchy. Read part one here. Read part two here.

Reasons for FGC: Tradition

Many of my interlocutors allude to adat or Malay tradition when asked for reasons they practice FGC. They view it as a normalised and long-established cultural tradition, which is often performed without question. There are also some interviewees who believe this leads to the unity of the community and is intrinsic to the Malay identity. However, those who are unsupportive of FGC question the premise of this tradition and that if there is no rational or logical reason behind it, “it doesn’t make sense to blindly follow it.”

macro photography of purple flowers
Photo by Carissa Bongalosa on Pexels.com

According to Gabriele Marranci, “FGC is transmitted generation after generation as an ordinary act of Malay Muslim identity. It can be considered an integral part of Malay Muslim birth rituals and is linked to a specific Malay Muslim identity. Malay Muslims often say, “We do this because it is our tradition. It is something that all Malay Muslims share both here in Singapore and in Malaysia.” Indeed, many of my interlocutors also agree that this practice has been very much normalised in Singapore. “This is tradition: sisters, granddaughters, daughters all do it, said Fauziah, an interviewee. “This is a strong Malay tradition, we can encourage it, but don’t force. It’s a natural next step.”

This tradition is usually passed down a matrilineal lineage, with the grandmothers and mothers of the family encouraging and sometimes even forcing their children to cut their granddaughters. This could be due to the division of labour in Malay families, where women usually take care of matters concerning the children’s development and well-being, while the father provides the economic means to raise them. As such, many men would leave the decision-making regarding the execution of FGC to their wives. They might not even want to know anything about it. It is considered too insignificant for fathers to have a stake or say in the issue.

However, those who are against FGC view the unquestioning nature of this practice as symptomatic of a larger problematic trend of traditionalism within the Malay community. “People do not question or discuss this, and it is a problem that it is not critically discussed,” said Ermy, another interviewee. “People just do it blindly, and so this might cause harm and injury.” Many Malay families continue this practice in an inadvertent manner, and one that is continued not because it is “actively better” but because it is just not worse. As such, FGC is simply passed down and accepted rather than its rationale being questioned or challenged.

At the same time, I noticed that amongst those interviewed, younger people (around the ages of 20-40 years old) are unwilling to perpetuate FGC if the sole reason is tradition. “If it’s just based on tradition, it doesn’t make sense to do something like that,” Hanisah, a 38-year old teacher, said. “Culture is not important to keep if it is causing pain.” Many younger Malay Singaporeans do not view FGC as something that possesses active benefits, and therefore, they do not see the point or logic in continuing it.

Control of female sexuality within patriarchy

Seven out of my eight interlocutors who support FGC readily admit that the cut is important to control women’s sexuality. According to them, FGC is to “cut down on the girl’s sexual desires (nafsu).” They suggest that “by nature, women have a higher sex drive, and so this is to lower chances of sex before marriage.” When asked to explain precisely how FGC leads to lowered sexual desire, or how this relationship can be measured, most interviewees are uncertain. In fact, I had a rather drawn-out conversation (complete with drawings on both our ends), about how the removal of the clitoral hood actually reveals the clitoris more, and so that logically follows that it is more easily stimulated, and therefore, might lead to higher sexual satisfaction. Even though supporters of FGC might be unsure how FGC affects sexual desire, the principles they hold for that view is important to acknowledge.

Believing that FGC is important to control female sexuality might be reflective of the prejudices and biases against women in the Malay community. These traditional values may have arisen because women are traditionally seen as the bearers of morality in societies. As such, it is important within the Malay community to ensure that women uphold important societal values and any potential for deviance is weeded out as soon as possible.

(The fourth and final installment will provide an analysis and concrete methods of engaging with discourses on FGC at the individual, community, governmental and international levels.)  

Indiv - SazaSaza is a Senior Executive of service learning at Republic Polytechnic in Singapore. She recently graduated from Yale-NUS College where she spent much of her college life developing her thesis on female genital cutting in Singapore. A highly under-researched, misunderstood and personal issue, Saza sought to understand the reasons behind this practice. She ends her thesis by advocating for medical and religious leaders to step up and clarify the fatwas and medical criteria surrounding this procedure in Singapore. Saza is passionate about women’s rights and empowerment and seeks to assist marginalized populations as much as possible.

 

Here’s what a new study says about female genital cutting in Malaysia

On By SahiyoIn health, human rights, Malaysia, ResearchLeave a comment

By Zahra Qaiyumi

Female genital cutting (FGC) is prevalent among Muslim women in rural Malaysia, and many of them believe the practice is a religious obligation. Ironically, several religious leaders in the country insist that female genital cutting is not an Islamic requirement at all.

two women in white hijab veils
Photo by mentatdgt on Pexels.com

These are some of the major findings of a new research study on FGC in Malaysia, conducted by Abdul Rashid and Yufu Iguchi in 2018.

The study was conducted in two rural majority Muslim areas of Kedah and Penang in the Northern region of Peninsular Malaysia. The study consisted of survey data collected from 605 participants, focus groups held with a smaller subset of the participants, and interviews with 8 traditional practitioners who perform or performed FGC. Additionally, 2 interviews were conducted with Muftis, who are religious scholars or jurists qualified to issue Islamic legal opinions in Malaysia.

The major findings of the study are below.

Prevalence and type of FGC:

    1. Almost all participants (99.3%) had undergone FGC at an early age and wanted FGC to continue.
    2. The predominant form of FGC practiced in Malaysia is type IV. The paper defines this as the tip of the clitoris being nicked using a pen-knife or razor.

Age at which FGC was conducted:

    1. The median age of the participants at the time of FGC was 6 years old, which is also the median age the participants felt was the suitable age FGC should be performed. However, the authors suggest that children as young as 2 months old undergo FGC in Malaysia.

Medicalization of the practice:

    1. In general, older participants had FGC performed on them by traditional practitioners as compared with younger participants.
    2. Younger participants were of the opinion that doctors should conduct FGC as compared with older participants who preferred traditional practitioners.
    3. More participants from the younger group would permit doctors to perform FGC on their children as compared with the older group.
    4. More of the practice is being conducted in clinics by physicians because of the scarcity of traditional practitioners.

Reasons for the practice and its continuation:

    1. The most common reasons for FGC among the participants surveyed are hygiene (25.0%), health (24.0%) and religious obligation (23.0%).
    2. A majority of the participants believe FGC is a requirement in religion (wajib), whereas the traditional practitioners and Mufti’s who are responsible for issuing edicts related to religious matters say it is not a religious requirement.

Future directions:

It is encouraging that traditional practitioners and Mufti’s believe FGC is not a religious requirement. Perhaps this can be used as a tool to better educate the community about the practice of FGC and ultimately bring an end to the practice.

Read the complete study on FGC in Malaysia here.

The complexities of female genital cutting (FGC) in Singapore: Part II

On By SahiyoIn advocacy, health, human rights, Research, Saza Faradilla, SingaporeLeave a comment

Part II: Cleanliness and religious reasons for FGC

By Saza Faradilla

Country of Residence: Singapore

This blog post is the second in a four-part series about female genital cutting (FGC) in Singapore. This second installment explains two of the five reasons raised by my interlocutors about FGC in Singapore: cleanliness and religion. (Read part one here.)

While medical practitioners confirmed that the cut has no effect on cleanliness, Muslim interlocutors believed it still helps with cleanliness, which was pivotal to their religiosity. Religiously, FGC is expounded upon in a hadith (record of the traditions or sayings of the Prophet Muhammad), but there have been various interpretations of this hadith. Institutionally, the Islamic Religious Council of Singapore (MUIS) has avoided releasing any official statements on the religious mandate of FGC for the Muslim community.

grayscale photography of woman kneeling on area rug
Photo by rawpixel.com on Pexels.com

This second installment explains some of the reasons the interlocutors provided for practicing FGC – cleanliness and religion.

Reasons for FGC

Cleanliness

The first reason some interlocutors (especially those who support FGC) shared is that of cleanliness. They believe a part of the vagina traps dirt and needs to be removed, which makes for easier cleaning. To them, this high hygiene standard is particularly crucial for prayer. The evocation of religion is significant here because it shows that my interlocutors actually view religion as the reason for FGC, and that cleanliness happens to fall under that umbrella. However, the practitioner I spoke to disagreed and said that there are no medical benefits to FGC because the “cut is so small, it doesn’t affect anything”. I believe the perceived idea of cleanliness and purity arises out of a misunderstanding of the cut and its specificities (amount cut, area cut etc).

Religion

According to Amnesty International, “FGC predates Islam and is not practiced by the majority of Muslims, but has acquired a religious dimension”. For most of my interlocutors, their belief in Islam is an extremely important reason for FGC.

I will first explore the ways my interlocutors linked FGC to Islam through the evocation of several hadiths and mazhab (Islamic jurisprudence, usually referring to specific Islamic teachers), and then go on to engage with different readings of these hadiths, and also discuss the position that religious authorities and leaders have taken with respect to FGC in Singapore. One of the hadiths that was alluded to by many of my interlocutors is the one told by Al-Baihaqi:

“There are a group of people who allow cutting for women by referring to the hadith where Um Habibah was cutting a group of women. On one day, Prophet Muhammad visited her and found a knife in her hand (for cutting). Prophet asked and confirmed that the function of that knife is really for cutting. Um Habibah asked, “Is cutting for women haram (forbidden)?” Nabi (Prophet) Muhammad said, “Oh women of Ansar, do the cutting but be sure to not cut too much.”

My interlocutors who support FGC said this hadith provided a clear approval of FGC from Prophet Muhammad, as he did not try to stop Um Habibah from cutting other women, but actually endorsed it. Not all my interlocutors were able to provide exacting details of this account, and they mention the details to varying extents. Most know of this as hearsay.

On the other hand, protestors of FGC interpret the hadiths and religious instructions differently. With reference to the same hadith above, Dalia said, “The fact that Prophet Muhammad came across this proves that it was already an Arabic tradition that was pre-Islamic. A lot of things that were already happening, the Prophet did not stop. He was trying to win over the Qurayshi people and so he could not exactly stop them. But the fact that he said to not take much means he already disapproves of FGC”.

I was keen to interview someone from MUIS (Islamic Religious Council of Singapore). Although repeated emails to them went unanswered, I found a past fatwa  where MUIS strongly endorses FGC as part of the Islamic tradition.

“According to the majority of ulama, circumcision is compulsory for men and women. It should be done early in life, preferably when still an infant, to avoid complications, prolong [sic] pain and embarrassment if done later in life. Any good Muslimah doctor can perform circumcision for women.”

However, this fatwa was removed from the website  in recent years, and MUIS has not since provided a reason for the removal or replaced it with another fatwa.

From my research, it is evident that religion is a significant reason for those who practice FGC. Indeed, religion is used to justify FGC around the Muslim world. It is notable that the same hadith is interpreted very differently by both proponents and opponents of FGC. In my concluding paragraphs, I will discuss the policy implications of MUIS taking an ambiguous stance toward FGC and urge them to produce a clear directive.

Part III of this series will focus on more reasons for the justification of FGC, including tradition and the control of female sexuality within patriarchy. 

Indiv - Saza.jpg

 

Saza is a Senior Executive of service learning at Republic Polytechnic in Singapore. She recently graduated from Yale-NUS College where she spent much of her college life developing her thesis on female genital cutting in Singapore. A highly under-researched, misunderstood and personal issue, Saza sought to understand the reasons behind this practice. Saza is passionate about women’s rights and empowerment and seeks to assist marginalized populations as much as possible.

Learning new methods of data analysis to conduct research on female genital cutting

On By SahiyoIn advocacy, Cameron Adelman, health, human rights, ResearchLeave a comment

By Cameron Adelman

A major finding of the research project I have been conducting on the social and emotional correlates of female genital cutting (FGC) is that in communities that are more supportive of FGC, there are more reasons to support the practice. Some reasons in support of FGC include the practice as a coming of age ceremony, being promoted by religious/spiritual/community leaders, and being used to preserve a girl’s virginity and to promote her marriageability. Additionally, women are more likely to suffer social and emotional consequences such as having less social support and more negative feelings surrounding the community’s beliefs.

purple and white orchid in shallow focus lens
Photo by Pixabay on Pexels.com

In my last blog post, I talked about the conception of my research project on risk factors for female genital cutting and social/emotional issues related to the practice, and the divergence of the project from what I had originally envisioned. The majority of my data and the statistical analyses I ran were from the Demographic Health Surveys Program (DHS). The analysis of the DHS data pointed toward a number of social, emotional, and physical issues that appeared to be more common in women who had experienced FGC, as well as a number of beliefs that were more common in women who had experienced FGC, and some socioeconomic factors that appeared to be related. From this information, I was able to go through my own data and select the information that could help support a working theory of increased stress and emotional concerns for women who had experienced FGC. My data was also helpful for establishing a link between community attitudes and social/emotional wellbeing.

My analysis of the data Sahiyo led to a few key findings:

  • First, the number of cultural reasons supporting FGC was positively correlated with how supportive a community is of FGC. With a positive correlation, this means that as one factor increases, the other does as well, so the more reasons a participant selected for why FGC was a part of her culture, the more supportive her community was likely to be of FGC.
  • Second, the number of cultural reasons for why FGC is practiced was negatively correlated with how the community attitude toward FGC made a participant feel. With a negative correlation, this means that as one factor increases, the other decreases. The more reasons a participant selected for why FGC was a part of her culture, the more negatively she felt about her community’s supportiveness of FGC.
  • Third, how supportive a community is of FGC was negatively correlated with how a participant felt about the community attitude, and how many personal sources of support a participant listed that she had available to her.
  • Finally, the number of personal sources of support a participant had was positively correlated with how a participant felt about her community’s attitude toward FGC.

Despite the immense help of Sahiyo, I had only 11 participants of my own after sending out a survey to gather data, which was insufficient for a full research paper. This limit is what led me to the DHS. After seeing how significant the findings from the DHS data were it became clear that the best route forward was to take the aspects of my data from Sahiyo members about community attitudes and use that to supplement my findings from DHS.

With my data analysis completed, I’ve begun the work of writing the paper that will hopefully be submitted for publication in a research journal at the end of the semester. The results so far suggest unique challenges to supporting women in communities that still actively promote and support FGC. I hope with the work I have done that it can lead to improved services for women in areas both supportive and unsupportive of female genital cutting.

More on Cameron:

IMG_5046Cameron Adelman is a senior neuroscience major and women and gender studies minor at Wheaton College in Massachusetts. He has been working on his research project about social and emotional effects of FGC since last year. The findings of his research among women who have experienced FGC suggest a number of sociocultural confounds in trying to develop and deliver support systems for women living in practicing communities. Cameron’s hope is to help advise best practices that take these factors, as well as additional risks to wellbeing, into account.

The Disturbing Trend of Medicalising Female Genital Mutilation

On By SahiyoIn Activists, advocacy, health, human rights, medicalization, Mental Health, Research, Trauma2 Comments

by Lorraine Koonce-Farahmand

In the Zero Tolerance campaign to end Female Genital Mutilation (FGM), what has been noted is the arc of progress. Increasingly, women and men from practising groups have declared support for ending FGM; and in several countries, the prevalence of FGM has decreased significantly. A BMJ Global Health study reported that the rates of FGM have fallen dramatically amongst girls in Africa in the last two decades. Using data from 29 countries going back to 1990, the BMJ study found that the biggest fall in cutting was in East Africa where the prevalence rate dropped from 71% of girls under 14 in 1995, to 8% in 2016.  Some countries with lower rates – including Kenya and Tanzania, where 3-10% of girls endure FGM – helped drive down the overall figure. Nevertheless, UNICEF’s groundbreaking report shows that whilst much progress has been made in abandoning FGM, millions of girls are still at risk.

FGC infographics_3

Flourishing against this backdrop is the compromise of medicalisation of FGM that competes against progress in the Zero Tolerance Campaign. A disturbing number of parents are seeking out healthcare providers to perform FGM. According to the World Health Organization (WHO), medicalisation is when a healthcare provider performs FGM in a clinic or elsewhere. Such procedures are usually paid for under the assumption that medicalisation is not FGM, and is done to mitigate health risks associated with the practice. Consequently, in recent years, the medicalisation of FGM has taken place globally, particularly in Egypt, Indonesia, Kenya, Malaysia, Mali, Nigeria, Northern Sudan, and Yemen. In many of these countries, one-third or more of women had their daughters cut by medical staff with access to sterile tools, anesthetics, and antibiotics. The non-governmental organization, 28 Too Many has investigated the involvement of health professionals and has highlighted what must be done to reverse this trend. 28 Too Many reported that the medicalisation of FGM in Egypt is an enormous challenge. Currently, 78.4% of incidences of FGM in Egypt are carried out by health professionals. Egypt had the highest rate of health workers performing FGM at 75%, with Sudan at 50% and Kenya at 40%. A 2016 study by The United Nations International Children’s Emergency Fund (UNICEF) and the Africa Coordinating Centre for the Abandonment of FGM/C (ACCAF) also found that FGM is increasingly being performed by medical practitioners.   

Parents and relatives seek safer procedures, rather than outright abandon FGM. The medicalisation trend has conveniently forgotten that FGM violates women’s and children’s human rights to health, to be free from violence, to have the right to physical integrity and non-discrimination, and to be free from cruel, inhumane, and degrading treatment. The “just a nick” is essentially gender-based violence (GBV). What is being “nicked” is still part of a woman’s labia majora, labia minora or clitoris. The medicalisation of FGM perpetuates that women are inferior human beings. This is not in harmony with international human rights standards.

There is also clearly an economic incentive for promoting medicalisation. Medical personal perform it for financial gain under the premise that if the crux of the issue is the health side effects and pain, by using sterilised instruments and medication the problem has dissipated. The misguided assertion that medicalisation is a viable option is ignoring the fact that all types of FGM have been recognised as violating human rights. These rights that have been codified in several international and regional treaties mirror worldwide acceptance and political consensus at various UN world conferences and summits. Committees such as The Committee on the Elimination of All Forms of Discrimination against Women, (CEDAW), the Committee on the Rights of the Child, and The Human Rights Committee have been active in condemning FGM. Medicalisation goes against the principles enshrined in these treaties and conventions.

The disturbing medicalization trend continues to argue that this less severe form of FGM can protect girls and women from harm. This was echoed in The Economist article of June 18th, 2016, ‘Female Genital Mutilation: an Agonising Choice’. In the article, it was asserted that because three decades of campaigning for a total ban on FGM have failed, a new approach is warranted. The article advocated “nicking” of girl’s genitals by trained health professionals as a lesser evil. This reasoning was echoed in the Journal of Medical Ethics by two U.S.-based doctors, Dr. Kavita Shah Arora, Director of Quality, Obstetrics, and Gynaecology at the MetroHealth Medical Center in Cleveland, and Dr. Allan Jacobs, Professor of Reproductive Medicine at Stony Brook University. They wrote that “we must adopt a more nuanced position that acknowledges a wide spectrum of procedures that alter female genitalia.” They assert that they do not believe minor alterations of the female genitalia reach the threshold of a human rights violation. They also asserted that the nicking of the vulva and removing the clitoral hood should not be considered child abuse. They posit that by undergoing these acceptable procedures in the U.S. during infancy, girls can avoid the risk of being sent abroad for more extensive procedures.

These doctors and writers from influential respected journals are often held in high esteem by decision-makers, policy-makers, and experts. However, the advocation of medicalisation grotesquely undermines the hard and courageous work undertaken to end FGM worldwide. The medicalisation trend has ostensibly failed to recognise that the proposal of removing the clitoral hood and “just nicking” the vulva contradicts the WHO’s statement that there is absolutely no reason, medical, moral or aesthetic, to cut any part of these exterior organs.

There are compelling reasons why the medicalisation of FGM is fundamentally wrong.

  • The medicalisation is and would be carried out on young girls between infancy and the age of 15. Medicalisation is an attack against the sexual and psychological integrity of young girls. Many are not in a position to say no, unable to give informed consent or to effectively resist the practice.
  • Medicalisation reflects a deep-rooted inequality between the sexes and constitutes an extreme form of discrimination against women. In some communities in order to be married a female is not considered an adult and “marriageable” without undergoing FGM, which may be performed to define her gender and/or ethnic identity. In many African communities, marriage is a women’s predominate source of economic survival. The medicalisation trend reinforces and supports this lack of choice women must make in order to be accepted in their society.
  • Accepting certain types of FGM would lead to confusion for communities and health professionals. It will adversely affect the work done on raising awareness of FGM and prevention and protection of girls.
  • The risk of a well-founded fear of persecution would be seriously undermined for asylum seekers. Asylum seekers with potential claims for international protection, either for themselves or for daughters, could plausibly be denied refugee status if confusion is created on whether or not the type of FGM they would be potentially subjected to constitutes a well-founded fear of persecution.  

The medicalisation of FGM is not an appropriate response to the health risks associated with FGM. All FGM causes a variety of negative outcomes for the health and psychological well-being of women and girls. Medicalisation fails to eliminate long-term gynaecological and obstetric complications, as well as the lifelong emotional, psychological and sexual problems. It does not prevent the feelings of anxiety, betrayal, depression, low self-esteem, panic, phobia nor other psychological issues. As FGM has no proven medical benefits, as professionals who have sworn to the Hippocrates oath to do no harm, ultimately, it is unethical to contribute to the continuation of a procedure that is quite harmful and disabling for women. Medicalisation of FGM gives it an aura of normalcy, legitimacy, and acceptability. The mutilation of females is outrageous when considering that the alterations proposed are both traumatic and life-changing.

An additional concern of the medicalisation trend is the bleak message that removing a female body part for non-medical reasons is acceptable as it is just a “nick.” Who will be there to determine the measure of the “nick”? What part shall be nicked? The clitoral prepuces? The labia minora? Near the special receptacles of nerve endings that are clustered in the clitoris?  The skin of the inner surface of the labia? Is the medicalisation trend assuming that this undefined “nicking” by a chosen trained professional now is safe and correct?

The implication that it is just a nick obscures and trivializes the underlying degradation that this nick imposes on a woman and the senseless attack on women’s’ genitals for no other reason than that they are female. It reinforces the sense of inferiority on this already marginalised gender.

FGM is not open for debate without violating international law and medical ethics. As long as it is accepted in any form, FGM will thrive. Partial FGM is simply not acceptable. A nick is simply unacceptable.  The key phrase is zero tolerance.

More about Lorraine:

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Lorraine is is a British solicitor and a New York lawyer. She is currently an international law professor in the Anglo-American Law degree programme at the Universitié De Cergy where she lectures on gender law and human rights, and at the Universitié De Paris-Dauphine where she lectures on the Legal Aspects of Gender Violence. She is often an invited speaker on GBV and FGM. Recently, she was invited as a speaker to lead the medicalisation workshop at the End FGM European Network conference that was held in Paris.

 

The importance of creating a body of knowledge on female genital cutting

On By SahiyoIn Research, United StatesLeave a comment

By Cameron Adelman

My ultimate career goal is to work in sexual health with underserved populations. Access to sexual and reproductive health services is incredibly difficult in most states in the United States. It is even more difficult for people living in low-income areas, for the LGBTQIA community, for immigrants, and for people coming from non-Western cultures and perspectives. In designing a research project, these constraints to care services were something I wanted to focus on in some capacity. Genital cutting is a health concern most Western practitioners are unprepared to encounter. Considering the lack of research into psychological and sociocultural relationships to FGC, I felt even the small scale research I would be able to conduct as an undergraduate student could still have an impact by increasing the body of knowledge available.

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Photo by Janko Ferlic on Pexels.com

When I first started working on my project to explore some of the social and cultural factors impacting the quality of life for FGC survivors living in the United States, I was unprepared for the challenges in data collection I would face. I knew that some of the organizations I contacted to recruit participants might decline to participate, but I did not expect so many to not respond at all. The four organizations I originally selected to contact became twelve, and only one yielded any participant data.

My original aim was to collect data from thirty survivors. I figured this was a modest goal, and between the multiple organizations I had contacted that it would not be impossible. I have collected data from eleven survivors. After four months of managing communications between a dozen organizations, I collected just over one third of my initial goal. Even for women who had reached out to support services and organizations, there was still this barrier of stigma and shame preventing the kind of data collection I had hoped for.

The difficulties in data collection lead me to exploring large international databases for information from large scale surveys I could use in addition to my own survey results. I was determined not to let the struggles in data collection stop me from completing this project that had been in the works for over a year. If anything, the barrier in data collection only provided further evidence to the extent of the need for additional research. The taboo nature surrounding FGC and its impact on survivors will never improve if the body of knowledge on the subject remains so limited.

The direction my project has taken has revealed a cycle that keeps this field of research from advancing. The stigma surrounding FGC, the blame and self doubt many women feel about their experience with it, and the difficulties in speaking out against FGC in practicing communities makes collecting data from survivors extremely difficult. The lack of data and research about FGC makes it difficult to reduce the social attitudes and survivor guilt, and support survivors in efforts to speak out. In short, you cannot add to the body of research without data, but you cannot collect sufficient data because of the taboo nature, which an increased body of research could help improve.

From the little data I have been able to collect, there is a clear negative correlation between how supportive someone’s community is of FGC and how that makes women feel – the more supportive a community is of FGC, the more negatively a woman feels about that, and vice versa. Additionally, women in communities that are supportive or very supportive of FGC have had fewer sources of personal support than women in communities that are unsupportive or very unsupportive of FGC. This speaks to the unique challenges in reaching women living in FGC supportive/practicing communities for resources and support, compared to survivors who no longer live in FGC practicing communities. I am still intending to try to address through my research the unique constraints facing survivors in communities and areas supportive of FGC, and the additional social and emotional problems these women may face. I just have to think beyond the scope of the data I have collected through my survey.

As the direction of my research project has morphed and changed over the last few months, it has only served to emphasize the need for this kind of research. The social stigma and shame cannot be addressed if research is not available to speak to the needs and support necessary for survivors. As an undergraduate student, the scope of my research is limited, but I hope even that can be a step along the path to better understanding and support for survivors of FGC.

More on Cameron:

IMG_5046Cameron Adelman is a senior neuroscience major and women and gender studies minor at Wheaton College in Massachusetts. He has been working on his research project about social and emotional effects of FGC since last year. The findings of his research among women who have experienced FGC suggest a number of sociocultural confounds in trying to develop and deliver support systems for women living in practicing communities. Cameron’s hope is to help advise best practices that take these factors, as well as additional risks to wellbeing, into account.

 

Female Genital Cutting (FGC): Is it an Islamic Practice? (Part 2)

On By SahiyoIn Debangana Chatterjee, ResearchLeave a comment

By Debangana Chatterjee

Though often being referred to as an Islamic practice, Female Genital Cutting (FGC) precedes both Islam and Christianity. It is believed to have originated in the Pharaonic era of Egypt. Elizabeth Boyle, author of Female Genital Cutting: Cultural Conflict in the Global Community, mentions in the book that before the advent of Islam, Egyptians, who valued FGC (particularly infibulation), introduced a strong slave system and expanded it towards the adjacent geographic region. At the onset of Islam in the Egyptian controlled region, Islam asserted a stringent prohibition towards enslaving other Muslims. Hence, non-Muslim were continued to be used as slaves, and since FGC was done to these non-Muslim women slaves to increase their worth and value as slaves, FGC was by extension spread to other parts of Africa by the slave traders. This remains one of the driving factors behind the spread of FGC in Africa simultaneous to the rise of Islam.

Despite FGC predating Islam, the myth of it being an Islamic practice persists due to the impressions of virginity and purity remaining closely associated with the religion’s values. There are ample reasons to challenge the unnecessary association of the practice with the Islamic culture. First, FGC was common among the Egyptian Coptic Christians and a number of Tanzanian Christian communities. In fact, FGC was also reportedly performed on Western women in the 1950s as a cure to nymphomania and depression according to L. Amede Obiora.

Secondly, the practice is rife only among a limited number of Islamic practitioners of the world. Islam is the world’s second largest religion with approximately 1.6 billion followers of the religion consisting of 23.2 percent of the world population. On the other hand, there are around 200 million reported cases of FGC worldwide which includes non-Islamic people as well. Even if one takes these numbers as absolute, merely 12 percent (approx) of the entire Islamic population is affected by the practice. Thus, FGC does not necessarily qualify as an Islamic practice, considering most of the followers of the religion either nullify FGC or even remain oblivious to it. Third: the Holy Quran altogether stands in opposition to inflicting harm; going by that logic Islam cannot be supportive of FGC inflicting mental/physical harm of any sort onto women/girls. Despite the Prophet being explicit about sunna (tradition) on male genitals, FGC’s existence within Islam remains debatable.

In many countries, Islamic traditions often remain debatable, including discussions on FGC. In the documentary The Cutting Tradition, an imam from the Harar region of Ethiopia is heard explaining how it already existed among various communities and the Prophet merely advised a sunna way of cutting where only the nicking of the clitoral prepuce is permitted. In the same documentary the Grand Mofti of Egypt, Fadilet Al-Mofti Ali Gomma repudiates any religious basis for FGM/C, though in 1994 a religious decree was issued in the country in favour of the practice stating it as an honourable deed for women. In fact, the decree, issued by one of Egypt’s prominent clerics Sheikh Gad el-Haqq, admittedly mentioned that FGC is not obligatory in Islam but should be followed due to the traditional rituals attached to it.

Even in the Afar region of Ethiopia, religious leaders are seen invoking Islamic scripture and text to counter continuation of FGC among practicing community members.

The practice came to South-East Asia in the 13th century, due to the advent of Islam in the region after the change in regime. The Shafi school of Sunni Islam in Indonesia and Malaysia considers FGC an Islamic practice, yet they are culturally influenced by the region where Yemen and Oman are situated, countries that have considerable FGC prevalence.

At a time in the world when right-wing politics riles up with growing Islamophobia, it is important not to straightjacket Islam in order to avoid its unnecessary vilification and mindless demonization. Islam, as it grew, got entangled with cultural traditions in such a manner that it often looks inseparable. But a close and nuanced study of the matter opens it up for further scrutiny and leaves room for potential dialogic engagement with the communities practicing female genital cutting so that in time these communities will come to abandon it.

 Read Part 1 – What Islam says about Female Genital Cutting and how far are these texts invincible?

More about Debangana

Debangana is a doctoral scholar at the Centre for International Politics Organisation and  Disarmament (CIPOD), Jawaharlal Nehru University. Through her research, she is trying to locate the existing Indian discourse surrounding the practices of FGM/C and Hijab into the frame of international politics. If you would like to connect with Debangana, you can reach her at debangana.1992@gmail.com.