Female Genital Mutilation: Treatment, Culture, and Health Issues

Female genital mutilation (FGM) is a major health problem for young girls around the world. Most common in Africa and the Middle East, the ages of women subjected to FGM range anywhere from infancy to age fifteen, and sometimes beyond into adulthood. As more and more women from Africa enter the United States, American clinicians are thrown into the FGM debate as they treat these women for various health issues. FGM is also referred to as female “circumcision,” and the act is often a cause of cultural, religious, and social attitudes within the community. The procedure has absolutely no health benefits for young girls and can be responsible for infections and other health complications throughout life.

Clinicians treating circumcised women need to see through the negative criticism of the procedure in order to treat and care for their families effectively. It might start with using the word “circumcision” instead of terms like mutilation or cutting. The later words are harsh and negative in nature, and using a more neutral term like circumcision may help the patient feel more comfortable discussing their health; although, there is still debate about what language is best. Some women from Africa prefer “genital mutilation,” believing the term “circumcision” is deceptive. Others feel the opposite, believing “mutilation” is judgmental and inflammatory (Horowitz and Jackson, 1997). The point is that Clinicians need to work past their horror or disgust regarding the issue, separating their feelings about the practice and focus on the best cause of action for the patients who have been circumcised. Clinicians should see it as a cultural issue, not just a medical one.

Female “circumcision,” or FGM may seem harsh to an outside observer; however, the victims of the practice may actually be some of the strongest supporters of the procedure. This may be motivated by various cultural or social factors. In one study, almost half of the Nigerians involved gave the reason, “It is the custom of our people” (Horowitz and Jackson, 1997). To many people in these cultures, female “circumcision” is simply part of the way they live. It is possible that if they refused, or rebelled from the procedure, then they would be ostracized from the community, creating more difficulties for their families. Besides the fear of alienation or increased struggle, social values rooted in beliefs about proper sexual behavior, like premarital virginity, marital fidelity, and feminine modesty, also play a role in the perpetuation of FGM. These social and cultural issues may determine how the woman wants to be treated for health concerns that are sure to come up throughout their lives.

Since FGM is often performed at a young age, most women experience various, ongoing, health complications as a result of the procedure. FGM is classified into four major types: Clitoridectomy, Excision, Infibulation, and Others. Infibulation is perhaps the most horrifying. This procedure has long-term consequences that will most likely include the need for later surgeries. The vaginal opening is surgically narrowed and sealed together with the inner or outer labia. Only a small, pencil-sized hole is left for urination and menstrual flow. After this procedure, surgeries are inevitable if the woman wishes to partake in sexual intercourse or have a child; the seal will have to be cut in order for penal penetration or childbirth. FGM damages normal, otherwise perfectly healthy and functioning body parts. It causes higher risks of urinary tract infection, cysts, and infertility that lasts a lifetime.

FGM is a complex issue. It is deeply rooted in cultural attitudes, and outsiders see the procedure as a tradition of cruelty, volatile, and indecent. However, the victims of the practice may not see it the same way, and to treat them effectively clinicians must move past their feelings to work towards what’s best for the affected women. Whether referred to as female mutilation, cutting, or circumcision, the procedure affects millions of women.

References

Female genital mutilation. (n.d.). WHO. Retrieved February 19, 2014, from http://www.who.int/mediacentre/factsheets/fs241/en/

Horowitz, C. R., & Jackson, J. C. (1997, August 12). Female "Circumcision". US National Library of Medicine National Institutes of Health. Retrieved February 20, 2007, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1497147/