Female Genital Mutilation

Warning : The following content highlights, addresses and questions one of the most hideous social practices, that has somehow managed to exist among us and yet remained unnoticed until now. The content might encompass textual and visual elements that might be disturbing to perceive. Viewer discretion is highly requested.

If you think circumcision is merely limited to males, then kindly allow me to dissolve that myth of yours. ‘Female genital mutilation (FGM)’ or ‘Khatna’ comprises all procedures that involve partial or total removal of the external female genitalia (often involves the removal / cutting of the labia majora & clitoris), or other injury to the female genital organs for non-medical reasons. This, by any means, shouldn’t be confused with ‘Vaginoplasty (a consensual surgical procedure that results in the construction or reconstruction of the vagina done in case of treatment or removal of malignant growths or abscesses)’ and ‘Labioplasty (a consensual plastic surgery procedure for altering the labia minora or inner labia & the labia majora or outer labia)’.

For the sake of everyone’s convenience, we’ll have a quick look-over of what organs and their parts are being discussed here.

1. Clitoris : It’s the pleasure centre of the vulva. Although it has no role in childbirth, yet it is primarily responsible for female orgasm during intercourse or masturbation. It is also called ‘Female Penis’ as it is believed to be the remnant of male penile tissue at embryo stage.

2. Labia Majora : It is a pair of rounded folds of skin and fat (adipose) tissue that are part of the external female genitalia. Their function is to cover and protect the inner, more delicate and sensitive structures of the entire genitalia system.

3. Labia Minora :  It is a pair of thin cutaneous (related to skin) folds that form part of the vulva, or external female genitalia. They function as protective structures that surround the clitoris, urinary orifice (urine opening), and vaginal orifice (vaginal opening).

4. Prepuce : Also known as Clitoral Hood, it acts a protective covering layer over the clitoris.

HISTORY OF FEMALE GENITAL MUTILATION.

Although the origins of this practice are unknown, yet many accounts of its medieval relationship can be found. Gerry Mackie (an American Political Scientist) suggested that, infibulations may have begun there with the Meroite Civilization (ancient city on the eastern banks of Nile river : 800 BCE – 350 CE), before the rise of Islam, to increase confidence in paternity. According to historian Mary Knight, Spell 1117 (1991 BCE – 1786 BCE) of the Ancient Egyptian Coffin Texts may refer in hieroglyphs to an uncircumcised girl.

The proposed circumcision of an Egyptian girl, Tathemis, is also mentioned on a Greek papyrus, from 163 BCE, in the British Museum: “Sometime after this, Nephoris [Tathemis's mother] defrauded me, being anxious that it was time for Tathemis to be circumcised, as is the custom among the Egyptians.” The examination of mummies has shown no evidence of FGM. According to Grafton Elliott Smith (Australian-British anatomist), who examined hundreds of mummies in the early 20th century, the genital area may resemble Type III because during mummification the skin of the outer labia was pulled toward the anus to cover the pudendal cleft, possibly to prevent a sexual violation. 

Gynaecologists in 19th-century Europe and the United States removed the clitoris to treat insanity and masturbation. A British doctor, Robert Thomas, suggested clitoridectomy as a cure for nymphomania in 1813. In 1825 The Lancet described a clitoridectomy performed in 1822 in Berlin by Karl Ferdinand von Graefe on a 15-year-old girl who was masturbating excessively. 

Isaac Baker (an English gynaecologist) performed several clitoridectomies during 1859 – 1866. In the U.S.A., J. Marion Sims followed Brown's work and in 1862 slit the neck of a woman's uterus and amputated her clitoris. According to a 1985 paper in the Obstetrical & Gynecological Survey, clitoridectomy was performed in the United States into the 1960s to treat hysteria, erotomania and lesbianism.

AT WHAT AGE FGM IS COHERCED UPON FEMALES ?

The age group put into FGM is variably ranging over span of infancy to even adulthood in some parts of the world. In some areas, FGM is carried out during infancy – as early as a couple of days after birth, while in others, it takes place during childhood, at the time of marriage, during a woman's first pregnancy or after the birth of her first child. Recent reports suggest that the age has been dropping in some areas, with most FGM carried out on girls between the ages of 0 - 15 years.

WHAT ARE THE DIFFERENT TYPES OF FGM ?

The World Health Organization (WHO) has identified 04 types of FGM, which are :

 

1. Type - I / Clitoridectomy : In this partial or total removal of the clitoris and/or it’s prepuce is done.

2. Type – II / Excision : In this, partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora is done. The amount of tissue that is removed varies widely from community to community.

3. Type – III / Infibulation : In this, narrowing of the vaginal orifice with a covering seal is done. The seal is formed by cutting and re-positioning the labia minora and/or the labia majora. This can take place with or without removal of the clitoris.

4. Type – IV : All other harmful procedures to the female genitalia for non-medical purposes, for example: pricking, piercing, incising (making cuts in the clitoris or cutting free the clitoral prepuce), scraping or cauterization falls under this category.

 

WHO PERFORMS FGM ?

FGM is usually carried out by elderly people in the concerned communal factions (usually, but not exclusively, women) designated to perform this task or by traditional birth attendants. Among certain populations, FGM may be carried out by traditional health practitioners, (male) barbers, and members of secret societies, herbalists or sometimes a female relative. In some cases, medical professionals perform FGM. This is referred to as the ‘medicalization of FGM’.

WITH WHAT INSTRUMENTS FGM IS PERFORMED ?

FGM is carried out with special knives, scissors, and scalpels, pieces of glass or razor blades. Anaesthetic & antiseptics are generally not used unless the procedure is carried out by medical practitioners. In communities where infibulations is practiced, girls' legs are often bound together to immobilize them for 10-14 days, allowing the formation of scar tissue. 

WHY FGM IS COHERCED UPON FEMALES ?

In every society in which it is practiced, Female Genital Mutilation is a manifestation of deeply entrenched gender inequality. Where it is widely practiced, FGM is supported by both men & women, usually without question, and anyone that opposes; objects or questions, follow the norm may face condemnation, harassment and ostracism. It may be difficult for families to abandon the practice without support from the wider community. In fact, it is often practiced even when it is known to inflict harm upon girls because the perceived social benefits of the practice are deemed higher than its disadvantages.

Various reasons for coercion of FGM are as follows :

1. Psychosexual reasons : FGM is carried out as a way to control women’s sexuality, which is sometimes said to be insatiable if parts of the genitalia, especially the clitoris, are not removed. It is thought to ensure virginity before marriage and fidelity afterward, and to increase male sexual pleasure.

2. Sociological & Cultural reasons : FGM is seen as part of a girl’s initiation into womanhood and as an intrinsic part of a community’s cultural heritage. Sometimes myths about female genitalia (e.g., that an uncut clitoris will grow to the size of a penis, or that FGM will enhance fertility or promote child survival) perpetuate the practice.

3. Hygiene & Aesthetic reasons: In some communities, the external female genitalia are considered dirty and ugly and are removed, ostensibly to promote hygiene and aesthetic appeal.

4. Religious reasons : Although FGM is not endorsed by either Islam or by Christianity, supposed religious doctrine is often used to justify the practice.

5. Socio-economic factors : In many communities, FGM is a prerequisite for marriage. Where women are largely dependent on men, economic necessity can be a major driver of the procedure. FGM sometimes is a prerequisite for the right to inherit. It may also be a major income source for practitioners.

 

RELIGIOUS ROOTS OF FGM.

Female genital mutilation (FGM) - also known as ‘Khatna’ or ‘Khafz’ in the Muslim Bohra community, where it is practised in India. The United Nations has declared female genital mutilation a human rights violation, and yet, the act is not banned in India. In the community, the clitoris part of a woman's vagina is also known as 'haraam ki boti' or 'source of sin' or more simply, 'unwanted skin'. The idea behind cutting off this part of the vagina is padded with centuries of patriarchy - if a woman knows the pleasure she can receive through it, she might go “astray” in the marriage, or brings "shame" to the community.

SIDE – EFFECTS OF FGM AMONG FEMALES.

FGM has serious implications for the Sexual & Reproductive health of girls and women. Its effects depend on a number of factors, including the type performed, the expertise of the practitioner, the hygiene conditions under which it is performed, the amount of resistance and the general health condition of the female undergoing the procedure. Complications may occur in all types of FGM, but are most frequent with infibulations.

Immediate complications include severe pain, shock, haemorrhage, tetanus or infection, urine retention, ulceration of the genital region and injury to adjacent tissue, wound infection, urinary infection, fever, and septicaemia. Haemorrhage and infection can be severe enough to cause death.

Long-term consequences include complications during childbirth, anaemia, the formation of cysts and abscesses, keloid scar formation, damage to the urethra resulting in urinary incontinence, dyspareunia (painful sexual intercourse), sexual dysfunction, hypersensitivity of the genital area and increased risk of HIV transmission, as well as psychological effects.

Infibulations (type III FGM), may cause complete vaginal obstruction resulting in the accumulation of menstrual flow in the vagina and uterus. It creates a physical barrier to sexual intercourse and childbirth. An infibulated woman therefore has to undergo gradual dilation of the vaginal opening before sexual intercourse can take place. Often, infibulated women are cut open on the first night of marriage (by the husband or a circumciser) to enable the husband to be intimate with his wife. At childbirth, many women also have to be cut again because the vaginal opening is too small to allow for the passage of a baby. Infibulations is also linked to menstrual and urination disorders, recurrent bladder and urinary tract infections, fistulae and infertility.

 

UNITED NATION’S APPROACH TO FGM.

UNFPA & UNIECF have jointly lead the largest global programme to accelerate the elimination of FGM and provide care for its consequences. This programme works with governments, civil society organizations, networks of religious leaders, parliamentarians, youth & human rights activists, and academia to:

• Support the development of policies and legislation, and ensure adequate resources, to end FGM.

• Amplify interventions that expand collective knowledge about the harms of FGM and empower champions for its elimination.

• Support gender equality and girls’ and women’s rights.

• Empower young people to end FGM in their communities.

• Address the trend of medicalization by galvanizing health professionals to view FGM as a human rights violation.

• Integrate FGM responses into sexual and reproductive health, maternal and child health, and child protection services – areas that offer entry points for identifying and supporting girls and women who are at risk or have been subjected to FGM.

• Mainstream FGM into health training programmes, mobilize doctors, nurses and midwives in support of FGM prevention and care, and empower health providers to serve as role models, counsellors and advocates in the effort to end FGM.

• Establish a global knowledge hub for the measurement and dissemination of social norms and good practices captured by the Joint Programme for policy-making and improved programming.

 

WHAT IS THE INDIAN SCENARIO ?

FGM in India is practised by the Dawoodi Bohra, a sect of Shia Islam with 01 million members in India. Known as ‘khatna’, ‘khafz’, and ‘khafd’, the procedure is performed on 06 – 07 year old girls and involves the total or partial removal of the clitoral hood. The spiritual leader of the Dawoodi Bohra, Mufaddal Saifuddin, clarified that while “religious books, written over a thousand years ago, specify the requirements for both males and females as acts of religious purity”, the Bohras must “respect the law of the land” and refrain from carrying out Islamic female circumcision in countries where it is prohibited. Other Bohra sects including the Sulemani Bohras and the Alavi Bohras, as well as some Sunni communities in Kerala, are reported as practising FGM.

In May 2017, a public interest litigation (PIL) case, filed by a Delhi based lawyer – Sunita Tiwari in India's Supreme Court, seeking a ban on FGM in India. The Supreme Court received the petition and sought responses from 04 states & 04 central government ministries.

An advocate for the petition claimed the practice violated children's rights under Article 14 (Right to Equality) &  Article 21 (Right to Life) of the Constitution of India, while an advocate opposing the petition argued that khafz is an essential part of the community's religion, and their right to practise the religion is protected under Articles 25 and 26.

The Ministry of Women & Child Development reported in December 2017 that “there is no official data or study which supports the existence of FGM in India.” Earlier, in May 2017, Women and Child Development Minister Maneka Gandhi announced that the government will ban FGM if it is not voluntarily stopped.

In April 2018 India's Attorney General K. K. Venugopal asked a bench of the Supreme Court to issue directions regarding the case, saying that FGM was already a crime under existing law. The bench adjourned the case and issued notices to Kerala and Telangana, having earlier notified Maharashtra, Gujarat, Rajasthan and Delhi.

In September 2018 the Supreme Court referred the PIL to a 05 - judge constitution bench at the request of K.K. Venugopal and the counsel for the Dawoodi Bohras.

In November 2019, the Supreme Court decided that the issue of FGM be referred to a larger 07 - judge bench and that it be examined alongside other women's rights issues. The court said it was a “seminal issue” regarding the power of the court to decide whether a practice is essential to a religion.

How can be there a law against a certain practice that violates Right to dignity of life, when the government doesn’t even recognize & acknowledge it?

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